1/76. incidence of vitreoretinal pathologic conditions within 24 months after laser in situ keratomileusis.OBJECTIVE: To report for the first time a case series of vitreoretinal pathologic conditions after laser in situ keratomileusis (LASIK) and to determine its incidence. DESIGN: Case series. PARTICIPANTS: Five refractive surgeons and 29,916 eyes that underwent surgical correction of ametropia (83.2% were myopic) ranging from -0.75 to -29.00 diopters (D; mean: -6.19 D) and from 1.00 to 6.00 D (mean: 3.23 D) participated in this retrospective study. MAIN OUTCOME MEASURES: Vitreoretinal complications after LASIK. RESULTS: The clinical findings of 20 eyes (17 patients) with LASIK-related vitreoretinal pathologic conditions are presented. Fourteen eyes experienced rhegmatogenous retinal detachments (RDs). Two eyes experienced corneoscleral perforations with the surgical microkeratome when a corneal flap was being performed (one experienced a vitreous hemorrhage and the other later experienced an RD). In four eyes, retinal tears without RDs were found. In one eye, a juxtafoveal choroidal neovascular membrane (CNVM) developed. Retinal tears were treated with argon laser retinopexy or cryotherapy. Corneoscleral perforations were sutured, and the RD was managed with vitrectomy. The remaining RDs were managed with vitrectomy, cryoretinopexy, scleral buckling, argon laser retinopexy, or pneumatic retinopexy techniques. The CNVM was surgically removed. The incidence of vitreoretinal pathologic conditions determined in our study was 0.06%. CONCLUSIONS: Serious complications after LASIK are infrequent. Vitreoretinal pathologic conditions, if managed promptly, will still result in good vision. It is very important to inform patients that LASIK only corrects the refractive aspect of myopia. Complications of the myopic eye will persist.- - - - - - - - - - ranking = 1keywords = detachment, retinal detachment (Clic here for more details about this article) |
2/76. Spontaneous involution of a large retinal arterial macroaneurysm.BACKGROUND: Acquired retinal macroaneurysms are round dilatations of retinal arterioles that occur in the posterior fundus. They tend to rupture before they grow large and cause a visual decrease. The average diameter of macroaneurysms in the previous reports is 281 micrometer. methods: A 63-year-old man complained of a sudden decrease of visual acuity in the left eye. Fundus examination of his left eye revealed a large protruded mass, 2 disc diameters in size, at the first bifurcation of the inferotemporal retinal artery. Preretinal vitreous bleeding and serous retinal detachment were observed around the lesion. indocyanine green (ICG) angiography showed this mass to be continuous with the inferotemporal retinal artery and ICG dye leaked from the retinal artery into the lumen of the mass, with pulsation. RESULTS: Six months later, the large macroaneurysm underwent spontaneous involution. CONCLUSION: As shown in this patient, retinal macroaneurysms may grow extremely large. ICG angiography was useful to diagnose this large retinal arterial macroaneurysm.- - - - - - - - - - ranking = 1keywords = detachment, retinal detachment (Clic here for more details about this article) |
3/76. Recurrent vitreous hemorrhages due to combined pigment epithelial and retinal hamartoma: natural course and indocyanine green angiographic findings.We report the clinical and angiographic features as well as the natural course of an optic disk and juxtapapillary combined pigment epithelial and retinal hamartoma in a 23-year-old white girl. The patient presented 3 episodes of recurrent vitreous hemorrhages in the first 4 years of follow-up, which were spontaneously and totally absorbed. During the last 6 years, she was absolutely free of any ocular symptom. The tumor did not show any growth during the 10 years of follow-up. The digital indocyanine green angiography, which was normal in the early frames, revealed a mild, patchy hyperfluorescence corresponding to the tumor location in the late phase.- - - - - - - - - - ranking = 0.0049853324532674keywords = pigment (Clic here for more details about this article) |
4/76. Diode laser photocoagulation for retinopathy of prematurity: a histopathologic study.Laser photocoagulation has largely supplanted cryotherapy as an effective treatment for retinopathy of prematurity. This case describes the ocular histopathologic findings of a pair of eyes in a severely premature male infant treated with diode laser photocoagulation for bilateral stage 3 retinopathy of prematurity (ROP) for 360 degrees in zone 1 with severe plus disease. The right eye responded to treatment; the left eye developed persistent vitreous hemorrhage and total retinal detachment. The histopathologic examination of laser burns in the right eye disclosed segmental areas of chorioretinal scarring with retinal atrophy and gliosis, loss of RPE and extensive atrophy of the choroid and its vasculature, which involved both the choriocapillaris and larger vessels. The left eye had iris neovascularization, a chronic organized vitreous hemorrhage and a totally detached retina. The histopathologic findings in an eye of a premature infant with threshold ROP treated with diode laser photocoagulation resembled those reported after transsceral cryotherapy. Diode laser photocoagulation may produce less severe chorioretinal damage.- - - - - - - - - - ranking = 1keywords = detachment, retinal detachment (Clic here for more details about this article) |
