PURPOSE: To investigate the clinical outcomes of combined vitrectomy and intrascleral fixation of a new posterior chamber intraocular lens (PC IOL) as a treatment for IOL dislocation. METHODS: We conducted a retrospective interventional study at our medical facility from January 2015 to January 2017. Posteriorly dislocated IOLs were removed with pars plana vitrectomy. Two intrascleral tunnels, 2.0 mm in length, were created 1.5 mm to the limbus at 6 and 12 o'clock positions. Both haptics of new foldable acrylic 3-piece IOLs were inserted into the tunnel until the IOL was secured in a central position. We analyzed the preexisting ocular condition, visual acuity (VA), and refractive error preoperatively and postoperatively, and recorded postoperative complications. RESULTS: Forty-nine patients (50 eyes) were enrolled in the study. The mean follow-up period was 12.8 ± 6.6 months. A best-corrected VA of 6/12 or better was achieved in 43 eyes (86%). The mean VA significantly improved from 0.32 logarithm of the minimum angle of resolution (logMAR) at baseline to 0.18 logMAR at last follow-up (p = 0.03). The refractive status after intrascleral fixation of the PC IOL revealed a mean hyperopic shift of +1.09 ± 1.28 diopters from the predicted spherical equivalent. Postoperative vitreous hemorrhages occurred in six cases and were cleared without visual compromise. Cystoid macular edema was well-controlled by topical nonsteroidal anti-inflammatory drugs (NSAID) medications in two cases. In two cases, IOL dislocation recurred and required re-operation. There were no serious adverse events of suture-related complications, retinal detachment, corneal compromise, or endophthalmitis in any of the patients. CONCLUSIONS: Our data revealed that use of combined vitrectomy and intrascleral fixation of PC IOLs is a safe and efficient technique to correct IOL dislocation. We observed good visual outcomes with only minor complications.
Dislocations ; Endophthalmitis ; Follow-Up Studies ; Humans ; Lenses, Intraocular ; Macular Edema ; Postoperative Complications ; Refractive Errors ; Retinal Detachment ; Retrospective Studies ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

PURPOSE: To report a case of ocular perforation by an acupuncture needle directly through the bulbar conjunctiva. CASE SUMMARY: A 62-year-old male visited our clinic with acute ocular pain and decreased vision in his left eye. He had received intraocular acupuncture therapy one day earlier. A slit-lamp examination revealed conjunctival hyperemia and vitreous prolapse at the superonasal quadrant of the bulbar conjunctiva. Grade one of anterior chamber cells was found in the left eye. Dilated fundoscopy revealed three retinal hemorrhages at the superonasal quadrant of the retina; vitreous hemorrhage and opacity were also observed. Thus, vitrectomy and injections of intravitreal antibiotics were performed. Intraoperatively, we identified the entry site, located in the superonasal retinal quadrant, immediately behind the ora serratia. At the three-month postoperative follow-up, the patient's visual acuity was 0.9 in the left eye and the retina remained flat with no postoperative complications. CONCLUSIONS: We observed a case of ocular perforation and endophthalmitis following ocular acupuncture treatment. This case illustrates the dangers of intraocular acupuncture therapy.
Acupuncture Therapy ; Acupuncture* ; Anterior Chamber ; Anti-Bacterial Agents ; Conjunctiva* ; Endophthalmitis ; Follow-Up Studies ; Humans ; Hyperemia ; Male ; Middle Aged ; Needles* ; Postoperative Complications ; Prolapse ; Retina ; Retinal Hemorrhage ; Retinaldehyde ; Serratia ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

