Acute onset of retinal detachment after posterior chamber phakic intraocular lens implantation.

CASE REPORT: A 34-year-old man with severe myopia, presented with acute visual loss in his right eye. This occurred 3 hours after a posterior chamber phakic (PCP) intraocular lens (IOL) implantation, and was associated with a rhegmatogenous retinal detachment. Retinal retachment surgery was performed without complications, with the outcome showing good anatomical and functional results during a 2-year follow-up period. DISCUSSION: Despite the fact that several authors have described retinal detachments following PCP IOL implantation in highly myopic patients, there is no evidence that this procedure increases the risk of retinal detachment in these patients. The occurrence of the retinal detachment immediately after the phakic IOL implantation supports the hypothesis that the surgical procedure could induce iatrogenic changes in patients with high myopia, which could increase the incidence of retinal detachment. In contrast to other reports, the interval between the PCP IOL implantation and the retinal detachment was only 3 hours in our patient. We believe this demonstrates the importance of performing a complete preoperative vitreoretinal examination in patients with severe myopia.

Intravitreal bevacizumab (Avastin) in the treatment of macular edema secondary to retinal vein occlusion.

OBJECTIVE: To evaluate efficacy and safety of intravitreal injections of bevacizumab in the treatment of macular edema secondary to retinal vein occlusion (RVO). METHODS: Prospective study, noncomparative, interventional case series. Twelve consecutive patients (12 eyes) with macular edema associated with nonischemic retinal vein occlusion were treated with intravitreal bevacizumab (1.25 mg). All subjects underwent standardized ophthalmic evaluation at baseline and at weeks 1, 4, 12, and 24, consisting of visual acuity (VA) measurement using ETDRS charts, and imaging with ocular coherence tomography evaluating changes in foveal thickness (FT) and macular volume (MV). RESULTS: The median age was 66 years (+/- 4.16), and the median duration of symptoms was 4 months (+/- 1.81). There were six cases of inferior branch vein occlusion and six cases of superior branch retinal vein occlusion. Mean VA improved from 1.32 +/- 0.24 (logMAR values) at baseline to 0.8 +/- 0.15 (p = 0.0003) at the 6-month follow-up. The macular edema responded promptly, and a trend to restoration of normal macular anatomy was observed at by the seventh day. Mean FT improved from 615.50 +/- 116.29 microns to 420 +/- 72.53 microns (p = 0.001), and the mean MV improved from 19.81 +/- 2.31mm3 to 9.23 +/- 1.38 (p = 0.0001) at the 6-month follow-up.