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Purpose: To evaluate preoperative factors influencing the visual outcome and postoperative factors associated with the changes in visual acuity, after reattachment surgery to treat macula-off rhegmatogenous retinal detachment., Methods: A total of 180 eyes of 180 patients who underwent reattachment surgery to treat macula-off rhegmatogenous retinal detachment, and who were followed up for more than 12 months, were reviewed retrospectively. Preoperative and postoperative characteristics, including optical coherence tomography findings, were comprehensively analyzed using univariate and multivariate models to evaluate preoperative factors influencing best-corrected visual acuity 12 months after macula-off rhegmatogenous retinal detachment surgery and postoperative factors associated with changes in best-corrected visual acuity after surgery., Results: Preoperatively, the extent of detachment (P = 0.037), macula-off duration (P < 0.001), and integrity of the external limiting membrane (β = 0.163; P = 0.002) were significantly associated with postoperative visual prognosis. Six factors were associated with changes in visual acuity after surgery: disruption of ellipsoid zone integrity (β = 0.167; P < 0.001), the Henle's fiber layer and the outer nuclear layer (HFL + ONL)/photoreceptor layer ratio (β = 0.199; P < 0.001), the photoreceptor outer segment length (β = -0.020; P < 0.001), the photoreceptor inner segment length/photoreceptor outer segment length ratio (β = 0.047; P = 0.005), the ratio of photoreceptor layer thickness between the RD eye and fellow eye (β = -0.126; P = 0.018), and the photoreceptor outer segment length ratio between the RD eye and fellow eye (β = -0.425; P < 0.001)., Conclusion: Preoperative factors associated with the visual outcome after macula-off rhegmatogenous retinal detachment surgery were the extent of detachment, macula-off duration, and external limiting membrane integrity. Postoperatively, predictive factors were the outer retinal microstructures, particularly the photoreceptor outer segment layer.

Purpose: To evaluate the safety of retinal detachment (RD) surgery in eyes with iris-fixated phakic intraocular lenses (pIOLs) and the efficacy of the pIOLs in correcting myopia after RD surgery., Setting: Single university-based tertiary referral center., Design: Retrospective case series., Methods: Eyes that had RD surgery (RD group) and healthy fellow eyes (control group) of the same patients were evaluated over 1 year. Surgical success, corrected distance visual acuity (CDVA), anterior chamber depth (ACD), endothelial cell density (ECD), and intraocular pressure (IOP) were assessed preoperatively and postoperatively to evaluate the safety of the surgery. The uncorrected distance visual acuity (UDVA) and spherical equivalent were assessed to evaluate the efficacy of the pIOL after RD surgery., Results: Twenty-two eyes of 11 patients were assessed. Reattachment was achieved in 10 eyes (90.9%) with the first intervention. After 1 year, the mean UDVA was 0.16 ± 0.15 logMAR (SD) in the RD group and 0.09 ± 0.12 logMAR in the control group (P=.332). The mean CDVA was 0.03 ± 0.07 logMAR in the RD group. The differences in the mean postoperative ACD and ECD between the 2 groups were not significant (P=.088 and P=.270, respectively). The mean IOP in the RD group was significantly higher than in the control group up to 1 month postoperatively; thereafter, the difference was not significant., Conclusions: Preservation of a pIOL during RD surgery did not diminish the safety of the surgery. The efficacy of the pIOL in correcting myopia was not markedly compromised., (Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: To assess the efficacy and safety of iris-fixated phakic intraocular lens (pIOL) implantation to correct myopia in eyes with previous retinal detachment (RD) surgery., Setting: Department of Ophthalmology, Soonchunhyang University College of Medicine, Seoul, South Korea., Design: Retrospective case series., Methods: Patients having pIOL implantation in both eyes were enrolled. Eyes that had scleral buckling or encircling (RD group) and healthy fellow eyes (non-RD group) were evaluated over a 6-year follow-up. The corrected distance visual acuity (CDVA), endothelial cell density (ECD), intraoperative complications, and long-term complications were safety outcomes. Uncorrected distance visual acuity (UDVA), predictability, and stability of refraction were efficacy outcomes., Results: The study comprised 34 eyes (17 patients). The mean postoperative CDVA and ECD were not significantly different between groups, and no patient lost CDVA. The rate of transient intraocular pressure spike was significantly higher in the RD group (P=.043). After 3 years and 6 years, the mean postoperative UDVA was 0.06 logMAR ± 0.09 (SD) and 0.08 ± 0.10 logMAR, respectively, in the RD group and 0.04 ± 0.08 logMAR and 0.04 ± 0.09 logMAR, respectively, in the non-RD group (P=.518 and P=.478, respectively). The rate of eyes within ±0.50 diopter of the desired refraction and the postoperative refraction was not significantly different between groups. No eye had vitreoretinal changes requiring secondary surgical intervention., Conclusion: Iris-fixated pIOL implantation corrected the myopic refractive error in patients who had scleral buckling or encircling surgery for RD with a high degree of efficacy, safety, and long-term stability., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned., (Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: The authors investigated the surgical outcomes of massive subretinal hemorrhage draining via a retinotomy procedure in bullous hemorrhagic retinal detachment (HRD)., Methods: Clinical records of consecutive patients with age-related macular degeneration who underwent surgery for bullous HRD were reviewed. Outcomes included anatomical success, visual acuity, and postoperative complications., Results: Seventeen consecutive eyes of 17 patients were included in this series. Of the 17 eyes, 8 eyes had total HRD and 9 eyes had half total inferior HRD including the macula. The mean interval between initial symptom presentation and operation was 22.6 ± 11.7 days. All patients underwent pars plana vitrectomy and internal drainage of the subretinal hemorrhage through a posterior drainage retinotomy. The mean follow-up period was 37.1 months (range, 12-66 months). Finally, successful retinal reattachment was achieved in 15 of the 17 eyes (88.2%), but 2 remained nonprogressive localized inferior retinal detachment because of proliferative vitreoretinopathy. All preoperative visual acuities were hand movements or worse, and 10 eyes (58.8%) achieved a postoperative minimum functional vision of 20/1000 or better., Conclusion: Successful retinal reattachment and achievement of minimum functional vision is possible after PPV and retinotomy with evacuation of a massive subretinal hemorrhage for bullous HRD secondary to age-related macular degeneration.