PURPOSE: To evaluate the long-term outcomes of intravitreal anti-vascular endothelial growth factor (VEGF) monotherapy for patients diagnosed with submacular hemorrhage secondary to exudative age-related macular degeneration. METHODS: This retrospective, observational study included 49 patients (49 eyes) who initially presented with submacular hemorrhage associated with exudative age-related macular degeneration and who were followed-up for at least 24 months. Only eyes that were treated with intravitreal anti-VEGF monotherapy were included in the study. Best-corrected visual acuity (BCVA) measurements obtained at diagnosis, six months, and the final visit were compared. The associations of BCVA at the final visit with baseline BCVA, BCVA at six months, symptom duration, hemorrhage extent, and central foveal thickness were also analyzed. RESULTS: Over the course of follow-up (mean, 32.1 +/- 8.5 months), an average of 5.1 +/- 2.2 anti-VEGF injections were administered. Recurrent hemorrhage was noted in 13 eyes (26.5%). The mean logarithm of the minimal angle of resolution BCVA at diagnosis, six months, and the final visit were 1.40 +/- 0.52, 0.87 +/- 0.64, and 1.03 +/- 0.83, respectively. Both baseline BCVA (p = 0.012) and BCVA at six months (p < 0.001) were significantly associated with BCVA at the final visit. CONCLUSIONS: Improved visual acuity was maintained for more than two years with intravitreal anti-VEGF monotherapy. BCVA at six months is a useful clinical index to predict long-term visual prognosis.
Aged ; Aged, 80 and over ; Angiogenesis Inhibitors/administration & dosage ; Bevacizumab/*administration & dosage ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Humans ; Intravitreal Injections ; Male ; Middle Aged ; Ranibizumab/*administration & dosage ; Retina/*diagnostic imaging ; Retinal Hemorrhage/diagnosis/*drug therapy/etiology ; Retrospective Studies ; Time Factors ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular Endothelial Growth Factor A/*antagonists & inhibitors ; Visual Acuity ; Wet Macular Degeneration/complications/diagnosis/*drug therapy

PURPOSE: To evaluate 25-gauge transconjunctival sutureless vitrectomy for primary repair of rhegmatogenous retinal detachment (RRD). METHODS: We performed a retrospective study of 46 consecutive eyes of 46 patients who underwent 25-gauge transconjunctival sutureless vitrectomy to repair primary RRD. Outcome measures included single surgery anatomical success rate, final anatomical success rate, postoperative visual acuity, and surgical complications. RESULTS: Forty eyes were phakic and six eyes were pseudophakic. Twenty-six eyes had superior quadrant retinal tear, 12 eyes had inferior quadrant tear and eight eyes had both. The mean operation time was 56.3 minutes. The single surgery anatomical success rate was 93.48% (43/46). Two eyes with recurrent retinal detachment underwent fluid gas exchange: one received barrier laser treatment in the outpatient clinic, and the other underwent reoperation; the final success rate was 100%. The best corrected visual acuity improved from 1.34 log MAR to 0.48 log MAR (p < 0.01) in macula - off patients (30 eyes) and from 0.32 log MAR to 0.07 log MAR (p = 0.279) in macula - on patients (16 eyes). Postoperative complications included wound leaking (two eyes), cataract progression (13 eyes), vitreous hemorrhage (one eye), transient hypotony (one eye), and increased intraocular pressure (seven eyes). CONCLUSIONS: Primary repair of RRD using 25-gauge transconjunctival vitrectomy resulted in an excellent final anatomical success rate and postoperative visual outcomes.
Ambulatory Care Facilities ; Cataract ; Humans ; Intraocular Pressure ; Outcome Assessment (Health Care) ; Postoperative Complications ; Reoperation ; Retinal Detachment* ; Retinal Perforations ; Retrospective Studies ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage ; Wounds and Injuries

PURPOSE: To assess the clinical outcomes in idiopathic epiretinal membrane (ERM) patients after vitrectomy and ERM removal with or without additional indocyanine green (ICG)-assisted internal limiting membrane (ILM) peeling. METHODS: The medical records of 43 patients with an idiopathic ERM that underwent vitrectomy and ERM removal between July 2007 and April 2010 were reviewed. The patients were divided into two groups: triamcinolone-assisted simple ERM peeling only (group A, n = 23) and triamcinolone-assisted ERM peeling followed by ICG staining and peeling of the remaining internal ILM (group B, n = 20). RESULTS: No difference was found between the two groups in terms of visual acuity, macular thickness, P1 amplitude or implicit time on multifocal-electroretinogram (mfERG) at six and 12 months postoperatively. In group B, ICG staining after ERM peeling demonstrated that the ILM had been removed together with the ERM in 12 eyes (60%), and all 12 eyes showed punctate retinal hemorrhages during ERM peeling. There was no recurrence of an ERM in either group. CONCLUSIONS: Additional procedures involving ICG staining and ILM peeling during ERM surgery do not appear to have an additive effect on the clinical outcomes in terms of visual acuity, retinal function based on mfERG, or recurrence rate.
Aged ; Coloring Agents/diagnostic use ; Epiretinal Membrane/*surgery ; Female ; Follow-Up Studies ; Humans ; Indocyanine Green/*diagnostic use ; Male ; Middle Aged ; Postoperative Complications/*diagnosis ; Retinal Hemorrhage/diagnosis ; Retrospective Studies ; Treatment Outcome ; Visual Acuity ; *Vitrectomy

