Ultrasound biomicroscopy of the anterior segment of the eyeball after implantation of a phakic IOL in patients with different refractive errors

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.

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Toxic anterior segment syndrome following phakic posterior chamber IOL: a rarity

BMJ Case Reports ◽

10.1136/bcr-2018-225806 ◽

2018 ◽

Vol 11 (1) ◽

pp. bcr-2018-225806 ◽

Cited By ~ 4

Author(s):

Archita Singh ◽

Noopur Gupta ◽

Vinod Kumar ◽

Radhika Tandon

Keyword(s):

Intensive Therapy ◽

Anterior Segment ◽

Secondary Glaucoma ◽

Sterile Inflammation ◽

Posterior Chamber ◽

Refractive Errors ◽

Corneal Decompensation ◽

Toxic Anterior Segment Syndrome ◽

Idiosyncratic Response ◽

Posterior Chamber Iol

Implantable collamer lenses (ICL) have gained popularity for correction of myopia where kerato-refractive procedures are not indicated as in cases of high myopic refractive errors. Toxic anterior segment syndrome (TASS) is a very uncommonly reported postoperative complication following ICL implantation. A young patient developed severe corneal oedema and anterior segment inflammation on the first day after ICL implantation. Analysing retrospectively, possible idiosyncratic response to intracameral pilocarpine was considered as a cause for TASS. Prompt and intensive therapy with oral and topical potent steroids was visually rewarding. TASS, though a sterile inflammation can have catastrophic sequelae such as corneal decompensation and secondary glaucoma. Hence, timely identification and management is important.

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Ultrasound biomicroscopy in anterior segment inflammatory disorders

Annals of Ophthalmology ◽

10.1007/s12009-000-0086-2 ◽

2000 ◽

Vol 32 (4) ◽

pp. 301-306

Author(s):

Jyotirmay Biswas ◽

Muna P. Bhende ◽

Sandeep V. Mondkar

Keyword(s):

Anterior Segment ◽

Ultrasound Biomicroscopy ◽

Inflammatory Disorders

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High-Frequency Ultrasound Biomicroscopy of the Anterior Segment Morphometry before and Immediately after Pars Plana Vitrectomy

European Journal of Ophthalmology ◽

10.5301/ejo.2010.4949 ◽

2011 ◽

Vol 21 (2) ◽

pp. 173-178 ◽

Cited By ~ 12

Author(s):

Meira Neudorfer ◽

Nir Oren ◽

Adiel Barak

Keyword(s):

High Frequency ◽

Pars Plana Vitrectomy ◽

Anterior Segment ◽

Ultrasound Biomicroscopy ◽

High Frequency Ultrasound ◽

Pars Plana ◽

Frequency Ultrasound

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Recurrent Uveal Effusion after Laser Iridotomy

Case Reports in Ophthalmology ◽

10.1159/000455038 ◽

2017 ◽

Vol 8 (1) ◽

pp. 26-30 ◽

Cited By ~ 2

Author(s):

Hiroshi Sakai ◽

Michiko Yonahara ◽

Miyako Sakai

Keyword(s):

Anterior Segment ◽

Ultrasound Biomicroscopy ◽

Angle Closure ◽

Ocular Pain ◽

Laser Peripheral Iridotomy ◽

Blurred Vision ◽

Laser Iridotomy ◽

Primary Angle Closure ◽

Peripheral Iridotomy ◽

Uveal Effusion

A 59-year-old woman was seen by an ophthalmologist for blurred vision, ocular pain, headache, and nausea. She was diagnosed with acute primary angle closure (APAC) and successfully treated with medications. Using ultrasound biomicroscopy (UBM), engorged episcleral vein was observed and small uveal effusion was diagnosed after laser peripheral iridotomy (LPI). The uveal effusion disappeared and was again diagnosed by UBM together with anterior segment inflammation with ocular pain. Iritis caused by LPI after APAC might be a cause of uveal effusion in this specific case.

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Clinical 3D Imaging of the Anterior Segment With Ultrasound Biomicroscopy

Translational Vision Science & Technology ◽

10.1167/tvst.10.3.11 ◽

2021 ◽

Vol 10 (3) ◽

pp. 11

Author(s):

Richard W. Helms ◽

Ahmed Tahseen Minhaz ◽

David L. Wilson ◽

Faruk H. Örge

Keyword(s):

3D Imaging ◽

Anterior Segment ◽

Ultrasound Biomicroscopy

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Anterior segment optical coherence tomography and ultrasound biomicroscopy for measuring thickness of corneal and bulbar conjunctival tumours

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312337 ◽

2021 ◽

pp. bjophthalmol-2018-312337

Author(s):

Noémie Lauwers ◽

Katleen Janssens ◽

Michelle Mertens ◽

Danny Mathysen ◽

Martin Lammens ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Gold Standard ◽

Imaging Techniques ◽

Anterior Segment ◽

Ultrasound Biomicroscopy ◽

Thickness Measurement ◽

Histopathological Analysis ◽

Optical Coherence ◽

Tumour Thickness ◽

Thickness Measurements

Background/ObjectiveAnterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) are two non-invasive imaging techniques used for the measurement of tumour thickness in corneal and bulbar conjunctival tumours. Histopathology (HP), however, remains the gold standard for the measurement of tumour thickness. The aim of this study was to determine whether AS-OCT and UBM are as accurate as HP for measuring tumour thickness.MethodsForty-two corneal and bulbar conjunctival tumours were imaged using AS-OCT and UBM. Images were assessed and tumour thickness was measured. Eleven patients subsequently underwent surgical excision. All specimens were measured during histopathological analysis. The correlation of the thickness measurement on HP to AS-OCT and UBM was then statistically analysed. In cases where the tumour was not excised, thickness measurement comparisons between AS-OCT and UBM were analysed.ResultsAS-OCT and UBM measurements of tumour thickness were found to be significantly positively correlated (p=<0.001), as were UBM and HP thickness measurements (p=0.031). HP and AS-OCT measurements, however, only showed a mild but non-significant positive correlation.ConclusionBoth AS-OCT and UBM are useful techniques to image and measure the thickness of corneal and conjunctival bulbar tumours. While AS-OCT provides better details than UBM, it was more limited in visualising the posterior boundary of the tumour, particularly in malignant tumours. While thickness measurements of both methodologies were correlated, neither should yet be considered as replacements to the gold standard of HP.

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Management of Surgical Complications

Glaucoma ◽

10.1093/oso/9780199757084.003.0018 ◽

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.

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