Background/Objectives: Intolerable postoperative pain perception (IPPP) may occur in patients undergoing vitreoretinal surgery (VRS), while general anesthesia (GA) is often preferred over regional techniques due to multiple contraindications. Intraoperative administration of intravenous rescue opioid analgesics (IROA) during GA increases the risk of perioperative adverse events; however, this requirement can be reduced through preventive analgesia. The Adequacy of Anesthesia (AoA) concept, based on entropy EEG and the Surgical Pleth Index (SPI), allows real-time titration of IROA to maintain optimal nociception/anti-nociception balance and create comparable intraoperative conditions across patients. This study aimed to identify risk factors for IPPP after VRS performed under AoA-guided GA combined with intravenous preventive analgesia using COX-3 inhibitors. Methods: A total of 165 patients scheduled for VRS were randomized to receive AoA-guided GA combined with intravenous preventive analgesia using either paracetamol plus metamizole, paracetamol alone, or metamizole alone. Results: Data from 153 patients were analyzed. Neither age, body mass index, smoking status, arterial hypertension, diabetes mellitus, intraoperative noxious maneuvers, demand for IROA, nor length of surgery correlated with the incidence of IPPP under AoA-guided GA. The combination of paracetamol and metamizole resulted in the lowest rate of IPPP among all groups. Conclusions: AoA-guided GA combined with COX-3 inhibitors appears to standardize intraoperative nociception/anti-nociception balance in patients undergoing VRS, effectively mitigating most known risk factors for IPPP, with female sex independently associated with its occurrence. We recommend the optimization of perioperative pharmacotherapy through individualized AoA-guided GA with intravenous COX-3 inhibitors to minimize IPPP incidence.

Vitreoretinal surgery, requiring precise microscale tissue manipulation, is well-suited for robotic assistance. Image registration enhances surgeons’ visual perception by aligning high-resolution preoperative OCT images with the intraoperative environment, improving visibility of anatomical features not seen in microscope images. However, optical distortions from the cornea, lens, eye curvature, and scanning patterns challenge the use of diagnostic data in robotic navigation. This study introduces a novel technique for curvature-corrected retinal registration, integrating diagnostic OCT with instrument-integrated OCT. The pipeline comprises feature extraction, curvature correction, initial alignment, and fine registration. Experiments using an artificial model eye and ex vivo porcine eye validate the method. Curvature correction achieves accuracy comparable to existing methods, with deviations of 17 upmum for the model eye and 460 upmum for the porcine eye. Post-registration, the fiducial marker error reduces to 103 upmum for the model eye and 318 upmum for the porcine eye. Our method provides intraoperative diagnostic context, enabling reliable topological assistance in retinal robotic systems.

Purpose. To determine short-term changes in intraocular pressure (IOP) after intravitreal injection of 0.1 mL pegcetacoplan (Syfovre; Apellis Pharmaceuticals) for the treatment of geographic atrophy (GA). Methods. This prospective, interventional study evaluated a case series of patients with GA without corneal pathology or a history of vitreoretinal surgery who received pegcetacoplan injections. IOP was measured with a handheld applanation tonometer immediately prior to injection, immediately after injection, and at 5, 10, 20, and 30 minutes postinjection. Results. Fifty-one patients (total 73 eyes) were enrolled. The mean (±SD) preinjection IOP was 15.3 ± 3.3 mm Hg, which significantly increased to 40.2 ± 13.7 mm Hg (P < .001) immediately after injection. Subsequent IOP measurements showed a gradual decrease to 31.3 ± 11.6 mm Hg at 5 minutes (P < .001), 23.2 ± 9.7 mm Hg at 10 minutes (P < .001), 19.6 ± 8.6 mm Hg at 20 minutes (P < .001), and 16.4 ± 4.9 mm Hg at 30 minutes (P = .05) postinjection. No further treatment was required, except that the left eye of 1 patient with a history of primary open-angle glaucoma and persistent IOP elevation underwent anterior chamber tap 20 minutes after injection. Multivariate linear regression analysis revealed that a higher IOP at 30 minutes postinjection was significantly associated with the preinjection IOP (P = .004) and with a history of glaucoma (P = .019). Conclusions. Following pegcetacoplan injections, immediate IOP elevation was observed, which gradually declined within the first 30 minutes. Eyes with higher baseline IOP or a history of glaucoma exhibited higher postinjection IOP.

