scholarly journals A Novel Method for the Localization and Management of Traumatic Cyclodialysis Cleft

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Mingling Wang ◽  
Shufang Hu ◽  
Zhenquan Zhao ◽  
Tianlin Xiao
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Intraocular Pressure ◽  
Clinical Study ◽  
Ultrasound Biomicroscopy ◽  
Slit Lamp ◽  
Normal Range ◽  
Postoperative Visual Acuity ◽  
Novel Method ◽  
Cyclodialysis Cleft

Purpose.To propose a novel surgical method for the localization and management of traumatic cyclodialysis clefts.Methods.Five patients with traumatic cyclodialysis clefts who underwent the innovative surgery were retrospectively reviewed. The new method was introduced to repair a cyclodialysis cleft with two running sutures from the middle to each end of the cleft under the guidance of a probe. Preoperative and postoperative visual acuity (VA), intraocular pressure (IOP), slit lamp and gonioscopic results, ultrasound biomicroscopy (UBM), and optical coherence tomography (OCT) findings were recorded.Results.Cyclodialysis clefts were completely closed postoperatively in four patients (four eyes); this was confirmed by progressively improved VA, restoration into the normal range of the IOP, disappearance of suprachoroidal fluid, and reduced macular edema. Only one patient with multiple clefts had an incomplete reattachment.Conclusions.This clinical study offers a novel and efficient method to localize and repair the cyclodialysis clefts.

scholarly journals Evaluation of Outflow StructuresIn Vivoafter the Phacocanaloplasty

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Daiva Paulaviciute-Baikstiene ◽  
Renata Vaiciuliene ◽  
Vytautas Jasinskas ◽  
Ingrida Januleviciene
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Anterior Segment ◽  
Open Angle ◽  
Glaucoma Medication ◽  
Postoperative Visual Acuity

Purpose. To evaluate thein vivochanges in Schlemm’s canal (SC) and the trabecular meshwork (TM) in patients with primary open-angle glaucoma (POAG) after phacocanaloplasty using anterior segment optical coherence tomography (AS-OCT).Methods. Ten eyes of nine patients with POAG (6 men and 3 women) who underwent phacocanaloplasty. Preoperative and postoperative visual acuity (VA), intraocular pressure (IOP), and use of glaucoma medications were evaluated. The main outcome measures were the area of SC and TM thickness assessed using AS-OCT before and 12 months after surgery.Results. We found statistically significant reduction in IOP (from 26.4 (8.6) mmHg to 12.9 (2.5) (p<0.05) mmHg), increase in VA from 0.7 (0.4) to 0.9 (0.2), and decrease in glaucoma medication from 2.6 (1.2) to 1.1 (1.3) at 12 months postoperatively. There was a significant increase in the SC area (3081.7 (842.8) μm2versus 5098.8 (1190.5) μm2,p<0.001) and a decrease in mean TM thickness (91.2 (18.6) μm versus 81.3 (15.1) μm,p=0.001) after surgery. We found negative correlations between SC area and IOP before surgery (r=-0.67,p=0.03) and also between SC area before and IOP reduction 12 months after the phacocanaloplasty (r=-0.80,p=0.005).Conclusions. Our results showed statistically significant dilation of SC area and reduction of TM thickness after phacocanaloplasty in POAG patients. The degree of SC expansion was related to the IOP decrease.

scholarly journals Asymptomatic chronic hypotony due to subclinical choroidal effusion after blunt trauma

2020 ◽  
Vol 17 (2) ◽  
pp. 203-208
Author(s):  
John Mark Sim De Leon ◽  
Ronald Steven Medalle
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Case Report ◽  
Blunt Trauma ◽  
Ultrasound Biomicroscopy ◽  
Scleral Flap ◽  
Hypotony Maculopathy ◽  
Post Traumatic ◽  
Choroidal Effusion ◽  
Cyclodialysis Cleft

