Fixation of PC IOL haptics in a limbus-parallel scleral tunnel provided exact centration and axial stability of the IOL and prevented distortion and subluxation in most cases.

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The study indicates that junior trainees can be taught phacoemulsification with acceptable complication rates and visual results. The results compare favorably with reports of senior surgeons converting to phacoemulsification, trainee surgeons learning extracapsular surgery, and recently reported phacoemulsification series.

Background/aims This is the first nationwide prospective study to investigate the incidence and risk factors of endophthalmitis following pars plana vitrectomy (PPV). Methods This was a prospective, nationwide casecontrol study. Cases of presumed infectious endophthalmitis within 6 weeks of PPV were reported via the established British Ophthalmological Surveillance Unit. The surveillance period was 2 years. Controls (patients who had PPV but no endophthalmitis) were recruited from nine randomly selected UK centres. Results 37 reports were received and 28 cases met the diagnostic criteria for presumed infectious endophthalmitis following PPV. The incidence of endophthalmitis following PPV was 28 cases per 48 433 PPVs (1 in 1730 with a 95% CI of 1 in 1263 to 1 in 2747). 272 controls were randomly recruited from nine UK centres. Smaller gauge port sizes were not found to be a risk. Immunosuppression (OR 19.0, p=0.001) and preoperative topical steroids (OR 131.4, p<0.001) increased the endophthalmitis risk. Operating for retinal detachment was associated with a reduced risk of endophthalmitis (OR 0.10, p=0.005). Conclusions Endophthalmitis following PPV is rare. Operating with smaller gauge port sizes does not increase the risk of endophthalmitis.

This study helps surgeons promptly identify cases of endophthalmitis following vitrectomy and informs them about the various management options currently used and the likely outcome of this devastating complication.

Results Visual acuity data on 6482 (84.7%) of the 7652 individuals were obtained. Of these, 184 had significant visual impairment (prevalence 2.84%) including 49 who were blind (vision of less than 3/60 in their better eye, prevalence 0.75%); if blindness was defined as vision less than or equal to 6/60, prevalence was 1.13% (n = 73). Details of 3 individuals could not be ascertained. Only 67 were registered, either as partially sighted (n = 42) or as blind (n = 25). In the maj ority (n = 133; 68%) of these 181 individuals the visual impairment was due to causes other than diabetic retinopathy.Conclusions The prevalence of blindness and visual impairment in our population of people with diabetes was low. Non-diabetic eye disease accounted for the maj ority of this visual impairment. This provides essential baseline data against which future progress can be assessed. Screening and treatment can greatly reduce the incidence of visual impairment due to diabetic retinopathy, but its impact on overall visual impairment rates in the population of people with diabetes will be more modest.

ABSTRACT.Purpose: Ocular side effects of systemic 5-fluorouracil therapy include excessive lacrimation which often resolves on cessation of therapy. Permanent stenosis of lacrimal puncta and canaliculi is rare. This report highlights this uncommon complication of 5-fluorouracil therapy. Methods: Report of two cases and review of literature. Results: Severe stenosis of puncta and canaliculi may be associated with prolonged systemic 5-fluorouracil therapy. Conclusion: It is important for both the oncologist and ophthalmologist to be aware of the potential ocular toxicity of 5-fluorouracil. Surgical management to relieve the epiphora is often challenging, and early intervention may be beneficial.

Purpose. To evaluate the visual outcomes and effect of phacoemulsification surgery on the progression of neovascular age-related macular degeneration (AMD). Methods. Retrospective, noncomparative, and interventional case series. Thirty eyes from 29 subjects with neovascular AMD treated with intravitreal antivascular endothelial growth factor (VEGF) injections who underwent phacoemulsification and had a postsurgery follow-up of 6 months were included. LogMAR best corrected visual acuity (BCVA) was assessed preoperatively; 1 month, 3 months, and 6 months postoperatively; and finally at the last visit. The frequency of anti-VEGF therapy, calculated as the number of intravitreal injections per month, and central macular thickness (CMT) before and after cataract surgery were determined. Results. Median (range) logMAR BCVA was 0.69 (0.16 to 1.32) preoperatively; 0.55 (−0.04 to 1.32) at 1 month, 0.52 (−0.1 to 1.32) at 3 months, and 0.50 (0.0 to 1.32) at 6 months postoperatively; and 0.6 (0.0 to 1.4) at final visit (P = 0.0011). There was no difference in the frequency of anti-VEGF injections between the immediate 6 months before and after phacoemulsification, which was equal to 0.1667 injections per month (P = 0.6377). Median CMT measured 203 μm preoperatively, which temporarily increased to 238 μm at 1 month after surgery (P = 0.0093) and then spontaneously returned to baseline, measuring 212.5 μm at 3 months postoperatively (P = 0.3811). Conclusion. Phacoemulsification surgery significantly improved vision in patients with neovascular AMD, with no increased need for anti-VEGF injections to keep the macula dry postoperatively.