To review fluorophores used in ophthalmology and summarize properties relevant to imaging, diagnosis, and safety. Discussion of excitation, emission, and other essential properties of specific fluorophores. Sodium fluorescein, a fluorophore, is used for angiography and remains the cornerstone for retinal vascular imaging. Indocyanine green is also a fluorophore that absorbs light at longer wavelengths, enabling improved choroidal visualization and aiding in the diagnosis of various vascular, inflammatory, and neoplastic diseases. It is also used to stain the internal limiting membrane during vitreoretinal surgery. Other fluorophores, such as rose bengal, are used topically and can be used in the treatment of corneal fungal infections. Riboflavin has uses in the cornea, and curcurmin has potential uses due to its binding affinity to amyloid. In addition to fluorescein and indocyanine green, there are expanding uses for additional fluorophores, with further investigation needed for new imaging and treatment techniques.

Vitreoretinal surgery remains the gold standard approach for the management of serious retinal disorders such as retinal detachment, macular hole, diabetic retinopathy, and proliferative vitreoretinopathy (PVR). The key to surgical success lies in the appropriate selection and application of intraocular tamponade agents. Air, expansile gases (SF6, C³F8), and silicone oil provide mechanical support within the vitreous cavity, promoting retinal reattachment and preserving postoperative anatomical integrity. However, both early and late complications associated with tamponade use have been reported, among which cataract formation is one of the most significant. This review comprehensively addresses the pathophysiology, risk factors, and current surgical and medical management strategies for cataracts developing after intraoperative and postoperative tamponade application.

Proliferative diabetic retinopathy (PDR) remains a primary cause of blindness, as it can lead to tractional retinal detachment and vitreous hemorrhage. Although advanced treatments such as panretinal laser photocoagulation and anti-angiogenic therapy reduce the risk of vision loss, a substantial proportion of diabetic retinopathy cases may still progress to severe complications. With the advent of modern instruments, high-tech imaging systems, and minimally invasive vitrectomy techniques, surgical intervention should increasingly be considered as a preventive measure rather than a rescue therapy. This review highlights the evolution of vitreoretinal surgery for PDR and current advances in this field. Early vitrectomy, performed before the angiofibrotic shift and before the need for silicone oil tamponade, represents an additional option for preserving visual function.

Proliferative diabetic retinopathy (PDR) is a severe vitreoretinal disease that can lead to significant visual impairment. Vitrectomy is commonly performed in advanced cases; however, postoperative complications, such as proliferative membrane formation and retinal detachment may still occur. Early detection of these complications is essential for timely intervention and prevention of further vision loss. Retinal morphological changes, including tractional retinal detachment due to re-proliferation, may develop after vitreoretinal surgery. This study aimed to evaluate postoperative retinal morphological changes in PDR using wide-field optical coherence tomography (WF-OCT). Seventy-five eyes from 64 patients with PDR who underwent vitrectomy and had high-quality WF-OCT images taken at 1 and 2 months postoperatively were included. Subtracted wide-field retinal thickness map images were generated to analyze changes in retinal thickness. Retinal thickness changes were detected in 171 subfields across 64 eyes. The most common cause was the resolution of traction (51.5%), followed by traction worsening due to postoperative proliferative membrane formation (17.0%). Resolution of retinal edema was observed in 16 central and five peripheral subfields, whereas worsening was noted in five central and one peripheral subfield. Retinal thickness changes due to worsening traction were identified in four central and 25 peripheral subfields. WF-OCT effectively detected postoperative retinal morphological changes in eyes with PDR, including changes in the peripheral retina. These findings highlight the clinical utility of WF-OCT for postoperative monitoring and treatment planning.

BACKGROUNDDiabetic retinopathy (DR) is the leading cause of blindness among working-age adults, with an increasing prevalence due to the global burden of diabetes.AIMTo develop a polygenic risk score (PRS) to identify high-risk groups for DR and evaluate its severity in patients with type 2 diabetes (T2D).METHODSThis population-based study included 13335 patients with T2D, comprising 7295 patients with DR and 6040 without DR. Genetic data, duration of DR diagnosis, body mass index, systolic blood pressure, diastolic blood pressure, and glycated hemoglobin A1c levels were obtained from the study population. The PRS was constructed from a genome-wide association study conducted in a Taiwanese Han population. Electronic medical records were used to track patients with T2D and analyze the associations between PRS, timing of DR diagnosis, and therapeutic interventions. The hazard ratio (HR) of PRS for DR development and severity was estimated using multivariate Cox proportional hazards regression.RESULTSThe results demonstrated that patients with T2D in the top PRS decile had a 1.21-fold greater risk of developing DR [HR = 1.21; 95% confidence interval (CI): 1.01-1.45; P = 0.041] over a 20-year follow-up period. Among patients with DR, those in the highest PRS decile exhibited a 4.81-fold increased risk of requiring more than four laser treatments (HR = 4.81; 95%CI: 1.40-16.5; P = 0.012) and a 1.38-fold increased risk of undergoing vitreoretinal surgery (HR = 1.38; 95%CI: 1.01-1.90; P = 0.044).CONCLUSIONPatients with T2D with a higher PRS are at increased risk of developing DR and may experience more severe forms of the disease.

