Simplifying biometry in oil-filled eyes: A novel formula for axial length calculation in eyes with 1000 cSt silicone oil

Purpose: To derive a formula for accurate axial length (AL) assessment using routine ultrasound in silicone oil?filled eyes, where optical biometry is unavailable or not possible. Methods: This was a prospective, consecutive, nonrandomized study of 50 eyes of 50 patients conducted in a tertiary care hospital in North India. AL measurements were taken using both manual A?scan and IOL master, both in silicone oil?filled status and 3 weeks after silicone oil removal. A correction factor of 0.7 was used for AL adjustment in oil?filled eyes. The corrected AL (cAL) was compared with IOL master values in oil?filled eyes. Agreement analysis was carried out using Bland Altman plot. Linear regression analysis was done using uncorrected manual AL to find a new equation. Data was analyzed using Stata 14. A P value <0.05 was taken as significant. Results: The study included 40 males and 10 females, with an age range of 6–83 years (mean 41.9 years). The mean AL of the oil?filled eye as measured by manual A?scan was 31.76 mm ± 3.09 and by IOL master was 24.7 mm ± 1.74. Linear regression analysis was performed in randomly selected 35 eyes of the observed data to obtain a new equation: predicted AL (PAL) = 14 + 0.3 × manual AL. The mean difference between PAL and optically measured AL with silicone oil in situ was 0.98 ± 1.67. Conclusion: We propose a new formula for better prediction of the correct AL in silicone oil?filled eyes using ultrasound?based AL measurement.

Post-vitrectomy secondary macular holes: Risk factors, clinical features, and multivariate analysis of outcome predictors

Purpose: We report clinical characteristics, risk factors, treatment outcomes, and prognostic predictors of post?vitrectomy secondary macular holes (MHs). Methods: This was a retrospective observational case series from November 2014 to December 2020. Eyes that developed secondary MH, two weeks and beyond after primary vitrectomy for non?MH indications, were enrolled. Pre? and intraoperative records were screened to exclude pre?existence of MH. Eyes with multiple vitreoretinal surgeries prior to MH detection and tractional myopic maculopathy were excluded. Results: A total of 29 eyes of 29 patients with a mean age of 52 years developed secondary MH post?vitrectomy. The most common indications for primary vitrectomy were rhegmatogenous retinal detachment (RRD, 48.2%) and tractional retinal detachment (TRD, 24.1%). Time to MH detection after primary vitrectomy was 91.5 ± 117.6 days. The mean minimum hole diameter was 530 ± 298 microns. Epi?retinal membrane and cystoid degeneration was noted in 6 (20.7%) and 12 (41.3%) eyes, respectively (p = 0.088). The mean time from MH detection to MH repair was 34 ± 42 days. The surgical intervention included internal limiting membrane peeling with tamponade in 25 eyes. Overall, 80% showed anatomic hole closure, 90.9% versus 57.1% in the RRD and TRD (p = 0.092), respectively. The mean best?corrected visual acuity (BCVA) at the final visit was 0.71 logarithm of the minimum angle of resolution. Thirteen eyes (52%) had a BCVA of 20/100 or better. Minimal hole diameter (p = 0.029) only predicted final visual acuity. The interval between MH diagnosis and repair did not affect hole closure significantly (p = 0.064). Conclusion: Secondary MH post?vitrectomy closed successfully with limited visual improvement and trails behind idiopathic MH.

Endophthalmitis Caused by Mixed Infections in Silicone Oil-filled Eye:One Case Report / 中国医学科学院学报

The incidence of endophthalmitis after vitrectomy is extremely low,especially lower in silicone oil-filled eyes.Silicone oil exerts a toxic effect on the cell membranes of microorganisms and leads to the lack of nutrients.It is thus believed to inhibit the growth of bacteria and fungi.Endophthalmitis induced by mixed bacteria in silicone oil-filled eye has been rarely reported.We reviewed the clinical manifestations,diagnosis,and treatment of a patient with endophthalmitis caused by mixed infection of

