Ophthalmic Surgery, Lasers & Imaging

BACKGROUND AND OBJECTIVE: To evaluate the clinical results of reverse optic capture (ROC) with single-piece posterior chamber intraocular lenses (PC-IOLs) in cases of phacoemulsification cataract and IOL surgery with posterior capsular rupture. PATIENTS AND METHODS: Preoperative diagnosis, intraoperative events, surgical parameters, intraoperative and postoperative complications, and preoperative and postoperative visual acuity and refraction of 16 eyes that underwent ROC were reviewed and analyzed...

A modified Gundersen conjunctival flap combined with amniotic membrane to treat symptomatic bullous keratopathy and poor visual prognosis is described. A 360° conjunctival peritomy was performed 2 mm from the limbus. After complete epithelial removal of the corneo-conjunctival surface, an amniotic membrane graft was sutured at the peripheral cornea with a running 10-0 nylon suture. Single 9-0 polyglactin sutures attached the edges of the amniotic membrane with the peritomized conjunctiva, which lay over the amniotic membrane...

BACKGROUND AND OBJECTIVE: To compare anterior-segment optical coherence tomography (AS-OCT), ultrasound biomicroscopy (UBM), and direct visualization for detecting vitreous incarceration in sutureless sclerotomies. MATERIALS AND METHODS: Prospective, randomized, and observer-masked experimental study in which 23-gauge vitrectomy was performed in pig eyes. Postoperative incisional vitreous incarceration was evaluated by AS-OCT, UBM, and direct visualization. RESULTS: One hundred eighteen pig eyes were included...

BACKGROUND AND OBJECTIVE: To evaluate the changes in central corneal thickness (CCT), anterior chamber depth (ACD), and iridocorneal angle (ICA) with anterior segment optical coherence tomography (AS-OCT) following scleral buckling surgery. PATIENTS AND METHODS: Thirty-one eyes with rhegmatogenous retinal detachment that underwent scleral buckling were included in this prospective study. Changes in CCT, ACD, and ICA were measured with AS-OCT. RESULTS: There was a significant increase in the CCT at 1 day and 1 week postoperatively...

BACKGROUND AND OBJECTIVE: Birdshot chorioretinitis is a rare disease independently involving the retina and the choroid. Retinal involvement has deleterious functional consequences. This study aimed to follow retinal profiles in early (< 1 year, untreated), intermediate (1 to 6 years, receiving therapy), and late (> 6 years) birdshot chorioretinitis. PATIENTS AND METHODS: Optical coherence tomography images were retrospectively evaluated in 28 eyes and retinal thickness was calculated in the foveola, parafoveal nasal, and temporal area; nasal and temporal mid-peripheral macula; and nasal and temporal periphery of the macula...

BACKGROUND AND OBJECTIVE: To investigate the relationship between retinal vessel morphology (branching coefficient, bifurcation angle, and fractal analysis) and retinal nerve fiber layer (RNFL) thickness in an elderly population. PATIENTS AND METHODS: One hundred and one participants from the Lothian Birth Cohort 1936 (population of people all born in 1936) were studied. RNFL thickness measurements (using optical coherence tomography [OCT]) and digital retinal photographs were collected...

BACKGROUND AND OBJECTIVE: To evaluate the safety and efficacy of intraoperative subconjunctival bevacizumab as an adjunctive treatment after surgical excision of primary pterygium. PATIENTS AND METHODS: This was a randomized prospective clinical study. Group 1 (21 eyes) underwent pterygium excision with conjunctivo-limbal autograft. Group 2 (20 eyes) received subconjunctival 1.25 mg/0.05 mL of bevacizumab at the end of the surgery. RESULTS: There were no statistically significant differences regarding age, sex, laterality, or dimensions of the pterygia or grafts between the two groups (P > ...

BACKGROUND AND OBJECTIVE: To analyze the rationale for performing penetrating keratoplasty (PK) rather than Descemet's stripping automated endothelial keratoplasty (DSAEK) in patients with bullous keratopathy (BK) in Japan. PATIENTS AND METHODS: A total of 136 eyes of 130 patients with consecutive BK were enrolled. Patients treated by DSAEK were categorized as the DSAEK group. The remaining patients were considered unsuitable for DSAEK due to the presence of risk factors, and were treated by PK (PK group)...

BACKGROUND AND OBJECTIVE: To compare the postoperative refractive outcomes between IOLMaster biometry (Carl Zeiss Meditec, Inc., Dublin, CA) and immersion ultrasound biometry for axial length measurements. PATIENTS AND METHODS: Refractive outcomes in 354 eyes were compared using the IOLMaster and the immersion ultrasound biometry. Predicted refraction was determined using manual keratometry and the SRK-T formula with personalized A-constant. RESULTS: The axial lengths measured using the IOLMaster and immersion ultrasound were 24...

