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Background and Objective: To utilize quantitative ultra widefield retinal imaging to investigate the risk factors associated with the incidence and severity of postoperative epiretinal membrane (ERM) in patients who underwent primary rhegmatogenous retinal detachment (RRD) repair. Patients and Methods: This retrospective study included patients who underwent pars plana vitrectomy (PPV) with scleral buckle (SB) for RRD, without a prior history of ERM, and who underwent ultra widefield imaging postoperatively between June 2020 and February 2022. The size and location (distance from the macula) of the drainage retinotomy and the area of peripheral pathology, including retinal breaks and laser scars, were quantitatively measured with cloud-based software. The severity of postoperative ERM formation at 6 months was graded from grade 1 to 4. We investigated the risk factors that were significantly associated with the incidence and severity of postoperative ERM at 6 months. Results: We included 80 eyes (80 patients) in this study. Postoperative ERM developed in 37 eyes (46%) at 6 months. The severity of ERM was grade 1 in 24 eyes (65%), grade 2 in 6 eyes (16%), grade 3 in 4 eyes (11%), and grade 4 in 3 eyes (8%). Postoperative ERM was not associated with the presence or the location of drainage retinotomy ( P = 0.836 and 0.820, respectively). However, it was significantly associated with larger surface area of drainage retinotomy ( P = 0.039). In addition, postoperative ERM was significantly associated with a larger area of peripheral pathology ( P = 0.012), a larger extent of RRD ( P = 0.013), vitreous hemorrhage ( P = 0.026), redetachment within 6 months ( P = 0.022), use of silicone oil as a tamponade ( P = 0.047), and number of surgeries within 6 months ( P = 0.027). These factors, in addition to 360° endolaser, were also significantly associated with the severity of postoperative ERM. In multivariable linear regression analysis, the only variable that remained statistically significant was the size of the drainage retinotomy ( P = 0.023). Conclusion: The pathogenesis of postoperative ERM is multifactorial. Large drainage retinotomies may increase the risk of ERM formation. [ Ophthalmic Surg Lasers Imaging Retina 2023;54:206–216.]

BACKGROUND AND OBJECTIVE: Data regarding hemorrhagic complications of direct oral anticoagulants (DOACs) and vitreoretinal surgery are limited. PATIENTS AND METHODS: Multicenter analysis of longitudinal, aggregated electronic health records of patients undergoing pars plana vitrectomy (PPV) with no prior history of ocular hemorrhage. Retrospective analysis of patients undergoing PPV between January 1, 2013, and December 31, 2019. The main outcomes were development of postoperative hemorrhagic complications within 1 month following vitreoretinal surgery. RESULTS: A total of 58,131 eyes underwent PPV, with 2,956 (5.1%) on anticoagulant medication prior to surgery. Eight hundred twenty-eight eyes (1.4%) developed a postoperative hemorrhage. Of eyes with anticoagulation use, 50 of 2,956 (1.29%) developed a hemorrhage, whereas 778 of 55,175 (1.41%) of the eyes with no prior anticoagulation use developed a postoperative hemorrhage ( P = .2107). CONCLUSION: Use of DOACs prior to vitreoretinal surgery does not appear to be associated with increased rates of postoperative intraocular hemorrhage. [ Ophthalmic Surg Lasers Imaging Retina . 2021;52:374–379.]

BACKGROUND AND OBJECTIVE: To analyze the anatomic success rate of pars plana vitrectomy (PPV), retinectomy, and silicone oil (SO) tamponade without scleral buckle (SB) for repair of recurrent rhegmatogenous retinal detachment (RRD) associated with proliferative vitreoretinopathy (PVR). PATIENTS AND METHODS: Retrospective, consecutive, single-surgeon case series of 28 eyes of 28 patients with PVR-associated RRD repaired with PPV, retinectomy, and SO tamponade without SB. RESULTS: The single-procedure anatomic success rate was 85.2% at 3 months and 82.1% at 12 months. Final reattachment rate was 100.0%. There were no preoperative factors that predicted single procedure anatomic success. Mean logarithm of the minimal angle of resolution visual acuity (VA) was improved at 3 months (1.61 to 1.51, P = .732) and at 12 months (1.61 to 1.41; P = .271). VA outcome was related to preoperative macula and lens status. CONCLUSION: The single-procedure anatomic success rate of PPV, retinectomy, and SO tamponade without SB for PVR-related recurrent RRD is comparable to prior reports of similar surgery incorporating SB. [ Ophthalmic Surg Lasers Imaging Retina. 2019;50:e278–e287.]

