Ultrasonography was performed in 24 eyes harboring malignant melanomas of the choroid to study tumor regression after xenon-arc photocoagulation at periodic intervals after each photocoagulation session. Ophthalmoscopically, 20 (83%) eyes revealed a complete regression of the tumor after 3 months to 3 years of treatment. However, ultrasonography revealed complete tumor regression in only 13 (65%) out of these 20 eyes while the remaining 7 (35%9 eyes had a residual tumor prominence of 0.75–1 µs. 14 (70%) out of 20 tumors were completely regressed 1 year after photocoagulation treatment. Most of the eyes revealed complete disappearance of the tumor after 3–5 photocoagulation sessions. Though 4 tumors which did not respond to photocoagulation treatment were located in the central temporal retina within the vascular arcade, no statistically significant difference could be seen between tumor regression and location of the tumor. Complete tumor regression was seen in 4 out of 5 eyes after encircling coagulation alone while 16 out of 19 eyes revealed complete tumor regression after addition of direct treatment of the tumor. Photocoagulation appeared to be a useful tool in the treatment of small choroidal melanomas.
In 73 eyes, retinal detachments complicated by proliferative vitreoretinopathy (PVR) were treated by intravitreal injections of Healon, in addition to scleral buckling procedures. The number of completely reattached retinas three months postoperatively was dependent upon the grade of PVR: 50% were reattached when PVR comprised only one quadrant (Grade C-1); 30% when two to four quadrants were involved (Grade C-2, C-3 and D-1). Reattachment was not achieved in two cases of PVR with funnel-like configurations (D-2). Major complications that could be attributed to Healon did not occur. The results indicate that Healon injections, combined with scleral buckling procedures, are an encouraging approach to retinal detachments with PVR Grades C-2 through D-1.
In accordance with many histopathological and clinical studies supporting our findings, we suggest that shrinkage of the capsular bag can be reduced by not using foldable IOL, by early anterior YAG capsulotomy or by the use of an IOL with a larger optic.
SUMMARYThe relationship between axial length and equatorial diameter and eye volume has been studied in 4 groups of eyes: intact emmetropic eyes, emmetropic eyes with retinal detachment, eyes with moderate myopia and retinal detachment, and eyes with high myopia and retinal detachment. It was found that eyes with detached retinas, regardless of whether they are myopic or emmetropic, are of significantly different dimensions from emmetropic control eyes. There is usually a significant increase in equatorial diameter and therefore in equatorial circumference. The results indicate that eyes with detached retinas differ from normal eyes in their abnormally large size.
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