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Rinko Akamine, Naomi Miyamoto, Shoko Kiritoshi, Mami Kusaka, Masayuki Akimoto Osaka Red Cross Hospital, Osaka, JapanCorrespondence: Masayuki AkimotoOsaka Red Cross Hospital, 5-30 Fudegasakicho, Tennojiku, Osaka, 543-8555, JapanEmail masayuki@akimoto3.comBackground: We previously reported a novel technique using an elastic silicone bowl, which was handmade from a phaco test chamber, to salvage dislocated lenses and perform phacoemulsification and aspiration (PEA) on the bowl. However, creating the bowl was challenging.Methods: A factory-made elastic silicone sheet (ESS), a ready-to-use alternative for the posterior capsule of the lens, was prepared. We used this sheet to salvage and support the dislocated/subluxated lenses in 11 eyes of nine patients.Results: We could use a sheet immediately after we opened the package. In all the cases, we could insert a sheet beneath the lens and PEA performed at the center of the operative field. There was only one incident where the lens could not be placed onto the disc at the first attempt, but the lens was eventually salvaged. There was no risk of rupture during PEA, and the ESS could be removed completely without any complications.Conclusion: The factory-made ESS described here can be used for salvaging dislocated/subluxated lenses and safely performing PEA.Keywords: lens dislocation, perfluorocarbon, alternative posterior capsule of the lens

Mami Kusaka, Yu Kagitani, Sachiyo Hama, Mihori Kita Department of Ophthalmology, National Hospital Organization Kyoto Medical Center, Kyoto, JapanCorrespondence: Mihori KitaDepartment of Ophthalmology, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-Cho, Fukakusa, Fushimi-Ku, Kyoto-city, Kyoto, 612-8555, JapanTel +81-75-641-9161Fax +81-75-643-4325Email mihorik@kuhp.kyoto-u.ac.jpAbstract: A 63-year-old female with a history of retinal detachment repair with scleral buckle from 28 years prior presented with exposure of the buckle in her right eye. After removing the buckle and anchoring sutures, the operation field was washed with 0.25% polyvinyl alcohol-iodine, vancomycin, and ceftazidime. Cultures revealed Mycobacterium chelonae. Systemic meropenem was discontinued on postoperative day 5. The retina remained attached, and there was no recurrence over a 1-year follow-up. We report a case of NTM buckle infection that responded well to thorough washings with polyvinyl alcohol-iodine and antibiotic solutions instead of using a prolonged course of systemic antibiotics.Keywords: scleral buckle, infection, Mycobacterium chelonae, nontuberculous mycobacteria, NTM, polyvinyl alcohol-iodine, artificial device

Mihori Kita, Mami Kusaka, Hiroshi Yamada, Sachiyo Hama Department of Ophthalmology, National Organization Kyoto Medical Center, Kyoto, JapanCorrespondence: Mihori KitaDepartment of Ophthalmology, National Organization Kyoto Medical Center, 1-1 Mukouhata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, JapanTel +81 75 641 9161Fax +81 75 643 4325Email mihorik@kuhp.kyoto-u.ac.jpPurpose: To assess the updated chandelier illumination-assisted scleral buckle procedures using a 3D visualization system.Subjects and methods: We report a single-center, retrospective, consecutive surgical case series of 18 eyes of 16 patients that underwent scleral buckle procedures combining the use of chandelier endoillumination, a noncontact wide-angle viewing system, an anti-drying contact lens, and a recently developed 3D visualization system. The mean age of the patients was 30.2 years, and the mean follow-up time was 11.3 months.Results: Retinal reattachment was achieved after the first surgery in all cases. There were no cases that required conversion of the 3D visualization to a conventional microscopic view. This updated chandelier-assisted scleral buckle procedure was successfully performed without any intraoperative or postoperative complications, except for the occurrence of postoperative diplopia in one case in which a supplementary radial buckle was used for a deep tear.Conclusion: The updated chandelier illumination-assisted scleral buckling surgery using a 3D visualization system appears to be a valuable and promising method for managing rhegmatogenous retinal detachment due to atrophic holes in lattice degeneration or ciliary tears in younger cases.Keywords: scleral buckling, chandelier illumination, wide-angle viewing system, 3D visualization system, retinal detachment, contact lens

Mihori Kita, Mami Kusaka, Hiroshi Yamada, Sachiyo HamaDepartment of Ophthalmology, National Organization Kyoto Medical Center, Kyoto, JapanCorrespondence: Mihori KitaDepartment of Ophthalmology, National Organization Kyoto Medical Center, 1-1 Mukouhata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, JapanTel +81 75 641 9161Fax +81 75 643 4325Email mihorik@kuhp.kyoto-u.ac.jpPurpose: To introduce a new three-dimensional (3D) endoscope system for vitrectomy.Subjects and methods: We report a single-center, retrospective, consecutive surgical case series of 391 eyes that underwent 25G hybrid vitrectomy. To create 3D endoscopic images, a 3D converter HD-3D-A was connected to a monocular endoscopic system.Results: The 3D endoscope system was successfully used to perform hybrid vitrectomy. No intra- or postoperative complications related to this system were encountered in any of the cases.Conclusion: This 3D endoscope system appears to be a valuable and promising tool for use in vitrectomy.Keywords: endoscope, 3D, vitrectomy, hybrid, wide-angle view