scholarly journals Posterior Wall Collapse in High Myopia following Cataract Surgery

2018 ◽  
Vol 9 (1) ◽  
pp. 167-171
Author(s):  
Galia A. Deitz ◽  
Adam R. Sweeney ◽  
Hoon C. Jung

Purpose: We report a case of posterior globe collapse of an eye after initial recovery from uncomplicated cataract surgery in a patient with high myopia and discuss the course of management involving recognition and emergent air injection with globe reformation. Case Report: A 64-year-old functionally monocular male with a history of high myopia presented for follow-up after uncomplicated cataract surgery. Uncorrected distance visual acuity (UCDVA) at postoperative day 1 was 20/150 with an intraocular pressure (IOP) of 19 mm Hg. At the week 1 visit, UCDVA had decreased to 20/200 with an IOP at 9 mm Hg. After preliminary exam, the keratome site suture was removed, after which the patient reported vision changes. A dilated fundus exam was performed revealing posterior scleral wall collapse. A clinical diagnosis of hypotony was made and a pars plana injection of 1 mL air was performed. This resulted in immediate subjective improvement of vision. Exam the next day revealed UCDVA 20/50 with pinhole improvement to 20/30 and IOP 15 mm Hg. Conclusion: This case demonstrates postoperative hypotony in a patient with pathologic myopia, following cataract surgery. Pathologically myopic eyes may have greater propensity to collapse in the setting of reduced IOP.

2019 ◽  
Vol 98 (5) ◽  
pp. 291-294 ◽  
Author(s):  
Saudamini J. Lele ◽  
Mickie Hamiter ◽  
Torrey Louise Fourrier ◽  
Cherie-Ann Nathan

Sialendoscopy has emerged as a safe, effective and minimally invasive technique for management of obstructive and inflammatory salivary gland disease. The aim of our study was to analyze outcomes of sialendoscopy and steroid irrigation in patients with sialadenitis without sialoliths. We performed a retrospective analysis of patients who underwent interventional sialendoscopy with steroid irrigation from 2013 to 2016, for the treatment of sialadenitis without sialolithiasis. Twenty-two patients underwent interventional sialendoscopy with ductal dilation and steroid irrigation for the treatment of sialadenitis without any evidence of sialolithiasis. Conservative measures had failed in all. Eleven patients had symptoms arising from the parotid gland, 4 patients had symptoms arising from the submandibular gland, while 6 patients had symptoms in both parotid and submandibular glands. One patient complained of only xerostomia without glandular symptoms. The mean age of the study group which included 1 male and 21 females was 44.6 years (range: 3-86 years). Four patients had autoimmune disease, while 7 patients had a history of radioactive iodine therapy. No identifiable cause for sialadenitis was found in the remaining 11 patients. The mean follow-up period was 378.9 days (range: 16-1143 days). All patients underwent sialendoscopy with ductal dilation and steroid irrigation. Twelve patients showed a complete response and 9 patients had a partial response, while 1 patient reported no response. Only 3 patients required repeat sialendoscopy. The combination of sialendoscopy with ductal dilation and steroid irrigation is a safe and effective treatment option for patients with sialadenitis without sialoliths refractory to conservative measures. Prospective studies with a larger case series are needed to establish its role as a definitive treatment option.


2020 ◽  
Vol 1 (3) ◽  
pp. 145-153
Author(s):  
Sheng-Xia Wang ◽  
◽  
Yun-Hong Du ◽  
Wen-Jing Liu ◽  
Ping Liu ◽  
...  