Clinical efficacy of pseudo-ginseng powder for post-vitrectomy vitreous hemorrhage in diabetic patients / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the efficacy of pseudo-ginseng power for post-vitrectomy vitreous hemorrhage in diabetic patients and provide new insight into the treatment options. <p>METHODS: Totally 32 eyes of 32 patients with post-vitrectomy hemorrhaged secondary to proliferative diabetic retinopathy were included. Patients were prescribed with pseudo-ginseng powered, 1.5g, twice a day, for 3 consecutive sections(21d). The visual acuity, optical coherence topography image quality and degree of vitreous hemorrhage was assessed before and after the treatment were analyzed to evaluate the efficacy of pseudo-ginseng powder. <p>RESULTS: No adverse reaction was seen in all subjects after 21d of treatment. And 88% of the patients had improved visual acuity. The mean best corrected visual acuity(LogMAR)was 1.93±0.46 and 1.42±0.5, before and after treatment, respectively. For the patients with visual acuity no worse than 0.02, finger counting to less than 0.02 and light perception, the improvement rate was 100%. For patients with visual acuity from hand motion, the improvement rate was 60%. The improvement rate for optical coherence tomography image quality was 94%, and 94% for degree of vitreous hemorrhage. <p>CONCLUSION: Pseudo-ginseng power is effective in patients with postvitrectomy hemorrhaged secondary to proliferative diabetic retinopathy. It accelerated the elimination of vitreous hemorrhage and improved the visual acuity as well as decreased the likelihood of re-cooperation.

Observation of transscleral cyclophotocoagulation for glaucoma secondary to vitrectomy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the clinical efficacy and safety of transscleral cyclophotocoagulation(TSCP)for glaucoma secondary to vitrectomy. <p>METHODS: A retrospective review was performed within 20 patients(20 eyes)with glaucoma secondary to vitrectomy underwent TSCP in our hospital from October 2014 to October 2016. The follow-up time was 3mo. The postoperative visual acuity, intraocular pressure(IOP)and complications were observed. <p>RESULTS: One month after operation, the postoperative IOP increased in 9 cases. Another 4 eyes were performed TSCP again, and three of them got the normal IOP recovery. At the last follow-up, visual acuity had no significant changes(<i>P</i>=0.655); IOP was effectively controlled in 14(70%)patients. Meanwhile, the mean postoperative IOP(24.6±11.4mmHg)was statistically reduced than the mean preoperative IOP(42.3±5.9mmHg, <i>P</i><0.05). No serious complications, like hypotony and suprachoroidal hemorrhage, had been observed during 3-month follow-up. <p>CONCLUSION: TSCP procedure is a safe, effective, repeatable surgery for patients with glaucoma secondary to vitrectomy.

The Efficacy of Fluid-Gas Exchange for the Treatment of Postvitrectomy Retinal Detachment

PURPOSE: This study was designed to evaluate the efficacy of fluid-gas exchange for the treatment of postvitrectomy retinal detachment. METHODS: We retrospectively reviewed the records of 33 consecutive patients (35 eyes) who underwent fluid-gas exchange treatment for postvitrectomy retinal detachment using the two-needle pars plana approach technique. RESULTS: The retinal reattachment rate was 80.0% after complete intravitreal gas disappearance following the fluid-gas exchange; the overall success rate was 65.7%. Visual acuity was improved or stable in 80.0% of cases; a two-line or greater vision improvement or a best-corrected visual acuity of 0.4 or better occurred in 62.9% of cases. The success rates for superior retinal detachments and posterior pole retinal detachments were 76.5% and 85.7%, respectively. CONCLUSIONS: Fluid-gas exchange represents a simple and cost-effective alternative outpatient procedure for retinal reattachment without reoperation for the treatment of superior and posterior pole retinal detachments.

Efficacy of Intravitreal Triamcinolone Acetonide for Eyes with Postvitrectomy Diabetic Vitreous Hemorrhage

PURPOSE: To evaluate the efficacy of intravitreal triamcinolone acetonide (IVT) for the management of postvitrectomy diabetic vitreous hemorrhage. METHODS: The authors conducted a retrospective study of patients with postvitrectomy diabetic vitreous hemorrhage who were administered 4 mg (0.1 cc) of triamcinolone acetonide ophthalmic suspension. Ocular history, adverse events, BCVA, intraocular pressure, external eye examination, slit-lamp biomicroscopy, fundus examination, B-scan ultrasonography, and fundus photography were assessed on day 1, weeks 1, 2, and 4 and months 2 and 3. RESULTS: There were 19 eyes of 18 consecutive patients with mean follow-up after IVT injection of 28 weeks. Of the 19 eyes, 17 eyes (89%) experienced clearing of vitreous hemorrhage within 1 to 5 weeks (mean, 1.7 weeks) with visible triamcinolone precipitates along with blood clot in the inferior aspect of fundus. Of these 17 eyes, 12 eyes (63%) maintained vitreous hemorrhage-free condition at last follow-up with a mean visual acuity of 20/63 (range, 20/320 20/25), whereas 5 (29%) developed recurrent vitreous hemorrhage after clearing of vitreous hemorrhage. Vitreous hemorrhage was not cleared in 2 eyes, which required surgical procedures. CONCLUSIONS: IVT injection may be beneficial for clearing recurrent postvitrectomy Diabetic Vitreous Hemorrhage.