Combination of Anti-VEGF and Laser Photocoagulation for Diabetic Macular Edema: A Review.

Diabetic macular edema (DME) is the most common cause of vision loss in diabetic patients. Thirty years ago, the Early Treatment Diabetic Retinopathy Study (ETDRS) demonstrated that focal/grid laser photocoagulation reduces moderate vision loss from DME by 50% or more; thus, macular photocoagulation became the gold standard treatment for DME. However, with the development of anti-VEGF drugs (bevacizumab, ranibizumab, and aflibercept), better outcomes were obtained in terms of visual acuity gain and decrease in macular thickness in some studies when antiangiogenic drugs were administered in monotherapy.

Pars Plana Vitrectomy Alone for the Management of Pseudophakic Rhegmatogenous Retinal Detachment with Only Inferior Breaks.

Purpose: To report the surgical results of primary pseudophakic rhegmatogenous retinal detachment (RRD) with only inferior retinal breaks (IRBs) repaired by pars plana vitrectomy (PPV) alone and complete drainage of subretinal fluid.

Design: Prospective, interventional cohort study.

Participants: A total of 147 consecutive pseudophakic eyes of 147 patients with primary RRD with causative inferior breaks.

Retinal venous occlusions: diagnosis and choice of treatments.

Retinal vascular occlusive disorders constitute one of the major causes of blindness and impaired vision. There is marked controversy on their pathogeneses, clinical features and particularly their management. Recently, advances in clinical research added antivascular endothelial growth factor, corticosteroids and sustained-release implants to our armamentarium in the management of retinal vein occlusions.

Epiretinal membrane after pars plana vitrectomy for primary pseudophakic or aphakic rhegmatogenous retinal detachment: incidence and outcomes.

Purpose: To compare outcomes of eyes that did or did not develop an epiretinal membrane (ERM) after repair of primary pseudophakic or aphakic rhegmatogenous retinal detachment by pars plana vitrectomy alone.

Methods: Interventional, prospective, consecutive case series. Of 312 consecutive eyes that underwent pars plana vitrectomy for primary rhegmatogenous retinal detachment, 28 (8.

Macular holes after rhegmatogenous retinal detachment repair: surgical management and functional outcome.

Purpose: To review the surgical management and functional outcome of macular holes (MHs) developing after rhegmatogenous retinal detachment repair.

Methods: Retrospective, interventional, noncomparative case series. Twenty patients with MH developing after rhegmatogenous retinal detachment repair were included.

Pars plana vitrectomy alone with diffuse illumination and vitreous dissection to manage primary retinal detachment with unseen breaks.

Objective: To report on pars plana vitrectomy with diffuse illumination, wide-angle viewing, and meticulous vitreous dissection for identifying and managing retinal breaks when no breaks were detected before surgery for primary rhegmatogenous retinal detachment.

Methods: Prospective clinical study of 61 of 800 consecutive eyes (7.6%) (61 of 782 patients) seen at a university hospital during the 48-month study for primary rhegmatogenous retinal detachment in whom no break could be identified preoperatively despite thorough examinations.

Transconjunctival sutureless 23-gauge vitrectomy for diabetic retinopathy. Review.

This paper reviews the current experience and trends in 23-gauge transconjunctival sutureless vitrectomy for diabetic retinopathy in those patients that need a surgical intervention for either vitreous hemorrhage, fibrovascular proliferation with traction retinal detachment affecting or threatening the macula, traction-rhegmatogenous retinal detachment, or refractory macular edema with taut posterior hyaloid. Since the instruments in 23-gauge vitrectomy are less flexible and perform in a more similar way to 20-gauge instruments, the vitrectomy is more thorough and for more complex manoeuvres can be done. The 23-gauge transconjuntival sutureless vitrectomy avoids some of the shortcomings of the 25-gauge systems.

Prospective clinical trial evaluating the efficacy of photodynamic therapy for symptomatic circumscribed choroidal hemangioma.

Purpose: To evaluate photodynamic therapy (PDT) for symptomatic circumscribed choroidal hemangioma (CCH).

Design: Prospective, multicenter, nonrandomized clinical trial.

Participants: Thirty-one eyes of 31 patients with posterior pole CCH and symptoms caused by exudation into the macular area.

Topical anesthesia: possible risk factor for endophthalmitis after cataract extraction.

Purpose: To assess the relationship between the risk for acute endophthalmitis after cataract extraction and whether certain factors, such as surgeon qualification, numerical order, duration of surgery, operating theater, and type of anesthesia (topical or retrobulbar), could be modified to decrease the risk.

Setting: Single-center academic practice.

Methods: Two epidemiological studies were performed: a case-control study and a retrospective cohort study.

Radial optic neurotomy in central retinal vein occlusion: comparison of outcome in younger vs older patients.

Purpose: To evaluate the effectiveness of radial optic neurotomy (RON) for central retinal vein occlusion (CRVO) in patients < or =50 years of age (group 1) vs those >50 (group 2).

Design: Prospective, interventional, comparative case series.

