Pars plana vitrectomy with SO injection seems to be a safe and efficient surgical approach in the treatment of primary uncomplicated rhegmatogenous retinal detachment in patients living in high altitude (>1,000 m). Also, PPV and SO injection are associated with good anatomical and functional outcomes in our series. Reattachment rates are high, and rates of proliferative vitreoretinopathy are low. Cataract formation and elevated IOP represent frequent but successfully controlled complications.
Purpose: To evaluate the risk factors for elevated intraocular pressure (IOP) after pars plana vitrectomy (PPV) with silicone oil injection (SOI). Procedures: This prospective interventional study included 254 consecutive eyes receiving PPV with SOI. Results: Elevated IOP developed in 48% of the eyes postoperatively. The onset of IOP elevation was early (≤1 week) in 61.5% of the eyes, intermediate (1–6 weeks) in 28.7%, and late (> 6 weeks) in 9.8%. The incidence of IOP elevation was higher with primary uncomplicated rhegmatogenous retinal detachment than with tractional detachment (p = 0.01). Pseudophakia, high myopia, and high preoperative IOP were found to have higher incidences of ocular hypertension, whereas diabetic patients had a lower incidence. Conclusion: IOP elevation is a common complication following silicone oil (SO) tamponade. Risk factors for ocular hypertension development are pseudophakia, high myopia, high preoperative IOP, and low-viscosity SO.
Purpose: To assess the efficacy of topical 1.5% azithromycin in the treatment of mo derate to severe chronic blepharitis and to compare the efficacy of two different treatment modalities. Methods: A randomized clinical trial included 67 patients with chronic anterior and/or posterior blepharitis, followedup for 3 months. Signs and symptoms were graded according to severity. Patients were randomized into two groups: 33 patients in group I and 34 patients in group II. Group I patients were treated with topical 1.5% azithromycin twice a day for three days, and Group II patients were treated with topical 1.5% azithromycin twice a day for three days then at bedtime for the rest of the month. All patients were instructed to apply warm compresses and an eyefriendly soap twice daily. Results: Patients in both groups tolerated the treatment with minimal irritation. A signi ficant improvement in signs and symptoms was noted at the one week fol lowup visit. Group II showed a more pronounced and longerlasting improvement that persisted after three months of followup. Conclusion: Topical 1.5% azithromycin ophthalmic solution is an effective treat ment option for chronic blepharitis. In moderate to severe blepharitis, a one month treatment is safe and shows better improvement than the threeday protocol with no significant relapse until three months of followup.
Objective. To report the rate of progression of keratectasia after primary crosslinking (CXL) and evaluate the safety and efficiency of CXL redo. Materials and Methods. We conducted a retrospective analysis of the patients who underwent CXL between 2010 and 2013 at the Beirut Eye Specialist Hospital, Lebanon. Progression of keratectasia was based on the presence of an increase in maximum keratometry of 1.00 D, a change in the map difference between two consecutive topographies of 1.00 D, a deterioration of visual acuity, or any change in the refraction. Primary and redo CXL were done using the same protocol. Results. Among the 221 eyes of 130 patients who underwent CXL, 7 eyes (3.17%) of five patients met the criteria of progression. All patients reported a history of allergic conjunctivitis and eye rubbing and progressed within 9 to 48 months. No complications were noted and all patients were stable 1 year after CXL redo. Conclusion. Allergic conjunctivitis and eye rubbing were the only risk factors associated with keratoconus progression after CXL. A close followup is thus mandatory, even years after the procedure. CXL redo seems to be a safe and efficient technique to halt the progression after a primary CXL.
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