• Idiopathic macular holes are generally considered an untreatable condition. We used modern vitrectomy techniques to evaluate two questions: (1) Is it possible to reattach the retina around the macular hole? (2) If it is reattached, will the patient's central vision improve? In 30 (58%) of 52 patients, we were able to reattach successfully the detached macula with our surgical procedure. In 22 (73%) of the 30 patients in whom the macula was successfully reattached, there was an improvement in visual acuity of two lines or better. In the 22 patients in whom reattachment of the macular hole was not obtained, there was no significant improvement in visual acuity. Thus, the overall success rate for improved vision postoperatively was 42% (22/52). Complications related to surgery were observed in eight patients (15%) early in our experience with this procedure and included increase in the size of the macular hole, mottling of the retinal pigmented epithelium, and a vascular occlusion. Our clinical observations indicate that the treatment of macular holes by vitrectomy may offer some promise for this otherwise untreatable condition. In patients in whom reattachment was successful, the technique used appeared to allow for clinically significant improvements in visual acuity. However, additional work on increasing surgical success and minimizing surgical complications, as well as a further understanding of the mechanism of retinal reattachment, is required before widespread use of this procedure for treating macular holes.

Vitreous surgery for idiopathic macular holes. Results of a pilot study.

https://deepblue.lib.umich.edu/bitstream/handle/2027.42/26516/0000054.pdf;sequence=1

Wound healing in glaucoma filtering surgery.

Our understanding of glaucoma has undergone dramatic changes in the past decade. The ferment has derived from new epidemiologic information, improved diagnostic methods, and developments in surgical and drug therapy. This review concentrates on primary open-angle glaucoma, the most prevalent form of the disorder in Western countries. Definition Primary open-angle glaucoma usually affects both eyes and combines a particular abnormal appearance of the optic disk (optic-nerve head) with a slowly progressive loss of visual sensitivity (Figure 1). The characteristic appearance of the glaucomatous optic disk is visible by ophthalmoscopy (Figure 2). The present standard for determining visual loss in glaucoma . . .

Open-Angle Glaucoma

Glutathione-dependent protection against oxidative injury.

Vitreous Surgery for Macular Holes

Anterior Chamber Tube Shunt to an Encircling Band in the Treatment of Neovascular Glaucoma

Deferoxamine (Desferal)-induced toxic retinal pigmentary degeneration and presumed optic neuropathy.

Cataracts removed intracapsularly by cryoprobe technique from human diabetics were analyzed for sugars and polyols by gas liquid chromatography. The contents of sorbitol and fructose of lenses followed blood glucose levels at least up to 250 mg/dl. Studies indicate thai human lens is capable of synthesizing substantial amounts ofpolyol pathway metabolites given exposure to high glucose levels such as are prevalent in diabetes. The synthesis of sorbitol was found to be susceptible to quercitrin, an inhibitor of aldose reductase. The implications of these findings in the formation of cataracts in diabetic individuals have been discussed.

Stanley S. Schocket

Papers

Anterior Chamber Tube Shunt to an Encircling Band in the Treatment of Neovascular Glaucoma

Deferoxamine (Desferal)-induced toxic retinal pigmentary degeneration and presumed optic neuropathy.

Implications of aldose reductase in cataracts in human diabetes.

Anterior chamber tube shunt to an encircling band in the treatment of neovascular glaucoma and other refractory glaucomas. A long-term study.

Clindamycin in the treatment of toxoplasmic retinochoroiditis.