IOL Fixation Using Gore-Tex Four-Point Fixation of a Single Piece IOL

Samuel Hobbs, MD

Eyetube

This video demonstrates IOL exchange in the eye of a patient with a history of complex retinal detachment repair. Samuel Hobbs, MD, uses Gore-Tex sutures in a four-point fixation to secure a single-piece IOL to the sclera. This technique can allow for the fixation of virtually any acrylic lens, including toric and multifocal lenses, giving surgeons versatility of keeping the primary lens choice even in the absence of capsular support.

High Astigmatism and Amblyopia

What are the options for improving the vision of this young patient?

Pavel Stodulka, MD, PhD; Brett Mueller, DO, PhD; Stefanie Schmickler, MD; and Abi Tenen, MBBS(Hons), FRANZCO

Cataract and Refractive Surgery Today

.fluid-width-video-wrapper{ margin-bottom: -75px !important; } CASE PRESENTATION A 31-year-old woman presents with a desire for improved vision in her amblyopic left eye. Upon examination, the patient’s corrected distance visual acuity (CDVA) is 0.2 decimal OS with a refraction of +1.75 -5.00 x 10º. Her uncorrected near visual acuity (UNVA) is barely J13 OS and does not improve with her distance refraction. The right eye is slightly amblyopic, and her CDVA is 0.7 OD with a plano refraction. She has worn glasses since childhood when her right eye was patched but does not like them. As a result, the patient currently wears spectacles only for driving. Mild horizontal nystagmus is evident and increases with sideways gaze. Scheimpflug corneal tomography of the left eye finds a central corneal thickness of 526 µm, 4.90 D of regular astigmatism, and an anterior chamber depth of 2.8 mm (Figure 1). The endothelium is healthy, and endothelial cell density measures 2,800 cells/mm2. No signs of dry eye disease and no intraocular pathology are found.

A Reference Guide for OCT Angiography

An illustrative overview of OCTA findings to help you implement this tool in common clinical scenarios.

Ivy Zhu, MD; Nicole L. Decker, BS; and Amani A. Fawzi, MD

Retina Today

AT A GLANCE OCT angiography (OCTA) has several advantages over traditional imaging techniques, including being noninvasive, depth resolved, and rapid. OCTA can distinguish the various vascular networks without obscuration by leakage, making it helpful for characterizing neovascularization and nonperfusion. OCTA is particularly useful in cases of type 1 neovascularization, where sub-retinal pigment epithelium neovascularization can develop without active exudation. En face OCTA and OCT B-scans are complementary and, together, can provide the clinician with a wealth of knowledge. There are several conditions for which OCTA can provide detailed information that would otherwise be time-consuming or impossible to find with traditional techniques. OCT angiography (OCTA) is a noninvasive imaging technique that uses the principles of motion detection to reveal depth-resolved images of the retinal and choroidal vasculature, down to the capillary level.1 OCTA has several advantages over traditional imaging techniques, including being noninvasive (no dye injection), depth resolved, and rapid. A key benefit of OCTA is its ability to distinguish the various vascular networks without obscuration by leakage, making it very helpful for characterizing retinal neovascularization and nonperfusion with precision beyond dye-based angiography. Here, we detail several clinical scenarios in which OCTA can be a useful diagnostic tool and illustrate key imaging features. In general, absence of flow (nonperfusion) is best appreciated with en face images. The presence of abnormal flow is most accurately detected using a combination of en face imaging assisted by the OCT B-scan with flow overlay to pinpoint abnormal flow related to structural pathological changes.