scholarly journals Late-Onset Inadvertent Bleb Formation following Pars Plana M3 Molteno Implant Tube Obstruction

2017 ◽  
Vol 8 (1) ◽  
pp. 73-80 ◽  
Author(s):  
Anmar M. Abdul-Rahman ◽  
Anthony Molteno
Keyword(s):  
Late Onset ◽  
Anterior Segment ◽  
Wound Dehiscence ◽  
Early Postoperative Period ◽  
Tube Obstruction ◽  
Entry Wound ◽  
Molteno Implant ◽  
Pars Plana ◽  
Bleb Formation ◽  
Mixed Mechanism

Purpose: To report a case of inadvertent bleb formation presenting 18 months after pars plana M3 Molteno implant tube obstruction in a patient with mixed mechanism glaucoma. Materials and Methods: An 84-year-old Caucasian male with mixed mechanism glaucoma underwent slit-lamp examination, gonioscopy, colour anterior segment photography and anterior segment optical coherence tomography (AS-OCT). Results: An inadvertent bleb developed 18 months after pars plana implant tube re-positioning with a 6/0 Vicryl tie ligature. The bleb was located in the area anterior to the implant plate; it was characterised by a thin, transparent, avascular and multi-cystic wall, with a visible stoma at the posterior edge of the bleb. The bleb was functioning as demonstrated by an intraocular pressure of 6 mm Hg at presentation and a punctate fluorescein uptake pattern of the bleb wall. The bleb over the plate of the Molteno implant was non-functioning, likely secondary to tube obstruction by vitreous in the early postoperative period. AS-OCT showed a tract from the anterior chamber commencing at an entry wound through a corneal tunnel to the posterior stoma at the base of the inadvertent bleb. Conclusions: We hypothesise that the pathophysiologic factors resulting in an inadvertent bleb are a result of a combination of apoptosis, late-onset wound dehiscence and internal gaping of a centrally placed corneal wound. In addition, aqueous hydrodynamic factors may play a role.

scholarly journals Traumatic scleral wound dehiscence with filtering bleb formation after surgical repair of penetrating globe injury

2013 ◽  
Vol 5 (1) ◽  
pp. 136-137 ◽  
Author(s):  
A Ozkaya ◽  
Z Alkin ◽  
Y Acet ◽  
U Yigit
Keyword(s):  
Surgical Repair ◽  
Ocular Trauma ◽  
Anterior Segment ◽  
Wound Dehiscence ◽  
Rare Occurrence ◽  
Filtering Bleb ◽  
Bleb Formation ◽  
The Right ◽  
Blunt Ocular Trauma

Backgropund: Filtering bleb formation after surgical repair of penetrating globe injury is a rare occurrence. Case: A 45-year-old male who had undergone surgical repair of a corneoscleral laceration 16 months earlier presented to emergency room after blunt trauma to the left eye. His best-corrected visual acuities were 20/20 in the right eye and 20/25 in the left. An anterior segment examination found a conjunctival filtering bleb formation on scarred sclera at superotemporal location near the limbus. Anterior chamber was slightly shallow and the Seidel test was negative. Intraocular pressures were 17 mm Hg in the right eye, 7 mm Hg in the left. The fundus examination revealed no abnormal findings. The patient was treated with topical aplication of a steroid and a cycloplegic drop during three weeks. After 16 months follow-up, the visual acuity remained unchanged with the persistence of filtering bleb. IOP was 8 mm Hg in the left eye. Follow-up examinations showed no complications related to trauma. Conclusion: Blunt ocular trauma can cause dehiscence in old scleral scars and subsequent filtering bleb formation. Nepal J Ophthalmol 2013; 5(9):136-137 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7843

A novel missense TGFBI variant p.(Ser591Phe) in a Finnish family with variant lattice corneal dystrophy

2021 ◽  
pp. 112067212199730
Author(s):  
Aino Maaria Jaakkola ◽  
Petri J Järventausta ◽  
Reetta-Stiina Järvinen ◽  
Pauliina Repo ◽  
Tero T Kivelä ◽  
...  
Keyword(s):  
Transforming Growth Factor Beta ◽  
Transforming Growth Factor ◽  
Late Onset ◽  
Family Members ◽  
Anterior Segment ◽  
Corneal Dystrophy ◽  
Ophthalmological Examination ◽  
Lattice Corneal Dystrophy ◽  
Tgfbi Gene ◽  
Novel Variant

