Chandelier Retroillumination in a Complex Cataract Extraction

Birkaran Sadhar, and Eric D. Rosenberg, DO, MScEng

Eyetube

Birkaran Sadhar, and Eric D. Rosenberg, DO, MScEng, present a case in which they perform chandelier retroillumination using the Ngenuity 3D Visualization System (Alcon) to extract a complex cataract in the eye of a 75-year-old man with vitreous prolapse.

Sutureless Scleral Fixation of IOLS

Evaluating real-world outcomes.

Zachary Zavodni, MD

Cataract and Refractive Surgery Today

Double-Flanged Polypropylene Technique: 5-Year Results Canabrava S, Carvalho MS1Industry support: None ABSTRACT SUMMARY A prospective observational case series evaluated the outcomes of patients who underwent the flanged polypropylene scleral fixation of capsular tension segments (CTSs) and IOLs. A total of 71 eyes were divided into three groups: double-flanged CTS (n = 25), four-flanged nonfoldable IOL (n = 18), and four-flanged foldable IOL (n = 28). The sutures made of 5-0 and 6-0 polypropylene were used in 60% and 40% of the cases, respectively. Partial-thickness scleral tunnels were created in all cases to facilitate burial of the flanges. Follow-up averaged 28.24 months (range, 6–60 months). Descriptive outcome measures included patients’ visual acuity, flange position (intrascleral vs sub-Tenon vs conjunctival erosion), and complications such as IOL dislocation and retinal detachment. Study in Brief A prospective observational case series assessed the long-term results and complications of the scleral fixation of capsular tension segments and IOLs with the double-flanged polypropylene technique. Overall, fixation remained stable throughout the 5-year study period. Flange exposure or erosion occurred in less than 3% of cases. WHY IT MATTERS The double-flanged polypropylene technique has become popular for the scleral fixation of IOLs owing to its efficiency and speed.

Acute-Onset Vogt-Koyanagi-Harada Syndrome

This autoimmune condition may present with only ocular findings early in the disease course.

Steven Scheidt, MS, and Heeral R. Shah, MD

Retina Today

Vogt-Koyanagi-Harada (VKH) syndrome is a rare autoimmune and granulomatous inflammatory condition that affects the central nervous system. VKH has a vast range of presentations, which may involve cerebrospinal fluid, skin, hair, and eyes. VKH syndrome mainly occurs in adults, but there is a case report of a 3-year-old girl with VKH.1 VKH syndrome has an idiosyncratic phenotype and may present with early or late physical manifestations. Although the pathophysiology is not completely understood, VKH syndrome can be subdivided into a prodrome, an acute, and a chronic phase. The prodrome phase is characterized by nonspecific features such as fever, malaise, headache, and dizziness, which last for a few days. The acute phase lasts for a few weeks and is characterized by bilateral posterior uveitis and other ocular findings. In rare cases, the posterior uveitis may not occur at the same time in the contralateral eye but will have a short delay.2 The chronic stage can last a few months to years and involves depigmentation of the skin and uvea. At this point vitiligo is most often seen, commonly affecting the eyelashes, face, and trunk. Other symptoms such as alopecia may occur, and patients may present with changes in the color of the choroid to bright orange with a pale optic nerve.3 CASE PRESENTATION A 26-year-old woman presented to the emergency department with an acute onset of progressive worsening bilateral eye pain and blurry vision. She denied any discharge from the eyes and stated that she had been having headaches, nausea, and fever for a few days.