Suprachoroidal hemorrhage following sutureless scleral-fixated intraocular lens - A case series.

Suprachoroidal hemorrhage (SH) is a rare complication of scleral-fixated intraocular lens (SFIOL). In this series, we report three cases of sutureless SFIOL who developed SH postoperatively. Details of surgery, treatment, and outcome were analyzed. Two cases had limited SH which resolved with conservative treatment and had optimum visual recovery. One case developed massive SH needing surgical drainage, with final best-corrected visual acuity of 6/18 due to a persistent retinal fold. SH can be a potential complication while creating scleral grooves for haptic fixation. The use of a bent needle instead of a straight microvitreoretinal knife while creating scleral grooves might reduce the risk of SH in sutureless SFIOL surgeries.

Superior Orbital Fissure Syndrome in a Case of Breast Cancer.

Metastasis from breast cancer to the head and neck region is a rare occurrence. However, of all the cancers that metastasise to the orbit, breast cancer is the leading cause in women. Usually, breast cancer metastasises to the fat and muscles in the orbit, and involvement of the bony orbital wall is rare. We report a case of a 52-year-old woman who presented with metastasis to the left greater wing of the sphenoid and adjacent squamous temporal bone. Ophthalmoplegia and proptosis were the initial manifestations in this patient, which lead to the diagnosis of the underlying breast cancer.

Behavior of hyperreflective spots noted on optical coherence tomography following intravitreal therapy in diabetic macular edema: A systematic review and meta-analysis.

PURPOSE: Hyperreflective spots (HRS) are considered as spectral domain optical coherence tomography biomarkers in predicting response to intravitreal therapy (IVT) in diabetic macular edema (DME). We aimed to determine if there was a quantitative reduction in HRS following IVT in DME, if the response to antivascular endothelial growth factor (anti-VEGF) drugs was different from steroids, and if HRS-response was associated with improvement in visual acuity (VA) or reduction in central macular thickness (CMT). METHODS: PubMed/MEDLINE, Scopus, ProQuest, CINAHL, Wiley online, and Web of Science were searched (between January 1, 2011 and July 1, 2020). Publication bias and heterogeneity were assessed. Meta-analysis was done using the random-effects model. RESULTS: Totally, 1168 eyes from 19 studies were eligible for inclusion. IVT was associated with a reduction in quantitative HRS (z = -6.3, P < 0.0001). Studies, however, showed heterogeneity (I2 = 93.2%). There was no difference between anti-VEGF and steroid therapies (P = 0.23). The evidence on predicting VA and CMT outcomes were limited by the number of analyzable studies, owing to the wide variation in individual study designs, and lack of randomized controlled trials. CONCLUSION: We could conclude that there is a definite reduction in quantitative HRS following either form of IVT. We highlight the lacunae in the existing literature on HRS in DME and propose goals for future studies to harness the advantage of this promising biomarker.

Persistent macular detachment after successful macular hole closure and its management in an emmetropic eye.

Macular hole with a concomitant macular detachment is unusual in emmetropic eyes. A middle aged women was operated for a full thickness macular hole with inverted flap technique. There was persistence of subretinal fluid for 4 months even after the hole was successfully closed. A second surgery was performed to remove the highly viscous subretinal fluid. This report highlights the technical difficulties in managing such cases. This case also highlights the need for recognition of coexisting pathologies before deciding the surgery.

Combined Parafoveal Telangiectasia, Multifocal Central Serous Chorioretinopathy, and Choroidal Hemangioma.

The exact pathogenesis of parafoveal telangiectasia (PFT) is unknown, but various associations have been reported in literature such as diabetes and hypertension. Coexisting pathologies like diabetic retinopathy with PFT are not uncommon. We encountered a unique combination of PFT with multifocal central serous chorioretinopathy and choroidal hemangioma in a patient with diabetes mellitus. Multimodal imaging confirmed the findings and focal treatment to central serous chorioretinopathy leaks led to resolution of the subretinal fluid. This unique combination has been rarely reported so far. The long-term follow-up of such cases can help us to understand if there exists common pathogenesis of these varied diseases.

Extraocular needle- guided haptic insertion technique of scleral fixation intraocular lens surgeries (X-NIT).

The most challenging step in sutureless scleral fixation of intraocular lens (SFIOL) is exteriorization of haptics. The conventional handshake technique has a learning curve since it involves intraocular handing over of haptics from one forceps to another. Here, we describe "extraocular needle-guided haptic insertion technique" (X-NIT), a novel technique of exteriorizing haptics that totally eliminates intraocular manipulations. This method involves sequential introduction of two bent 26-gauge needles through the sclera (pars plicata zone) into the eye which are brought out through a sclerocorneal wound. The intraocular lens haptics are threaded through these needles and exteriorized. Nineteen consecutive patients underwent surgery by this technique. There were no intraoperative complications. The mean best-corrected visual acuity (BCVA) of these patients at 1-month follow-up was 0.5 ± 0.3 (logarithm of the minimum angle of resolution) with 18 of 19 eyes showing one or more lines of improvement in BCVA. X-NIT is a safe, easy, cost-effective, and highly reproducible technique, especially for beginners.