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The purpose was to report the outcome after usage of three topical eyedrops combination, consisting of one steroid, one carbonic anhydrase inhibitor (CAI), and one non-steroidal anti-inflammatory drug (NSAID) in the treatment of pseudophakic cystoid macula edema (PCME) or Irvine–Gass syndrome. Treatment response monitoring of two patients with PCME to the combination of three eyedrops in a fixed dose regimen done using Optical Coherence Tomography. In both cases, significant improvement was documented within 1 week of starting the treatment, with respect to both visual acuity as well as central macular thickness and intraretinal fluid or cystoid macula edema (CME) resolution. The combination of three topical drugs of difluprednate (steroid), dorzolamide (CAI), and nepafenac (NSAID) is highly effective in treating select cases of pseudophakic CME and negates the need for usage of intravitreal (IVT) or posterior sub-Tenon’s injection of drugs such as triamcinolone acetonide, i.e., IVT triamcinolone acetonide, or posterior subtenon thus avoiding its associated complications.

Purpose: This study aims to evaluate the incidence and risk factors for vitreous rebleed (VRB) following 25-gauge sutureless vitrectomy for vitreous hemorrhage (VH) in diabetic retinopathy. Methods: A retrospective review of 190 diabetic patients having undergone vitrectomy for VH at a tertiary eye care center was analyzed. Demographic data of patients along with risk factors such as blood sugar levels (BSL), blood pressure (BP), anticoagulant use, and pan-retinal photocoagulation status (PRP) were tabulated. Depending on the commencement of VRB, patients were divided into immediate rebleed-within 2 weeks and delayed rebleed-beyond 2–4 weeks. Results: Forty-one patients had VRB, out of which 18 patients had immediate VRB and 23 patients had delayed VRB. The average duration between vitrectomy and VRB was 3.28 months. Twenty-eight patients were male and 13 were females. Average age at presentation was 53.8 years. Thirty-four patients (82.9%) were found to have high BSL and 28 patients (68.3%) had high BP and they developed rebleed (P < 0.01) after an initial hemorrhage-free period (average = 5.15 months). Fifteen patients (36.6%) underwent first time PRP intraoperatively, and they had immediate rebleed (P < 0.01) without any hemorrhage-free period (average = 0.9 months). Eight patients (19.5%) were on perioperative anticoagulants; however, their statistical significance did not persist in the multivariable model. There were neither age nor gender predilection toward rebleed (P > 0.05). Conclusion: The incidence rate of VRB was found to be 21.6%. Age and gender did not contribute to rebleed. Intraoperative PRP was a risk factor for immediate rebleed. Poor glycemic and BP control was a risk factor for delayed rebleed.

Successful management of intraocular foreign body (IOFB) is deemed possible by the advent of superior surgical procedures, even in those patients who present late. We report a case of a 46-year-old male, who presented with sudden onset of defective vision in his right eye of 2 days duration and with a previous history of trauma following bulb blast at the age of 5 years. Examination revealed retinal detachment with multiple intraocular glass foreign body in his right eye. The primary management, in this case, was phaco-aspiration of lens through limbal tunnel, scleral buckling, 23G pars plana vitrectomy, IOFB removal through anterior segment, endolaser, and silicone oil injection. After 6 months, silicone oil was removed, and posterior chamber intraocular lens was implanted. This is a rare case wherein multiple glass IOFBs had remained quiescent in the eye for more than four decades resulting in retinal detachment at a later date and successful management with good visual outcome was possible.

A 60-year-old female came to our hospital with defective vision due to persistent diabetic macular edema and was treated with intravitreal ozurdex implant in the right eye. Three days later, the patient presented with diminution of vision, ocular pain, congestion, and hypopyon with no fundus view. B-scan ultrasonography showed vitritis, and diagnosis of endophthalmitis was made. Subsequently, 25-gauge pars plana vitrectomy was performed along with intravitreal vancomycin and amikacin and removal of implant. On culture, there was growth of coagulase-negative staphylococcus which was resistant to ofloxacin antibiotic. A week following treatment, there was significant improvement in the patient's sign and symptoms with improvement in vision. Our case demonstrated that acute endophthalmitis can occur following dexamethasone intravitreal implant.

