Purpose is to o review the pathogenic mechanism for ocular hypertension and glaucoma development after pars plana vitrectomy. Both acute and chronic causes are considered and special attention is paid to the theories and clinical evidence on the risk of developing Open Angle Glaucoma (OAG) after Pars Plana Vitrectomy (PPV). Most existing scientific literature on the issue agree on the role of ascorbate as an oxygen scavenger within the vitreous chamber. Oxygen tension in the vitreous and anterior chamber is maximum inn proximity of the retinal surface and endothelium, respectively and steeply decreases toward the lens; on both sides, and trabeculate. Vitreous removal and, to a lesser extent, liquefaction, greatly reduces oxygen tension gradient in vitreous chamber while cataract extraction has similar effects on anterior chamber oxygen gradients. Oxygen derivatives originated from the cornea and retina are actively reduced by the vitreous gel and/or the crystalline lens. Vitreous removal and cataract extraction reduce drastically this function. Most reported clinical series confirm this hypothesis although protocol difference and follow-up length greatly impact the reliability of results.

Ascorbate; Pars Plana Vitrectomy; Open Angle Glaucoma; Oxidative Stress; Vitreous Me-tabolism 0. How to Use This Template

Pars plana vitrectomy is today a common first-line procedure for treatment of rhegma-togenous retinal detachment (RRD). Removal or preservation of the natural lens at the time of vitrectomy is associated with both advantages and disadvantages. The combi-nation of cataract extraction (i.e., phacoemulsification) with pars plana vitrectomy (PPVc) enhances visualization of the peripheral retina and the surgical management of the vitreous base. However, PPVc prolongs the surgical time and is associated with iatrogenic loss of the accommodation function in younger patients, possible postoperative aniso-metropia, and unexpected refractive results. Performance of pars plana vitrectomy alone (PPVa) requires good technical skills to minimize the risk of lens damage, and quickens cataract development. We retrieved all recent papers that directly compared PPVc and PPVa using parameters that we consider essential when choosing between the two procedures (the success rate of anatomical RRD repair, postoperative refractive error, intra and postoperative complications, and costs). PPVa and PPVc were generally comparable in terms of RRD anatomical repair. PPVc was associated with fewer intraoperative, but more postoperative, complications. Macula-off RRD PPVc treatment was often associated with undesirable myopic refractive error. PPVa followed by phacoemulsification was the most expensive procedure.

In this review, the author shows that ferritin has documented quantum dot material properties that have been reported in numerous independent studies and can generate coherent electron conduction bands over substantial distances, using quantum coherence. In addition, neuromelanin is a conjugated polymer, and quantum dot/conjugated polymer combinations have been reported in numerous independent studies to generate coherent electron conduction bands for solar photovoltaic applications. Both ferritin and neuromelanin are present in large quantities in the dopamine neurons of the substantia nigra pars compacta and the norepinephrine neurons of the locus coeruleus. The unique structure of subgroups of these neurons that have a large number of axon branches and synapses appears to have evolved to take advantage of these coherent electron conduction bands to coordinate conscious action. Independent clinical and laboratory studies are also reviewed that corroborate this theory of coordinated action in these neuron groups. Proposed research to validate the theory using an existing fluorescent probe material is proposed.

A newly-discovered physical mechanism involving electron tunneling in layers of the protein ferritin that are found in catecholaminergic neurons (catecholaminergic neuron electron transport or CNET), is hypothesized to support communication between neurons. Recent tests further confirm that these ferritin layers can also perform a switching function (in addition to providing an electron tunneling mechanism) that could be associated with action selection in those neurons, consistent with earlier predictions based on CNET. While further testing would be needed to confirm the hypothesis that CNET allows groups of neurons to communicate and act as a switch for selecting one of the neurons in the group to assist in reaching action potential, this paper explains how that hypothesized behavior would be consistent with Integrated Information Theory (IIT), one of a number of consciousness theories (CTs). While the sheer number of CTs suggest that any one of them is not sufficient to explain consciousness, this paper demonstrates that CNET can provide a physical substrate that is consistent with IIT and which can also be applied to other CTs, such as to conform them into a single explanation of consciousness.

We evaluated the closure of idiopathic full-thickness macular holes (MHs) the day after surgery in minimizing the burden and maximizing patient outcomes. Herein, 25-gauge pars plana vitrectomy, internal limiting membrane peeling, and fluid-gas (20% sulfur hexafluoride) were performed for the treatment. Patients were instructed to remain in the facedown position until the confirmation of MH closure, and the position was discontinued in cases where the closure was confirmed. In total, 43 eyes of 43 patients, whose average age was 69.7±8.6 years, were enrolled in this study. We used swept-source (SS)-optical coherence tomography (OCT) for the confirmation of MH closure for gas-filled eyes and used spectral domain (SD)-OCT for the reconfirmation of MH closure after the gas volume was reduced to less than half of the vitreous cavity. MH closure was confirmed in 40 eyes (93%, the closure group) on the next day after surgery. The time from surgery to SS-OCT imaging was 24.7 hours. Although facedown positioning was terminated in cases where MH closure was confirmed, there were no cases in which the MH was re-opened afterward. The basal and minimum MH size was significantly larger in the non-closure group than that in the closure group (p = 0.027, p = 0.043, respectively). Therefore, checking with SS-OCT the day after surgery and terminating facedown positioning in cases where MH closure was confirmed would be a useful method, removing great burden for the elderly without sacrificing the MH closure rate.