BackgroundIntraocular foreign bodies (IOFBs) are an important cause of visual loss within the group of working age population. We aim to present the clinical features and the algorithm according to which we manage the foreign bodies that are located in the posterior segment of the eye. We define the outcomes and the prognostic factors that influenced the final visual acuity and globe survival in patients with IOFBs that we extracted by pars plana vitrectomy (PPV) over a 5-year period.MethodsWe reviewed the medical records of all the cases with IOFBs that we removed by PPV, over 5 years (2009–2013). We extracted the following parameters: age, gender, wound anatomy, IOFB characteristics, ocular lesions, initial and final visual acuities. We used the program SPSS version 20.0.0. for the statistical analysis of our data.ResultsDuring 5 years, we treated 21 IOFBs by PPV, representing 12.20 % of all the open globe injuries. All the patients were males with the median age of 36 years. The foreign body was located in the vitreous - 11 cases (52.38 %), retina - seven cases (33.33 %) and perforating - three cases (14.28 %). Retinal detachment (RD) at presentation was identified in eight cases (38.09 %) and endophthalmitis, in six cases (28.57 %). The visual outcome was significantly worse in patients with RD at presentation (p = 0.012) and with IOFBs larger than 3 mm (p = 0.042). Endophthalmitis did not influence the visual outcome.ConclusionsThe worse prognostic factors were: RD at presentation and large foreign body.Trial registration numberIRCT2015040418966N3 / Apr. 9/2015

Purpose. To evaluate the outcome and identify the prognostic factors of traumatic endophthalmitis over a 5-year period. Methods. We reviewed the medical records of all the traumatic endophthalmities that we treated in our department over the last 5 years (2009–2013). We extracted the following parameters: age, gender, wound anatomy, associated ocular lesions, treatment, and initial and final visual acuities. We used the program SPSS version 20.0.0. for the statistical analysis of our data. Results. During the last 5 years, we treated 14 traumatic endophthalmities, representing 46.66% of all types of endophthalmities. The infection rate in open globe injuries was 8.13% and 34.78%, if an intraocular foreign body (IOFB) was associated. All the patients were males with the median age of 37 years. Initial visual acuities varied between light perception and 0.4 and the timing of treatment from a few hours to 10 days. We administered antibiotic and anti-inflammatory drugs, systemically and intravitreally, in all cases. We performed pars plana vitrectomy in 64.28% of cases. In 57.14% of cases, the final visual acuity was 0.1 or more. Conclusions. IOFBs increased significantly the risk for endophthalmitis. The worse prognostic factors were retinal detachment at presentation and delayed treatment. This trial is registered with IRCT2014082918966N1.

Purpose: This study aimed to evaluate the outcome of transpupillary diode laser photocoagulation for retinopathy of prematurity (ROP) at one institution in Romania.Methods: This retrospective case series included all infants who received indirect diode laser photocoagulation for ROP between January 1, 2006, and December 31, 2012. Results:The 160 eyes of 83 infants were classified into two categories: 136 eyes (85%) with classic disease (stage III ROP in zones 1 or 2) and 24 eyes (15%) with aggressive posterior ROP (AP-ROP). ROP regressed in 141 eyes (88.12%). The success rate was significantly better in the classic ROP group (94.11%) compared to the AP-ROP group (54.16%) (P < .001). Conclusions:The ROP regression rate after the laser treatment was 88% in this series.

Purpose. This study aims to evaluate the regression of retinopathy of prematurity (ROP) after one intravitreal injection of bevacizumab and the factors that influenced it. Methods. This retrospective case series was carried out at the “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania. It includes all the consecutive infants treated for ROP with one intravitreal bevacizumab injection, from January 1, 2009, throughout July 31, 2013. The follow-up continued for 60 weeks after injection. We recorded ROP classification, regression, gender, gestational age, birth weight, postnatal age and postmenstrual age at treatment, and pregnancy type. Regression was analyzed according to each of the abovementioned factors, with the program IBM SPSS 20 (Chicago, Illinois, USA). Results. This study includes 74 eyes of 37 infants of which 52 had aggressive posterior ROP (70.27%) and 22 had zone I stage 3+ ROP (29.72%). One week after the bevacizumab injection, ROP regressed in 63 eyes (85.13%), with a statistically significant higher rate in zone I stage 3+ ROP (100%), as compared with aggressive posterior ROP (78.84%) (P = 0.03). We recorded no complications subsequent to the intravitreal injections of bevacizumab. We identified no late retinal detachment. Conclusion. ROP regression rate after one intravitreal bevacizumab injection was 85.13%. This trial is registered with trial registration number IRCT2014101618966N2.

