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Ophthalmologica highlights

Sebastian Wolf

Posted: Tuesday, September 1, 2020

EN FACE OCT A SENSITIVE PREDICTOR OF VISION LOSS
En face OCT optical coherence tomography can accurately predict vision loss in eyes with untreated premacular membrane (PMM) with macular pucker (MP), a new study suggests. The retrospective observation study involved 342 eyes diagnosed with PMM with MP who were untreated for mean observation period of 448 days. The study’s authors used spectral-domain optical coherence tomography imaging to characterise a range of retinal disease parameters. Additionally, they used en face OCT to identify and calculate the area the thickened retina portion. In the 20% of eyes in which visual acuity worsened by two lines or more, the only consistent predictor of PMM progression was the area of retinal thickening.
Li D.Q. et al, “ Predicting Progression of Untreated Macular Pucker Using Retinal Surface En Face Optical Coherence Tomography volume”, Ophthalmologica 2020, Volume 243, Issue 5.

PRONE POSITIONING BEST AVOIDED
A new study suggests that retinal detachment patients may achieve best results if they go without prone posturing in the early operative period after undergoing retinopexy with gas tamponade. The single-centre retrospective series involved 67 eyes with macula-involved RD and superior breaks treated with vitrectomy, retinopexy, and gas tamponade, and no prone posture. The postoperative anatomical success rate was 89% and only 26% had a fundus autofluorescent imaging macular shift. The authors note that that is the lowest rate of FAF shift yet reported in patients with macula-involved RD.
M A P Fajgenbaum et al, “Rate of Postoperative Autofluorescent Macular Shift with Expanding Gas Bubble Tamponade and No Prone Posture Ambulatory Care in Patients with Macula-Involved Retinal Detachment”, Ophthalmologica 2020, Volume 243, Issue 5.

HEADS-UP 3D NO BETTER FOR VITREORETINAL SURGERY
Three-dimensional (3D) heads-up visualisation systems may improve operative fluency in cataract and corneal surgery but decrease operative fluency in vitreoretinal surgery, a new report suggests. The study involved five surgeons and their respective residents who performed cataract and corneal procedures as well as vitreoretinal procedures using of a 3D visualisation system (Ngenuity, Alcon®) and conventional surgical microscope (OPMI LUMIRA 700, Zeiss®). In their responses to a questionnaire completed after each surgery, the participants reported no significant differences between the two systems in terms of surgical risk, intraoperative complications and visual or physical comfort in either type of procedures. However, with the heads-up system they reported slightly enhanced operative fluency during anterior segment procedures and reduced operative fluency during vitreoretinal procedures.
F Berquet et al,“Comparing Heads-Up versus Binocular Microscope Visualization Systems in Anterior and Posterior Segment Surgeries: A Retrospective Study Ophthalmologica 2020” , Volume 243, Issue 5