Maria Montserrat Bausili Portabella

Purpose: To describe our experience using the gyroscopic mouse in digitally assisted vitreoretinal surgery. Methods: We used a commercially available gyroscopic mouse to control the on-screen cursor of the NGENUITY System for digitally assisted vitreoretinal surgery. The gyroscopic mouse is sealed in a clear sterile plastic bag to allow for intraoperative use. This allowed both the surgeon and assistant to be fully scrubbed while retaining full control of the NGENUITY system's functions. The mouse also allowed the mentor to provide detailed instructions through the on-screen cursor by highlighting important landmarks. Conclusion: Using a sterile gyroscopic mouse improved the teaching utility and surgical workflow of digitally assisted vitreoretinal surgery.

Purpose Purpose: To evaluate the long-term stability of scleral-sutured intraocular lenses (IOLs) and analyse the possible causes of suture breakage. Setting Barraquer Institute in Barcelona, Spain. Design Retrospective study of consecutive cases. Methods Study of patients with scleral-sutured IOL with aphakia, subluxated or luxated IOL were included. Follow-up was longer than 6 months and patients over 18 years of age. Preoperative data (best-corrected visual acuity testing (BCVA), intraocular pressure (IOP), axial length and slit-lamp examination), intraoperative data (characteristics of the scleral flaps, suture material (Prolene or Mersilene) and scleral-sutured IOL) and postoperative data (BCVA, IOP, slit-lamp examination and complications) through 10 years were collected for analysis. Results 345 consecutive cases of scleral-sutured IOL were included. 25 eyes underwent a second operation after a prior sutured IOL due to suture breakage (mean 40.2±39.6 months after the first surgery) and three of them needed a third surgery. Younger adults (less than 40-year old), the use of a combination of Prolene and Mersilene sutures to perform the surgery and suturing only one flap were found to have higher risk of suture breakage after a follow-up of 10 years. The probability of surviving of the scleral-sutured IOL at 10 years after surgery was 0.79. Conclusions Scleral-sutured posterior chamber IOL in eyes with a lack of capsular support is a safe and effective procedure with a low rate of complication and stable visual acuity. Further studies with special focus on young adults or myopic eyes are required to demonstrate long-term safety in those special cases.