ABSTRACT
BACKGROUND/AIMS: To analyze the long-term changes in retinal perfusion and functional improvement induced by radial optic neurotomy (RON) in central retinal vein occlusion (CRVO). METHODS: Sixty-three eyes of 63 consecutive patients with CRVO were included. Twenty-eight (44.5%) patients underwent RON and 35 (55.5%) were followed as a control group. Time of arteriovenous transit and visual acuity were determined at baseline and after 1-year follow-up. RESULTS: After 1 year, retinal perfusion status improved in 63.1% of operated eyes and 14.3% of controls (p = 0.048). The improvement in arteriovenous retinal transit was statistically significant (p = 0.023) only in the RON group. The visual improvement in the RON group was significantly better (p = 0.043) than in the control group. Moreover, the development of chorioretinal anastomosis was significantly higher (p = 0.036) after RON than in controls and correlated with better functional results. In operated eyes there was a lower incidence of CRVO-related complications. CONCLUSION: RON improved retinal perfusion and achieved a better functional outcome. The measurement of perfusion changes as presented here may be useful for monitoring CRVO and assessing other treatment modalities.
Subject(s)
Ophthalmologic Surgical Procedures , Optic Nerve/surgery , Optic Neuropathy, Ischemic/surgery , Retinal Artery/physiology , Retinal Vein Occlusion/physiopathology , Retinal Vein Occlusion/surgery , Retinal Vein/physiology , Aged , Decompression, Surgical/methods , Female , Fluorescein Angiography , Humans , Intraocular Pressure , Male , Optic Nerve/blood supply , Optic Neuropathy, Ischemic/physiopathology , Prospective Studies , Regional Blood Flow , Visual Acuity/physiologyABSTRACT
PURPOSE: Peeling of the internal limiting membrane (ILM) has improved the outcomes in vitreoretinal surgery of macular diseases. Indocyanine green (ICG) is used to stain and improve the visualization of the ILM. This paper aims to describe a modified approach to stain and peel the ILM avoiding potential adverse side effects. METHODS: After a core vitrectomy, 0.05 ml of ICG in a concentration of 5 mg/ml is quickly injected under water around the macular region. The tip of the syringe is positioned about 5 mm from the macular tissue, in a way that about a 3-mm diameter area around the fovea is stained by the ICG. Additional ICG is immediately removed by aspiration. Peeling of the ILM is accomplished with a forceps. RESULTS: Neither residual ICG in the vitreous cavity nor any clinical signs of phototoxicity like retinal edema were detected in any patients operated by this technique. CONCLUSIONS: This modified technique to stain the ILM limits the amount and concentration of ICG. The locally limited contact of ICG with the retinal surface seems to be a safe procedure to stain the ILM.
Subject(s)
Coloring Agents , Edema/surgery , Indocyanine Green , Macula Lutea/surgery , Retinal Diseases/surgery , Retinal Perforations/surgery , Staining and Labeling/methods , Coloring Agents/administration & dosage , Humans , Indocyanine Green/administration & dosage , Injections , Membranes/surgeryABSTRACT
We describe a modified technique to minimize the risk of hypotony during the placement of transscleral anchoring sutures. An anchor thread is used to transsclerally fixate a posterior chamber intraocular lens (IOL). The IOL is placed precisely and without trauma. The technique was used in 17 patients. Postoperatively, all IOLs were well centered. Visual acuity increased from a preoperative mean of 0.25 to a postoperative mean of 0.40. The mean postoperative refraction was -0.75 diopter (D) (range +0.50 to -4.50 D). Longer phases of hypotony do not occur, and the use of CIF needles can be omitted.
