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Introduction: This study aimed to examine the impact of cataract surgery on the corneal endothelium and central corneal thickness (CCT) in pediatric patients, and to identify the factors associated with corneal alterations. Methods: This retrospective study included consecutive children undergoing bilateral or unilateral cataract surgery and intraocular lens implantation at the Eye Hospital of Wenzhou Medical University, with or without posterior capsulorhexis and anterior vitrectomy, and an age-matched normal control group. This study aimed to assess whether changes in corneal parameters, including CCT, corneal endothelial cell density (CD), average cell area (AVE), standard deviation of size (SD), coefficient of variation (CV), percentage of hexagonal cells (6A) before and after surgery, and endothelial cell loss (ECL) differed among the bilateral cataract, unilateral cataract, and control groups. Furthermore, the potential effects of anterior vitrectomy, axial length, preoperative anterior chamber depth, surgical duration, horizontal corneal diameter, intraoperative pupil diameter (PD), and the number of corneal sutures on corneal endothelial parameters and CCT were investigated. Results: A total of 107 eyes from 107 children were included in the study. In the bilateral cataract group, CD significantly decreased, AVE and CCT significantly increased, and ECL was significantly higher than in the control group. The unilateral cataract group also exhibited a significant increase in CCT. Additionally, the number of corneal sutures was negatively correlated with CD, and PD was negatively correlated with CV in the unilateral cataract group. Conclusion: Cataract surgery in pediatric patients results in increased CCT, reduced CD, and morphological changes in corneal cells. A greater number of corneal sutures and a smaller PD increased the risk of CD reduction and elevated CV in the unilateral cataract group, underscoring the need for ophthalmologists to minimize corneal damage in these children. [ABSTRACT FROM AUTHOR]

AIM: To observe the clinical outcomes of femtosecond laser-assisted cataract phacoemulsification combined with anterior vitrectomy in the treatment of pediatric cataracts.METHODS: Retrospective study. A total of 10 patients(17 eyes)diagnosed as pediatric cataract in Foshan Aier Eye Hospital from January 2021 to September 2022 were collected, including 5 males(9 eyes)and 5 females(8 eyes), with an age of 3～9(4.50±1.20)years old. All children underwent femtosecond laser assisted phacoemulsification combined with anterior vitrectomy. The visual acuity, intraocular pressure and pigment deposits of intraocular lens(IOL)surface, synechia and hyperplasia of posterior capsule lens at 1wk, 1 and 6mo postoperatively were observed during the 6mo follow-up.RESULTS: All surgical procedures were successful, and there was no serious complication intraoperatively or postoperatively. BCVA(LogMAR)was 0.63±0.18 preoperatively and 0.42±0.10, 0.32±0.09, and 0.22±0.08 at 1wk, 1 and 6mo postoperatively(all P0.05). The incidence of IOL surface pigment deposits at 1wk, 1 and 6mo after surgery was 3 eyes(18%), 1 eye(6%), and 1 eye(6%), respectively, the incidence of synechia was 0 eye, 1 eye(6%), 2 eyes(12%), and the incidence of posterior capsule lens hyperplasia was 0 eye, 0 eye, and 2 eyes(12%), respectively.CONCLUSION: Femtosecond laser-assisted cataract phacoemulsification combined with vitrectomy for the removal of the anterior vitreous can effectively prevent anterior capsular tear and the occurrence of posterior capsule opacification.

Background An iris-claw intraocular lens (IOL) has been widely used as a secondary implant in aphakic patients and insufficient capsular or zonular support. They have gained popularity due to their simple fast technique, favourable functional outcomes, and safety Methods A non-comparative prospective interventional case series study about IOL implantation was conducted for a period of 1 year, by convenience sampling method. In our centre 3000 IOL implantations were done in 2022-2023 (1 year). Out of them 70 were Retro pupillary Iris Claw IOL implantations done at Dr. P.S.R Regional eye hospital, Kurnool medical college, Kurnool Results Out of 70 patients 8 have some complications after iris claw implantation. 11.2% have complications and 88.8% have good outcome with iris claw implantation. The observed complications are as follows abnormal pupil, decreased in visual acuity, raised intra ocular pressure, significant Anterior chamber reaction, iris abnormalities, post operative glaucoma, cystoid macular edema, endothelial decompensation. Conclusion Both primary and secondary retropupillary iris claw implantation is a viable option for the eyes without capsular support with less complications post operatively; it is safest and easiest method. we can overcome the problems of surgical aphakia and also aphakia due to trauma. [ABSTRACT FROM AUTHOR]

