Creatively tiding over the crisis

Background: A patient with a retained intraocular metallic foreign body post?trauma was taken up for vitrectomy and intraocular foreign body removal. Unfortunately, the intraocular magnet was not available at the moment on the table! How a little bit of creativity and innovative thought helped us tide over this crisis is the content of this video. Purpose: To demonstrate magnetization of a metallic surgical instrument for temporary use in the event of unavailability of the intraocular magnet for intraocular foreign body removal. Synopsis: A ferromagnetic substance can be magnetized temporarily using an existing magnet. We obtained a general?purpose magnet and wrapped it in sterile plastic, using which we magnetized normal intraocular forceps and a Micro Vitreo Retinal (MVR) blade by giving about 20–30 strokes over the magnet in a single direction. This aligned the magnetic domains in the metal in a parallel fashion. These Do It Yourself (DIY)? magnetic instruments were then effectively utilized to remove the metallic intraocular foreign body. Highlights: The video showcases effectively harnessing the available resources and tiding over the dearth of a necessary instrument, with the right use of an innovative idea and some creativity!.

Long-term real-world outcomes in retinal vein occlusions: How close are we to the trials?

Purpose: To assess and analyze the visual outcomes of patients with retinal vein occlusions in a real?world setting with a long?term follow?up of more than 5 years. Methods: Retrospective analysis of 56 patients having retinal vein occlusions from a tertiary eye center, with a mean follow?up of 7 years was performed. Primary outcome measures were mean change in best?corrected visual acuity (BCVA) from baseline at 6 months, 1 year, 2 years, 3 years, and final visit (?5 years), proportion of patients having BCVA better than 20/40 and worse than 20/200, and mean number of injections. Secondary outcome measures were change in central macular thickness (CMT), development of subsequent retinal vein occlusion (RVO) in same eye or the other eye, and development of neovascular complications. Results: The mean change in letter score was + 11.84 in branch RVO (BRVO), +7.14 in non?ischemic central RVO (CRVO), and ?9.5 in ischemic CRVO at 1 year, which changed to + 8.57, ?5 and ? 24, respectively, at the end of follow?up. CMT had improved from 506 ± 98.8 ?m, 576.44 ± 149 ?m, and 618 ± 178.27 ?m, respectively, at baseline to 267 ± 94 ?m, 345.20 ± 122.61 ?m, and 265.50 ± 107.75 ?m, respectively, in BRVO, non?ischemic, and ischemic hemi RVO (HRVO)/CRVO groups. The total mean number of injections given in BRVO, non?ischemic CRVO, and ischemic CRVO groups were 4.6, 6.6, and 4.1, respectively. None of the patients with BRVO developed neovascular glaucoma (NVG). Non?ischemic to ischemic HRVO/CRVO conversion was noted in 4/11 eyes at a mean duration of 12.6 months. NVG was noted in 7/9 eyes (77.8%) in initial ischemic CRVO/HRVO group and 3/4 (75%) converted eyes. Conclusion: Patients with BRVO have good visual outcomes with anti?VEGF, while in CRVO results may vary considerably owing to patient compliance and treatment burden on long?term follow?up in a real?world setting