Posterior sub-tenon's bevacizumab injection in diabetic macular edema; a pilot study

Purpose: To evaluate the short-term results of sub-tenon's injection of bevacizumab in patients with clinically significant macular edema [CSME]

Methods: In this prospective non comparative interventional case series, sub-tenon's injection of 2.5 mg/0.1 ml bevacizumab was performed for eyes with CSME. Macular thickness and best corrected visual acuity measurements were performed before and one month after injections

Results: Nineteen eyes of twelve patients with a mean age of 59.8 +/- 5.7 years were evaluated. Thirteen eyes [68.4%] had center-involving macular edema. No significant difference was observed between pre- and post-injection central subfield retinal thickness measurements [P = 0.3]. Central subfield thickness measurements improved or remained unchanged in 13 eyes [68.4%]. Baseline BCVA of 0.48 +/- 0.35 LogMAR improved to 0.36 +/- 0.26 LogMAR after injection [P = 0.01]. Improvement of >2 lines in BCVA was found in 5 eyes [26.3%], and no eye lost >2 lines of BCVA. No complication associated with sub-tenon's injection was observed

Conclusion: Sub-tenon's injection of bevacizumab resulted in significant short-term visual improvement in eyes with CSME. Retinal thickness changes were not significant

Capsulorhexis: pearls and pitfalls

A critical step in phacoemulsification [as well as extracapsular cataract extraction] is making a window in anterior capsule wall [i.e. anterior capsulotomy]. Continuous Curvilinear Capsulorhexis [CCC] has become recognized as the standard method of anterior capsulectomy. Techniques employed for CCC have undergone sustained evolution. The present review evaluates elementary principles of CCC. Management of CCC in the presence of small pupil and pseudoexfoliation syndrome is discussed. Main differences of pediatric CCC from its adult-style counterpart and finally several techniques of rescue of an extending capsulorhexis are also reviewed