Inverted flap technique for a large traumatic macular hole with choroidal rupture and subretinal hemorrhage

Large traumatic macular holes (TMHs) tend to be irregular and have a variable predictability. The inverted flap technique makes use of remnants of internal limiting membrane (ILM) at the periphery of the MH. The peeled-off ILM contains Müller cell fragments which can induce gliosis and help in closure of MH. We operated on a case of large TMH (~899 μ minimum linear diameter) with choroidal rupture and subretinal hemorrhage in a young female with the inverted flap technique of ILM peeling and observed successful closure of the MH. The excellent anatomical and surgical results achieved in our case seem to suggest this to be a safe and effective surgical manoeuvre for such cases

Assessment of choroid thickness by swept‑source optical coherence tomography (SS-OCT) in patients with posterior uveitis

Background: This study aimed to measure the changes in choroid thickness using Swept-Source Optical Coherence Tomography (SS-OCT) after treatment of posterior uveitis along with changes in fundus auto-fluorescence pattern. Material and methods: This prospective observational cohort study was conducted from December 2018 to May 2020, in which 32 eyes of 20 patients presenting in the out-patient department with a clinical diagnosis of posterior uveitis were enrolled. Best-corrected visual acuity (BCVA) by Snellen chart, intraocular pressure (IOP) Measurement using a non-contact tonometer, choroidal thickness by SS-OCT, and fundus imaging by Fundus Autofluorescence was done. All tests were done at baseline, first follow-up of 2 ± 1 weeks and the second follow-up of 6 ± 2 weeks. Data was compiled and analyzed. Results: The mean age of patients was 31 ± 6.9 years with M:F of 3:1. During the second follow-up, with the healing of the lesions, there was a significant reduction in the choroidal thickness at all levels by SS-OCT (p < 0.05), with significant improvement in BCVA (0.05 vs. 0.14 vs. 0.31, p < 0.05). IOP increased significantly at the first follow-up to 17.31 from baseline (16.25) (p = 0.032). However, the rise at the second follow-up was not significant (17.03 vs. 16.25 at baseline, p = 0.15). On fundus autofluorescence, normal autofluorescence and hypofluorescence increased at the second follow-up of 6 weeks (p < 0.0001) Conclusion: SS-OCT showed a significant decrease in the choroidal thickness at all levels during the follow-ups. The healing of the posterior uveitis lesions and fundus autofluorescence became normal simultaneously

Bimanual 25-gauge chandelier technique for direct perfluorocarbon liquid-silicone oil exchange in retinal detachments associated with giant retinal tear

Direct perfluorocarbon liquid (PFCL)-silicone oil exchange presents its own set of challenges in the micro incision vitreous surgery era. We propose a simple bimanual technique to circumvent this problem. Thirteen eyes of patients with retinal detachment associated with giant retinal tears underwent vitrectomy followed by self-retaining endo illuminator (Chandelier) assisted direct PFCL-silicone exchange. No intra or postoperative complications related to the surgical technique were noted. All patients had attached retinas and satisfactory visual recovery at 6 months. Direct bimanual PFCL silicone oil exchange using a Chandelier seems to be a safe and effective technique