Retinal complications post posterior chamber phakic intraocular lens implantation at a tertiary eye hospital in the Eastern Province of Saudi Arabia.

PURPOSE: Phakic intraocular lenses treat higher degrees of myopia not possible previously with conventional refractive surgery. The aim of this study is to report the incidence and risk factors of retinal complications after posterior chamber PIOL implantation and assess the differences in biometric parameters between patients who developed such complications versus those who did not. METHODS: This retrospective study recruited 514 patients who underwent ICL implantation to correct myopia at a tertiary eye hospital center in the Eastern province of Saudi Arabia. Follow up period was at least one year. Medical records of the patients were reviewed to obtain the required data. Associations between respondents' characteristics and retinal complications were evaluated using the Chi-squared test. RESULTS: The mean (SD) age was 27.7 (± 6.5) years ranging from 18 to 47. Laser treatment was performed in 14 cases (2.7%). Retinal complications occurred in six cases (1.2%). The risk of retinal complication was significantly higher among patients with high axial length (OR = 1.3, 95% CI 1.2, 1.4) and patients with high pre-spherical equivalent before ICL (OR = 1.09, 95% CI 1.03, 1.4). CONCLUSION: Patients with higher axial length and higher pre-spherical equivalent before ICL implantation are at high risk of retinal complications.

Orbital Floor Blowout Fracture Reconstruction Using Moldable Polymethyl Methacrylate: A Report of Two Cases and Their Imaging Findings.

Background: Blowout fracture is defined as an internal orbital fracture that does not involve the orbital rim. This type of fracture results in the loss of tissue and disruption of the structure of the orbital wall. The symptoms and signs include pain, enophthalmos, diplopia, orbital emphysema, and ecchymosis. The surgeon's main goal is to reconstruct the orbit in the best possible manner to achieve optimal anatomy and functionality of the orbit wall postoperatively. There is no consensus regarding the best material for use in surgical orbital reconstruction, despite the commercial availability of several biological and manufactured materials. Moreover, material selection is often based on the practitioner's preferences/experience and patient safety. This study reported two cases of orbital fracture reconstruction using moldable methyl polymethacrylate as a bone surrogate. This material has already been used in dentistry, neurosurgery, and orthopedic surgery and is potentially hazard-free for orbit surgery. Case Presentation: Two victims of motor vehicle collisions presented with blowout orbital fractures. Cross-sectional imaging revealed inferior fractures involving the orbital wall. High-resolution tomographic modeling was used to plan surgical orbital floor reconstruction using moldable polymethyl methacrylate material. The short-term outcome of the implant appeared favorable at the one-year follow-up, based on regular patient monitoring and cross-sectional imaging assessment. Postoperative improvement with positive clinical outcomes was observed during both patients' follow-up visits. Conclusion: Moldable polymethyl methacrylate can be used safely and effectively for reconstructive surgeries for the management of blowout orbital fractures. This new technique ensured a satisfactory short-term postoperative orbital configuration and tolerance and good esthetic and functional results without adverse effects. This customizable product is affordable and easy to fabricate.