Felipe U. Huamonte

Photocoagulation Treatment of Proliferative Diabetic Retinopathy: The Second Report of Diabetic Retinopathy Study Findings

Data from the Diabetic Retinopathy Study (DRS) show that photocoagulad inhibited the progression of retinopathy. These beneficial effects were noted to some degree in all those stages of diabetic retinopathy which were included in the Study. Some deleterious effects of treatment were also found, including losses of visual acuity and constriction of peripheral visual field. The risk of these harmful effects was considered acceptable in eyes with retinopathy in the moderate or severe retinopathy in the moderate or severe proliferative stage when the risk of severe visual loss without treatment was great. In early proliferative or severe nonproliferative retinopathy, when the risk of severe visual loss without treatment was less, the risks of harmful treatment effects assumed greater importance. In these earlier stages, DRS findings have not led to a clear choice between prompt treatment and deferral of treatment unless and until progression to a more severe stage occurs.

Reduction of immediate complications after panretinal photocoagulation.

With the use of either argon laser or xenon arc panretinal photocoagulation, 42 eyes with diabetic retinopathy were treated in two or more sessions at least 2 weeks apart. In the week following completion of photocoagulation, choroidal detachment was noted in 34 eyes (81%), shallowing of the anterior chamber in 16 eyes (38%), exudative retinal detachment in 5 eyes (12%), and increased intraocular pressure in 3 eyes (7%). These complication rates are lower than those reported in a similar series of 50 eyes in which panretinal photocoagulation was completed in 1-3 days. RETINA 4:166-170, 1984

Dark-without-pressure fundus lesions.

Seven black patients had dark brown homogeneous geographical areas of the fundus. Six cases were associated with sickle cell haemoglobinopathies and one was associated with systemic hypertension. These flat lesions were uniform in colour and occurred in the posterior pole or in the midperiphery. They appeared to be transient and often disappeared leaving no residue. The cause is unknown. By analogy with white-without-pressure fundus lesions, we have called these areas dark-without-pressure.

Vitreous Scissors and Forceps

Vitreous scissors with bent blades and forceps of larger than usual dimension were developed for removal of inflexible membranes and intraocular foreign bodies.

Fifty consecutive eyes with anterior segment disease treated by the pars plana approach.

Results of a pars plana approach using the Peyman vitrophage to treat various anterior segment diseases are presented in 48 patients (50 eyes). These included cases of ocular trauma, congenital cataracts, complications following unplanned and planned extracapsular cataract extractions and phacoemulsification, and dense secondary membranes. Visual acuity improved in 86%, remained unchanged in 10% and worsened in 4% of all eyes.