Purpose: We studied the incidence and outcome of endophthalmitis after manual small incision cataract surgery in a high volume tertiary eye care center. Materials and Method: It was a retrospective study and the data were retrieved from the hospital records of the patients who underwent manual small incision cataract surgery in a tertiary eye care center from April 2010 to October 2012. The preoperative visual acuity, cataract grading, preoperative risk factors, surgical complications, postoperative visual acuity, time interval between surgery and endopthalmitis, microbiological profile, treatment given, and final visual acuity were recorded. Results: A total of 64,926 patients were operated between April 2010 and October 2012. All the patients were followed up at Day 1, Day 7, and 6 weeks postoperatively. Of these, 31 cases were diagnosed as endophthalmitis and were treated accordingly. Conclusion: The incidence of endophthamitis in this study is 0.048%, which is comparable to all modern studies.

We report a novel management technique in case of advanced vitreomacular traction which avoids deroofing of macula and prevent the formation of iatrogenic macular hole. The primary treatment modality in the management of such cases is pars plana vitrectomy with posterior vitreous detachment (PVD) induction and with or without membrane peeling. We performed pars plana vitrectomy with minimal induction of PVD and release of traction all around the macula. No membrane peeling was done due to risk of deroofing of the macula and formation of iatrogenic macular hole. Postoperative course was stable with improvement in visual acuity (VA) and flattening of macula. This technique marked an alternative surgical approach in treatment of advanced vitreomacular traction.

We are presenting the initial results of inverted internal limiting membrane (ILM) flap technique for large macular hole. Five eyes of five patients with large diameter macular hole (>700 μm) were selected. All patients underwent inverted ILM flap technique for macular hole. Anatomical closure and functional success were achieved in all patients. There was no loss of best-corrected visual acuity in any of the patients. Inverted ILM flap technique in macular hole surgery seems to have a better hole closure rates, especially in large diameter macular holes. Larger case series is required to assess the efficacy and safety of this technique.

AIM: The aim of this study is to evaluate the effect of panretinal photocoagulation (PRP) on macular perfusion using optical coherence tomography-angiography (OCT-A) in eyes with proliferative diabetic retinopathy (PDR) by assessing the vessel density (VD) and the size of the foveal avascular zone (FAZ) of the superficial capillary plexus (SCP) and the deep capillary plexus (DCP), before and after PRP. SETTINGS AND DESIGN: Prospective interventional study. SUBJECTS AND METHODS: Twenty-nine eyes of 17 patients with PDR underwent a measurement of best-corrected visual acuity (BCVA) and were imaged using OCT and OCT-A at baseline and 6-months of follow-up. Patients received three sittings of PRP using frequency-doubled neodymium-doped yttrium aluminum garnet laser. STATISTICAL ANALYSIS USED: The OCT-A variables were analyzed using generalized estimating equations. RESULTS: BCVA was unchanged at 6-months follow-up (P = 0.09). FAZ of SCP and DCP (P = 0.28 and 0.89, respectively), VD at foveal SCP (P = 0.08), foveal DCP (P = 0.05), parafoveal SCP (P = 0.13), and parafoveal DCP (P = 0.07) showed no statistically significant difference at 6 months post PRP. CONCLUSIONS: OCT-A parameters were not significantly affected by PRP at 6-months follow-up indicating no alteration in macular perfusion. Further analyses with larger samples and longer duration are warranted to confirm our results. [ABSTRACT FROM AUTHOR]

We report the use of a novel technique "syndrome evaluation system" (Xcyton) as a rapid diagnostic tool in the diagnosis of a case of post-operative polymicrobial endophthalmitis. A patient with low-grade chronic endophthalmitis caused by Propionibacterium acnes and Candida species was diagnosed using this technology from aqueous sample and then treated with intravitreal antibiotics and antifungals.