Introduction: We describe the phenotype of a variant lattice corneal dystrophy (LCD) potentially caused by a novel variant c.1772C>T p.(Ser591Phe) in exon 13 of the transforming growth factor beta-induced (TGFBI) gene. Case report: The proband, a 71-year-old woman referred because of bilateral LCD, first seen at the age of 65 years, with recent progressive symptoms, underwent a clinical ophthalmological examination, anterior segment optical coherence tomography and confocal microscopy. Additionally, three siblings and three children were examined. The identified TGFBI variant was screened in six family members using Sanger sequencing. A corneal dystrophy gene screen was performed for the proband. Translucent subepithelial irregularities and central to midperipheral stubby branching corneal stromal lattice lines, asymmetric between the right and the left eye, were visible and resulted in mild deterioration of vision in one eye. Genetic testing revealed a novel variant c.1772C>T in TGFBI, leading to the amino acid change p.(Ser591Phe). One daughter carried the same variant but had only thick stromal nerve fibres at the age of 49 years. The other family members neither had corneal abnormalities nor carried the variant. No keratoplasty is yet planned for the proband. Conclusions: We classify the novel variant in TGFBI as possibly pathogenic, potentially causing the late-onset, asymmetric variant LCD. Our findings add to the growing number of TGFBI variants associated with a spectrum of phenotypes of variant LCD.

scholarly journals Changes in anterior segment optical coherence tomography following pars plana vitrectomy without tamponade

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Alireza Khodabande ◽  
Massood Mohammadi ◽  
Hamid Riazi-Esfahani ◽  
Shahab Karami ◽  
Massood Mirghorbani ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Chamber ◽  
Pars Plana Vitrectomy ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Optical Coherence ◽  
Mean Values ◽  
Iop Measurement ◽  
Pars Plana ◽  
The Mean

Abstract Background To evaluate changes in anterior segment morphology on anterior segment optical coherence tomography (AS-OCT) following pars plana vitrectomy (PPV) without tamponade. Methods Patients who underwent PPV without tamponade for epiretinal membrane were evaluated. Eligible patients underwent intraocular pressure (IOP) measurement and AS-OCT preoperatively as well as 1 month and 6 months post-operatively. Anterior chamber width (ACW), anterior chamber depth (ACD), trabecular iris angle (TIA), angle opening distance at 500 and 750 µm (AOD), and trabecular iris space area at 500 and 750 µm (TISA) at four quadrants were recorded and analyzed. Additionally, the mean values of TIA (MTIA), AOD (MAOD), and TISA (MTISA) for each eye (mean of four quadrants) were analyzed. Results 23 patients completed the study. The mean age of participants was 56.4 ± 3.6 years of age and 13/23 (56%) were female. Mean IOP of patients was 18.1 ± 1.1, 18.3 ± 1.1, and 18.1 ± 1.2 preoperatively,1 month post-operatively, and 6 months post-operatively, respectively. (p = 0.83). No difference was detected post-operatively in measurements of ACW, ACD, MTIA, MAOD500, MAOD750, MTISA500, and MTISA750. Conclusion Pars plana vitrectomy without tamponade was not associated with changes in anterior chamber morphology.

Ocular manifestations in patients who underwent COVID-19 in the early stages after Phaco surgery with implantation of IOL

2021 ◽  
pp. 80-85
Author(s):  
T.N. Savranova ◽  
◽  
V.U. Rozukulov ◽  
A.F. Yusupov ◽  
◽  
...  
Keyword(s):  
Dry Eye ◽  
Anterior Part ◽  
Anterior Segment ◽  
Early Postoperative Period ◽  
Posterior Segment ◽  
Vascular Pathology ◽  
Ocular Manifestations ◽  
Uveal Tract ◽  
Ocular Symptoms ◽  
Rehabilitation Period

Purpose. To study the ocular manifestations in patients with pseudophakia who underwent COVID-19 during the rehabilitation period after surgery. Material and methods. 46 patients with Phaco with implantation of IOL who underwent COVID-19 in the period from 1 week to 2 months after surgery. Of the examined patients, there were 28 men (61%), 18 women (391%). The average age of the patients was 63±1,2 years. Results. In 78% of cases, vascular pathology of the anterior and posterior segments of the eyeball was observed in patients who underwent COVID-19 in the early postoperative period after Phaco with implantation of IOL. Conclusions. The main ocular symptoms from the anterior segment of the eyeball in patients in 17% of cases were the occurrence or intensification of previously existing manifestations of the «dry eye» syndrome, as well as inflammatory phenomena from the anterior part of the uveal tract. From the posterior segment of the eye, in 70% of cases, there was a progression of vascular disorders, as well as the appearance of complications associated with manifestations of hypercoagulation syndrome and systemic vasculopathy. Key words: Covid-19, cataract phacoemulsification, pseudophakia.