We investigated the demographic characteristics and risk factors of Korean patients with naIve central or branch retinal vein occlusion (CRVO or BRVO). This study enrolled 41 clinical sites throughout Korea and included 557 consecutive patients with retinal vein occlusion (RVO) from May through November 2010. A total of 557 patients with new-onset RVO participated in this study. Two hundred and three (36.4%) patients were diagnosed with CRVO and 354 (63.6%) patients were diagnosed with BRVO. Comparisons between the two groups showed that the prevalence of diabetes mellitus was significantly higher in CRVO patients and hypertension was significantly higher in BRVO patients (P = 0.001 and 0.002, respectively). Poor baseline visual acuity was significantly associated with female and old age in BRVO patients (P = 0.002 and 0.013, respectively), whereas the wide intraretinal hemorrhage (CRVO, P = 0.029; BRVO, P < 0.001) and the macular ischemia (CRVO, P < 0.001; BRVO, P < 0.001) were associated with both groups. The study results show the clinical features of RVO in Korean patients. Hypertension is strongly associated with BRVO and diabetes mellitus is more strongly associated with CRVO in Korean patients with RVO. As the first nationwide study performed by the Korean Retinal Society, the results of this study can be applied to future studies on RVO.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Child ; Child, Preschool ; Demography ; Diabetes Complications ; Female ; Humans ; Hypertension/complications ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Regression Analysis ; Republic of Korea ; Retinal Hemorrhage/complications ; Retinal Vein Occlusion/complications/*diagnosis ; Risk Factors ; Sex Factors ; Young Adult

PURPOSE: To report the effects and complications of conjunctival fixation to the sclera in conjunctivochalasis patients with inferior punctal occlusion. METHODS: The authors of the present study evaluated the degree of conjunctivochalasis and performed Fluorescein Dye Disappearance Test (FDT) in 15 eyes of 8 patients diagnosed with conjunctivochalasis with inferior punctal occlusion. Under topical anesthesia, the inferior bulbar conjunctiva was attached to the sclera with 3 8-0 vicryl stitches 8 mm posterior from the limbus. After surgery, the relief of symptoms, postoperative complications and improvement of conjunctivochalasis were observed. RESULTS: One week after the surgery, all 15 eyes achieved a subjective improvement of symptoms and the degree of conjunctivochalasis and FDT showed statistical difference after surgery (p = 0.000, 0.000, respectively). A complication occurred in 1 eye which was a retinal hemorrhage due to scleral puncture. CONCLUSIONS: Conjunctival fixation to the sclera could improve epiphora in conjunctivochalasis patients with inferior punctal occlusion. However, this procedure should be performed with caution.
Anesthesia ; Conjunctiva ; Eye ; Fluorescein ; Humans ; Lacrimal Apparatus Diseases ; Polyglactin 910 ; Postoperative Complications ; Retinal Hemorrhage ; Sclera