BACKGROUND: Retrobulbar block is known to cause varying degrees of upper eyelid edema associated with moderate exophthalmos, which may adversely affect surgical conditions. It has been hypothesized that anatomical differences in the ocular adnexa between patients with Asian and European eyelid anatomy may determine the severity of edema following retrobulbar block. AIM: This study aimed to evaluate the effectiveness of retrobulbar block and the surgeon’s comfort during surgery in patients with Asian and European eyelid anatomy. METHODS: A prospective controlled study was conducted involving 80 patients aged 51–75 years who underwent retrobulbar block for anesthesia during vitreoretinal surgery. Group 1 (n = 40) included patients with European eyelid anatomy, and group 2 (n = 40) with Asian eyelid anatomy. Changes in intraocular pressure and upper eyelid thickness were assessed at different stages of the block, along with preparation time for surgery, analgesia level, akinesia, and surgeon’s comfort. RESULTS: In group 1, the upper eyelid thickness increased by 0.9 ± 0.1 mm, whereas in group 2 it increased by 2.8 ± 0.4 mm (p = 0.000), due to postseptal infiltration of the upper eyelid tissue with local anesthetic. The mean akinesia score was 1.0 ± 0.2 in group 1 and 1.4 ± 0.6 in group 2 (p = 0.021), with higher scores indicating reduced akinesia effectiveness. In group 1, intraocular pressure increased to 17.6 ± 1.9 mm Hg after the retrobulbar block and was 15.9 ± 1.9 mm Hg after compression, which corresponded to the baseline values before the block. In group 2, maximal increase in intraocular pressure was recorded after the retrobulbar block—24.9 ± 6.3 mm Hg (p = 0.0000)—and after compression—21.5 ± 5.4 mm Hg (p = 0.0000), which exceeded the baseline values (16.2 ± 1.3 mm Hg). The presence of ocular hypertension resulted in additional preoperative preparation time aimed at reducing intraocular pressure: in 5% of patients in group 1 and 28.75% of patients in group 2. Pain assessment showed residual pain in group 2 (2.6 ± 1.3 on the numeric rating scale), 1.5 times higher than in group 1 (1.6 ± 1.5, p = 0.0001), requiring additional intraoperative analgesia. Surgeon’s comfort in group 2 was reduced due to decreased palpebral fissure width from 21.4 ± 1.1 mm to 14.8 ± 1.9 mm after the retrobulbar block, associated with anesthetic infiltration of the upper eyelid. CONCLUSION: Retrobulbar block in patients with Asian eyelid anatomy was associated with a significant increase in eyelid thickness and intraocular pressure, prolonged surgical preparation time, and the need for additional intravenous analgesia, resulting in reduced surgeon comfort during ophthalmic procedures.

Background: Subhyaloid hemorrhage is a vision-threatening condition commonly caused by retinal vascular disorders, trauma, or systemic diseases such as hypertension and diabetes mellitus. Management strategies vary, ranging from observation to surgical interventions. Nd: YAG laser hyaloidotomy has emerged as a minimally invasive therapeutic option that allows for rapid drainage of premacular blood into the vitreous cavity, thus accelerating visual recovery.Case Presentation: We report the case of a 17-year-old girl who experienced acute, painless vision loss in her right eye after a Valsalva maneuver. Fundus examination revealed a dense, boat-shaped premacular hemorrhage consistent with subhyaloid hemorrhage. Nd: YAG laser hyaloidotomy was performed using a posterior capsulotomy lens and a single 3.5 mJ pulse to puncture the posterior hyaloid face. Immediate drainage of blood into the vitreous cavity was observed. Over a follow-up period of eight weeks, complete resolution of hemorrhage and significant improvement of visual acuity (from counting fingers at 4/60 to 6/6) were documented.Conclusion: Nd: YAG hyaloidotomy represents an effective, safe, and minimally invasive therapeutic approach for selected cases of subhyaloid hemorrhage. This case underscores the importance of timely intervention in preventing prolonged visual impairment and highlights the role of laser therapy as an alternative to invasive vitreoretinal surgery.

