Should Unilateral Congenital Corneal Opacities in Peters’ Anomaly be Grafted?

2011 ◽  
Vol 21 (6) ◽  
pp. 695-699 ◽  
Author(s):  
Chrysanthi Basdekidou ◽  
Pascal Dureau ◽  
Catherine Edelson ◽  
Patrice De Laage De Meux ◽  
Georges Caputo
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Axial Length ◽  
Corneal Opacity ◽  
Late Complications ◽  
Posterior Segment ◽  
Time Of Surgery ◽  
Peters Anomaly ◽  
Corneal Opacities

Purpose. To evaluate the surgical outcomes and visual results after penetrating keratoplasty for congenital unilateral corneal opacities in Peters anomaly. Methods. This was a retrospective study of 14 children who underwent keratoplasty for a unilateral Peters anomaly between 1999 and 2009. All patients received a topical treatment of cyclosporine and corticosteroids. Suture ablation was performed between the first and second postoperative month and all patients had spectacle correction and amblyopia treatment. Age at time of surgery, posterior segment status evaluated by ultrasonography, axial length, preoperative intraocular pressure, fellow eye status, mean follow-up time, early and late complications, final graft outcome, refraction, and visual acuity upon the last visit were noted. Results. Mean age at the time of surgery was 9 months. Posterior segment was normal in all cases. Mean axial length was 18 mm and mean intraocular pressure was 11 mmHg. Mean follow-up was 30 months. Four children had graft rejection episodes, 2 of which responded to medication. Four underwent cataract surgery, one developed pupil deformation requiring a pupilloplasty and 2 cases were complicated by surgical glaucoma. A total of 11 eyes (78.6%) had clear grafts at the end of the follow-up. Mean spherical equivalent was −1.5 D. Visual acuity was measurable in 3 cases and was 20/50 in one case, 20/63 in the second, and 20/2000 in the third. Concerning preverbal children, central, steady, and maintained fixation was found in 8 cases. Conclusions. Operating on a unilateral congenital corneal opacity is a challenging decision and should be taken after explaining the need for long-term follow-up to the parents. Useful vision can be achieved and maintained after strict amblyopia therapy. A multidisciplinary ophthalmologic follow-up is necessary.

scholarly journals EFFICACY OF INTRAVITREAL TRIAMCINOLONE ACETONIDE FOR DIABETIC MACULAR EDEMA

2016 ◽  
Vol 3 (2) ◽  
pp. 30-34
Author(s):  
Prachand Gautam ◽  
Koshal Shrestha ◽  
Gyanendra Lamichhane ◽  
Sushila Patel
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Diabetic Macular Edema ◽  
Intravitreal Triamcinolone ◽  
Hard Exudates ◽  
Intravitreal Triamcinolone Acetonide ◽  
Diffuse Diabetic Macular Edema

INTRODUCTION: Diabetic retionopathy is a microangilpathy. The present study was done to investigate results of Intravitreal Triamcinolone Acetonide injection for the treatment diffuse diabetic macular edema. MATERIAL AND METHODS: The study included 40 eyes of 40 patients with clinically significant diffuse diabetic macular edema. Eyes were diagnosed with diabetic macular edema according to Early Treatment Diabetic Retinopathy Study guidelines. An Intravitreal injection of Triamcinolone Acetonide at the dose of 4 mg/0.2 ml was administered. Best corrected visual acuity was measured as the logarithm of the minimum angle of resolution (logMAR) and snellen vision drum and size of macular edema (hard exudates) was obtained by slit lamp biomicroscopy using +90 D Volk lens at each visit. Intraocular pressure (IOP) and other complications related with steroid and injection related complications were also evaluated. Subsequently patients were followed up on 1st day, 2nd week and 3rd month. RESULTS: All patients were completed second follow up at 3 months. The mean size of macular edema, which obtained at 3 months postoperatively, was significantly different from the baseline measurement from 1.4125 to 0.9474 DD. Mean visual acuity improved significantly from baseline at 3 months of follow up was 0.7421 LogMAR (≈ 6/30 in Snellen chart). Eleven eyes developed intraocular pressure higher than 21 mmHg at 2nd week postoperatively. Other drug and injection related complications were not developed. Increased IOP were controlled with anti glaucoma drugs. CONCLUSIONS: Intravitreal Triamcinolone was a promising therapeutic method for diabetic macular edema. TriamcinoloneAcetonide effectively reduces size of macular edema and improves visual acuity in the short term.Journal of Universal College of Medical Sciences (2015) Vol.03 No.02 Issue 10 Page: 30-34

