Three-port lens-sparing vitrectomy for aggressive posterior retinopathy of prematurity: early surgery before tractional retinal detachment appearance.

PURPOSE: Aggressive posterior retinopathy of prematurity (APROP) may suddenly develop into tractional retinal detachment (TRD), often resulting in poor vision if untreated. The aim of the current study is to examine the anatomic results and complications of lens-sparing vitrectomy (LSV) for stage 3 APROP, before TRD appearance. METHODS: A retrospective, noncomparative, consecutive case series of 13 eyes of 9 patients (mean gestational age 24.1+/-0.9 weeks [range: 23-25 weeks], mean birthweight of 725.8+/-107.9 grams [range: 598-897 grams]) with stage 3 APROP was carried out. The eyes did not respond to at least one session of retinal laser photocoagulation, showing signs of disease progression. All eyes underwent 20-gauge LSV before retinal detachment appearance. RESULTS: All eyes underwent 20-gauge three-port LSV and intraoperative additional laser photocoagulation. At the end of the surgery, five eyes were tamponaded with air; in eight eyes, a balanced salt solution was left in the vitreous cavity. After 13.5+/-5.3 months of follow-up (range: 4-22), the retina was completely attached in all eyes, without any signs of progression. The authors did not observe any intraoperative or postoperative complications. CONCLUSIONS: Surgical approach to stage 3 APROP refractory to laser photocoagulation could be effective and safe in order to avoid the progression of the disease.

Corneal astigmatism after cataract extraction.

We studied all cataract surgery done at the ophthalmologic clinic of the University of Bari, Italy in the last 20 years (1966-85). We considered three methods of anterior-chamber incision (blade, Worsth's knife, Graefe's bistoury) and their effect on the dioptric values obtained from ophthalmometry a year after surgery. The larger corneal astigmatism occurred after opening the anterior chamber with Graefe's method; the best results were obtained using Worsth's knife. In this evaluation, the surgeon was not considered. Because postsurgical astigmatism is important for visual acuity after cataract extraction, it is desirable to keep astigmatism as minor as possible.

Rieger's and Williams syndrome. A rare clinical case.

The authors describe a rare case of Rieger's syndrome which, in addition to the classically associated dental malformations, also presents a Williams syndrome with bilateral megaloureter.

Iris cysts in three generations conveyed by means of a genetic process connected with sex.

The authors report a case of pigmented cysts of the iris, observed in female subjects of the same family and of three generations. They hypothesize that it may be due to a hereditary alteration connected to sex, and believe it should be considered as a mesodermal alteration, occurring during embryonic development. The treatment has been para-surgical by means of a Nd-YAG laser, operating in a free-running mode, with impulses directed onto the cysts.

Nd-YAG laser in our experience.

The authors report on their experience with Microruptor 2, Fankhauser's YAG laser. Over a period of about 18 months, approximately 500 patients with different pathological conditions of the eye were treated. The treatments were noninvasive and given to outpatients under surface anesthesia. The instrument is suitable for use in cases requiring splitting of cataract residues, in capsulotomies (also in the presence of intraocular lenses), in the treatment of iridocorneal adhesions, in the prophylaxis of acute attacks of glaucoma, in ectopia pupillae, and in selected cases of vitreous membranes and strands.