Cannula breakage during 25G+ minimally invasive vitrectomy: a case report.

BACKGROUND: With the continuous improvement of surgical instruments in vitrectomy, the use of a trocar and cannula not only optimizes the incision process but also facilitates insertion and withdrawal of instruments during the procedure. Nevertheless, incision-related complications have also been reported in the literature. However, cannula fractures during 25G+ minimally invasive vitrectomy have rarely been reported. CASE PRESENTATION: A 62-year-old man underwent 25G+ pars plana vitrectomy for proliferative diabetic retinopathy. At the beginning of the operation, we used a trocar with a cannula to perform the sclerotomy. After the trocar was pulled out, the cannula was not seen on the surface of the sclera. Thus the inside and outside of the eye were carefully searched. The broken cannula tip was found in the ciliary body corresponding to the superonasal sclerotomy site and was subsequently removed. CONCLUSIONS: Awareness regarding the risk of intraoperative fractures of 25G+ minimally invasive ocular surgical instruments is imperative. Whenever a broken or missing cannula is encountered, the residual part should be immediately extracted to avoid revision surgeries and postoperative complications.

Topical Review: Causes of Refractive Error After Silicone-oil Removal Combined with Cataract Surgery.

SIGNIFICANCE: This review summarizes the main factors of refractive error after silicone oil removal combined with cataract surgery.The post-operative refractive results of silicone oil removal combined with cataract surgery are closely related to the patient's future vision quality. This report summarizes the factors that influence the difference between the actual post-operative refractive power and the pre-operatively predicted refractive power after silicone oil removal combined with cataract surgery, including axial length, anterior chamber depth, silicone oil, commonly used tools for measuring intraocular lens power, and intraocular lens power calculation formulas, among others. The aim of the report is to assist clinical and scientific research on the elimination of refractive error after silicone oil removal combined with cataract surgery.

Polarity and epithelial-mesenchymal transition of retinal pigment epithelial cells in proliferative vitreoretinopathy.

Under physiological conditions, retinal pigment epithelium (RPE) is a cellular monolayer composed of mitotically quiescent cells. Tight junctions and adherens junctions maintain the polarity of RPE cells, and are required for cellular functions. In proliferative vitreoretinopathy (PVR), upon retinal tear, RPE cells lose cell-cell contact, undergo epithelial-mesenchymal transition (EMT), and ultimately transform into myofibroblasts, leading to the formation of fibrocellular membranes on both surfaces of the detached retina and on the posterior hyaloids, which causes tractional retinal detachment. In PVR, RPE cells are crucial contributors, and multiple signaling pathways, including the SMAD-dependent pathway, Rho pathway, MAPK pathways, Jagged/Notch pathway, and the Wnt/ß-catenin pathway are activated. These pathways mediate the EMT of RPE cells, which play a key role in the pathogenesis of PVR. This review summarizes the current body of knowledge on the polarized phenotype of RPE, the role of cell-cell contact, and the molecular mechanisms underlying the RPE EMT in PVR, emphasizing key insights into potential approaches to prevent PVR.

The Pathogenesis and Treatment of Complications in Nanophthalmos.

Microphthalmos is a type of developmental disorder ophthalmopathy, which can occur isolated or combined with other ocular malformations and can occur secondary to a systemic syndrome. Nanophthalmos is one of the clinical phenotypes of microphthalmos. Due to the special and complex structure of nanophthalmic eyes, the disorder is often associated with many complications, including high hyperopia, angle-closure glaucoma, and uveal effusion syndrome. The management of these complications is challenging, and conventional therapeutic methods are often ineffective in treating them. The purpose of this paper was to review the concept of nanophthalmos and present the latest progress in the study of the pathogenesis and treatment of its complications. As it is considerably challenging for ophthalmologists to prevent or treat these nanophthalmos complications, timely diagnosis and a suitable clinical treatment plan are vital to ensure that nanophthalmos patients are treated and managed effectively.