scholarly journals Aphakia Correction by Injection of Foldable Intra Ocular Lens in the Anterior Chamber

2013 ◽  
Vol 5 ◽  
pp. OED.S12672
Author(s):  
Kagmeni Giles ◽  
Moukouri Ernest ◽  
Domngang Christelle ◽  
Nguefack-Tsague Georges ◽  
Cheuteu Raoul ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Teaching Hospital ◽  
Case Series ◽  
University Teaching ◽  
Case Series Study ◽  
The Mean ◽  
The University

We assessed the outcomes of the use of anterior chamber foldable lens for unilateral aphakia correction at the University Teaching Hospital of Yaounde. In this retrospective, non-comparative, consecutive case series study, we reviewed the records of patients who underwent an operation for aphakia correction by the means of injection of an angular supported foldable lens between January 2009 and December 2011 in the University Teaching Hospital Yaounde. Student's paired t-test was carried out to compare preoperative and postoperative visual acuity (VA) and intraocular pressure (TOP). P-values less than 0.05 were considered statistically significant. Twenty-one patients were included in the study; twelve were male (57.1%) and nine were female (42.9%). The mean age was 55.38 ± 17.67 years (range 9–75 years). The mean follow-up duration was 5.95 ± 3.14 months (range 2–12 months). The mean logMAR visual acuity was 1.26 ± 0.46 pre-operatively and 0.78 ± 0.57 post-operatively ( P = 0.003). The change in intraocular pressure was not statistically significant. Complications included intraocular hypertension (over 21 mmHg) in 3 patients (14.3%) and macular edema, pupillar ovalization, and retinal detachment in one patient each. The results indicate that injection of an angular support foldable lens in the anterior chamber is a useful technique for the correction of aphakia in eyes without capsular support. More extended follow-up, however, and a larger series of patients are needed to ascertain the effectiveness and safety of this procedure.

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.

Cataract extraction in patients with primary congenital glaucoma

2019 ◽  
Vol 30 (3) ◽  
pp. 525-532
Author(s):  
Laura Morales-Fernández ◽  
José María Martínez-de-la-Casa ◽  
Blanca Benito-Pascual ◽  
Federico Saénz-Francés ◽  
Enrique Santos-Bueso ◽  
...  
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Intraocular Pressure ◽  
Cataract Extraction ◽  
Hazard Ratio ◽  
High Rate ◽  
Congenital Glaucoma ◽  
Primary Congenital Glaucoma ◽  
Corneal Decompensation

Objective: To assess incidence and risk factors of cataract extraction in patients with primary congenital glaucoma, surgical outcome, and complications. Material and method: Retrospective cohort study, in which 108 patients with primary congenital glaucoma were included. Data collected were need for cataract extraction and at what age, intraocular pressure at diagnosis of primary congenital glaucoma, required antiglaucomatous surgeries, possible mutation in the CYP1B1 gene, and final visual acuity. Among the patients who required cataract extraction were visual acuity, intraocular pressure, and complications, evaluated preoperatively and postoperatively. The data were analysed with STATA. Results: A total of 198 eyes of 108 patients were included, with a median follow-up of 8 years (range: 5–53). In all, 32 eyes (16.2%) of 24 patients (22%) required cataract extraction. The median age for cataract extraction was 12.94 years (interquartile range: 2.42–22). The main identified risk factors associated with cataract extraction were antiglaucomatous surgeries (hazard ratio 1.48, p < 0.001) and valvular implant (hazard ratio 2.78, p < 0.001). Lens was implanted in 30/32 eyes and the main complications were intraocular pressure decontrol ( n = 13), capsular fibrosis ( n = 7), corneal decompensation ( n = 4), lens subluxation ( n = 4), and endophthalmitis ( n = 1). Visual acuity improvement was observed after cataract extraction in 66.67% of eyes. Conclusions: There is a high incidence of cataract surgery in patients with primary congenital glaucoma, but generally outside of pediatric age. A greater risk of cataract extraction was identified in those patients with a greater number of antiglaucomatous surgeries, especially after valvular implantation. Despite the high rate of complications related to cataract extraction in primary congenital glaucoma, good visual improvement was observed after surgery.