To evaluate the demographic and clinical characteristics, treatment indications, long-term outcomes and prognostic factors in patients with congenital x-linked retinoschisis (CXLR) managed conservatively or surgically. This retrospective, international, multicentre study included data from retina specialists across 14 centres in 9 countries. Demographic information, best corrected visual acuity (BCVA), phenotype, optical coherence tomography (OCT) findings and disease management were analysed. Surgical indications, techniques and anatomical and visual outcomes were evaluated. A total of 635 eyes of 318 patients were included. Median age at presentation was 9 years (range: 0-81). Observation was preferred in 73.5% of eyes, laser photocoagulation (LPC) in 9.3% and vitreoretinal surgery in 18.1%. Surgical patients presented younger (7 vs. 10 years; p = 0.002) and with worse baseline BCVA (1.50 vs. 0.50 LogMAR; p < 0.0001). Disease symmetry was lower in surgical cases (24.4%) than in conservative and LPC groups (p < 0.0001). Vitreous veils, peripheral pigmentary changes and white spiculations were predictive of surgical need, particularly in eyes with rhegmatogenous retinal detachment (RRD) and vitreous haemorrhage (VH). OCT predictors of peripheral progression included absence of ganglion cell layer cysts and presence of outer plexiform layer cysts. Single-surgery anatomical success was 68.7%, increasing to 94.7% with additional procedures. Inner-wall retinectomy significantly improved outcomes in macula-threatening retinoschisis (p = 0.026). Visual acuity improved significantly after surgery in RRD and VH cases (p = 0.003). CXLR shows a broad clinical spectrum requiring individualized care. Fundus and OCT features effectively predicted progression and surgical need. Surgical management achieved high success, with inner-wall retinectomy beneficial in certain cases.

OQrimo® is a robotic assistant system that supports vitreoretinal surgery by holding an intraocular endoscope or illumination device to assist the surgeon. In April 2023, Japan approved this system, and as the world's first clinical institution to implement OQrimo®, we aimed to evaluate its safety and clinical utility. Retrospective case series METHODS: The study analyzed all vitreoretinal surgery utilizing OQrimo® at Kyushu University Hospital between December 1, 2023 and November 31, 2024. Data collection included patient demographics, preoperative diagnoses, surgical procedures, equipment used, surgical records, and perioperative complications. We analyzed OQrimo's safety profile and patterns of clinical use based on these data. Eight eyes from eight patients were included. Preoperative diagnoses included proliferative vitreoretinopathy, panuveitis, acute retinal necrosis, macular hole, and secondary glaucoma due to uveitis. The purpose of pars plana vitrectomy included silicone oil removal, vitreous biopsy, internal limiting membrane peeling, and Ahmed valve implantation via pars plana. OQrimo® maintained stable endoscope positioning in all cases, enabling observation of the peripheral retina without scleral indentation. In seven cases, OQrimo's endoscopic visualization and a wide-viewing system were used simultaneously. No intraoperative or postoperative complications were observed in any case. We confirmed the safety of OQrimo® during its initial clinical application. The system facilitated the observation of the peripheral retina using an intraocular endoscope without scleral indentation.

PurposeThis study compares monitored anesthesia care (MAC) with general anesthesia (GA) for vitreoretinal surgery, aiming to assess safety, efficacy, and patient outcomes.Patients and MethodsThis was a prospective non-randomized clinical trial. This trial was conducted during vitreoretinal surgery. Forty Patients were included in this study and divided into MAC and GA groups. The patients were divided in to two groups. In one group, patients who were operated under general anesthesia and in the other group those who were operated with conscious sedation were included. Anesthesia quality, surgical outcomes, anesthesia time, surgery time and recovery time were compared between two groups using standardized criteria and statistical analysis.ResultsMAC provided comparable analgesia, immobilization, and hemodynamic stability to GA, with no reported complications. All patients in both groups had successful surgery. Anesthesiologist favored MAC for its hemodynamic control, while surgeons showed no preference. MAC exhibited shorter anesthesia time than GA with lower anesthetics. These findings support the use of MAC in vitreoretinal surgery, especially for patients at risk of complications from GA.ConclusionModerate sedation with MAC offers a safe and effective alternative to GA for vitreoretinal surgery, with similar outcomes, reduced anesthesia time, and lower drug doses. Further research with larger cohorts is warranted to validate these results and refine anesthesia protocols.

