Spontaneous attachment of complex Descemet’s membrane detachment following multiple failed interventions

2021 ◽  
Vol 14 (8) ◽  
pp. e243960
Author(s):  
Shikha Gupta ◽  
Karthikeyan Mahalingam ◽  
Tushar Agarwal

We describe a case with complex Descemet membrane detachment (DMD) which persisted despite initial two failed surgical attempts to appose the ocular tissues. However, over time, tissue alignment was obtained spontaneously. A 60-year-old woman, operated trabeculectomy, had a total DMD intraoperatively during a complicated cataract surgery. Initial attempt to DM repositioning with intracameral air injection failed. Anterior Segment Optical Coherence Tomography (ASOCT) showed detachment of both DM and pre-Descemet’s layer (PDL). After consultation with a corneal surgeon, patient was again attempted for Intra-operative Optical Coherence Tomography (iOCT)-guided settlement of DMD with intracameral air which again failed. So, the patient was registered for lamellar corneal transplant, but at 3 months follow-up, DM had spontaneously attached, confirmed on ASOCT. This case shows for the first time that even complex DMDs involving PDL, can spontaneously appose despite failed surgical interventions.

2021 ◽  
Vol 10 (2) ◽  
pp. 231
Author(s):  
Giacinto Triolo ◽  
Piero Barboni ◽  
Giacomo Savini ◽  
Francesco De Gaetano ◽  
Gaspare Monaco ◽  
...  

The introduction of anterior-segment optical-coherence tomography (AS-OCT) has led to improved assessments of the anatomy of the iridocorneal-angle and diagnoses of several mechanisms of angle closure which often result in raised intraocular pressure (IOP). Continuous advancements in AS-OCT technology and software, along with an extensive research in the field, have resulted in a wide range of possible parameters that may be used to diagnose and follow up on patients with this spectrum of diseases. However, the clinical relevance of such variables needs to be explored thoroughly. The aim of the present review is to summarize the current evidence supporting the use of AS-OCT for the diagnosis and follow-up of several iridocorneal-angle and anterior-chamber alterations, focusing on the advantages and downsides of this technology.


2016 ◽  
Vol 7 (3) ◽  
pp. 450-456 ◽  
Author(s):  
Davide Allegrini ◽  
Giovanni Montesano ◽  
Alfredo Pece

Iris nevus is common: 6% of patients with suspected iris melanoma have lesions other than melanoma, and 36% of them are nevi. Iris nevus turns into melanoma in approximately 8% of cases at a mean of 15 years. This case report provides the first description of an iris tumor examined with iris optical coherence tomography angiography (OCTA) compared to iris fluorescein angiography (IFA). A 60-year-old man with a diagnosis of iris nevus in the left eye was referred to our department for IFA and iris OCTA. The iris vasculature in IFA was visible only in the early phases, but not clearly. OCTA, however, gave visualization of the vascular network and very precisely defined the vessels of the whole lesion, except for the pupillary portion, which was masked by superficial pigment accumulations. IFA and iris OCTA can add information about the vascular architecture compared to slit-lamp biomicroscopy, ultrasound biomicroscopy, and anterior-segment OCT. However, IFA is time-consuming and invasive and can – very occasionally – cause serious adverse reactions. In contrast, OCTA defines the texture of the iris vasculature better. In conclusion, OCTA is a new method, easy to execute, needing no dye injection, and provides useful information on the vascular network of iris lesions. It could therefore be helpful in the diagnosis and follow-up of these lesions.


2019 ◽  
Vol Volume 12 ◽  
pp. 335-338
Author(s):  
Shai Cohen ◽  
Yisroel Tucker ◽  
Sharon Guttman ◽  
Ettel Bubis ◽  
Yair Rubinstein ◽  
...  

2017 ◽  
Vol 11 (3) ◽  
pp. 113-119 ◽  
Author(s):  
Joobin Hooshmand ◽  
James CY Leong ◽  
Jeremy O'Connor ◽  
Ghee S Ang ◽  
Anthony P Wells

ABSTRACT Aim To evaluate by anterior segment optical coherence tomography (AS-OCT) the medium-term (mean duration 3.2 years) anatomical changes in the anterior chamber angle (ACA) after laser peripheral iridoplasty. Materials and methods This is a longitudinal, retrospective case series of 31 eyes of 31 patients with primary angle-closure suspicion, primary angle closure (PAC), or primary angle-closure glaucoma (PACG) who underwent laser peripheral iridoplasty. All patients had persistent iridotrabecular contact (ITC) despite the presence of a patent peripheral iridotomy (PI). An AS-OCT was performed in dark conditions before and after laser iridoplasty. Quadrants of ITC, intraocular pressure (IOP), and the AS-OCT parameters of the temporal and nasal ACAs were measured and analyzed. Results Prior to iridoplasty, the average number of quadrants of ITC was 3.3. At the first postiridoplasty visit (mean duration 6.8 weeks), this reduced to 1.7 quadrants but increased to 1.9 by the final follow-up visit (mean duration 3.2 years). Twenty-five patients (80.1%) had less ITC at the first postlaser visit increasing to 27 (87.1%) patients by the final visit. Two (6.5%) required a second iridoplasty, while 3 (9.7%) required cataract surgery. All parameters of angle width showed a statistically significant increase in magnitude. All patients maintained IOP ≤ 21 mm Hg throughout the follow-up period. Conclusion Iridoplasty is a useful adjunct in widening the ACA, particularly in those with persistent angle closure after iridotomy but with no cataract. While not successful in all patients, it can act as a temporizing measure to widen the drainage angle until such time that cataract surgery can be performed. Clinical significance Laser peripheral iridoplasty can be used as an adjunct in angle-closure glaucoma patients with no cataract. How to cite this article Hooshmand J, Leong JCY, O'Connor J, Ang GS, Wells AP. Medium-term Anatomical Results of Laser Peripheral Iridoplasty: An Anterior Segment Optical Coherence Tomography Study. J Curr Glaucoma Pract 2017;11(3):113-119.


