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Objectives No guidelines are available in France for peribulbar block for eye procedures. It is our hypothesis that continued use of acetyl salicylic acid for forestalling myocardial or cerebrovascular ischemic events does not increase the risk of hemorrhage, compared with discontinuation of its use in patients who undergo eye procedures under peribulbar block. Methods For this prospective control study we enrolled two groups of 500 patients scheduled for intra-ocular eye surgery requiring a peribulbar block. Patients treated with acetyl salicylic acid were included in group A (500 patients). Patients who had never been treated with acetyl salicylic acid constituted the control group (group B: 500 patients). Hemorrhages were graded as follows: 1 = spot ecchymosis; 2 = lid ecchymosis involving half of the lid surface area or less; 3 = lid ecchymosis all around the eye, without increase in intra-ocular pressure; 4 = retrobulbar hemorrhage with increased intraocular pressure. Results In group A, lid hemorrhages (grade 1) were observed in 30 patients (6.0%). No grade 2, 3 or 4 hemorrhages were encountered in this group. In group B, lid hemorrhage (grade 1) was observed in 20 patients (4.0%) and grade 2 in one patient (0.2 %), but no grade 3 or 4 hemorrhages were encountered. Statistical tests showed the absence of significance between both groups. Conclusion We conclude that between the groups with and without pre-operative acetyl salicylic acid the occurrence rate of lid hemorrhage was not significant in peribulbar block.

We report a case of endophthalmitis who underwent a vitreous biopsy to assess sensitivity and to inject broad-spectrum intraocular antibiotics. Minimal inhibitory concentration (MIC) values of antibiotics against a coagulase-negative staphylococcus and Proprionibacterium acnes were also assessed.

PURPOSE: To report a case of silicone oil intrusion in the upper eyelid, expressed by ptosis occurrence 19 years after surgery. METHODS: Vitrectomy followed by transscleral subretinal fluid drainage and silicone oil tamponade was performed on a 57-year-old man for retinal detachment. Nineteen years later, the patient was referred for mobile subcutaneous lumps of the upper right eyelid. Preoperative examination showed total invasion of the eyelid by silicone oil, as confirmed by pathology. RESULTS: Silicone oil leak developed through the transscleral drainage lumen and worsened with ocular hypertension. We assume that ptosis was induced by the weight of inflammatory tissue and consequently the development of a lymphoedema. CONCLUSION: We report a case of silicone ptosis. Two concomitant factors induced oil leakage: the puncture site and postoperative hypertonia.

Aims: To evaluate the characterics and surgical prognosis of macular holes that develop after rhegmatogenous retinal detachment repair. Design: Retrospective, interventional, consecutive case series. Methods: The case records of nine patients who developed a new full-thickness macular hole after prior RD repair were reviewed over 6 years. Optical coherence tomography (OCT) confirmed these holes. They were offered surgical repair with a median follow-up of 13.3 months (1–63 months). Main outcomes included preoperative vitreo-macular status, OCT evaluation and postoperative visual acuity. Results: 1007 eyes underwent surgery for prior retinal detachment between August 1999 and September 2005. Nine eyes developed a full-thickness macular hole (prevalence 0.9%): five developed after scleral buckling surgery, one after pneumatic retinopexy and three after primary vitrectomy. The mean time to macular hole diagnosis after RD was 2.9 months (0.5–18). All patients underwent macular hole surgery by the same surgeon. At 1 month, macular hole repair was noticed in eight eyes. In this group, visual acuity at a median of 11.9 months of follow-up was 20/125 (20/400 – 20/63). Three eyes had an improvement of more than three Snellen lines. Conclusions: Macular holes developing after RD repair is a rare complication (less than 1%). Its physiopathological mechanisms are not well known. Conventional macular hole surgery including pars plana vitrectomy, inconstant internal limiting membrane delamination and long-acting gas tamponade seems to achieve to macular reattachment (89%). The visual outcome seems conditioned by the macular status noticed during the RD.