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Background and objective To compare pneumatic retinopexy (PnR) and scleral buckling (SB) for repair of primary rhegmatogenous retinal detachment. Materials and Methods Single-centre retrospective analysis of patients undergoing PnR and SB. Inclusion criteria comprehend phakic patients with a single retinal break or a group of breaks in detached retina in the same quadrant above the 8- and 4-o’clock meridians. A total of 184 patients were included, respectively 106 underwent PnR and 78 SB. Follow-up time was 6 months. Results Final visual outcome did not differ significantly between the two procedures (P = 0.12). Single-procedure reattachment rate was significantly higher in SB (94%) than in PnR (68%) (P Conclusion SB has a higher single reattachment rate than PnR. However, final visual outcomes of both procedures are comparable. In selected cases, PnR can be repeated with a high successful rate.

Purpose To report a real-life experience with the Argus II retinal prosthesis system in blind patients with end-stage retinitis pigmentosa (RP) or choroideremia (CHM), focusing on the pivotal role of optical coherence tomography (OCT) in both preoperative and postoperative management. Methods This hospital-based case series included 3 blind patients who were uneventfully implanted with Argus II epiretinal device. These patients (2 with RP and 1 with CHM) were selected during the Argus™ II Retinal Prosthesis System PostMarket Surveillance Study Protocol. Complete screening procedures had involved 66 eyes of 33 patients afferent to the Center for Retinitis Pigmentosa of the Veneto Region. Results Preoperative OCT examination resulted in the exclusion of 8 eyes in 4 patients with bilateral posterior staphyloma diagnosing unexpected staphylomatous macular patterns in 2 patients with RP and no sign of pathologic myopia. Postoperative OCT study of Argus II proximity to retinal surface indicated a plausible correlation between electrode–retina distance and perceptual threshold in 2 of our 3 patients. In particular, during the first 6 months of follow-up, the patient with the closest contact between device and macula showed a continuous vision-related improvement in the performance of several real-life tasks. Conclusions The present findings illustrate the modalities by which each different OCT examination is an essential tool to optimize safety and efficacy profiles during Argus II protocol. Optical coherence tomography will be crucial for future investigative approaches on patient selection criteria and next-generation implant design.

Purpose: To compare endothelial damage induced by different cataract incision sites and sizes using specular microscopy. Setting: Department of Ophthalmology, Hospital of San Dona di Piave, Venice, Italy. Methods: Eighty-one eyes having phacoemulsification were randomly assigned to 1 of 3 groups of 27 eyes each: 3.5 mm clear corneal incision (CCI) with silicone foldable intraocular lens (IOL) implantation; 5.5 mm sutured CCI with poly(methyl methacrylate) (PMMA) IOL implantation; 5.5 mm scleral tunnel with PMMA IOL implantation. All incisions were centered at the 120-degree semimeridian; that is, they were superotemporal in right eyes and superonasal in left eyes. Noncontact specular microscopy was performed in the center and at the 12 o'clock position preoperatively as well as 1 week and 1, 3, and 12 months postoperatively. The endothelial cell density, mean cell area, cell size variation coefficient, percentage of hexagonality, and corneal thickness were considered. Results: Progressive endothelial cell loss and an increase in mean cell area occurred in all groups during the follow-up. The cell loss percentages relative to the endothelial center appeared similar among the groups and slightly although not significantly lower in the scleral tunnel group. The scleral tunnel group had a statistically significant lower cell loss percentage at the 12 o'clock position than the 2 CCI groups at all follow-ups. Conclusions: The scleral tunnel group had less postoperative endothelial damage than the 2 CCI groups, with a statistically significant difference at the 12 o'clock position. This is probably because the scleral tunnel incision is placed more posteriorly and therefore induces less direct and indirect endothelial trauma.

To compare astigmatic and topographic changes induced by different oblique cataract incisions.Department of Ophthalmology, Hospital of San Donà di Piave, Venice, Italy.One hundred sixty-eight eyes having phacoemulsification were randomly assigned to 1 of 3 groups: 3.5 mm clear corneal incision (CCI), 60 eyes; 5.5 mm sutured CCI, 54 eyes; 5.5 mm scleral tunnel, 54 eyes. Incisions lay on the 120 degree semimeridian. Corneal topography was performed preoperatively and 1 week and 1 and 3 months postoperatively. Simulated keratometric readings were used to calculate astigmatism amplitude and surgically induced astigmatism (SIA). Postoperative topographic changes were determined by subtracting the preoperative from the postoperative numeric map readings.Three months postoperatively, the mean SIA in the right and left eyes, respectively, was 0.68 diopter (D) +/- 1.14 (SD) and 0.66 +/- 0.52 D in the 3.5 mm CCI group, 1.74 D +/- 1.43 D and 1.64 +/- 1.27 D in the 5.5 mm CCI group, and 0.46 +/- 0.56 D and 0.10 +/- 1.08 D in the scleral tunnel group. Right and left eyes showed similar SIA amplitude but different SIA axis orientation. The SIA was significantly higher in the 5.5 mm CCI group than in the other 2 groups 1 and 3 months postoperatively (P.01). All groups showed significant wound-related flattening and nonorthogonal steepening at 2 opposite radial sectors. Topographic changes were significantly higher in the 5.5 mm CCI group and significantly lower in the scleral tunnel group.Right and left eyes showed similar SIA amplitude but different SIA axis orientation and topographic modifications, probably because of the different superotemporal and superonasal corneal anatomic structure. The 5.5 mm CCI induced significantly higher postoperative astigmatism, SIA, and topographic changes.