Iontophoretic Dexamethasone Phosphate Compared to Topical Prednisolone Acetate 1% for Noninfectious Anterior Segment Uveitis

2020 ◽  
Vol 211 ◽  
pp. 76-86
Author(s):  
John Sheppard ◽  
Sunir Garg ◽  
Christopher Lievens ◽  
Lisa Brandano ◽  
Barbara Wirostko ◽  
...  
Keyword(s):  
Anterior Segment ◽  
Prednisolone Acetate ◽  
Dexamethasone Phosphate

Management of Surgical Complications

Glaucoma ◽  
2012 ◽  
Author(s):  
Thomas Patrianakos
Keyword(s):  
Anterior Segment ◽  
Ultrasound Biomicroscopy ◽  
Risk Profile ◽  
Prednisolone Acetate ◽  
Common Complication ◽  
Glaucoma Filtration Surgery ◽  
Glaucoma Drainage Devices ◽  
Tuberculin Syringe ◽  
Bleb Failure

•Glaucoma filtration surgery (GFS) has been associated with higher long-term failure rates and a substantially higher risk profile than most other ophthalmic surgeries. •Identifying and properly managing complications associated with GFS is essential in ensuring the best possible outcome. •Infection is a devastating complication of GFS that must be considered in a separate category (please see Chapter 7 for blebitis and bleb-related endophthalmitis). •Complications unique to glaucoma drainage devices (GDD; see Chapter 12) will be discussed at the end of the chapter. •One simple way to diagnose a complication resulting from GFS is to subcategorize possibilities according to the IOP and anterior chamber (AC) depth. •Table 13.1 shows the four potential outcomes after GFS, and the text below provides additional details about each potential complication. •Usually occurs in the first few months after surgery. •The most common complication of trabeculectomy. •Due to progressive episcleral fibrosis and blockage under the scleral flap. •Incidence has decreased due to intraoperative use of antifibrotics. •Bleb appears constricted, shallow, or flat with increased vascularity and loss of microcysts. •Negative Seidel test. •Gonioscopy reveals an open sclerostomy site, which is essential to differentiate from an inadequate fistula or fistula blockage from iris, blood, fibrin, or vitreous. •Anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) may reveal adherence of Tenon’s capsule and conjunctiva to underlying sclera. •Approached in a stepwise fashion. • Decreases rate of episcleral fibrosis in hopes of rescuing the function of the bleb.•Prednisolone acetate 1% every 2 hours for first 1 to 2 weeks, then taper slowly over 2 to 3 months. •Administered if early signs of bleb failure/episcleral fibrosis are present. •Technique •Instill topical anesthesia followed by direct application of a cottontipped pledget approximately 90 to 180 degrees away from the bleb. •Use a 30-gauge needle on a tuberculin syringe to inject 5 mg (0.1 cc) of undiluted 5-fluorouracil (5-FU; available in a concentration of 50 ug/mL) under the conjunctiva at the anesthetized site. •Avoid areas of bleb elevation and areas that show increased conjunctival vascularity.

scholarly journals Bilateral Severe Sterile Inflammation with Hypopyon after Simultaneous Intravitreal Triamcinolone Acetonide and Aflibercept Injection in a Patient with Bilateral Marked Rubeosis Associated with Ocular Ischemic Syndrome

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Ceren Durmaz Engin ◽  
Ziya Ayhan ◽  
Süleyman Men ◽  
Aylin Yaman ◽  
A. Osman Saatci
Keyword(s):  
Cataract Surgery ◽  
Triamcinolone Acetonide ◽  
Anterior Segment ◽  
Visual Outcome ◽  
Sterile Inflammation ◽  
Prednisolone Acetate ◽  
Intravitreal Triamcinolone ◽  
Ocular Ischemic Syndrome ◽  
The Right ◽  
Ischemic Syndrome

We report the clinical course of a diabetic patient with bilateral cataract and rubeosis in association with ocular ischemic syndrome and initially treated him with simultaneous intravitreal 2 mg aflibercept and 2 mg triamcinolone acetonide injection at the same setting prior to planned cataract surgery and further photocoagulation. However, sterile anterior segment inflammation characterized by hypopyon occurred four days apart in OU. Right eye developed the sterile inflammation at the third postinjection day and the left eye developed the sterile inflammation at the seventh postinjection day (two days after the uneventful cataract surgery with intraocular lens implantation) without any pain or significant redness. Vitreous biopsy taken during the right phacovitrectomy was negative for any microbial contamination. Both eyes were treated successfully with intensive topical prednisolone acetate with a relatively good visual outcome. It is likely that underlying ocular ischemic syndrome might have facilitated the formation of sterile inflammation as blood-aqueous barrier disruption and flare have already been present.

