Management of recurrent rhegmatogenous retinal detachment.

Rhegmatogenous retinal detachment (RRD) repair is one of the most common vitreoretinal surgeries a surgeon performs. In an ideal scenario, RRD can be repaired with a single surgical intervention; however, despite excellent skill, flawless technique, and the introduction of high-end technology, up to 10% of cases require additional interventions to ultimately repair recurrent detachments. It is thus important to study the outcomes of multiple interventions to understand whether performing repeat vitrectomy on patients with a history of failed surgeries is worthwhile. Thus, recurrent retinal detachment (re-RD) remains a significant challenge for vitreoretinal surgeons as well as the patients considering the economic and the emotional burden of undergoing multiple interventions. The advent of microincision vitrectomy system, perfluorocarbon liquids, and effective intraocular tamponades has opened new doors for managing re-RDs. In this article, we have reviewed and summarized the various causes and approaches for management for optimal anatomical and functional outcomes.

Chandelier-assisted retroillumination for phacoemulsification in phacovitrectomy.

Purpose: To describe chandelier-assisted retroillumination for phacoemulsification in patients with poor fundal glow due to posterior segment pathology during combined phacovitrectomy procedure. Methods: This was a prospective observational study. Thirty eyes underwent combined phacoemulsification and 25G sutureless pars plana vitrectomy. Sclerotomy port for chandelier tip was made in the inferotemporal or superonasal quadrant based on the incision site for phacoemulsification. Later, it was replaced with infusion cannula or endoilluminator. Cases included had posterior segment pathologies such as vitreous hemorrhage and vitritis. Results: Red reflex was markedly enhanced during phacoemulsification for all cases. In all eyes, a continuous curvilinear capsulorhexis was achieved without the use of dye. The posterior capsule remained intact in all cases. The visual acuity in all patients improved, and the median best-corrected visual acuity was 20/60 (range: 4/60-20/30) at 6 months. There were no intraoperative or postoperative complications. Conclusion: Cases with poor red reflex pose a challenge for anterior segment surgeons, and chandelier-assisted retroillumination proves to be a safe and effective tool in combined phacovitrectomy surgeries. Moreover, no additional cannula port is required for this chandelier insertion.

Branch retinal artery occlusion post-penetrating globe injury with intraocular foreign body.

Intraocular foreign body (IOFB) in cases of penetrating eye injury accounts for an important indication of vitreoretinal intervention following ocular trauma. Vascular occlusion as a complication of IOFB is rare. Here we present a case of a 34-year-old male with post-traumatic cataract and an intraocular metallic foreign body (IOFB) lodged in the superficial layers of the retina inferotemporal to the disc, causing an inferotemporal branch retinal artery occlusion. The case was managed by lensectomy with pars plana vitrectomy and IOFB removal followed by a second procedure of secondary IOL implantation. Final best-corrected visual acuity improved to 6/24. This case highlights an unusual sequelae following penetrating ocular trauma.