Aims To determine the intraoperative and postoperative complications and visual outcome of eyes undergoing cataract extraction after previous retinal detachment repair by pars plana vitrectomy (PPV). Methods Retrospective analysis of 72 patients who had cataract extraction by phacoemulsification having had retinal detachment repair by vitrectomy and internal tamponade. Results Best-corrected visual acuity (BCVA) had improved in 53 (74%) of eyes at 3 weeks after cataract surgery and 65 (90%) at final follow-up. Fifty-three eyes (74%) attained 6/12 visual acuity at final follow-up compared with 19 (26%) eyes with a preoperative vision better than 6/12. There was a significant improvement in BCVA after cataract extraction (Po0.001). Poor vision was usually related to retinal comorbidity. Intraoperative events occurred in nine eyes (12.5%) including capsulorrhexis tears, zonular dehiscence and vitreous loss. Postoperative events occurred in 15 eyes (20.8%). Retinal re-detachment occurred in four eyes (5.6%). Conclusions Cataract extraction after retinal detachment surgery by vitrectomy generally results in a significant visual improvement, however, there is an increased intraoperative and postoperative complication rate. The risk of retinal re-detachment may previously have been underestimated.
Purpose The lateral tarsal strip (LTS) for involutional ectropion is often performed with a medial spindle (tarsoconjunctival diamond excision). We aimed to evaluate how well the LTS alone can achieve symptomatic relief. Methods A retrospective, comparative case series was performed on consecutive patients undergoing LTS alone or with medial spindle for involutional ectropion. Outcomes for LTS alone were clinically derived functional success (improvement in symptoms and aesthetic appearance) and anatomical success (judged by punctal position in the tear lake, punctal movement during blinking and absence of ectropion). We verified if these outcomes compared favourably with those of the patients who had undergone an LTS with medial spindle. Procedure selection was based on pre-operative clinical examination, especially the lateral pinch and twist test (this is described). Complications were also recorded. Results Of 67 eyes, 23 had LTS alone and 44 had LTS with a medial spindle. Of those having LTS alone the functional success rate was 87% (95% CI (66.4, 97.2%)). This did not differ significantly from a success rate of 89% (75.4, 96.2%) in LTS with a medial spindle (P ¼ 0.99). A total of 78% (56.9, 92.5%) of patients undergoing LTS had a good anatomical result compared with 82% (67.3, 91.8%) of those who had an additional medial spindle (P ¼ 0.75). Complication rates were similar between the groups. Conclusion Where the lateral pinch and twist test returns the eyelid to a good position, the LTS alone can suffice for the management of involutional ectropion.
The technique of large chorioretinal biopsy described appears to be safe. It produced good amounts of chorioretinal tissue for histopathological analysis. Positive histology results were seen in the majority of the sample and especially in those where vitreous biopsy alone proved to be inadequate.
The present findings indicate that retina from eyes with advanced PVR may itself be subject to inflammatory changes, and indicate that the PVR process is not limited to retinal membranes, but involves a more widespread distribution of inflammation than is generally appreciated.
Provided lens care is satisfactory and the patient does not have unreasonable expectations, a tinted contact lens can be a useful device. In view of the cost implication, this is a valuable service provided by the hospital.
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