AIM: To assess the patient-reported outcome of phacoemulsification with posterior chamber single focus foldable intraocular lens (SIOL) using the Chinese version of Catquest-8SF questionnaire (Catquest-8SF-CN), evaluate the applicability of Catquest-8SF scale in northern Chinese and its sensitivity to cataract surgery. METHODS: Prospective clinical case follow-up study. The patients were recruited from the Central Hospital of Tai’an and completed the Catquest-8SF questionnaire by face-to-face interviews before and 3mo after surgery at the hospital. RESULTS: A total of 120 cataract patients with median age 67.6y and 52.5% female completed the Catquest-8SF. The Cronbach’s α coefficient of the total scale, daily-activity sub-table and comprehensive-evaluation sub-table were 0.861, 0.853 and 0.748 respectively. There was a high level of consistency between two investigators. The cumulative contribution rate was 66.64% by using the principal component analysis and the maximum variance orthogonal rotation method. The preoperative score of the Catquest-8SF-CN had a significant negative correlation with preoperative binocular mean weighted visual acuity and age (P<0.05), while a significant positive correlation with education level (F=6.094, P<0.001). The patients without systemic comorbidities got higher score than those who with (P<0.05). Three months after surgery, 102 (85%) patients came for follow-up and completed the questionnaire. Significant improvement of visual acuity was observed in both binocular and monocular surgery groups (t=10.404, P<0.001). There was higher improvement in binocular weighted visual acuity of binocular surgery group than in monocular surgery group (t=-20.77, P<0.001). The postoperative score was significantly higher in both groups than before (P<0.001). There was a significant improvement in the total score after cataract surgery. The 94 patients (92.2%) were very satisfied or satisfied with the operation; 92 patients (90.2%) thought the surgery achieved their expectations, and they all felt satisfactory. The degree of satisfaction was significantly correlated with the improvement score of the scale and it was also correlated with their expectation of the surgery. CONCLUSION: The Chinese version of Catquest-8SF questionnaire is suitable for the age-related cataract population in northern China. It is highly responsive to cataract surgery and brief, so it may have the potential to become part of a routine clinical assessment for cataract surgery in China. The patient’s overall satisfaction is high, which illustrates that the medical service we provide matches the patient’s needs. The degree of satisfaction was significantly correlated with the improvement score of the scale and it was also correlated with their expectation of the surgery.


2021 ◽  
Vol 8 ◽  
Author(s):  
Zheng Zhang ◽  
Yue Qi ◽  
Wenbin Wei ◽  
Zi-Bing Jin ◽  
Wen Wang ◽  
...  

Purpose: This work aimed to study the effect of posterior scleral reinforcement (PSR) on choroidal thickness (CT) and blood flow.Methods: This study included 25 eyes of 24 patients with high myopia ( ≤ -6.0 dioptres or axial length ≥ 26.0 mm) who underwent PSR surgery. All patients completed the 1-month follow-up visit. Myopic macular degeneration (MMD) was graded according to the International Meta-Analysis for Pathologic Myopia (META-PM) classification based on color fundus photographs. Swept-source optical coherence tomography angiography (SSOCTA) was performed to investigate CT, choroidal perfusion area (CPA), and choriocapillaris perfusion area (CCPA) change following PSR surgery.Results: The distribution of MMD categories was 9 (36.0%) in category 1, 10 (40.0%) in category 2, and 6 (24.0%) in category 3 or 4. MMD severity was strongly correlated with CT (all P &lt; 0.01) and CPA (all P &lt; 0.04). Postoperative CT at each sector increased significantly at 1 week's follow-up, compared to preoperative measures (all P &lt; 0.05). Postoperative CPA at subfoveal, superior, inferior, and nasal sectors also increased significantly 1 week after PSR surgery (all P &lt; 0.05). Moreover, the increased CT, CPA, and CCPA remain after PSR surgery at 1 month's follow-up, but the difference was not statistically significant.Conclusions: We demonstrated that the CT and choroidal blood flow increased significantly in patients with high myopia who underwent PSR surgery in a short period of time. In addition, the CT and CPA were independently associated with MMD. However, whether the transient improvement of the choroidal circulation could prevent long-term progression of high myopia warrants further study in the future.


