scholarly journals Clear Corneal Phacovitrectomy with Posterior Capsulorhexis and IOL Implantation in Management of Selective Vitreoretinal Cases

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Ernest V. Boiko ◽  
Sergey V. Churashov ◽  
Alexei N. Kulikov ◽  
Dmitrii S. Maltsev
Keyword(s):  
Case Series ◽  
Vitreous Hemorrhage ◽  
Visual Outcome ◽  
Anterior Capsule ◽  
Epiretinal Membranes ◽  
Good Visual Outcome ◽  
The Mean ◽  
Capsular Bag ◽  
Anterior Proliferative Vitreoretinopathy

Purpose. To describe our technique, clear corneal phacovitrectomy with posterior capsulorhexis (CCPV), for the management of selected posterior segment intraocular foreign body (IOFB), posteriorly dislocated lens fragments (PDLF), and proliferative diabetic retinopathy (PDR) cases.Methods. This was a single-center retrospective interventional case series. In 21 patients (21 eyes) we performed phacovitrectomy through three clear corneal tunnel incisions (CCTI) and posterior capsulorhexis to remove IOFB (n=8), PDLF from the vitreous cavity after complicated phacoemulsification (n=6), and vitreous hemorrhage and epiretinal membranes in PDR (n=7). The procedure was completed with implantation of a hydrophobic acrylic IOL through the CCTI.Results. The mean visual acuity (logMAR) was 0.90 preoperative and improved to 0.26 over a mean follow-up of 8.7 months (range, 6–12 months). The intraocular lens was implanted into the capsular bag (n=12) or onto the anterior capsule (n=9). One PDR patient experienced an intraprocedural complication, hemorrhage from isolated fibrovascular adhesions. One IOFB patient developed apparent anterior proliferative vitreoretinopathy and required a repeat intervention.Conclusion. Selected vitreoretinal IOFB, PDLF, and PDR cases can be successfully managed by a combined surgical approach involving clear corneal phacovitrectomy with posterior capsulorhexis and implantation of an IOL, with good visual outcome and a low complication rate.

Retinotomy and retinectomy for anterior inferior proliferative vitreoretinopathy: Can visual outcome be improved?

2021 ◽  
pp. 112067212110128
Author(s):  
Mumin Hocaoglu ◽  
Murat Karacorlu ◽  
M. Giray Ersoz ◽  
Isil Sayman Muslubas ◽  
Serra Arf
Keyword(s):  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Clinical Stage ◽  
Case Series ◽  
Visual Outcome ◽  
Attachment Rate ◽  
Good Visual Outcome ◽  
The Mean

Purpose: To describe the treatment outcomes and prognostic factors of retinotomy/retinectomy for rhegmatogenous retinal detachment (RD) complicated anterior inferior proliferative vitreoretinopathy (PVR). Methods: Retrospective, nonrandomized, single-center case series. The outcomes of 126 cases of retinotomy/retinectomy for RD complicated by advanced (Grade C) anterior inferior PVR managed consistently by one surgeon during a 15-year period were evaluated. Results: Forty-two eyes (33%) had primary RDs and 84 (67%) had recurrent RDs. The extent of retinotomy/retinectomy varied: 90° in 21 eyes (17%), >90° to <180° in 49 eyes (39%), and ⩾180° to ⩽240° in 56 eyes (44%). The retinotomy/retinectomy location was peripheral in 58 eyes (46%) and equatorial in 68 eyes (54%). The mean follow-up period was 43 ± 42 months. The silicone oil (SO) was removed from 98% of the eyes. The single-operation success rate after the primary retinectomy was 87%, and the final attachment rate was 94%. Visual acuity improved from 20/630 to 20/160 ( p < 0.001). Vision ⩾20/200 was achieved in 101 eyes (80%). Good visual outcome was correlated positively with preoperative VA ( p = 0.02), previous vitrectomy with gas tamponade ( p = 0.007), and was negatively correlated with number of previous RD operations ( p = 0.01), larger extent of RD ( p = 0.02) and more extensive retinotomy/retinectomy ( p = 0.04). Conclusions: An appropriate and timely intervention, including vitrectomy alone, inferior relaxing retinotomy/retinectomy and standard SO tamponade provide satisfactory outcomes for RDs complicated by PVR. Lesser extension of grade C PVR at baseline, such as PVR limited to one quadrant should encourage vitreoretinal specialists to consider retinotomy/retinectomy at a milder clinical stage of PVR development.

Refractive and Visual Outcomes after Scleral Fixated Intraocular Lens Implantation in Children with Ectopia Lentis

2020 ◽  
Vol 12 (1) ◽  
pp. 75-82
Author(s):  
Regina Lalramhluni ◽  
Soveeta Rath ◽  
Ankita Shrivastav ◽  
Prem Kumar Singh ◽  
Rahul Mayor ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Visual Outcome ◽  
Ectopia Lentis ◽  
Corrected Visual Acuity ