Surgical results of heavy silicone oil HWS-45 3000 as internal tamponade for inferior retinal detachment with PVR: a pilot study.

PURPOSE: To report the results of a prospective pilot study using a new heavy agent, HWS-45 3000, as endotamponade in complicated inferior retinal detachment. METHODS: Ten consecutive patients satisfying the enrolment criteria were studied. Inclusion criteria was the presence of inferior retinal detachment complicated by PVR grade C2 or more (according to Retina Society classification) or retinal detachment due to penetrating ocular trauma or giant retinal tears. Heavy silicone oil was injected at the end of surgery after peeling of retinal membranes and/or retinotomy. Follow-up protocol visits were scheduled at 1 day, 1 week, 1 month, and 2 months after the initial surgery and 1 week, 1 month and 6 months after HWS-45 3000 removal surgery. Oil removal was planned after about 2 months from the main surgery. RESULTS: At the 1-month protocol visit, eight eyes presented retinal reattachment and two eyes presented a retinal detachment not involving the posterior pole. Visual acuity ranged from 2.2 logMAR to 1.0 (mean: 1.45, SD: 0.53). Oil removal surgery was scheduled about 60 days postoperatively. All eyes required additional endolaser treatment during removal surgery, and four eyes epiretinal membrane peeling. In two eyes that presented retinal detachment not involving the posterior pole, tamponading with 5700 cSt silicone oil was necessary. At 3- and 6-month protocol visits, all patients presented retina reattached; two eyes had silicone oil as internal tamponade. CONCLUSION: From our first results, HWS-45 3000 appears to be a well-tolerated heavy oil suitable for the treatment of complicated inferior retinal detachment.

Acute and subacute effect of rheopheresis on microvascular endothelial function in patients suffering from age-related macular degeneration.

This study was performed on seven patients affected by the atrophic form of age-related macular degeneration (AF-ARMD). The patients under investigation belonged to a larger study aimed at evaluating the efficacy of rheopheresis treatment (RT) on the visual function of AF-ARMD patients. Following the protocol of the larger study, patients received RT twice a week, every two weeks, for a total of ten treatments, as well as high-dose supplementation with zinc and vitamins A, E and beta-carotene. Recruited patients underwent skin laser Doppler flowmetry coupled with skin iontophoresis of the endothelium-dependent vasodilator acetylcholine (ACh) and a test of skin post-ischemic reactive hyperemia, before and after the first RT (time 1: all seven patients) and the fifth RT (time 2: six patients). A significantly higher absolute (anova for repeated measures) and relative (percentage change from the baseline) skin blood flux response (SBFR) to ACh iontophoresis was observed after RT, compared to before RT at time 1 (679 +/- 43% and 436 +/- 78%, respectively; P < 0.05), as well as before RT at time 2 compared to before RT at time 1 (683 +/- 74% and 436 +/- 78%, respectively; P < 0.05). Absolute and relative SBFR to ischemia did not differ either after RT compared to before RT at time 1, or before RT at time 2 compared to before RT at time 1. These findings are consistent with an acute and subacute beneficial effect of RT on skin microvascular endothelial function in the studied AF-ARMD patients.

Heavy silicone oil (Densiron-68) for the treatment of persistent macular holes: Densiron-68 endotamponade for persistent macular holes.

PURPOSE: To evaluate the efficacy and safety of the use of Densiron-68 as intraocular endotamponade for the treatment of persisting macular holes (persistent MHs). METHODS: Retrospective interventional case study on 23 consecutive eyes showing persistent MHs after unsuccessful primary surgery that underwent retreatment with pars plana vitrectomy and Densiron-68 filling. The main outcome measures were: anatomic closure evaluated with optical coherence tomography (OCT), final best-corrected visual acuity (BCVA), and postoperative complications. RESULTS: A total of 23 patients (52-88 years) were studied. Pre-operative OCT showed full-thickness MH (mean size 560 microm) in all patients. Densiron-68 was left in situ for 1.5-3 months. Final follow-up time was 12 months after the last surgery. Postoperative OCT showed the complete closure of the PMH in 20 of 23 eyes. Pre-operative BCVA ranged from 20/200 to 20/630 (1.50-1.00 logMAR, mean 1.14). Final postoperative BCVA ranged from 20/30 to 20/400 (0.18-1.30 logMAR, mean. 0.61). Nineteen eyes (82%) showed a significant increase in visual acuity by at least three lines: 11 (47%) patients gained at least four lines. Three eyes remained unchanged (13%). One case deteriorated by two lines (4%). No major complications were recorded. CONCLUSIONS: Retreatment with Densiron-68 filling was safe and achieved encouraging anatomic and functional results.

Simultaneous appearance of acute myeloid leukemia in a patient with bilateral primary uveal melanoma.

We report a rare case of a patient with bilateral uveal melanoma (the first eye surgically treated 6 years before the occurrence of melanoma in the contralateral eye), who developed an acute myeloid leukaemia.