Examining the effect and safety of orthokeratology in controlling the development of myopia: Based on fluorosilicone acrylic breathable material

2020 ◽  
Vol 10 (5) ◽  
pp. 740-747
Author(s):  
Yanxia Song ◽  
Haixia Tian ◽  
Suling Yang ◽  
Feifan Du ◽  
Huihui Sun ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Axial Length ◽  
Corneal Endothelium ◽  
Clinical Effect ◽  
Naked Eye ◽  
Corrected Visual Acuity ◽  
Significant Difference ◽  
Before And After

We aimed to evaluate the clinical effect and safety of orthokeratology in controlling the development of myopia. We assessed the changes in visual acuity, diopter change, axial length, corneal endothelium count, intraocular pressure, and corneal Q value in 30 adolescents with 60 years of wearing an orthokeratology lens. In this study, no significant difference was observed between the naked eye vision and corrected visual acuity before wearing the lens (t = –0.23, P = 0.59); furthermore, no significant difference was observed in diopter, axial length, corneal endothelium count, and intraocular pressure 1 year before and after wearing the lens (t = 1.24, P = 0.45; t = –0.89, P = 0.25; t = –0.43, P = 0.57; t = 1.43, P = 0.61); by contrast, there was a significant difference in the corneal Q value before and after wearing the lens (t = –8.37, P = 0.001). These results suggest that the fluorosilicone acrylic breathable material corneal orthopedic lens is safe and effective in controlling myopia, and has little effect on the physiology of the eye.

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.

scholarly journals Case Report of Myopia Correction by ReLEx SMILE in a Patient with Superficial Corneal Opacity

2020 ◽  
Vol 17 (2) ◽  
pp. 295-299
Author(s):  
N. V. Maychuk ◽  
I. A. Mushkova ◽  
A. M. Mayorova ◽  
A. A. Shpak
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Anterior Segment ◽  
Corneal Opacity ◽  
Optical Center ◽  
Interface Zone ◽  
Uncorrected Visual Acuity ◽  
Corneal Opacities ◽  
Different Depths ◽  
The Right

Introduction. Reduced corneal transparency leads to dissipation of energy of the femtosecond laser (FSL), which may complicate the formation of the intrastromal incision and limits the use of FSL in eyes with corneal opacities and scars. The purpose of this work is to demonstrate the possibility of successful ReLEx SMILE in a patient with superficial corneal opacity located in the paracentral zone. Case report. Patient R., 29 years old, complained of decreased vision in both eyes since childhood. Visual acuity OD = 0.1 sph –2.75D = 1.0; OS = 0.1 sph –3.50 D cyl –0.75D ax 165° = 1.0. Biomicroscopy of the right eye visualized a superficial semi-transparent corneal opacity of 5 x 3 mm located at 5.30–6 hours at a distance of 1.3 mm from the optical center. According to the anterior segment optical coherence tomography (AS-OCT) the depth of the opacity was 73–78 microns and was limited by the Bowman’s membrane. ReLEx SMILE for myopia correction was performed on both eyes with 6.7 mm lenticule diameter at a depth of 120 µm, which covered the opacity area by 1.1 mm. The surgery was standard and uncomplicated. Seven days postoperatively the patient did not complain. Uncorrected visual acuity (UCVA) was 1.0 for both eyes (and binocularly it was 1.2). According to the AS-OCT data, a hyperreflective line of the interface zone was visualized on the right eye at the depth of 141–147 µm; the opacified superficial corneal layers were detected in the lower paracental zone over the interface line. In one month after the surgery the visual acuity did not change: UCVA = 1.0 in both eyes (binocularly 1.2). Conclusion. ReLEx SMILE technology can be considered as one of the options for myopia correction in patients with superficial corneal opacity located in the paracental zone. More observations are required to evaluate the effectiveness of this technology on corneas with paracentral opacities different in sizes and located at different depths.