Purpose – to demonstrate our experience in the application of autologous retinal transplantation in a patient with a giant macular hole. Material and methods A 54-year-old patient presented with complaints of a significant decrease in visual acuity, difficulties in the perception of object shapes, and the presence of a central scotoma. Before surgery, the best corrected visual acuity was 0.02. Optical coherence tomography (OCT) revealed a giant macular hole with a diameter of 1248 micrometers. The patient underwent bimanual autologous retinal transplantation into the area of the giant macular hole using perfluorocarbon liquid, followed by tamponade with silicone oil. Results The performed bimanual autologous retinal transplantation in a giant macular hole with the use of perfluorocarbon liquid was successful both anatomically and functionally, as confirmed by objective examination data. This suggests that the technique can be effectively applied in the treatment of giant macular holes. Perimetry of the macular zone demonstrated positive dynamics. On the first day after the surgery, the best corrected visual acuity improved to 0.3. One month later, the ophthalmoscopic picture remained stable without any signs of autograft dislocation. OCT confirmed persistent attachment of the flap, and the perimetry results maintained positive dynamics. The best corrected visual acuity remained at the achieved level, indicating the high effectiveness of the method and a favorable prognosis for visual rehabilitation. Conclusion Experience with autologous retinal transplantation suggests that this method is effective in the treatment of giant macular holes, allowing significant improvement of both anatomical and functional outcomes. Key words: vitreoretinal surgery, macula, giant macular hole, autologous retinal transplantation

BackgroundThe demand for vitreoretinal surgery (VRS) specialists is increasing globally due to the rising prevalence of retinal diseases such as diabetic retinopathy and age-related macular degeneration. In Saudi Arabia, the burden of retinal diseases is particularly high, with diabetic retinopathy affecting about one-third of diabetic patients. Despite this, factors influencing ophthalmology trainees’ decisions to pursue VRS fellowship remain underexplored. This study aimed to identify the key factors shaping career decisions among ophthalmology trainees in Saudi Arabia.MethodsA cross-sectional study was conducted between July and December 2024, targeting senior ophthalmology residents and vitreoretinal surgery fellows across Saudi Arabia. A purposive sampling method was used, and data were collected via an online survey adapted from a validated tool and assessed for content validity. The survey explored exposure to VRS, research opportunities, mentorship, and career motivations using a 5-point Likert scale. Descriptive statistics and nonparametric Mann-Whitney U tests were applied.ResultsA total of 61 trainees participated, of whom 35 (57.4%) reported pursuing a VRS fellowship. Male trainees were significantly more likely to pursue VRS than females (88.6% vs. 46.2%, p < 0.001). Most VRS pursuers reported deciding during residency years R2–R3, and 40% had performed over 100 cataract procedures. Major motivators included strong interest in complex surgeries (74.3%), advanced technology (51.4%), and the perceived prestige of VRS (54.3%). Exposure to VRS, research opportunities, and program match success were significantly associated with career choice, while mentorship and work–life balance played a lesser role.ConclusionThe decision to pursue vitreoretinal surgery among ophthalmology trainees in Saudi Arabia is primarily influenced by early exposure, surgical complexity, and perceived prestige. Gender disparities remain evident, with male trainees more likely to enter VRS, partly due to limited female mentorship. Enhancing mentorship opportunities and fostering early exposure may help address these disparities and sustain interest in the subspecialty.

The article presents the prospects for the use of new models of thermoelectric equipment developed to solve some urgent problems of ophthalmology, in particular the justification and implementation of the technology of controlled local artificial hypothermia of the eye in vitreoretinal surgery. Thermoelectric devices for measuring intraocular temperature, epibulbar temperature, and heat flux on the surface of the eye were demonstrated, which allow for comprehensive perioperative monitoring of thermal processes in the eye during vitreoretinal surgery. The design of new thermoelectric devices is also described, which provide active cooling/heating of irrigation fluid or eye structures, and which create opportunities for controlling thermal intraocular processes both intraoperatively and in the pre- and postoperative periods.

