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Idiopathic epiretinal membrane(IERM)is a kind of epiretinal membrane without any other known ocular conditions, which occurs mostly in the middle-aged and elderly people over the age of 50. As IERM worsens, the structure and function of the retina in the macular region are altered, leading to symptoms like reduced vision and metamorphopsia. The pathogenesis of IERM remains unclear, and surgery is the primary treatment option. However, there is no consensus on the best time to have surgery, and there are differences in how well patients recover their vision following surgery. Optical coherence tomography(OCT)and OCT angiography(OCTA), as non-invasive and rapid diagnostic tools to observe retinal microstructure and blood flow changes in the macula, have been extensively utilized in clinical settings. The use of OCT and OCTA parameters to predict postoperative visual acuity has emerged as a hot topic in IERM research. This article provides a comprehensive review of current research on the correlation between various OCT and OCTA parameters and the prediction of postoperative visual acuity in IERM, aiming to assist clinicians in determining the optimal timing for surgery and balancing the benefits and risks involved.

Purpose: To determine the factors affecting the visual outcome after surgical repair of limbal corneal lacerations at a tertiary eye care center in South India. Methods: A retrospective analysis of patients diagnosed with limbal tears between 2011 and 2021 was conducted. Demographic information such as age, gender, cause of injury, and size of the laceration was recorded. Comprehensive ocular examination was performed, including gentle B scan evaluation whenever not contraindicated for detailed posterior segment evaluation. Only those cases with a minimum follow up of one year were included. Postoperative best corrected visual acuity, intraocular pressure (IOP), cornea clarity, and integrity of the wound at last follow up were noted. Results: Out of the 20 patients, 15 (75%) were males and 5 (25%) were females. The mean age was 42.6 ± 22.4 years. All 20 patients had a penetrating injury, with four (20%) injured by a stick, two (10%) by an iron rod, three (15%) due to road traffic accident (RTA), three (15%) by glass, and eight (40%) with other nonspecific objects [two (10%) with needle, two (10%) with elastic rope, two (10%) with bangle, and two (10%) with metal]. The average time between the injury and the surgery was 48 hours (2 days). Four (20%) patients underwent a second surgery within a week of repair. After limbal tear repair, at final follow up at 3 years, 7 (35%) had VA worse than 20/800, 3 (15%) had VA between 20/100 and 20/800, and 10 (50%) achieved VA better than 20/80. Conclusion: Preoperative visual acuity (VA), mode of injury, and size of wound affect the final visual outcome after surgical repair of limbal corneal laceration. Preoperative VA and mode of injury were statistically significant even in the multivariate analysis. [ABSTRACT FROM AUTHOR]

Purpose: To determine the factors affecting the visual outcome after surgical repair of limbal corneal lacerations at a tertiary eye care center in South India. Methods: A retrospective analysis of patients diagnosed with limbal tears between 2011 and 2021 was conducted. Demographic information such as age, gender, cause of injury, and size of the laceration was recorded. Comprehensive ocular examination was performed, including gentle B scan evaluation whenever not contraindicated for detailed posterior segment evaluation. Only those cases with a minimum follow-up of one year were included. Postoperative best-corrected visual acuity, intraocular pressure (IOP), cornea clarity, and integrity of the wound at last follow-up were noted. Results: Out of the 20 patients, 15 (75%) were males and 5 (25%) were females. The mean age was 42.6 ± 22.4 years. All 20 patients had a penetrating injury, with four (20%) injured by a stick, two (10%) by an iron rod, three (15%) due to road traffic accident (RTA), three (15%) by glass, and eight (40%) with other nonspecific objects [two (10%) with needle, two (10%) with elastic rope, two (10%) with bangle, and two (10%) with metal]. The average time between the injury and the surgery was 48 hours (2 days). Four (20%) patients underwent a second surgery within a week of repair. After limbal tear repair, at final follow-up at 3 years, 7 (35%) had VA worse than 20/800, 3 (15%) had VA between 20/100 and 20/800, and 10 (50%) achieved VA better than 20/80. Conclusion: Preoperative visual acuity (VA), mode of injury, and size of wound affect the final visual outcome after surgical repair of limbal corneal laceration. Preoperative VA and mode of injury were statistically significant even in the multivariate analysis.

AIM: To compare the postoperative visual acuity among eyes with proliferative diabetic retinopathy (PDR) of different stages after pars plana vitrectomy (PPV) in type 2 diabetic patients. METHODS: A retrospective study was conducted for PDR eyes undergoing PPV in type 2 diabetic patients. All patients were divided into three groups based on Chinese Ocular Fundus Diseases Society (COFDS) classification for PDR: Group A (primary vitreous hemorrhage), Group B (primary fibrovascular proliferation) and Group C (primary vitreous hemorrhage and/or fibrovascular proliferative combined with retinal detachment). The postoperative visual acuity and the change between postoperative and preoperative visual acuity were compared among three groups. The associated risk factors for postoperative visual acuity were analyzed in the univariate and multiple linear aggression. RESULTS: In total, 195 eyes of 195 patients were collected in this study, including 71 eyes of 71 patients in Group A, 75 eyes of 75 patients in Group B and 49 eyes of 49 patients in Group C. The eyes in Group A got better postoperative best-corrected visual acuity (BCVA) compared to the eyes in Group B and C (0.48±0.48 vs 0.89±0.63, P

Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians. Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed. Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO group had a higher number of postoperative complications compared with the MSICS group (p < 0.001). Postoperative borderline and poor uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications. Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.