Methods: The study included 43 consecutive patients with CRVO and preoperative visual acuity (VA) < or =0.

Pars plana vitrectomy, laser retinopexy, and aqueous tamponade for pseudophakic rhegmatogenous retinal detachment.

Objective: To evaluate a novel pars plana vitrectomy (PPV) approach with aqueous tamponade for repair of primary pseudophakic rhegmatogenous retinal detachment (RRD).

Design: Prospective, noncomparative, interventional case series.

Participants: Sixty nonconsecutive patients (60 eyes) with primary pseudophakic RRD.

Radial optic neurotomy for management of hemicentral retinal vein occlusion.

Objective: To evaluate the effect of radial optic neurotomy on visual acuity (VA) and foveal thickness in patients with hemicentral retinal vein occlusion.

Methods: A prospective noncomparative case series of 13 eyes in 13 patients with hemicentral retinal vein occlusion and a preoperative VA of 20/60 or less from a total of 232 retinal vein occlusions diagnosed. All patients underwent pars plana vitrectomy, posterior hyaloid dissection, and radial optic neurotomy at the nasal border of the optic disc.

Reopening of 2 macular holes after neodymium:YAG capsulotomy.

We report 2 cases of reopening of macular holes after successful neodymium:YAG (Nd:YAG) posterior capsulotomy. Both patients had surgery for closure of macular holes with recovery of visual acuity. To our knowledge, this is the first report of recurrent macular holes after Nd:YAG laser posterior capsulotomy treated successfully with surgery.

Management of inferior breaks in pseudophakic rhegmatogenous retinal detachment with pars plana vitrectomy and air.

Objective: To determine the role of pars plana vitrectomy without scleral buckling and air as a tamponade with 24 hours of prone positioning in the management of inferior breaks in primary pseudophakic rhegmatogenous retinal detachment.

Methods: Prospective, noncomparative, interventional case series. Fifteen consecutive eyes (15 patients) with primary pseudophakic rhegmatogenous retinal detachment with causative breaks located between the 4-o'clock and 8-o'clock positions underwent pars plana vitrectomy with air tamponade.

Pars plana vitrectomy alone for the management of inferior breaks in pseudophakic retinal detachment without facedown position.

Objective: To introduce a new approach with pars plana vitrectomy (PPV) alone and no facedown positioning in the management of pseudophakic retinal detachments (RDs) with inferior breaks.

Design: Prospective noncomparative interventional case series.

Participants: Forty consecutive pseudophakic eyes of 40 patients with rhegmatogenous RD with causative inferior breaks.

Rhegmatogenous retinal detachment in phakic eyes after posterior chamber phakic intraocular lens implantation for severe myopia.

Objective: To report the clinical presentation, surgical management, and outcomes of rhegmatogenous retinal detachment (RRD) in patients with severe myopia corrected by posterior chamber phakic (PCP) intraocular lens (IOL) implantation.

Design: Retrospective, noncomparative, interventional case series.

Participants: Sixteen eyes of 15 patients in whom retinal detachment developed after PCP IOL implantation.

Silicone posterior chamber phakic intraocular lens dislocated into the vitreous cavity.

Purpose: To report two highly myopic patients with silicone posterior chamber phakic intraocular lenses (Phakic Refractive Lens; CIBA Vision, Duluth, Ga) that luxated into the vitreous cavity without history of ocular trauma.

Methods: Two patients with posterior chamber phakic intraocular lenses (PIOLs) that luxated into the vitreous cavity of the right eye were examined. Each eye underwent pars plana vitrectomy and removal of the posterior chamber PIOL under retrobulbar anesthesia.

Management of macular edema in branch retinal vein occlusion with sheathotomy and recombinant tissue plasminogen activator.

Purpose: The common adventitial sheath that surrounds the retinal venule and arteriole at the crossing site plays a crucial role in branch retinal vein occlusion (BRVO). The purpose of this study was to report the surgical recanalization of the occluded vein using a bimanual technique and recombinant tissue plasminogen activator (tPA) and its effect on final visual acuity.

Methods: Arteriovenous sheathotomy was performed, using a bimanual technique, followed by fluid-air exchange and injection of 25 mg of recombinant tPA over the area of the occluded vein.

Optical coherence tomography in optic pit maculopathy managed with vitrectomy-laser-gas.

Background: Optic disc pit (ODP) maculopathy has a poor visual prognosis if left to its natural course. Several therapeutic approaches have been attempted. The cases of 11 patients evaluated with optical coherence tomography (OCT) and treated with vitrectomy-laser-gas and their functional and anatomical outcomes are presented.

Chorioretinal anastomosis after radial optic neurotomy for central retinal vein occlusion.

Objectives: To evaluate the incidence of chorioretinal anastomosis after radial optic neurotomy and to determine its effect on visual acuity and foveal thickness in patients with central retinal vein occlusion.

Methods: We conducted a prospective, uncontrolled, interventional study of 14 patients with preoperative visual acuities below 20/125. Pars plana vitrectomy and radial optic neurotomy were performed.