SCLEROTOMY LEAKAGE IN TRANSCONJUNCTIVAL SMALL-GAUGE PARS PLANA VITRECTOMY: Effect of Removing the Cannula Over the Light Pipe.

Purpose: To determine the effect of cannula removal over the light pipe on the incidence of sclerotomy leakage and to evaluate other factors that may influence the incidence of sclerotomy leaks and hypotony on conclusion of small-gauge transconjunctival pars plana vitrectomy.

Methods: Retrospective, interventional clinical study of consecutive patients who underwent small-gauge transconjunctival pars plana vitrectomy at a single academic center. Eyes were divided into a group in which cannulae were removed over the light pipe (Group L) and a group in which cannulae were simply pulled out (Group N).

Intraoperative breakage of a disposable 23-gauge trocar tip.

Purpose: To report breakage of the tip of a 23-gauge trocar system during pars plana vitrectomy.

Methods: Retrospective single case report.

Results: A 56-year-old man was undergoing pars plana vitrectomy for vitreous hemorrhage using a 23-gauge 1-step trocar/cannula entry system.

Emerging pharmacotherapies for diabetic macular edema.

Diabetic macular edema (DME) remains an important cause of visual loss in patients with diabetes mellitus. Although photocoagulation and intensive control of systemic metabolic factors have been reported to achieve improved outcomes in large randomized clinical trials (RCTs), some patients with DME continue to lose vision despite treatment. Pharmacotherapies for DME include locally and systemically administered agents.

Management of ruptured retinal arterial macroaneurysm with intravitreal bevacizumab.

The authors report the management of a ruptured retinal arterial macroaneurysm and associated hemorrhages with intravitreal injections of bevacizumab. A 79-year-old woman presented with a history of systemic arterial hypertension and a ruptured retinal arterial macroaneurysm with pre-retinal, intraretinal, and subretinal hemorrhages extending into the macula. Visual acuity at presentation was 20/400.

Management of ruptured retinal arterial macroaneurysm with intravitreal bevacizumab.

The authors report the management of a ruptured retinal arterial macroaneurysm and associated hemorrhages with intravitreal injections of bevacizumab. A 79-year-old woman presented with a history of systemic arterial hypertension and a ruptured retinal arterial macroaneurysm with pre-retinal, intraretinal, and subretinal hemorrhages extending into the macula. Visual acuity at presentation was 20/400.

Resolution of Pigmented Keratic Precipitates Following Treatment of Pseudophakic Endophthalmitis Caused by Propionibacterium Acnes.

Propionibacterium acnes is a well-recognized cause of chronic postoperative endophthalmitis after cataract surgery. The subtle clinical signs of this infection and its initial favorable response to topical steroids may lead to delayed diagnosis and treatment. Two patients with culture proven P.

Methicillin-resistant Staphylococcus epidermidis isolation from the vitrectomy specimen four hours after initial treatment with vancomycin and ceftazidime.

A patient presented with acute-onset, postoperative endophthalmitis and visual acuity of light perception. Because of a time delay in arranging a pars plana vitrectomy (PPV), the patient was treated with a prompt vitreous tap for culture an injection of vancomycin and ceftazidime. Four hours later, the PPV was performed and additional antibiotics were injected.

Lack of toxicity of stainless steel retinal tacks during 21 years of follow-up.

Retinal tacks were historically used in the repair of complex retinal detachment associated with giant retinal tear. The authors describe a patient with retinal detachment associated with giant retinal tear who was treated successfully with pars plana vitrectomy, use of stainless steel retinal tacks, endolaser photocoagulation, and gas-fluid exchange. Twenty-one years after treatment, the retina has remained attached, the tacks are in place, and best-corrected visual acuity is 20/30 in the operated eye.

Prediction of postoperative astigmatism in cataract surgery.

Background: The purpose of this study was to predict postoperative astigmatism using refraction, keratometry, and other preoperative information after phacoemulsification with posterior chamber intraocular lens (IOL) implantation.

Methods: A retrospective study was conducted of 176 eyes of 161 patients undergoing phacoemulsification for visually significant cataract with capsular bag or sulcus IOL fixation at the Hunter Holmes McGuire Veterans Administration Medical Center, Richmond, Va. Eyes with complications and final-corrected visual acuity of less than 20/60 were excluded.