The role of endoscopic vitreous microsurgery in proliferative diabetic retinopathy.
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Biomedical subjects
Publications and source records attributed to C D Witherspoon.
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For fear of endophthalmitis and siderosis, ferrous intraocular foreign bodies are usually removed as soon as they are discovered; markedly reduced, siderotic ERG changes are considered permanent. We report a patient who presented with a chronically retained intravitreal foreign body and significant clinical as well as electrophysiologic signs of siderosis. Only 3 months after surgery, the ERG showed almost complete recovery. If siderosis is not present, adequate and regular follow-up examinations may in certain cases substitute for immediate removal of chronically retained intraocular foreign bodies.
Over the centuries, the management of eyes with intraocular foreign bodies (IOFB) has posed a special challenge to the physician, and the anxiety created by such injuries has never abated. During the past few decades, several new diagnostic tests, IOFB removal techniques, and methods to treat the complications of the injury have been introduced. Nevertheless, old habits die hard: many of the management options that used to be standard are not appropriate any more but have proved difficult to change. This article reviews over forty of these die-hard myths and confronts them with factual statements published in the peer-review international literature.
OBJECTIVE: To evaluate a new surgical technique for traumatic macular holes and to provide epidemiological information for such holes. MATERIALS AND METHODS: Vitrectomy with internal limiting membrane (ILM) removal but without adjuvant use on 17 consecutive eyes. RESULTS: The hole closed in 100% of eyes. Vision improved > or = 2 Snellen lines in 16 eyes (94%). The macula showed additional trauma-related damage in 10 eyes (59%). No permanent complication related to ILM removal was seen. Among 4440 eyes with contusion trauma in the United States Eye Injury Registry, the risk of macular hole formation is 9 times higher in eyes closed than with open globe injury (1.4% versus 0.15%). CONCLUSIONS: Without introducing special risks, removal of the macular ILM appears to be a highly successful surgical option in improving vision in eyes with traumatic macular holes. The majority of eyes benefit from ILM removal, even when additional traumatic macular pathology is present.
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