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V De Molfetta

Publications and source records attributed to V De Molfetta.

At least 19 recordsLinked to original sources
PubMed1999

Surgical removal of subfoveal choroidal neovascular membranes in high myopia.

BACKGROUND: A study was carried out to elucidate the anatomical and functional outcome after surgical excision of subfoveal choroidal neovascular membranes in high myopia. METHODS: Sixty-five patients with high myopia (> or =6 diopters), well-defined subfoveal neovascular membranes on fluorescein angiography and preoperative visual acuity < or =20/100 were selected for surgery. A standardized surgical technique was used in all cases, by a single surgeon. The main outcomes assessed were Snellen visual acuity, surgical retinal pigment epithelium defect and postoperative perfusion of the choriocapillaris. Multifactor analysis of variance and chi-square/Fisher's exact test statistics were used to assess the association between patients' pre- and postoperative characteristics and outcome measures. RESULTS: Follow-up ranged from 6 to 48 months (mean 16 months). Mean postoperative visual acuity (0.18) was significantly better than mean preoperative visual acuity (0.09). Visual acuity improved by at least two lines in 29 eyes (45%) and was unchanged in 24 (37%). Overall, 43 eyes (66%) had visual acuity of 20/200 or better and 15 (23%), 20/60 or better. Predictive factors with a significant effect on final visual acuity were mean visual acuity, preoperative status of retinal pigment epithelium and postoperative perfusion of the choriocapillaris. Postoperative perfusion was detected in 31 (48%) of the total 65 eyes and in 12 (67%) of the 18 eyes with normal retinal pigment epithelium at baseline. The mean postoperative retinal pigment epithelium defect was 4.6 times larger than the original neovascular membrane. In selected patients, SLO macular scotometry showed areas of retained retinal sensitivity within the atrophic scar. CONCLUSION: The natural history of subfoveal neovascularization in high myopia is rarely visually restorative. By contrast, surgical excision of the membranes is feasible and may restore visual acuity in selected patients. This therapeutic approach merits a formal multicenter clinical trial.

Adolescent↗
PubMed1998

Effect of decreasing surface and interface irregularities after photorefractive keratectomy and laser in situ keratomileusis on optical and functional outcomes.

PURPOSE: To assess a new method for decreasing corneal ablated surface irregularities after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) by performing a final smoothing immediately after the treatment. METHODS: One hundred forty-seven eyes with ablation irregularities after PRK or LASIK using the Nidek ED-5000 excimer laser and examined with the Nidek EAS 1000, were randomized into two groups: 74 eyes had final smoothing and 73 eyes were patched immediately. Preoperative mean refraction for the smoothing group was -7.55 +/- 2.50 D and for the patched group, it was -7.30 +/- 1.90 D, (p = 0.04). RESULTS: AT 12 months after treatment, mean haze was 0.5 +/- 0.3 in the smoothing group and 1.2 +/- 0.4 in the patched group (p = 0.006); mean spectacle-corrected visual acuity was 1.1 +/- 0.25 in the smoothing group and 0.95 +/- 0.18 in the patched group (p = 0.02); the percentages of eyes within 1.00 D of the planned correction was 68% in the smoothing group and 33% in the patched group. CONCLUSION: Performing a final smoothing immediately after PRK or LASIK improves refractive and optical outcomes.

Adult↗
PubMed1998

A method for examining surface and interface irregularities after photorefractive keratectomy and laser in situ keratomileusis: predictor of optical and functional outcomes.

PURPOSE: To develop a system for the examination of the ablated surface after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) and to correlate the surface regularity to the functional outcome. METHODS: A Nidek Eas-1000 Anterior Eye Segment Analysis System was used to examine the ablated surface or the interface regularity immediately after PRK and LASIK. Eighty eyes were evaluated and divided into three study groups; group 1; regularity (18 eyes), group 2; mild irregularity (32 eyes) group 3; severe irregularity (30 eyes). RESULTS: At 12 months postoperatively, group 1 (regularity) showed the best percentage of eyes with 0 haze (100%) and with a refraction +/- 1.00 D of plano (89%); group 2 (mild irregularity) 84% had 0 haze and 62% were +/- 1.00 D of plano; group 3 (severe irregularity) 27% had 0 haze and 47% were +/- 1.00 D of plano. CONCLUSION: The patients with no postoperative irregularity had a sharply lower incidence of haze and a better refractive outcome with respect to plano, confirming the influence of ablation regularity on the results and the importance of this analysis in clinical practice.

