Comparison of effectiveness and complications in trabeculotomy with phacoemulsification between ab externo and ab interno using a spatula-shaped microhook

AbstractTo compare the short-term surgical effectiveness and safety profile of trabeculotomy ab externo and ab interno with microhook in terms of the recovery of visual acuity. A retrospective chart review was performed on patients who underwent trabeculotomy combined with phacoemulsification and lens implantation at Asahi General Hospital, with 6 months of follow-up. The patients treated by trabeculotomy were classified into two groups depending on the surgical procedures: ab interno with Tanito microhook (TMH) and ab externo with rigid probe trabeculotome (LOT). The demographics, preoperative and postoperative intraocular pressure (IOP), number of medications (Med), best-corrected visual acuity (BCVA), surgical-induced astigmatism (SIA), and postoperative complications were analyzed at pre-operation, and 1 week and 1–6 months post-operation. Fifty-two eyes of 38 Japanese patients underwent TMH and 42 eyes of 32 patients underwent LOT. The decreases in IOP and Med from the baseline were significant at all time points in both groups (p < 0.001), but there were no significant differences between the two groups. BCVA improved significantly in TMH and LOT after the operation (p < 0.001). BCVA and SIA significantly improved, mostly at 1 week in TMH, compared with LOT (p = 0.02 and 0.003). Hyphema and IOP spike exceeding 30 mmHg (spike) occurred in 11% and 6% of participants in TMH, and 33% and 26% of participants in LOT, respectively. Hyphema and IOP spike occurred more frequently in the LOT than in the TMH group (p = 0.01 and 0.005). Ab interno trabeculotomy showed similar IOP-lowering effects as ab externo, but had less postoperative complications.

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The effects of antithrombotic therapy in ab interno trabeculotomy with a spatula-shaped microhook

PLoS ONE ◽

10.1371/journal.pone.0262548 ◽

2022 ◽

Vol 17 (1) ◽

pp. e0262548

Author(s):

Satoru Kanda ◽

Takashi Fujishiro ◽

Takashi Omoto ◽

Ryosuke Fujino ◽

Kiyoshi Ishii ◽

...

Keyword(s):

Postoperative Complications ◽

Antithrombotic Therapy ◽

Retrospective Chart Review ◽

Japanese Patients ◽

University Hospital ◽

Perioperative Phase ◽

Medication Score ◽

Number Of Patients ◽

Ab Interno

To evaluate the effects of the discontinuation of antithrombotic drugs on intraocular pressure (IOP) reduction and complications from ab interno trabeculotomy for patients with glaucoma. We performed a retrospective chart review on the data of patients treated with antithrombotic agents who have undergone ab interno trabeculotomy through Tanito microhook combined with cataract surgery at the Asahi General Hospital and the Tokyo University Hospital, with 6 months of follow-up. The patients were classified into two groups depending on whether they discontinued (AT-) or continued (AT+) antithrombotic therapy during the perioperative phase. The demographics, pre- and postoperative IOP, medication score, best-corrected visual acuity (BCVA), and postoperative complications were analyzed preoperatively and postoperatively at 1 week and 1–6 months. The series included 44 eyes from 44 Japanese patients. The AT- and AT+ groups included 21 eyes from 21 patients and 23 eyes from 23 patients, respectively. The decrease in IOP from the baseline at 1 week postoperative was significantly different between the two groups (p = 0.009), but there were no significant differences observed in the other visits. Hyphema and IOP spikes exceeding 30 mmHg occurred in 10% and 10% of AT- participants, and in 43% and 26% of AT+ participants, respectively. Hyphema and spikes with hyphema occurred more frequently in the AT+ than in the AT- group (p = 0.02 and p = 0.05). The number of patients who had spikes was not significantly different (p = 0.27). In trabeculotomy using the Tanito microhook®, discontinuing antithrombotic therapy had better IOP-lowering effects and less postoperative complications.

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Epiretinal Membrane Peeling in Patients With Good Preoperative Vision

Journal of VitreoRetinal Diseases ◽

10.1177/2474126416680669 ◽

2017 ◽

Vol 1 (1) ◽

pp. 52-56 ◽

Cited By ~ 2

Author(s):

Nicholas D. Chinskey ◽

Gaurav K. Shah

Keyword(s):

