Patients Underwent Pars Plana Vitrectomy Research Articles

INTRAVITREAL METHOTREXATE INJECTION FOR THE TREATMENT AND PREVENTION OF PROLIFERATIVE VITREORETINOPATHY.

To report on our experience using intravitreal methotrexate (MTX) in patients with retinal detachment associated with proliferative vitreoretinopathy and/or open globe injury. This study performed a retrospective chart review of a consecutive series of 21 eyes of 21 patients who underwent serial intravitreal MTX injection for treatment and/or prevention of proliferative vitreoretinopathy from December 2021 to January 2024. Twenty-one patients underwent pars plana vitrectomy, membrane peeling, laser photocoagulation, silicone oil infusion, and intravitreal MTX injection. Postoperatively, all eyes received a series of intravitreal MTX (400 μg/0.1 mL) injections. Optimally, injections were administered weekly for 8 weeks and every 2 weeks for four weeks for a total of 13 injections, beginning intraoperatively at the conclusion of retinal reattachment surgery. Mean baseline preoperative and postoperative visual acuity was logarithm of the minimum angle of resolution 3.2 (approximately hand motions vision) and 2.5 (between CF and hand motions vision), respectively, yielding an average improvement in visual acuity of 0.7 logarithm of the minimum angle of resolution units (0 ETDRS lines/letters). These 21 patients received an average of 10.5 injections. With a single operation, detachments in 19 (90%) of 21 eyes were successfully reattached. Corneal epithelial defects were noted in 7 (33%) of 21 patients. Serial intravitreal MTX injection was associated with 90% single operation retinal reattachment rate in the setting of retinal detachment with proliferative vitreoretinopathy or retinal detachment at high risk of proliferative vitreoretinopathy.

Rhegmatogenous Retinal Detachment with Giant Retinal Tear: Case Series and Literature Review.

Background/Objectives: This paper reviews three cases of rhegmatogenous retinal detachment (RRD) with giant retinal tear (GRT), focusing on surgical management and outcomes, and synthesizes the current literature on the subject. Methods: We retrospectively analyzed three cases of male patients diagnosed with RRD with GRT at our hospital from April 2022 to November 2023. The patients, aged 57, 66, and 60, underwent surgical interventions, with postoperative follow-up extending up to six months. All patients underwent pars plana vitrectomy (PPV), endolaser photocoagulation, fluid-air exchange, and intravitreal gas injection (perfluoropropane (C3F8) 14%) in each case. Surgeries were performed within four days of the patients' initial visits. Outcome measures included visual acuity improvement, intraocular pressure stabilization, and retinal reattachment rates. Complications in the patients were also evaluated. Results: The patient who had not previously undergone cataract surgery (Case 1) had it concurrently with the retinal surgery. Four months after the initial surgery, Case 3 developed a secondary epiretinal membrane (ERM) and subsequently underwent ERM removal surgery. Postoperative care involved the tailored use of anti-inflammatory medications and frequent monitoring to mitigate complications such as proliferative vitreoretinopathy, epiretinal membrane formation, and redetachment. Conclusions: While limited by the small sample size, this report underscores the potential benefits of prompt surgical intervention, meticulous postoperative care, and proactive management of complications in RRD with GRT. Insights from these cases, supported by multiple literature reviews, may inform treatment strategies and highlight areas for further research in larger, more diverse patient populations.

Clinical Presentations and Surgical Outcomes in Traumatic Iris and Lens-Related Injuries Due to Blunt Trauma

Purpose: The aim of this study was to evaluate the clinical presentation, treatment options, and surgical outcomes of patients admitted with traumatic iris and lens-related injuries due to blunt trauma. Methods: This retrospective study included 43 eyes of 43 patients who presented with traumatic iris and lens injuries between September 01, 2022 and July 01, 2023. Results: The mean age was 46.1±14.6 years and the mean ocular trauma score was 74.7±9.9. According to the cause of injury, the most common cause in males is assault, and the most common cause in females is fall. Nine (20.9%) patients underwent pars plana vitrectomy. Six (14%) patients underwent cataract surgery with phacoemulsification and intraocular lens implantation into “the bag.” Conclusions: In conclusion, other concomitant pathologies may make these surgeries difficult to perform. Early evaluation and timely management are essential to achieve the best possible outcomes in patients with traumatic iris and lens-related injuries.

