Clinical Significance of Macula-Off Rhegmatogenous Retinal Detachment Preoperative Features on Optical Coherence Tomography.

BACKGROUND AND OBJECTIVE: To evaluate the clinical significance of preoperative spectral-domain optical coherence tomography (OCT) features and their association with postoperative outcomes in eyes with primary macula-off rhegmatogenous retinal detachment (RRD). PATIENTS AND METHODS: This is a retrospective case series of all consecutive cases undergoing repair of primary macula-off RRD at two tertiary care academic centers between January 2018 to January 2021. RESULTS: Among 406 eyes, baseline visual acuity (ß = 0.184, P = .001) and time to surgery (ß = 0.009, P = .033) were predictive of postoperative visual acuity at 1-year follow-up after adjusting for age, sex and lens status, as well as presence of preoperative features on OCT such as outer retinal corrugations and height of the retinal detachment. CONCLUSION: Baseline visual acuity and time to surgical repair are the best predictors of vision outcomes following macula-off RRD repair. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:S23-S29.].

Exploring the relationship between head anatomy and cochlear implant stability in children.

In our experience, surgical outcomes in children have been excellent with a low complication rate. Our aim in this study was to better understand what aspects of our current surgical technique have been successful with a view to retain those that are beneficial as we proceed with implantation of future devices. Because the receiver-stimulator and overlying skin flap may be more vulnerable to damage in children than adults, we concentrated on issues related to the positioning and security of this part of the implant on the head. Three specific areas of vulnerability were explored in separate experiments. In Experiment 1, we determined the effect of the position of the device on the ability of a child to roll their head without allowing contact between the device and a supporting surface. The 'freeroll' angle was determined for devices position conventionally (back position) and for those in which the device is placed in a more anterior position (up position). In Experiment 2, we studied the retentive capacity of the child's pericranium and measured the displacement force required to dislodge an implant from the bed if retained by the calvarium only. In Experiment 3, we compared the skull curvature of children in whom the device was placed in the back versus the up position. These results inform us as how to best proceed with implantation in children using future devices that have thinner and wider receiver-stimulators.