PurposeTo investigate the incidence and predisposing factors of macular pucker formation after pars plana vitrectomy in patients who developed primary rhegmatogenous retinal detachment.MethodsWe retrospectively reviewed a consecutive series of 284 eyes in 284 patients who underwent primary retinal detachment repair by pars plana vitrectomy alone between January 1, 2009 and December 31, 2010. Patients with a history of retinal surgery or another visually significant ocular problem were excluded.ResultsPostoperatively, of the 264 eyes that completed at least six months of follow-up, 16 (6.1%) eyes developed obvious macular pucker at clinical examination. Of these 16 eyes, ten (70.0%) underwent repeat vitrectomy with membrane peeling for macular pucker removal during the follow-up period. The mean time from primary vitrectomy for the retinal reattachment to the secondary vitrectomy with membrane peeling for macular pucker was 7.9 months. The mean improvement in vision after membrane peeling surgery was 0.37 (logarithm of the minimum angle of resolution). Using an independent t-test, chi-square test, and Mann-Whitney U-test, we found that the number or size of retinal break and vitreous hemorrhage could be significant risk factors of macular pucker.ConclusionsIn our study, 6.1% of eyes which underwent pars plana vitrectomy alone for primary retinal detachment developed a postoperative macular epiretinal membrane. Multiple or large retinal breaks and postoperative vitreous hemorrhage were related to macular pucker formation. Overall, the 70.0% of eyes which underwent secondary vitrectomy with membrane peeling for removal of macular pucker showed a favorable visual outcome.
Epidermal cysts of periorbit and intraorbit are common problems to ophthalmologists, but giant periorbital epidermal cyst is exceedingly rare. Only a few cases have been reported previously. A 62-year-old woman presented with a large right periorbital area mass that resulted in right upper lid complete ptosis and severe gaze limitation in all directions. Visual acuity of right eye was finger count (20/2000). Computed tomography and magnetic resonance imaging revealed a bone-destroying mass involving the lateral side of the right superior orbital limb. Complete surgical removal was performed through skin incision. The superior-lateral orbital limb was reconstructed with bone cement and Leibinger plate. Pathologic examination revealed a giant epidermal cyst (9.8×5.2×4.0 cm) of the periorbital area. After surgery, there was near-complete resolution of ptosis and gaze limitation. In addition, marked elevation of visual acuity was observed (20/125 on best-corrected visual acuity).
The cell-derived extracellular matrix (ECM) membrane is a bio-absorbable membrane composed of aseptic ECM obtained from swine knee chondrocyte. The purpose of our study was to evaluate the inhibitory effect of the cell-derived ECM membrane in postoperative adhesion following strabismus surgery on rabbit eyes. Twenty four adult male New Zealand albino rabbits were used. Each rabbit has undergone 3 mm resection of the superior rectus muscle in both eyes. The cell-derived ECM membrane was applied between the conjunctiva and superior rectus muscle only to right eye in each rabbit. The eyes were divided into a surgery-ECM group and a surgery-no ECM group. The rabbits were sacrificed at 2, 4, and 6 weeks after the surgery. Each time, 16 eyes of 8 rabbits were enucleated to observe the adhesion in muscle and adjacent tissue grossly by blunt dissection. Then, histopathological sections were analyzed for inflammation and fibrosis by staining with hematoxylin-eosin and Masson trichrome, respectively. Inflammation and fibrosis were graded on a scale of 0 to 4. A researcher was blind to the experiments performed all the examinations. Comparing with the surgery-no ECM group, there was no significant difference with regard to inflammation at the area of superior rectus muscle resection at 2, 4, and 6 postoperative weeks (p = 0.52, p = 0.55, p = 0.82). However, a significant reduction in the degree of adhesion (p = 0.01, p = 0.03, p = 0.04) as well as decreased fibrosis (p = 0.04, p = 0.03, p = 0.02) between muscle and conjunctiva after strabismus surgery was observed in all surgery-ECM groups. The current results demonstrated that the cell-derived ECM membrane could inhibit the formation of postoperative adhesion and fibrosis between conjunctiva and muscle. The authors concluded that the use of ECM membrane could reduce postoperative adhesion around surgical area after strabismus surgery in rabbits.
The cell-derived extracellular matrix (ECM) membrane is a bio-absorbable membrane composed of aseptic ECM obtained from swine knee chondrocyte. The purpose of our study was to evaluate the inhibitory effect of the cell-derived ECM membrane in postoperative adhesion following strabismus surgery on rabbit eyes. Twenty four adult male New Zealand albino rabbits were used. Each rabbit has undergone 3 mm resection of the superior rectus muscle in both eyes. The cell-derived ECM membrane was applied between the conjunctiva and superior rectus muscle only to right eye in each rabbit. The eyes were divided into a surgery-ECM group and a surgery-no ECM group. The rabbits were sacrificed at 2, 4, and 6 weeks after the surgery. Each time, 16 eyes of 8 rabbits were enucleated to observe the adhesion in muscle and adjacent tissue grossly by blunt dissection. Then, histopathological sections were analyzed for inflammation and fibrosis by staining with hematoxylin-eosin and Masson trichrome, respectively. Inflammation and fibrosis were graded on a scale of 0 to 4. A researcher was blind to the experiments performed all the examinations. Comparing with the surgery-no ECM group, there was no significant difference with regard to inflammation at the area of superior rectus muscle resection at 2, 4, and 6 postoperative weeks (p = 0.52, p = 0.55, p = 0.82). However, a significant reduction in the degree of adhesion (p = 0.01, p = 0.03, p = 0.04) as well as decreased fibrosis (p = 0.04, p = 0.03, p = 0.02) between muscle and conjunctiva after strabismus surgery was observed in all surgery-ECM groups. The current results demonstrated that the cell-derived ECM membrane could inhibit the formation of postoperative adhesion and fibrosis between conjunctiva and muscle. The authors concluded that the use of ECM membrane could reduce postoperative adhesion around surgical area after strabismus surgery in rabbits.
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