Purpose Intravitreal implantation of dexamethasone implant (Ozurdex®) is being widely used for the treatment of macular edema (ME) after branch or central retinal vein occlusion, diabetic ME, and persistent ME associated with uveitis or Irvine-Gass syndrome. We describe a complication: migration of the dexamethasone implant into the anterior chamber through basal iridectomy (Ando) in a pseudophakic patient with development of corneal edema and secondary high intraocular pressure. Methods This is a case report of migration of Ozurdex® through basal iridectomy in a pseudophakic patient with iris claw lens. Conclusions Pseudophakic patients, with a history of vitrectomy, even those with a basal iridectomy (Ando), are at high risk for migration of the Ozurdex® into the anterior chamber and development of corneal edema.

PURPOSE:To evaluate the rate of adherence to prescribed nutritional supplementation in patients affected by age-related macular degeneration, in an Italian tertiary referral tertiary center.METHODS:Patients with age-related macular degeneration, age-related eye disease study Categories 3 and 4, were recruited and underwent an 11-item questionnaire.RESULTS:The study included a total of 193 patients meeting the age-related eye disease study nutritional supplementation criteria (174 patients with age-related eye disease study Category 4 and 19 with Category 3). Seventy-seven (40%) were taking oral supplementation, 70 of whom (90%) 1 tablet/day. Oral supplementation was recommended by the personal ophthalmologist in 85 patients (44%), including all those currently receiving it. Eight patients of 85 (9.4%) rejected supplementation despite it being recommended, mostly because they were already taking other medicines. Ninety-four patients (48%) claimed they had not received any information from their ophthalmologist.CONCLUSION:Our data reveal that Italian patients with age-related eye disease study Categories 3 and 4 have a low adherence to nutritional supplementation. In 65% of cases, patients were not adequately informed by their ophthalmologist of the potential benefits of oral supplementation for age-related macular degeneration; indeed, 108 patients (56%) were not even aware such nutritional treatments are available. Ophthalmologists should be aware of the importance of giving advice to persons with age-related macular degeneration regarding the benefits of oral supplements.

Purpose: To investigate the relationship between type of intraocular tamponade and unintentional retinal displacement after vitrectomy for rhegmatogenous retinal detachment. Methods: Twenty-three eyes of 23 consecutive patients affected by rhegmatogenous retinal detachment underwent 3-port pars plana vitrectomy with gas (C3F8) or silicone oil (polydimethylsiloxane) tamponade. Ophthalmologic examination and fundus autofluorescence were performed before surgery (baseline) and at the 7-day, 1-month, and 3-month postoperative visits. Macula sparing rhegmatogenous retinal detachment underwent fixation test (with microperimetry) at baseline and at the 7-day and 1-month follow-up examinations. Results: Fundus autofluorescence revealed postoperative retinal displacement in 12 of the 23 eyes (52.2%). Occurrence of retinal displacement was higher in eyes with gas tamponade (10 of 14 eyes; 71.4%) compared with eyes with silicone oil (2 of 9 eyes; 22.2%) (P = 0.036). Retina shifted downward in all eyes with C3F8 and upward in all eyes with polydimethylsiloxane. Baseline and follow-up macular fixation was tested in 10 macula-on cases. In all cases, a shift of mean fixation point was present at the 7-day postoperative examination, with a partial return toward the baseline mean fixation point at the 1-month follow-up examination. Conclusion: In eyes with rhegmatogenous retinal detachment treated with vitrectomy and gas or silicone oil tamponade, retinal displacement may occur despite successful reattachment. Type of intraocular tamponade seems to influence the occurrence of retinal dislocation and its direction.

PURPOSE: To evaluate in a prospective study the efficacy of intrasurgical autologous plasmin enzyme (APE) in producing posterior vitreous detachment.DESIGN: Consecutive, interventional case series.METHODS: A group of 12 eyes of 11 patients with diabetic macular edema secondary to posterior vitreous cortex contraction was considered. A quantity of 0.1- to 0.2-ml containing 0.8 to 1.2 IU of APE prepared by our Coagulation Service was injected into the vitreous body 25 minutes before surgery. The efficacy of the APE was subjectively evaluated. A control group of 10 eyes with the same clinical characteristics underwent the same surgery without APE injection. Complete eye examinations, including optical coherence tomography, were performed on all patients before surgery and during the 1-year follow,up period.RESULTS: During surgery in the APE-treated group, the posterior vitreous cortex was judged adherent in three cases, partially detached in six cases, and totally detached in three cases. In two cases a complete collapse of the vitreous body was observed. During surgery in the non-APE-treated group, the posterior vitreous cortex was judged still adherent in nine of 10 eyes and partially detached in 1 eye. Comparing the postoperative results between the APE,treated group and the non-APE-treated group, we found no significant differences in final postoperative retinal thickness (P = .2552), whereas we found a significant difference in final visual acuity (P = .0121).CONCLUSIONS: Autologous plasmin enzyme was useful in inducing a pharmacologic posterior vitreous detachment and in facilitating surgery. It did not seem to interfere with the final retinal thickness, and it ameliorates the final visual acuity. (C) 2004 by Elsevier Inc. All rights reserved.