2021 ◽  
Vol 7 (3) ◽  
pp. 548-553
Author(s):  
Isha Chaturvedi ◽  
Kamaljeet Singh ◽  
Jagriti Rana ◽  
Kshama Dwivedi ◽  
Reena Sachan

Anterior segment optical coherence tomography (AS-OCT) is a newer technology that provides two-dimensional images of corneal infiltration. This study was undertaken to assess whether AS-OCT can aid objective evaluation and response to treatment in resolving microbial keratitis. This prospective study was performed on 17 patients of who underwent slit lamp and AS-OCT examination at presentation and follow up on days 3, 7, 14, 28 and 6 weeks. A standardized scanning protocol was used to measure the corneal thickness (CT) and infiltrate thickness (IT) using the caliper tool of a commercially available AS-OCT device. The mean CT in the infiltrated area and mean IT, both were thickest at presentation (710.88 um and 288.76 um respectively). The mean CT decreased to 665.12 µm, 650.24 µm, 584.35 µm, 549 µm, 507.47 µm on days 3, 7, 14, 28 and 6 weeks respectively. Similarly, the mean IT decreased to 287.24 µm, 244.41 µm, 197 µm, 174.59 µm and 154.82 µm. Paired t- test was used to calculate the statistical change in CT and IT, which was significant (p<0.0001) at 6 weeks, at the rate of 0.67% and 1.01% per day. AS-OCT can show morphological characteristics of microbial keratitis and give quantitative assessment at every follow up.


2020 ◽  
Vol 13 (12) ◽  
pp. e236692
Author(s):  
Anahita Kate ◽  
Swapna S Shanbhag ◽  
Ritin Goyal ◽  
Sayan Basu

A 24-year-old young man presented to us with total limbal stem cell deficiency (LSCD) in the right eye 1 year post ocular chemical burn. The patient subsequently underwent limbal biopsy in the healthy contralateral eye and autologous simple limbal epithelial transplantation in the right eye. The patient was followed up with sequential imaging of the cornea with high-resolution anterior segment optical coherence tomography (HR-ASOCT) for 3 years. The serial HR-ASOCT imaging in the operated eye showed regeneration of the epithelium from the limbal transplant over the human amniotic membrane (hAM) with integration of the transplant within the cornea with subepithelial retention of the hAM. Over the long-term follow-up, thinning of the hAM and thickening of the epithelium was noted. At 3 years, the cornea maintained an intact epithelium with no signs of recurrence of LSCD.


2017 ◽  
Vol 102 (4) ◽  
pp. 544-548 ◽  
Author(s):  
Guillermo Garcia-De la Rosa ◽  
Andrew Olivo-Payne ◽  
Juan Carlos Serna-Ojeda ◽  
Maria Sandra Salazar-Ramos ◽  
Alejandro Lichtinger ◽  
...  

ObjectiveTo assess anterior segment changes, including iridocorneal angle and vault, after toric and non-toric implantable collamer lens (ICL) V4c (STAAR Surgical AG) implantation under different lighting conditions.MethodsLongitudinal, prospective, case series. Patients with high myopia (>6 dioptres) underwent toric and non-toric ICL V4c implantation. Optical coherence tomography measurements were taken under different lighting conditions preoperatively and at 1 week and 1, 6 and 12 months of follow-up.ResultsSeventy-six eyes of 42 patients underwent ICL V4c implantation. Mean age was 27.4 years (±5.14 years, range 20 to 39 years). The average iridocorneal angle showed a statistically significant decrease (p<0.05) in all mesopic, scotopic and photopic conditions after 1 week of surgery compared with the preoperative measurements; in mesopic conditions, it decreased 14.1°, in photopic conditions 14.8° and scotopic conditions 13.2°. The angle measurement had a statistically significant change only in mesopic conditions (p=0.01) over the 1-year follow-up. The average vault under mesopic conditions was 0.661±0.21 mm at week 1. The vault measurement change was statistically significant over the 1-year follow-up in mesopic conditions (p=0.01). Refractive results showed a significant improvement in both uncorrected and corrected distance visual acuity (p<0.001).ConclusionThere is a significant reduction in the iridocorneal angle after ICL V4c implantation. Furthermore, there is a change under mesopic conditions in both the iridocorneal angle and vault during long-term follow-up.


2020 ◽  
Vol 17 (1) ◽  
pp. 41-44
Author(s):  
Deepmala Mazumdar ◽  
Barsha Lal ◽  
Rashima Asokan

We report a case of six-year-old boy who presented with a progressive intracorneal cyst in the left eye. Anterior segment optical coherence tomography (AS-OCT) was performed, and it showed the location of the cyst in the corneal stroma. Its dimension was measured to be 7.09 Å~ 2.12 mm. The cyst aspiration was successfully done. AS-OCT helped in the management and follow-up of the condition.


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