Purpose: To study the usefulness of intravitreal triamcinolone acetonide injection during vitrectomy in highly myopic eyes with retinal detachment due to a macular hole. Methods: Pars plana vitrectomy was performed in 6 patients with retinal detachment resulting from a highly myopic eye with a macular hole. After separation of the posterior hyaloid and removal of any visible epiretinal membrane, triamcinolone acetonide was injected over the posterior pole. Excised specimens were evaluated by transmission electron microscopy. Results: Upon injection of triamcinolone acetonide, the entire epiretinal membrane and residual vitreous cortex could be visualized in all patients. The epiretinal membrane and residual posterior vitreous cortex were completely removed. Successful reattachment was performed without retinal damage in all cases. Electron microscopy revealed a cellular epiretinal membrane within a collagenous matrix lining the smooth internal surface of the internal limiting membrane. No complications related to the use of triamcinolone acetonide were encountered. Conclusion: Intraoperative visualization of the epiretinal membrane and residual posterior vitreous cortex with triamcinolone acetonide was found to be a useful adjunct to vitrectomy. Using triamcinolone acetonide during vitrectomy may facilitate both removal of the epiretinal membrane around the macular hole and separation of the residual vitreous cortex from the retina in highly myopic eyes with retinal detachment.

IgG4-related dacryoadenitis showed various ophthalmologic symptoms due to extensive inflammation beyond the lacrimal gland, frequent association with other IgG4-related disease or allergic phenomena, and steroid responsiveness.

Purpose: To study the safety and usefulness of trypan blue application and conventional endoillumination for enhancing visualization during phacoemulsification and foldable intraocular lens implantation in cases of cataract with vitreous hemorrhage. Methods: Ten eyes of 10 patients with cataract and coexisting vitreous hemorrhage underwent combined trypan-blue- and endoillumination-assisted phacoemulsification and foldable intraocular lens implantation with vitrectomy. In a two-step surgery, after staining the anterior capsule with trypan blue, continuous circular capsulorhexis was performed; then, phacoemulsification was performed using conventional endoillumination. Specular microscopy was performed before and 3 months after surgery on eyes that underwent trypan-blue- and endoillumination-assisted phacoemulsification and on control eyes that underwent standard phacoemulsification to evaluate the toxic effect of trypan blue on corneal endothelial cells. Results: Trypan blue application improved visualization of the anterior capsule, and a complete capsulorhexis could be performed in all eyes. In all 10 eyes, endoillumination was required to visualize the lens structure, and phacoemulsification could be accomplished. Specular microscopy revealed that there was no significant difference in the level of corneal endothelial cell loss between the trypan-blue- and endoillumination-assisted phacoemulsification group and the control group. Conclusion: The described double visualization technique may assist phacoemulsification in selected cases of cataract with vitreous hemorrhage.

Objective Autoimmune pancreatitis (AIP) may be a pancreatic lesion of

AM patching suppressed myofibroblastic differentiation and MMP expression in the stroma after an alkali burn. An inhibition gradient suggests that AM may release unknown soluble factors possessing some antiscarring capability.