Cornea↗
PubMed1996

Indocyanine green and fluorescein angiography of surgically excised macular choroidal neovascularizations: correlations with histopathologic and ultrastructural findings.

BACKGROUND: Informations are expected from the histopathological study of surgically excised choroidal neovascular membranes (CNMs), particularly in relation to the angiographic aspects of vascular architecture. METHODS: Fluorescein and indocyanine green (ICG) angiograms were studied together with the histopathological features of 12 surgically excised subfoveal CNMs in eyes affected by age-related macular degeneration (ARMD). RESULTS: Instead of the early and delayed diffuse hyperfluorescence secondary to CNMs observed on fluorescein angiography (seven were well defined, five scar evolved), ICG revealed (a) very early hypofluorescence of the membrane bulk over the fluorescence of the outer choroidal vascular bed and (b) late hyperfluorescence gradually increasing and partially defining the border of membranes. CNMs with well-defined hyperfluorescent aspects were characterized by fibrovascular bulk lined on one side by retinal pigment epithelium. Fibrosis reaction predominated over the vascular components in scar-evolved membranes. CONCLUSIONS: Fluorescein and ICG angiographic differences in the appearance of CNMs could depend on (a) the morphological structure and size of the CNM (b) its location within the chorioretinal layers and (c) different molecular characteristics of the dyes used.

Aged↗
PubMed1996

Surgical removal of idiopathic, myopic and age-related subfoveal neovascularization.

BACKGROUND: We investigated the functional outcomes of macular surgery for idiopathic, myopic and age-related subfoveal neovascular membranes and looked for preoperative features associated with better final visual acuity (VA). METHODS: We retrospectively studied 61 patients who had undergone macular surgery in our department between October 1992 and September 1994. Follow-up ranged from 5 to 27 months. Of 61 eyes with subfoveal neovascularizations, 6 were idiopathic, 21 had high myopia (-13 D median) and 34 displayed age-related macular degeneration (AMD). Median preoperative VA was 5/200 in AMD, 20/300 in myopia and 20/200 in idiopathic cases. RESULTS: Four of the six eyes with idiopathic subfoveal neovascularization had VA 20/60 or better after a median follow-up of 18 months. Of the 21 eyes with high myopia, 10 (48%) improved and 13 (62%) were 20/200 or greater after a median follow-up of 12 months. Among the 34 eyes with AMD, VA improved in 7 (21%), but only 6 (18%) were 20/200 or better after a median follow-up of 7 months. Overall, complications included five retinal detachments, ten cataracts and an increase in size of the retinal pigment epithelium defect over the neovascular membrane of 2.3 +/- 0.8 times (mean +/- SD) in idiopathic eyes. 5.9 +/- 3.6 times in myopia and 19.5 +/- 12.2 times in AMD. Recurrence rates for idiopathic, myopic and age-related neovascular membranes were 33%, 19% and 18% respectively. Etiology (P = 0.035), initial VA in myopic eyes (P = 0.026) and initial size of the neovascular membranes in AMD (P = 0.025) were preoperative factors with a significant effect on final visual outcome. CONCLUSIONS: Surgical excision of subfoveal neovascular membranes yields different functional results depending on the underlying disease. Severe alteration of the retinal pigment epithelium-Bruch's membrane complex may be responsible for the poor visual outcomes in AMD.

Adolescent↗
PubMed1993

Perfluorocarbon liquids as postoperative short-term vitreous substitutes in complicated retinal detachment.

