LVP keratoprosthesis: anatomical and functional outcomes in bilateral end-stage corneal blindness

2018 ◽  
Vol 103 (5) ◽  
pp. 592-598 ◽  
Author(s):  
Sayan Basu ◽  
Ritu Nagpal ◽  
Juan Carlos Serna-Ojeda ◽  
Swapnil Bhalekar ◽  
Bhupesh Bagga ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Retention Rate ◽  
Survival Rates ◽  
Case Series ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Dry Eyes ◽  
Corneal Blindness ◽  
Prospective Case Series ◽  
End Stage

PurposeTo describe the anatomical and functional outcomes of the novel LVP keratoprosthesis (Kpro), developed as an alternative to the modified osteo-odonto keratoprosthesis (MOOKP), in eyes with end-stage corneal blindness where conventional corneal surgeries are contraindicated.MethodsThis prospective case series included 58 eyes of 56 patients (12 children and 44 adults) with severe bilateral keratopathy and completely dry, dermalised ocular surfaces who underwent unilateral LVP Kpro implantation from 2012 to 2016. In this two-stage procedure, an ocular surface labial mucous membrane grafting was performed, followed for 3 months by the implantation of the device under the engrafted mucosal flap. The primary outcome measures were anatomical retention rate and improvement in best corrected visual acuity (BCVA). The secondary outcome measure was rate of occurrence of complications.ResultsMean postoperative follow-up was 2.5±1.1 years. Kaplan-Meier survival analysis showed an anatomical retention rate of 90.8%±3.9% at 1 year, 80%±5.7% at 2 years and 76.6%±6.5% at 3–5 years. The survival rates were comparable in children and adults (91% vs 72% at 5 years, p=0.258). About 61.5% of eyes maintained 20/400 or better vision and median BCVA improved from perception of light to 20/70 at 1 year postoperatively (p<0.0001). Complications like retroprosthetic membrane formation, glaucoma, vitritis, endophthalmitis and panophthalmitis occurred in 43%, 26%, 22%, 12% and 3% of the eyes, respectively.ConclusionThe LVP Kpro is an effective procedure for the treatment of end-stage corneal blindness in completely dry eyes. The LVP Kpro can be particularly useful in situations where the MOOKP is contraindicated or difficult to perform.

scholarly journals Intraoperative ultrasonography for presumed brain metastases: a case series study

2012 ◽  
Vol 70 (10) ◽  
pp. 793-798 ◽  
Author(s):  
Helder Picarelli ◽  
Marcelo de Lima Oliveira ◽  
Edson Bor-Seng-Shu ◽  
Eduardo Santamaria Carvalhal Ribas ◽  
Alexandre Maria Santos ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Functional Outcomes ◽  
Systemic Disease ◽  
Survival Rates ◽  
Tumor Resection ◽  
Intraoperative Ultrasound ◽  
Case Series ◽  
Case Series Study ◽  
Actual Contribution ◽  
Series Study

Brain metastases (BM) are one of the most common intracranial tumors and surgical treatment can improve both the functional outcomes and patient survival, particularly when systemic disease is controlled. Image-guided BM resection using intraoperative exams, such as intraoperative ultrasound (IOUS), can lead to better surgical results. METHODS: To evaluate the use of IOUS for BM resection, 20 consecutives patients were operated using IOUS to locate tumors, identify their anatomical relationships and surgical cavity after resection. Technical difficulties, complications, recurrence and survival rates were noted. RESULTS: IOUS proved effective for locating, determining borders and defining the anatomical relationships of BM, as well as to identify incomplete tumor resection. No complications related to IOUS were seen. CONCLUSION: IOUS is a practical supporting method for the resection of BM, but further studies comparing this method with other intraoperative exams are needed to evaluate its actual contribution and reliability.

scholarly journals Effectiveness of a Preservative-Free Eye Drop, Cyclosporine 0.05% Emulsion, and Omega-3 Supplementation as a Fixed Combination in Dry Eye Disease – a Pilot Study

2018 ◽  
Vol 1 (1) ◽  
pp. 01-06
Author(s):  
Tokko HA ◽  
Al-Awadi A ◽  
Somani S
Keyword(s):  
Dry Eye ◽  
Fixed Combination ◽  
Case Series ◽  
Secondary Outcome ◽  
Combination Regimen ◽  
Eye Drops ◽  
Secondary Outcome Measure ◽  
Omega 3 ◽  
The Impact ◽  
Preservative Free

