The success rates of primary 23-gauge PPV with either C3F8 or SO tamponade in pseudophakic eyes with rhegmatogenous retinal detachment was higher than the same procedure performed in phakic eyes. Still, the retrospective and limited data presented is too preliminary to suggest or recommend that practitioners perform simultaneous combined cataract surgery with retinal detachment and requires further studies in a larger and prospective design to confirm these present findings.

Uncomplicated PPV seems to increase the IOP, particularly in those who are pseudophakic and have a family history of open-angle glaucoma. This increase in IOP may lead to glaucomatous damage if not managed appropriately. Patients with a previous PPV need to be followed by an ophthalmologist to monitor the IOP in the vitrectomized eye.

We retrospectively evaluated a heavy silicone oil (HSO) as a long-term intraocular endotamponade agent to treat complicated RD by inferior PVR in 25 eyes of 25 patients. Patients underwent PPV and injection of Oxane HD as an internal tamponade agent. A comparison of preoperative and postoperative BCVA at month 1, month 6, and last visit was made in the group in which HSO was removed and in the group in which HSO was not removed. Statistical calculations were performed using the Wilcoxon test. The HSO was removed from 11 patients after a mean of 26.55 ± 21.38 months. The HSO remained inside the vitreous cavity in 14 eyes due to a high chance of PVR recurrence (mean follow-up period, 11.07 ± 7.44 months). Anatomic success was achieved in 92%. The BCVA in the group, in which HSO was not removed, improved significantly during the first 6 months. Among the patients who had the oil removed, there was improvement in BCVA after 1 month. Oil emulsification was the most common adverse effect in 52% of eyes. HSO is an effective tamponade in complex rhegmatogenous and tractional RD complicated by PVR. HSO can remain in the eye for long periods with relative tolerability and safety.

Introduction Disc degeneration in the cervical spine is a prevalent clinical predicament often requiring surgery. Anterior cervical decompression and fusion (ACDF), the most commonly performed procedure, poses risks of pseudoarthrosis, and adjacent segment disease (ASD).1,2 An emerging alternative treatment option is prosthetic total disc replacement (TDR),3 which preserves segmental mobility. Our group previously developed a biological TDR device using composite AF/NP disc-like construct with viable cells and mechanical properties analogous to the native discs in a rat tail model.4 In this study, we evaluated the in vivo efficacy of this tissue-engineered intervertebral disc (TE–IVD) in a beagle cervical model assessing radiological and histological parameters. Material and Methods TE-IVD construction: Canine-sized TE–IVDs were constructed as previously described.4 Cervical IVDs from skeletally mature beagles were separated into AF and NP tissues; component cells were isolated and cultured in vitro. Cultured NP cells were seeded with alginate, injected into a predesigned mold, and encircled with two layers of an AF cell laden collagen gel. The combined construct was kept in media for 2 weeks as the surrounding annulus fibrous aligned and contracted until required TE–IVD diameter was attained. Experimental Protocol: Overall, eight skeletally mature beagles were divided into the following two groups: the control group ( n = 2) underwent discectomy with fully resected IVDs, and the experimental group ( n = 6) underwent TE–IVD implantation postdiscectomy. Adjacent proximal segments served as internal healthy controls. Postoperative X-ray and MRI were taken at 2 and 4 weeks; disc height indices5 and NP hydration using a pre-established algorithm6 were analyzed. Beagles were humanely killed at 4 weeks for histological assessment. Results TE–IVDs were successfully implanted postdiscectomy ( Fig. 1A , B). At 2 weeks, MRIs of TE–IVDs revealed T2 high intensity with acute outer inflammation because of the surgical invasion, which faded by 4 weeks. At 4 weeks, TE–IVDs maintained position in the disc space with relatively increased T2 intensity, whereas discectomized segments manifested as black discs ( Fig. 1C , D). These findings suggest that the implanted TE–IVDs engraft in the disc space despite significant biomechanical demands of the beagle cervical environment. In fact, disc height indices of the TE–IVDs and discectomized discs were 71 and 49%, respectively, of that of healthy control discs. Likewise, MRIs revealed that NP hydration of the implanted TE–IVDs was over 70% of that of healthy discs. Histological assessments further demonstrated chondrocyte-like cell viability in the TE–IVD, abundant proteoglycan content in the extracellular matrices, and substantial integration into host tissues without signs of immune reactions. [Figure: see text] Conclusion Despite the severe local milieu of the beagle cervical spine owing to mechanical loading, our in vivo TE–IVDs when appropriately implanted, maintained their position and structure at 4 weeks. The TE–IVDs displayed dynamic adaptation to the host environment, with extracellular matrix production and cell proliferation. They further maintained disc height as well as NP hydration at 4 weeks with up to 70% viability as the normal healthy discs. References Nesterenko SO, Riley LH III, Skolasky RL. Anterior cervical discectomy and fusion versus cervical disc arthroplasty: current state and trends in treatment for cervical disc pathology. Spine 2012;37(17):1470–1474 Sugawara T, Itoh Y, Hirano Y, Higashiyama N, Mizoi K. Long term outcome and adjacent disc degeneration after anterior cervical discectomy and fusion with titanium cylindrical cages. Acta Neurochir (Wien) 2009;151(4):303–309, discussion 309 Kelly MP, Mok JM, Frisch RF, Tay BK. Adjacent segment motion after anterior cervical discectomy and fusion versus Prodisc-c cervical total disk arthroplasty: analysis from a randomized, controlled trial. Spine 2011;36(15):1171–1179 Bowles RD, Gebhard HH, Härtl R, Bonassar LJ. Tissue-engineered intervertebral discs produce new matrix, maintain disc height, and restore biomechanical function to the rodent spine. Proc Natl Acad Sci U S A 2011;108(32):13106–13111 Kim JS, Kroin JS, Li X, et al. The rat intervertebral disk degeneration pain model: relationships between biological and structural alterations and pain. Arthritis Res Ther 2011;13(5):R165 Grunert P, Hudson KD, Macielak MR, et al. Assessment of intervertebral disc degeneration based on quantitative magnetic resonance imaging analysis: an in vivo study. Spine 2014;39(6):E369–E378