Purpose: To evaluate the association of baseline morphologic stage of rhegmatogenous retinal detachment (RRD) using OCT with postoperative anatomic and visual acuity (VA) outcomes., Design: Retrospective cohort study., Subjects: Consecutive primary fovea-involving RRDs referred from January 2012 to September 2022., Methods: Patients with primary RRD and no prior macular pathology with gradable baseline OCT were assessed. Best-corrected VA (BCVA) was assessed at presentation and at 3, 6, and 12 months postoperatively. OCT scans were graded for parafoveal morphologic stage of RRD and foveal photoreceptor integrity., Main Outcome Measures: Association of morphologic stage of RRD with 12-month BCVA., Results: Three hundred fifty-one patients were included. Sixty-eight percent (238/351) were male, the mean (standard deviation) age was 61.2 (± 12.8) years, and 59% (206/351) were phakic. Thirteen percent (47/351) presented in stages 1 and 2, 15% (54/351) in stage 3a, 36% (126/351) in stage 3b, 24% (83/351) in stage 4, and 12% (41/351) in stage 5. Increasing stage was associated with worse foveal photoreceptor integrity, reduced baseline BCVA and longer duration of central vision loss (P < 0.001). Mean (standard deviation) 12-month BCVA by stage was 0.77 (± 0.64) for stages 1 and 2, 1.00 (± 0.53) for stage 3a, 1.36 (± 0.55) for stage 3b, 1.33 (± 0.66) for stage 4 and 1.55 (± 0.47) for stage 5. Increasing stage was associated with reduced postoperative BCVA (P < 0.001) at all time points after adjusting for covariates. A subgroup analysis of acute detachments with retinal pigment epithelium-photoreceptor dysregulation demonstrated no difference in postoperative BCVA between stages 1, 2, and 3a. However, 12-month BCVA was significantly better in stages 1, 2, and 3a vs. stage 3b (P = 0.002) and stage 3a vs. 3b (P = 0.008)., Conclusions: This study validates the clinical relevance of a recently proposed OCT-based staging system for outer retinal morphologic changes over time in RRD. Postoperative BCVA was significantly reduced in patients with worse presenting stage at all time points. In acute RRDs, 12-month BCVA was significantly better in stages 1, 2, and 3a vs. stage 3b, which suggests early stages may have better retinal recovery compared with stage 3b or worse. Stage 3b may represent a critical point where substantial structural changes occur, leading to worse outcomes in acute RRDs. Patients presenting with fovea-involving RRDs in stages 1, 2, or 3a may benefit from more urgent intervention., Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article., (Copyright © 2024 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

AIM: To observe the efficacy of the minimal scleral buckling in the treatment of long-standing retinal detachment.METHODS: The clinical data of 54 eyes in 54 cases of long standing retinal detachment treated by the minimal scleral buckling in our hospital during January 2014 to September 2018 were analyzed retrospective. Patients were followed up for 6mo. The rate of postoperative retinal reattachment, the best corrected visual acuity(BCVA), intraocular pressure, eye axis and astigmatism were observed. According to the preoperative time of retinal detachment, retinal detachment range, macular involvement or not and presence of PSF or not, the improvement of postoperative BCVA were analyzed.RESULTS: The retina reattached in 49 eyes(91%)after primary operation. Postoperative persistent subretinal fluid was observed in 29 eyes of them by optical coherence tomography. At the last follow up, BCVA increased in 12 eyes(22.2%), remained unchanged in 38 eyes(70.4%), and decreased in 4 eyes(7.4%).The preoperative time of retinal detachment, retinal detachment range, macular involvement or not and presence of PSF or not had an impact on the postoperative recovery of BCVA.CONCLUSION: The minimal sclera buckling surgery is an effective method to treat long standing retinal detachment. But postoperative visual acuity recovery is related to many factors.

