Purpose: To assess intra-operative complications and feasibility of removing crystalline lens fragments from the vitreous cavity through a limbal incision compared to a pars plana approach.
Design: Retrospective cohort study.
Subjects: 16 eyes underwent phacofragmentation via a limbal approach (Group A) and 9 eyes through a pars plana approach (Group B) at an academic center over a 10-year period.
Methods: We collected pre-operative, intra-operative, and post-operative data. We compared rates of intraoperative complications, including corneal wound burn, iris or capsular damage, retinal tears, and hemorrhage, and recorded post-operative BCVA and IOP measurements at the one-month post-operative appointment. We also compared rates of post-operative complications, including corneal edema, choroidal detachment, or retinal detachment.
Main Outcome Measures: Primary outcomes of the study were the rates of intraoperative complications and the feasibility of crystalline lens removal with the limbal approach. We defined the latter outcome as the ability to complete lens removal without switching to the pars plana route.
Results: Mean BCVA for group A was 1.6, and for group B was 2.0 ( = .19). There was no significant difference between the two groups in the incidence of intraoperative complications, including corneal wound burn, iris damage, anterior capsular tear, iatrogenic retinal tear, or suprachoroidal hemorrhage ( > .99). There was no significant difference in the incidence of intra-operative vitreous hemorrhage ( = .36). Additionally, there was no significant difference in post-operative corneal edema ( = .27), choroidal detachment ( = .52), or retinal detachment ( > .99). The mean post-operative BCVA was 1.0 in group A and 1.0 in group B ( = .75). We completed all cases in group A using the limbal approach without switching to the pars plana route.
Conclusion: Phacofragmentation through a limbal incision provides a feasible option for dropped nuclear fragment removal and is not associated with a higher risk of complications than the pars plana route.
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http://dx.doi.org/10.1080/08820538.2024.2376630 | DOI Listing |
Acta Ophthalmol
January 2025
Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway.
Purpose: To study choroidal thickness (CT) and luminal areas of choroidal vessels in the setting of fovea-off rhegmatogenous retinal detachment (RRD).
Methods: Twenty-seven eyes with RRD were prospectively studied before and after pars plana vitrectomy and SF6 tamponade, using swept-source optical coherence tomography (SS-OCT). CT was measured pre- and postoperatively both subfoveally and in attached macular areas.
Am J Ophthalmol Case Rep
December 2024
Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
Purpose: To report a case of corneoscleral juvenile xanthogranuloma (JXG) with progressive anterior segment involvement refractory to topical steroids.
Observations: A 4-month-old male was referred for a new-onset subconjunctival lesion in the right eye. He was found to have a thickened, yellow corneoscleral lesion and hyphema, presumed to be ocular JXG.
Retina
January 2025
Department of Ophthalmology, University Medical Center Rostock, Rostock, Germany.
Purpose: Formation of a full thickness macular hole (FTMH) after vitrectomy is rare. The aim of this study was to describe risk factors, clinical course, anatomical and functional prognosis of secondary FTMH development following surgery for primary rhegmatogenous retinal detachment (RRD).
Methods: Retrospective study.
Retina
January 2025
Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
Purpose: To describe effects of sustained-release steroid delivery devices on intraocular pressure (IOP) in eyes with glaucoma drainage devices (GDD).
Methods: Retrospective case series of eyes with steroid implants (dexamethasone or fluocinolone acetonide) and prior GDD (Ahmed, Baerveldt) without uveitis. Outcomes included IOP, IOP rise, central foveal thickness (CFT), and IOP medications.
Ocul Immunol Inflamm
January 2025
Francis I. Proctor Foundation, University of California, San Francisco, California, USA.
Purpose: To report on the clinical and cytopathological features of metastatic lung adenocarcinoma to the eye masquerading as an intermediate uveitis.
Methods: Retrospective chart review.
Results: A 63-year-old woman with a history of lung adenocarcinoma in remission presented with progressive vision loss and floaters in the right eye.
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