Endoscopic vitreoretinal surgery: Review of current applications and future trends.

Endoscopy provides unique optical properties to circumvent anterior segment opacities and visualize difficult-to-access anatomical regions, including retroirideal, retrolental, ciliary body, and anterior retinal structures. We summarize the basic principles and utilization of endoscopic vitreoretinal surgery, along with recent technological advances in the field base on a structured literature search in Pubmed, Embase, and Google Scholar database up to February, 2020. Endoscopy has been used in the management of retinal detachment, ischemic retinopathies with neovascular glaucoma, severe ocular trauma, endophthalmitis, lens-related disorders in the posterior segment, pediatric vitreoretinal diseases, and implantation of retinal prostheses. Ongoing development of endoscopic technology aims to provide higher resolution images with endoscopes of smaller diameter. New surgical techniques supported by the adoption of endoscopy are available to manage challenging surgical scenarios. Endoscopy can be a useful adjunct to microscope wide-angle viewing systems in the management of complex vitreoretinal diseases.

Thelaziasis as an uncommon cause of giant papillary conjunctivitis.

INTRODUCTION: We report a local human case of Thelazia callipaeda eye infection in a 49-year-old lady with history of fly contact in Hong Kong. CASE DESCRIPTION: A 49-year-old lady presented with right eye foreign body sensation for one month. She recalled a fly being stuck onto her right upper eyelashes with mascara when she went hiking in a forest trail in Hong Kong. On assessment there were a lot of giant papillae on palpebral conjunctiva. Three living worms crawling on conjunctiva were discovered and removed in total. The worms were identified as Thelazia callipaeda by morphology and molecular sequencing. After removal, her symptoms resolved completely. CONCLUSION: Human thelaziasis is probably under-reported in many countries. The presence of giant papillary conjunctivitis in non-contact lens wearers should alert clinicians to the possibility of thelaziasis in patients with compatible exposure history in endemic regions. Ophthalmologists should increase their awareness towards this uncommon disease and should not wrongly attributed the symptoms to allergic conjunctivitis.

Muir-Torre Syndrome in a Middle-Aged Chinese Patient with Sebaceous Carcinoma of the Eyelid.

Muir-Torre syndrome is a rare, autosomal dominant condition characterized by the presence of a skin tumor of sebaceous differentiation and visceral malignancies. We reviewed the case of a 46-year-old Chinese man who had a bleeding mass over the right upper eyelid. He had a history of colon cancer and a family history satisfying the Amsterdam criteria for hereditary non-polyposis colorectal cancer syndrome with germline mutation in the MutS homolog-2 gene. The eyelid lesion was excised completely and submitted for histopathologic examination which showed sebaceous carcinoma. Frozen section and conjunctival map biopsy showed no residual malignancy or local metastasis. Post-operative positron-emission tomography with combined computed tomography did not reveal any residual or visceral malignancy. He had no recurrence in the 32-month follow-up period. We should consider Muir-Torre syndrome in patients with sebaceous carcinoma, especially in the presence of personal and/or family history of visceral malignancies.

Primary 23-gauge transconjunctival sutureless vitrectomy for rhegmatogenous retinal detachment.

PURPOSE: To describe the results of primary 23-gauge transconjunctival sutureless vitrectomy for rhegmatogenous retinal detachment (RRD). METHODS: In a prospective case series, 24 eyes of 24 consecutive patients with RRD underwent primary 23-gauge transconjunctival pars plana vitrectomy with intraocular gas tamponade. Postoperative follow-up ranged from 6 months to 16 months. RESULTS: Fifteen eyes (62.5%) had multiple breaks. Seven eyes (29.2%) had inferior breaks. Other complications included giant tear in one eye, peripheral choroidal detachment in one eye, and concomitant macular holes in two eyes. The primary anatomical success rate was 91.7%. The mean postoperative visual acuity at postoperative month 3 improved from 20/41 to 20/25 (P = 0.111) and from 20/735 to 20/56 (P < 0.0001) in macula-on and macula-off cases, respectively. One patient (4.2%) had hypotony on postoperative day 1. No patients developed choroidal detachments. No sutures were used in any of the sclerotomy sites. Of the patients, 87.5% reported no or mild foreign body sensation, whereas 79.1% reported no or mild pain on the first postoperative day. CONCLUSIONS: Twenty-three-gauge transconjunctival sutureless vitrectomy appears to be a feasible option in treating RRD in selected cases, with the potential benefit of reducing postoperative ocular irritation.