scholarly journals Wide-Field Landers Temporary Keratoprosthesis in Severe Ocular Trauma: Functional and Anatomical Results after One Year

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Katarzyna Nowomiejska ◽  
Dariusz Haszcz ◽  
Cesare Forlini ◽  
Matteo Forlini ◽  
Joanna Moneta-Wielgos ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
Corneal Opacity ◽  
Corneal Graft ◽  
Wide Field ◽  
Eye Trauma ◽  
Temporary Keratoprosthesis ◽  
One Year

Purpose. To evaluate longitudinal functional and anatomical results after combined pars plana vitrectomy (PPV) and penetrating keratoplasty (PKP) using a wide-field Landers intraoperative temporary keratoprosthesis (TKP) in patients with vitreoretinal pathology and corneal opacity due to severe ocular trauma.Material and Methods. Medical records of 12 patients who had undergone PPV/PKP/KP due to severe eye trauma were analyzed. Functional (best-corrected visual acuity) and anatomic outcomes (clarity of the corneal graft, retinal attachment, and intraocular pressure) were assessed during the follow-up (mean 16 months).Results. Final visual acuities varied from NLP to CF to 2 m. Visual acuity improved in 7 cases, was unchanged in 4 eyes, and worsened in 1 eye. The corneal graft was transparent during the follow-up in 3 cases and graft failure was observed in 9 eyes. Silicone oil was used as a tamponade in all cases and retina was reattached in 92% of cases.Conclusions. Combined PPV and PKP with the use of wide-field Landers TKP allowed for surgical intervention in patients with vitreoretinal pathology coexisting with corneal wound. Although retina was attached in most of the cases, corneal graft survived only in one-fourth of patients and final visual acuities were poor.

scholarly journals Clinical Application of Foldable Capsular Vitreous Bodies in the Treatment of Severe Ocular Trauma and Silicone Oil Dependent Eyes

2021 ◽  
Author(s):  
Hao Jiang ◽  
Chao Xue ◽  
Yanlin Gao ◽  
Ying Chen ◽  
Yan Wang
Keyword(s):  
Visual Acuity ◽  
Clinical Application ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
Anterior Segment ◽  
Vitreous Body ◽  
Corneal Opacity ◽  
Ultrasound Biomicroscopy ◽  
Significant Difference

Abstract Background: Recently, a new type of foldable capsular vitreous body (FCVB) has been developed for clinical application to fill the vitreous cavity with vitreous substitutes. It may be an ideal substitute for the vitreous body in eyes with severe retinal detachment. The aim of this study was to assess the application of a foldable capsular vitreous body (FCVB) in the treatment of severe ocular trauma and silicone oil (SO) dependent eyes.Methods: A retrospective analysis was performed on the clinical application of FCVB in the treatment of severe ocular trauma and SO dependent eyes. The results of best-corrected visual acuity and intraocular pressure (IOP) evaluation, B-scan ultrasonography or color Doppler ultrasonography, ultrasound biomicroscopy, and anterior segment photography were recorded during follow-up. A paired t-test was used to compare the difference in IOP before and after FCVB implantation. Results: Seven eyes of seven patients were included in the 6 months follow-up. In all cases, B-scan ultrasonography and ultrasound biomicroscopy showed that FCVB adapted closely to the globe wall and ciliary body, thus supporting the retina. Visual acuity did not improve, except in one case from LP to HM. The mean±SD IOP was 9.29±1.60mmHg prior to FCVB implantation and 10.43±0.98mmHg after implantation, with no significant difference between these measurements (P=0.066). Five of the seven patients developed differing degrees of corneal opacity and keratopathy. Conclusions: FCVB implantation may be a safe and effective method for the treatment of severe ocular trauma and SO dependent eyes. However, corneal opacity and keratopathy are potential serious complications after surgery. Appropriate case selection and proper surgical time require further investigation.

scholarly journals Late-Onset Glaucoma-Filtrating Bleb Leak in a Penetrating Keratoplasty Patient: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Zuleyha Yalniz-Akkaya ◽  
Ayse Burcu ◽  
Firdevs Ornek
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Penetrating Keratoplasty ◽  
Late Onset ◽  
Corneal Graft ◽  
Case Presentation ◽  
Bleb Leak ◽  
One Year ◽  
Human Pericardium