Purpose: To evaluate the long-term outcomes of silicone oil (SO) tamponade using the reservoir technique vs standard oil fill technique for complex vitreoretinal surgery. Methods: This retrospective comparative case series evaluated 313 SO tamponade surgeries (230 eyes). In the reservoir technique, the posterior segment is filled with SO. The infusion line is temporarily opened to atmosphere, allowing SO to egress into the line, creating the reservoir. The pressurized air infusion is then reset to 15 mm Hg to maintain a complete SO fill during sclerotomy closure. In the palpation method, SO is introduced without creating a reservoir or moderating infusion pressure, and digital palpation of the globe determines adequate fill. Results: Moderately severe ocular hypertension (intraocular pressure [IOP] ≥ 30 mm Hg) occurred less frequently in the reservoir group (1.6%) compared with the palpation group (9.3%; P = .005). Prolonged ocular hypertension (IOP ≥ 25 mm Hg for ≥ 2 visits) was also less frequent in the reservoir group (2.9% vs 9.1%; P = .02). SO emulsification was less frequent in the reservoir group (2.7% vs 9.4%; P = .04). Eyes in the reservoir group required fewer SO placement surgeries (1.2 vs 1.5 surgeries per eye; P = .01), while final anatomic success rates were similar (reservoir: 80.4%, palpation: 78.2%; P = .5). Visual outcomes were comparable between groups. Conclusions: The reservoir technique for SO tamponade placement reduces the risk of IOP elevation, minimizes the need for reoperation, and decreases SO complications. These findings support the reservoir technique as a reliable and consistent method for SO placement in complex vitreoretinal surgeries.

When encountering diseases of the anterior vitreous and peripheral retina (ie, the "middle segment" of the eye), vitreoretinal (VR) surgeons are specifically trained in surgical techniques for managing the vitreous and visualizing the peripheral retina during anterior vitrectomy, and therefore they are well equipped to address the complications of surgery involving the anterior vitreous space. This clinical update reviews and compares the current literature discussing techniques and patient outcomes related to complete pars plana vitrectomy versus incomplete, subtotal pars plana vitrectomy, and addresses the proposition of developing an abridged training curriculum for non-VR surgeons to acquire the knowledge and skills required to perform these procedures. Recent studies confirmed that operating in the anterior vitreous carries potential risk of retinal tear, retinal detachment, and other adverse events that may cause vision loss. To mitigate these risks, studies suggest that use of dedicated visualization equipment and illumination instruments are necessary for surgeons to safely perform anterior vitrectomy and recognize complications, should any occur. Performing VR surgery in the absence of wide-angle viewing systems, endoillumination, careful peripheral examinations, modern vitrectomy platforms, and appropriate training may lead to outcomes that are detrimental to patient safety.

Background/Objectives: The aim of this study was to determine the frequency of the indications and compare the results and prognosis of combined penetrating keratoplasty (PKP) and vitreoretinal surgery (PKPVR) performed for infectious keratitis with endophthalmitis (IKE) to those performed for other non-infectious indications in a German university eye hospital. Methods: Medical records were searched for patients who underwent PKPVR between 2016 and 2024. Demographic data, indication, best corrected visual acuity (BCVA), and intraocular pressure (IOP) at the first and last visits; data on conservative and surgical treatment; and data on the development of phthisis bulbi and the need for enucleation were recorded. Results: A total of 129 eyes of 128 patients were included in this retrospective study (61 ± 22 years, male: 64%). Of these eyes, 50% were treated for IKE and 50% for other non-infectious indications. The mean follow-up time was 24 ± 23 months, BCVA improved from logMAR 2.3 ± 0.5 to 2.0 ± 0.7 at the last visit (p < 0.01), and the percentage of severe visual impairment (logMAR ≥ 1.3) decreased postoperatively from 97% to 86%. A total of 9/129 eyes were eventually enucleated (7%), and another 5/129 had developed phthisis bulbi at the last visit (4%). Compared to the non-infectious group, the IKE-group had a significantly higher enucleation rate (p = 0.05) and also a higher rate of significant visual improvement (from logMAR ≥ 1.3 to <1.3) (p = 0.04). Eyes which achieved a significant BCVA improvement in the IKE-group had a significantly lower rate of retinal infiltration, hemorrhage, and ischemia (p = 0.03). Conclusions: PKPVR is an indispensable procedure for eliminating infection in eyes with IKE. Compared to other non-infectious indications, the IKE-group had the highest rate of both enucleation and significant BCVA improvement.

Perspectives in vitreoretinal surgery: profound and continuous transformation