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Purpose: To compare intra‐ and postoperative results of sutureless scleral fixated Carlevale intraocular lens (IOL) with iris fixated Artisan IOL. Methods: Monocentre, retrospective analysis of refractive outcomes and intra‐ and postoperative complications of patients who received a Carlevale or Artisan IOL between January 2019 and March 2022. Results: 178 eyes of 169 patients were included (101 Carlevale and 77 Artisan IOLs). The standard follow‐up time was 1 month. Two statistically significant differences were found: in the deviation of the postoperative spherical equivalent of the refraction from the preoperative chosen IOL target (p = 0.019; mean deviation was −0.46 in the Carlevale and 0.08 in the Artisan group), and the number of eyes with complications between the Carlevale and Artisan groups (p = 0.003; 33 in the Carlevale and 42 in the Artisan group). Conclusion: The current study is the largest so far comparing both refractive outcomes and complications after implantation of Carlevale and Artisan IOL. The Carlevale IOL does not carry a greater complication risk on the short‐term follow‐up. This provides additional evidence that the Carlevale IOL has to be added to the armamentarium of the ophthalmic surgeon. [ABSTRACT FROM AUTHOR]

Objectives: To assess the mismatch between the clinical observation of vitreous alterations and self-reported symptoms in young patients complaining of symptomatic vitreous opacities (SVO). Methods: The ophthalmic medical records of young patients presenting primarily with SVO were retrospectively evaluated. Symptoms severity was assessed using a questionnaire. The status of the vitreous body was examined with indirect ophthalmoscopy at the slit-lamp and classified according to an ad hoc severity scale. Results: Sixty eyes of thirty otherwise healthy patients (median age: 32.5 (IQR: 29.0-37.0) years old) complaining of SVO (median duration: 38 months; interquartile range: 18-84 months) were enrolled. SVO was rated as severe by 50% of participants, affecting all the activities explored in the questionnaire. Twenty-three patients (76.6%) reported SVO-related depression and/or anxiety, for which eleven patients (36.6%) were or had been using medication. Fifty-eight eyes (96.6%) showed no evidence of (or minimal) vitreous opacity, while two eyes (3.3%) were found to have significant vitreous opacity. No significant inter-gender differences ( p > 0.05) and no significant differences ( p > 0.05) were found between the severity of vitreous opacity and patients' reported symptoms nor with their psychological status and medication use. Conclusions: Severe discomfort related to the perception of vitreous floaters exists in young patients whose vitreous gel examination is unremarkable or shows only minor alterations. We believe this discrepancy can be explained by optical anisotropy; significant forward-scattering of light, which results in floater symptoms; and reduced back reflection, which limits the clinical observation.

Purpose: To describe cases of reabsorption of subretinal acquired vitelliform material (acquired vitelliform lesion [AVL]) associated with vitreomacular disorders after 25-gauge pars plana vitrectomy and peeling of internal limiting membrane., Methods: Data of consecutive patients who underwent 25-gauge transconjunctival pars plana vitrectomy for vitreomacular disorders at the Department of Ophthalmology of the University Hospital of Brussels (Belgium) were collected. Patients featuring AVL on fundus examination or on spectral domain optical coherence tomography were recruited. Patients were followed up for 12 months after surgery., Results: Four eyes of three consecutive white patients presenting AVL were included. Three cases were affected by macular pucker, whereas one case featured vitreomacular traction syndrome. Progressive flattening of the AVL after surgery was observed in three eyes of three patients. One eye did not show any resorption of the submacular accumulation. In two eyes, atrophy of the retinal pigment epithelium and the outer retinal layers was observed along with resolution of the AVL, with significant worsening of visual acuity postoperatively., Conclusion: The outcome of surgery in cases of submacular AVL associated with vitreomacular interface syndromes could be heterogeneous and may depend on the duration of the disease and baseline optical coherence tomography characteristics of the lipofuscin accumulation.

Introduction: The purpose of this report is to describe a case of macular hole development after vitrectomy for floaters with induction of posterior vitreous detachment., Case Report: A 44-year-old otherwise healthy man presented with visually debilitating floaters in his right eye; these had been present for more than 2 years. Preoperative examination was unremarkable in both eyes, apart from some degree of vitreous degeneration in the right eye. Preoperative visual acuity was 20/20 bilaterally. A 25-gauge transconjunctival sutureless pars plana complete vitrectomy with induction of posterior vitreous detachment was performed in the right eye. Upon examination 1 month after surgery, a small full-thickness macular hole was detected in the right eye. Visual acuity was diminished to 20/80. The macular hole was closed after a second vitrectomy with internal limiting membrane peeling and gas tamponade., Conclusion: Macular hole development should be listed as a possible complication of vitrectomy for visually debilitating floaters when a posterior vitreous detachment is induced during surgery.

Purpose: To describe a patient with acute central serous chorioretinopathy after use of γ-hydroxybutyric acid (GHB), also known as "liquid ecstasy.", Methods: Observational case report of a patient who developed central serous chorioretinopathy a day after use of GHB at a party., Results: A young adult male patient presented at the department complaining of non-improving acute onset of vision loss in the left eye after use of GHB at a party 3 weeks before. Fundus examination, optical coherence tomography, and fluorescein angiography revealed a dome-shaped retinal elevation centered to the macula of the left eye, suggesting the diagnosis of central serous chorioretinopathy. Spontaneous subretinal fluid resolution with improvement of vision was observed a month later., Conclusion: γ-hydroxybutyric acid has been reported to induce an acute increase in cortisol secretion after its administration. In addition, a case of Cushing syndrome after chronic abuse of GHB has been described. The acutely increased cortisol levels, induced by GHB, might have been the cause of central serous chorioretinopathy in the patient.

