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Cyanoacrylate Tissue Adhesive in the Management of Recurrent Retinal Detachment Caused by Macular Hole
616
May, 1990
AMERICAN JOURNAL OF OPHTHALMOLOGY
guish the patients who will benefit from postoperative subconjunctival 5-fluorouracil from those who are more likely to suffer complications. We cannot, however, overemphasize that the results reported simply reflect the clinical course of patients during the first year. It is too early to draw conclusions regarding either the long-term safety or efficacy of 5-fluorouracil as an adjunct to filtering surgery. This underscores the need for the vigilant follow-up of all patients in the study. THE FLUOROURACIL FILTERING SURGERY STUDY GROUP
Miami, Florida
detachment with macular hole, especially in patients with proliferative vitreoretinopathy in the posterior pole. In selected patients, the use of radial retinotomy in the macula might obviate the need for cyanoacrylate retinopexy. JERALD A. BOVINO, M.D. DANIEL F. MARCUS, M.D.
Toledo, Ohio Reference 1. Bovino, J. A., and Marcus, D. F.: Radial retinotomy in the macula. Retina 4:123, 1984.
_ _ _ _ _ _ _ Reply Cyanoacrylate Management Detachment
Tissue Adhesive in the of Recurrent Retinal Caused by Macular Hole
EDITOR;
The article, "Cyanoacrylate tissue adhesive in the management of recurrent retinal detachment caused by macular hole," by S. M. Sheta, T. Hida, and B. W. McCuen (Am. J. Ophthalmol. 109:28, January 1990), describes a valuable new tool for the vitreoretinal surgeon to manage failed retinal detachments with macular holes. In the discussion, the authors review previous surgical options for the management of failed retinal detachment with macular hole, including pneumatic retinopexy, vitrectomy with fluid-air exchange, and macular coagulation or buckling. We reported a technique of using radial retinotomy around the edges of a macular hole to treat failed retinal detachments with epiretinal membranes.' This technique should be considered as an additional surgical option in the management of retinal
_
EDITOR:
We thank Dr. Bovino and Dr. Marcus for pointing out their technique of radial retinotomy in the macula as an additional method of dealing with recurrent retinal detachment secondary to macular holes. They reported success with this technique in the only patient who would fit our criteria for inclusion. We reemphasize that we used cyanoacrylate retinopexy in our patients to avoid techniques with potentially higher risks and complications. We would consider a technique in which retinal cuts are made in the center of the fovea to be potentially more risky than simply closing the retinal break without enlarging it. SHERIF M. SHETA, M.D.
Cairo, Egypt
TETSUO HIDA, M.D.
Tokyo, Japan BROOKS W. MCCUEN II, M.D.
Durham, North Carolina
May, 1990
AMERICAN JOURNAL OF OPHTHALMOLOGY
guish the patients who will benefit from postoperative subconjunctival 5-fluorouracil from those who are more likely to suffer complications. We cannot, however, overemphasize that the results reported simply reflect the clinical course of patients during the first year. It is too early to draw conclusions regarding either the long-term safety or efficacy of 5-fluorouracil as an adjunct to filtering surgery. This underscores the need for the vigilant follow-up of all patients in the study. THE FLUOROURACIL FILTERING SURGERY STUDY GROUP
Miami, Florida
detachment with macular hole, especially in patients with proliferative vitreoretinopathy in the posterior pole. In selected patients, the use of radial retinotomy in the macula might obviate the need for cyanoacrylate retinopexy. JERALD A. BOVINO, M.D. DANIEL F. MARCUS, M.D.
Toledo, Ohio Reference 1. Bovino, J. A., and Marcus, D. F.: Radial retinotomy in the macula. Retina 4:123, 1984.
_ _ _ _ _ _ _ Reply Cyanoacrylate Management Detachment
Tissue Adhesive in the of Recurrent Retinal Caused by Macular Hole
EDITOR;
The article, "Cyanoacrylate tissue adhesive in the management of recurrent retinal detachment caused by macular hole," by S. M. Sheta, T. Hida, and B. W. McCuen (Am. J. Ophthalmol. 109:28, January 1990), describes a valuable new tool for the vitreoretinal surgeon to manage failed retinal detachments with macular holes. In the discussion, the authors review previous surgical options for the management of failed retinal detachment with macular hole, including pneumatic retinopexy, vitrectomy with fluid-air exchange, and macular coagulation or buckling. We reported a technique of using radial retinotomy around the edges of a macular hole to treat failed retinal detachments with epiretinal membranes.' This technique should be considered as an additional surgical option in the management of retinal
_
EDITOR:
We thank Dr. Bovino and Dr. Marcus for pointing out their technique of radial retinotomy in the macula as an additional method of dealing with recurrent retinal detachment secondary to macular holes. They reported success with this technique in the only patient who would fit our criteria for inclusion. We reemphasize that we used cyanoacrylate retinopexy in our patients to avoid techniques with potentially higher risks and complications. We would consider a technique in which retinal cuts are made in the center of the fovea to be potentially more risky than simply closing the retinal break without enlarging it. SHERIF M. SHETA, M.D.
Cairo, Egypt
TETSUO HIDA, M.D.
Tokyo, Japan BROOKS W. MCCUEN II, M.D.
Durham, North Carolina