Objective: Our aim to examine the results of surgical treatment and follow-up of patients diagnosed with congenital cataract and who are under our clinical follow-up. Material and Method: In this study, a diagnosis of congenital cataract was made, anterior continuous curvilinear capsulorhexis, phacoaspiration,posterior continuous curvilinear capsulorhexis, anterior vitrectomy operation and/or intraocular lens implantation was performed in the ciliary sulcus, apakic follow-up was performed, and patients aged 0-34 years at the time of surgery. 84 eyes of 50 patients were evaluated Results: The mean follow-up period was 30.9±23months.After an average of 33 months of follow-up in 16 eyes, intraocular lens was applied to the ciliary sulcus in 57 eyes at an average of 45 months. During the follow-up period, secondary glaucoma was observed in 7eyes, intraocular lens dislocation in 9 eyes, pupillary irregularity and localized iris atrophy in 17 eyes,and anterior vitreous membrane development in 5 eyes. The preoperative best corrected visual acuity of the patients was 0.08±0.02 (P+P+ or hand motion-5m counting finger), and the postoperative best corrected visual acuity was 0.4±0.3, which was statistically significant(P<0.001).Apakic follow-up and secondary intraocular lens were applied to 16 patients, with an average visual acuity of 0.2. Conclusion: In the surgical treatment of congenital cataracts, anterior continuous curvilinear capsulorhexis, phacoaspiration, posterior continuous curvilinear capsulorhexis, anterior vitrectomyand/or intraocular lens implantation into the ciliary sulcus is an effective, reliable, and good visual technique in preventing posterior capsule occlusion and minimizing surgical complications. [ABSTRACT FROM AUTHOR]

Background: Anterior vitrectomy is a skill all cataract surgeons should develop and master. Every surgeon will have complications at some point in his/her career. Complication management should be part of the surgical training for all cataract surgeons. Posterior capsular rent does not translate to poor visual outcomes. If managed properly, excellent visual outcomes can be achieved and complications minimized. We aim to simplify the anterior vitrectomy procedure by this video. Purpose: This video will serve as a step-by-step practical guide to the intraoperative management of posterior capsular rent by simplifying the anterior vitrectomy procedure. Synopsis: This video will demonstrate how to tackle the dreaded complication of a posterior capsular rent with vitreous disturbance, and achieve optimal postoperative outcomes. Highlights: We demonstrate how a PCR appears, and once identified, how to proceed. In addition, nuances regarding foot positions and different vitrectomy modes are included. Biaxial vitrectomy is explained. Lens placement post-PCR is demonstrated. Furthermore, a brief about postoperative management is included. Video link: https://youtu.be/dTo7sMpe8h8

Purpose: To describe a clinical case of lumen obstruction a few days after implantation of the PreserFlo® Microshunt which has been resolved by anterior vitrectomy. Observation: A 76-year-old patient with advanced and progressing primary open-angle glaucoma (POAG) presented ten days after PreserFlo® Microshunt implantation in his left eye with an intraocular pressure (IOP) of 24 mmHg because of vitreous obstruction. Anterior vitrectomy with 25 Gauge vitrector was performed to remove the vitreous using a bimanual technique with two corneal accesses. The surgery was successful in lowering uncontrolled IOP without device repositioning. A free lumen and a IOP in the low range of tens was observed during follow-up. Conclusions and importance: PreserFlo ® MicroShunt obstruction by vitreous in pseudophakic patient is a possible complication. Anterior vitrectomy without the need of tube repositioning was successful in lowering uncontrolled IOP.

