Two Cases of Flanged Intrascleral Fixation Performed with Vitrectomy and Air-fluid Exchange

Purpose@#We report two cases in which vitrectomy, air-fluid exchange, and flanged intrascleral fixation were employed to treat crystalline or intraocular lens dislocation associated with retinal detachment.Case summary: Two patients visited our clinic complaining of visual disturbance in the right and left eye respectively. At the initial visits, slit-lamp examination revealed subluxation of a crystalline lens (with zonulysis on the nasal side) in case 1 and dislocation of an intraocular lens (IOL) in case 2. Since retinal detachment was accompanied in both patients, they also underwent vitrectomy and air-liquid exchange during surgery. To fix the intraocular lens to the sclera, both ends of IOL haptics were cauterized using a low-temperature handheld device and flanged haptics had been deeply inserted into scleral tunnels. The intraocular pressure fell and vitreous hemorrhage developed immediately after surgery, but improved on additional treatment. At 18 and 6 months (cases 1 and 2) after surgery, the implanted IOLs were moved to the centers of the pupils without complications. @*Conclusion@#Flanged intrascleral fixation is stable and effective when treating a patient who requires vitrectomy and air-fluid exchange to deal with a retinal disease.

Efficacy of Preservative-free Latanoprost in Normal-tension Glaucoma with Mild to Moderate Dry Eye

Purpose@#To evaluate the efficacy and safety of preservative-free latanoprost in patients with normal-tension glaucoma who had mild to moderate dry eye after switching from preserved latanoprost. @*Methods@#This retrospective study was conducted in patients with normal-tension glaucoma who had mild to moderate dry eye. All enrolled patients had used preserved latanoprost and switched to preservative-free Latanoprost. The study consisted of a baseline visit (treatment with preserved latanoprost) and four follow-up visits conducted after 1, 3, 6, and 12 months of treatment with preservative-free latanoprost. Intraocular pressure (IOP), mean deviation (MD), ocular surface disease index (OSDI), Shirmer’s test score, tear break-up time (TBUT), corneo-conjunctival fluorescein staining, and adverse drug reactions were evaluated. @*Results@#The mean IOP and MD values during treatment with preserved latanoprost were 14.1 ± 2.6 mmHg and -2.68 ± 0.11 dB, respectively. The mean IOP and MD values at 12 months after switching to preservative-free latanoprost were 13.9 ± 1.9 mmHg and -2.66 ± 0.12 dB, respectively. The OSDI, Shirmer’s test score, BUT, and corneo-conjunctival fluorescein staining during treatment with preserved latanoprost were 53.15 ± 8.86, 4.97 ± 1.71 mm, 4.92 ± 1.72 seconds, and 2.92 ± 1.05, respectively. The OSDI, Shirmer’s test score, TBUT, and corneo-conjunctival fluorescein staining at 12 months after switching to preservative-free latanoprost were 49.07 ± 6.97, 5.51 ± 1.48 mm, 5.49 ± 1.46 seconds, and 2.47 ± 1.09, respectively. There were no serious adverse drug reactions causing ocular damage. @*Conclusions@#Preservative-free latanoprost was effective for improving objective and subjective symptoms compared to preserved latanoprost; it maintained a stable IOP and visual field value in patients with normal-tension glaucoma who had mild to moderate dry eye.