OUTCOMES OF SURGERY IN PROLIFERATIVE VITREORETINOPATHY.

AIM: To present the anatomical and functional outcomes of surgery in cases of rhegmatogenous retinal detachment complicated (at presentation) by proliferative vitreoretinopathy (PVR). MATERIAL AND METHODS: Retrospective study of the cases operated upon by a single surgeon between October 2012 and September 2014. RESULTS: A total of 49 eyes of 49 patients had PVR at presentation (12 cases with PVR stage B, 21 with stage C and 16 with stage D). 82% had a VA < or = 0.05 at presentation. Peripheral retinectomy was the primary surgery in 57% of cases. Reinterventions was required in 16.3% of the cases (silicon oil extraction was not considered reintervention). Although at the first postoperative examination 32% of eyes had an IOP > 21 mmHg without medication, only 8% retained a high lOP at the last visit. At the last visit 73.4% of eyes presented attached retina (an additional 6% had an attached macula under silicone oil, but sub retinal fluid in the inferior quadrants). A final VA > or = 0.05 was recorded in 67.3% of eyes (of which half had VA > or = 0.1) CONCLUSIONS: In cases presenting with retinal detachment complicated by PVR the possibility of reinterventions and the risk of intraocular hypertension should be considered. Unfortunately, even some cases with favorable anatomical outcome will not present ambulatory vision. Keywords:

[Long-term clinical course after cataract surgery in patients with diabetes mellitus]. / Evolutia functionala pe termen lung dupa operatia de cataracta la pacientii cu diabet.

PURPOSE: To determine the visual outcome at 5 years postoperatively in patients operated for cataract associated with diabetes mellitus. PATIENTS AND METHODS: Retrospective study on a group of 41 eyes in patients with diabetes, who were operated for cataract (the same surgeon) by facoemulsification and IOL implantation in the capsular bag, without intraoperative complications, for 60 months (during 2003-2007). RESULTS: 27 patients with diabetes were included in the study, the average duration of diabetes was 10, 3 years. Average postoperative visual acuity (VA) was 0.5 at six weeks postoperatively. Preoperative VA improvement was observed in 78%. There was a decrease in VA of 85% at more than 5 years after surgery and 15% of eyes had preserved VA. VA decrease was due to the occurrence, progression and worsening of retinopathy (69%) and diabetic maculopathy, posterior capsular opacification (34%), glaucoma, age-related macular degeneration (12%). CONCLUSIONS: Visual acuity was maintained in 15% and decreased in 85% of patients due to diabetic retinopathy, glaucoma, age-related macular degeneration.

[Long-term course of visual acuity in patients with cataract surgery]. / Evolutia pe termen lung a acuitatii vizuale la pacientii operati de cataracta.

PURPOSE: To compare immediate and 5 years postoperatively visual acuity (VA), after uncomplicated cataract surgery and emphasizing the main causes of visual acuity loss. MATERIAL AND METHODS: This is a retrospective study that included 475 eyes that underwent uncomplicated cataract surgery between 2003-2007 by the same surgeon. 51 patients (73 eyes) returned to the last followup visit, 5 years postoperatively. RESULTS: Of 73 eyes, 18 eyes (24.66%) had VA < 0.5, 53 eyes (72.60%) had VA between 0.5-1 and 2 eyes (2.74%) had VA > 1, 5 years postoperatively. 26% (19 eyes) revealed reduced best corrected visual acuity in comparison to that from 6 weeks postoperatively Causes that led to reduced VA are: posterior capsular opacification (46.57%), age related macular degeneration (26.02%), glaucoma (10.95%), diabetic retinopathy (9.58%). CONCLUSIONS: Approximately a quarter of patients showed reduced VA after more than 5 years postoperatively; more than three quarters had VA > 0.5 on the last follow-up visit. The most frequent causes of reduced VA are age-related macular degeneration, glaucoma, appearence or worsening of diabetic retinopathy, posterior capsular opacification.