ObjectiveTo develop and internally validate a compact model for estimating the 1-year risk of new-onset postoperative macular oedema in patients with diabetic retinopathy undergoing vitrectomy.MethodsThis single-centre retrospective cohort included 650 recorded patients treated from January 2023 to April 2025. The primary analysis comprised 607 patients with ascertainable 1-year outcomes, with one study eye per patient; 43 patients lost to follow-up were assessed separately. New-onset macular oedema required new intraretinal cystoid spaces and/or subretinal fluid on optical coherence tomography during postoperative days 30–365, together with central macular thickness ≥300 μm or an increase ≥30 μm from baseline. The five-predictor logistic model used pre-incision measurements and was fitted in all 607 patients. Internal validation used 1, 000 bootstrap resamples; a 32-candidate, 10-fold cross-validated least absolute shrinkage and selection operator (LASSO) analysis with selection-inclusive bootstrap validation assessed the stability of the separate LASSO procedure.ResultsNew-onset postoperative macular oedema occurred in 207 of 607 patients (34.1%). The apparent area under the receiver operating characteristic curve (AUC) was 0.823 and the optimism-corrected AUC was 0.818. The corresponding Brier scores were 0.159 and 0.163; the corrected calibration intercept and slope were −0.011 and 0.969. At an illustrative probability threshold of 0.30, 40 of 323 patients (12.4%) in the lower-risk group and 167 of 284 (58.8%) in the higher-risk group developed the outcome. Selection-inclusive validation of the LASSO sensitivity model yielded a corrected AUC of 0.805. Systolic pressure was not statistically significant in the five-predictor model (P = 0.329).ConclusionThe five-variable model showed useful discrimination and acceptable bootstrap-corrected calibration in this single-centre cohort. It should be regarded as an internally validated risk-stratification model that requires external and prospective validation before clinical implementation.
Lacrimal gland adenoid cystic carcinoma (LGACC) is a rare and aggressive malignancy characterized by perineural invasion, late recurrence, and high mortality. No consensus treatment guidelines exist, and management strategies range from eye-sparing excision to orbital exenteration combined with chemotherapy and radiotherapy. This report describes a 32-year-old Hispanic man with a six-year history of right orbital pressure that progressed to pain, diplopia, and lacrimation. Clinical examination revealed 20/20 visual acuity bilaterally, a palpable right upper eyelid mass, and hypoglobus with inferonasal globe displacement. Imaging identified a well-defined right lacrimal gland mass, and biopsy confirmed adenoid cystic carcinoma. Intra-arterial chemoreduction was not feasible; however, three cycles of systemic cisplatin and doxorubicin resulted in no radiographic tumor reduction. The patient subsequently underwent right orbital exenteration, followed by adjuvant radiotherapy, and remains under multidisciplinary surveillance, with no evidence of local recurrence at 34 months of follow-up. LGACC is best managed with an individualized, interdisciplinary, and multimodal approach. Given the lack of consensus guidelines and the risk of late recurrence, long-term monitoring is essential, and further research is required to establish surveillance and management strategies.
PurposeTo report a case of alexandrite laser-induced foveal injury complicated by acute anterior uveitis, which showed a significant clinical improvement over serial follow-up.ObservationsWe report the case of a 23-year-old female, a laser hair removal technician, who presented with sudden central visual loss in her left eye (LE) after an accidental exposure to an alexandrite laser beam while cleaning the probe. At the initial presentation, visual acuity (VA) of the LE was 0.1. Optical coherence tomography (OCT) demonstrated a loss of the foveal depression with a vertical hyperreflective column extending from the inner retinal layers to the retinal pigment epithelium (RPE), with focal disruption of the ellipsoid zone (EZ) and the external limiting membrane (ELM) at the fovea. Over 5 months with regular follow-up, VA improved to 1.0. OCT demonstrated residual central foveal disruption with localized attenuation of the EZ and RPE, confined to a smaller area compared with baseline.Conclusions and importanceThis case demonstrates the importance of safety protocols when handling laser devices to prevent accidental eye injuries, and demonstrates the potential for good clinical outcomes with regular evaluation and follow-ups.
Posterior chamber implantable collamer lens (ICL) implantation provides additive refractive correction for selected phakic patients, especially those with high myopia and limited corneal laser options. This narrative Mini Review synthesizes literature published mainly from January 2021 through May 2026 to connect patient selection with measurable safety boundaries, separate lens power and size planning, dynamic vault assessment, and long-term surveillance. It also discusses hyperopic ICLs, non-EVO lenses, alternative phakic IOL platforms such as IPCL, and emerging artificial intelligence. True anterior chamber depth, age-appropriate endothelial reserve, open angles, crystalline lens status, and refractive stability define eligibility. Central vault is interpreted using pragmatic numerical categories alongside angle, pressure, and lens findings; no single vault threshold guarantees safety or mandates exchange. Refractive and vault prediction models have different inputs and outcomes, and favorable average accuracy does not establish performance in extreme or underrepresented anatomy. Modern central-port ICLs show good outcomes in appropriately selected myopic eyes, while evidence for hyperopic and alternative platforms is smaller and not interchangeable. The proposed clinical framework represents expert synthesis rather than a validated decision rule. Future priorities include externally validated multimodal prediction and prospective lifelong safety monitoring.
In this case report, we describe a 52-year-old woman with high myopia presented with a macular hole retinal detachment for 5 months. Fundus examination showed a full-thickness macular hole with localized retinal detachment, accompanied by both superior and inferior posterior scleral staphylomas. Spectral-domain optical coherence tomography confirmed a large full-thickness macular hole with associated epiretinal proliferation. She underwent 27-gauge vitrectomy using an inverted epiretinal proliferation flap technique without internal limiting membrane peeling, followed by gas tamponade. Postoperatively, the retina was reattached and the macular hole was closed. Best-corrected visual acuity improved from hand motions to 20/200. At the 12-month final follow-up, BCVA remained stable at 20/200, with no evidence of hole reopening or recurrent retinal detachment. This case demonstrates that inverted epiretinal proliferation (ERP) flap with internal limiting membrane (ILM) preservation may represent a feasible tissue-preserving reconstructive strategy for selected patients with myopic macular hole retinal detachment (MHRD) when sufficient ERP is present.
