scholarly journals Intrascleral Suture Anchoring: A Flapless/Grooveless Four-Point Intraocular Lens Fixation Technique

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Xin Hu ◽  
Bo Zhao ◽  
Haiying Jin
Keyword(s):  
Intraocular Lenses ◽  
Surgical Trauma ◽  
Suture Fixation ◽  
Fixation Technique ◽  
Retinal Tear ◽  
Present Technique ◽  
Aphakic Eyes ◽  
The Mean ◽  
Anchoring Technique

Purpose. We describe a minimally invasive suture fixation technique for four-point fixation of intraocular lenses (IOLs) in the treatment of aphakic eyes, namely, the intrascleral suture anchoring technique. Neither scleral flaps nor large conjunctival dissections are required. Methods. This study included 11 eyes (11 patients). After looping the eyelets on the IOL haptics and externalizing the threads, the curved needle attached to the externalized thread was started with two sequential intrascleral passes from the first fixation point to reach the second fixation point. The same procedure was performed for the other side of the IOL. A fixation knot was created in the sclerotomy by the two ends of the thread to close the suture loop for IOL fixation. Another knot was created about 2 to 3 mm from the exiting point and was intrasclerally anchored by the aid of the attached curved needle. Results. The mean postoperative follow-up period was 9.7 ± 5.8 months (range 5–15 months). The IOLs of all eyes remained well positioned and stable postoperatively. The postoperative visual acuities were improved. No suture erosion, suture loosening, hypotony, scleral atrophy, chronic inflammation, retinal tear, and/or detachment were observed within the follow-up period. Conclusion. The present technique is an alternative, flapless method for the four-point suture fixation of IOLs. It provides both minimal surgical trauma and reliable stability.

scholarly journals Intraocular Suture Looping Technique for Flapless Four-Point Refixation of Dislocated Intraocular Lenses

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Xin Hu ◽  
Bo Zhao ◽  
Haiying Jin
Keyword(s):  
Chronic Inflammation ◽  
Intraocular Lens ◽  
Intraocular Lenses ◽  
Scleral Fixation ◽  
Retinal Tears ◽  
Present Technique ◽  
The Mean ◽  
The Creation ◽  
Polypropylene Sutures

Purpose. To describe a flapless/grooveless technique for four-point refixation of a dislocated intraocular lens (IOL) with four fenestrated haptics. Methods. An intraocular suture looping technique was performed with the assistance of two 27-gauge needles. A looping needle was passed into the eye through paracentesis and was used to loop both fenestrated haptics on the same side with an 8–0 polypropylene thread. A guiding needle was used to guide the looping needle out of the eye at the scleral fixation sites. After looping each pair of fenestrated haptics on nasal/temporal sides with 8–0 polypropylene sutures, the IOL was refixated by definitive knotting. The exterior suture ends were buried into the sclera without the creation of scleral flaps/grooves. Results. The technique was employed in four eyes (three patients). The mean postoperative follow-up period was 13.8 ± 2.2 months. Postoperatively, the IOLs of all the eyes remained well positioned and stable. The postoperative visual acuities of all the eyes were improved. No suture erosion, hypotony, scleral atrophy, chronic inflammation, retinal tears, and/or detachments were observed within the follow-up period. Conclusion. The present technique provides minimal surgical invasion for the transscleral refixation of a dislocated IOL with four fenestrated haptics.

scholarly journals Trans-optic Suture Fixation of Subluxated Intraocular Lenses

2021 ◽  
Author(s):  
Avner Belkin ◽  
Veronika Yehezkeli ◽  
Ehud Assia
Keyword(s):  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Suture Fixation ◽  
Slit Lamp ◽  
Lens Position ◽  
Clinical Scenarios ◽  
Operative Complications ◽  
Aphakic Eyes ◽  
Post Operative Complications

