Pulled-in-two syndrome in a patient with heavy eye syndrome.

We report the case of a 73-year-old woman diagnosed with heavy eye syndrome who underwent loop myopexy of the superior rectus and lateral rectus muscles after suffering pulled-in-two syndrome caused by exploration of the medial rectus muscle, which could not be recovered. Given that intraoperative forced ductions remained positive after loss of the muscle, a loop myopexy of the superior rectus muscle and lateral rectus muscles was performed. Postoperatively the patient regained full adduction, and her esotropia improved notably.

Early Diagnosis and Management of Aggressive Posterior Vitreoretinopathy Presenting in Premature Neonates.

Background And Objective: Aggressive posterior vitreoretinopathy (APVR) manifests with a broad area of retinal avascularity, progressive neovascularization, and/or tractional retinal detachment during the neonatal period.

Patients And Methods: A multicenter, retrospective, observational, consecutive case series study was performed to evaluate the retinal findings and structural retinal outcomes in patients treated for APVR within the first 3 months of life.

Results: Three premature neonates with a non-retinopathy of prematurity (ROP) APVR identified during routine ROP screening exams exhibited relatively severe, rapidly progressive retinal vascular abnormalities.

Retinal vascular nonperfusion in siblings with Dandy-Walker variant.

We report the case of a 2-month-old girl with Dandy-Walker variant who presented with strabismus, pathologic myopia measuring -16.00 D in each eye, diffuse chorioretinal atrophy and pigment mottling in the macula of both eyes, and areas of retinal capillary nonperfusion in both eyes. The patient's brother also has Dandy-Walker variant and was found to have bilateral severe myopia, myopic fundi, tilted optic disks with peripapillary atrophy, extensive areas of white without pressure, areas of lattice degeneration, and several chronic-appearing atrophic retinal holes surrounded by pigmentation.

Cross-Sectional Analysis of Neurocognitive Function, Retinopathy, and Retinal Thinning by Spectral-Domain Optical Coherence Tomography in Sickle Cell Patients.

Purpose: The purpose was to examine the relationship between neurocognitive function and two distinct forms of retinopathy in sickle cell disease.

Materials And Methods: Patients with sickle cell disease (n = 44, age range: 19-56 years, 70% female) were prospectively recruited for this cross-sectional study. Retinopathy was characterized by: (1) Presence of focal retinal thinning on spectral domain optical coherence tomography and (2) determination of the sickle retinopathy stage on funduscopic exam based on Goldberg classification.

Bilateral Congenital Posterior Capsular Defects and Ectopic Cataracts.

Preexisting posterior capsular defects are rare and can be associated with infantile cataracts. The authors review possible etiologies of this condition and emphasize the importance of cautious preoperative planning and surgery.

The effect of rectus muscle recession, resection and plication on anterior segment circulation in humans.

Background: Plication is an alternative tightening procedure to resection. In monkeys, plication has been shown to preserve anterior segment circulation compared with full-tendon tenotomy, but this is unconfirmed in humans.

Purpose: To evaluate anterior segment circulation by iris angiography before and after strabismus surgery in humans.

Assessment of torsion after superior rectus transposition with or without medial rectus recession for Duane syndrome and abducens nerve palsy.

Background: Superior rectus transposition with or without medial rectus recession has been advocated for the treatment of abducens nerve palsy and esotropic Duane syndrome. Early reports have focused mainly on postoperative ocular alignment, but there is concern that superior rectus transposition may induce torsional misalignment. The purpose of this study was to evaluate torsional outcomes after superior rectus transposition surgery using prospective preoperative and postoperative torsional assessments.

Bilateral traumatic expulsive aniridia after phacoemulsification.

We report a case of bilateral traumatic expulsive aniridia after uneventful phacoemulsification through small clear corneal incisions. Phacoemulsification was performed 8 and 13 months prior to the trauma in the left and right eyes, respectively. In both eyes, the intraocular lens and capsular bag were undisturbed after trauma.

Chronic anterior uveitis in common variable immunodeficiency.

Purpose: To describe patients with uveitis and common variable immunodeficiency (CVID).

Design: Retrospective observational case series.

Methods: Retrospective review of patients with uveitis and CVID, specifically focusing on clinical presentation and treatment.

Impact of resident participation in cataract surgery on operative time and cost.

Objective: To investigate the impact of resident participation in cataract surgery on operative time and cost.

Design: Retrospective chart review.

Participants: All patients who underwent phacoemulsification cataract surgery by an attending or resident surgeon of the Penn State Hershey Eye Center between July 1, 2004, and June 30, 2007.