Video Atlas of Anterior Segment Repair and Reconstruction

2019 ◽  
Author(s):  
Amar Agarwal ◽  
Ashar Agarwal ◽  
Ashvin Agarwal ◽  
Athiya Agarwal ◽  
Sreelakshmi P. Amar ◽  
...  
Keyword(s):  
Anterior Segment

Outcome of Buccal Mucosal Graft Urethroplasty in Long Segment Anterior Urethral Stricture

2020 ◽  
Vol 19 (2) ◽  
pp. 64-68
Author(s):  
Mrinmoy Biswas ◽  
Sudip Das Gupta ◽  
Mohammed Mizanur Rahman ◽  
Sharif Mohammad Wasimuddin
Keyword(s):  
Urethral Stricture ◽  
Flow Rate ◽  
Surgical Outcome ◽  
Simple Technique ◽  
Anterior Segment ◽  
Maximum Flow ◽  
Anastomotic Site ◽  
Buccal Mucosal Graft ◽  
Male Patients

Objective: To assess the success of BMG urethroplasty in long segment anterior urethral stricture. Method: From January 2014 to December 2015, twenty male patients with long anterior segment urethral stricture were managed by BMG urethroplasty. After voiding trial they were followed up at 3 month with Uroflowmetry, RGU & MCU and PVR measurement by USG. Patients were further followed up with Uroflowmetry and PVR at 6 months interval.Successful outcome was defined as normal voiding with a maximum flow rate >15ml /sec and PVR<50 ml with consideration of maximum one attempt of OIU after catheter removal. Results: Mean stricture length was 5.2 cm (range 3-9 cm) and mean follow-up was 15.55 months (range 6-23 months). Only two patients developed stricture at proximal anastomotic site during follow-up. One of them voided normally after single attempt of OIU. Other one required second attempt of OIU and was considered as failure (5%). Conclusion: BMG urethroplasty is a simple technique with good surgical outcome. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.64-68

ÜBER DIE ANTAGONISTISCHE WIRKUNG VON TRIJODTHYRONIN UND PROGESTERON AUF DEN PREDNISOLONEFFEKT AM EPIPHYSENKNORPEL (PRÜFUNG DER REISSFESTIGKEIT)

1963 ◽  
Vol 42 (1) ◽  
pp. 29-38 ◽  
Author(s):  
L. Ther ◽  
H. Schramm ◽  
G. Vogel
Keyword(s):  
Tensile Strength ◽  
Dose Response ◽  
Single Injection ◽  
Relative Effectiveness ◽  
Prednisolone Acetate ◽  
Response Curves ◽  
Deoxycorticosterone Acetate ◽  
Weight Range ◽  
Diuretic Action ◽  
Maximal Load

ABSTRACT Longitudinal tension exerted on a killed rat's femur results always in rupture on the same place viz: the distal epiphyseal line. The power required to produce this effect can be measured with a simple dynamometer. The tensile strength increases with advancing age and during exsiccation (thirst). In untreated rats (weight range 100–120 g) this value amounts to about 1.5–1.8 kg. Tensile strength of the femoral epiphyseal line may be influenced by hormones. Corticosteroids such as prednisolone acetate and cortisol acetate increase the level of maximal load to more than 2.0 kg. In general the effect of a single injection reaches a climax after 48 hours. Dose-response-curves can be established and relative effectiveness may be gathered therefrom. Deoxycorticosterone acetate likewise increases tensile strength in spite of the fact that contrary to prednisolone exhibiting diuretic action this compound has a water retaining effect. Triiodothyronine and progesterone when given alone produce a slight decrease in tensile strength. The effect of prednisolone when given simultaneously with one of these two compounds is antagonized: this phenomenon is more pronounced in the case of triiodothyronine.