Abstract PurposeTo report a technique for fixating posterior chamber intraocular lenses (PCIOLs) to the sclera by passing sutures through the lens materialMethodsCases in which PCIOLs were fixated to the sclera using trans-optic sutures were included in this series. Intra and post-operative complications were recorded, and lens position was assessed using slit lamp examination.ResultsFourteen cases were included in this series. In 9 cases the procedure was performed using 9-0 polypropylene in pseudophakic eyes to correct subluxation, centration, tilt or to replace a broken haptic. In 5 cases this technique was used for primary PCIOL fixation using a flanged 6-0 polypropylene suture in aphakic eyes. In all cases the lenses remained centered and stable at the end of follow up, and no post-operative complications occurred.ConclusionTrans-optic suturing is a safe and effective alternative method for fixation of IOLs in a variety of pseudophakic and aphakic clinical scenarios.

scholarly journals Abstaining from symptomatic implants of modified tension band wiring by nonabsorbable suture fixation for transverse patella fractures

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Puripun Jirangkul ◽  
Arkaphat Kosiyatrakul
Keyword(s):  
Steel Wire ◽  
Clinical Results ◽  
Tension Band ◽  
Fixation Technique ◽  
Nonabsorbable Suture ◽  
Patella Fractures ◽  
Sufficient Stability ◽  
The Mean ◽  
Conventional Stainless Steel

Abstract Background Modified tension band fixation has become commonly used for transverse patella fractures. The conventional stainless steel wire provides sufficient stability but may be associated with complications. Objective The study aimed to evaluate the effectiveness of a new modified tension band fixation technique for transverse patella fractures using a nonabsorbable suture. Material and methods We present the result of a prospective series using a nonabsorbable suture (FiberWire) for transverse patella fractures. The mean follow-up period totaled 12 months. A total of 16 patients were evaluated by radiographic and clinical review. The postoperative clinical evaluation employed Lysholm and Böstman scores. Result All clinical results on follow-up were good to excellent. Minimal intra-articular joint stepping and further fracture displacement were recorded. No patient needed re-operation, and functional outcomes of the knee were satisfactory. No significant differences were found between the injured and contralateral knee range of motion. No symptomatic implants and skin complications were noted, and all fractures were completed heal within 15 weeks. Conclusion FiberWire provided sufficient stability and reduced postoperative complications. The results proved appropriate, and the technique has merit, as it obviates the need for re-operation.

scholarly journals Efficacy of threading lasso fixation in repairing partial articular supraspinatus tendon avulsion lesions: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sun-Yu Chen ◽  
Zhan-Hao Xiao ◽  
Jian-Kun Wang
Keyword(s):  
Los Angeles ◽  
Clinical Outcomes ◽  
Case Series ◽  
Visual Analog Scale Score ◽  
Supraspinatus Tendon ◽  
Fixation Technique ◽  
Retrospective Case ◽  
The Mean ◽  
Tendon Avulsion

Abstract Background The partial articular supraspinatus tendon avulsion (PASTA) lesion repair remains a topic of debate. We have performed in situ repair of PASTA lesions using a potentially viable threading lasso fixation technique. This retrospective case series aimed to evaluate the clinical outcomes of PASTA lesion repair using threading lasso fixation. To the best of our knowledge, this is the first study to review this technique and its outcomes in terms of pain and upper extremity function. Methods Twenty-five patients with PASTA lesions who were treated with threading lasso fixation were reviewed. All patients were followed up for at least 1 year. Preoperative and follow-up data were retrospectively collected and reviewed. Clinical outcomes were assessed to evaluate the efficacy of the surgery. Results There were no postoperative complications. The average follow-up period was 25.7 (22–27) months. At the last follow-up, all patients underwent follow-up magnetic resonance imaging; only two cases showed a partially healed tendon and no case converted to full-thickness tear. Furthermore, shoulder pain decreased and mobility was recovered, with statistically significant differences in all scoring measures. Specifically, the mean visual analog scale score decreased from 5.4 ± 1.2 before surgery to 1.1 ± 0.8 at the last follow-up (t = 14.908, P < 0.01), and the mean American Shoulder and Elbow Surgeons Shoulder Assessment Form score improved significantly from 51.6 ± 6.4 to 89.3 ± 5.2 (t = 22.859, P < 0.01). Additionally, the mean University of California Los Angeles score improved from 17.8 ± 3.5 preoperatively to 32.3 ± 1.4 (t = 19.233, P < 0.01). Conclusions Arthroscopic repair using threading lasso fixation is a novel transtendinous technique for patients with partial articular supraspinatus tendon avulsion. Tendon integrity is preserved with this method, which may result in improved function. Overall, threading lasso fixation technique is an effective treatment.