In our report, we present the hypersonic vitrectomy (Vitesse, Bausch and Lomb) being employed for anterior vitreous liquefaction and removal in posterior capsular rupture. The capsular tear with nucleus drop during conventional phacoemulsification was managed by vitrectomy using the hypersonic vitrector after posterior-assisted levitation followed by intraocular lens (IOL) implantation. The minimal cortical and epinuclear lens particles in the anterior chamber and vitreous were also liquefied with a stoke length of 30 to 40 μm and aspirated via the Vitesse vitrectomy system. The same probe performs the vitrectomy and the nucleus removal. The postoperative period was uneventful with clear cornea, normal fundus, and 20/20 best-corrected visual acuity (BCVA). The hypersonic vitrectomy utilizes the ultrasound power of 29.5 kHz and a stoke length of 0 to 60 μm for liquefaction of the vitreous. It can be a safe alternative for vitrectomy and lens removal in a single setting.

In our report, we present the hypersonic vitrectomy (Vitesse, Bausch and Lomb) being employed for anterior vitreous liquefaction and removal in posterior capsular rupture. The capsular tear with nucleus drop during conventional phacoemulsification was managed by vitrectomy using the hypersonic vitrector after posterior-assisted levitation followed by intraocular lens (IOL) implantation. The minimal cortical and epinuclear lens particles in the anterior chamber and vitreous were also liquefied with a stoke length of 30 to 40 μm and aspirated via the Vitesse vitrectomy system. The same probe performs the vitrectomy and the nucleus removal. The postoperative period was uneventful with clear cornea, normal fundus, and 20/20 best-corrected visual acuity (BCVA). The hypersonic vitrectomy utilizes the ultrasound power of 29.5 kHz and a stoke length of 0 to 60 μm for liquefaction of the vitreous. It can be a safe alternative for vitrectomy and lens removal in a single setting. [ABSTRACT FROM AUTHOR]

Abstract Background This study aimed to evaluate the factors influencing final visual acuity in pediatric traumatic cataracts. Methods Data of patients who presented with traumatic cataracts were reviewed retrospectively. We evaluated age at trauma; gender, trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; time, location, and type of intraocular lens (IOL) implantation; initial and final best corrected visual acuity (BCVA); amblyopia rate; and complications. Results In all, 61 eyes of 59 patients aged

Introduction: This study aimed to illustrate the efficacy of the combination of lens extraction, trabeculectomy, and anterior vitrectomy in patients with secondary angle-closure glaucoma (ACG) with autosomal recessive bestrophinopathy or Best vitelliform macular dystrophy. Methods: This is a retrospective self-controlled case series study. Five patients undergoing a single trabeculectomy in one eye and triple surgery in the other eye were enrolled. All patients underwent a complete ophthalmic examination that included best-corrected visual acuity (BCVA), intraocular pressure (IOP), ultrasound biomicroscopy, and static gonioscopy. Multimodal fundus imaging was performed, including color fundus photography, fundus autofluorescence, and optical coherence tomography. Genetic testing was also analyzed. Results: Among the 10 eyes, the mean IOP was 31.4 ± 4.7 mmHg before surgery. The mean axial length (AL) was 21.53 mm and the anterior chamber depth (ACD) was 2.31 mm. There were no statistically significant differences in preoperative IOP, BCVA, ACD, and AL between the two groups (all P > 0.05). The mean follow-up time was 64.0 months. All five eyes with a single trabeculectomy developed malignant glaucoma (MG). No complications were found in the other five eyes with triple surgery, and the anterior chamber was deepened and stable after surgery until the last visit. The mean IOP at the last visit was normalized to 16 mmHg without using any medications. Conclusions: Triple surgery is superior to single trabeculectomy for patients with ACG and BEST1 mutation, effectively bypassing MG complications. The vitreous may play a vital role in the mechanism of ACG in those patients and the high incidence of MG after filtering surgery. [ABSTRACT FROM AUTHOR]

