This report describes the results of a prospective trial to evaluate the efficacy of pars plana vitrectomy (PPV) in conjunction with perfluoro-n-octane (PFO) as initial treatment of pseudophakic retinal detachment (RD) with no breaks diagnosed preoperatively. Fourteen consecutive eyes presenting with pseudophakic RD in which retinal breaks could not be identified preoperatively underwent primary PPV, internal microsurgical identification of the retinal breaks with endoillumination and noncontact wide angle viewing system, PFO retinal reattachment, transscleral cryopexy or endolaser treatment of breaks, PFO-air exchange, and final injection of 20% sulfur hexafluoride. In five eyes, a scleral buckle was also used. Mean follow-up period was 18 months. In 13 of the 14 eyes in which no breaks had been identified preoperatively, breaks were diagnosed during surgery. Perfluoro-n-octane retinal attachment facilitated accurate microscopic treatment of retinal breaks. The retina was reattached with a single operation in all eyes. Eleven eyes had final visual acuity of 20/60 or better. Complications were minimal. Pars plana vitrectomy in conjunction with PFO expression of subretinal fluid is effective in the initial treatment of pseudophakic RD with no preoperative diagnosis of retinal breaks.

Almost fifteen years since its initial description, intraoperative floppy iris syndrome (IFIS) during phacoemulsification surgery remains a challenge for cataract surgeons in all its key aspects that include the stratification of the preoperative risk, preoperative prophylaxis treatment, surgery design and intraoperative management. Since its original association with tamsulosin intake, IFIS has been positively correlated with a plethora of risk factors which include: gender, age, hypertension, other a1-adrenergic receptor antagonists, finasteride, angiotensin II receptor inhibitors, benzodiazepines, antipsychotics, hypertension drugs and decreased dilated pupil diameter. The assessment and stratification of the preoperative risk is pivotal in screening patients prone to develop IFIS. For these patients, it is essential that preoperative prophylaxis, employment of necessary measures and surgical technique modifications are considered. A multidisciplinary approach of IFIS is a mandate, thus ophthalmologists, urologists and sometimes other specialties should cooperate to “educate” each other about the risks of their respective fields. They both must be aware of the joint statement on IFIS by the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery which suggests either the initiation of tamsulosin after phacoemulsification or the use of a non-selective a1-ARA for benign prostatic hyperplasia treatment. In conclusion, awareness of the risk factors associated with IFIS and their detailed preoperative documentation is crucial in addressing IFIS. The lack of such an awareness can turn a routine, uneventful surgery into one with significant visual morbidity.

Background and objectives: The purpose of this study is to determine the impact of the most prominent cardiovascular and metabolic risk factors in patients undergoing cataract surgery. Materials and Methods: The study included 812 consecutive patients undergoing unilateral, uneventful cataract surgery by means of phacoemulsification, at the 2nd Department of Ophthalmology, Medical School, Aristotle University of Thessaloniki, Greece, during a calendar year. Patients were assessed for the type of cataract and the presence of three diseases, under pharmacological treatment, that have been reported as risk factors for the development of cataract (arterial hypertension, diabetes mellitus, and dyslipidemia). Results: There was a statistically significant difference between the types of cataract and individual risk factors (p < 0.001). Hypertension was the most frequentrisk factor, ranging from 43.8% in patients with subcapsular cataracts, 24.3% in patients with nuclear cataracts, 28.6% in patients with cortical cataracts, and 27.6% in patients with mixed type cataracts. There was a statistically significant difference as to the total number of risk factors per cataract type (p < 0.001); almost all patients with subcapsular cataracts had at least one risk factor (98.4%) while this percentage was 90.5% for patients with mixed cataracts, 85.7% for patients with cortical cataracts, and78.6% for patients with nuclear cataracts. Conclusions: Diabetes mellitus did not have a large incidence in our sample as a single risk factor, while hypertension did. This finding raises the importance of early detection of hypertension, a cardiovascular condition that typically progresses undetected for a number of years.