Return to the Operating Room after Vitrectomy for Vitreous Opacities: Intelligent Research in Sight Registry Analysis.

PURPOSE: To investigate the rate of return to the operating room after vitrectomy surgery for vitreous opacities. DESIGN: Retrospective registry cohort. PARTICIPANTS: Individuals receiving care in ophthalmology practices participating in the Intelligent Research in Sight (IRIS®) Registry. METHODS: Data from the IRIS Registry were analyzed for patients who underwent vitrectomy for vitreous opacities. Cases were identified by the combination of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), and International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), codes (379.21, 379.22, 379.24, and 379.25), and a Current Procedural Terminology (CPT) code for vitrectomy surgery. MAIN OUTCOME MEASURES: The number and percentage of eyes that underwent additional eye surgery within 1 year after vitrectomy for vitreous opacities were identified, as was the nature of the additional procedures per CPT code. RESULTS: Fifty thousand eight hundred thirty-six eyes that underwent vitrectomy surgery linked to one of the ICD-9-CM or ICD-10-CM codes for vitreous opacities were identified. In 17 615 eyes, the surgery was linked to the vitreous opacities code exclusively, and not to epiretinal membrane or macular hole codes. Of these, 2187 eyes (12.4%) returned to the operating room for cataract surgery, and 643 eyes (3.7%) returned to the operating room for a noncataract procedure. Four hundred fifty-seven eyes (2.6%) returned to the operating room for retinal detachment repair. CONCLUSIONS: In the IRIS Registry, eyes undergoing vitrectomy for vitreous opacities returned to the operating room for an ophthalmic surgery other than cataract extraction 3.7% of the time, and retinal detachment repair was performed 2.6% of the time.

OUTCOMES OF NONCONFLUENT DIODE LASER PANRETINAL PHOTOCOAGULATION FOR AGGRESSIVE POSTERIOR RETINOPATHY OF PREMATURITY AFTER INTRAVITREAL BEVACIZUMAB.

PURPOSE: To assess the safety and efficacy of less dense panretinal photocoagulation after intravitreal bevacizumab in aggressive posterior retinopathy of prematurity infants. METHODS: Retrospective consecutive case series of premature infants diagnosed with aggressive posterior retinopathy of prematurity between August 2012 and November 2015 who received intravitreal bevacizumab with subsequent modified indirect diode laser panretinal photocoagulation for reactivation or incomplete vascularization. Main outcome measures included postprocedural reactivation, retinal detachments, or anterior segment ischemia. RESULTS: Sixty-one eyes of 31 premature infants were identified. The average gestational age was 24 ± 2.2 weeks (range 22-27), and the average birth weight was 661.5 ± 167.1 g (range 340.0-930.5 g). The average follow-up was 3.9 ± 1.3 years (range 1.3-5.4 years). At the last follow-up, no patient had experienced postlaser reactivation, retinal detachments, anterior segment ischemia, or other laser complications. CONCLUSION: This study suggests that nonconfluent panretinal photocoagulation for aggressive posterior retinopathy of prematurity infants who have received intravitreal bevacizumab may be safe and effective. This study's strengths include a sizeable sample size, long-term follow-up of nearly 4 years, and consistency in treatment among patients by a single, experienced retinopathy of prematurity specialist.

The development and spontaneous resolution of a full-thickness macular hole in bartonella henselae neuroretinitis in a 12-year-old boy.

PURPOSE: To describe an unusual case of Bartonella henselae neuroretinitis complicated by macular hole (MH) development. OBSERVATIONS: A full-thickness macular hole developed in a 12-year-old boy in association with serology-confirmed Bartonella henselae neuroretinitis. Following a period of observation, the MH closed without intervention. CONCLUSION AND IMPORTANCE: MH may occur as a complication of neuroretinitis secondary to Cat-Scratch Disease.

Choroidal Melanoma Mimicker: A Case of Metastatic Clear-Cell Renal Cell Carcinoma.

Choroidal melanoma is the most common primary intraocular malignancy, yet metastatic disease remains the most common malignancy of the eye. Differentiating these entities is essential as treatment, systemic associations, and prognosis vary dramatically between the two. Established diagnostic criteria are accurate for the diagnosis of uveal melanoma. Yet, metastatic disease may be misdiagnosed as a uveal melanoma in rare cases. We report a case of metastatic clear-cell renal cell carcinoma masquerading as uveal melanoma. A 73-year-old Caucasian man with a history of renal cell carcinoma presented with a 15 × 12 × 7 mm homogenous, pigmented, and acoustically hollow mass without hemorrhage or exudation. The patient was initially treated with plaque radiotherapy with good tumor regression. However, the patient developed pain and vision loss due to total exudative retinal detachment. Subsequent enucleation allowed histopathologic confirmation of clear-cell renal cell carcinoma. Nine years following enucleation, the patient remains in complete remission without evidence of other systemic metastases. Renal cell carcinoma should be considered when evaluating patients with probable uveal melanoma. Delayed-onset ocular metastasis from renal cell carcinoma exhibits an atypical clinical course with the possibility of durable remission following enucleation.

Temporalis fascia transplant for vocal fold scar and sulcus vocalis.

OBJECTIVES/HYPOTHESIS: To evaluate vocal outcomes in 10 patients 1 year after autologous transplantation of temporalis fascia into Reinke's space (ATFV) for vocal fold scar and sulcus vocalis. STUDY DESIGN: Retrospective, clinical case series. METHODS: Subjective and objective evaluation was performed 12 months after surgery using laryngovideostroboscopy (LVS) in all patients, the Voice Handicap Index-10 (VHI-10) in seven patients, GRBAS (grade, roughness, breathiness, asthenia, strain) scale in nine patients, and noise-to-harmonics ratio (NHR), phonatory range (PR) and maximum phonation time (MPT) in six patients. RESULTS: LVS improved in all but one patient. A significant decrease was noted in the GRBAS subscales grade, roughness, asthenia, and strain (P<.05). Breathiness was almost significant, with a P value of .052. There was an average decrease in the VHI-10 of 8.14 (P=.032). NHR, MPT, and PR did not statistically improve. CONCLUSIONS: ATFV for vocal fold scar and sulcus vocalis results in significant subjective vocal improvement that persists at least 1 year after surgery. LEVEL OF EVIDENCE: 4.