Perfluorocarbon liquid-assisted inverted inner limiting membrane-flap for large macular hole after recurrent rhegmatogenous retinal detachment.

A 45-year-old Caucasian myopic woman with a severe vision impairment (20/320) in the left eye due to a macula-off rhegmatogenous retinal detachment (RRD) underwent vitrectomy with silicone oil tamponade followed by an inferior relaxing retinectomy with heavy silicone oil tamponade during the second procedure for recurrence of RRD due to proliferative vitreoretinopathy. Four weeks after the second surgery, visual acuity was 20/200 and the patient complained metamorphopsia in the same eye due to a large full-thickness macular hole. A perfluorocarbon liquid-assisted inverted inner limiting membrane-flap technique was performed. Visual acuity improved to 20/80 after closing of macular hole and partial recovery of outer retinal layers at 3 months from the last surgery.

Panretinal Photocoagulation Does Not Change Macular Perfusion in Eyes With Proliferative Diabetic Retinopathy.

BACKGROUND AND OBJECTIVE: To quantify and compare the vessel density (VD) in the superficial capillary plexus (SCP) and the deep capillary plexus (DCP), as well as the size of the foveal avascular zone (FAZ) in patients with proliferative diabetic retinopathy (PDR) before and after panretinal photocoagulation (PRP). PATIENTS AND METHODS: This prospective clinical study was conducted in the Department of Ophthalmology, Miulli Hospital Acquaviva delle Fonti, Italy. Each patient underwent measurement of best-corrected visual acuity (BCVA), fluorescein angiography, spectral-domain optical coherence tomography (OCT), and OCT angiography (OCTA) at baseline. Patients received PRP within 7 days from baseline, using frequency-doubled Nd:YAG pattern scan laser. BCVA and OCTA were repeated at 1 month and at 6 months. Repeated measure one-way analysis of variance was used to investigate differences between OCTA parameters before and after PRP. RESULTS: Eighteen eyes of 14 patients with diabetes (11 males, 78.6%) were enrolled. Patients underwent a mean of four laser treatments. BCVA was slightly worse at baseline (0.30 ± 0.20) compared to the visual function after 6 months (0.25 ± 0.24; P = .3). FAZ (0.33 ± 0.19 mm2 vs. 0.33 ± 0.16 mm2; P = .6), foveal SCP (16.4 ± 8.0 vs. 16.5 ± 6.5; P = .4), foveal DCP (28.5 ± 8.6 vs. 28.2 ± 8.1; P = .8), parafoveal SCP (38.4 ± 5.7 vs. 38.6 ± 4.5; P = .9), and parafoveal DCP (46.1 ± 5.2 vs. 43.8 ± 5.1; P = .3) did not change 6 months after PRP. CONCLUSIONS: OCTA parameters were not significantly affected by peripheral laser treatment at both short- (1-month) and medium- / long-term (6-month) follow-up. Further analysis with larger samples and longer duration is warranted to confirm these results. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:174-178.].

COMPARATIVE ANALYSIS OF RETINAL REATTACHMENT SURGERY WITH OR WITHOUT INTERNAL LIMITING MEMBRANE PEELING TO PREVENT POSTOPERATIVE MACULAR PUCKER.

PURPOSE: To determine whether internal limiting membrane (ILM) peeling during pars plana vitrectomy for rhegmatogenous retinal detachment reduces the incidence of epiretinal membrane (ERM) formation. METHODS: In this retrospective study, preoperative, intraoperative, and postoperative data from all eyes undergoing pars plana vitrectomy for rhegmatogenous retinal detachment between January 2007 and December 2013 was analyzed. All cases with at least 1-year of follow-up were included. Data collection included vision, intraoperative complications, occurrence of ERM, and spectral domain optical coherence tomography characteristics. The OCTs were retrieved for all eyes and were graded by a single masked grader. RESULTS: Out of 159 eyes recruited, ILM peeling was done in 78 eyes (49%). Overall occurrence of ERM was 20%. Seven eyes (9%) in ILM peeling group and 25 eyes in the non-ILM peeling group (31%) showed ERM (P = 0.001). Postoperative vision was significantly better in eyes that had ILM peeling (0.48 ± 0.4 logarithm of the minimum angle of resolution [20/63] vs. 0.77 ± 0.6 logarithm of the minimum angle of resolution [20/125], P = 0.003). In multivariable models adjusting for type of tamponade, ILM peeling reduced the likelihood of ERM formation by 75% (P = 0.01). CONCLUSION: Internal limiting membrane peeling during pars plana vitrectomy for rhegmatogenous retinal detachment significantly reduces ERM formation in the postoperative period and is associated with better visual and anatomical outcomes.