Purpose: To describe a case of bilateral pseudophakic malignant glaucoma treated with a new variant of irido-zonulo-hyaloid-vitrectomy. Observations: A patient who developed refractory bilateral pseudophakic malignant glaucoma underwent an irido-zonulo-hyaloid-vitrectomy via the anterior chamber in both eyes, one 2-months apart from the other. The procedure involved the use of an 18 Gauge needle to perform a straight vertical irido-zonulo-hyaloidotomy and a 25 Gauge vitreous cutter to complete the vitrectomy. The intraocular pressure was recorded on day 1, day 7, day 14, then monthly until 6 months postoperatively, whereas an ultrasound biomicroscopy of the anterior chamber was performed on day 1 and 6 months after the operation. The malignant glaucoma resolved in both eyes with no intra- nor post-operative complications. At 6 months from the surgeries none of the eyes developed recurrences. Conclusions: The new variant of irido-zonulo-hyaloid-vitrectomy we propose for the management of refractory pseudophakic malignant glaucoma resulted to be a safe and effective technique.

AIM: To observe the safety and efficacy of the 25G anterior vitrectomy surgical technique via scleral flap in phacoemulsification combined with trabeculectomy for glaucoma and cataract with extremely shallow anterior chamber.METHODS: This retrospective case review consisted of 18 eyes of 18 patients(8 males and 10 females), of those, 11 eyes had acute angle-closure glaucoma with angle-closure greater than 180 degree, and 7 eyes had lens subluxation combined with glaucoma. All 18 patients underwent phacoemulsification, intraocular lens(IOL)implantation, trabeculectomy, and anterior vitrectomy via the scleral flap in cases where conservative management techniques cannot control intraocular pressure(IOP). The main outcomes were best corrected visual acuity(BCVA), anterior chamber depth(ACD), IOP, slit-lamp microscopic examination, number of medications, fundus examination, and complications.RESULTS: The average axial length(AL)was 21.5±0.6 mm. Mean age was 62.3±7.9 years. Mean ACD increased significantly from 0.78±0.43 mm to 2.89±0.41 mm 1wk after surgery(P

Background: This study aimed to evaluate the factors influencing final visual acuity in pediatric traumatic cataracts.Methods: Data of patients who presented with traumatic cataracts were reviewed retrospectively. We evaluated age at trauma; gender, trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; time, location, and type of intraocular lens (IOL) implantation; initial and final best corrected visual acuity (BCVA); amblyopia rate; and complications.Results: In all, 61 eyes of 59 patients aged < 16 years with cataracts after trauma were included. The mean age of the children was 7.2 ± 3.9 years. Primary IOL implantation was performed in 70.9% of eyes. The BCVA was 0.7 LogMAR or better in 5.9% of the 49 eyes in which the visual acuity could be measured at the time of trauma and in 69.1% of 55 eyes in which it could be measured after treatment. Evaluation of factors potentially influencing the final visual acuity revealed that eyes that had undergone posterior capsulotomy (PC) and anterior vitrectomy (AV) during cataract surgery had significantly better final visual acuity compared with eyes that did not undergo these procedures.Conclusions: In children with posttraumatic cataracts, final visual acuity was not affected by patient age and gender; trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; and time, location, and type of intraocular lens (IOL) implantation. Improvements in the final BCVA could be seen only by PC + AV combined with lens aspiration with or without IOL implantation. However, this approach of amblyopia treatment needs to be confirmed by more comprehensive and prospective studies. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to show visual rehabilitation in pediatric cataract with primary intraocular lens implantation. Materials and Methods: 106 eyes of 91 pediatric patients between 2 to 20 years of age who underwent cataract surgery with primary IOL implantation from June 2018 to January 2020 were included in the study. All the surgeries were performed by a single experienced pediatric ophthalmologist. Phacoemulsification, anterior vitrectomy, and primary posterior capsulorhexis with primary IOL implantation were done in all patients. Patients were reviewed 1 week, 1 month, and 6 months postoperatively. Results: Visual acuity improved from 1.7 logarithm of the minimum angle of resolution (logMAR) before the surgery to 0.74 logMAR at the last follow-up. Twelve eyes had postoperative complications which included posterior capsule opacification in 12 eyes, pupillary fibrin membranes in 17 eyes, and corneal edema in 2 eyes. Conclusion: The current study suggests that primary IOL implantation is safe when in an experienced hand for pediatric age group.