Objective: To present a case report of asymptomatic post-traumatic chronic hypotony in which the cause was undetected until phacoemulsification. Methodology: Case report. Results: A 55-year-old female’s left eye suffered blunt trauma causing hyphema and iritis, which were successfully managed; however, up to a year after, the intraocular pressure (IOP) ranged from 3 to 5 mmHg and the anterior chamber remained very shallow (Van Herick grade 4) with the lens–iris diaphragm pushed anteriorly with difficulty assessing the angles for recession or clefts . Visual acuity was initially 20/20 upon resolution of the hyphema but worsened to 20/40 a year after, presumably due to a developing cataract. Periodic dilated fundus examinations revealed no hypotony maculopathy or choroidal effusions. Prior to phacoemulsification, ultrasound biomicroscopy (UBM) revealed 360 degrees of mild peripheral choroidal effusions. During phacoemulsification, after intraocular lens insertion, direct gonioscopy revealed a supero-nasal cyclodialysis cleft (2 clock hours) and this was repaired intraoperatively with direct cyclopexy through a partial thickness scleral flap. Postoperatively, the vision improved to 20/20 without correction and the IOP normalized to 16 to 18 mmHg. Conclusion: Chronic hypotony post-trauma may be asymptomatic and the cause may not be clinically evident and may be detected by UBM (choroidal effusion). In our case, the proximate aetiology (cyclodialysis cleft) of the effusion was only observed intraoperatively after phacoemulsification for which cyclopexy was performed which increased the IOP to physiologic levels.

scholarly journals Prognosis of Functional Results of Arising or Immature Cataract Phacoemulsification High Myopia

2018 ◽  
Vol 15 (2S) ◽  
pp. 126-133
Author(s):  
A. A. Pilyagina ◽  
O. A. Fabrikantov ◽  
S. V. Shutova
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
High Myopia ◽  
Posterior Vitreous Detachment ◽  
Ultrasound Biomicroscopy ◽  
Morphological Parameters ◽  
Optical Coherence ◽  
Postoperative Visual Acuity ◽  
Complicated Cataract ◽  
Spectral Optical Coherence Tomography

Actuality. Complicated cataract surgery in high myopia is accompanied by the high risk of intra- and postoperative complications caused by this background disease. The presence of lens opalescence influences the results of many functional diagnostic tests. Diagnostic and prognostic research of the modern methods of investigation such as spectral optical coherence tomography, ultrasound biomicroscopy and B-scanning is urgent in patients with high myopia and cataract. The true prognosis of visual functions in these patients will allow solving the problem of cataract phacoemulsification expediency, decreasing the risks of complications.Purpose. To determine prognostic criteria of complicated cataract phacoemulsification outcome in high myopia.Patients and methods. 62 patients (101 eyes) with arising or immature cataract and high myopia were examined. All patients underwent ultrasound biomicroscopy of retinal periphery, ultrasound B-scanning of vitreous body and spectral optical coherence tomography of macular zone preoperatively, in the first postoperative days, in a month, in 6–8 months. We performed the correlation analysis of the initial morphological parameters and postoperative visual acuity. To solve the problem of the favorable outcome prognostication (achieving a certain level of visual acuity by the definite term after surgery) the method of binary logistic regression was used.Results and conclusion. The performed mathematical analysis showed the correlation between the postoperative visual acuity and the initial morphological parameters in a myopic eye: the value of ocular anterior posterior axis, the height of the posterior vitreous detachment, posterior staphyloma, the retinoschisis length in the superior outer segment, epiretinal membrane height, pigmented epithelium destruction and discharge, increased choroidal reflectivity, subfoveal choroidal thickness. We built the mathematical models that allowed predicting with high accuracy the probability of achieving a certain level of postoperative visual acuity following cataract phacoemulsification in high myopia. 