Purpose: We aim to evaluate the impact of combining a preservative-free drop, cyclosporine 0.05% emulsion, and omega-3 oral supplementation on the signs and symptoms of dry eye in a typical ophthalmic practice.Design: A retrospective case series conducted on patients with dry eye disease.Methods: Patients diagnosed with dry eye in a typical ophthalmology practice were initiated on a fixed combination regimen which included a preservative-free eye drop (I-DROP ® PUR GEL, I-MED pharma), cyclosporine 0.05% ophthalmic emulsion, and oral omega-3 supplement(Dry Eye Omega Benefits®, PRN)for 3 monthsconsecutively. The primary outcome measured was a symptom score using the Canadian Dry Eye Assessment Tool (CDEA). Secondary outcome measure was Non-invasive Keratograph Break-up Time (NIKBUT). Primary and secondary outcomes measured at baseline and 3 months following intervention were compared.Results: Thirty-six patients were included with a female male ratio of 2.6:1 and average age of 64.Patient symptoms improved significantly following the intervention as demonstrated by a lower CDEA score during the second visit compared to the first visit (16.11 vs. 19.50, respectively) (p< .05). NIKBUT scores were also significantly improved as demonstrated by a higher score during the second visit compared to the first in both the right (13.18 vs. 11.44) (p< .05) and left (14.62 vs. 12.78) (p< .01) eyes, respectively.Conclusion: A fixed combination of preservative-free eye drops, cyclosporine 0.05% and omega-3 supplementation may be an effective first line treatment option in alleviating symptoms and improving signs of patients suffering from dry eye.

Combined Standard Medication and Acupuncture for Copd: A Case Series

2012 ◽  
Vol 30 (2) ◽  
pp. 96-102 ◽  
Author(s):  
Masao Suzuki ◽  
Kenji Namura ◽  
Yasushi Ohno ◽  
Masato Egawa ◽  
Takako Sugimoto ◽  
...  
Keyword(s):  
Outcome Measure ◽  
Acupuncture Treatment ◽  
Case Series ◽  
Secondary Outcome ◽  
Chronic Obstructive ◽  
Secondary Outcome Measure ◽  
Obstructive Pulmonary Disease ◽  
Medication Therapy ◽  
Bode Index ◽  
Standard Medication

Background Traditional acupuncture has been used in patients with chronic obstructive pulmonary disease (COPD). However, only a few studies have been performed to determine the efficacy of this treatment. Objective To observe changes in the symptoms of COPD during acupuncture treatment in patients with COPD stratified according to the severity of the disease. Methods A prospective case series of 26 patients with dyspnoea on exertion due to COPD was followed from October 2004 to October 2008 in the Departments of Respiratory Internal Medicine, Gifu University of Medicine and Meiji University of Integrative Medicine, Japan. All participants received acupuncture treatments once a week for 10 weeks in addition to standard medication therapy. The main outcome measure was the modified Borg dyspnoea scale after the 6 min walk test (6MWT) and the secondary outcome measure was the BODE index. Results All 26 patients showed significant improvement in the Borg dyspnoea scale after 10 weeks of acupuncture treatment (from 4.02 (2.85) to 1.96 (1.97), mean difference −2.06, 95% CI −3.03 to −1.09, p=0.0002, paired t test). Improvements in the BODE index, 6MWT and oxygen saturation during exercise, which indicates better reduced dyspnoea on exertion and prognosis, were also found. Conclusion The results of this study suggest that acupuncture treatment has clinically useful effects, at least in the short term, in reducing dyspnoea on exercise in patients with COPD, particularly in those more severely affected.

The FICI grading for a dacryocystorhinostomy ostium

2021 ◽  
pp. 112067212199474
Author(s):  
Mohammad Javed Ali ◽  
Adit Gupta ◽  
Chittabhathina Sri Lakshmi ◽  
Mohammad Hasnat Ali
Keyword(s):  
Functional Outcomes ◽  
Statistical Tests ◽  
Recursive Partitioning ◽  
Case Series ◽  
Conditional Inference ◽  
Statistical Software ◽  
Fluorescein Dye ◽  
Prospective Case Series ◽  
Larger Sample ◽  
Significant Factors