Pediatric Free-floating Anterior Chamber Cyst of the Iris Pigment Epithelium

2018 ◽  
Vol 1 ◽  
pp. 3
Author(s):  
Joshua S Agranat ◽  
Yoshihiro Yonekawa
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Chamber ◽  
Incidental Finding ◽  
Pigment Epithelium ◽  
Anterior Segment ◽  
Ultrasound Biomicroscopy ◽  
Optical Coherence ◽  
Visual Axis ◽  
Associated Malignancy ◽  
Anatomic Locations

Iris pigment epithelial (IPE) cysts are a subset of iris cysts that arise from the IPE. They are spontaneously erupting epithelial-lined cavities that are found in various anatomic locations of the iris, including the iris pupillary margin, midzone, periphery, and free floating in the vitreous or anterior chamber. We report the case of an asymptomatic 13-year-old boy with an incidental finding of a dislodged anterior chamber cyst diagnosed on routine examination. Modern multimodal image analysis of the cyst including anterior segment optical coherence tomography and ultrasound biomicroscopy (UBM) was utilized to characterize the microstructural anatomy of the lesion. The patient was managed conservatively without complications. Cysts of the IPE typically do not affect vision or ocular health and can be monitored and observed after ascertaining no associated malignancy. Initial diagnostic investigation can include UBM and anterior segment optical coherence tomography. Intervention should be reserved only for cases where the cyst growth leads to obstruction of the visual axis and/or other secondary complications.

The effect of PRK on corneal epithelium thickness and pachmetry in treatment of myopia.

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Furkaan Majied Hamied ◽  
Deyaa Neama Kadhim ◽  
Sohaib A Mahmood
Keyword(s):  
Refractive Error ◽  
Anterior Segment ◽  
Thickness Change ◽  
Corneal Epithelial ◽  
Epithelial Thickness ◽  
Refractive Outcomes ◽  
Epithelium Thickness ◽  
Profile Changes ◽  
Corneal Epithelial Thickness ◽  
Myopic Astigmatism

In order to facilitate the corneal stromal ablation in photorefractive keratectomy the epithelium is removed so corneal repair associated with changes in epithelium and stroma. To study the corneal epithelial thickness and pachymetry profile changes after photorefractive keratec­tomy (PRK) for myopia. Retrospective analysis of the postoperative corneal epithelial thickness and pachymetry profile changes in 22 eyes of 12 patients treated with PRK for myopia or myopic astigmatism. Corneal and epithelial thickness maps within the central 6 mm were obtained by anterior segment spectral-domain optical coherence tomography (SD-OCT) preop­eratively and at 3 months postoperatively. Correlations between pachymetry,epithelial thickness changes and the amount of correction,were analyzed.Compared to preoperative values,the central 2 mm and the paracentral 2 to 5 mm zone epithelium was 1 ± 2.85 and 1 ± 3.11 μm thicker,respec­tively,at 3 months postoperatively (P <.05). The spheri­cal equivalent (SE) changed from-2.80 ± 2.028 diop­ters (D) preoperatively to -0.40 ± 0.42 D at 3 months postoperatively. Females show greater postoperative epithelial thickening, 2.6 ± 3.77 μm,than males,0.34 ± 1.98 μm. There was a trend toward greater epithelial thickening with a larger amount of programmed SE correction, and thinner preoperative epithelium. No correlation between epithelial thickness change and postoperative change in refraction was detected.Negative correlation between between age, refractive error,with the pre and post-operative pachymetry. In general female pachymetry reading is higher than it in male.The corneal epithelial thickness in­creased after PRK up to 3 months postoperatively. It was affected by the amount of myopia treated, gender, and preoperative epithelial thickness. The refractive outcomes did not affected by the postoperative epithelial thickening. Negative correlation between between age, refractive error, with the pre and post-operative pachymetry. In general female pachymetry reading is higher than it in male.

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