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.

The Development and Impact of the Malyugin Ring

The journey of a groundbreaking device in cataract surgery that revolutionized pupillary dilation techniques.

Boris Malyugin, MD, PhD

Cataract and Refractive Surgery Today

An unobstructed view of the surgical field and sufficient access to the crystalline lens are major factors in the success of cataract surgery. Mechanical pupillary dilation is the last resort for surgeons when pharmacologic protocols fail to provide the desired diameter. This failure may occur owing to mechanical barriers to pupillary excursions, such as anterior or posterior synechiae, or because of the iris muscle’s inability to respond to pharmacologic stimuli. FROM CONCEPT TO CREATION Genesis. Pupil expansion rings have become popular and share the market equally with iris hooks. Of the available rings, the Malyugin Ring (MicroSurgical Technology [MST]) is the most successful. As the inventor of this device, my intention was to address the challenges of pupillary dilation with a design that was both effective and surgeon friendly. The ring features unique elements designed to engage the pupillary margin securely (Figure 1).

Uveal Reactive Lymphoid Hyperplasia

Be on the lookout for this rare cause of choroidal lesions.

Loka Thangamathesvaran, MD, and J. Fernando Arevalo, MD, PhD

Retina Today

A 72-year-old man with no past medical or ocular history presented for evaluation of a choroidal lesion found in his right eye on routine examination. His BCVA was 20/30 OD and 20/20 OS. The anterior segment was normal in each eye. Fundus examination of the right eye showed multifocal, creamy yellow choroidal infiltrates with peripapillary hyperpigmentation and focal subretinal yellow deposits (Figure 1). ICG angiography showed hypofluorescence corresponding to the choroidal lesions in the right eye. Fluorescein angiography showed early peripapillary blockage with late staining of the lesion in the right eye (Figure 2). Macular OCT showed choroidal elevation with an intact overlying retina and scattered subretinal hyperreflective lesions (Figure 3). B-scan ultrasonography showed peripapillary fundus thickening (Figure 4). DIAGNOSIS AND FOLLOW-UP The differential diagnosis was broad and included infectious (syphilis, tuberculosis [TB], and human immunodeficiency virus [HIV]), inflammatory (sarcoidosis, acute posterior multifocal placoid pigment epitheliopathy, and posterior scleritis), and oncologic (primary vitreoretinal lymphoma, reactive lymphoid hyperplasia of the uvea, metastatic lesions, diffuse melanoma, and uveal effusion syndrome) etiologies. An extensive lab workup was ordered, including tests for HIV, TB, syphilis, angiotensin-converting enzyme, lysozyme, toxoplasmosis, anti-double-stranded DNA, anti-myeloperoxidase antibody, anti-proteinase 3, and toxocariasis.