Anterior hyaloid membrane dissection using the conventional surgical microscope: a novel surgical approach in 2 patients

Background To describe the dissection and removal of the anterior hyaloid membrane using the conventional surgical microscope. Case presentation This microscopic surgical approach involves dissecting the anterior hyaloid at the natural anatomical plane. A 30-gauge needle mounted on a 3.0 cc syringe is used to inject filtered air anterior to the anterior hyaloid membrane. Two patients needed this procedure; the first patient was pseudophakic with proliferative diabetic retinopathy, tractional retinal detachment, and vitreous hemorrhage. The second patient was phakic with proliferative diabetic retinopathy, anterior proliferative vitreoretinopathy, and recurrent vitreous hemorrhage. Both patients tolerated the procedure well with no complications. Conclusion Pneumatic dissection of the anterior hyaloid membrane is previously thought to be only possible with the aid of ophthalmic endoscopy. This novel surgical approach provides surgeons with the option to perform pneumatic dissection of the anterior hyaloid when ophthalmic endoscopy is not available. Prospective studies are needed to reveal possible additional benefits or risks associated with this approach.

Abdominal Cocoon in an Adolescent Male

Abdominal cocoon is an uncommon peritoneal condition characterized by partial or complete encasement of small bowel by a thick rind of fibrous tissue and adhesions. Only few cases of this disease have been reported in world literature. The etiology of this condition is unknown, and most often it is found in adolescent girls from tropical or subtropical countries, and usually diagnosed incidentally on exploration. Surgery (membrane dissection and extensive adhesiolysis) is the treatment of choice. Here, we report a case of abdominal cocoon in a 20-year-old male patient, with a brief review of the literature. DOI: http://dx.doi.org/10.3126/kumj.v10i4.11009 Kathmandu Univ Med J 2012;10(4):83-86