scholarly journals Dexamethasone intravitreal implant for macular edema: a pilot study in a public health center

2020 ◽  
Vol 45 (Suppl.3) ◽  
pp. e020104
Author(s):  
Maria Júlia Izzo Crespo ◽  
Cristina Nery Carbajo ◽  
Glaucia Luciano da Veiga ◽  
Fernando Luiz Affonso Fonseca ◽  
Vagner Loduca Lima ◽  
...  
Keyword(s):  
Public Health ◽  
Visual Acuity ◽  
Intraocular Pressure ◽  
Macular Edema ◽  
Vision Loss ◽  
Therapeutic Option ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Cross Sectional

Introduction: Macula edema consists in one of the most common causes of visual impairment. Objective: To evaluate the safety and efficacy of continuous release of 0.7 mg dexamethasone (using implantable device) for treatment of macular edema. Methods: Cross-sectional observational study of 16 patients treated with 0.7 mg dexamethasone intraocular implant. Visual acuity, intraocular pressure and central macular thickness were recorded at baseline, 1-month and 3-month follow-up. Results: 15 eyes of 13 patients were included. Most eyes (n=9) improve visual acuity from baseline at 1-month follow-up; this improvement persisted through 3-monyh follow-up in six eyes. The central macular thickness decreased in the majority of the subjects at 1-month (n=12) and at 3-month (n=10) follow-up. Three eyes presented with elevated intraocular pressure. Conclusion: Dexamethasone implant can both reduce the risk of vision loss and improve anatomical features of macular edema due to several pathologies studied. This implant may be used safely and should be considered a therapeutic option to Brazilian Public Health System.

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 Comparison of Phacotrabeculectomy and Phacotrabeculectomy with Subconjunctival 5-Fluorouracil

2014 ◽  
Vol 52 (196) ◽  
pp. 1010-1013
Author(s):  
Nanda Kumari Gurung ◽  
Prachand Gautam ◽  
Shanti Gurung ◽  
Binita Bhattarai
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Statistical Difference ◽  
Surgical Techniques ◽  
Significant Statistical Difference ◽  
Keywords Glaucoma ◽  
Group A ◽  
Group B ◽  
Age Range

Introduction: Glaucoma is the second leading cause of blindness worldwide. Phacotrabeculectomyis a technique in which glaucoma and cataract surgery performed. Methods: Prospective study was carried out in the department of glaucoma at Lumbini Eye Institute, Bhairahawa.100 patients who underwent phacotrabeculectomy within a period of two years. Patients were divided into two groups those who received 5FU (n=47) and no antifibrotic agent (n= 53). Results: The age range was from 38 to 80 years; mean age of 62.97±9.14 SD. 55% were male and 45% were female.The postoperative IOP reduction in last follow- up group A was mean=13.08±1.57SD and mean=13.23±1.73SD in group B. This was statically significant with P <0.001. Bleb survival was almost similar in two groups 3.17(78.31%) in group A and 3.20 (78.93%) in group B. 85% visual acuity was improved in both groups. Conclusions: Phacotrabeculectomy and phacotrabeculectomy with inj. 5FU, both were equally effective surgical techniques in terms of visual acuity, IOP control and bleb survival.There was no significant statistical difference vis-à-vis the success of Phacotrabeculectomy using of either these two techniques.  Keywords: glaucoma; 5FU; intraocular pressure; phacotrabeculectomy.

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