scholarly journals Treatment of Infected Tibial Non-Unions with Ilizarov Technique: A Case Series

2020 ◽  
Vol 9 (5) ◽  
pp. 1352 ◽  
Author(s):  
Gianluca Testa ◽  
Andrea Vescio ◽  
Domenico Costantino Aloj ◽  
Danilo Costa ◽  
Giacomo Papotto ◽  
...  
Keyword(s):  
Bioactive Glass ◽  
Antibacterial Properties ◽  
Case Series ◽  
Long Bone ◽  
Ilizarov Technique ◽  
Fixation Technique ◽  
Bone Resection ◽  
Bone Segment ◽  
The Mean

Background: The Ilizarov external fixation technique has been widely used for the treatment of long-bone infected non-unions. After surgical infected bone resection, to allow filling of the remaining bone gap, biomaterials with antibacterial properties could be used. The aim of this study was to report outcomes of infected tibial non-unions treated using the Ilizarov technique and antibacterial bioactive glass. Methods: Between April 2009 and December 2014, 26 patients with infected tibial non-unions were treated with the Ilizarov technique and possible use of the bioactive glass, S53P4. The Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria, a clinical and radiographic evaluating tool, was used for assessing the sample. Results: The average age at the start of treatment was 51 years. The mean follow-up time was 113 weeks. According to the ASAMI Functional Scoring System, 10 excellent (38.5%) cases and 12 good (46.1%) values were recorded. According to the ASAMI Radiological System, they were excellent in 16 (61.5%) cases and good in nine (34.6%). Conclusions: Treatment of infected tibial non-unions using the Ilizarov technique was effective in bone segment regeneration. To fill the remaining bone gap, additional bioactive glass S53P4 could be used, allowing a decrease in re-interventions and minimizing complications.

Parameters affecting postoperative success of surgery for stage 4A/4B ROP

2019 ◽  
Vol 103 (11) ◽  
pp. 1624-1632
Author(s):  
Cemal Özsaygili ◽  
Sengul Ozdek ◽  
Mehmet Cuneyt Ozmen ◽  
Hatice Tuba Atalay ◽  
Duygu Yalinbas Yeter
Keyword(s):  
Functional Results ◽  
First Year ◽  
Preoperative Treatment ◽  
Posterior Hyaloid ◽  
Retinal Tear ◽  
Stage 4 ◽  
The Mean ◽  
Second Year ◽  
Surgically Induced

