The annual incidence of RRD in northern New Zealand is comparable to values reported for other parts of the world and, consistent with previous studies, the incidence of RRD was found to increase with age, and in association with trauma, high myopia and cataract surgery.
The overall risk for RRD after cataract surgery by phacoemulsification was small. However, in the younger patient, the risk for pseudophakic detachment was higher. In light of this finding, the requirement for cataract surgery in this group should be reassessed.
We have reviously described surgical techni ues for draining severe cases of secondary glaucoma by means of% artificial implant Wherever posshe these implants have been inserted in two stagesThe modern microsurgical operation of trabeculectomy gives excellent results in selected cases of primary glaucoma. However, where glaucoma develops in young patients or is associated with trauma, aphakia, chronic uveitis, anterior segment neovascularisation or failure of a previous drainage operation, results are generally poor. In the latter group, we use a draining implant consisting of a thin silicone tube connected to drain on to the upper surface of one or two rigid circular episcleral plates. These implants are placed with the silicone tube lying in the angle of the anterior chamber and the plate or plates firmly sutured to the sclera and covered by a thick flap of Tenon's tissue and conjunctiva.The aqueous that is drained by these implants passes through the tube to enter a cleft between the episcleral plate and the overlying tissues. From this cavity it escapes freely in the first seven to ten days after operation. During this time the intraocular pressure (IOP) is very low, ranging between 0 and 5 mmHg. This period of hypotension ceases when the tissue reaction to the presence of the implant and to the aqueous
Objective To determine the incidence of posterior vitreous detachment (PVD) in a series of patients who have undergone cataract surgery by phacoemulsification. Design Comparative case series Participants A consecutive series of 149 patients who underwent cataract surgery aged between 50 and 60 years were evaluated in this study. Methods Patients identified as being eligible for this study were recalled for an ophthalmic assessment, which included a dilated retinal examination. Main Outcome Measures The status of the vitreous was recorded following an evaluation by slit-lamp biomicroscopy, binocular indirect ophthalmoscopy, and B-scan ultrasonography.Results A PVD was documented in 50.8% of the pseudophakic eyes as compared to 20.8% in the phakic fellow eyes. This difference was statistically significant. Furthermore, the incidence of PVD was greater in pseudophakic eyes with an axial length of 25 mm or greater compared to those eyes with an axial length of o25 mm. Neodymium: yttrium garnet (Nd:YAG) capsulotomy did not influence the prevalence of PVD. In this series of eyes, with a median follow-up interval of 77 months the incidence of pseudophakic retinal detachment (PRD) was 4% Conclusions The incidence of PVD in pseudophakic eyes in the 6th decade is higher than those phakic eyes, and is likely to be associated with the increased risk of PRD observed in this age group.
The most common clinical scenario for patients presenting with presumed infectious endophthalmitis in this series was in the perioperative setting. We did not find that the prognosis was influenced by the microbiological isolate or clinical setting. However, those patients presenting with poor acuities typically had the worst outcomes. Pacific ethnicity was also associated with increased rate of complications.
The findings are presented on the updated Kempster pedigree with Sorsby's fundus dystrophy. The study confirms the features described in other families: autosomal dominant inheritance with complete penetrance, loss of central vision due to subfoveal ingrowth of new vessels, and progressive peripheral chorioretinal atrophy. By contrast to other reports the family in the current study have peripheral retinal dysfunction, a deposit of a subretinal yellow material throughout the fundus and a tritan colour defect, all prior to the loss of central vision; in some patients there was loss of central vision from atrophic disease, rather than from ingrowth of subretinal new vessels; and, there was a different temporal progression of the central subretinal neovascular complex. These features suggest the possibility of genetic heterogeneity.
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