Delayed vitreous prolapse causing corneal decompensation with normal Intraocular pressure: A case report

Vitreous prolapse is a postcataract surgery complication that can further cause corneal decompensation, glaucoma, macular edema, and retinal detachment. We present a rare case report of delayed vitreous prolapse in a 55-year-old man 20 years after cataract surgery with posterior capsular rupture causing diminution of vision and central corneal decompensation. To our surprise, the intraocular pressure was 18.6 mmHg (within the normal limits). The patient underwent pars plana vitrectomy for the same and had excellent postoperative visual recovery.

Position Adherence in Patients Underwent Pars Plana Vitrectomy with Silicone Oil Tamponade.

Position adherence of patients with Pars Plana Vitrectomy with Silicone Oil Tamponade after discharge is of positive significance. However, patients undergoing a day surgery makes the quality of discharge teaching and readiness for hospital discharge is insufficient, which will influence their position adherence at home. This study aimed to find the correlation of discharge teaching, readiness for hospital discharge, and position adherence in patients who underwent PPV with silicone oil tamponade from the day ward. This was a cross-sectional survey. One hundred ninety-four patients with day surgery were recruited by convenient sampling from Zhongshan Ophthalmic Center, China. Data were collected using the quality of discharge teaching scale, readiness for hospital discharge scale, and position adherence scale. Patients' education level, residence, poor postoperative vision, ophthalmic surgery history, and quality of discharge teaching are the main factors of readiness for discharge. Only 41(21%) patients had good position adherence, and education level and readiness for discharge are the main factors of position adherence. Discharge teaching improves patients' knowledge and competence of self-care and helps patients prepare for the transition from hospital to home, and readiness for hospital discharge significantly influences position adherence after discharge and indirectly plays a vital role in postoperative vision recovery and surgical effect.

RETINOPATHY OF PREMATURITY IN TERTIARY REFERRAL EYE HOSPITAL IN INDONESIA: CHARACTERISTICS AND MANAGEMENT

Abstract
 Introduction & Objectives : Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the retina that occurs in premature infants. Incidence of ROP is higher in middle- and lower-income countries, including Indonesia; hence information about the characteristics of the patients is essential to make strategies regarding its management. The aim of this study is to describe the characteristics and managementof patients with retinopathy of prematurity at the National Eye Center, Cicendo Eye Hospital.
 Methods : Data were obtained retrospectively from medical records from January 2018 until December 2020 using ICD-10 coding for retinopathy of prematurity. Variables include demographic data, clinical characteristics, and management.
 Results : In total, 177 patients (340 eyes) were included in this study. Demographically, 53.7% of the patients were boys; 67.8% came from West Java; 93.2% were referred; and 85.9% were health coverage users. The mean gestational age was 29.9±2.6 weeks and the mean birth weight was 1415.6±393.1 grams. Most of the patients have bilateral conditions and already have stage 5 ROP, regardless of their gestational age and birth weight. Conservative management was given to 95.5% of stage 5 ROP patients. As many as 50% of stage 4 patients underwent pars plana vitrectomy, and 85.4% stage 3 patients were managed by laser photocoagulation. Those in earlier stages were mainly observed first.
 Conclusion : Patients with ROP at Cicendo Eye Hospital mostly came in the advanced stage of the disease with conservative management. Early screening, timely referral, and prompt treatment are recommended in order to prevent blindness in premature infants.

Subconjunctival deferoxamine for corneal rust deposits associated with ocular siderosis: A case report