Purpose This study aims to investigate the effect of lensectomy with anterior vitrectomy plus goniosynechialysis followed by a secondary iris-claw intraocular-lens implantation on intraocular pressure (IOP) and visual acuity in pediatric patients with microspherophakia-associated angle-closure glaucoma. Patients and methods A prospective randomized interventional case-series surgical study included 24 eyes of 12 patients aged from 6 to16 years with angle-closure glaucoma. Patients initially underwent lensectomy plus anterior vitrectomy and goniosynechialysis in a primary session followed later by secondary iris-claw implantation. The main outcome measure was IOP control and stability and the secondary outcome measure was visual acuity. Results IOP decreased from 25±2.59 mmHg preoperatively to 13.21±1.77, 14.71±2.33, 16.17±3.25, 16.13±3.55, 15.63±1.17, 15.67±1.17, 15.67±1.17, 15.71±1.23, 15.71±1.23, 5.71±1.23, 15.71±1.23, and 15.71±1.23 at 1, 3, 6, 12, 18, 24, 30, 36, 42, 48, 54, and 60 months postoperatively. IOP was controlled with complete success in 62.5% of cases and qualified success in 29.2%, while 8.3% became controlled with further glaucoma surgery. Anterior-chamber depth increased from 1.56±0.7 preoperatively to 3.33±0.20 postoperatively and remained stable over the next 5 years (P˂0.001). Visual acuity significantly improved from 0.79±0.1 to 0.88±0.8 (P˂0.001). Refractive error significantly decreased from −16 D preoperatively to −0.5 D postoperatively (P˂0.01). Antiglaucoma treatment decreased significantly as 62.55% of patients stopped receiving antiglaucoma treatment postoperatively (P˂0.001). Conclusion Lensectomy with anterior vitrectomy and goniosynechialysis followed by secondary iris-claw intraocular-lens implantation is effective in the control of angle-closure glaucoma secondary to microspherophakia and results in significant improvement in visual acuity.

AimTo investigate the change of posterior capsular outcomes of pediatric cataract surgery with primary in-the-bag intraocular lens (IOL) implantation.MethodsWe conducted a case series of pediatric cataract children who underwent cataract extraction with primary in-the-bag IOL implantation, posterior capsulorhexis or vitrectorhexis, and limited anterior vitrectomy at the Eye Hospital of Wenzhou Medical University between 2016 and 2019. Digital retro-illumination photographs of pediatric eyes were obtained at baseline and 6 months, 12 months, and the last visit postoperatively. Capsular outcomes of the posterior capsular opening area (PCOA) and lens reprolifration area at those time points were compared. Correlations between the PCOA and influential factors, such as age at surgery, axial growth, and follow-up duration, were analyzed. The study was registered at register.clinicaltrials.gov (NCT04803097).ResultsData of 23 patients (27 eyes) were used in the final analysis. During follow-up, the PCOA enlarged at a rate of 0.29–0.32 mm2/month during the first six months postoperatively and 0.05–0.08 mm2/month over the next 1–2 years. Six months postoperatively, the PCOA enlargement statistically and positively correlated with the follow-up duration and axial growth. The area of lens reprolifration was 0.46 ± 1.00 mm2 at six months postoperatively and then remained stable.ConclusionThe PCOA enlarged rapidly within the first six months after the pediatric cataract surgery with primary IOL implantation. Six months postoperatively, the enlargement of PCOA was positively correlated with follow-up duration and axial growth. Posterior capsulorhexis or capsulectomy should be performed with a diameter of 3.0 to 4.0 mm for good visual axis transparency and the protection of in-the-bag IOL.

