Combined intravitreal bevacizumab with phacoemulsification in visually significant cataract and visually significant exudative maculopathy

We investigated the visual outcome of combined phacoemulsification with intravitreal bevacizumab, in eyes with dense cataract and visually significant exudative maculopathy. Prospective longitudinal pilot study of consecutive patients treated by two surgeons in 2006, using intravitreal bevacizumab at the end of phacoemulsification. The historical control group consisted of consecutive subjects with exudative maculopathy and dense cataract treated by the same surgeons with the help of phacoemulsification without intravitreal bevacizumab prior to 2006. Thirty-one treated patients had the mean [SD] logMar best corrected visual acuity improving from - 1.48 [0.50] preoperatively to - 0.67 [0.38] in the first postoperative week [p< 0.001], to - 0.64 [0.40] in the first postoperative month [p< 0.001], and to - 0.62 [0.42] [p< 0.001] on the last follow-up [mean 4.2 months, range 1 - 9 months]. Fourteen control patients had the mean [SD] log Mar best corrected visual acuity improving from - 1.78 [0.79] preoperatively, to - 0.91 [0.53] in the first postoperative week [p< 0.001], to - 0.86 [0.45] in the first postoperative month [p< 0.001], and to - 0.90 [0.47] [p< 0.001] on the last follow- up [mean 19.6 months, range 1 - 49 months]. Initial visual acuities, final visual acuities, and percentage of visual improvement at one month were all not significantly better in the intervention compared to the control group at one month. In the study group, the fovea was flattened at the one-month follow-up, by 90-diopter slit lamp examination and / or Optical coherence tomography. The combination of intravitreal bevacizumab and phacoemulsification is beneficial for maximal visual rehabilitation in the first postoperative month

Branch retinal artery occlusion following embolization of a maxillary sinus tumor

Retinal vascular complications following embolisation of carotid artery branches have been occasionally reported. Since the result can be catastrophic and is often irreversible, all efforts to prevent this complication should be considered prior to the intervention. We report the occurrence of a branch retinal artery occlusion following embolization of a maxillary sinus tumor. Cerebral angiography pre- and post-embolization; pathology results from the excised tumor; fundoscopic, visual field, and fluorescein angiographic findings are reported. A combination of risk stratification and preoperative evaluation methods which might help in prevention of this serious complication are discussed