The forbidden touch: mechanical clearing of gas-induced crystalline lens feathering during vitrectomy surgery.

BACKGROUND AND OBJECTIVE: Lens feathering due to intraocular gas may cause significant challenges with intraoperative visualization during posterior segment surgery. Herein, we describe an intraoperative technique for improving posterior segment visualization impacted by lens feathering. METHODS: New technique to improve visualization in vitrectomy from gas-induced cataract. RESULTS: The light pipe is used to gently massage posterior subcapsular lens vacuoles to improve the surgical view intraoperatively. CONCLUSION: We report an effective and efficient technique to improve lens feathering during vitreoretinal surgery without need for cataract extraction.

TRAUMATIC RETINAL DETACHMENT CAUSED BY NERF GUN SHOT IN A PEDIATRIC PATIENT.

PURPOSE: To present a case of retinal detachment caused by a Nerf-gun shot in a pediatric patient. METHODS: Single case report. RESULTS: A 16-year-old white man presented with a nasal visual field deficit and floaters in his left eye for 1 month after being shot with a foam-ball Nerf gun by a friend. Fundus examination revealed a midperipheral retinal dialysis extending from 1 to 4:30 clock hours with a macula-on retinal detachment and superficial proliferative vitreoretinopathy. He underwent successful 25-gauge pars plana vitrectomy with membrane peel, retinectomy, injection of perfluoron, endolaser, and use of 1,000 centistoke silicone oil for tamponade. CONCLUSION: This is the first reported case of traumatic retinal detachment secondary to a Nerf-gun shot.

Predictors of Visual Acuity Outcomes Following Vitrectomy for Idiopathic Macular Hole.

BACKGROUND AND OBJECTIVE: To investigate predictors of visual outcomes in patients who underwent vitrectomy for full-thickness macular hole (FTMH) with at least 1 year of follow-up. PATIENTS AND METHODS: Retrospective, noncomparative, consecutive case series of 132 eyes of 122 patients who underwent surgical repair of idiopathic FTMH with at least 1 year of follow-up. Predictors of visual acuity (VA) outcomes were analyzed using linear regression. RESULTS: Mean follow-up time was 22.2 months. Twenty-three eyes (17.4%) had age-related macular degeneration (AMD), of which 17 (73.9%) cases were mild and nonexudative. At final follow-up, poor preoperative VA (P < .001), perioperative complications (P < .001), AMD (P < .001), and delay from preoperative evaluation to surgery (P = .037) were significant predictors of final VA. In multiple regression, these variables remained significant (P < .001, P = .011, P < .001, and P = .002, respectively). CONCLUSION: Poor preoperative VA, perioperative complications, AMD, and delay to surgery were significant predictors of final VA following FTMH repair. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:566-570.].