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Penetrating orbital injury with a foreign body is a complex problem that requires an interdisciplinary therapeutic approach. Conventionally, an external approach using either transconjuntival or transseptal entry is used by an ophthalmologist. However, there is a risk of damage to the optic nerve and orbital tissue using only the traditional approach. This study concerns a 36-year-old male who has an intra-orbital foreign body (OrbFB). Timely three-dimensional reconstruction computed tomography scan demonstrated an 8-cm-long intra-OrbFB adjacent to the optic nerve penetrating to the contralateral nasal cavity. Endoscopic inspection confirmed a chopstick fragment. Assisted by transnasal endoscopy, the chopstick penetrating from the orbit to the nasal cavity was smoothly removed. Nasal endoscopy is useful for an ophthalmologist in removing foreign body in the orbit. [ABSTRACT FROM AUTHOR]

Background: To evaluate the efficacy of micro-incision vitrectomy surgery using a non-contact wide-angle viewing system for fovea-attached type epiretinal membrane, and to report the factors influencing the outcome. Methods: A retrospective, comparative case series that included 50 patients with fovea-attached type epiretinal membrane who received micro-incision vitrectomy surgery using a non-contact wide-angle viewing system. Results: All patients were followed-up for a minimum of 12 months. Seven cases were classified as group 1A (mainly outer retinal thickening), 17 were group 1B (more tenting of outer retina and distorted inner retina), and 26 were group 1C (prominent inner retina thickening and inward tenting of outer retina). Outcome measures included operation time, recurrent rate, postoperative BCVA, and CRT. The mean operative time was 26.2 minutes. The mean change of BCVA (LogMAR) was − 0.43 (p< 0.001). The mean change of CRT was 135.3 μm (p< 0.001). The mean change of CRT was significantly higher in group 1C. Worse preoperative BCVA, male gender, and longer operative time can predict better postoperative BCVA found by multivariate logistic regression and multiple regression models. Conclusion: Significant improvement in BCVA and CRT is noted after micro-incision vitrectomy surgery to operate fovea-attached type epiretinal membranes. Worse preoperative BCVA, male, and longer operation time could predict better improvement. These findings may assist surgeons in better evaluating the potential of this method to help their patients with epiretinal membranes. [ABSTRACT FROM AUTHOR]

To evaluate the efficacy of microincision vitrectomy surgery (MIVS) for the treatment of post-cataract surgery endophthalmitis, and to report the factors which influence the outcome. This retrospective case series included eyes with post-cataract surgery endophthalmitis that had received MIVS between June 2014 and May 2017. The anatomical and functional results were analyzed. 24 eyes of 24 patients were included with mean age 72.0 ± 8.6 years old. Best-corrected visual acuity (BCVA) improved in 70.8% of patients with a significant mean logMAR BCVA change of −0.6 ± 0.9. Positive culture rate was 25%. In all study eyes, inflammation became silent after MIVS. In univariate analysis, patients with improved BCVA have shorter duration between cataract surgery and MIVS and less likely to have positive culture results. Using degree of BCVA improvement as a continuous variable, it showed that duration between cataract surgery and MIVS had significantly negative correlation with BCVA improvement. Patients with positive culture results had significantly lower BCVA improvement. Multiple regression models also confirmed the most important outcome-influencing factors. MIVS is an efficient management for post-cataract surgery endophthalmitis. BCVA is significantly improved after MIVS. No matter in univariate or multivariate analysis, positive culture results and longer duration between cataract surgery and MIVS have significant negative effects on the outcome of post-cataract surgery endophthalmitis. Multicenter collaboration should be conducted in order to formulate better management protocols of this vision-threatening complication of cataract surgery. [ABSTRACT FROM AUTHOR]

Tumor of lacrimal sac invading into orbit has to be removed carefully to avoid injuring the eyeball, optic nerve, and extraocular muscles. Transnasal endoscopic-assisted tumor excision is a method to remove the tumor from the nasal cavity through the lacrimal sac to the orbit in one procedure. A 55-year-old female patient with thyroid carcinoma removed more than 10 years ago. She recently had a swollen submandibular lymph node enlargement, which was pathologically diagnosed as metastatic carcinoma. Follow-up investigation showed a tumor in the ipsilateral lacrimal sac with invasion into adjacent orbit and nasal cavity. The tumor was removed through image-guided surgery (IGS), navigation-assisted transnasal endoscopic-assisted excision. The tumor was removed as much as possible. The eyeball, extraocular muscles, and optic nerve were not injured in the surgery. Postoperative swelling was minimal with mild nasal hemorrhage. No ecchymosis and conjunctiva chemosis and eyelid swelling was noticed. Ocular motility was full without diplopia. Although exenteration and partial maxillectomy were suggested after pathological result showed a carcinoma of lacrimal sac, patient did not want these extensive surgery immediately. On patient request to reserve the eyeball function, navigation-assisted transnasal endoscopic excision is a safe and efficient method for the preliminary surgery. This case of orbital tumor excision using endoscope and IGS navigation system is the first case by Taiwan ophthalmologists. [ABSTRACT FROM AUTHOR]