Vitrectomy Combined with Intraoperative Dexamethasone Implant for the Management of Refractory Diabetic Macular Edema

PURPOSE: To evaluate the 1-year results of vitrectomy performed in combination with intraoperative dexamethasone implant for tractional and nontractional refractory diabetic macular edema (DME). METHODS: Thirteen eyes from 13 subjects who were diagnosed with tractional DME and 17 eyes from 17 subjects who were diagnosed with nontractional refractory DME underwent vitrectomy and dexamethasone implant injection. Changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) during the one year following vitrectomy were evaluated in each group. Additionally, changes in intraocular pressure and other complications were investigated postoperatively. RESULTS: In eyes with tractional DME, a statistically significant improvement in BCVA was noted at 3, 6, and 12 months, and a statistically significant improvement in CMT was noted at 1, 3, 6, and 12 months from baseline after vitrectomy (p < 0.05). In eyes with nontractional refractory DME, a statistically significant improvement in BCVA was noted at 12 months, but there were no significant improvements in CMT despite the tendency to decrease from baseline. Sixteen (53.3%) of the 30 eyes included in this study showed intraocular pressure elevation, which was addressed using antiglaucoma medication, and there were no other severe complications. CONCLUSIONS: Vitrectomy combined with intraoperative dexamethasone implant may be safe and effective in treating DME, especially tractional DME. In this study, patients with nontractional DME required more additional treatments and time for anatomical and functional improvement compared to patients with tractional DME.

Poorly Differentiated Neuroendocrine Carcinoma of the Eyelid

PURPOSE: To report a case of poorly differentiated neuroendocrine carcinoma of the eyelid. CASE SUMMARY: A 70-year-old male presented with a 5-month history of a right upper eyelid mass. The mass appeared as 1.2 × 1.2 cm on the right upper eyelid. A mass excision was performed under frozen section control. The tumor was completely excised with a safety margin clearance and an upper eyelid reconstruction was performed. Histopathological examination revealed a tumor composed of small atypical cells which showed a high nuclear/cytoplasm ratio, nuclear molding, and increased mitotic activity. Immunohistochemical examination revealed positive reactivity for Ki-67, synaptophysin, CD56, and negative reactivity for chromogranin, cytokeratin 20, and thyroid transcription factor-1. CONCLUSIONS: Primary neuroendocrine carcinoma of the eyelid is extremely rare, but the tumor has high malignancy and readily metastasizes. Poorly differentiated neuroendocrine carcinoma should be considered in the differential diagnosis of a rapidly growing eyelid mass.

Comparison of Intraocular Lens Power Calculation Methods Following Myopic Laser Refractive Surgery: New Options Using a Rotating Scheimpflug Camera

PURPOSE: To evaluate and compare published methods of calculating intraocular lens (IOL) power following myopic laser refractive surgery. METHODS: We performed a retrospective review of the medical records of 69 patients (69 eyes) who had undergone myopic laser refractive surgery previously and subsequently underwent cataract surgery at Samsung Medical Center in Seoul, South Korea from January 2010 to June 2016. None of the patients had pre-refractive surgery biometric data available. The Haigis-L, Shammas, Barrett True-K (no history), Wang-Koch-Maloney, Scheimpflug total corneal refractive power (TCRP) 3 and 4 mm (SRK-T and Haigis), Scheimpflug true net power, and Scheimpflug true refractive power (TRP) 3 mm, 4 mm, and 5 mm (SRK-T and Haigis) methods were employed. IOL power required for target refraction was back-calculated using stable post-cataract surgery manifest refraction, and implanted IOL power and formula accuracy were subsequently compared among calculation methods. RESULTS: Haigis-L, Shammas, Barrett True-K (no history), Wang-Koch-Maloney, Scheimpflug TCRP 4 mm (Haigis), Scheimpflug true net power 4 mm (Haigis), and Scheimpflug TRP 4 mm (Haigis) formulae showed high predictability, with mean arithmetic prediction errors and standard deviations of −0.25 ± 0.59, −0.05 ± 1.19, 0.00 ± 0.88, −0.26 ± 1.17, 0.00 ± 1.09, −0.71 ± 1.20, and 0.03 ± 1.25 diopters, respectively. CONCLUSIONS: Visual outcomes within 1.0 diopter of target refraction were achieved in 85% of eyes using the calculation methods listed above. Haigis-L, Barrett True-K (no history), and Scheimpflug TCRP 4 mm (Haigis) and TRP 4 mm (Haigis) methods showed comparably low prediction errors, despite the absence of historical patient information.

A Case of Retinal Cavernous Hemangioma Diagnosed with Spectral Domain Optical Coherence Tomography

No abstract available.