Aim: To compare the postoperative visual acuity among eyes with proliferative diabetic retinopathy (PDR) of different stages after pars plana vitrectomy (PPV) in type 2 diabetic patients., Methods: A retrospective study was conducted for PDR eyes undergoing PPV in type 2 diabetic patients. All patients were divided into three groups based on Chinese Ocular Fundus Diseases Society (COFDS) classification for PDR: Group A (primary vitreous hemorrhage), Group B (primary fibrovascular proliferation) and Group C (primary vitreous hemorrhage and/or fibrovascular proliferative combined with retinal detachment). The postoperative visual acuity and the change between postoperative and preoperative visual acuity were compared among three groups. The associated risk factors for postoperative visual acuity were analyzed in the univariate and multiple linear aggression., Results: In total, 195 eyes of 195 patients were collected in this study, including 71 eyes of 71 patients in Group A, 75 eyes of 75 patients in Group B and 49 eyes of 49 patients in Group C. The eyes in Group A got better postoperative best-corrected visual acuity (BCVA) compared to the eyes in Group B and C (0.48±0.48 vs 0.89±0.63, P <0.001; 0.48±0.48 vs 1.04±0.67, P <0.001; respectively). The eyes in Group A got more improvement of BCVA compared to the eyes in Group B and C (1.07±0.70 vs 0.73±0.68, P =0.004; 1.07±0.70 vs 0.77±0.78, P =0.024; respectively). In the multiple linear regression analysis, primary fibro-proliferative type ( β =0.194, 95%CI=0.060-0.447, P =0.01), retinal detachment type ( β =0.244, 95%CI=0.132-0.579, P =0.02), baseline logMAR BCVA ( β =0.192, 95%CI=0.068-0.345, P =0.004), silicone oil tamponade ( β =0.272, 95%CI=0.173-0.528, P <0.001) was positively correlated with postoperative logMAR BCVA. Eyes undergoing phacovitrectomy had better postoperative BCVA ( β =-0.144, 95%CI=-0.389 to -0.027, P =0.025)., Conclusion: PDR eyes of primary vitreous hemorrhage type usually have better visual acuity prognosis compared to primary fibrovascular proliferation type and retinal detachment type. COFDS classification for PDR may have a high prognostic value for postoperative visual outcome and surgical management indications., (International Journal of Ophthalmology Press.)

Purpose: To share the experience that is gained in combined extraocular muscle and different lens surgery technics in patients with strabismus and lens abnormalities. Materials and Methods: The records of patients which we performed combined lens and strabismus surgery were reviewed retrospectively. All patients had exotropia along with cataracts. Ten combined surgeries were performed on 10 patients. The average age was 33.8 years, 7 patients were men and the rest were women. The patients were operated on general, retrobulbar or peribulbar anesthesia. The operations were performed by three different surgeons. Strabismus surgery involved operating on horizontal recti, recession and/or resection. One patient had binocular muscle surgery whereas all other patients had monocular muscle surgery. Seven patients had cataract extraction while 2 underwent sulcus fixated intraocular lens (IOL) implantation and 1 underwent scleral sutured IOL implantation. Results: There were no peroperative complications related to lens or strabismus surgery. All patients had exotropia over 40 Δ diopters preoperatively. One patient had amblyopia and the other had retinal detachment before the operation. Eight patients had some degree of increase in visual acuity while 9 of the 10 patients achieved good motor alignment which was defined as a residual angle of ≤10 Δ diopters of horizontal deviation. Sensory testing results were available for 7 patients postoperatively; 5 of these patients were able to demonstrate fusion. No patient developed postoperative diplopia. Conclusions: Simultaneous extraocular muscle and lens surgery seem to be an effective and safe option for patients with low complication rates and satisfactory results. [ABSTRACT FROM AUTHOR]

Macular recovery after surgery for retinal detachment (RD) depends on preoperative and postoperative predictive factors. Preoperative visual acuity is the main preoperative factor correlating positively with good macular recovery. Preoperative factors, which influence macular recovery negatively, include duration of macular detachment, height of macular detachment and vitreomacular traction. Postoperative factors, which influence macular recovery negatively, include cystoid macular oedema, epiretinal membranes, retinal folds, subretinal retinal pigment epithelium (RPE) migration and persistent subretinal fluid on optical coherence tomography (OCT). According to the latest available data, a detached macula has to be reattached within 5 days to optimize functional recovery. However, new therapeutic options such as exposure to hyperoxia or different growth factors may help to improve the final visual outcome in the presence of an already detached macula. [ABSTRACT FROM AUTHOR]

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Bei 104 Patienten wurde vor der geplanten Kataraktoperation der Retinometervisus mit dem neuen Gerät Lambda 100 der Fa. Heine und dem Gerät IRAS 760 der Fa. Interzeag bestimmt. Der postoperativ erzielte Fernvirus korrelierte bei mitteldichten Katarakten in 48% (Interzeag) bzw. 65% (Heine) mit dem ermittelten Retinometerwert. Maculopathien wurden richtig erfaßt, bei Patienten mit Glaukomschäden ergaben sich meist falsch positive Voraussagen. Prior to cataract surgery the retinal visual acuity was determined in 104 patients with the Heine Retinometer Lambda 100 and the Interzeag IRAS 760. The values were compared with the postoperative visual acuity. In patients with moderate cataracts the predicted visual acuity was accurate in 48% (Interzeag) and in 65% (Heine) of the eyes. In the case of senile macular degeneration a good correlation was observed, whereas false positive results did occur in patients with glaucomatous damage. [ABSTRACT FROM AUTHOR]