Vitrectorhexis in penetrating eye injuries in adults

2018 ◽  
Vol 29 (6) ◽  
pp. 689-693
Author(s):  
Miklós D Resch ◽  
Anikó Balogh ◽  
Gábor L Sándor ◽  
Zsuzsanna Géhl ◽  
Zoltán Zsolt Nagy
Keyword(s):  
Foreign Body ◽  
Pars Plana Vitrectomy ◽  
Anterior Segment ◽  
Posterior Chamber ◽  
Ocular Injury ◽  
Eye Injuries ◽  
Anterior Capsule ◽  
Safe Alternative ◽  
Anterior Lens Capsule ◽  
Pars Plana

Introduction: Vitrectorhexis is an alternative for manual continuous curvilinear capsulorhexis originally developed for paediatric cataract surgery. The aim of our study was the evaluation of the technique in adult patients with penetrating ocular injury and traumatic cataracts. Methods: Eight eyes of 8 patients (23–41 years, all males) had penetrating mechanical corneal trauma. Anterior lens capsule was penetrated in all cases and additional posterior capsule defect in five cases. Intraocular foreign body was detected in one case in the crystalline lens and in two cases in the posterior segment. Standard 23G infusion cannula and vitreous cutter were applied to perform anterior capsule opening, removal of lens material, anterior vitrectomy and pars plana vitrectomy if needed. No phacoemulsification or irrigation/aspiration probe was used. Results: Vitrectorhexis could be performed in 7 out of 8 cases with the preservation of peripheral anterior capsule; primary implantation of posterior chamber intraocular lens was possible in all cases (in the bag in three eyes and into the sulcus in five eyes). Anterior chamber was stable in all cases intraoperatively, and no dropped nucleus or lens fragment loss was observed. Surgery was combined with pars plana vitrectomy in three cases, with foreign body removal (when necessary). No postoperative complication occurred. Conclusion: Vitrectorhexis was found to be an effective and safe alternative method in the management of complex anterior segment trauma cases. With its use, traditional cataract surgical devices can be substituted and additional benefits of vitreous cutter can be utilized in selected cases, especially in young adults.

scholarly journals Agrobacterium radiobacter Endophthalmitis Associated with Baerveldt Tube Exposure

2021 ◽  
Vol 12 (3) ◽  
pp. 921-926
Author(s):  
Landon J. Rohowetz ◽  
Nimesh A. Patel ◽  
Ann V. Quan ◽  
Kenneth C. Fan ◽  
Nicolas A. Yannuzzi ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Late Onset ◽  
Subsequent Treatment ◽  
Agrobacterium Radiobacter ◽  
Negative Bacillus ◽  
Initial Improvement ◽  
Pars Plana ◽  
Baerveldt Tube ◽  
Clinical Worsening

<i>Agrobacterium radiobacter</i> is a Gram-negative bacillus and a rare cause of endophthalmitis. An 85-year-male presented with late-onset endophthalmitis associated with exposure of an inferonasal Baerveldt tube. The patient was initially treated with anterior chamber paracentesis and intravitreal antibiotics. Aqueous humor culture revealed <i>A. radiobacter</i> resistant to cefazolin, ceftazidime, amikacin, tobramycin, and trimethoprim-sulfamethoxazole. Subsequently, the patient underwent explantation of the glaucoma drainage implant (GDI). After initial improvement, the patient had clinical worsening and was diagnosed with recurrence. Subsequent treatment involved explantation of the second GDI in addition to pars plana vitrectomy with silicone oil infusion, intraocular lens removal, and administration of intravitreal antibiotics. Visual acuity improved but remained at count fingers at 2 weeks. This is the first reported patient with <i>A. radiobacter</i> endophthalmitis associated with an exposed GDI. This report illustrates the resistant nature of this organism in addition to the efficacy of silicone oil administration and intraocular prosthesis explantation.