BACKGROUND AND OBJECTIVE: This review compares 23-gauge pars plana vitrectomy (PPV) alone versus combined 23-gauge pars plana vitrectomy and scleral buckle (PPV/SB) for primary repair of pseudophakic rhegmatogenous retinal detachment (RRD). PATIENTS AND METHODS: A retrospective review of 70 eyes that underwent 23-gauge PPV and 43 eyes that received 23-gauge PPV/SB for pseudophakic RRD. Minimum follow-up was 3 months. Outcome measures included anatomical success, visual acuity, and complication rates. RESULTS: The 23-gauge PPV group achieved primary anatomical success in 58 of 70 cases (83%). Primary success in the PPV/SB group occurred in 36 of 43 cases (84%). Final anatomical success was achieved in all 113 cases (100%). The difference in primary success rates was not statistically significant ( P = 1.000, Fisher exact test). Average visual acuity for macula-on RRDs in the PPV group showed a +0.07 logMAR improvement ( P = .580) versus a +1.34 improvement ( P < .001) in macula-off PPV cases. SB/PPV macula-on cases showed a decrease in logMAR visual acuity by −0.06 ( P = .380) while macula-off SB/PPV cases improved by +1.28 ( P = .002). There were no significant complications in either group. CONCLUSION: Both 23-gauge PPV and PPV/SB are effective procedures for repairing pseudophakic RRD and exhibit similar rates of success. [ Ophthalmic Surg Lasers Imaging Retina . 2015;46:702–707.]

BACKGROUND AND OBJECTIVE: To investigate outcomes of contemporary surgical techniques for repair of rhegmatogenous retinal detachments (RRD) associated with giant retinal tears (GRT). PATIENTS AND METHODS: Retrospective, consecutive case series including 58 eyes of 58 patients. Mean age was 52 years (range: 16 to 83 years). All patients underwent 23-gauge pars plana vitrectomy with use of perfluorocarbon liquid and intravitreal tamponade (28 with silicone oil, 25 with octafluoropropane gas, and five with sulfur hexafluoride gas). Scleral buckle (SB) was placed in 30 eyes (52%). RESULTS: At a mean follow-up of 17 months, mean visual acuity improved from 20/500 preoperatively to 20/88 at final follow-up. Fifty-one patients (88%) had single-surgery anatomic success, and all patients achieved final retinal reattachment. Use of SB ( P = 1.0), silicone oil ( P = .1), or 360° endophotocoagulation ( P = .7) did not correlate with higher rates of successful repair. CONCLUSION: Contemporary vitreoretinal surgery techniques achieve high rates of primary anatomic success in GRT-related RRDs. [ Ophthalmic Surg Lasers Imaging Retina . 2015;46:566–570.]

BACKGROUND AND OBJECTIVE: To evaluate ranibizumab for exudative age-related macular degeneration previously treated with pegaptanib, bevacizumab, or both. PATIENTS AND METHODS: This was a retrospective, interventional case series of patients with exudative age-related macular degeneration who were treated with ranibizumab after being initially treated with pegaptanib, bevacizumab, or both. The primary outcome was change in visual acuity following the switch to ranibizumab. RESULTS: One hundred two eyes of 92 patients were identified. Following the switch to ranibizumab, there was an average gain of 0.7 lines in visual acuity. Ninety-four eyes (92%) lost 3 or fewer lines, 29 eyes (28%) gained more than 3 lines, and 3 eyes (3%) lost more than 6 lines after switching to ranibizumab. Lesion type and time between previous vascular endothelial growth factor inhibitor and ranibizumab did not affect the response. CONCLUSION: Ranibizumab maintained visual acuity in the majority of patients and appears to be an effective treatment regardless of previous anti-vascular endothelial growth factor therapy. [Ophthalmic Surg Lasers Imaging 2010;41:182–189.]

BACKGROUND AND OBJECTIVE To report postoperative complications in eyes undergoing 25-gauge pars plana vitrectomy (PPV). PATIENTS AND METHODS Seventy consecutive eyes that underwent 25-gauge PPV for various indications, including epiretinal membrane, non-clearing vitreous hemorrhage, and idiopathic macular hole, and had a minimum follow-up of 12 weeks were reviewed retrospectively. Main outcome measures included bestcorrected Snellen visual acuity, intraocular pressure (IOP), intraoperative complications, and postoperative complications. RESULTS The mean visual acuity improved from 20/368 preoperatively to 20/105 postoperatively (P P = .031) but not in eyes filled with intravitreal air (P = .30) or gas (P = .52). Sclerotomy sutures were required intraoperatively in 5 eyes (7.1 %) and postoperative day 1 hypotony was noted in 4 eyes (5.7%). All of these complications were noted in fluid-filled eyes except for one case of postoperative day 1 hypotony with gas tamponade. CONCLUSIONS Intraoperative and postoperative complications were rare in this series of 25-gauge PPV. Postoperative cataract progression and hypotony were the most common complications. Fluid-filled eyes appear to have a higher risk of wound leakage and postoperative hypotony after 25-gauge PPV than eyes with air or gas tamponade. [Ophthalmic Surg Lasers Imaging 2007;38:270- 275.] AUTHORS From the Retina Service (OPG, CDR, MSF, RSK, ACH, JAM, JFV), Wills Eye at Thomas Jefferson University, Philadelphia, Pennsylvania; and the Department of Ophthalmology (EDW), Walter Reed Army Medical Center, Washington, DC. Accepted for publication April 20, 2007. Funded in part by the Eye Research Institute and Wills Eye Retina Service, Philadelphia, Pennsylvania. Presented in part at the Annual Retina Society Meeting, Del Coronado, California, September 14-18, 2005, and the Association for Research in Vision and Ophthalmology, Annual Meeting, Ft. Lauderdale, Florida, April 30-May 4, 2006. Address correspondence to Carl D. Regillo, MD, Wills Eye Institute, 840 Walnut Street, Suite 1020, Philadelphia, PA 19107.