PurposeTo describe the long-term anatomical and functional results of surgery for retinal detachment (RD) associated with stage 4 retinopathy of prematurity (ROP) and patient and surgery-related factors affecting postoperative success.DesignRetrospective case series at a single tertiary referral paediatric vitreoretinal practice.MethodsOne hundred and twenty-one eyes of 82 infants (40 female/42 male) who underwent lens-sparing vitrectomy (LSV) or lensectomy with vitrectomy surgery for stage 4A and 4B ROP at Gazi University Department of Ophthalmology between 2011 and 2016 were enrolled in this study. Patient characteristics including gestational age, birth weight, gender, stage of ROP at presentation, preoperative treatment (laser, anti-vascular endothelial growth factor (VEGF) or combined), anatomical and functional outcome and complications were recorded. The effect of birth weight, gestational age, presence of plus disease, preoperative treatment status, surgically induced posterior hyaloid detachment, postoperative vitreous haemorrhage and iatrogenic retinal tear formation on anatomical and functional results was evaluated.Results61.2% of the eyes were stage 4A and 38.8% were stage 4B ROP. The mean follow-up was 24.5 months. 18.2% of the eyes had no preoperative treatment. Anatomical success was 86.5% for stage 4A and 68.1% for stage 4B at the first year, 91.7% for stage 4A and 69.4% for stage 4B at the second year, and 95.8% for stage 4A and 57.9% for stage 4B at the third year. Functional success was 85.1% for stage 4A and 65.9% for stage 4B at the first year, 89.6% for stage 4A and 61.1% for stage 4B at the second year, and 87.5% for stage 4A and 57.8% for stage 4B at the third year. The mean visual acuity was 1.12±0.34 logarithm of the minimum angle of resolution (logMAR) for stage 4A and 1.34±0.32 logMAR at the 3-year follow-up duration (p>0.05). There was preoperative plus disease in 59.5% of the eyes. Subsequent retinal surgeries were required in 17.4% of the eyes. Presence of plus disease and absence of preoperative treatment, iatrogenic retinal tear formation and postoperative vitreous haemorrhage were found to have significant negative effects, while surgical induction of posterior hyaloid detachment and sparing the lens intraoperatively affected the anatomical and functional results positively.ConclusionsSurgery for stage 4 ROP-associated RD resulted in encouraging anatomical and functional outcomes and the results are even better in eyes with preoperative (laser/anti-VEGF) treatment, LSV and surgically induced posterior hyaloid detachment.

scholarly journals Osseous Healing With Nonrigid Suture Fixation in the Arthroscopic Latarjet Procedure

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096448
Author(s):  
Jack W. Weick ◽  
Vivek Kalia ◽  
Emily Pacheco ◽  
Jon A. Jacobson ◽  
Michael T. Freehill
Keyword(s):  
Ct Scan ◽  
Case Series ◽  
Ct Scans ◽  
Suture Fixation ◽  
Latarjet Procedure ◽  
Average Percentage ◽  
Cortical Button ◽  
The Mean ◽  
Graft Migration

Background: The Latarjet procedure is a popular means to surgically address anterior glenohumeral joint instability. Although the Latarjet procedure is becoming increasingly common, challenges persist and include postoperative complications secondary to use of the conventional 2 bicortical fixation screws. Recently, a novel surgical technique using a guided surgical approach for graft positioning with nonrigid fixation via a suture suspensory system has been described. Purpose: To evaluate healing rates and stability of the grafts in patients who underwent this new Latarjet technique. Study Design: Case series; Level of evidence, 4. Methods: We retrospectively gathered anonymized computed tomography (CT) data sets from a total of 107 patients who underwent nonrigid suture fixation using a cortical button fixation for anterior glenohumeral instability. Of the 107 patients, 45 had CT scans performed at 2 different time periods. The CT scans of each patient were compared by 2 fellowship-trained musculoskeletal radiologists. Data recorded included age, sex, date of scan, initial graft position on the glenoid, presence and degree of graft migration relative to the equator on follow-up scan, and percentage of osseous healing (as assessed by osseous bridging) on the follow-up scan. Descriptive statistics were calculated to evaluate the average migration and average percentage of healing at both time points. Results: Our population (n = 45) consisted of 38 men (84.4%) and 7 women (15.6%). The mean age was 27.1 ± 1.1 years. The mean time between initial CT scan (2 weeks postoperatively) and follow-up CT scan was 26 ± 2 weeks. On follow-up scan, reviewer 1 found 75.6% of patients had greater than 75% healing, and reviewer 2 found 70.2% of patients had greater than 75% healing. The center of the graft was measured at or below the equator on follow-up examination in 43 of 45 (95.6%) patients by reviewer 1 and 44 of 45 (97.8%) patients by reviewer 2. Conclusion: Based on these findings, nonrigid suture fixation using a cortical button device offers an effective alternative to traditional screw fixation for the Latarjet procedure with a high level of osseous healing and minimal graft migration.

