Spectral domain optical coherence tomography features of multiple subfoveal retinal pigment epithelial tears after intravitreal bevacizumab.

Retinal pigment epithelial (RPE) tear has been described to occur spontaneously, after laser photocoagulation and in recent times, after intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents. In the latter case, the rapid contraction of the choroidal vascular membrane underneath a serous RPE detachment is believed to be the underlying cause. Preservation of good visual acuity after the occurrence of RPE tear with continued use of intravitreal VEGF agents has been reported. In this case report, we describe the occurrence of multiple RPE tears with the use of intravitreal bevacizumab and also correlate the preservation of visual acuity with features seen on spectral domain optical coherence tomography.

Illuminated curved 25-gauge vitrectomy probe for removal of subsclerotomy vitreous in vitreoretinal surgery.

Incarceration of vitreous in sclerotomy sites during pars plana vitrectomy can lead to wound-related complications similar to vitreous incarceration in cataract surgery. We describe an illuminated curved 25-gauge vitrectomy probe for removing vitreous from sclerotomy sites. Polyester tubing is used to secure a fiber optic endoilluminator (0.5 mm) with the curved 25-gauge vitrector (0.5 mm). The resultant illuminated curved vitrector (20 G) has a diameter of 1.0 mm. It facilitates complete removal of vitreous around the internal sclerotomies under direct visualization in both phakic and pseudophakic eyes. The same was confirmed with ultrasound biomicroscopy of the sclerotomy sites. Curved vitrector reduces postoperative complications related to incarcerated vitreous in phakic and pseudophakic eyes and other sclerotomy-related wound complications.

Liquid crystal display microperimetry in eyes with reduced visual acuity from macular pathology.

PURPOSE: To correlate fixation stability and retinal sensitivity measured by liquid crystal display (LCD) microperimetry to visual acuity in eyes with macular pathology. DESIGN: Retrospective chart review METHODS: The cohort included 26 eyes of 26 patients, divided into two groups according to visual acuity (Group 1 eyes 6/15 - 6/48, Group 2: < or = 6/60). Macular sensitivity and fixation stability were measured using the LCD microperimeter. Mean retinal sensitivity (at central 12 degrees) and fixation stability (at 2 degrees and 4 degrees) were correlated with best-corrected visual acuity. RESULTS: Mean retinal sensitivity correlated with the visual acuity in both groups [Group 1 eyes: 28 point central 12 degrees (9.0 dB); Group 2: central 12 degrees (4.183 dB)] (P < 0.05). The fixation stability correlated similarly with the visual acuity for the groups [Group 1 eyes: 2 degrees (81.2%) and 4 degrees (94.6%); Group 2 eyes: 2 degrees (44.1%) and 4 degrees (80.7%] (P < 0.05). CONCLUSION: In the present study, the mean retinal sensitivity and fixation stability measured with LCD microperimeter correlated with visual acuity. LCD microperimetry reliably measures fixation stability and retinal sensitivity in eyes with various macular pathologies.

Self retaining contact lens system for vitreous surgery.

We describe the principle and desiign of a new self-retaining contact lens system for vitreous surgery. The system has three lenses: theplano-concave, prism and magnifying lens. This system is based on the principle of a direct imaging contact lens, designed for a 150-200mm focal length operating micrcroscope. The contact lenses are designed to have an inferior concave surface [radius of curvature (ROC) 7.7mm], modified by theaddition of four footplates to provide stability and centration during vitreous surgery. The lenses are used with a drop of viscoelastic material placed between the concave surface of the contact lens and cornea. This induces negative suction and helps retain the lens in position during surgery. These specially designed lenses provide a stable, well-centered, high-resolution, magnified view of the fundus. This system eliminates the need for a skilled assistant or for suturing the lens to the sclera during vitreous surgery.