PURPOSE:To determine the incidence, prognostic factors and management of macular edema (ME) associated with silicone oil (SO) tamponade. METHODS:This retrospective, comparative, observational study included patients who underwent pars plana vitrectomy (PPV) and SO tamponade for rhegmatogenous retinal detachment (RRD) or persistent full-thickness macular hole (FTMH). Demographic data, clinical characteristics, and OCT findings were analyzed, focusing on the presence of ME. Propensity score matching was performed to control for confounding variables, and multivariable logistic regression identified predictive factors for ME development. RESULTS:A total of 114 eyes of 112 patients was included. ME developed in 64 out of 114 eyes (56.1%) during SO tamponade. The mean duration of SO tamponade was significantly longer in the ME group (665 days, SD 580) compared to the non-ME group (239 days, SD 196) (p<0.0001). PVR was present in 74 eyes (71.4%) in the RRD group. Additionally, 49% of eyes that did not develop ME during SO tamponade experienced ME after SO removal, with an average CMT increase of 39 μm (SD 9). Multivariable logistic regression analysis identified retinectomy (62% in the ME group vs. 29% in the non-ME group, p=0.0013) and longer duration of SO tamponade (p<0.0001) was associated with ME. CONCLUSIONS:This study demonstrates a high incidence of ME in eyes with SO tamponade. Prolonged SO tamponade and retinectomy were significant predictors of ME development. These findings emphasize the importance of careful monitoring and timely SO removal to minimize ME-related complications.

Intraocular foreign bodies (IOFBs) remain a severe complication of ocular trauma commonly encountered worldwide. This literature review aimed to discuss current practice patterns, areas of controversy, and advances in the management of IOFBs. Injuries involving IOFBs carry significant ocular morbidity and management can be extremely challenging. A systematic approach to preoperative evaluation and IOFB surgical management is detailed in this article and should be applied in each case. The location and composition of an IOFB have important implications on surgical approach and timing, especially in cases of toxic metals and vegetable matter. The advantages, disadvantages, and previous literature regarding immediate versus delayed foreign body removal are presented. Surgical approaches are described, with an emphasis on posterior chamber IOFB management and removal via pars plana vitrectomy. Final visual acuity is variable, but approaches have been used to prognosticate outcomes including the Ocular Trauma Score. By synthesizing current IOFB literature, the goal is to provide practitioners with guidance that will maximize the chances of surgical success and patient outcomes.

PURPOSE:To report the initial experience of a modified intraocular lens (IOL) scleral fixation technique using 6/0 prolene in a double-flanged sutureless technique with a 27-gauge needle. METHODS:Twenty-nine consecutive patients with IOL surgery were retrospectively reviewed between December 2021 and October 2023. Early Treatment Diabetic Retinopathy Study letters, spherical equivalent (SE), astigmatism axial degree, and intraocular pressure were evaluated at baseline and 1, 2, 3, and 6 months postoperatively. Surgery-related complications were evaluated during follow-up. RESULTS:Early Treatment Diabetic Retinopathy Study letters or SE at 1, 2, 3, and 6 months postoperation was significantly improved compared with baseline levels. Patients with younger (estimate [SE] = 8.011 [2.485], P = 0.006), preoperative lens drop (estimate [SE] = 8.621 [2.906], P = 0.009), idiopathic cataract (estimate [SE] = 6.021 [2.099], P = 0.048), high baseline Early Treatment Diabetic Retinopathy Study letters (estimate [SE] = 15.449 [2.352], P < 0.001), or low baseline SE (estimate [SE] = 6.357 [2.406], P = 0.018) had the greatest improvement in Early Treatment Diabetic Retinopathy Study letters during follow-up. Patients with preoperative lens or IOL dislocation had a greater postoperative SE improvement than those with preoperative lens or IOL subluxation (dislocation vs. subluxation: estimate [SE] = -189.235 [70.692], P = 0.016). There were no cases of vitreous hemorrhage, cystoid macular edema, endophthalmitis, subluxation, or dislocation were observed during the 6-month follow-up. CONCLUSION:This modified IOL scleral fixation technique is a simple, safe, and efficient method that avoids haptic manipulation and slippage, reduces postoperative complications, achieves completely sutureless surgery, and results in an achievement of surgical refractive goals.

PURPOSE:To develop a simple tool to remove retained submacular perfluorocarbon liquid bubbles (R-PFCL) and to inject recombinant tissue plasminogen activator safely in subretinal space in submacular hematomas. METHOD:A retrospective, interventional study was performed where a simple homemade micro-viscous fluid control was developed to gain access to subretinal space in a controlled way. The rubber cap of the plunger of a 1-mL syringe was cut; this cut rubber cap of the plunger was fitted inside an empty 1-mL tuberculin syringe, and its end was fitted with the tubings of viscous fluid control of the vitrectomy machine. Now, viscous fluid control mode was activated by attaching a 38-G/41-G subretinal needle for extracting submacular PFCL bubbles (R-PFCL group, n = 12) and to deliver recombinant tissue plasminogen activator injection in significant submacular hematomas cases (submacular hematomas group, n = 32). Best-corrected visual acuity (BCVA), fundus photographs, and optical coherence tomography were analyzed. Follow-up was done for at least 6 months. RESULTS:Vision improved from preoperative mean BCVA logarithm of the minimum angle of resolution 0.99 (20/195) ± 0.27 to postoperative mean BCVA logarithm of the minimum angle of resolution 0.75 (20/112) ± 0.21 (P-value < 0.05) in R-PFCL group and from preoperative mean BCVA logarithm of the minimum angle of resolution 1.99 (20/1954) ± 0.75 to postoperative mean BCVA logarithm of the minimum angle of resolution 0.75 (20/112) ± 0.37 (P-value < 0.001) in submacular hematomas group. CONCLUSION:Our homemade micro-viscous fluid control is a safe tool to extract retained submacular PFCL bubbles and to deliver a precise dose of subretinal drugs like recombinant tissue plasminogen activator for a subretinal hematoma in a controlled way.