2017 ◽  
Vol 6 (2) ◽  
pp. 1546
Author(s):  
Nabil Khzam ◽  
Reza Shah Mansouri ◽  
Alexander Poli ◽  
Mahmoud M. Bakr

Fibrous epulis or peripheral ossifying fibroma is a reactive non-neoplastic condition that affects the gingiva as a result of chronic irritation. A case of a 44 year old female is presented in this study with a gingival swelling related to the maxillary central incisors. The Patient reported a history of trauma ten years ago and a recent root canal treatment of tooth 21, followed by referral to a specialist with a misdiagnosis for a combined periodontic-endodontic lesion affecting the maxillary central incisors. Excisional biopsy of the lesion revealed a diagnosis of ulcerated fibrous epulis with osseous metaplasia also known as peripheral ossifying fibroma. Periodontal debridement was performed to eliminate supra and subgingival plaque and calculus as well as gingival inflammation that could have been the source of irritation. The clinical and histopathological pictures and the surgical procedures associated with management of the periodontal disease are described. The etiological factor behind the development of the gingival reactive lesion remains unknown and could be the history of trauma, the chronic irritation induced by the plaque and calculus associated with the periodontal disease or a combination of both. We endeavour to follow up the case in order to report any recurrence.


2016 ◽  
Vol 4 (1) ◽  
pp. 23
Author(s):  
Pooja Singh ◽  
Manish Jha ◽  
Animesh Mutha ◽  
Kirti Bahar

Developmental dental disorders may be due to anomalies in tooth number, size, shape and structure. Gemination and fusion are anomalies of shape with close similarity but with different etiology. Gemination and fusion are anomalies of shape with close similarity but with different etiology. The etiology of germination is not fully understood environmental factors such as trauma, vitamin deficiencies, systemic diseases and certain genetic predisposition have been suggested as possible causes. A 9 year old male patient reported to the department of pedodontics and preventive dentistry Dr R Ahmed Dental College & Hospital with the chief complaint of unaesthetic upper front teeth on clinical examination. It was found that the upper central incisors were markedly large in size with buccolingual grooves present partially separating two halves of crown. The incisors were caries free and there was no history of pain or any discomfort. Since the roots were not completely formed the patient was kept on follow up for the treatment to be delivered.


Author(s):  
Noviana Kurniasari Vivin ◽  
Ari Djatikusumo ◽  
Elvioza Elvioza ◽  
Gitalisa Andayani ◽  
Anggun Rama Yudantha ◽  
...  

Abstract Background: The incidence of nucleus drop or intraocular lens (IOL) drop as the complication of phacoemulsification increases due to the increased frequency of phacoemulsification. Pars plana vitrectomy (PPV) followed by endofragmentation and secondary IOL implantation is the choice of procedure for management. This study aims to determine the frequency, outcomes, and complication of PPV in the case of nucleus drop or IOL drop in the Department of Ophthalmology, Fakultas Kedokteran Universitas Indonesia – Rumah Sakit Cipto Mangunkusumo (FKUI-RSCM) Methods: This study is a retrospective descriptive study conducted in the Vitreoretinal Division of the Department of Ophthalmology, FKUI - RSCM. Research data was taken from the medical records of all nucleus drop or IOL drop patients underwent PPV in January 2017-December 2017. Results: There were 19 cases studied. The incidence of nucleus drop occurred in phacoemulsification surgery techniques (94.7%) and ECCE techniques (5.3%). Vitrectomy surgery was performed ≤2 weeks in 31.6% and >2 weeks in 68.4% after the patient first arrived at the vitreoretinal clinic. Most pre-PPV visual acuity was 1/60-6/60 (47.1%). In the final follow-up, visual acuity improved from 6/45 to 6/6 occurred in 42.2% of cases. Complication after PPV and secondary IOL implantation include elevated IOP (10.5%), IOL decentration (5.3%), corneal decompensation (5.3%), macular edema (5.3%), and retinal detachment (5.3%). Conclusion: Nucleus drop or IOL drop generally occurs in phacoemulsification cataract surgery techniques. Improved visual acuity was achieved after PPV and secondary IOL implantation at the end of the follow-up period. Most common post-PPV complication is elevated IOP.  