Introduction: Ocular siderosis is a vision-threatening condition resulting from intraocular iron toxicity. This case re-establishes a role for subconjunctival deferoxamine, a chelating agent uncommonly used in ophthalmology, as an adjunctive treatment for ocular siderosis. Case Report: A 37-year-old healthy male presented two months after an injury at work with intermittent pain and blurry vision in the right eye. Presenting visual acuity (VA) was 20/100 in the right eye. With delayed presentation, the patient already had ocular siderosis with corneal rust deposits and retinal damage. The patient underwent pars plana vitrectomy (PPV) with surgical view impaired by corneal deposits and intraocular metallic intraocular foreign body (IOFB) that disintegrated upon attempted removal. At six months postoperatively, VA was 20/70 in the right eye, and examination revealed worsened diffuse, pigmented subepithelial deposits in the central cornea, iris atrophy, cotton wool spots, optic nerve pallor, and a residual IOFB in the anterior vitreous, consistent with worsened ocular siderosis. Superficial keratectomy was performed in combination with repeat PPV to improve surgical visualization and aid in IOFB removal. An amniotic membrane was placed and a subconjunctival injection of deferoxamine was administered. The cornea was well-healed with significantly improved siderosis and no epithelial defects on 2-week postoperative follow-up. Visual acuity was 20/60 at last follow-up two months postoperatively after second surgery. Conclusion: In treating ocular siderosis, subconjunctival injection of deferoxamine can be a useful addition to surgical IOFB removal to prevent the accumulation of iron deposits in the anterior segment of the eye.

Zespół Sticklera – opis przypadku i analiza literatury

PurposeTo present a case of patient with Stickler syndrome and retinal detachment with crystalline lens subluxation.Material and MethodsRetrospective case report.ResultsA 9-years-old patient approached Ophthalmology Department with retinal detachment in her right eye and proliferative vitreoretinopathy stage D2. Her medical history revealed previous cryotherapy of her right eye, high myopia (-14.5 D), bilateral glaucoma, bilateral posterior subcapsular cataracts and subluxated crystalline lens in her righteye. Further clinical examination of her right eye revealed best corrected visual acuity of light perception without localization, intraocular pressure 45 mmHg. Patient underwent pars plana vitrectomy with subluxated crystalline lens facoaspiration and silicone oil injection of her righteye. After 2 months pars plana vitrectomy was repeated with removal of silicon oil and further SF6 endotamponade. During control examination 6 months later right’s eye best corrected visual acuity was 5/16, intraocular pressure 23 mmHg. In USG of her right eye remains of silicon oil were noticed with retina attached.ConclusionsPars plana vitrectomy with silicon oil injection is effective method of treatment of retinal detachement in patients with Stickler syndrome. Those operations might be followed by many complications. Early diagnosis is essential in prevention of ocular complications in patient with Stickler syndrome.

An outbreak of subhyaloid hemorrhage after accidental laser exposure during an Indian festival.

To report the clinical manifestations and outcomes of patients who experienced retinal damage due to accidental laser exposure during a festival in Kolhapur, Maharashtra. Consecutive patients who presented with sudden loss of vision following exposure to laser lights during a religious Indian festival (Ganapati festival) on the same day (9 September 2022) at the same location (idol visarjan procession) were identified from the medical records of various eye hospitals in Kolhapur district of Maharashtra. Eyes with persistent subhyaloid hemorrhage (SHH) were taken up for neodymium-doped yttrium aluminum garnet (Nd: YAG) posterior hyaloidotomy. Patients were examined at weekly intervals up to 1 month. Thirty-four eyes of 34 men were identified with age ranging from 18 to 27 years. The mean duration of exposure to the laser projections was 4.9 ± 1.7 h, and the mean distance from the laser source was 7.3 ± 2.7 feet. All presented with SHH involving the macula. SHH had a median size of 3 disc diameters or larger in 30 eyes (88%), and 29 (97%) of these required hyaloidotomy while one patient underwent pars plana vitrectomy. The mean visual acuity improved from 1.45 ± 0.5 log of minimum angle of resolution (logMAR; 20/560 Snellen) to 0.11 ± 0.19 logMAR (20/25 Snellen) (P < 0.001). One eye showed full-thickness macular hole with visual acuity of 20/200. We report a large number of patients experiencing laser-induced SHH, resembling an outbreak, due to exposure to a malfunctioning high-powered recreational laser during a religious festival.