Introduction. Late-onset bleb leaks occur more frequently after the use of adjunctive antimetabolites and require surgical management to seal and preserve filtrating bleb.Case Presentation. A 48-year-old female presented with decreased visual acuity for five days in her left eye. She had a left penetrating keratoplasty one year earlier and two trabeculectomies 7 years earlier. Visual acuity was hand motions, intraocular pressure was 3 mmHg, corneal graft was clear, mature cataract was present, and axial length was 30.48 mm. The conjunctiva covering the superotemporal sclerotomy was avascular, flat, and partially lost. After heavily painting the bleb with a fluorescein, late-onset point leak was revealed. Overlying conjunctiva was excised. The atrophic, irregular, and partially absent scleral flap was covered by a processed human pericardium graft and conjunctival advancement. Postoperatively, intraocular pressure stabilized around 16 mmHg. After four months, phacoemulsification and intraocular lens implantation were performed. Visual acuity did not exceed 0.1 (in decimal notation) due to degenerative myopia-related macular atrophy. Corneal graft remained clear at her 6-month followup period.Conclusion. Surgical bleb revision using a pericardium graft and conjunctival advancement seems to be an effective method for treating late bleb leaks. However, careful follow-up is required for detecting recurrent leaks and elevated intraocular pressure.

Customised gold weight eyelid implantation in paralytic lagophthalmos

2008 ◽  
Vol 122 (10) ◽  
pp. 1088-1091 ◽  
Author(s):  
N Jayashankar ◽  
K P Morwani ◽  
M J Shaan ◽  
S R Bhatia ◽  
K T Patil
Keyword(s):  
Visual Acuity ◽  
Prospective Study ◽  
Study Design ◽  
Study Group ◽  
Upper Eyelid ◽  
Eyelid Closure ◽  
Gold Weight ◽  
One Year ◽  
A Prospective Study

AbstractGold eyelid implantation is widely considered the procedure of choice to reanimate the upper eyelid in paralytic lagophthalmos. Commercially supplied implants are not readily available in all places and are sometimes cumbersome to import.Objective:We aimed to devise a method whereby every surgeon performing gold eyelid implantation could have easy and quick access to the implant. Furthermore, we aimed to develop a means of creating an implant of the exact weight required for complete eyelid closure.Study design and setting:A prospective study was performed from 1997 to 2005 in a tertiary research hospital, involving 50 subjects requiring gold upper eyelid implantation and using the technique in question.Results:Only patients with a minimum follow up of one year were included in the study group. Symptoms improved in 96 per cent of subjects, who were able to dispense with eyedrops and eye ointments. Visual acuity improved in 92 per cent of patients. There were two extrusions amongst the early cases.Conclusion and significance:Customised gold eyelid implantation offers an alternative in regions where commercial implants are not easily obtained.

scholarly journals Effect of phacoemulsification with intraocular lens implantation in eyes with cataract and functioning filtering blebs

2013 ◽  
Vol 13 (2) ◽  
pp. 33-41
Author(s):  
Devendra Maheshwari ◽  
Rengappa Ramakrishanan ◽  
Mohideen Abdul Kader ◽  
Neelam Pawar ◽  
Ankit Gupta
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
The Mean ◽  
One Year ◽  
Best Corrected Visual Acuity

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p < 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.

scholarly journals The Therapeutic Effect of Corneal Transplantation for Refractory Pseudomonas Aeruginosa Corneal Ulcer

2019 ◽  
Author(s):  
Yan Li ◽  
Ting Wang ◽  
Qiang Wang ◽  
Shanhao Jiang ◽  
Xin Wang
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Visual Acuity ◽  
Corneal Ulcer ◽  
Corneal Transplantation ◽  
Corneal Graft ◽  
Successful Outcome ◽  
Lamellar Keratoplasty ◽  
Corneal Transplant ◽  
Surgical Method

Abstract Purpose To observe the treatment outcome of corneal transplantation for advanced medically uncontrolled culture-proven pseudomonas aeruginosa corneal ulcer.Design Retrospective analysisSubjects and methods 26 patients (eyes) with refractory culture-positive pseudomonas aeruginosa corneal ulcer who failed to respond to drug therapy and underwent consecutive corneal transplant procedures in a hospital (2008.1-2018.8). Etiology, medical history, clinical features, surgical type, vision, recurrence, complications and treatment were recorded, and the relationship between postoperative recovery and selection of surgical method was analyzed.Results Of the 26 patients with pseudomonas aeruginosa corneal ulcer, 9 (34.6%) received penetrating keratoplasty (PKP) and 17 (65.4%) received lamellar keratoplasty (LKP). 22 patients (84.6%) obtained a successful outcome through one corneal transplantation. Of the 9 patients who received PKP, 1 patient having graft rejection 6 months after surgery (endothelial type) obtained successful outcome through adequate drug treatment., while 1 case received success by graft repair combined with amniotic membrane transplantation on the 5 months postoperatively for fungal corneal graft ulcer. In the 17 patients underwent LKP, 2 received a second successful lamellar corneal transplantation for corneal graft melting 2 months after the first surgery. In all the 26 patients, the corneal infection was effectively brought under control by corneal transplantation, and none of them had recurrent ulcers during at least 6months' follow-up. The visual acuity was significantly improved at the last follow-up compared with that before surgery. The postoperative visual acuity of patients underwent LKP was better than that of those who underwent PKP ( p =0.018).Conclusions Corneal transplantation can effectively treat refractory pseudomonas aeruginosa corneal ulcer worsening despite adequate medical treatment and improve eyesight. Compared with PKP, LKP can be the main surgical method to treat refractory pseudomonas aeruginosa corneal ulcer.