The causes of retinal hypoxia are many and varied. Under hypoxic conditions, a variety of soluble factors are secreted into the vitreous cavity including growth factors, cytokines, and chemokines. Cytokines, which usually serve as signals between neighboring cells, are involved in essentially every important biological process, including cell proliferation, inflammation, immunity, migration, fibrosis, tissue repair, and angiogenesis. Cytokines and chemokines are multifunctional mediators that can direct the recruitment of leukocytes to sites of inflammation, promote the process, enhance immune responses, and promote stem cell survival, development, and homeostasis. The modern particle-based flow cytometric analysis is more direct, stable and sensitive than the colorimetric readout of the conventional ELISA but, similar to ELISA, is influenced by vitreous hemorrhage, disruption of the blood-retina barrier, and high serum levels of a specific protein. Finding patterns in the expression of inflammatory cytokines specific to a particular disease can substantially contribute to the understanding of its basic mechanism and to the development of a targeted therapy.

Purpose: To describe the incidence of hypotony after 25-gauge vitrectomy and to identify preoperative and intraoperative factors that influence the occurrence of hypotony., Design: Retrospective, nonrandomized, interventional case series., Methods: We reviewed 122 consecutive cases of 25-gauge vitrectomy for all surgical indications. The primary outcome measure was intraocular pressure (IOP) at postoperative day 1, measured with Goldmann tonometry. Secondary outcome measures were clinical signs of hypotony and other complications., Results: Hypotony, defined as an IOP of 5 mm Hg or less, was found in 13.1% of cases on postoperative day 1. Clinical signs of hypotony were encountered in 7 eyes (5.7%). The risk of hypotony was significantly lower in cases with air or gas tamponade (3.3%) than in cases without tamponade (22.4%). Hypotony was encountered more often in reoperations (29.9%) than in primary operations (9.2%; statistically significant difference). In cases in which intravitreal triamcinolone was used, the risk of hypotony was significantly higher (35.3%) than in cases without triamcinolone (10.3%). Phakic eyes had significantly less chance of hypotony (6.7%) than pseudophakic eyes (15.6%) and eyes undergoing combined phacoemulsification and vitrectomy (25.0%). At postoperative day 7, all cases of hypotony recovered spontaneously. None of our cases developed endophthalmitis., Conclusion: Our results show that a transient hypotony occurs commonly after 25-gauge vitrectomy. Hypotony was significantly influenced by tamponade, reoperation, intraoperative lens status, and use of intravitreal triamcinolone. Although all cases of hypotony recovered spontaneously without permanent damage, the high frequency of hypotony does impose potential risks. Increased vigilance with focus on perioperative antisepsis and low tolerance of sclerotomy leakage are important for the prevention of endophthalmitis. Strategies aimed at lowering the risk of hypotony are needed to improve the safety of this promising technique., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Aim: The aim of this study to present the surgical treatments performed in Italy for congenital nasolacrimal duct obstruction., Methods: This was a retrospective review of the Ministry of Health database for groups aged 0-1 and 1-4 years from 1999 through 2005., Results: During the study period, a total of 9081 surgical procedures was performed on children 0-4 years of age, 2739 of which on infants under 1 year of age and 6342 on children 1-4 year-old; 8067 (88.8%) of these interventions were represented by nasolacrimal duct probing, 2556 of which in infants under one year of age and 5511 in the 1-4 year age group. Total number of the other surgical techniques was 984, 183 of which among infants younger than one year of age and 801 among children aged 1-4 years. The seven-year mean number of surgical treatments corresponds to a rate of 7.3/10000 live births for infants <1 year old and 4.3/10000 for children aged 1-4 years., Conclusion: When congenital nasolacrimal duct obstructions do not improve spontaneously, probing resulted the more common surgical treatment performed. Our data are related exclusively to infantile inpatients and cases managed on an office basis are not included. Consequently, our figures cannot be considered indicative of the incidence of this pathology in Italy. However, the mean number per 10000 of surgical procedures may represent, in our opinion, a useful indicator for the more severe forms of congenital lacrimal drainage system pathologies.

Inborn errors of metabolism are a substantial field of medicine. Although genetic syndromes associated with cataracts are rare, they are important since early detection and effective treatment of visual handicaps is one of the most urgent duties of any practitioner and pediatrician. Cooperation among pediatricians, ophthalmologists, orthoptists and geneticists, as well as the institution of a high-risk registry for visual handicaps appears to be of paramount importance.

Familial juvenile nephronophthisis (FJN) is a frequent cause of chronic renal failure in children and adolescents. Typically it presents after 6 years of age through adolescence, but may become apparent in early childhood. The clinical presentation is insidious, and the early symptoms of polyuria and polydipsia are often overlooked in the presence of a relatively normal urinalysis and in the absence of proteinuria, azotemia, and hypertension. Thus most patients are not diagnosed until after the onset of renal failure. These children are excellent candidates for properly selected transplantation.

This article reviews several autosomal recessive syndromes characterized by pigmentary retinopathy and, in many, combined with deafness, hypogonadism, and/or mental retardation. These syndromes are manifested in infancy and childhood. Although no specific treatment is available, an early diagnosis can be the first step in initiating symptomative management and preventive measures for the patient and family.

Waardenburg's Syndrome (WS), a rare disorder inherited as an autosomal dominant trait with variable penetrance, is characterized by white forelock, eye-ear symptoms and signs, and dysmorphic features. The authors describe two cases of WS with mental retardation and developmental and EEG anomalies. Therefore they suggest to perform an EEG in all suspected cases of WS.