Effectiveness of Silicone Oil Tamponade with Pars Plana Vitrectomy in Isolated Cases of Vitreous Hemorrhage with Advanced Diabetic Retinopathy

Purpose: To assess the effectiveness and safety of silicone oil as tamponade in vitrectomy performed for isolated cases of vitreous hemorrhage in patients with advanced diabetic retinopathy. Study Design: Quasi experimental. Place and Duration of Study: Al-Ibrahim Eye Hospital, Karachi from October 2022 to March 2023. Methods: Forty two cases of advanced diabetic retinopathy (either sex), with developing vitreous hemorrhage (active bleeding) were enrolled through convenient sampling. Demographic characteristics and pre-operative examination of eyes including Best corrected visual acuity (BCVA), intraocular pressure (IOP), indirect ophthalmoscopy, gonioscopy and ultrasonography (in cases where fundus was not visible) were performed. All the patients underwent pars plana vitrectomy (PPV) and pan retinal photocoagulation (PRP). Silicone oil was used as tamponade. Post-operative follow up was at first week after surgery and repeated at 3rd month and 6th month. Effect of silicon oil tamponade on re-bleeding after surgery was specifically observed. Anatomical outcome and side effects were also noted during the study period. Results: Out of 42 cases, re-bleed occurred in 2 cases (4.76 %). However, intraocular pressure (IOP) was raised in 3cases (7.1%) and cataract formed in 2 cases (4.76%). No other side effect was observed throughout the study period. Conclusion: Use of silicone oil as tamponade effectively decreases re-bleeding in patients of advanced diabetic retinopathy after vitrectomy. However, few complications such as increased intraocular pressure and cataract can occur that are manageable both medically and surgically.

Role of Intrasilicon Oil Methotrexate Injection to Prevent Development of Proliferative Vitreoretinopathy

Purpose: To determine the role of intra-silicon oil methotrexate injection to prevent Proliferative Vitreoretinopathy. Study Design: Quasi experimental Study. Place and Duration: Ophthalmology department of Sahiwal Teaching Hospital, Sahiwal from February 2022 to August 2022. Methods: Study included patients of either gender, older than 19 years with rhegmatogenous retinal detachment with Proliferative vitreoretinopathy (PVR) grade B or less. There were two groups and each group had fifty-one patients. All patients underwent pars plana vitrectomy and silicon oil tamponade. Group 1 was control group. Group 2 had intravitreal injections of methotrexate 500mg at the end of surgery. We repeated the injections at 1st, 2nd, and 4th week postoperatively. Results: There were 56 (54.9%) male and 46 (45.1%) female patients. Postoperatively visual acuity improved in thirty cases (58.82%) in group 1 and in forty-two cases (82.35%) in group 2. Postoperatively PVR developed in 11 (21.57%) patients in group 1 while in group 2 no patient had PVR. Recurrent Retinal detachment occurred in 9 (19.61%) patients in group 1 and 3 (5.88%) patients in group 2. Chi square test demonstrated statistically significant difference in the frequency of development of PVR and re-detachment of retina between two groups, p&lt;0.05. Conclusion: Methotrexate is an effective adjuvant used in Pars plana Vitrectomy for rhegmatogenous retinal detachment repair. It prevents Proliferative vitreoretinopathy resulting in better surgical and functional outcome.

Effect of Oral Riboflavin and Direct-sun UV-A on Tumor Necrosis Factor Alpha (TNF-α) Concentrations in Tears of Mild-Moderate Keratoconus Patients

Purpose: To determine the role of intra-silicon oil methotrexate injection to prevent Proliferative Vitreoretinopathy. Study Design: Quasi experimental Study. Place and Duration: Ophthalmology department of Sahiwal Teaching Hospital, Sahiwal from February 2022 to August 2022. Methods: Study included patients of either gender, older than 19 years with rhegmatogenous retinal detachment with Proliferative vitreoretinopathy (PVR) grade B or less. There were two groups and each group had fifty-one patients. All patients underwent pars plana vitrectomy and silicon oil tamponade. Group 1 was control group. Group 2 had intravitreal injections of methotrexate 500mg at the end of surgery. We repeated the injections at 1st, 2nd, and 4th week postoperatively. Results: There were 56 (54.9%) male and 46 (45.1%) female patients. Postoperatively visual acuity improved in thirty cases (58.82%) in group 1 and in forty-two cases (82.35%) in group 2. Postoperatively PVR developed in 11 (21.57%) patients in group 1 while in group 2 no patient had PVR. Recurrent Retinal detachment occurred in 9 (19.61%) patients in group 1 and 3 (5.88%) patients in group 2. Chi square test demonstrated statistically significant difference in the frequency of development of PVR and re-detachment of retina between two groups, p&lt;0.05. Conclusion: Methotrexate is an effective adjuvant used in Pars plana Vitrectomy for rhegmatogenous retinal detachment repair. It prevents Proliferative vitreoretinopathy resulting in better surgical and functional outcome.

