Objective To evaluate the anatomical and functional results of retinotomy in treatment of complicated retinal detachment. Methods Twenty-three eyes were treated with retinectomy during vitrectomy for complicated retinal detachment with proliferative vitreoretinopathy when complete reattachment of retina was not obtained despite careful mambrane peeling. After released the peripheral vitreoretinal contraction or pulled subretinal membranes, perfluorocarbon liquid injection, laser retinopexy and silicone oil tamponade were performed. Retinotomy size ranged from 30-degree to 360-degree (average 132-degree). Results Retinal attachment were obtained in all of the operated eyes at the end of the operation. Silicone oil was removed from 15 eyes (65.0%) within 3~11 months postoperatively. After a minimum follow-up of 6 months, the retinae were completely attached in 17 eyes ( silicone oil was not removed in 4 eyes ) and visual acuity of 0.02 or better was obtained in 11 eye (48.0%). Recurrent retinal detachment occurred in 2 eyes in which the silicone oil had been removed. The major complications were recurrence of the proliferation in 6 eyes (26.0%) and hypotony in 3 eyes (13.0%). Conclusion Retinotomy is beneficial to reattach the retina for eyes with advanced proliferative vitreoretinopathy in seemin gly inoperable cases. (Chin J Ocul Fundus Dis,2001,17:87-89)
OBJECTIVE:To evaluate the therapeutic effect of acetazolamide treatment on chronic cystoid macular edema (CME). METHODS:Thirty-seven patients (40 eyes)with documented chronic CME of various causes were prospectively treated for 4-week periods with acetazolamide or a placebo in a randomised,crossover study that compared their effects on the reduction of macular edema and improvement of visual functions. Central retinal artery(CRA) blood flow was determined using Doppler velocimetry and vessel diameter measurement using computerised digital image analysis of monochromatic fundus photographs on 10 patients (12 eyes)with CME pre-and post-administration of acetazolamide. RESULTS:More than half the patients showed a response to acetazolamide with partial or complete resolution of. edema. Thirty eyes had improved in visual acuity in the treated patients. Statistically significant improvement were seen in 10deg; thresholds of visual field and ERG b wave amplitude. No improvement was seen when the patients received placebo. There were significant increase of blood flow velocity in CRA and retinal vessels diameter after acetazolamide were administered 3 hours later in CME patients (Plt;0.05). CONCLUSION: Acetazolamide could be of value in reducing the degree of edema and improving visual function to chronic CME. The improvement on retinal circulation might be a major cause to limit the CME. (Chin J Ocul Fundus Dis,1997,13: 89-92)