scholarly journals Management of Distal Humerus Fractures With Jess Fixator

2015 ◽  
Vol 3 (4) ◽  
pp. 16-20
Author(s):  
Prakriti Raj Kandel ◽  
Kishor Man Shrestha ◽  
Laxmi Pathak
Keyword(s):  
Distal Humerus ◽  
Humerus Fracture ◽  
Medical Sciences ◽  
Distal Humerus Fracture ◽  
Fixation Technique ◽  
Fixation Techniques ◽  
Humerus Fractures ◽  
The Mean ◽  
Distal Humerus Fractures

INTRODUCTION: Fractures of distal humerus are rare comprising approximately 2% of all fractures and a third of all humerus fractures. Even with the development of newer fixation techniques, the treatment of distal humerus fractures remains a great challenge to any orthopaedic surgeon. Thus this present study was conducted to evaluate the results of Joshi's External Stabilization System (JESS) in the management of distal humerus fracture with or without intercondylar extension. MATERIALS AND METHODS: This retrospective study was conducted by collecting records of thirty two adult patients who sustained distal humerus fracture and were managed with JESS fixation under anaesthesia over a period of two years in Universal College of Medical Sciences Teaching Hospital (UCMSTH) after obtaining permission from Institutional ethical committee. RESULTS: According to AO (Arbeitsgemeinschaft für Osteosynthesefragen) classification, 2 patients had C1 fracture and 30 patients had C2 fractures. The mean duration of JESS application was 16 weeks. The mean follow up was 8 months. The functional outcome was evaluated by using Cassebaum's functional rating system. Among C1 fractures, 50% showed fair and 50% showed good result whereas among C2 fractures, 40% showed good, 46.66% showed fair and 13.33% showed poor results.  CONCLUSIONS: JESS fixation technique represents a viable option in the management of open as well as close intercondylar fractures of the distal humerus.

scholarly journals Sutureless Intrascleral Haptic-Hook Lens Implantation Using 25-Gauge Trocars

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Zhi-Xiang Hu ◽  
HaiShuang Lin ◽  
Lingying Ye ◽  
Zhong Lin ◽  
Tianyu Chen ◽  
...  
Keyword(s):  
Vitreous Hemorrhage ◽  
Crystalline Lens ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Axial Stability ◽  
Wound Leakage ◽  
The Mean ◽  
A New Technique ◽  
Posterior Chamber Iol

Purpose. To report a new technique for sutureless intrascleral fixation of three-piece foldable intraocular lenses (IOLs) using 25-gauge trocars. Methods. We performed this technique on patients with insufficient posterior capsule support. Seventeen eyes from 15 patients with aphakia, dislocated IOL, or subluxated crystalline lens undergoing posterior chamber sutureless implantation of an IOL were studied. The haptics of the IOL were externalized using two 25-gauge forceps. The haptics were bended back (hook-like) into the vitreous cavity through a scleral incision made by using a 25-gauge trocar. And, IOL tilt was determined by using a slit lamp and UBM, and complications were recorded. Results. The IOLs were fixed with exact centration and axial stability. No wound leakage was reported even without the use of sutures. The mean best-corrected visual acuity (BCVA) was 0.82 logarithm of the minimum angle of resolution (logMAR) units preoperatively, and the mean BCVA was 0.44 logMAR units at the 6-month follow-up visit. No postoperative retinal detachment, endophthalmitis, IOL tilt or dislocation, or vitreous hemorrhage was noted. Conclusion. Sutureless intrascleral haptic-hook posterior chamber IOL implantation using 25-gauge trocars provides good IOL fixation with reliable wound closure without the use of sutures. This trial is registered with ChiCTR1800017436.

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