[Long-term results and prognosis in pars plana vitrectomy in complications of diabetic retinopathy].
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Biomedical subjects
Publications and source records attributed to I Karel.
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Twenty-one patients were followed up for at least 6 months after pars plana vitrectomy and liquid silicone injection into the vitreous for complicated retinal detachment by means of specular microscopy. In 17 eyes without silicone penetration into the anterior chamber, only insignificant changes were observed. In contrast, in 4 eyes, where a large drop of liquid silicone penetrated into the anterior chamber, the cell densities rapidly decreased to critical values and a marked pleomorphism of large endothelial cells with abnormal intracellular details indicated serious damage of the surviving cells. A characteristic structureless reflecting layer with contourlike lines in some areas of the specular image was a newly observed bizarre change that was caused by the replacement of the anterior chamber fluid by liquid silicone with markedly different optical properties.
Specular microscopic and histopathologic findings in the corneal endothelium were compared after the injection of liquid silicone into the anterior chamber of both eyes in 15 rabbits. The findings demonstrated serious damage to the endothelium in the area of contact of liquid silicone with the posterior surface of the cornea and disclosed some problems in the interpretation of specular microscopic findings. An abnormal endothelial mosaic can be probably found even in a zone of preserved intercellular borders or in a zone with a relief of the bases of extinct endothelial cells.
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In five patients suffering from retinal detachment resulting from macular holes, simple fixation of the macular Silastic sponge implant by means of Dacron-reinforced silicone sheeting was employed. The retinal reattached in all cases.
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