PURPOSE: To describe the ophthalmoscopic features and natural history in a case series of eyes that developed intraocular hemorrhages associated with perinatal distress and to evaluate their clinical courses. METHODS: A retrospective chart review of 289 neonates with a medical history of perinatal distress was conducted. Among these 289 patients (578 eyes), 29 eyes of 17 neonates were found to have had retinal hemorrhages or vitreous hemorrhages (VH). A comprehensive chart review, including details of fundoscopic findings and perinatal history, was conducted. RESULTS: Intraocular hemorrhage was present in 5.5% of the patients. Most hemorrhages (82.7%) were intraretinal. In our population, 17% (n = 5) of hemorrhages resolved within two weeks, but 31% (n = 9) did not resolve even after four weeks. Most hemorrhages spontaneously resolved without any specific sequelae; however, one infant's dense unilateral VH persisted up to three months after birth. When the patient was seen again at 3.5 years of age, she had developed axial myopia and severe amblyopia of the involved eye. CONCLUSIONS: In asphyxiated newborns, the possibility of intraocular hemorrhages should be considered. Long-standing, dense hemorrhages obscuring the macula may lead to severe vision deprivation amblyopia. Therefore, ophthalmic examination should be considered in neonates with perinatal distress, and close observation is necessary for hemorrhages that do not resolve in this amblyogenic age group.
Asphyxia Neonatorum/*complications ; Female ; Follow-Up Studies ; Humans ; Infant, Newborn ; Male ; Ophthalmoscopy ; Retinal Hemorrhage/diagnosis/*etiology ; Retrospective Studies ; Time Factors ; Visual Acuity ; Vitrectomy

PURPOSE: To describe the ophthalmoscopic features and natural history in a case series of eyes that developed intraocular hemorrhages associated with perinatal distress and to evaluate their clinical courses. METHODS: A retrospective chart review of 289 neonates with a medical history of perinatal distress was conducted. Among these 289 patients (578 eyes), 29 eyes of 17 neonates were found to have had retinal hemorrhages or vitreous hemorrhages (VH). A comprehensive chart review, including details of fundoscopic findings and perinatal history, was conducted. RESULTS: Intraocular hemorrhage was present in 5.5% of the patients. Most hemorrhages (82.7%) were intraretinal. In our population, 17% (n = 5) of hemorrhages resolved within two weeks, but 31% (n = 9) did not resolve even after four weeks. Most hemorrhages spontaneously resolved without any specific sequelae; however, one infant's dense unilateral VH persisted up to three months after birth. When the patient was seen again at 3.5 years of age, she had developed axial myopia and severe amblyopia of the involved eye. CONCLUSIONS: In asphyxiated newborns, the possibility of intraocular hemorrhages should be considered. Long-standing, dense hemorrhages obscuring the macula may lead to severe vision deprivation amblyopia. Therefore, ophthalmic examination should be considered in neonates with perinatal distress, and close observation is necessary for hemorrhages that do not resolve in this amblyogenic age group.
Asphyxia Neonatorum/*complications ; Female ; Follow-Up Studies ; Humans ; Infant, Newborn ; Male ; Ophthalmoscopy ; Retinal Hemorrhage/diagnosis/*etiology ; Retrospective Studies ; Time Factors ; Visual Acuity ; Vitrectomy

PURPOSE: To investigate the results of 23-gauge sutureless vitrectomy and preoperative bevacizumab in diabetic retinopathy cases. METHODS: A total of 212 eyes received pars plana vitrectomy by a single surgeon for proliferative diabetic retinopathy and were followed up for at least 6 months. The change of visual acuity and operative complications among the 20-gauge vitrectomy (group I, 86 eyes), 23-gauge vitrectomy (group II, 30 eyes), and 23-gauge vitrectomy with preoperative intravitreal bevacizumab (IVB) injection (group III, 96 eyes) were retrospectively analyzed. RESULTS: One month postoperatively, visual improvement was better in groups II and III than in group I. Three months postoperatively, visual improvement was better in group III than in groups I and II. Six months postoperatively, visual improvement in group III was better than in group I, but there was no significant difference between group II and III. Intraoperative retinal breaks and postoperative vitreous hemorrhage were less common in group III than in groups I and II. CONCLUSIONS: In patients with proliferative diabetic retinopathy, 23-gauge sutureless vitrectomy showed faster visual recovery compared with 20-gauge vitrectomy, and vitrectomy with preoperative bevacizumab had less intraoperative and postoperative complications than vitrectomy without preoperative bevacizumab.
Antibodies, Monoclonal, Humanized ; Diabetic Retinopathy ; Eye ; Humans ; Postoperative Complications ; Retinal Perforations ; Retrospective Studies ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage ; Bevacizumab