2020 ◽  
pp. 112067212093209 ◽  
Author(s):  
Marco H Ji ◽  
Sayena Jabbehdari ◽  
Natalia F Callaway ◽  
Darius M Moshfeghi

Introduction: Focal choroidal excavation (FCE) is a concavity of the choroid detected on optical coherence tomography (OCT). It is usually idiopathic and the affected eyes are otherwise healthy with near-normal overlying retinal architecture and good visual acuity. Purpose: To report a case of bilateral conforming FCE in the setting of Stargardt disease and inactive ocular toxoplasmosis. Case report: A 20-year-old man with known history of Stargardt disease, healed toxoplasmosis, and high myopia presented to our ophthalmology department for follow-up examination and was found with bilateral FCEs not present in any of his previous examinations. Conclusion: FCEs have been reported in the literature in otherwise healthy eyes as well as a broad spectrum of ocular diseases. The case herein reported Stargardt disease, toxoplasmosis, and high myopia all could potentially contribute to the pathogenesis of these findings. Further studies are needed to define etiologies as well as clinical significance and course of FCEs.


2006 ◽  
Vol 104 (3) ◽  
pp. 436-439 ◽  
Author(s):  
Hugues Duffau ◽  
Michèle Kujas ◽  
Luc Taillandier

✓ Although controversial, episodic nocturnal wandering (ENW) is thought to be a rare and atypical form of nocturnal epilepsy, originating in the frontal lobe and responsive to antiepileptic drugs (AEDs). The authors report the case of a patient harboring a right temporoinsular low-grade glioma, who presented with a 3-year history of agitated somnambulent episodes resistant to AEDs. Interestingly, the ENW totally resolved after tumor resection and the patient reported no recurrence during a follow-up period of 4.5 years. To the authors’ knowledge, this is the first report of ENW due to a glioma; the findings support the theory that ENW may represent an unusual type of lesional epilepsy that is surgically correctable. Moreover, a temporoinsular origin of ENW can now be considered.


2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Jin A Choi ◽  
Sung Kun Chung

Postoperative endophthalmitis is a rare clinical occurrence. However, it remains one of the most serious complications following cataract surgery because of its poor prognosis. We investigated the epidemiologic trends in postoperative endophthalmitis following cataract surgery, particularly in Asian populations. The incidence of postcataract endophthalmitis was generally consistent with epidemiologic data reported from Caucasian populations. The most frequently occurring causative organism was coagulase-negative Staphylococci in most studies of Asian populations. However, Pseudomonas aeruginosa and Nocardia were found to be the most common microorganisms in several studies. The rates of culture positivity were slightly lower than in Caucasian studies. In the evaluation of risk factors of poor visual outcomes, initial visual acuity and virulence of the causative microorganisms were generally found to be the most important risk factors. A history of pars plana vitrectomy was found to be the major risk factors for developing endophthalmitis in several studies.


2014 ◽  
Vol 8 (1) ◽  
pp. 48-50 ◽  
Author(s):  
Bolaños-Jiménez Rodrigo ◽  
López-Lizárraga E Paulina ◽  
March de R Francesc ◽  
Telich-Tarriba J Eduardo ◽  
Navas Alejandro

Purpose : Ectopia lentis (EL) is a major criteria for the diagnosis of Marfan syndrome, it may vary from an asymptomatic mild displacement to a significant subluxation that places the equator of the lens in the pupillary axis. The purpose of this work is to present the case of a patient with Marfan syndrome who received treatment for subluxation at our institution. Case Report : A 51-year-old female diagnosed with Marfan syndrome presented to the emergency department with bilateral eye redness, foreign body sensation and crusting around the eyes on awakening. She had the following history of cardiac and ophthalmologic complications, including: 1. Lens subluxation 2. High myopia 3. Aortic root dilation, 4. Mitral valve prolapse and 5. Tricuspid insufficiency. Conclusion : The ophthalmological management of Marfan patients is challenging and periodical follow-up is needed. Surgical versus conservative management is controversial, each case needs to be evaluated individually to analyze the risks and benefits of the procedures.


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