* BACKGROUND AND OBJECTIVE: To evaluate the potential acuity meter in predicting visual acuity after photodynamic therapy of choroidal neovascular membranes caused by age-related macular degeneration. * PATIENTS AND METHODS: Retrospective study of 55 eyes in 51 patients with subfoveal predominantly classic choroidal neovascularization due to age-related macular degeneration. Pre-photodynamic therapy Snellen visual acuity minus the visual acuity with the potential acuity meter was compared with the actual improvement in visual acuity. Significant improvement in visual acuity after photodynamic therapy was defined as a gain of more than 2 lines in Snellen visual acuity (0.2 logarithm of the minimal angle of resolution units). * RESULTS: Eighteen (51.4%) of 35 eyes with a potential for improvement experienced an actual improvement in their Snellen visual acuity after photodynamic therapy (P < .001). All eyes lacking a potential for improvement failed to experience an actual improvement in visual acuity after photodynamic therapy. * CONCLUSION: The eyes that demonstrated better visual acuity with the potential acuity meter in this study seemed more likely to experience an improvement in visual acuity after photodynamic therapy. [Ophthalmic Surg Lasers Imaging 2006;37:6-11.]

BACKGROUND AND OBJECTIVE To present a consecutive case series of patients 50 years or younger who underwent photodynamic therapy (PDT) for choroidal neovascularization (CNV) from etiologies other than age-related macular degeneration. PATIENTS AND METHODS Retrospective chart review of 35 consecutive eyes of 34 patients. RESULTS Visual acuity remained stable or improved in 20 of 35 eyes. Thirteen eyes with myopic degeneration had pre-treatment and post-treatment mean visual acuities of 20/100 and 20/200, respectively. Eight eyes with idiopathic CNV had an improvement of mean visual acuity from 20/200 to 20/125. Six eyes with ocular histoplasmosis displayed a stable mean visual acuity of 20/50. Of 3 eyes with angioid streaks, visual acuity remained stable in 2 eyes and declined in 1 eye. Five eyes with other etiologies all had improved vision. CONCLUSION Although the current literature shows evidence that PDT is beneficial in treating CNV secondary to myopic degeneration, the evidence for etiologies such as idiopathic causes, ocular histoplasmosis, and angioid streaks is optimistic but remains unproven. Our study suggests that PDT may be beneficial in stabilizing and improving vision when treating CNV from these etiologies. [Ophthalmic Surg Lasers Imaging 2006;37:182-189.] AUTHORS From the Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania. Accepted for publication February 26, 2006. Presented at the 23rd Annual Meeting of the American Society of Retina Specialists in Montreal, Quebec, Canada, July 16-20, 2005. Address reprint requests to Allen C. Ho, MD, Retinovitreous Associates, 910 East Willow Grove Ave., Wyndmoor, PA 19038.

The authors report a case of idiopathic polypoidal choroidal vasculopathy and sudden decrease in vision in which indocyaníne green (ICG) angiography aided in the diagnosis and treatment. ICG angiography identified choroidal-based vascular abnormalities in a patient with idiopathic polypoidal choroidal vasculopathy. One of these areas demonstrated apparent leakage and was treated with laser photocoagulation, resulting in resolution of subretinal fluid and improvement in visual acuity. ICG angiography provides a clearer visualization of the choroidal vasculature than fluorescein angiography and can aid in the diagnosis and treatment of idiopathic polypoidal choroidal vasculopathy. [Ophthalmic Surg Lasers 1996;27:467470.]

The authors present a technique of transscleral fixation of a posterior chamber intraocular tens modified to permit a small-incision approach by using a foldable silicone lens. This modification improved intraoperative globe stability and reduced operative time. This procedure also has the potential for expediting postoperative recovery and visual rehabilitation. [Ophthalmic Surg Lasers 1996;27:473-475.]