1/33. Giant retinal tears resulting from eye gouging in rugby football.A 29 year old myopic man sustained two separate giant retinal tears in his right eye following deliberate eye gouging during a rugby tackle. These were successfully repaired by vitrectomy and intraocular silicone oil injection. Although the postoperative course was complicated by pupil block glaucoma, he regained corrected visual acuity of 6/5 after oil removal. This injury highlights the potentially sight threatening nature of this type of rugby injury and the importance of early referral for specialist treatment.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/33. Primary vitrectomy for rhegmatogenous retinal detachment: an analysis of failure.PURPOSE: To find the cause of failure in primary vitrectomy for rhegmatogenous retinal detachment. methods: Retrospective review of 171 consecutive cases of RRD treated by primary pars plana vitrectomy (PPV) from a tertiary referral centre to identify the 25 cases in which surgery had failed. Detachments with giant or macula breaks at initial presentation, with proliferative diabetic retinopathy or with PVR greater than grade B were excluded. RESULTS: The failure rate after the first operation was 14.6% and the commonest cause of failure was missed retinal breaks, accounting for 64.3% of failures. CONCLUSION: Missed retinal breaks are the commonest cause of failure of primary PPV for RRD although proliferative vitreoretinopathy may contribute to surgical failure. This re-emphasises the importance of assiduous peroperative retinal examination.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/33. Early rhegmatogenous retinal detachment following laser in situ keratomileusis for high myopia.PURPOSE: Four eyes had early rhegmatogenous retinal detachment within 3 months of laser in situ keratomileusis (LASIK) for correction of high myopia using the microkeratome, Clear Corneal Molder. methods: In two eyes, retinal detachment resulted from horseshoe tears, one occurring in an otherwise normal region of the retina and the other at the margin of an area of lattice degeneration detected during preoperative examination. The first eye was treated with retinopexy using a 287 encircling scleral exoplant, drainage of subretinal fluid, and laser photocoagulation by indirect ophthalmoscopy. The other eye was treated with pneumatic retinopexy and cryotherapy. In the other eyes, retinal detachment was the result of giant tears with no evidence of prior retinal degeneration. These eyes were treated with pars plana vitrectomy, fluid-gas exchange with 15% perfluoropropane (C3F8), endolaser photocoagulation, and a 42 encircling scleral exoplant. RESULTS: After treatment, the first two eyes achieved spectacle-corrected visual acuity of 20/40. In the last two eyes, final spectacle-corrected visual acuity was 20/400 in one eye and light perception in the other. CONCLUSIONS: Although no cause-effect relationship between LASIK and retinal detachment can be stated, these cases suggest that LASIK may be associated with retinal detachment, particularly in highly myopic eyes. Further studies are necessary to determine high-risk patient characteristics.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/33. Perfluorodecalin-induced intravitreal inflammation.OBJECTIVE: To report an unusual case of intravitreal inflammation in a human eye caused by the presence of residual perfluorodecalin in a case of giant retinal tear and retinal detachment. methods: The posterior capsule of the lens, which was infiltrated with deposits, was collected during surgery. The specimen was stained with hematoxylin and eosin, with periodic acid-Schiff, and for melanin. Part of it was examined with electron microscopy. Immunohistochemical staining was performed to demonstrate CD68 antigens, cytokeratin, and glial fibrillary acid protein. RESULTS: Vacuolated macrophages and retinal pigment epithelial cells infiltrated the posterior capsule. Electron microscopy showed the presence of membrane-lined vacuoles within the macrophages. A monolayer of epithelial cells covered the cellular infiltration. CONCLUSION: Residual perfluorodecalin can induce an intraocular chronic macrophage response.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/33. Giant tear retinal detachment after laser in situ keratomileusis--a case report.A 42-year-old woman with a refractive error of -10.00S - 2.00C x 105 degrees in the right eye underwent laser in situ keratomileusis (LASIK) at our hospital. LASIK was performed using the Schwind excimer laser (Keratom Multiscan, Schwind, Kleinostheim, germany) and Moria LSK--One manual microkeratome with a 130 microns ablation plate. The uncorrected visual acuity improved postoperatively, and the patient was very satisfied. However, nine months later, she complained of sudden loss of visual acuity in the right eye. Indirect ophthalmoscopy revealed a giant retinal tear extending from 10:00 to 2:00 o'clock position with retinal detachment and vitreous hemorrhage. We performed scleral buckling procedure (with silicone band encircling), vitrectomy, and fluid-gas exchange with air/SF6 mixture. The retina attached postoperatively and remained so during 3-month follow-up period, but cellophane maculopathy was noted.