6/0 PROLENE DOUBLE-FLANGED INTRAOCULAR LENS SUTURELESS SCLERAL FIXATION WITH A 27-GAUGE NEEDLE FOR INTRAOCULAR LENS SURGERY.
Retina (Philadelphia, Pa.)
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.
10.1097/IAE.0000000000004289
"Micro-Viscous Fluid Control": A Simple Homemade New Tool to Access Subretinal Space in a Controlled Way.
Retina (Philadelphia, Pa.)
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.
10.1097/IAE.0000000000004137