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Advances in vitreoretinal surgical techniques over the last twenty-five years have expanded the list of indications for vitreoretinal surgical treatment. There are several conditions in which macular oedema is associated with vitreous pathology that is amenable to surgical treatment. This article reviews the role of vitreoretinal surgery in the management of many of these conditions including pseudophakic macular oedema, epiretinal membranes, uveitis, vit-reomacular traction syndrome, and diabetic maculopathy.

The visual outcome of cataract surgery in diabetics with retinopathy is poorer than in non-diabetics, and appears to be particularly poor in eyes with maculopathyl. Postoperative macular oedema may represent clinically significant macular oedema unrecognized or untreated because of lens opacity, diabetic macular oedema stimulated or exacerbated by cataract surgery2–5, or a form of the Irvine Gass syndrome6,7. The reduction in incidence of postoperative astigmatism and inflammation associated with the adoption of small incision techniques for cataract surgery permits an attempt to redefine these syndromes, which we undertook using intraoperative and serial postoperative fundus fluorescein angiography.

We want to describe two unusual aspects of the diabetic retinopathy called Acute diabetic retinopathies.

The retinal pigment epithelium and the endothelial cells of the retinal vessels constitute two important cellular barriers which control the movement of substances and fluid into the retina. Both cellular layers may further influence the internal environment of the retina by actively transporting organic anions and fluid out of the retina. Functional failure of either layer results in intraretinal accumulation of fluid.

In the group of cases classifiable as chronic arteriolar capillaropathies therapy may be directed towards a pre-retinopathy initiating general state, the arteriolar stage of the retinopathy with its diminished perfusion pressure, the capillaropathy stage with its leaking capillaries and to the reaction stage with neovascularisation. There are discussed the value of each approach, proven or theoretical, singly or in combination. There is stressed the need to bear in mind the individual arteriolar capillary unit, a number of which even in the severe cases may still be able to maintain some circulation as evidenced by the persistence of some vision however slight. A few pence to a poor person may be a gift.

This chapter deals with the results of binkhorst lens implant operations performed by c. D. binkhorst, the only surgeon with a post-operative follow-up period of up to 15 years.

Before discussing the technique and the results of photocoagulation in diabetic retinopathy, it is important to consider its natural history, its prognosis and its preoperative evaluation.