Visual Acuity ◽

Epiretinal Membrane ◽

Chart Review ◽

Vitreous Hemorrhage ◽

Retrospective Chart Review ◽

Corrected Visual Acuity ◽

Additional Procedure ◽

Pars Plana ◽

Baseline Visual Acuity

Objective: To evaluate the outcomes of patients undergoing removal of an epiretinal membrane (ERM) with good starting visual acuity. Design: Retrospective chart review. Participants: Forty eyes of 40 patients seen at a tertiary, referral-based private practice. Methods: All patients undergoing pars plana vitrectomy with removal of an ERM by a single surgeon (G.K.S.) from the years 2012 to 2014 were evaluated. Patients who were phakic, had a baseline visual acuity of 20/50 or worse, and those who had surgery less than 6 months prior to data collection were excluded. Results: Of the 40 patients included, only 2 (5%) developed a serious postoperative complication. One had a vitreous hemorrhage that cleared without further surgical intervention, and another developed a macula on retinal detachment that required 1 additional procedure. Nineteen (47.5%) had improved best-corrected visual acuity (BCVA), 10 (25%) maintained their initial BCVA, 7 (17.5%) lost 1 to 2 lines, and 4 (10%) lost 3 lines or greater at their last follow-up visit. When looking only at idiopathic ERMs in the group, the results were similar with 48% with improved vision, 29% maintained the initial BCVA, 16% lost 1 to 2 lines, and 6% lost 3 lines or greater. Discussion: Surgery to remove an ERM is a reasonable option for those with significant metamorphopsia and highly symptomatic blurring of central vision, even with good baseline visual acuity.

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Characteristics And Outcomes of Perforating Trauma With Intraorbital Foreign Body

10.21203/rs.2.13519/v2 ◽

2020 ◽

Author(s):

Hui Ren ◽

Xiaobing Hu ◽

Min Zhou ◽

Yongheng Huang ◽

Diwen Guo ◽

...

Keyword(s):

Visual Acuity ◽

Foreign Body ◽

Chart Review ◽

Ocular Trauma ◽

Retrospective Chart Review ◽

Light Perception ◽

Orbital Surgery ◽

Ocular Trauma Score ◽

Trauma Score

Abstract Background: To evaluate the characteristics and outcomes of patients with perforating trauma with intraorbital foreign body (IOrbFb). Methods: Retrospective chart review of 31 consecutive patients with perforating trauma and IOrbFb treated in Eye and ENT Hospital of Fudan University from 2014 to 2018. Results: 30 (96.8%) patients were male and 1 (3.2%) was female. The ocular trauma score (OTS) was 1 in 18 (58.1%) patients, 2 in 8 (25.8%) patients and 3 in 5 (16.1%) patients. At the time of the last follow-up, the visual acuity was 20/40 or better in 3 (9.7%) patients, between 20/50-20/200 in 6 (19.4%) patients, between 20/200 or worse in 6 (19.4%) patients, no light perception 16 (51.6%) patients and 14 (45.2%) patients underwent evisceration/enucleation. Conclusions: The visual prognosis of perforating trauma with IOrbFb is closely related to OTS. Removal of IOrbFbs is safe with current orbital surgery techniques.

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Late endoscopic evaluation of the ostium size after external dacryocystorhinostomy

European Journal of Ophthalmology ◽

10.1177/1120672120976044 ◽

2020 ◽

pp. 112067212097604

Author(s):

Reem R Al Huthail ◽

Yasser H Al-Faky

Keyword(s):

Chart Review ◽

Retrospective Chart Review ◽

Tertiary Hospital ◽

Nasal Endoscope ◽

Long Term Follow Up ◽

Mean Size ◽

External Dacryocystorhinostomy ◽

The Mean

Objective: To evaluate the effect of chronicity on the size of the ostium after external dacryocystorhinostomy (DCR) with intubation. Methods: Design: A retrospective chart review of patients who underwent external DCR with intubation over 10 years from January 2003 at a tertiary hospital. All patients were recruited and examined with rigid nasal endoscope. Results: A total number of 66 (85 eyes) patients were included. The mean age at the time of evaluation was 53.1 years with gender distribution of 54 females (81.8 %). The mean duration ±SD between the date of surgery and the date of evaluation was 33.2 ± 33.6 (6–118 months). Our study showed an overall anatomical and functional success of 98.8% and 95.3%, respectively. The mean size of the ostium (±SD) was 23.0 (±15.7) mm2 (ranging from 1 to 80.4 mm2). The size of the ostium was not a significant factor for failure ( p = 0.907). No statistically significant correlation was found between the long-term duration after surgery and the size of the ostium ( R: 0.025, p = 0.157). Conclusions: Nasal endoscopy after DCR is valuable in evaluating the ostium with no observed potential correlation between the long-term follow-up after surgery and the size of the ostium.

