Altered glucose metabolism, along with low-grade inflammation, has been proposed to be involved in retinal detachment (RD)-induced cone loss. Here, we assessed intravitreal glucose and cytological profile in patients with macula-off RD. METHODS: Glucose concentration was analysed in vitreous samples from 137 non-diabetic patients undergoing vitrectomy for either primary macula-off RD (n = 73) or epiretinal membrane (ERM; n = 64). Cellularity was assessed in vitreous cytospin preparations by a semi-quantitative immunostaining approach. RESULTS: Intravitreal glucose concentration was higher in the RD group (2.28 mmol.L-1 n =73 vs 1.6 mmol.L-1 n = 64; p < 0.0001). Overall cellularity and density of macrophages were significantly higher in the vitreous of RD patients (respectively p = 0.003 and p < 0.0001). Among the RD patients, intravitreal glucose concentration correlated with macrophages density (p = 0.002): its levels remained significantly higher in eyes in which macrophages were innumerable compared to lower macrophages densities RD eyes (p = 0.0095). CONCLUSIONS: We observed a strong relationship between intravitreal glucose concentration and vitreous macrophage density. Additional indicators for vitreous glycation and low-grade inflammation should be further studied.

Purpose Proliferative vitreoretinopathy (PVR) is the leading cause of failure in retinal detachment surgery. The migration of retinal pigment epithelial cells and the proliferation of the extracellular matrix has been associated with PVR. The purpose of this prospective study was to compare the cellular contents of the vitreous of patients undergoing retinal detachment surgery with patients scheduled for macular surgery. Methods The vitreous samples of patients with epiretinal membrane and rhegmatogenous retinal detachment were obtained at the initial phase of surgery without previous intraocular infusion. A cytological analysis and Papanicolaou staining was performed in all cases. The concentration of vitreous cells in 62 patients with retinal detachment and 62 undergoing macular surgery (52 epiretinal membranes, 6 macular holes and 4 vitreomacular traction syndromes) were analyzed semi‐quantitatively. Results An increased concentration of vitreous cells and free pigment was observed in a higher proportion in retinal detachment specimens compared with patients undergoing macular surgey. In the retinal detachment group, there was a higher amount of hyalocytes (p=0,017) and macrophages (p=0,00865). There was no correlation between any cell concentration and PVR induced recurrence of retinal detachment. Interestingly, in the vitreous of eyes with vitreomacular traction, no cells could be detected. Conclusion Vitreous changes observed in patients with retinal detachment appear to involve vitreous cells particularly hyalocytes and macrophages, whereas in vitreomacular traction, syndromes no cellular reaction could be detected.

Purpose The visco‐elastic features of silicone oil are a limiting factor transconjunctival vitreoretinal surgery. The flow resistence increases with the reduction of the inner diameter of the extrusion canula. Thise increases the duration of silicone oil extraction. The purpose of this study was to compare 2 surgical procedures for silicone oil extrusion: 20 versus 23 Gauge. Methods A retrospective pilot study compared two groups of patients scheduled for silicone oil extraction. In the first group silicone oil extraction was performed through a 20 Gauge scllerotomy after conjunctival dissection whereas a 25 Gauge tranconjunctival sclerotomy enabled saline infusion. In the second group both infusion and silicone oil extraction was performed through 23 Gayge transconjunctival sclerotomies. The duration of each procedure was the main outcome measure. Results The mean duration of the 23 Gauge procedure was 42 minutes compared with 22 minutes in the combined 20/25 Gauge procedure. Transitory intraoperative hypotonia was encountered in two patients, one in each group. During the post‐operative follow up, a vitreous hemorrhage occurred in one patient of the 23 Gauge procedure group. Conclusion Comparing two surgical procedures for silicone oil extraction, the conjunctival dissection time in the 20/25 Gauge group seems to be largely counterbalanced by the rapidity of the silicone oil extraction through a larger sclerotomy. The use of a combined 20/25 Gauge full transconjunctival procedure could probably reduce furthermore the duration of surgery .