ABSTRACT.Purpose: To report the results of transscleral fixation of posterior chamber intraocular lenses in adults. Methods: We carried out a retrospective analysis of 91 eyes of 81 patients who underwent implantation of posterior chamber lenses with transscleral sutures between 1997 and 2006. The mean age of the patients was 62 years (range 19-94 years). Sixty-eight eyes (74.7%) were aphakic at the time of surgery. In 10 patients (11.0%) an intracapsular cataract extraction and in six patients (6.6%) a pars plana lensectomy was performed prior to the fixation of the posterior chamber intraocular lens. In seven eyes (7.7%) a previously implanted IOL was removed. The mean follow-up was 36 months (range 6-116 months). Results: The mean preoperative best corrected visual acuity (BCVA) was 0.37 (range counting fingers to 1.0), which improved to 0.5 (range light perception to 1.0) postoperatively. At the end of follow-up, BCVA was unchanged or improved in 81 eyes (89.0%), reduced by 2 Snellen lines in four eyes (4.4%), and between finger counting and light perception in four eyes (4.4%). The most serious complication was suprachoroidal haemorrhage, which occurred in two eyes. Retinal detachment occurred in three eyes, all of which successfully reattached after surgery. Suture erosion or spontaneous dislocation caused by suture degradation or breakage was not seen. Conclusions: Secondary implantation of posterior chamber intraocular lenses with transscleral fixation is a reasonably safe procedure in adults, with relatively few serious complications. Even in patients with longterm follow-up, suture breakage was not seen.

ABSTRACT.Purpose: To confirm the predictive value of photopic cone b-wave implicit time in 30 Hz flicker electroretinography (ERG) for ocular neovascularization (NV) in central retinal vein occlusion (CRVO), and to compare the ERG results to the presumed healthy fellow eye. Methods: A retrospective analysis of 71 consecutive patients with CRVO. After ERG examination, all patients were followed for at least 12 months, or until NV was found. Three patients died during the study period; none of the other patients were lost to follow-up. Results: Twenty-four patients (33.8%) developed NV during follow-up. The mean cone b-wave implicit time of all patients was 32.6 ms [standard deviation (SD) 5.21]. All 18 patients with an implicit time of 35.0 ms or higher (> 0.5 SD from mean) developed NV. In patients who developed NV, the average implicit time was 38.5 ms (range 29.7-43.9 ms); in patients without NV (n ¼ 47), the average implicit time was 29.6 ms (range 24.7-34.9 ms) (P < 0.0001). The average implicit time in the presumed healthy fellow eye was 28.7 ms (range 24.4-33.9 ms) in patients with NV, and 26.5 ms (range 23.7-33.2 ms) in patients without NV (P ¼ 0.002). The mean interocular difference in implicit time was 9.9 ms (range 4.1-15.7 ms) in patients with NV and 2.9 ms (range )1.0 to 10.0 ms) in patients without NV (P < 0.0001). Conclusion: Patients with CRVO should be examined routinely with photopic 30 Hz flicker ERG, which is a simple and objective clinical test that can identify patients at risk of ocular NV. On the assumption that the presented ERG settings are used, implicit times of 35.0 ms or higher (> 0.5 SD from mean) are clearly associated with the development of ocular NV. To compare the ERG result of the affected eye to the presumed healthy fellow eye is probably of less value.

ABSTRACT.Purpose: We have previously shown that photopic cone b-wave implicit time ‡35.0 ms in 30 Hz flicker electroretinography (ERG) predicts ocular neovascularization (NV) in central retinal vein occlusion (CRVO). Here, we evaluate the effects of early panretinal photocoagulation (PRP) in patients with ERGverified ischaemic CRVO. Methods: Patients with CRVO, admitted to our department between 2000 and 2008, were classified as having ischaemic or non-ischaemic CRVO based on the ERG-results. In a first group of 71 patients, 18 patients had ischaemic CRVO and were assigned to standard treatment that is regular examinations and PRP as soon as NV was found. In a consecutive group of 65 patients, 18 patients with ischaemic CRVO received early PRP. In this group, ERG was performed on average 6 weeks after the first symptoms of CRVO. The patients underwent PRP as soon as possible after the ERG-examination, and the treatment was completed within one to three sessions. Results: Twelve patients in the standard treatment group developed neovascular glaucoma during a mean period of 5 months after the CRVO. In the early treatment group, one patient developed subtle iris rubeosis 7 months after PRP. Otherwise, none of the patients showed any signs of ocular NV, and the intraocular pressure remained within normal range, without the necessity of supplementary medication, during a mean follow-up of 41 months.Conclusions: This study indicates that ocular NV in patients with CRVO can be predicted by photopic 30 Hz flicker ERG and that early PRP in ERG-verified ischaemic CRVO could be suggested as standard treatment.

Photodynamic therapy for subfoveal new vessels may be associated with retinal precipitation of lipoprotein, presumably because early extraction of water and salts from the subretinal fluid increases the concentration of leaked plasma proteins. Despite reperfusion of the subretinal vessels, macromolecular leakage appears to cease within 100 days, indicating that functional maturation of the new vessels has occurred, with an associated decrease in pore size.