Purpose This study aims to investigate the effect of lensectomy with anterior vitrectomy plus goniosynechialysis followed by a secondary iris-claw intraocular-lens implantation on intraocular pressure (IOP) and visual acuity in pediatric patients with microspherophakia-associated angle-closure glaucoma. Patients and methods A prospective randomized interventional case-series surgical study included 24 eyes of 12 patients aged from 6 to16 years with angle-closure glaucoma. Patients initially underwent lensectomy plus anterior vitrectomy and goniosynechialysis in a primary session followed later by secondary iris-claw implantation. The main outcome measure was IOP control and stability and the secondary outcome measure was visual acuity. Results IOP decreased from 25±2.59 mmHg preoperatively to 13.21±1.77, 14.71±2.33, 16.17±3.25, 16.13±3.55, 15.63±1.17, 15.67±1.17, 15.67±1.17, 15.71±1.23, 15.71±1.23, 5.71±1.23, 15.71±1.23, and 15.71±1.23 at 1, 3, 6, 12, 18, 24, 30, 36, 42, 48, 54, and 60 months postoperatively. IOP was controlled with complete success in 62.5% of cases and qualified success in 29.2%, while 8.3% became controlled with further glaucoma surgery. Anterior-chamber depth increased from 1.56±0.7 preoperatively to 3.33±0.20 postoperatively and remained stable over the next 5 years (P˂0.001). Visual acuity significantly improved from 0.79±0.1 to 0.88±0.8 (P˂0.001). Refractive error significantly decreased from −16 D preoperatively to −0.5 D postoperatively (P˂0.01). Antiglaucoma treatment decreased significantly as 62.55% of patients stopped receiving antiglaucoma treatment postoperatively (P˂0.001). Conclusion Lensectomy with anterior vitrectomy and goniosynechialysis followed by secondary iris-claw intraocular-lens implantation is effective in the control of angle-closure glaucoma secondary to microspherophakia and results in significant improvement in visual acuity. [ABSTRACT FROM AUTHOR]

Purpose: To describe a modified surgical approach with anterior vitrectomy, phacoemulsification (phaco) cataract extraction and irido-zonulo-hyaloid-vitrectomy (IZHV) in protracted acute angle closure crisis (AACC). Patients and methods: Non-comparative, retrospective case series including 21 eyes in 19 consecutive cases of protracted AACC, which persists for at least 7 days despite maximal medical and laser therapies, were included in this study. All patients underwent a modified surgical procedure with anterior vitrectomy, phaco cataract extraction, IOL implantation, goniosynechialysis (GSL) and IZHV, using modest phaco dynamic parameters with intraocular pressure (IOP) set at 30 mmHg through the procedure using Centurion® Vision System equipped with active fluidics while the anterior vitrectomy was set at 4000 or 5000 rpm. IOP and anterior chamber space were maintained through the procedure using ophthalmic viscosurgical device (OVD) injected through paracentesis whenever the Phaco or I/A probe was withdrawn from within the anterior chamber. Medical history, visual acuity (VA), IOP and anterior and posterior segment findings were recorded and compared before and after surgical treatment. Results: The average age of all patients was 60.05 years old, while the average period of persistent AACC was 20.05 days. Preoperatively, the average IOP of all included eyes was 44.40 ± 8.42 mmHg despite maximal topical and systemic anti-glaucoma medications and/or laser surgeries, while the average VA was 1.46 ± 0.88 (log MAR). Postoperatively, IOP was well controlled in all patients with an average IOP at 12.06 ± 3.07 mmHg without any anti-glaucoma medications at follow-ups, which was decreased significantly from that in preoperative measurements (P < 0.001). Visual acuity was improved significantly at final follow-up with an average postoperative VA at 0.74 ± 0.77 (log MAR, P < 0.001). Anterior segment inflammation was surprisingly mild with no or minimal inflammatory cells or exudates. Anterior segment configuration was resolved in all the cases. There was no recurrent IOP spike, anterior chamber shallowing or severe complications during an average follow-up of 5.38 months (ranging from 3 to 6 months). Conclusions: Protracted AACC is a complex situation while a modified surgical strategy of anterior vitrectomy, phaco cataract extraction and IZHV provides a safe and efficient solution. [ABSTRACT FROM AUTHOR]

