Choroidal effusion or SCH can be intraoperatively managed to avoid expulsive hemorrhage and maintain the possibility of completing the surgery.

Purpose: To compare visual outcome and postoperative complications of combined 25-gauge pars plana vitrectomy and phacoemulsification with vitrectomy alone surgery in patients with epiretinal membrane and macular hole. Methods: A total of 110 eyes (73 eyes with epiretinal membrane and 37 eyes with macular hole) were enrolled in this prospective study. The eyes were divided into two groups: Group A included 55 eyes which underwent phacovitrectomy at the same time and Group B included 55 eyes which underwent vitrectomy alone. Follow-up visits were at 1, 3, and 6 months. Results: The best-corrected visual acuity correlation by analysis of variance measurement showed statistically non-significant differences between the two groups ( p = 0.32). The post hoc analysis from baseline, 1°, 2°, and 3° follow-ups was not statistically significant ( p > 0.05). The most common postoperative complication was cystoid macular edema that has been detected in 11 patients (10%) (seven eyes in Group A and four eyes in Group B): 2 patients (1.8%) developed a chronic macular edema. Intraocular hypertension occurred in five eyes (4.5%) (three in Group A and two in Group B). Four eyes (3.6%) underwent another surgical procedure for a persistent macular hole (two in Group A and two in Group B). The intraocular lens repositioning was performed one day after surgery in three eyes (2.7%) (Group A). The mean preoperative visual acuity was not different between the two groups ( p = 0.80). Conclusion: No significative differences between combined surgery and vitrectomy alone have been detected, in terms of postoperative complications and visual outcome.

To evaluate a 3-D visualization helmet (3DVH) during 23-gauge pars plana vitrectomy (PPV) for macular holes (MH) and macular puckers (MP). Methods: A total of 184 eyes of 184 patients undergoing PPV for MH or MP were randomly selected for surgery with 3DVH or standard Galilean microscope (GM). Only one highly trained surgeon performed each PPV. A surgical comfort score, ranging from 1 to 10 was recorded after each operation. Statistical analysis was run with SPSS to compare parameters before and after surgery and between the two groups. Results: No statistical differences were found between the two groups for mean best correct visual acuity improvement after surgery (p < 0.001). Mean surgery comfort evaluation was 7.63 AE 0.48 in 3DVH eyes and 8.21 AE 0.62 in GM ones (p = 0.09); mean overall surgical time was 35.12 AE 3.8 min in 3DVH eyes and 32.7 AE 2.27 min in GM ones (p < 0.001); mean peeling time was 14.24 AE 3.42 min in 3DVH eyes and 13.61 AE 4.63 min in GM ones (p = 0.11). Conclusions: According to the data observed in this study, the 3DVH provides adequate safety and efficacy in retinal and macular visualization during PPV for MH and MP.

The purpose of this study is to evaluate the safety and efficacy of two novel heavy dyes for macular surgery: DoubledyneTM and TwinTM. One eye from each of 144 patients undergoing surgery for macular hole or macular pucker was included in the study. The eyes were randomly divided into two groups according to the dye used during surgery. Best correct visual acuity (BCVA), intraocular pressure (IOP) and retinal morphology assessed by ocular coherence tomography (OCT) were evaluated before and 1, 3, 6 and 12 months after surgery. Only one surgeon performed each operation and provided a score ranging from 1 (poor) to 10 (excellent) for quality of staining and comfort in surgery. Statistical analysis was carried out with SPSS to compare parameters before and after surgery and between the two groups. No statistical differences were recorded in quality of staining (p = 0.11), in surgery comfort (p = 0.17) and total time of surgery (p = 0.44) between the two groups. BCVA statistically improved and central macular thickness (CMT) statistically decreased after surgery in both groups (p < 0.05). No toxic dye-related complications or long-term ones affecting the retina were observed in either group. According to this data, although confirmation in further studies with larger populations and longer follow up is required, DoubledyneTM and TwinTM proved to be safe and effective dyes for macular surgery.

Purpose: The aim of this study is to describe the management of cataract and refractory glaucoma in a case of congenital aniridia (AN)-1. Methods: In an 18-year-old female patient affected by congenital AN, bilateral coloboma of the zonula and lens, cataract and glaucoma, pars plana vitrectomy, cataract extraction and subsequent transcorneal ciliary body argon laser photocoagulation were performed. Results: Five years after laser treatment, the best-corrected visual acuity was 20/50 and the intraocular pressure was stable at 18 mm Hg with topical pharmacological management consisting of timolol 0.5% and latanoprost 0.005%. Conclusions: From our experience, transcorneal ciliary body photocoagulation after cataract extraction and vitrectomy could be a useful technique to manage high ocular pressure in eyes affected by congenital AN.