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Cholecystectomy for Biliary Hyperkinesia

The American Surgeon ◽

10.1177/000313481908500232 ◽

2019 ◽

Vol 85 (2) ◽

pp. 219-222 ◽

Cited By ~ 2

Author(s):

Joshua Gazzetta ◽

Betty Fan ◽

Paul Bonner ◽

John Galante

Keyword(s):

Laparoscopic Cholecystectomy ◽

Chart Review ◽

Gallbladder Disease ◽

Retrospective Chart Review ◽

Biliary Colic ◽

Study Cohort ◽

Final Pathology ◽

Pathology Reports ◽

Histologic Changes

Patients with classic biliary colic symptoms and documented gallbladder ejection fractions on the higher end of the spectrum on hepatobiliary iminoacetic acid scans with cholecystokinin stimulation are presently understudied and the benefits of cholecystectomy are unclear. To determine whether patients with biliary-type pain and biliary hyperkinesia (defined as a gallbladder ejection fractions of 80% or greater) benefit from laparoscopic cholecystectomy, a retrospective chart review encompassing five community hospitals was performed. Patients 16 years and older with diagnosed biliary hyperkinesia who underwent laparoscopic cholecystectomy between January 1, 2010 and May 31, 2015 were included. Pathology reports were reviewed for histologic changes indicating cholecystitis. Resolution of biliary colic symptoms was reviewed one to three weeks after surgery in their postoperative follow-up documentation. Within our study cohort, we found 97 patients who underwent laparoscopic cholecystectomy for biliary hyperkinesia. Within this population, 84.5 per cent of patients undergoing laparoscopic cholecystectomy for biliary hyper-kinesia had positive findings for gallbladder disease on final pathology. Of the 77 patients with data available from their first postoperative visit, 70 (90.9%) reported improvement or resolution of symptoms. Our findings suggest that symptomatic biliary hyperkinesia may be treated successfully with surgery.

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Kasai Procedure in Patients Older Than 90 Days: Worth a Cut

European Journal of Pediatric Surgery ◽

10.1055/s-0041-1740556 ◽

2021 ◽

Author(s):

Marie Uecker ◽

Joachim F. Kuebler ◽

Nagoud Schukfeh ◽

Eva-Doreen Pfister ◽

Ulrich Baumann ◽

...

Keyword(s):

Treatment Option ◽

Chart Review ◽

Retrospective Chart Review ◽

Primary Treatment ◽

Inclusion Criteria ◽

Bridge To Transplant ◽

Kasai Procedure ◽

Native Liver ◽

Native Liver Survival

Abstract Introduction Age at Kasai portoenterostomy (KPE) has been identified as a predictive factor for native-liver survival in patients with biliary atresia (BA). Outcomes of pediatric liver transplantation (LT) have improved over recent years. It has been proposed to consider primary LT as a treatment option for late-presenting BA infants instead of attempting KPE. We present our experience with patients older than 90 days undergoing KPE. Materials and Methods A retrospective chart review of patients with BA undergoing KPE at our institution between January 2010 and December 2020 was performed. Patients 90 days and older at the time of surgery were included. Patients' characteristics, perioperative data, and follow-up results were collected. Eleven patients matched the inclusion criteria. Mean age at KPE was 108 days (range: 90–133 days). Results Postoperative jaundice clearance (bilirubin < 2 mg/dL) at 2-year follow-up was achieved in three patients (27%). Eight patients (73%) received a liver transplant at a mean of 626 days (range: 57–2,109 days) after KPE. Four patients (36%) were transplanted within 12 months post-KPE. Two patients died 237 and 139 days after KPE due to disease-related complications. One patient is still alive with his native liver, currently 10 years old. Conclusion Even when performed at an advanced age, KPE can help prolong native-liver survival in BA patients and offers an important bridge to transplant. In our opinion, it continues to represent a viable primary treatment option for late-presenting infants with BA.

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Prevalence of amblyopia and patterns of refractive error in the amblyopic children of a tertiary eye care center of Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v5i1.7820 ◽

2013 ◽

Vol 5 (1) ◽

pp. 38-44 ◽

Cited By ~ 7

Author(s):

K Sapkota ◽

A Pirouzian ◽

NS Matta

Keyword(s):

