Intraoperative retinal detachment prophylaxis in vitrectomy for retained cataract fragments.

PURPOSE: To assess the safety and efficacy of peripheral 360-degree laser retinopexy as prophylaxis against rhegmatogenous retinal detachment (RRD) in eyes having pars plana vitrectomy (PPV) for the removal of retained cataract fragments. SETTING: Private practice, Callahan Eye Foundation Hospital, University of Alabama at Birmingham, and Helen Keller Foundation for Research and Education, Birmingham, Alabama, USA. METHODS: This retrospective analysis comprised a consecutive series of patients who had PPV with 360-degree laser retinopexy for retained cataract fragment removal between January 1, 1995, and December 31, 2000. All laser treatments were applied with indirect ophthalmoscope delivery. RESULTS: In 78 eyes of 78 patients, the mean interval between cataract surgery and PPV with 360-degree laser retinopexy prophylaxis was 14 days. One (1.3%) of 78 eyes had postoperative RRD during a mean follow-up of 6 years. No laser-related complications occurred. CONCLUSIONS: The incidence of RRD after PPV with 360-degree laser retinopexy prophylaxis was 1.3%, a significant reduction from the average 8.2% RRD rate in the literature (P = .024). Although future prospective trials are indicated, the results suggest that 360-degree laser retinopexy prophylaxis could significantly reduce the incidence of this visually disabling complication.

An analysis of 3599 midfacial and 1141 orbital blowout fractures among 4426 United States Army Soldiers, 1980-2000.

OBJECTIVE: We sought to present the epidemiology associated with 3599 midfacial and 1141 orbital blowout fractures. STUDY DESIGN AND SETTING: We conducted a multicenter, 20-year retrospective analysis of hospitalization data on U.S. Army active duty soldiers. RESULTS: Men composed 96% of the patients, with men aged 20 to 29 years the most affected. Of midfacial and blowout fractures, 54.8% and 70.2% occurred with concomitant injury, with 36.2% and 50.9% sustaining other facial fractures, respectively. Three hundred forty orbital blowout fractures (29.8%) had an associated eye injury. Common mechanisms included fighting and motor vehicle accidents. CONCLUSIONS: Young men comprised the most susceptible population, and assault was the predominant mechanism. A high incidence of concomitant injury in midfacial and orbital blowout fractures, particularly ocular and intracranial injury, emphasizes the importance of a thorough physical examination. SIGNIFICANCE: We report the results from one of the largest series of midfacial and orbital floor blowout fractures from a population that crosses urban, rural, and foreign boundaries.