Treatment of retinal embolus by photocoagulation.

Abstract

Perfluoropropane SIR, We should like to report a case where the intraocular gas, perfluoropropane (C3F8), was used to reform a flat anterior chamber occurring after fistulising surgery. The technique may be of value to others facing this problem.A 68-year-old man underwent routine trabeculectomy. From the first postoperative day the eye was hypotonous and the anterior chamber shallow. By the fourth day large choroidal effusions were present and cornea-lens contact had developed.The anterior chamber was reformed with sodium hyaluronate (Healonid) and the sclerostomy sutured tightly shut. Unfortunately by the seventh day after trabeculectomy cornea-lens contact had recurred. The anterior chamber was again reformed with sodium hyaluronate and the choroidal effusions partly drained, but 72 hours later cornea-lens touch was present. On this occasion a bubble of 12% C3F8 was injected through an oblique track in the cornea into the anterior chamber without drainage of the choroidal effusion. This concentration is non-expansile' and was used in sufficient volume, approximately 0-5 ml measured in the syringe, to reform the anterior chamber.The bubble filled the anterior chamber for five days before slowly being absorbed, so that 12 days after injection aqueous filled more than half the chamber.

Trans-Luminal Nd:yag Laser Embolysis for Branch Retinal Artery Occlusion

“…However, no improvement of visual function occurred. 3 Recently, intravenous prostaglandin E1 acting as a peripheral vasodilator was reported to improve VA back to baseline in 4 days in one case. However, no other reports on this modality were found when searching the literature.…”

Transluminal Nd: YAG Laser Embolysis for Branch Retinal Artery Occlusion: A case Report

“…Numerous treatment modalities have been attempted in both CRAO and BRAO without much success including low-intensity photocoagulation, intravenous prostaglandin E1 infusion, and enhanced external counter pulsation. 1,3,4 Recently, Opremcak and Benner5 used the Nd:YAG laser to perform TYE in two patients with BRAO and a cilioretinal artery occlusion. TYE resulted in disappearance of the emboli and immediate restoration of retinal blood flow.…”

“…As mentioned in previous studies, it is possible that the improved visual acuities in patients with BRAO were unrelated to TYE or embolectomy. 1,[3][4][5] However, the synchrony of recirculation and restoration of vision immediately following TYE or embolectomy suggests a beneficial effect of this procedure. In light of our experience in this case, TYE can be taken into account and can be an option and feasible technique for restoring retinal blood flow and allowing for retinal recuperation and return of visual function in the majority of patients with BRAO.…”