Densiron 68 heavy silicone oil in the management of inferior retinal detachment recurrence: analysis on functional and anatomical outcomes and complications

AIM: To assess the efficacy and safety of a heavy silicone oil(Densiron 68) in the management of inferior retinal detachment recurrence.METHODS: A retrospective non-comparative consecutive case series study. Forty-nine cases of complex inferior retinal detachment were treated using Densiron 68 heavy silicone oil(HSO) as the endotamponade. Our main purpose was anatomic reattachment following Densiron 68 removal. Functional outcomes, rate of recurrences, the presence of inflammatory complications and intraocular pressure alterations were evaluated. RESULTS: Forty-nine patients affected by complex retinal re-detachment were recruited. The mean follow-up was 7.6(±1.5) mo. The mean best corrected visual acuity after Densiron 68 removal was 0.95 log MAR, standard error(SE: 0.068). Retinal reattachment was 61.2% after first surgery and 81.6% after second surgery. Nineteen cases(38.8%) had recurrences when intraocular heavy silicon oil was in situ, 26.3%(5 cases) of which involved the inferior retina. CONCLUSION: Densiron 68 efficiently fills the inferior retinal periphery and might lower the risk of inferior proliferative vitreoretinopathy development, in particular after a standard silicon oil tamponade that reduces the proliferative process in the upper quadrants of the retina.

IOL repositioning using iris sutures: a safe and effective technique

This retrospective non-comparative consecutive case series study was conducted at Azienda Ospedaliera Universitaria Careggi, Florence, Italy and describes a useful intraocular lens(IOL) repositioning technique using iris sutures. In our study, 41 consecutive cases of posteriorly dislocated IOLs were surgically treated between January 2015 and May 2017. Six of the cases were post-traumatic luxations, and 20 patients had pseudoexfoliation syndrome. All the patients underwent pars plana vitrectomy and same IOL repositioning using iris sutures. The mean followup was 12.2 mo. The mean preoperative best corrected visual acuity(BCVA) was 0.10±0.15 logMAR, whereas the mean postoperative BCVA was 0.08±0.14 logMAR. The mean postoperative BCVA did not change significantly from the preoperative BCVA. The final mean spherical equivalent was-0.44±0.49 SD. Three lenses(7.31%) were found tilted during post-operative follow-up. Two eyes(4.87%) had postoperative cystoid macular edema. No eyes had endophthalmitis, hypotony, retinal or choroidal detachment. The iris fixation technique seems to be a safe and valid option for the management of dislocated IOLs.

Via pars plana anterior iris enclavation IOL fixation

AIM:To describe a via pars plana anterior iris enclavation intraocular lens(IOL)fixation techniqueMETHODS:A total of 35 consecutive aphakic vitrectomised patients(average age 71.12±10.12 y)underwent pars plana vitrectomy(PPV)and via pars plana anterior iris enclavation IOL fixation.RESULTS:The mean preoperative best corrected visual acuity(BCVA)was 0.11±0.14 log MAR,the mean postoperative BCVA was 0.07±0.11 log MAR.The preoperative mean spherical equivalent was 7.22±4.21 D.The final mean spherical equivalent was-0.25±0.15 D.No eyes had hypotony,retinal or choroidal detachment or endophthalmitis.CONCLUSION:This technique may be a safe and useful in the case of aphakia,and a prospective study would be useful to confirm this findings.

Ultrathin Descemet stripping automated endothelial keratoplasty versus Descemet membrane endothelial keratoplasty:a fellow-eye comparison

Background:To compare the visual outcome and patients’satisfaction after ultrathin Descemet stripping automated endothelial keratoplasty(UT-DSAEK)and Descemet membrane endothelial keratoplasty(DMEK)performed on fellow eyes of the same patients.Methods:In this retrospective study,the records of 18 pseudophakic patients affected by Fuchs endothelial dystrophy who underwent DMEK in one eye and UT-DSAEK in the fellow eye were reviewed.Best corrected visual acuity(BCVA),corneal pachymetry,keratometry,corneal aberrations,photopic and mesopic contrast sensitivity,and endothelial cell counts measured 12 months after surgery in either eye were analyzed and compared.The results of a satisfaction questionnaire were also reviewed.Results:Twelve months after surgery,BCVA was not significantly different in UT-DSAEK and DMEK eyes(0.10±0.04 and 0.07±0.07 logMAR,respectively);at both 4-and 6 mm optical zones total and posterior corneal higher order aberrations(HOAs),posterior astigmatism and total coma were significantly lower after DMEK;BCVA in both groups was significantly correlated mainly with anterior corneal aberrations;contrast sensitivity was higher after DMEK especially in mesopic conditions and at medium spatial frequencies;the endothelial cell density was similar,although slightly higher in the UT-DSAEK group(p=0.10).The satisfaction questionnaire showed that although patients were highly satisfied from both procedures,more than half of them preferred DMEK and reported a more comfortable and quicker postoperative recovery.Conclusions:DMEK and UT-DSAEK showed no evidence of difference in terms of postoperative BCVA,although DMEK had a better performance in terms of contrast sensitivity,posterior corneal aberrations and overall patient satisfaction.