The results of 41 consecutive cases of double perforating eye injuries, operated with vitrectomy between December 1975 and December 1982, are reported. Fourteen eyes (34%) obtained a visual acuity of 5/10 or better, and 23 eyes (56%) obtained 5/200 or better. Twenty-eight (68%) developed retinal detachment, and 12 of these were attached by surgery. In this series the pre-operative visual function and the type of injury had a significant effect on the final result. No beneficial effect from early (within 14 days) vitrectomy could be shown.
4 x 4 mm pieces of human eye walls consisting of the sclera, the choroid and the pigment epithelium were kept in organ culture for 1 month and studied with light and transmission electron microscopy comparing the findings with normal tissue. After 1 month the choriocapillaris still had open vessel lumina lined with flattened endothelial cells containing organelles and vesicles on both inner and outer cell membranes. The endothelial cells lost their fenestrations and polarity in regard to the location of cell nuclei. Otherwise the ultrastructure was similar to that of the choriocapillaris in vitro. This study has shown that choriocapillaris can survive in organ culture for 1 month, and it permits further studies on the behaviour of the choroid under controlled conditions, and on the long-term effects of different types of trauma to the choroid in vitro.
Thirty-six eyes with retinal detachment and various degrees of proliferative vitreoretinopathy were operated with conventional buckling techniques and the additional use of intravitreal injected sodium hyaluronate (Healon). Eighteen eyes (50%) had re-attached retina 6 months post-operatively. The re-attachment rate depended upon the severity of the proliferative vitreoretinopathy. Three of 4 eyes with grade B, 4 of 5 with grade C-1, 8 of 13 with grade C-2, 2 of 11 with grade C-3 and 1 of 3 eyes with grade D-1 were reattached. Major complication occurred in 3 aphakic eyes where persistent intraocular pressure rise to 60-70 mmHg necessitated removal of Healon to normalize the intraocular pressure. In one eye Healon passed through a retinal rupture to the subretinal space.
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