RESUMEN
PURPOSE: To evaluate the preoperative factors influencing results of pneumatic retinopexy in patients with rhegmatogenous retinal detachment. METHODS: We analyzed retrospectively the preoperative and postoperative retinal findings, visual results, postoperative complications in 98 eyes of 98 patients who had undergone pneumatic retinopexy and followed for at least 3 months. RESULTS: Postoperatively visual acuity improved in 46 out of 59 patients whose preoperative visual acuity was equal to or less than 0.08, and in 20 out of 27 patients whose preoperative visual acuity was equal to or less than 0.5. The success rate of initial surgery was 75.5% and the final reattachment rate 99.0%. The anatomic success rate of each group did not differ in terms of the duration of retinal detachment, the size or quadrantal location of retinal break. The success rate was decreased when retinal detachment was broader or retinal breaks were multiple, although the difference was not statistically significant. The success rate was significantly lower when retinal break was located posterior to the equator than when retinal break was located on or anterior to the equator (40.0% vs 80.3%, 70.4%) (p=0.02). The main causes of failure in primary retinal reattachment were as follows: reopened retinal break in 8 eyes, new retinal break in 7 eyes, delayed absorption or shift of subretinal fluid in 5 eyes, proliferative vitreoretinopathy in 2 eyes, subretinal gas in 1 eye and endophthalmitis in 1 eye. CONCLUSIONS: Our results showed that the axial location of retinal break was the only preoperative factor influencing the success rate of pneumatic retinopexy. However, other factors may not be completely ruled out as influence factors for success rate considering the small number of patients in our study. Further study including larger series will be needed.
Asunto(s)
Humanos , Absorción , Endoftalmitis , Complicaciones Posoperatorias , Desprendimiento de Retina , Perforaciones de la Retina , Retinaldehído , Estudios Retrospectivos , Líquido Subretiniano , Agudeza Visual , Vitreorretinopatía ProliferativaRESUMEN
The purpose of this study was to evaluate alterations in corneal endothelial cell function and ultrastructure caused by benzalkonium chloride (BAC). Sixteen albino rabbits (32 eyes)were used for this study. One cornea of each matched pair was assigned to experimental group and the other cornea to control group. The experimental groups were divided into 4 groups, of which corneal endothelium were perfused with 0.01%, 0.001%, 0.0002%, and 0.0001% BAC. After paired rabbit corneas were isolated and mounted in the in vitro dual-chambered specular microscope, experimental corneas of each matched pair were perfused with different concentrations of BAC. Control corneas were perfused with glutathione-bicarbonate-Ringer solution(GBR). Corneal thickness was measured every 15 minutes throughout the perfusion period.Swelling rates were calculated by linear regression analysis, and compared to swelling rate of each paired mate perfused with GBR alone. At the end of perfusion,the corneas were fixed in 2.5%glutaraldehyde solution for transmission electron microscopy(TEM). Swelling rates of rabbit corneas perfused with BAC, 0.0001% did not differ significantly from control corneas (p>0.05). But, 0.0002%, 0.001%, and 0.01% BAC differed significantly from control corneas (p<0.05). BAC, 0.0001% showed normal corneal endothelial findings, but 0.0002% and 0.001% BAC showed reversible endothelial cellular injury. BAC, 0.01% showed irreversible endothelial cellular injury such as loss of nuclear membrane and disruption of cellular organelles. The results of this study indicate that long-term use of topical eye solutions containing BAC might induce corneal endothelial damage, especially in the absence of epithelial barrier such as corneal ulcer.