Aims-To evaluate the eVect of trans scleral cyclophotocoagulation (TSCPC) on intraocular pressure (IOP) in the eyes retaining intravitreal silicone oil with medically uncontrolled secondary glaucoma following intravitreal silicone oil injection. Methods-Medical records of 11 eyes of 11 patients who underwent TSCPC for medically uncontrolled glaucoma without pupillary block following intravitreal silicone oil injection for complicated retinal detachment were reviewed retrospectively. In all cases, intravitreal silicone oil was not removed for fear of retinal redetachment. Diode laser contact TSCPC was performed at a power of 1.5-2.5 W, for a duration of 2 seconds, and with 20-27 applications. IOP, number of glaucoma medications, and success rate were evaluated. Results-After a mean follow up period of 52.5 (SD 8.2) (range 42-68) weeks, the mean pretreatment level of IOP, 43.0 (14.4) (26-67) mmHg, had fallen to 14.5 (4.3) (7-20) mm Hg (p=0.003). The number of glaucoma medications was reduced from 2.6 (0.8) to 0.6 (1.0) (p= 0.005). Qualified success was achieved in nine eyes (81.8%) and complete success in six (54.5%). After TSCPC, patients' retinal status had not changed. Conclusion-Patients with medically uncontrolled glaucoma secondary to intravitreal silicone oil injection can be treated with TSCPC in spite of the retained intravitreal silicone oil. (Br J Ophthalmol 1999;83:713-717)
Fifty percent of the cases of diplopia were associated with either direct trauma or anesthetic myotoxicity to the extraocular muscles, in which overactions were more common than underactions. Thirty-two percent of the patients were presumed to have sensory strabismus, which suggested the importance of preoperative examination for strabismus as well as providing an explanation about the risk of postoperative diplopia before surgery.
To investigate the effect of basic Fibroblast Growth Factor (bFGF) on fibrovascular ingrowth into porous polyethylene orbital implants (Medpor) and to investigate any differences according to the method of administration. For the treated groups, after evisceration and Medpor implantation, bFGF was administered by soaking Medpor in the bFGF solution, and/or by injecting bFGF into the Medpor 1 week after the operation. Implants were removed 4 weeks after the operation and examined for the degrees of fibrovascular ingrowth by light microscopy. The percentages of the cross-sectional area of the implant occupied by fibrovascular ingrowth and the numbers of proliferated vessels were significantly higher in the bFGF-treated groups (Mann Whitney test, p<0.05). Administration routes had no effect on the degree of fibrovascular ingrowth (Kruskal-Wallis test, p>0.05). bFGF promoted fibrovascular ingrowth into porous polyethylene orbital implants regardless of the route of administration. Therefore, bFGF might be helpful to prevent complications such as implant exposure.
Abstract. The authors developed a technique for the retroscleral implantation of a porous polyethylene orbital implant after evisceration for the placement of an adequately large orbital implant without wound tension. The surgical results of the technique in 27 patients are reported. The technique involves the severance of the optic nerve after standard evisceration and the insertion of the orbital implant into the retroscleral and intraconal space through the side of the scleral shell. All patients received a 20-mm orbital implant. No complications such as infection, implant exposure, or worsened implant motility were observed during the average follow-up period of 22.4 months. Retroscleral implantation of the orbital implant after evisceration may be an appropriate procedure that allows placement of a large orbital implant without exposure or decreased implant motility. [Ophthalmic Surg Lasers Imaging 2005;36:436-440.]
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