Background: Anterior vitrectomy is a skill all cataract surgeons should develop and master. Every surgeon will have complications at some point in his/her career. Complication management should be part of the surgical training for all cataract surgeons. Posterior capsular rent does not translate to poor visual outcomes. If managed properly, excellent visual outcomes can be achieved and complications minimized. We aim to simplify the anterior vitrectomy procedure by this video. Purpose: This video will serve as a step‑by‑step practical guide to the intraoperative management of posterior capsular rent by simplifying the anterior vitrectomy procedure. Synopsis: This video will demonstrate how to tackle the dreaded complication of a posterior capsular rent with vitreous disturbance, and achieve optimal postoperative outcomes. Highlights: We demonstrate how a PCR appears, and once identified, how to proceed. In addition, nuances regarding foot positions and different vitrectomy modes are included. Biaxial vitrectomy is explained. Lens placement post‑PCR is demonstrated. Furthermore, a brief about postoperative management is included. [ABSTRACT FROM AUTHOR]

Purpose: To report a series of central retinal artery occlusions (CRAO) following cataract surgery complicated by posterior capsular rupture (PCR). Methods: Data from 14 patients with acute CRAO following cataract surgery was collected for this study including subject demographics, initial and final best-corrected visual acuity, systemic investigations, optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) findings. Results: Mean subject age was 59.9 ± 12.1 years. Male: Female ratio was 1:1. All patients were operated between October and November 2015 and presented with acute vision loss 1 to 4 days after surgery. All the patients underwent cataract surgery under peribulbar anesthesia and had PCR for which anterior vitrectomy (AV) was done. In all the cases Ethylene oxide (ETO) sterilized vitrectomy probe was used for AV. Clinical picture of CRAO was noted in all the cases during the immediate postoperative period. OCT showed inner retinal layer hyperreflectivity while FFA was normal in all the cases. The final visual acuity was poor in all the eyes. This paper discusses the possible mechanisms of CRAO in these cases. Conclusion: CRAO is a potential complication of peribulbar anesthesia for intraocular surgery in patients with vascular risk factors and hence any substance that can aggravate the vasospasm in such patients should be used cautiously. Vasospasm could be caused by ETO as residual ETO could be present in the vitrectomy machine tubing causing toxicity. It is recommended to be cautious while using ETO sterilized instruments for cataract surgery.

Purpose: This study evaluated bimanual intracapsular irrigation-aspiration for ectopia lentis with use of a small incision for 4-point scleral fixation of a foldable posterior-chamber intraocular lens (IOL) and anterior vitrectomy in patients with Marfan syndrome. Methods: We performed a retrospective study of 18 eyes from 10 patients with Marfan syndrome who underwent surgical intervention for ectopia lentis at our clinic between July 2012 and September 2018. In this study, intraoperative and postoperative complications, uncorrected visual acuity, best-corrected visual acuity, spherical equivalent, intraocular pressure, and endothelial cell density were evaluated. Results: No intraoperative complications were reported. In all cases, early postoperative evaluation revealed a clear cornea, round pupil, and well-centered IOL. Mean logMAR uncorrected visual acuity improved from 1.09 preoperatively to 0.56 postoperatively (P < 0.05). Mean logMAR best-corrected visual acuity improved from 0.45 preoperatively to 0.17 postoperatively (P < 0.05). Aside from transient ocular hypertension, no postoperative complications were reported. Conclusion: The combined surgical technique presented above yields excellent visual outcomes with an extremely low incidence of complications. This approach is simple, safe, and effective in the treatment of ectopia lentis in patients with Marfan syndrome.

Pediatric cataract remains a very important and difficult problem to manage, in spite of dramatic advances that have occurred in the field over the past 10 years. Since early treatment is the most important factor in determining the visual outcome in congenital cataract, prompt detection and treatment in the neonatal period are the aims. This review is to update the reader on advances and present concepts on the topic.