5/76. Echographic evaluation of a patient with diabetes and dense vitreous hemorrhage: an avulsed retinal vessel may mimic a tractional retinal detachment.PURPOSE: To report that an avulsed retinal vessel may appear as a tractional retinal detachment on echographic evaluation. methods: Case report. RESULTS: A 57-year-old diabetic woman presented with a nonclearing vitreous hemorrhage of 2 months duration in the left eye. Echography was consistent with a localized tractional retinal detachment on longitudinal sections; transverse sections demonstrated a pinpoint opacity in the vitreous cavity. Intraoperatively, an avulsed retinal vessel was noted in the area of echographic abnormality. CONCLUSION: An avulsed retinal vessel may mimic tractional retinal detachment on echography. Although trained ophthalmic echographers routinely perform both longitudinal and transverse sections during an echographic evaluation, less skilled observers must be aware of the importance of performing both longitudinal and transverse sections for accurate echographic diagnosis.- - - - - - - - - - ranking = 7keywords = detachment, retinal detachment (Clic here for more details about this article) |
6/76. Globe perforation associated with subtenon's anesthesia.PURPOSE: To report a case of globe perforation while initiating posterior subtenon's anesthesia. methods: Case report. A 40-year-old man with a history of retinal detachment in both eyes presented for repair of a second retinal detachment in the LE. RESULTS: Upon dissecting a space beneath the tenon capsule with scissors, the globe was perforated. CONCLUSION: In patients with prior ophthalmologic surgery, thinned sclera, or excess scar tissue, increased caution should be employed during initiation of sub-Tenon anesthesia or an alternative method should be used.- - - - - - - - - - ranking = 2keywords = detachment, retinal detachment (Clic here for more details about this article) |
7/76. Erosion and intrusion of silicone rubber scleral buckle. Presentation and management.OBJECTIVE: To describe the clinical presentation and management of erosion and intrusion of silicone rubber implants that are used in scleral buckling procedures for the treatment of retinal detachment. methods: The authors identified four patients from their practices during the last 20 years (1978-1998) who had erosion or intrusion of silicone rubber scleral buckles that were used to manage retinal detachment. Approximately 4400 scleral buckling procedures were performed during this period. A retrospective review of the medical records of all patients was performed. Factors that influenced management decisions concerning the intruding buckle are emphasized. RESULTS: All four patients had myopia. The interval between placement of the scleral buckle and development of intrusion ranged from 1 to 20 years. The buckles were intrascleral in three cases and episcleral in one. Recurrent detachment and vitreous hemorrhage were indications for surgical intervention in three cases. After the surgical removal of buckling elements, visual acuity stabilized in all patients and the retina remained attached in all cases. CONCLUSIONS: Erosion and intrusion of scleral buckle are rare complications of scleral buckling procedures. The intruding buckle may be left intact unless there is significant threat to the integrity of ocular structures, recurrent detachment, or hemorrhage. Manipulation of the encircling band or buckle does not necessarily alter the visual acuity or the status of the retina.- - - - - - - - - - ranking = 3.0739274979798keywords = detachment, retinal detachment (Clic here for more details about this article) |
8/76. vitreous hemorrhage following phakic anterior chamber intraocular lens implantation in severe myopia.PURPOSE: To describe two cases of vitreous hemorrhage following phakic anterior chamber lens (AC-IOL) implantation in high myopia. CASE REPORT: In case 1, hemorrhage developed one month after surgery, without retinal involvement, and visual acuity (VA) resulted 20/200 after pars-plana vitrectomy (PPV). In Case 2, vitreous hemorrhage was complicated by retinal detachment (RD). PPV and silicone oil injection were performed, with AC-IOL removal and cristalline lens extraction. After 2 years the retina was attached and VA was 20/80. DISCUSSION: Only few cases of RD, posterior uveitis and endophthalmitis are reported following phakic AC-IOL implant. vitreous hemorrhage could represent an additional posterior segment complication. Intraoperative manoeuvres, hypotony-induced posterior vitreous detachment and/or peripheral retina traction could play a role in engendering this complication in highly myopic eyes.- - - - - - - - - - ranking = 1.5369637489899keywords = detachment, retinal detachment (Clic here for more details about this article) |
9/76. Bilateral massive choroidal hemorrhage secondary to Glanzmann's syndrome.Characteristics of intraocular bleeding and its management in association with blood dyscrasias are discussed. We present a patient with massive bilateral choroidal hemorrhage secondary to Glanzmann's syndrome. magnetic resonance imaging and ultrasonographic findings were ordered. During the clinical course, bilateral intravitreal hemorrhage and tractional retinal detachment occurred. Left pars plana vitrectomy was performed under general anaesthesia. The procedure was unsuccessful because of intraoperative uncontrolled bleeding.- - - - - - - - - - ranking = 1keywords = detachment, retinal detachment (Clic here for more details about this article) |
10/76. Bilateral acute postoperative retinal detachment after cataract extraction: case report and review of the literature.A 57-year-old white man had extracapsular cataract extraction complicated by vitreous loss. On postoperative day 1, he was noted to have a total retinal detachment (RD) with vitreous hemorrhage. No predisposing anatomic risk factors were present except for the vitreous loss. During the RD repair, 2 small superior tears were discovered. Eleven months later, the patient had uneventful phacoemulsification in the fellow eye. On postoperative day 1, he again had a total RD with a superior retinal tear. Meticulous retinal evaluation had been performed preoperatively, and no holes or tears were discovered. The RD was repaired, and the best corrected visual acuity at the last examination was 20/40 in both eyes.- - - - - - - - - - ranking = 5keywords = detachment, retinal detachment (Clic here for more details about this article) |
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