Late-onset malignant glaucoma

2020 ◽  
Vol 3 ◽  
pp. 1
Author(s):  
Ramiro José Daud ◽  
Horacio Freile ◽  
Mauricio Freile ◽  
Soledad Mariano
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Acute Pain ◽  
Late Onset ◽  
Slit Lamp ◽  
Normal Range ◽  
Slit Lamp Examination ◽  
Complete Occlusion ◽  
Malignant Glaucoma ◽  
The Right

A case report on a 49-year-old female with diagnoses of ocular hypertension in her left eye (LE) treated with 250 mg/day acetazolamide for 2 years. During the slit-lamp examination, complete occlusion of both iridocorneal angles was detected. Intraocular pressure (IOP) was 10 and 35 mmHg in the right eye and LE, respectively. Phacotrabeculectomy was performed in the LE. After 1 month of the procedure, the patient developed a slowly progressive miopization from −1 to −3 diopters (D) the following months. Approximately 3 months after surgery, the patient developed an episode of acute pain, athalamia, and IOP 45 mmHg in her LE. Late-onset malignant glaucoma was suspected and the patient was treated with topical hypotensive and cycloplegic agent until a prompt vitrectomy was performed. Deepening of the anterior chamber and restoration of IOP to normal range was obtained after surgery.

scholarly journals Posterior capsular calcification without opacification of intraocular lens

2016 ◽  
Vol 8 (1) ◽  
pp. 91-94
Author(s):  
Rajesh S Joshi
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Posterior Capsule ◽  
Posterior Capsular Opacification ◽  
Slit Lamp ◽  
Peripheral Part ◽  
Postoperative Visual Acuity ◽  
The Third ◽  
Early Occurrence

Background: Posterior capsular clarity is important for long-term visual gain. Postoperative visual acuity could be reduced due to posterior capsular or intraocular lens opacification, which occur months or years after cataract surgery. We report early occurrence of posterior capsular calcification without opacification of intraocular lens. Case: We report the case of a 78-year-old male who had undergone phacoemulsification with implantation of hydrophilic intraocular lens (IOL) in the left eye for cataract. The patient was non-diabetic, and the surgical procedure was uneventful. On the third postoperative day, fine granular deposits were found on the mid-peripheral part of the posterior capsule. No deposits were found on IOL. The patient presented with diminished vision four months after surgery. Slit-lamp examination revealed distinct areas of calcification with an early opacification of the posterior capsule and no IOL calcification. Neodymium doped: YAG capsulotomy was done to clear posterior capsular opacification, and the patient regained visual acuity of 20/20. To the best of our knowledge, this report is the first to investigate posterior capsular calcification without opacification of IOL in a patient without any known etiological factors. Conclusion: This case is reported to stimulate future study on the use of BSS plus and the development of posterior capsular or IOL calcification. Nepal J Ophthalmol 2016; 8(15): 91-94

Ellipsoid layer restoration after Ozurdex® treatment in a patient with acute posterior multifocal placoid pigment epitheliopathy

2019 ◽  
pp. 112067211988359 ◽  
Author(s):  
Arnau Mora-Cantallops ◽  
M Dolores Pérez ◽  
Marcelino Revenga ◽  
Julio Jose González-López
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Optical Coherence ◽  
Dexamethasone Implant ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Intravitreal Dexamethasone Implant ◽  
History Of ◽  
Intravitreal Dexamethasone ◽  
Consequent Improvement

An atypical case of acute posterior multifocal placoid pigment epitheliopathy with a clear reappearance of the ellipsoid layer of the retina after Ozurdex® intravitreal implantation is presented. A 51-year-old woman reported a 3-week history of left eye photopsia. On slit-lamp examination, yellowish placoid lesions were found on her left eye fundus. Ancillary tests were performed. The patient was diagnosed as a left eye acute posterior multifocal placoid pigment epitheliopathy, and observational approach was decided. Later, the condition started to progress in an ampiginous manner and a decrease of visual acuity caused by an increase in number and size of the lesions was observed. As the disease was progressing with the conservative, observational approach, and the macula was menaced, an intravitreal dexamethasone implant was injected in the left eye with a consequent improvement of the visual acuity and lesion stabilization. The ellipsoid layer, unidentifiable inside the placoid lesions in previous optical coherence tomography tests, reappeared after the treatment. Intravitreal dexamethasone implants can be used to stabilize acute posterior multifocal placoid pigment epitheliopathy lesions and help resolve the condition. Spectral domain optical coherence tomography can also be useful for monitoring these lesions, as the ellipsoid layer may reappear upon resolution.