Intravitreal injection of bevacizumab has been shown to satisfactorily treat retinopathy of prematurity; nevertheless, the safety of antivascular endothelial growth factor therapy in children remains uncertain. We report a patient with bilateral, zone 1, stage 3 plus retinopathy of prematurity who was treated with combined laser photocoagulation and intravitreal ranibizumab injection and demonstrated full regression at 3 months after injection but then developed bilateral retinal detachments 1 month later., (Copyright © 2010. Published by Mosby, Inc.)

Purpose: To report three cases of Artisan phakic intraocular lens (PIOL) implantation to correct myopic refractive error after previous retinal detachment surgery treated with scleral encircling., Methods: Artisan PIOLs were implanted in a 29-year-old man with -21.0 -2.0 x 180 manifest refraction and best spectacle-corrected visual acuity (BSCVA) of 20/40 (case 1), a 28-year-old woman with BSCVA of 20/20 and -8.5 -1.0 x 180 manifest refraction (case 2), and a 44-year-old man with BSCVA of 20/32 and -11.75 -1.75 x 10 manifest refraction (case 3)., Results: In case 1, 24 months after implantation of the Artisan PIOL, uncorrected visual acuity (UCVA) was 20/40. In case 2, 24 months after surgery, UCVA was 20/32. In case 3, 3 months after surgery, UCVA was 20/32. There was no formation of new breaks, progressive vitreoretinal traction, or complications., Conclusions: The Artisan PIOL may provide an alternative method to correct high myopia after retinal detachment surgery.

Purpose: To evaluate the efficacy of a novel snail-tipped exoplant for macular buckling combined with vitrectomy in high myopic eyes with macular hole retinal detachment. Patient and methods: A novel exoplant was simply prepared with a 5 × 3 mm silicone sponge strengthened in the center with a malleable titanium plate. One end was bent to make a rolled tip like a snail shell to be placed under the macula. Combined vitrectomy with macular buckling using this exoplant was performed in eight consecutive cases. The long arm of the exoplant was manipulated manually to fit the curvature of the eyeball and the length was trimmed appropriately after scleral suturing of the exoplant. Results: Retinal reattachment was achieved in all cases (100%) and macular hole closure was confirmed in 6 eyes (75%). The mean best-corrected visual acuity improved from 1.53 ± 0.73 LogMAR preoperatively to 1.14 ± 0.59 LogMAR to postoperatively (p = 0.063). The mean pre- and postoperative AL was 28.44 ± 1.86 mm and 27.60 ± 1.83 mm, respectively (p = 0.016). The mean follow-up period was 15.4 months and no buckle-related complications such as diplopia, infection or exposure of the exoplant were noticed during the period. Conclusion: This exoplant could easily be prepared with readily available materials in the operating room and it was well tolerated with favorable anatomic results in high myopic eyes. Further studies of increased number of patients with long-term follow-up will be necessary. [ABSTRACT FROM AUTHOR]