Purpose: The objective of this study is to propose a simple grading to assess the health of a dacryocystorhinostomy (DCR) ostium. Methods: Prospective case series of 237 Ostia evaluated following dacryocystorhinostomy were included in the study. All the ostia were assessed for 10 parameters in detail using the earlier published DCR ostium scoring (DOS scoring). Each of the 10 parameters were scored individually, and final DOS scores were obtained. The anatomical and functional outcomes of each of the surgery were noted. The most significant parameters that influenced the success were determined using the binary recursive partitioning in a conditional inference framework. Data management and statistical tests were performed using the statistical “Software R” and the library “partykit” toolkits. Results: The most significant DCR ostium parameters that influenced the outcomes were anatomical and functional fluorescein dye transit ( p < 0.001), dynamicity of internal common opening (ICO) on the blink ( p < 0.001), end-on threats to ICO from granuloma, membrane or a synechia, and cicatricial closure of the Ostia. Each of these significant factors (FICI – Fluorescein endoscopy dye test, ICO dynamicity, Cicatricial ostium closure and ICO threats) were assigned simple scoring and the final scores were graded from 0 (poor DCR ostium) to +5 (excellent DCR ostium). FICI grading can guide the physician on the health status of the DCR ostium and the possible need for intervention. Conclusion: FICI DCR ostium grading is a simple, easy to perform, and physician-friendly system. More studies with larger sample size would help in further validating the FICI grading.

scholarly journals Autologous Blood Patch for Persistent Ascites Leak from Non-Closing Paracentesis Tracts

2019 ◽  
Vol 7 (9) ◽  
pp. 88
Author(s):  
Khan ◽  
Dushay
Keyword(s):  
Liver Disease ◽  
Autologous Blood ◽  
Symptomatic Relief ◽  
Case Series ◽  
Treatment Method ◽  
Wall Layer ◽  
End Stage Liver Disease ◽  
Blood Patch ◽  
Prospective Case Series ◽  
End Stage

Ascites, the fluid accumulation in the peritoneal cavity, is most commonly seen in patients with end-stage liver disease (ESLD). Evaluating ascites or providing symptomatic relief for patients is accomplished by performing a paracentesis. Ascites leak from a paracentesis site can be a complication of the procedure and is associated with increased morbidity. Currently, the best options for these patients include medical management or surgical abdominal wall layer closure. Utilizing a blood patch provides an alternative approach to managing such patients. A two-center prospective case series was performed evaluating the efficacy of the blood patch in patients with significant persistent ascites leak following a paracentesis. About 30 mL of the patients’ peripheral blood was used for the blood patch. Subjects were recruited over a period of one year and followed for 30 days after the procedure. A total of six patients were recruited for this study. Subjects underwent placement of autologous blood patch at the site of the ascites leak and 100% had resolution of the leak within 24 hours. None of the subjects developed any complications of the procedure. This study shows that an autologous blood patch is an effective, low-risk treatment method for ascites leaks following a paracentesis. It is a simple bedside procedure that can reduce morbidity in patients with end-stage liver disease.

scholarly journals Coarsened Exact Matching of Trabectome Surgery Combined with Baerveldt to Baerveldt: Same Session Trabectome Negates Tube Fenestration

2018 ◽  
Author(s):  
Hamed Esfandiari ◽  
Kiana Hassanpour ◽  
Peter Knowlton ◽  
Tarek Shazly ◽  
Mehdi Yaseri ◽  
...  
Keyword(s):  
Survival Rates ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Secondary Outcome ◽  
Cumulative Probability ◽  
Eye Drops ◽  
Exact Matching ◽  
Coarsened Exact Matching ◽  
Significant Difference

Purpose: To evaluate the efficacy and survival rates of trabectome-mediated ab interno trabeculectomy combined with non-fenestrated Baerveldt glaucoma implants (BT) in comparison to Baerveldt glaucoma implant alone (B).Method: A total of 175 eyes undergoing primary glaucoma surgery (60 eyes BT and 115 B) were enrolled in this retrospective comparative case series. Participants were identified using the procedural terminology codes. Groups were then matched using Coarsened Exact Matching (51 eyes in each group). The primary outcome measure was surgical success, defined as 5 mmHg &lt; IOP &le; 21 mmHg, and IOP reduction &ge; 20% from baseline, and no reoperation for glaucoma. Secondary outcome measures were intraocular pressure, the number of glaucoma medications, and best corrected visual acuity (BCVA).Results: The cumulative probability of success at one year was 61% in BT, and 50% in B. IOP decreased significantly from 23.5&plusmn;2.4 mmHg at baseline to 14.1&plusmn;2.7 mmHg at the final follow up in BT (P= 0.001). The corresponding numbers for B were 23.2&plusmn; 2.0 and 13.9&plusmn; 1.6, respectively (P= 0.001). There was no significant difference in IOP at the final follow-up (P=0.56). The number of medications at baseline was 2.3&plusmn;0.3 in both groups. However, BT needed significantly fewer drops at all postoperative time intervals and used 1.1&plusmn;0.3 (BT) and 2.0&plusmn;0.4 eye drops (B) at the final follow-up visit (P= 0.004). No dangerous hypotony or hypertension occurred in BT.Conclusion: Similar rates of success and IOP reduction were observed in BT and B. BT needed significantly fewer glaucoma medications. Tube fenestration was not necessary in BT resulting in less postoperative hypotony and hypertension.

