Modified ILM flap technique for macular hole.

Background: Currently, vitrectomy is considered as the first line of treatment in the management of macular holes. Various surgical modalities have been described to obtain anatomical closure. However, there are still challenges when the hole is large and chronic (>400 microns) in nature. Here we describe a modified technique of internal limiting membrane (ILM) peeling which results in the successful closure of such macular holes. Purpose: To demonstrate modified ILM flap techniques in management of chronic macular holes. Synopsis: Here we have described the role of modified ILM peeling techniques in three different cases such as chronic traumatic macular hole >400 microns, chronic idiopathic macular hole >400 microns and <400 microns. Highlights: This modified ILM flap technique provides the benefit of an inverted ILM flap, which helps in glial proliferation and also relives tangential traction thereby aiding in successful macular hole closure in chronic cases. Video link: https://youtu.be/RKVLd1mSw08.

Phaco-handpiece used as a Fragmatome for managing nucleus drop.

Background: Nucleus drop during cataract surgery is a dreaded complication and requires urgent vitreo-retinal intervention which is managed commonly using a fragmatome. However, a fragmatome is not readily available in routine ophthalmology set-ups because its use is very limited. On the other hand, a phaco-probe is commonly available with all surgeons and makes it cost-effective. Purpose: The purpose is to demonstrate the utility of a phaco-probe as an alternative to a fragmatome in managing nucleus drop during cataract surgery, making it cost-effective and less time-consuming and simple. Synopsis: The video shows two cases of complicated cataract surgery in which a nucleus is dropped in the vitreous cavity. The sleeve of the phaco-probe was removed, and infusion was disconnected to make it function as a fragmatome. We noted reduced lenticular repulsion from the phaco-handpiece tip as compared to the fragmatome, and no scleral burns were observed. The cases were completed by secondary placement of an intra-ocular lens in the sulcus in the same sitting. Thus, the phaco-probe can be considered to manage nucleus drop in the absence of a fragmatome. Highlights: A phaco-probe can be used as an alternative to a framgamtome, which is a cost-effective and simple technique. Video link: https://youtu.be/6c-40Bcijrc.

Ocular myiasis caused by Chrysomya bezziana - a case report.

Ophthalmomyiasis can have variable presentation depending on the type of fly, structures involved, and level of penetration. A 42-year-old female presented with extensive myiasis of the right eye. A lesion of 3×2 cm was noted at the medial canthus and was infested with maggots. The larvae were removed meticulously and the wound debrided. The larva isolated was that of Chrysomya bezziana (Old World screwworm). Computed tomography (CT) scan was normal. The wound was dressed regularly and healed by secondary intention. Ocular myiasis is a rare disease that can lead to life threatening consequences, such as intracranial extension. Prompt management with debridement and radical antibiotic therapy is essential.