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Purpose: To compare the prevalence of intravitreal silicone oil microdroplets detected by slit-lamp biomicroscopy in eyes with 6 or more injections of the same anti-vascular endothelial growth factor (VEGF) drug., Design: Prospective, cross-sectional case series., Participants: A total of 260 consecutive eyes receiving 1 of 3 intravitreal anti-VEGF drugs for choroidal neovascularization, diabetic macular edema, or venous occlusive disease. The control group included 147 fellow eyes with no prior intravitreal injections., Methods: The anterior and mid-vitreous were carefully examined using 12× to 16× magnification through dilated pupils with ocular saccades before an injection. Silicone oil microdroplets were graded on a scale from 0 to 4+ based on the number and size of droplets., Main Outcome Measures: Presence and severity of silicone oil microdroplets in the vitreous., Results: Silicone oil microdroplets were observed in 78.3% of eyes receiving bevacizumab in Becton Dickinson (BD, Franklin Lakes, NJ) 0.3-mL polypropylene syringes, 14.4% of eyes receiving ranibizumab in 1.0-mL BD polypropylene syringes or more recently glass prefilled syringes, 48.5% of eyes receiving aflibercept in 1.0-mL BD polycarbonate syringes, and 0% of eyes in controls. The differences among the 4 groups were statistically significant at P < 0.001. The severity of silicone oil microdroplets was significantly greater in eyes using BD 0.3-mL polypropylene syringes than BD 1.0-mL polypropylene syringes, BD 1.0-mL polycarbonate syringes, or controls (P < 0.001). The severity of silicone oil microdroplets in eyes using BD 1.0-mL polycarbonate syringes was significantly greater than BD 1.0-mL polypropylene syringes (P = 0.012) and controls (P < 0.001). There was no significant difference between silicone oil microdroplet severity between BD 1.0-mL polypropylene syringes and controls (P = 1.0)., Conclusions: The BD 0.3-mL polypropylene syringes with repackaged bevacizumab and the BD 1.0-mL polycarbonate syringes with aflibercept cause a higher likelihood of silicone oil microdroplets. Intravitreal injections in eyes receiving multiple regular anti-VEGF injections should be supplied in silicone-free syringes., (Copyright © 2020 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Purpose: To measure the rate of cataract development and progression of nuclear sclerotic cataracts (NSC), posterior subcapsular cataracts (PSC), and cortical spoking cataracts in nondiabetic patients <50 years of age after a pars plana vitrectomy., Design: Retrospective cohort study., Subjects: Twenty-six eyes of 26 patients <50 years of age that had undergone a pars plana vitrectomy were included., Methods: Clinical records were reviewed retrospectively., Main Outcome Measures: The NSC, PSC, and cortical spoking scores were recorded preoperatively and 1, 3, 6, 9, and 12 months after surgery until discharged from care, lost to follow-up, or last visit before cataract surgery. Eyes were graded on a scale of 0 to 4.0 using the lens opacities classification system LOCS II before and after pars plana vitrectomy for macular hole, epiretinal membranes, and vitreous hemorrhage. Linear regression analysis was performed to evaluate the rate of change in cataract score with elapsed time since surgery., Results: The mean age at surgery was 30.6±14.3 years in 26 eyes with a median follow-up of 12 months. Eleven of 26 surgical eyes (42.3%) that had a baseline NSC and PSC score of zero in their surgical eye developed NSC, PSC, or both after vitrectomy. The mean progression for NSC, PSC, and cortical spoking were 0.327±0.14 (P = 0.032), 0.414±0.14 (P = 0.008), and 0.00±0.00 over a mean follow-up of 1.43 years, respectively. Linear regression analysis shows minimal increase in NSC (+0.09/year; P < 0.001; R 2  = +0.331), a slight increase in PSC (+0.16/year; P < 0.001; R 2  = +0.835), and a minimal decrease in cortical spoking (-0.02/year; P < 0.05; R 2  = -0.09)., Conclusions: Our findings suggest there is a minimal but significant increase in NSC and PSC scores for patients <50 years after pars plana vitrectomy. Cataract progression is not a significant factor in the first few years after vitrectomy in patients <50 years of age., (Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)