To avoid postoperative "compartmentalization" of the vitreous cavity, which can potentially accelerate the recurrence of proliferative vitreoretinopathy (PVR), 32 eyes of 32 selected patients with complicated retinal detachment were managed with lensectomy, vitrectomy, 5-day internal tamponade with perfluorocarbon liquids (PFCL) and postoperative supine positioning until PFCL removal. Intraoperatively, 19 eyes had grade C3 or greater PVR; 10 eyes exhibited ocular trauma and 6 displayed giant tears. All but 5 patients (PFCL/fluid exchange) underwent PFCL/silicone oil exchange 5 days after surgery. Anatomic attachment of the retina was achieved with one operation in 25 (78%) of the 32 eyes with a median follow-up of 8 months (mean 8.4 months). Of the 20 eyes that underwent silicone oil removal, none redetached. Nineteen eyes (61%) showed no or only mild reproliferation; a macular pucker developed in 50% of the 20 eyes successfully reattached after PFCL/silicone oil exchange and in none of the 5 eyes successfully reattached after PFCL/fluid exchange. Intraocular tolerance of PFCL for up to 5 days of internal tamponade appeared to be good as judged by static threshold perimetry in the two patients tested and by our functional outcomes, with 88% of the reattached eyes showing a final visual acuity of 5/200 or better.

Adolescent↗
PubMed1992

The effect of simultaneous internal tamponade on fluid compartmentalization and its relationship to cell proliferation.

To determine whether the residual free spaces within the vitreous chamber that result after vitreoretinal surgery and internal tamponade may be avoided, and to verify whether such compartmentalization is of real importance in the recurrence of postoperative proliferative vitreoretinopathy (PVR), the use of simultaneous double filling with polydimethylsiloxane (PDMS) and fluorosilicone (FSiO) in the repair of complicated retinal detachment is evaluated in 12 selected cases. Initial retinal reattachment was achieved in all cases. PVR recurred in 10 patients (83%), 6 of whom showed partial retinal detachment. Inferior and superior postoperative residual free spaces were abolished by this procedure, but a new residual fluid space was created, lying horizontally between the bubbles and expanding in a triangular shape nasal to the optic disc and temporal to the macula. Overall, 9 of 10 eyes with PVR after surgery had proliferation involving these areas. These findings support the concept that compartmentalization is of major importance in determining postoperative cell proliferation.

Adult↗
PubMed1992

Combined silicone and fluorosilicone oil tamponade (double filling) in the management of complicated retinal detachment.

We evaluated the use of simultaneous double filling with polydimethylsiloxane (PDMS) and fluorosilicone (FSiO) in the repair of complicated retinal detachment in 12 selected cases. Initial retinal reattachment was achieved in all cases. Proliferative vitreoretinopathy (PVR) recurred in 10 patients (83%), 6 of which showed partial retinal detachment. Inferior and superior postoperative residual free spaces were abolished by this procedure, but a new residual fluid space was created, lying horizontally between the bubbles and expanding in a triangular shape nasally to the optic disk and temporally to the macula. Overall, 9 of 10 eyes with postoperative PVR had proliferation involving these areas. These findings support the concept that 'compartmentalization' is of major importance in determining postoperative cell proliferation.

Adult↗
PubMed1991

Open noncontrolled multicenter long-term trial with ciclosporin in endogenous non-infectious uveitis.

The efficacy, tolerability and safety of low doses (5-7 mg/kg/day) of oral ciclosporin (CS) for treatment of endogenous uveitis resistant to conventional therapy were studied in an open, noncontrolled, multicenter long-term trial. CS was shown to be effective for patients with posterior or intermediate noninfectious uveitis; it limited the progression of the disease, decreased the number and severity of inflammatory relapses, and improved visual acuity while reducing signs of intraocular inflammation. Moreover, in corticodependent patients, a steroid-sparing effect was also obtained. At low doses and by means of the careful monitoring of safety parameters, the side effects (especially renal function impairment) were well controlled. Efficacy was maintained during long-term treatment.

Adult↗
PubMed1979

Residual corneal astigmatism after perforating keratoplasty.

A statistical analysis was made of post-operative astigmatism after perforating keratoplasty in subjects with various corneal diseases. A total of 100 cases were analyzed on discharge (25th day) and 6 months after surgery. The degree of astigmatism and its time course was assessed, and its effect on post-operative visual acuity was investigated, including any changes resulting from removal of the continuous suture. Mean astigmatism values were 4 dioptres on discharge and 4.2 dioptres after 6 months. No statistically significant relation was found between degree of astimatism and recovery of visual acuity.

Adolescent↗