Clinically undetected retinal breaks causing retinal detachment: A review of options for management.

The successful detection of retinal breaks is a critical step in rhegmatogenous retinal detachment surgery in order to prevent persistent/recurrent retinal detachments. Not all retinal breaks causing retinal detachments are obvious. Retinal breaks may be obscured by opacities that are either anterior segment related, lens related, or posterior segment related.

Evaluation of economic efficiencies in clinical retina practice: activity-based cost analysis and modeling to determine impacts of changes in patient management.

Background: The purpose of this study is to report the use of activity-based cost analysis to identify areas of practice efficiencies and inefficiencies within a large academic retinal center and a small single-specialty group. This analysis establishes a framework for evaluating rapidly shifting clinical practices (anti-vascular endothelial growth factor therapy, microincisional vitrectomy surgery) and incorporating changing reimbursements for care delivery (intravitreal injections, optical coherence tomography [OCT]) to determine the impact on practice profitability. Pro forma modeling targeted the impact of declining reimbursement for OCT imaging and intravitreal injection using a strategy that incorporates activity-based cost analysis into a direct evaluation schema for clinical operations management.

Complications associated with clear corneal cataract wounds during vitrectomy.

Purpose: The purpose of this study was to report the intraoperative surgical complications that occurred during vitrectomy surgery associated with clear corneal incisions from previous cataract surgery.

Methods: Retrospective, multicenter, case series, and chart review of five patients.

Results: Five patients, 3 men and 2 women, with a median age of 75 years (range, 59-78 years), were followed up for a median of 7.

An in vivo human demonstration of 23 gauge infusion cannula air forces striking the retina during a fluid/air exchange vitrectomy for macular hole repair.

Purpose: To demonstrate, in vivo, that infusion cannula forces of air may strike the retina and optic nerve, which may explain why some patients develop post vitrectomy scotomas.

Design: Case report.

Methods: During a vitrectomy for a macular hole, following a subtotal fluid/air exchange using a 23-gauge infusion cannula and a 25-gauge chandelier light, an unusual circular light reflex was noted on the surface of the retina inferior and nasal to the optic nerve.

Comparison of the original Amsler grid with the modified Amsler grid: result for patients with age-related macular degeneration.

Purpose: To compare the sensitivity of the original Amsler grid presenting white lines on a black background with that of the modified standard version of the grid presenting black lines on a white background in the detection of visual disturbances.

Patients And Methods: One hundred eighty-two patients (182 eyes) with dry and exudative age-related macular degeneration and a history of metamorphopsia were instructed to use an Amsler grid. None of the patients were familiar with an Amsler grid or had used it previously.

Macular hole genesis: the hydration theory.

Optical coherence tomography 3 images and a simple model suggest macular hole formation may be due to a defect in the inner retina with secondary vitreous fluid accumulation into the middle and outer retinal tissue.