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/33. Multiple retinal holes in the macular region: a case report.PURPOSE: To describe the first case of multiple retinal holes in the macular region successfully treated with vitrectomy. METHOD: A single case report. A 44-year-old man was treated for impaired vision caused by multiple macular holes in the right eye. RESULTS: Fundus examinations detected six retinal holes in the right macula and a giant macular hole in the left eye. Optical coherence tomography disclosed multiple vitreoretinal adhesions in the right macula. We vitrectomized the right eye to produce posterior vitreous detachment and then tamponaded the vitreous cavity with 20% SF(6) gas, resulting in closure of holes and improvement of the vision. CONCLUSION: Multiple macular holes may be treated by surgical posterior detachment combined with gas tamponade. Vitreoretinal adhesions are a possible cause of these holes. Similar multiple holes may have coalesced into one giant hole in this patient's left eye.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
7/33. Giant retinal tear and meningococcus endogenous endophthalmitis.Giant retinal tear is seen in association with Stickler's syndrome, marfan syndrome, homocystinurea and after ocular trauma. Although bacterial meningitis(1) is not common since the advent of various antibiotics, meningococcus is the second most common cause of bacterial meningitis. Endogenous endophthalmitis(2) remains a challenge to clinicians despite the success of antibiotics in reducing its frequency and severity. The association of giant retinal tear and meningococcal endogenous endophthalmitis is not yet reported in the literature. We report here on a 14-year-old girl who developed a giant retinal tear after meningococcal meningitis and endogenous endophthalmitis, and we discuss the possible factors of its cause.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
8/33. Prophylactic 360 degrees cryotherapy in fellow eyes of patients with spontaneous giant retinal tears.PURPOSE: To assess the effect of prophylactic 360 degrees peripheral retinal cryotherapy in fellow eyes of patients with spontaneous giant retinal tears (GRTs) on the incidence of retinal detachment. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: Forty-eight consecutive patients (31 male, 17 female) with spontaneous GRTs were included. The average age was 41 /- 2 years. The average refraction of the fellow eye was -4.0 /- 0.8 diopters (D). INTERVENTION: patients underwent vitrectomy and silicone oil tamponade in the affected eye and 360 degrees peripheral cryotherapy in the unaffected fellow eye during the same anesthetic. MAIN OUTCOME MEASURE: Attachment of the retina in the fellow eye was determined clinically by indirect ophthalmoscopy. RESULTS: During a mean follow-up of 84 /- 10 months after cryotherapy, one patient (2%) experienced a retinal tear without retinal detachment, and three patients (6%) experienced a retinal detachment in the fellow eye. These occurred 18 /- 9 months after prophylactic treatment and were the result of a small retinal break in two cases and a GRT posterior to the treated area in one case. CONCLUSIONS: Prophylaxis of fellow eyes with 360 degrees cryotherapy appears to be associated with a lower incidence of retinal detachment than that reported in natural history studies. A prospective, randomized clinical trial of such prophylaxis is desirable but would require a sample size of at least 645 patients in each arm of the study, as well as long-term follow-up of at least 5 years to show an unequivocal difference in outcome.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
9/33. Filtering blebs at the site of sutured posterior chamber intraocular lenses.A 78-year-old man with a traumatic giant retinal tear and phacodonesis had 3-port pars plana vitrectomy (3PPPV), lensectomy, and sutured posterior chamber intraocular lens (IOL) implantation. Two years after surgery, a filtration bleb was noted at 1 of the suture sites. In another case, a 32-year-old man with lens subluxation secondary to Marfan's syndrome had 3PPPV, lensectomy, and sutured posterior chamber IOL implantation. Two months after surgery, a filtration bleb was noted at 1 of the suture sites. Sutured posterior chamber IOL implantation is 1 of the few instances in which there is virtually a full-thickness suture through the sclera. We presume the filtering bleb formed as a direct result of the permanent passage created from the posterior chamber to the subconjunctiva due to presence of the suture. Presence of a filtering bleb can lead to complications including endophthalmitis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/33. Bilateral giant macular hole in a patient with chronic renal failure.A 32-year-old woman with a medical history of chronic hypertension, chronic renal failure, and hearing deficit presented with bilateral giant macular holes. Possible mechanisms that cause giant macular holes and the relationship between renal failure and giant macular hole formation are discussed.- - - - - - - - - - ranking = 7keywords = giant (Clic here for more details about this article) |
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