AimThe aim of this study was to compare the pre- and posttreatment corneal densitometry and corneal thickness value of keratoconus (KCN) patients managed via contact lenses (CLs) or by both intrastromal corneal rings and contact lenses.Patients and methodsThis prospective study was performed at the Manchester Royal Eye Hospital, UK. Patients were recruited before treatment and followed up for 12 months. Data of corneal densitometry and corneal thickness were collected using the Oculus Pentacam at the pretreatment visit and posttreatment visit at 12 months.ResultsCorneal clarity significantly differs between both groups at pre treatment at zone 0–2 mm for the anterior layer (P=0.002). The same diversity is present at zone 2–6 mm for the anterior layer (P=0.003) and posterior layer (P=0.008). The corneal clarity diversity found was not statistically significant at 12 months post treatment (P>0.05). Corneal thickness was found to be statistically significantly different between pre treatment and post treatment for the CL group for central corneal thickness (CCT) and thinnest area (P=0.01 and P=0.02), respectively.DiscussionThis study shows that KCN management with Intacs was found to be effective in maintaining corneal clarity for a longer time than that with CL alone. On the other hand, corneal clarity reduces with disease progression in cases managed with CLs only. Analysis of Oculus Pentacam images provides an objective evaluation to monitor the corneal status after these different pathways of management.

Precis: Trabeculectomy can effectively lower intraocular pressure (IOP). A more junior surgeon profile is emerging. Mitomycin C (MMC) has replaced 5-fluorouracil (5-FU) intraoperatively with comparable success rates and a decrease in postoperative antimetabolite administration.Purpose: We compare 2-year outcomes for primary trabeculectomy in 2 cohorts, 10 years apart, performed at a large UK teaching hospital.Methods: Consecutive case series of trabeculectomies at Manchester Royal Eye Hospital between 2004-2005 (Cohort 1/C1) and 2014-2015 (Cohort 2/C2). Preoperative and postoperative data was collected for IOP outcomes and complications. Success was defined as IOP ≥ 6 and ≤ 21, ≤ 18, ≤ 16, ≤ 14, or ≤ 12 mm Hg with/without a ≥ 20% decrease from preoperative IOP. The need for and absence of postoperative antihypertensive medication defined qualified and complete success, respectively.Results: A total of 186 cases were analyzed [52 (C1), 134 (C2)]. Mean preoperative IOP was 24 ± 10 mm Hg (C1) and 21 ± 7 mm Hg (C2) (P = 0.01). Overall, 34 (79%), 33 (77%), 33 (77%), 29 (67%), and 25 (58%) patients in C1 and 88 (70%), 82 (65%), 73 (58%), 64 (51%), and 40 (32%) patients in C2 achieved complete success for IOP ≤ 21 mm Hg (P = 0.33), ≤ 18 mm Hg (P = 0.22), ≤ 16 mm Hg (P = 0.04), ≤ 14 mm Hg (P = 0.09), or ≤ 12 mm Hg (P = 0.004). Similarly, 43 (93%), 40 (87%), 40 (87%), 35 (76%), and 27 (59%) in C1 and 123 (98%), 116 (92%), 106 (84%), 87 (69%), and 58 (49%) in C2 achieved qualified success (P = 0.34, 0.37, 0.83, 0.48, and 0.19). In all, 32 (74%), 31 (72%),31 (72%), 28 (65%), and 24 (56%) in C1 and 64 (51%), 63 (50%), 61 (48%), 54 (43%), and 39 (31%) in C2 achieved complete success with ≥ 20% reduction from preoperative IOP and IOP of ≤ 21 mm Hg (P = 0.01), ≤ 18 mm Hg (P = 0.02), ≤ 16 mm Hg (P = 0.01), ≤ 1 mm Hg (P = 0.02), or ≤ 12 mm Hg (P = 0.006). By same definition, 37 (80%), 36 (78%), 36 (78%), 33 (72%), and 26 (57%) in C1 and 94 (75%), 93 (74%), 90 (71%), 75 (60%), and 58 (46%) in C2 achieved qualified success (P = 0.55, 0.69, 0.48, 0.20, and 0.30). Mean IOP at 2 years was 13 ± 5 mm Hg (C1) and 13 ± 4 mm Hg (C2) (P = 0.35). Overall, 62% had intraoperative 5-FU in C1; only MMC was used in C2 (P < 0.0001). Postoperative 5-FU was administered in 54% versus 22% in C1 and C2, respectively (P < 0.0001). Needling rates were not statistically different [42% (C1), 54% (C2)] (P = 0.22).Conclusions: Trabeculectomy is effective in lowering IOP with success comparable across various definitions. MMC replaced 5-FU as intraoperative antimetabolite resulting in reduced need for postoperative antimetabolite but not increased complications.

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