Dermatologic laser-induced ocular and periocular complications: a review.

This study aimed to discuss severe ocular and periocular complications after dermatological laser treatment. This literature review evaluated published journal articles (clinical trials or scientific reviews) extracted from electronic databases (MEDLINE and PubMed) and the reference lists of related articles. Individual eyeball structures, such as chromophores, were found to interact with laser radiation. The type of damage was found to be influenced by the wavelength emitted by the laser-active medium. Moreover, in the absence of proper protection of the eyeballs, the structures that are crucial for vision can be damaged. In conclusion, laser treatment can also cause serious and irreversible complications. Appropriate patient selection, intraoperative techniques, early identification, and interventions for adverse postoperative effects are crucial to avoid major complications and even blindness.

TEMPORARY KERATOPROSTHESIS COMBINED WITH VITRECTOMY FOR SEVERE GLOBE INJURY.

PURPOSE: To describe a case of a 44-year-old man with ocular trauma after a mine explosion. From the moment of the injury, the patient reported significant visual impairment (no perception of light in the right eye and a perception of light without localization in the left eye). The patient was diagnosed with a double-sided penetrating corneal scleral wound and traumatic cataract, retinal detachment, and intraocular foreign bodies after a battlefield mine explosion. METHODS: The three-stage procedure, consisting of using soft contact lens as temporary keratoprosthesis, vitrectomy, and penetrating keratoplasty, was performed in the damaged eye. RESULTS: A soft contact lens allowed for excellent visualization of the posterior segment during vitrectomy. At the 1-month follow-up, the eye that was operated on could sense light. The corneal transplant remained translucent, and the retina was attached. CONCLUSION: The described method, when performed by an experienced surgeon, may aid in simultaneously treating coexisting corneal opacification and vitreoretinal disorders.

Glial-Plug Proliferation after Inverted Internal Limiting Membrane Flap Technique for Idiopathic Macular Hole.

Purpose: This study aimed to analyze the effect of multiple folded internal limiting membrane (ILM) flap in the inverted ILM flap technique on postoperative outcomes of patients with full-thickness macular hole (FTMH). Methods: This retrospective study included 41 eyes of 41 patients with FTMH treated with vitrectomy using the inverted ILM flap technique. Complete ophthalmic examination was performed preoperatively, at 1 week, and at 1, 3, 6, 9, and 12 months after surgery. Results: Postoperative SD-OCT confirmed macular hole (MH) closure in all patients. The mean BCVA improved from 0.7 LogMAR (20/100) preoperatively to 0.5 LogMAR (20/63) postoperatively. In two cases, 7 days after vitrectomy, flap closure was noted. At the final visit after 12 months, the following foveal contours were noted: 14 U-shape (34.1%), 12 irregular (W-shape) (29.3%), and 6 V-shape (14.6%). We observed a type of "plug closure" in 9 (22%) eyes in which hyperproliferation was noted in one eye. Conclusions: The surgeons should be aware of potential hyperproliferation on the retinal surface after the multi-layered flap technique.

Encircling Scleral Buckling Surgery for Severe Hypotony with Ciliary Body Detachment on Anterior Segment Swept-Source Optical Coherence Tomography: A Case Series.

This study aimed to evaluate the usefulness of an encircling scleral buckling procedure to manage severe hypotony secondary to proliferative vitreoretinopathy (PVR)-induced retinal detachment. This retrospective study included six eyes of six patients (five women and one man) with hypotony (intraocular pressure [IOP] ≤ 6 mmHg) after multiple reattachment surgeries for PVR-induced retinal detachment. In patients with failure of hypotony resolution after conservative treatment (dexamethasone drops five times daily), 360° scleral buckling was performed under periocular anesthesia. The light perception was evaluated immediately postoperatively. The anatomic parameters were evaluated pre- and postoperatively observed on anterior segment swept-source optical coherence tomography. Ciliary body detachment (CBD) secondary to advanced cyclitic membranes associated with PVR grades C and D was detected in all eyes with hypotony. The mean IOP increased in all eyes (4.83 mmHg preoperatively vs. 10.17 mmHg postoperatively, p = 0.006), with subsequent improvement in best-corrected visual acuity (1.91 logMAR preoperatively vs. 1.50 logMAR postoperatively, p = 0.034). However, no eye showed any significant changes in CBD postoperatively. Scleral buckling surgery might be useful to increase IOP in eyes with persistent severe hypotonia secondary to PVR-induced CBD. Further studies are needed to improve outcomes in eyes with severe PVR-induced retinal detachment.

Vitrectomy with arteriotomy and neurotomy in retinal artery occlusion - A case series.