Endogenous endophthalmitis caused by urinary tract infection: A case report.

Endogenous endophthalmitis is a vision-threatening intraocular infection caused by hematogenous spread of infectious organisms from distant sites. A 71-year-old man with a history of fever and dysuria 5 days prior to presentation presented with sudden loss of vision in his left eye. The patient had no history of ocular surgery or trauma, and ocular examination revealed a large amount of exudative plaque covering the pupil. Therefore, fundus examination was not feasible. B-scan ultrasonography revealed a dome-shaped subretinal mass with an exudative retinal detachment. Endogenous endophthalmitis was diagnosed on the basis of these findings. The patient underwent pars plana vitrectomy and the early postoperative course was favorable. Vitreous cultures grew gram-negative bacilli, identified as Klebsiella pneumonia. Urinalysis revealed white blood cells (++) and urinary tract infection was the only identifiable risk factor for endogenous endophthalmitis. Urinary tract infection is an independent risk factor for endogenous endophthalmitis.

Effect of perfluoropropane (C3F8) versus sulfurhexafluoride (SF6) tamponades on the retinal microvasculature after macular hole surgery

PurposeTo determine the effects of C3F8 and SF6 gasses by using optical coherence tomography angiography (OCTA) in patients with surgically closed idiopathic full-thickness macular holes (FTMH). MethodsA prospective, comparative study, in which 38 eyes of 38 patients with an idiopathic FTMH were studied. Twenty patients were randomized to the C3F8 group and 18 patients to the SF6 group. All patients underwent pars plana vitrectomy, internal limiting membrane peeling with 14 % C3F8 or 20 % SF6 gasses. The superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel densities (VD), foveal avascular zone (FAZ) area in SCP, the choriocapillaris flow area; and subfoveal choroidal thickness (SFCT) were examined at preoperative and postoperative first- and third-month controls using OCTA. ResultsWhen the changes in the FAZ, SFCT, SCP and DCP VDs were compared, no significant differences were found between the groups (p>0.05 for all). It was determined that the 1-mm radius flow area increases in the C3F8 group at the first and third months after the surgery were significantly higher than in the SF6 group (p<0.05). A significant gain was observed in the BCVA values compared to their preoperative values for both groups; however any differences between the C3F8 and SF6 groups in terms of BCVA were not detected in this study. ConclusionThis is the first report to compare the effects of C3F8 and SF6 gasses on idiopathic FTMH surgery by using OCTA. C3F8 and SF6 gasses may have similar effect on the remodeling process of vascular tissues.

Bacterial endophthalmitis following anti-VEGF intravitreal injections: a retrospective case series

