AimTo quantify the areas of burden experienced by patients requiring repeated intravitreal injections (IVI) in the management of exudative retinal diseases.MethodsThe validated Questionnaire to Assess Life Impact of Treatment by Intravitreal Injections survey was administered to patients at four retina clinical practices across four US states. The primary outcome measure was Treatment Burden Score (TBS), a single score assessing overall burden.ResultsOf 1416 (n=657 age-related macular degeneration; n=360 diabetic macular oedema/diabetic retinopathy; n=221 retinal vein occlusion; n=178 other/uncertain) patients, 55% were women with an average age of 70 years. Patients most frequently reported receiving IVI every 4–5 weeks (40%). The mean TBS was 16.1±9.2 (range 1–48; scale of 1–54), and the TBS was higher in patients with diabetic macular oedema and/or diabetic retinopathy (DMO/DR) (17.1) compared with those with age-related macular degeneration (15.5) or retinal venous occlusive (15.3) (p=0.028). Though the mean level of discomfort was quite low (1.86) (scale 0–6), 50% of patients reported experiencing side effects more than half of the visits. Patients having received fewer than 5 IVI reported higher mean anxiety levels before (p=0.026), during (p=0.050) and after (p=0.016) treatment compared with patients having received more than 50 IVI. After the procedure, 42% of patients reported restrictions from usual activities due to discomfort. Patients reported a high mean satisfaction rating of 5.46 (scale 0–6) with the care of their diseases.ConclusionsThe mean TBS was moderate and highest among patients with DMO/DR. Patients with more total injections reported lower levels of discomfort and anxiety but higher disruption to daily life. Despite the challenges related to IVI, the overall satisfaction with treatment remained high.

Background As power-assisted liposuction (PAL) gains popular use, plastic surgeons operating these devices experience occupational exposure to hand-transmitted vibration, which can result in Hand-Arm Vibration Syndrome (HAVS), a debilitating neurovasculopathy. Objectives The objective of the study is to determine vibration exposure from the use of a PAL device during surgery in order to generate recommendations for safe use. Methods Vibration emission of a commonly used PAL system (MicroAire-650: Surgical Instruments) was examined using a vibration data logger under both controlled laboratory conditions and during 13 typical liposuction cases. Data were analysed and compared with established safety limits of vibration exposure. Results The experiments demonstrated a mean vibration magnitude of typical liposuction surgeries to be 5.69 ± 0.77 m/s2 (range 4.59 - 6.27 m/s2), which is significantly higher than the manufacturer declared value of 3.77 m/s2. Cannula size was shown to be the most significant contributor to vibration magnitude, with larger cannulas causing more vibration transmission. Conclusions These results indicate that recommendations must be made to prevent undue occupational exposure to vibration from PAL. The MicroAire-650 can generally be safely used for less than 1.5 hours per day. At exposure levels greater than 1.5 hours per day, there is increased risk of developing vibration-related injuries, and vibration reducing strategies should be implemented. At exposure levels greater than 6 hours per day, the safety limit is exceeded and there is significantly increased risk of developing HAVS and vibration exposure should be halted.

Background: This study investigated factors associated with fellow eye horseshoe retinal tear (HST) development in consecutive patients with a presenting eye HST. Materials and Methods: Medical records were reviewed for patients with initial HSTs between 2015 and 2017 and 24 factors were analyzed. Logistic regression was used to assess factors associated with fellow eye HST development. Results: In total, 242 patients with an HST were identified with mean follow-up of 68.3 months. Four associations with fellow eye HST development were identified: (1) presence of fellow eye lattice degeneration, (2) subsequent presenting eye HSTs, (3) fellow eye vitreous hemorrhage at presenting eye HST occurrence, (4) OCT-determined stage 3 fellow eye posterior vitreous detachment at presenting eye HST occurrence. Conclusion: Four clinical findings associated with fellow eye HST development following presenting eye HST were identified. These factors may be important considerations during management patients with HST. [ Ophthalmic Surg Lasers Imaging Retina 2023;54:338–345.]