Purpose: To compare the rates of rhegmatogenous retinal detachment (RRD) following an anterior vitrectomy (AV) alone during cataract surgery, compared to cases requiring a subsequent pars plana vitrectomy (PPV) for dropped nuclear lens fragments (DNLFs). Methods: Retrospective electronic note review of consecutive patients with a posterior capsular rupture (PCR) requiring either AV or subsequent PPV for DNLF over a 5-year period. Results: A total of 20,235 cataract operations were performed during the defined period with 199 cases (eyes) of PCR (0.98%). One hundred forty-four of these (72.4%) were managed with AV, and the remaining 55 cases were further complicated by DNLF and thus underwent secondary PPVs. A total of 80.0% of cases in the AV group had a final BCVA of 0.30 logMAR or better, and 77.35% in the DNLF group had a BCVA of 0.30 logMAR or better (p = 0.069). Final BCVA was 0.30 (range—0.18 to 3.0) in the AV group and 0.32 (range—0.18 to 1.8) in the DNLF group (p = 0.82). Final BCVA in those patients who suffered a RRD was poorer than the rest of the cohort in the AV group (p = 0.03). Seven of 144 cases in the AV group went on to develop a RRD with a median time of 11 months (range 1–18 months). None of the cases in the DNLF group went on to develop a RRD (P = 0.048). Conclusion: Following an anterior vitrectomy during complicated cataract surgery, the risk of RRD may be lower in patients who require a subsequent PPV for management of DNLF compared to patients who are managed with anterior vitrectomy alone. [ABSTRACT FROM AUTHOR]

AIM: To investigate the changes in vitreous gel structure after lens extirpation combined with anterior vitrectomy in rabbit eyes. METHODS: Twenty-eight chinchilla rabbits were divided into three groups. The control group (Group I) included 16 eyes from eight rabbits who did not receive any treatment. Group II included 20 eyes from 10 rabbits that underwent lens aspiration only. Group III included 20 eyes from 10 rabbits that underwent lens aspiration combined with posterior capsulotomy and anterior vitrectomy. Eyes were harvested on the 30th and 60th day postoperatively, respectively. Changes in vitreous gel stretch length due to gravity and the rate of vitreous liquefaction were observed. The collagen content in the vitreous body was examined using the L-hydroxyproline test. Electronic microscopic images were obtained from each eyeball. RESULTS: On both the 30th and 60th day postoperatively, the vitreous gel length of group III was significantly shorter than group I and group II (P

Purpose: This study aims to introduce a new suture method and report surgical outcomes of patients who underwent scleral-fixated intraocular lens (SF-IOL) implantation combined with either pars plana vitrectomy (PPV) or anterior vitrectomy (AV)., Methods: Twenty-three eyes performed SF-IOL implantation combined with PPV (Group 1), and 34 eyes performed SF-IOL implantation combined with AV (Group 2) were included in the study prospectively. The SF-IOL, either polymethyl methacrylate or foldable IOL, was sutured into the sclera using PC-9 sutures in an irregular, knotless, and zigzag-shaped manner. The scleral tunnel was approximately 12-15 mm long, with at least four sharp edges. Suture tips were trimmed within the scleral tunnel. Postoperative outcomes and complications were evaluated., Results: Both groups showed no complications such as suture tip expulsion, suture reaction, IOL dislocation, or increased intraocular pressure during postoperative visits. Group 1 exhibited a statistically significant improvement in visual acuity compared to preoperative values ( P = 0.036 for the 1 st month, <0.001 for the 3 rd month). Similarly, Group 2 demonstrated a statistically significant improvement in visual acuity compared to the preoperative period ( P = 0.001 for the 1 st month, <0.001 for the 3 rd month)., Conclusion: The "irregular, knotless, and zigzag-shaped scleral tunnel suture technique" yielded favorable results in terms of IOL stability and visual acuity. This technique can be safely employed in patients undergoing SF-IOL implantation combined with PPV or AV., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Saudi Journal of Ophthalmology.)