BackgroundTo describe the incidence of endophthalmitis and the treatment outcomes of acute bacterial endophthalmitis following intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections in a Brazilian hospital. The analysis was based on the timing of infection after intravitreal injection, culture results, visual acuity, and the presence of epiretinal membrane after a 1-year follow-up period, spanning nine years.MethodsThis retrospective case series, conducted over a 9-year period, aimed to evaluate the treatment outcomes of acute endophthalmitis following intravitreal Bevacizumab injections. The inclusion criteria involved a chart review of 25 patients who presented clinical signs of acute endophthalmitis out of a total of 12,441 injections administered between January 2011 and December 2019. Negative culture results of vitreous samples or incomplete data were excluded. Ultimately, 23 patients were enrolled in the study. Eight patients were treated with intravitreal antibiotic injections (IVAI) using vancomycin 1.0 mg/0.05mL and ceftazidime 2.25 mg/0.05mL, while 15 patients underwent pars plana vitrectomy (PPV) followed by intravitreal antibiotic injections at the end of surgery (IVAIES). The main outcome measures were the efficacy of controlling the infection with IVAI as a standalone therapy compared to early PPV followed by IVAIES. Data collected included pre-infection and one-year post-treatment best corrected visual acuity (BCVA), optical coherence tomography (OCT) abnormalities, and enucleation/evisceration rates. To compare groups, Mann-Whitney and ANOVA tests were employed for statistical analysis.ResultsThe incidence rate of bacterial endophthalmitis was 0.185% (1/541 anti-VEGF injections), with the highest infection rates observed in 2014 and 2017. Patients presented clinical symptoms between 2 and 7 days after injection. The most common isolated organisms were coagulase-negative Staphylococci and Streptococci spp. Treatment outcomes showed that both IVAI and PPV + IVAIES effectively controlled the infection and prevented globe atrophy. After one year, the PPV group with BCVA better than Light Perception had a significantly better BCVA compared to the IVAI group (p 0.003). However, PPV group had higher incidence of epiretinal membranes formation compared to the IVAI group. (P 0.035)ConclusionAnti-VEGF injections carry a risk of developing acute bacterial endophthalmitis. Isolated antibiotic therapy could be an effective treatment to control the infection, but performing PPV + IVAIES as a primary treatment showed promising results in terms of improving BCVA after one year, despite a higher rate of epiretinal membrane formation. Further studies are needed to confirm these findings.

FIL SSF intraocular lens opacification after pars plana vitrectomy with gas tamponade for traumatic lens luxation and retinal detachment: a case report and literature review

BackgroundTo report a case of sutureless scleral-fixated hydrophilic intraocular lens (FIL SSF IOL, Soleko, Italy) opacification following pars plana vitrectomy surgery using sulfur hexafluoride (SF6) for traumatic lens luxation associated with retinal detachment.Case presentationA 77-year-old woman was referred to our emergency department after blunt trauma in her right eye. At the ophthalmic evaluation, visual acuity was hand movement, biomicroscopy showed pseudoexfoliation syndrome and a traumatic lens luxation in the vitreous chamber. The patient underwent pars plana vitrectomy, subluxated cataract explantation, and FIL SSF IOL implant. During surgery, an inferior retinal detachment was encountered, requiring 20% SF6 gas tamponade. No adverse events were encountered. One month postoperatively, visual acuity (BCVA) improved to 0,3 logMAR. At the 3-month follow-up, the patient presented with BCVA of 0,5 logMAR, and biomicroscopy showed a minimal IOL opacification. Six months postoperatively, BCVA decreased to 1.0 logMAR, and diffuse, IOL opacification was noted at slit lamp examination. The patient refused any other surgical intervention for IOL exchange.ConclusionsAlthough hydrophilic IOL opacification gas related is known, to the best of our knowledge, this is the first case reported in the literature of FIL SSF IOL opacification after pars plana vitrectomy with gas tamponade for retinal detachment.

Evaluation of Corneal Endothelial Cell Density Changes in Eyes with Silicone Oil Tamponade after Pars Plana Vitrectomy

Aim To assess the changes in corneal endothelium by non-contact specular microscopy in eyes treated by pars plana vitrectomy (PPV) with temporary silicone oil (SO) tamponade with or without phacoemulsification. Patients and Methods We enrolled 24 patients, assigned into two groups: 12 patients underwent pars plana vitrectomy with SO injection (group 1) and 12 patients underwent combined phaco-vitrectomy with SO injection (group 2). All of them underwent an ophthalmological examination, which included: best corrected visual acuity (BCVA), intraocular pressure measurement, fundus examination and specular microscopy follow ups at the 1st week,1st month and 3rd month visits. Results The initial count of endothelial cell density (ECD) in group 1 was 2543.58 ± 759.62 cell/mm2 which decreased at 3rd month visit to 2299.33 ± 729.87 cell/mm2, while in group 2 was 2621.08 ± 514.50 &amp; 2307.50 ± 575.55 cell/mm2 respectively. We found statistically significant decrease in the mean cell density (MCD) in group 1 and group 2, at the 3rd month than at the 1st week. Three months after operation, coefficient of variation (CV) was 34.58 ± 4.29 % and 35.75 ± 4.16%, hexagonality (HEX) was 46.83 ± 8.67 % and 47.83 ± 10.50%, while mean central corneal thickness (CCT) was 553.08 ± 22.13 μm and 548.17 ± 33.12 for group 1 and 2 respectively, and no corneal edema reported at the study end. Conclusion The pars plana vitrectomy (PPV) with silicone oil (SO) injection procedure caused changes in corneal endothelial cells in varying between pleomorphism (decreased HEX), polymegathism (increased CV) and endothelial cell loss. A higher incidence of CV increase (polymegathism) reported after combined phaco-vitrectomy than pars plana vitrectomy alone with silicone tamponade. We recommend SO removal after achieving the proposed tamponading action of SO to avoid SO keratopathy.

