Retinal prostheses have been developed to fight blindness in people affected by outer retinal layer dystrophies. To date, few hundred patients have received a retinal implant. Inspired by intraocular lenses, we have designed a foldable and photovoltaic wide-field epiretinal prosthesis (named POLYRETINA) capable of stimulating wireless retinal ganglion cells. Here we show that within a visual angle of 46.3 degrees, POLYRETINA embeds 2215 stimulating pixels, of which 967 are in the central area of 5 mm, it is foldable to allow implantation through a small scleral incision, and it has a hemispherical shape to match the curvature of the eye. We demonstrate that it is not cytotoxic and respects optical and thermal safety standards; accelerated ageing shows a lifetime of at least 2 years. POLYRETINA represents significant progress towards the improvement of both visual acuity and visual field with the same device, a current challenging issue in the field.

Preoperative OCT of the detached macula can demonstrate widespread retinal edema, the extent of which does not appear to influence final postoperative vision. Delayed and incomplete visual recovery after successful reattachment of the retina may, however, be due to persistent circumscribed subfoveal fluid accumulation that is visible only on OCT not clinically or on fluorescein angiography.

The success rate of management of GRTs with vitrectomy, internal tamponade, and peripheral 360 degrees photocoagulation of the retina without scleral buckle is high. Photocoagulation of the peripheral retina over 360 degrees appears to decrease the risk of secondary peripheral retinal tears.

Macular recovery after surgery for retinal detachment (RD) depends on preoperative and postoperative predictive factors. Preoperative visual acuity is the main preoperative factor correlating positively with good macular recovery. Preoperative factors, which influence macular recovery negatively, include duration of macular detachment, height of macular detachment and vitreomacular traction. Postoperative factors, which influence macular recovery negatively, include cystoid macular oedema, epiretinal membranes, retinal folds, subretinal retinal pigment epithelium (RPE) migration and persistent subretinal fluid on optical coherence tomography (OCT). According to the latest available data, a detached macula has to be reattached within 5 days to optimize functional recovery. However, new therapeutic options such as exposure to hyperoxia or different growth factors may help to improve the final visual outcome in the presence of an already detached macula.

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Serous detachment of the neurosensory retina and of the retinal pigment epithelium is a rare event in the course of systemic disease. Retinal pigment epithelial detachments usually occur in association with serous retinal detachments, although, in some cases, they also may be observed as an isolated finding. In a number of patients, the initial pigment epithelial detachment may be at the origin of a later-developing serous detachment. Diagnosis of a serous detachment still is made clinically, although optical coherence tomography recently has allowed the detection of clinically occult serous elevations of the retina. The underlying mechanisms of subretinal exudation are thought to include choroidal vascular perfusion and permeability changes, which result in increased choroidal interstitial fluid with further extension into the subretinal space. These changes are mostly incurred in the course of systemic inflammatory and infectious diseases such as sarcoidosis, Vogt-Koyanagi-Harada disease, and cytomegalovirus infection, and also in association with disorders resulting in the acute occlusion of the precapillary choroidal arterioles by fibrin-platelet thrombi. Collagen vascular diseases, disorders associated with disseminated intravascular coagulopathy, and malignant hypertension fall into this category. Hypercortisolism, renal disease, and, very rarely, malignant disease also have been implicated in the development of serous retinal detachment. Therapy of the serous detachments consists primarily of treating the underlying systemic disease.

The risk of EO after IVI performed under the sterile conditions of the operating room was very low.