Accuracy of intraocular lens calculations based on fellow-eye biometry for phacovitrectomy for macula-off rhegmatogenous retinal detachments.

OBJECTIVES: To determine the accuracy of using fellow-eye biometry for intraocular lens calculations for phacovitrectomy for macula off rhegmatogenous retinal detachments. METHODS: Retrospective case review of phacovitrectomies for consecutive macula off retinal detachments over 10 years. Optical and/or ultrasound biometry was performed for affected and fellow eyes. Prediction error was determined by calculating the difference between predicted and actual refractive outcomes. Results from fellow- and same-eye biometry were compared. RESULTS: Forty-two eyes were included. The mean prediction errors for fellow- and same-eye biometry were -0.01 ± 1.09 and -1.22 ± 2.32 dioptres, respectively, indicating a myopic shift for same eye biometry calculations. The mean absolute prediction errors for fellow and same eye biometry were 0.73 ± 0.80 and 1.57 ± 2.08 dioptres, respectively. The difference was statistically significant (P = 0.016). CONCLUSIONS: When appropriate, intraocular lens calculations using fellow-eye biometry for phacovitrectomy for macula off rhegmatogenous retinal detachments are accurate and better than those from same-eye biometry.

A Case Report of Conservative Management for a Roller-Coaster-Related Vitreous Haemorrhage.

The purpose of this report is to describe the case and management of an unexplained vitreous haemorrhage that occurred after repeated roller-coaster riding. The authors inadvertently demonstrate the value of observation over immediate surgery in certain situations and review the literature on vitreoretinal and other ocular complications after roller-coaster riding. A 26-year-old male presented 12 h after riding high-velocity roller-coasters with a left vitreous haemorrhage. A hazy view of the retina and B-scan revealed a bullous area of superior-temporal retinal lifting. A diagnosis of a presumed macula-on retinal detachment was made and the patient was listed for a pars plana vitrectomy retinal detachment repair. An abnormal clotting result, which was subsequently found out to be erroneous, ultimately delayed the procedure. During this delay the vision and retinal view improved to an extent whereby the diagnosis of a retinoschisis with an intraretinal cyst was made and surgery was avoided. The patient regained 6/6 vision, without the need to undergo surgery. Historically the management of an unexplained vitreous haemorrhage was observation with serial B-scans. The current evidence and practice for treating unexplained vitreous haemorrhage have since moved towards early surgical intervention. The authors highlight that despite the current trend, a place remains for conservative management for selected cases.