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City Road, London EC] V2PD SUMMARY A control trial is reported which demonstrates that treatment with argon laser photocoagulation to certain patients with macular oedema following a branch vein occlusion does not alter significantly their visual prognosis. It confirms that patients with an intact perifoveal capillary arcade have a better prognosis than those with a broken arcade.

The aim of this retrospective study was to determine the effectiveness of maxillary, mandibular and chin advancement (MMCA) surgery as a treatment for obstructive sleep apnoea and to determine the cephalometric parameters of this surgery. Twenty consecutive adult patients with obstructive sleep apnoea for whom other treatments (constant positive airway pressure, mandibular advancement splint and soft tissue surgery) had failed underwent MMCA surgery. Pre-and postsurgical polysomnography studies measuring the Respiratory Disturbance Index (RDI), minimum blood oxygen saturation (MinSaO 2 ) and Epworth Sleepiness Scale (ESS) were compared. Lateral cephalometric radiographs measuring the pre-and post-surgical posterior airway space (PAS) were also analysed. Regression analysis indicated that the change in PAS at the level of B point largely accounted for the change in the RDI, although it was not significantly related with the postoperative oxygen saturation. MMCA surgery was found to be effective as a treatment for obstructive sleep apnoea, and improved all postoperative measures in this study. There was a significant relationship between B point, the PAS and a reduction in RDI.Keywords: Obstructive sleep apnoea, maxillary, mandibular and chin advancement surgery, cephalometric analysis.Abbreviations and acronyms: AHI = Apnoea Hypopnoea Index; ANS = anterior nasal spine; BMI = Body Mass Index; BSSO = bilateral sagittal split osteotomy; CPAP = constant positive airway pressure; ESS = Epworth Sleepiness Scale; MinSaO 2 = minimum blood oxygen saturation; MMCA = maxillary, mandibular and chin advancement; OSA = obstructive sleep apnoea; PAS = posterior airway space; RDI = Respiratory Disturbance Index; STO = surgical treatment objective; VPI = velopharyngeal incompetence; UPPP = uvulopalatopharyngoplasty.