scholarly journals Combined Pars Plana Glaucoma Drainage Device Placement and Vitrectomy Using a Vitrectomy Sclerotomy Site for Tube Placement: A Case Series

2020 ◽  
Author(s):  
Enchi Kristina Chang ◽  
Sanchay Gupta ◽  
Marika Chachanidze ◽  
John B. Miller ◽  
Ta Chen Chang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Statistical Tests ◽  
Case Series ◽  
Tube Placement ◽  
Glaucoma Drainage Device ◽  
Retrospective Case ◽  
Tube Obstruction ◽  
Pars Plana ◽  
Sclerotomy Site

Abstract Background: The purpose of this study is to report the safety and efficacy of pars plana (PP) glaucoma drainage devices (GDDs) with pars plana vitrectomy (PPV) using one of the vitrectomy sclerotomy sites for tube placement in patients with refractory glaucoma.Methods: Retrospective case series of 28 eyes of 28 patients who underwent combined PP GDD and PPV between November 2016 and September 2019 at Massachusetts Eye and Ear. Main outcome measures were intraocular pressure (IOP), glaucoma medication burden, best corrected visual acuity (BCVA), and complications. Statistical tests were performed with R and included Kaplan-Meier analyses, Wilcoxon paired signed-rank tests, and Fisher tests.Results: Mean IOP decreased from 22.8 mmHg to 11.4 mmHg at 1.5 years (p = 0.009), and mean medication burden decreased from 4.3 to 1.7 at 1.5 years (p = 0.009). Both IOP and medication burden were significantly lower at all follow-up time points. The probability of achieving 5 ≤ IOP ≤ 18 mmHg with at least 20% IOP reduction from preoperative levels was 77.7% at 1 year and 45.8% at 1.5 years. At their last visit, four eyes (14.3%) achieved complete success with IOP reduction as above without medications, and 13 eyes (46.2%) achieved qualified success with medications. Visual acuity was unchanged or improved in 23 eyes (82.1%) at their last follow-up. Two patients had a visual acuity decrease of >2 lines. Two eyes required subsequent PPV for tube obstruction, and one eye had transient hypotony.Conclusions: The results of pars plana GDD and vitrectomy using one of the vitrectomy sclerotomy sites for tube placement are promising, resulting in significant IOP and medication-burden reductions through postoperative year 1.5 without additional risk of postoperative complications. Inserting GDDs into an existing vitrectomy sclerotomy site may potentially save surgical time by obviating the need to create another sclerotomy for tube placement and suture one of the vitrectomy ports.

Multidisciplinary management of patients with pubic osteomyelitis, a rare but serious complication after surgery and radiation therapy for advanced gynaecological cancer

2021 ◽  
Vol 14 (1) ◽  
pp. e236289
Author(s):  
Ilse Haveman ◽  
Anne M van Altena ◽  
Charlotte PA Verschuren ◽  
Johanna WM Aarts
Keyword(s):  
Radiation Therapy ◽  
Multidisciplinary Approach ◽  
Late Onset ◽  
Wound Dehiscence ◽  
Vulvar Pain ◽  
Vaginal Carcinoma ◽  
Pelvic Area ◽  
The Impact

Pubic osteomyelitis is a rare and often late-onset complication of radiation therapy and surgery for vulvar and vaginal carcinoma. It typically presents with vulvar pain, fever, vaginal discharge and/or gait disorders. Pubic osteomyelitis is often accompanied by fistulas or wound dehiscence in the pelvic area. Its accurate diagnosis and treatment are challenging and require a multidisciplinary team effort. In our patients, multiple combined surgical procedures, long-term antibiotic treatment and days to weeks of hospital admission were necessary to treat pubic osteomyelitis. We emphasise the importance of timely and adequate diagnosis and multidisciplinary approach resulting in a course of treatment that is as effective as possible, limiting the impact on quality of life, which is generally high in this group of patients.

Late-onset toxic anterior segment syndrome

2015 ◽  
Vol 41 (3) ◽  
pp. 666-669 ◽  
Author(s):  
Goichiro Miyake ◽  
Ichiro Ota ◽  
Kensaku Miyake ◽  
Masahiro Zako ◽  
Masayoshi Iwaki ◽  
...  
Keyword(s):  
Late Onset ◽  
Anterior Segment ◽  
Toxic Anterior Segment Syndrome
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