scholarly journals Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Katarzyna Nowomiejska ◽  
Tomasz Choragiewicz ◽  
Dorota Borowicz ◽  
Agnieszka Brzozowska ◽  
Joanna Moneta-Wielgos ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Silicone Oil ◽  
Vitreoretinal Surgery ◽  
Eye Injuries ◽  
Primary Vitrectomy ◽  
Eye Trauma ◽  
Open Globe ◽  
Pars Plana ◽  
23 Gauge

Purpose.To evaluate functional and anatomical results of pars plana vitrectomy (PPV) in the retinal detachment (RD) followed by severe eye trauma.Methods.Retrospective analysis of medical records of forty-one consecutive patients treated with 23-gauge PPV due to traumatic RD. Age, gender, timing of PPV, visual acuity, and presence of intraocular foreign body (IOFB) and proliferative vitreoretinopathy (PVR) were included in the analysis.Results.Mean age of patients was 47 years; the majority of patients were men (88%). Closed globe injury was present in 21 eyes and open globe injury in 20 eyes (IOFB in 13 eyes, penetration injury in 4 eyes, and eye rupture in 3 eyes). Mean follow-up period was 14 months; mean timing of PPV was 67 days. Twenty-seven (66%) eyes had a functional success; 32 eyes (78%) had anatomical success. As a tamponade silicone oil was used in 33 cases and SF6 gas in 8 cases.Conclusions.Severe eye injuries are potentially devastating for vision, but vitreoretinal surgery can improve anatomical and functional outcomes. Among analysed pre- and intra- and postoperative factors, absence of PVR, postoperative retinal attachment, and silicone oil as a tamponade were related to significantly improved visual acuity.

scholarly journals A Female Case of X-Linked Retinoschisis with Macular Hole Bilaterally

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
A. Altun
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Surgical Experience ◽  
Flap Technique ◽  
Macular Holes ◽  
Female Case ◽  
Pars Plana

Purpose. We aimed at reminding that X-linked retinoschisis may also be seen in female patients and share our vitreoretinal surgical experience. Methods. The patient underwent pars plana vitrectomy including the closure of the macular holes with inverted ILM flap technique bilaterally. Lens extractions were performed by phacoemulsification during the removal of silicone oil endotamponade. Patient. An 18-year-old girl with X-linked retinoschisis and large macular holes in both eyes presented to the clinic of ophthalmology. It was confirmed that the patient had RS1 mutation Results. Nine-month-follow-up was uneventful for retinal findings. Significant improvement in visual acuity was achieved, and macular holes were remained closed. Conclusion. In cases with large macular holes due to XLR, an inverted ILM flap technique might be safe and effective. Four-month-silicone-endotamponade might be sufficient.

scholarly journals Ocular trauma in patients presenting to Dhulikhel Hospital

2012 ◽  
Vol 9 (1) ◽  
pp. 54-57 ◽  
Author(s):  
P R Sthapit ◽  
S Marasini ◽  
U Khoju ◽  
G Thapa ◽  
B P Nepal
Keyword(s):  
Visual Acuity ◽  
Clinical Presentation ◽  
Ocular Trauma ◽  
Public Awareness ◽  
Prevalence Studies ◽  
Young Males ◽  
Common Location ◽  
One Year ◽  
Complete History ◽  
Better Than

