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LETTER TO EDITOR
Year : 2005  |  Volume : 53  |  Issue : 3  |  Page : 210

Author's reply


Retina Foundation, Ahmedabad, India

Correspondence Address:
Kamal Nagpal
Retina Foundation, Near Shahibag Underbridge, Rajbhavan Road, Ahmedabad - 380 004
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Nagpal K, Nagpal M. Author's reply. Indian J Ophthalmol 2005;53:210

How to cite this URL:
Nagpal K, Nagpal M. Author's reply. Indian J Ophthalmol [serial online] 2005 [cited 2020 Jun 4];53:210. Available from: http://www.ijo.in/text.asp?2005/53/3/210/16688

Dear Editor,

We thank Dr Dubey for his interest in our article[1] and we would like to clarify some of the points he brought about.

1. By mentioning capillary non perfusion we meant any sign of obvious non perfusion. What we could not see because of masking effect of haemorrhages, we would not comment on, but there are cases where you can see capillary non perfusion in the periphery quite early. We mentioned that because we wanted to exclude obviously visible cases of ischaemic central retinal vein occlusion (CRVO), because as those cases probably would be better off with PRP to prevent ischaemic complications. It is our belief that radial optic neurotomy (RON) may not be able to help in these cases

2. We cleared haemorrhages by passively brushing the soft tip cannula gently over retinal the surface. We agree that these are intra retinal haemorrhages, but superficial and perhaps some sub internal limiting membrane haemorrhages do thin out. Under visualisation, one can see dense haemorrhages becoming relatively sparse after this manoeuvre (This can be seen on our surgical video recordings). We believe that this process diminishes the bulk and density of the haemorrhages, aiding postoperative recovery.

3. We agree that the role of liquid perfluorocarbon for compressing the fluid away from the macula is hypothetical, but by our clinical experience we do feel that it helps precipitate recovery both objectively and subjectively.

4. We agree that the multiple variables present in this study weaken our claim concerning the efficacy of RON in retinal re-perfusion, hastening of recovery and better post-CRVO clinical picture in a selected group of patients. A study could compare only vitrectomy and vitrectomy with RON, but RON without vitrectomy would go against the principles of vitrectomy as one would disturb the vitreous and make it prone to future retinal complications.



 
  References Top

1.
Nagpal M, Nagpal K, Bhatt C, Nagpal PN. Role of early radial optic neurotomy in central retinal vein occlusion. Indian J Ophthalmol 2005;53:115-8.  Back to cited text no. 1
    




 

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