scholarly journals Silver diamine fluoride as a minimally invasive and aerosol free approach in pediatric dentistry: An extensive case series

2021 ◽  
Vol 2 (2) ◽  
pp. 42-54
Author(s):  
Abhishek Soni ◽  
Sanchit Paul ◽  
Priyanka Sachdeva
Keyword(s):  
Minimally Invasive ◽  
Outcome Measure ◽  
Age Groups ◽  
Case Series ◽  
Pediatric Dentistry ◽  
Permanent Teeth ◽  
Secondary Outcome ◽  
Clinical Approach ◽  
Secondary Outcome Measure ◽  
Silver Diamine Fluoride

The current pandemic of COVID-19 warrants a repeal from conventional dentistry to an aerosol free, minimally invasive yet maximally effective clinical approach. Silver diamine fluoride (SDF) is an established modality for caries arrest in children fulfilling all the above. This extensive 25 case series highlights various clinical situations in which SDF was successfully used in children between 1-12 years of age with asymptomatic carious lesions of ICDAS score 2 or more in primary and permanent teeth. Primary outcome measure was caries arrest in the form of the hard and shiny lesion with no/minimal sensitivity. The secondary outcome measure was the zombie effect which was the residual staining on other tooth surfaces and indications of substantivity. SDF can be effectively and efficaciously used across different behaviour patterns and age groups of children in a various clinical scenario for both primary and permanent teeth routinely experienced in a paediatric dental office especially during these pandemic times with minimal aerosol generation.

scholarly journals Impact of Same-Session Trabectome Surgery on Ahmed Glaucoma Valve Outcomes

2018 ◽  
Author(s):  
Hamed Esfandiari ◽  
Tarek Shazly ◽  
Priyal Shah ◽  
Kiana Hassanpour ◽  
Pooya Torkian ◽  
...  
Keyword(s):  
Survival Rates ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Cumulative Probability ◽  
Ahmed Glaucoma Valve ◽  
Trabectome Surgery ◽  
Hypertensive Phase ◽  
One Year

Purpose: To evaluate the efficacy and survival rates of same session ab interno trabeculectomy with the trabectome and Ahmed glaucoma valve implant (AT) in comparison to the Ahmed glaucoma valve alone (A). Method: A total of 107 eyes undergoing primary glaucoma surgery were enrolled in this retrospective comparative case series, including 48 eyes which underwent AT and 59 eyes which received A alone. Participants were identified using the procedural terminology codes, and their medical records were reviewed. The primary outcome measure was surgical success, defined as intraocular pressure (IOP) &gt; 5 mmHg, &le; 21 mmHg, and IOP reduction &ge; 20% from baseline at two consecutive visits after three months, no reoperation for glaucoma. Secondary outcome measures were IOP, the number of glaucoma medications, incidence of a hypertensive phase, and best corrected visual acuity (BCVA). Results: The cumulative probability of success at one year was 70% in AT, and 65% in A (p=0.85). IOP decreased significantly from 26.6 &plusmn; 10.1 mmHg at baseline to 14.7 &plusmn; 3.3 mmHg at the final follow-up in AT (p= 0.001). The corresponding numbers for A were 28.8 &plusmn; 10.2 and 16.7 &plusmn; 4.9, respectively (p= 0.001). The final IOP was significantly lower in AT (p= 0.022). The number of medications at baseline was comparable in both groups (2.6 &plusmn; 1.2 in AT and 2.5 &plusmn; 1.3 in A, p=0.851). Corresponding number at 1 year visit was 1.2&plusmn;2 in AT and 2.8&plusmn;1.8 in A (p=0.001). The incidence of a hypertensive phase was 18.7% in AT and 35.5% in A (p=0.05). HP resolved in only 30% of eyes. The criteria for HP resolution were fulfilled in 9 eyes (30%). There was no difference in the rate of resolution of the hypertensive phase between AT and A (33.3% and 28.5%, respectively, p=0.67). Conclusion: Ahmed glaucoma valve implant with same session trabectome surgery significantly decreased the rate of the hypertensive phase and postoperative IOP as well as the number of glaucoma medications.

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