[Retinal detachment and vitreoretinal heredodegeneration].
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Biomedical subjects
Publications and source records attributed to Y M Tardif.
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All patients were examined preoperatively and postoperatively by indirect ophthalmoscopy and biomicroscopy with a three-mirror lens. The average follow-up was eight months. Our technique of sclerotomy consisted of an incision parallel to the limbus, measuring 1.5 times the diameter of the surgical instrument. The pars plana location was always verified with transillumination. A mattress suture over the lips of the sclerotomy was used to prevent any leakage during the procedure. The intraoperative complications included ciliary body laceration (1%), retinal tears (8%), and vitreous base incarceration in the wound. The postoperative complications consisted of retina dragged into the wound (4%), vitreous tract left by the instrument (6%), neovascular ingrowth (6%), and external symptoms from the Dacron (32%) or polyglycolic acid (5%) suture. The rate of complications is considered low for such high-risk surgery.
Ten eyes developed fibrovascular ingrowth from the sclerotomy following closed vitreous surgery. The complication was detected by examining all patients postoperatively by indirect ophthalmoscopy and biomicroscopy with a three-mirror lens. The average follow-up was 13.2 months. Nine patients had proliferative retinal disease prior to surgery and related systemic disease. In six eyes, useful vision was lost due to the ingrowth. In three eyes, a stabilization occurred. In one eye, that of a 12-year-old girl with an undefined syndrome of cochlear and retinal neovascularization, the ingrowth involuted. Rubeosis iridis was observed in 6 eyes that developed vascular ingrowth as opposed to 11 eyes in a control group of 78 eyes. Eyes with rubeosis iridis should not have vitreous surgery, and careful dissection of the Tenon capsule should be done over the sclerotomy.