Purpose: This study aimed to investigate the visual outcomes and anatomical changes after vitrectomy for retinal artery occlusion. Methods: Twelve patients with retinal artery occlusion (11 central retinal artery occlusion and 1 branch retinal artery occlusion) were part of this study. Our patients were treated with vitrectomy with arteriotomy or with neurotomy and arteriotomy. Complete ophthalmic examination was performed preoperatively, at 2 weeks, and 1, 3, 6, 9, and 12 months after surgery. Results: The mean preoperative best-corrected visual acuity (BCVA) was 1.94 logMAR, and the final BCVA after 12-months follow-up was 2.04 logMAR. After vitrectomy with arteriotomy, the BCVA in patients treated with neurotomy and arteriotomy was 1.65 and 2.45, respectively (P = 0.038). Conclusion: No benefits have been achieved from using vitrectomy in retinal artery occlusion cases.

Ophthalmic Complications after Needle-Based Medical Aesthetic Procedures: A Narrative Review.

BACKGROUND: This study aimed to discuss common complications of medical aesthetic treatments, which require ophthalmological intervention. METHODS: This literature study evaluated published journal articles (clinical trials or scientific reviews) that were extracted from electronic databases (MEDLINE and PubMed) and reference lists of related articles. Only articles available in English were considered for this review. RESULTS: Unskillful interference in the eye area can cause severe, irreversible complications, including blindness. This is a constant risk because of anatomical deviations, and retrograde blood flow. CONCLUSIONS: Accurate knowledge of anatomy, especially the vascular anatomy of high-risk sites, and the understanding of the depth and plane of injection, and various injection techniques minimize the risk of these complications.

Autologous Lens Capsule Flap Transplantation for Persistent Macular Holes.

PURPOSE: To analyze the anatomical and functional outcomes after autologous lens capsule transplantation in patients with persistent macular hole. METHODS: This is a retrospective observational study of five eyes of five patients treated with vitrectomy and autologous lens capsular flap transplantation. Complete ophthalmic examination was performed preoperatively and seven days and 1, 3, 6, 12, and 18 months after surgery. RESULTS: Successful macular hole closure was achieved in all patients. The mean minimum macular hole diameter before the surgery was 666.8 µm, and the mean basal diameter was 1086.4 µm. The mean visual acuity before lens capsular flap transplantation was 20/200, while after surgery, it was 20/125. CONCLUSIONS: Autologous lens capsular flap transplantation is a potential alternative treatment for patients with large persistent macular holes after other operative techniques have failed.

MECHANISM OF "FLAP CLOSURE" AFTER THE INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE.

PURPOSE: Recent studies described that in approximately 14% to 16% of cases of macular holes treated with the inverted internal limiting membrane flap technique, the hole was closed only by a thin layer of inverted internal limiting membrane-"flap closure." The aim of this article was to describe the functional and anatomical results in flap closure macular holes and also the mechanism of flap closure. METHODS: A retrospective observational study of 149 eyes of 139 patients treated with vitrectomy using the inverted internal limiting membrane flap technique was reviewed to aggregate eyes with flap closure. Complete ophthalmic examination was performed preoperatively and at 7 days, 1, 3, 6, and 12 months after surgery. RESULTS: Flap closure (Group 1) was noted in 24 eyes and other closure types in 125 eyes (Group 2). The mean minimal and base diameters of the macular holes in the flap closure group were greater than those in Group 2 (P < 0.001). The mean postoperative best-corrected visual acuity in the flap closure group (20/100) was lower than that in Group 2 (20/50) (P < 0.001). CONCLUSION: Flap closure probably enables closure of large macular holes with a higher probability of remaining open without the use of the inverted internal limiting membrane flap technique. Foveal architecture continuously improved.

Idiopathic uveal effusion syndrome - case report.

The idiopathic uveal effusion syndrome is a rare disease characterized by serous choroidal detachment. The pathogenesis of idiopathic effusion syndrome has not been conclusively determined yet. One hypothesis postulates compression of the vortex veins and abnormal diffusion of extravascular proteins. A possible complication of the disease is retinal detachment. We present a case of 59-year-old woman with idiopathic uveal effusion in the left eye. The uncorrected visual acuity was 5/5 in both eyes. Ultrasonography, ultrasound biomicroscopy, spectral optical coherence tomography and magnetic resonance imaging were performed, which excluded secondary causes of the disease. Spontaneous resolution was observed over a two-week period, without the recurrence in one-year follow up. The diagnosis was based on the clinical exam findings. The uveal effusion syndrome may be idiopathic, although in the majority of patients it is secondary to other ocular conditions, such as hypotony or inflammation.