Background Ocular trauma is an important cause of blindness and ocular morbidity throughout the world. Prevalence studies help to define the target group, plan strategies and thereby lessen trauma related blindness in the country. Objective To identify the risk factors for ocular trauma, those at risk, describe the visual acuity at time of clinical presentation, and assess the nature and severity of ocular trauma in patients presenting to Dhulikhel Hospital’s emergency department and eye OPD with ocular trauma. Methods It is a descriptive and prospective study of all the patients with ocular trauma presenting to Dhulikhel Hospital from December 2009 to December 2010. A complete history and detailed ophthalmologic evaluation was done and noted down. Results There were 112 subjects with ocular trauma. Mean age was 28.43±16.36 years with a range of one year to 74 years. Males predominated with 72.3% frequency (p<0.001). Incidence peaked in third decade of life (p<0.01). Ocular trauma peaked in months of September and October. Presenting visual acuity better than 6/12 was noted in 83.9% of cases whereas 2.7% of cases had visual acuity of <3/60. Household (56.3%, p<0.001) was the commonest place of injury with wooden objects (19.6%) being the commonest object of injury. Most of the injuries were mechanical (85.7%, p>0.001). ConclusionBlunt injuries were more common in young males. Household and workplace were common location of ocular injuries. Public awareness and strict legislation to use personal protective devices can help to reduce the occurrence of ocular injury.http://dx.doi.org/10.3126/kumj.v9i1.6264 Kathmandu Univ Med J 2011;9(1):54-7

Efficacy of surgical treatment of traumatic cataract with simultaneous intraocular lens implantation in children

2013 ◽  
Vol 4 (1) ◽  
pp. 37-40
Author(s):  
Diloram Asrarovna Zakirkhodzhayeva
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Early Postoperative Period ◽  
Eye Injury ◽  
Traumatic Cataract ◽  
Iol Implantation ◽  
Intraocular Injection ◽  
Lens Implantation ◽  
One Year

Background: eye injury is often accompanied by lens damage. Aim: To evaluate the efficacy of surgical treatment of traumatic cataract with simultaneous IOL implantation in children. Material and methods: The results of surgical treatment of traumatic cataract with simultaneous IOL implantation in 62 children were analyzed: in 48 boys (77.4%) and 14 girls (22.6%) with a mean age 8.1 years. Results: visual acuity after surgery gradually increased from 0.09 to 0.22 by the end of the first month, 0.43 in 6 months and 0.47 in one year of follow-up. In 85.5% of the operated children visual acuity in the late post-op period was accounted 0.3–1.0, and in 82.2% of cases binocular vision was recovered. In the early postoperative period following complications were observed: exudative iridocyclitis — 16.1%; deposits of fibrin in the pupil — 8%; pigment deposits on surface of the IOL — 19%; secondary cataract — 12%; IOL or its haptics dislocation — 3% cases. Conclusions: Early IOL implantation during traumatic cataract surgery in children is suitable. Use of viscoelastics allows minimizing the severity of postoperative inflammation and reducing a risk of complications. Intraocular injection of Gemasa during surgery is effective to resolve hyphema, intraocular hemorrhages and fibrinoid exudate.

Long-term clinical outcome of femtosecond laser-assisted lamellar keratectomy with phototherapeutic keratectomy in anterior corneal stromal dystrophy

2017 ◽  
Vol 102 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Jonghyun Lee ◽  
Jin Hyoung Kim ◽  
Doh Lee ◽  
Ji Woong Chang ◽  
Joo Youn Shin ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Corneal Opacity ◽  
Visual Disturbance ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Phototherapeutic Keratectomy ◽  
Corneal Erosion

PurposeTo evaluate long-term outcome of femtosecond laser-assisted lamellar keratectomy (FLK) with phototherapeutic keratectomy (PTK) in patients with anterior corneal stromal dystrophies.MethodsA total of 10 eyes from seven patients who underwent FLK were included. The patients had suffered from recurrent corneal erosion or visual disturbance in anterior corneal dystrophies (five Avellino dystrophies and two lattice dystrophies). Planar-shaped lamellar keratectomy was performed using femtosecond laser. The amount of corneal excision was determined by the depth of corneal opacity. Additional PTK with mitomycin C application was performed for smoothening of corneal cut surface. The patients were evaluated with following parameters: uncorrected visual acuity, best-corrected visual acuity (BCVA), mean anterior keratometric value, corneal irregularity, corneal high-order aberrations (HOA) and the recurrence of corneal erosion.ResultsMean duration of follow-up was 64 months (2.5–9.5 years). The BCVA improved more than two lines of Snellen chart at last visit. The changes of keratometric values were within ±1 D in eight out of 10 eyes. Corneal irregularities in central 5 mm cornea and the values of total corneal HOA in central 6 mm cornea decreased by 0.3–3.1 D and 0.01–2.2 µm, respectively. Corneal erosion did not recur in any of those patients during follow-up and corneal dystrophy did not recur in eight out of 10 eyes.ConclusionIn anterior corneal stromal dystrophies, FLK with PTK can be an effective surgical option to improve VA through decreasing corneal irregularities and HOA, while minimising corneal curvature changes.

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