PurposeTo determine whether the inverted internal limiting membrane (ILM) flap technique contributes to high reattachment and closure rates in patients with macular hole-associated retinal detachment (MHRD).Patients and methodsIn all, 15 eyes of 15 patients with MHRD undergoing 25-gauge pars plana vitrectomy with the inverted ILM flap technique or ILM peeling. The patients were divided into the inverted ILM flap technique group (6 eyes) and ILM peeling group (9 eyes). The logarithm of minimal angle of resolution best-corrected visual acuity (BCVA) and retinal attachment and macular hole closure rates were compared between the two groups before and after surgery.ResultsNo significant differences were found in the pre- and postoperative BCVA at 1 and 3 months after surgery in either group (inverted ILM flap technique group, preoperatively 1.04±0.55, 1 month 0.95±0.30, 3 months 0.83±0.22; ILM peeling group, preoperatively 1.00±0.44, 1 month 1.05±0.38, 3 months 1.06±0.49; P>0.05, respectively). The postoperative BCVA at 6 months after surgery was significantly better in the inverted ILM flap technique group than in the ILM peeling group (inverted ILM flap technique group, 0.62±0.35; ILM peeling group, 1.02±0.41, P=0.045). The improvement in BCVA was significantly better in the inverted ILM flap technique group than in the ILM peeling group (inverted ILM flap technique group, –0.41±0.29; ILM peeling group, 0.02±0.36; P=0.021). The primary macular hole closure rates were 100% in the inverted ILM flap technique group and 55.5% in the ILM peeling group. The primary reattachment rates were 100% in the inverted ILM flap technique group and 55.5% in the ILM peeling group. The primary macular hole closure and reattachment rates were not significantly different in both groups (P=0.056, respectively).ConclusionThe inverted ILM flap technique is a useful procedure for MHRD in highly myopic eyes.
IntroductionThe prevalence of intermittent claudication in people over 60 years is 6%. Femorofemoral crossover bypass represents an alternative for patients with unilateral intermittent claudication in which endovascular management is deemed unfavourable. We report diagnostic workout and treatment of an unusual late complication of Femorofemoral crossover.
Case reportAn 88-year-old woman presented at the emergency department with a large, tense-elastic, nonpulsing mass in her lower abdomen. In 2002, she underwent a Femorofemoral crossover bypass for right leg claudication. In 2005, the Femorofemoral crossover bypass was complicated by the formation of a pseudoaneurysm that required surgical correction. The mass became visible 3 months before admission to the emergency department and it had slowly enlarged. An outpatient computed tomography scan, without contrast medium because of chronic renal insufficiency, was performed, showing a mass coming from the abdominal wall, not further characterizable. When the mass began to be painful, and a visible abdominal wall skin ulcer that formed began to bleed, the patient was brought to emergency department.
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