Eales’ Disease: A Successful Treatment with Oral Corticosteroid

Introduction: Eales’ disease is an idiopathic inflammatory venous occlusion primarily affecting the peripheral retina. It commonly affects healthy young men aged 20-30 years, and 50-90% of patients develop bilateral involvement. Retinal changes include perivascular phlebitis, peripheral nonperfusion, and neovascularization. Case Presentation: We present a case of bilateral Eales’ disease; a 38-year-old man presented to our hospital with chief complaints of decreased and blurred vision, photopsia, and floaters in both eyes. The best corrected visual acuity (BCVA) at the initial presentation was hand movement in the right eye (RE) and 0.3 in the left eye (LE). The anterior segment and intraocular pressure (IOP) were normal. Funduscopy of both eyes highlighted dense vitreous opacity. In the RE, we found perivascular sheathing, perivascular exudates, dot and flame shape intraretinal hemorrhages, and focal occlusion of retinal vessels. In the LE, we found perivascular sheathing, perivascular exudates, and dot and flame shape intraretinal hemorrhages. Initial optical coherence tomography (OCT) results show central macular thinning. The disease resolved rapidly with an oral corticosteroid before the patient underwent pars plana vitrectomy. Conclusions: Eales’ disease can be treated with corticosteroids, anti-VEGF, laser photocoagulation, and pars plana vitrectomy. Even though the patient was planned for pars plana vitrectomy, we tried initial therapy using oral corticosteroids, which responded well to the patient’s chief complaints. OCT results also showed improvement in macular thickness after the third follow-up. Oral corticosteroid therapy shows good results in Eales’ disease treatment.

Removal of Intraocular Foreign Bodies Using a Modified Flute Needle

Purpose: To describe the construction of a novel intraocular snare and evaluate its effectiveness in intraocular foreign body (IOFB) removal. Method: This is a retrospective consecutive case series. Five patients underwent pars plana vitrectomy and IOFB removal using the intraocular snare constructed from modified flute needle. Results: All IOFBs were successfully engaged and removed with the snare on the first attempt. Three of the 5 cases (60%) enjoyed good visual outcome (0.4–1.0) postoperatively. No complication related to the use of the snare was encountered in this case series. Conclusion: Intraocular foreign body snare is simple, safe, and effective in IOFB removal.

Pathological Study of Untreated Intraretinal Gliosis Surgically Excised via Pars Plana Vitrectomy.

To evaluate the pathological process of intraretinal glioses by investigating mass tissues resected from untreated eyes with intraretinal glioses. Five patients with intraretinal gliosis without previous conservative treatment were included. All patients underwent pars plana vitrectomy. The mass tissues were excised and processed for pathological study. During surgery, we observed that the intraretinal gliosis mainly affected the neuroretina and the retinal pigment epithelium was not affected. Pathological examination revealed that all intraretinal glioses consisted of different proportions of hyaline vessels and hyperplastic spindle-shaped glial cells. In one case, the intraretinal gliosis was mainly composed of hyaline vascular components. In another case, the intraretinal gliosis showed a predominance of glial cells. The intraretinal glioses in the other three cases had both vascular and glial components. The proliferated vessels showed different amounts of collagen deposits against different backgrounds. Vascularized epiretinal membrane was found in some intraretinal glioses. Intraretinal glioses affected the inner retinal layer. Hyaline vessels were the most characteristic pathological changes; the proportion of proliferative glial cells varied in different intraretinal glioses. The natural course of intraretinal gliosis may involve the proliferation of abnormal vessels in the early stage, which then gradually become scarred and are replaced by glial cells.