Single-pass four-throw pupilloplasty for Urrets-Zavalia syndrome

2018 ◽  
Vol 28 (5) ◽  
pp. 552-558 ◽  
Author(s):  
Priya Narang ◽  
Amar Agarwal ◽  
Dhivya Ashok Kumar
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Intraocular Pressure ◽  
Anterior Segment ◽  
Anterior Chamber Angle ◽  
Single Pass ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Chamber Angle ◽  
Best Corrected Visual Acuity

Purpose: To demonstrate the efficacy and initial results of single-pass four-throw pupilloplasty in cases of Urrets-Zavalia syndrome. Methods: In this prospective interventional study, single-pass four-throw was performed to reconstruct the pupil in all symptomatic cases with Urrets-Zavalia syndrome. Applanation tonometry, indentation gonioscopy, and anterior segment optical coherence tomography for anterior chamber angle assessment were performed in all the cases. Results: Out of 10 cases that were identified with Urrets-Zavalia syndrome, the procedure was performed in 7 cases, whereas 3 cases were left untreated, as they did not have any visual complaints. Five out of seven eyes had preoperative raised intraocular pressure with appositional closure of the angle. Postoperatively, intraocular pressure was controlled in all the eyes, whereas one eye required antiglaucoma medications to control the intraocular pressure. The mean preoperative and postoperative best-corrected visual acuity was 1.1 ± 1.2 and 0.4 ± 0.4 LogMar, respectively. There was a significant improvement in the best-corrected visual acuity (p = 0.0169) in the postoperative period. The mean preoperative and postoperative intraocular pressure was 26.6 ± 11.23 and 16.3 ± 2.98 mm Hg, respectively (p = 0.0168). All the patients had a minimum of 6-month follow-up period (range = 6–8 months). Conclusion: Single-pass four-throw can be employed for cases with Urrets-Zavalia syndrome, and single-pass four-throw helps to prevent the postoperative glare and narrows down the pupil size effectively. Single-pass four-throw helps to alleviate the anterior chamber angle apposition in patients with Urrets-Zavalia syndrome by mechanically pulling the peripheral iris centrally as demonstrated on anterior segment optical coherence tomography. The study also reports the occurrence of Urrets-Zavalia syndrome after glued intraocular lens surgery.

Single-pass four-throw pupilloplasty for secondary angle-closure glaucoma associated with silicon oil tamponade

2018 ◽  
Vol 29 (5) ◽  
pp. 561-565 ◽  
Author(s):  
Priya Narang ◽  
Ashar Agarwal ◽  
Amar Agarwal
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Anterior Segment ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Single Pass ◽  
Silicon Oil ◽  
The Mean

Purpose: To describe the feasibility and efficacy of performing single-pass four-throw pupilloplasty for secondary angle-closure glaucoma post silicon oil tamponade. Methods: The procedure was performed in five eyes of five patients. All the cases underwent silicon oil removal with single-pass four-throw pupilloplasty. Single-pass four-throw procedure involves a single pass of needle through the iris tissue that is to be apposed followed by taking four throws by passing the suture end through the loop that is withdrawn from the anterior chamber as in a modified Siepser’s slip-knot technique. Both the suture ends are pulled and this leads to sliding of the loop into the anterior chamber. Surgical pupilloplasty stretches the peripheral iris tissue and helps in breaking the peripheral anterior synechia. Intraoperative gonioscopy and anterior segment optical coherence tomography were performed in all the cases. Results: Intraoperative gonioscopy and anterior segment optical coherence tomography demonstrated opening of the anterior chamber angles with breakage of peripheral anterior synechia. The mean preoperative and postoperative best-corrected visual acuity in logarithm of minimum angle of resolution was 1.24 ± 0.23 and 0.56 ± 0.18, respectively (p < 0.001). The mean preoperative and postoperative intraocular pressure was 38.2 ± 4.97 and 13.0 ± 2.35 mm Hg, respectively. There was a significant decrease in intraocular pressure and marked improvement in visual acuity in all the cases. Conclusion: Surgical pupilloplasty helps to relieve the post-silicon oil-induced secondary angle-closure glaucoma by breaking peripheral anterior synechia and significantly opening the anterior chamber angles.

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