Photo Essays
A practical approach to slit-lamp smartphone photography
Several approaches to smartphone anterior segment photography that involve purchasing an adapter to attach to the slit lamp have been described in the literature. Given the frequent updates in sizes and shapes of smartphones, a practical stepwise approach to capturing high-quality images without the need for an adapter is essential. First, the illumination is set to be diffuse, using the slit-lamp integrated diffuser (Fig. 1A, 1B). The camera flash is turned off, and the slit lamp is brought into focus on the anterior segment.Assistant-controlled directional chandelier
Chandelier endoillumination has become common everyday practice for most vitreoretinal surgeons. The assistant-controlled directional chandelier is a solution to controlling, minimizing glare of, and directing the light when using a chandelier endoillumination device (Video 1, available online). With the use of readily available items within a vitreoretinal operating room setting, the Luer connector is attached to the light pipe with adhesive dressing (A). Approximately 6 mm of residual light pipe is left exposed to stop the assistant from inadvertently advancing the light pipe too deeply into the eye (B).Management of a large metal intraocular foreign body
A 49-year-old man had been seen 1 month prior by a general ophthalmologist for a healing corneal abrasion. On examination, there was a dense vitreous hemorrhage and a subtle iris transillumination defect suspicious for an occult intraocular foreign body (IOFB; Fig. 1A). A computed tomography scan confirmed an IOFB that extended from the inferior posterior iris to the posterior pole (Fig. 1B). Intraoperatively, the traumatic cataract was removed along with the ruptured capsular bag (Video 1, available online).Management of a dislocated 3-piece intraocular lens with an iris prosthesis in situ
A 33-year-old man with a past injury of the left eye involving iris loss and choroidal rupture in 2002, presented with 1-month history of spontaneous blurry vision. On examination he had a dislocated 3-piece Ophtec (Netherlands) intraocular lens (IOL) in the vitreous with an iris prosthesis (Human Optics, Germany) dislocation sutured at 9:00 o'clock and poorly attached at 3:00 o'clock (Supplementary Video 1). The already kinked IOL was cut and explanted (A), and a secondary IOL inserted and fixated to the sclera behind the iris prosthesis using a Yamane technique (B).Scleral needling technique
Scleral needling technique is a novel, safe, and simple alternative to suturing for effectively securing leaking sclerotomies in microincision vitrectomy surgery. After air–fluid exchange and trocar cannula removal (A), air bubbles are visualized at the site of wound leakage by dripping balanced salt solution over the open sclerotomy (B). A closed 30-gauge needle syringe is perpendicularly inserted full thickness through the sclera adjacent to the scleral opening and removed immediately (C). The wound is then pressed with a blunt cannula.