Visual Acuity ◽

Refractive Error ◽

Chart Review ◽

Care Center ◽

Retrospective Chart Review ◽

Ophthalmological Examination ◽

Eye Care ◽

Common Cause ◽

Ocular Pathology ◽

The Mean

Introduction: Refractive error is a common cause of amblyopia. Objective: To determine prevalence of amblyopia and the pattern and the types of refractive error in children with amblyopia in a tertiary eye hospital of Nepal. Materials and methods: A retrospective chart review of children diagnosed with amblyopia in the Nepal Eye Hospital (NEH) from July 2006 to June 2011 was conducted. Children of age 13+ or who had any ocular pathology were excluded. Cycloplegic refraction and an ophthalmological examination was performed for all children. The pattern of refractive error and the association between types of refractive error and types of amblyopia were determined. Results: Amblyopia was found in 0.7 % (440) of 62,633 children examined in NEH during this period. All the amblyopic eyes of the subjects had refractive error. Fifty-six percent (248) of the patients were male and the mean age was 7.74 ± 2.97 years. Anisometropia was the most common cause of amblyopia (p < 0.001). One third (29 %) of the subjects had bilateral amblyopia due to high ametropia. Forty percent of eyes had severe amblyopia with visual acuity of 20/120 or worse. About twothirds (59.2 %) of the eyes had astigmatism. Conclusion: The prevalence of amblyopia in the Nepal Eye Hospital is 0.7%. Anisometropia is the most common cause of amblyopia. Astigmatism is the most common types of refractive error in amblyopic eyes. Nepal J Ophthalmol 2013; 5(9):38-44 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7820

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763. 30 Day Readmission Outcomes in Patients Over 80 Years of Age Enrolled in an Outpatient Parenteral Antibiotic Therapy (OPAT) Program

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.831 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S339-S340

Author(s):

Kathleen R Sheridan ◽

Joshua Wingfield ◽

Lauren McKibben ◽

Natalie Clouse

Keyword(s):

Readmission Rate ◽

Chart Review ◽

Age Groups ◽

Retrospective Chart Review ◽

Model Of Care ◽

Readmission Rates ◽

Parenteral Antibiotic ◽

Patient Demographics

Abstract Background OPAT is a well-established model of care for the monitoring of patients requiring long-term IV antibiotics1. We have previously reported a reduction in the 30-day readmission rate to our facility for patients managed in our OPAT program. However, little has been published to date regarding outcomes in OPAT patients over 80 years of age 2–3. Our OPAT program was established in 2013. Patients can be discharged to a facility or home to complete their course of antibiotics. Methods We conducted a retrospective chart review of all OPAT patients discharged from our facility from 2015 to 2018. Patients were divided into two groups based on age, <80 (n = 4618) and >80 (n = 562). Results Patient demographics are listed in Table 1. The overall 30-day readmission rate for patients older than 80 was 27.8%. For patients over 80 that had a follow-up ID clinic appointment, the 30-day readmission rate decreased to 15.7%. For patients younger than 80, the 30-day readmission rate was 36.0% with a decrease to 16.2% if patients were evaluated in the outpatient clinic. Figure 1. Staphylococcus Aureus was the predominant organism in both age categories. Vancomycin was the most common antibiotic used in both age groups followed by β lactams. Conclusion In general, patients aged over 80 years were more likely to be discharged to a facility to complete their antibiotic course than younger patients. These patients also were more likely to have other comorbidities. The 30-day readmission rate in each age group was relatively similar. OPAT in patients over age 80 can have similar 30-day readmission rates as for patients less than 80 years of age Disclosures All authors: No reported disclosures.

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Unpacking Loss to Follow-Up Among HIV-Infected Women Initiated on Option B+ In Northern Tanzania: A Retrospective Chart Review

East African Health Research Journal ◽

10.24248/eahrj.v3i1.593 ◽

2019 ◽

Vol 3 (1) ◽

pp. 6-15

Author(s):

Festo Mazuguni ◽

Boaz Mwaikugile ◽

Cody Cichowitz ◽

Melissa Watt ◽

Amasha Mwanamsangu ◽

...

Keyword(s):

Chart Review ◽

Retrospective Chart Review ◽

Loss To Follow Up ◽

Northern Tanzania

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Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

Annals of African Surgery ◽

10.4314/aas.v18i3.4 ◽

2021 ◽

Vol 18 (3) ◽

pp. 143-149

Author(s):

Samuel Kyei ◽

Ebenezer Zaabaar ◽

Frank Assiamah ◽

Michael Agyemang Kwarteng ◽

Kofi Asiedu

Keyword(s):

Visual Acuity ◽

Postoperative Complications ◽

Cataract Surgery ◽

Medical Records ◽

Cross Sectional Study ◽

Small Incision Cataract Surgery ◽

Cross Sectional ◽

Small Incision ◽

Uncorrected Visual Acuity

Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians. Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed. Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO grouphad a higher number of postoperative complications compared with the MSICS group (p <0.001). Postoperative borderline and poor uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications. Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.

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