BACKGROUND AND OBJECTIVE: To demonstrate the effect of topical heparin combined with topical steroid on corneal neovascularization (CN) in children. PATIENTS AND METHODS: Four children (5 eyes) with new-onset progressive CN in at least one eye received topical rimexolone or dexamethasone in combination with heparin until complete regression of CN was obtained. The regression of CN was documented by slit-lamp or anterior segment photography. RESULTS: All 5 eyes showed complete regression of CN within 5 months...

Orbital infarction syndrome is a rare but devastating disorder resulting in sudden visual loss. A patient with orbital infarction syndrome due to orbital cellulitis after transcanalicular dacryocystorhinostomy with diode laser is described. A 55-year-old woman presented 3 days after transcanalicular dacryocystorhinostomy. Initial examination revealed significant eyelid swelling, marked proptosis, total ophthalmoplegia, and no light perception in the right eye. Fundus examination revealed ophthalmic artery occlusion...

The authors report a clinical and echographic correlation of a retinal vasoproliferative tumor that assumed a mushroom shape. A 64-year-old man with a history of retinal detachment repair presented with vitreous hemorrhage. A clinical examination including standardized ultrasound was performed, which revealed a mushroom-shaped tumor with high reflectivity. The patient underwent pars plana vitrectomy with fine needle aspiration biopsy. Histopathology of the biopsy specimen demonstrated vascular proliferation...

A 38-year-old man with longstanding low intraocular pressure (IOP) in his right aphakic eye presented with severe pain and high IOP (35 mm Hg). On examination, visual acuity was light perception. The central and peripheral portions of the iris were directly opposed to the posterior corneal surface and synechial closure of the pupil margin. B-scan ultrasonography showed posterior vitreous detachment. The patient was treated with topical cycloplegics, a topical beta-blocker, and a systemic hyperosmotic agent...

Retained Descemet's membrane (DM) following penetrating keratoplasty (PKP) is a rare finding that may reduce visual acuity following opacification or endanger the graft endothelium. The association between Nd:YAG laser membranotomy and corneal graft failure is reported. Five of 1,350 patients (0.37%) undergoing PKP for pseudophakic bullous keratopathy or graft failure between 1986 and 2008 presented with inadvertent retained DM located close to the graft endothelium. The membrane opacified within 3 to 4 months, reducing the patients' vision...

BACKGROUND AND OBJECTIVE: The management of evisceration and enucleation has changed over time. The authors assessed the practice patterns regarding eye removal among oculoplastic surgeons. PATIENTS AND METHODS: Internet-based surveys were sent to American Society of Ophthalmic Plastic and Reconstructive Surgeons members regarding preferences in evisceration and/or enucleation, including indications, surgical techniques, preoperative evaluation modalities, implant types used, and postoperative complications experienced...

The Constellation Vision System (Alcon Laboratories, Fort Worth, TX) introduces advanced technology with its new microsurgical platform that is growing in popularity. One significant obstacle noted with initial use is a frequent efflux of bubbles from the vitrector that sometimes appears like frothing from the port. Although seemingly innocuous, these bubbles rise in the vitreous cavity and obstruct the surgeon's view of the retina. This frequently necessitates increased surgical time to allow bubble evacuation to restore a clear view to the retina...

BACKGROUND AND OBJECTIVE: Oxidative stress and mitochondrial dysfunction are implicated in the pathogenesis of age-related macular degeneration (AMD). Because increased flavoprotein fluorescence (FPF) is indicative of mitochondrial dysfunction, the authors attempted to detect mitochondrial dysfunction in eyes with AMD using FPF. PATIENTS AND METHODS: Six nonexudative eyes with AMD, including three with geographic atrophy (GA), and age-matched control eyes were imaged with a FPF device...

BACKGROUND AND OBJECTIVE: To evaluate clinical features, course, and outcome of patients with acute exudative paraneoplastic polymorphous vitelliform maculopathy (AEPPVM). PATIENTS AND METHODS: Retrospective case series of 5 patients. RESULTS: There were 3 males and 2 females, with a median age of 74 years. The primary neoplasms were cutaneous melanoma (n = 2), choroidal melanoma (n = 1), lung adenocarcinoma (n = 1), and lung plus breast adenocarcinoma (n = 1)...

The author reports the use of pars plana air-fluid exchange in promoting adhesion of the donor endothelial graft to the host cornea during Descemet's membrane stripping with endothelial keratoplasty in the absence of an intact lens-iris diaphragm. A three-port pars plana 25-gauge core vitrectomy is performed, followed by the insertion of the endothelial graft into the anterior chamber with a glide. After the limbal incision and the paracentesis site are sutured, the air-fluid exchange is done from the vitreous cavity toward the anterior chamber until the eye is completely filled with air...

A novel surgical technique and novel surgical instrumentation for closing a pupil defect in a closed chamber eye is described. The technique was performed in a laboratory setting using ex-vivo porcine eyes using a 30-gauge deployment system to repair iris defects. Given the difficulty of suturing in a closed chamber eye, the use of an injectable, shape memory alloy clip offers the advantages of rapid, easy deployment and increased strength over conventional suture techniques.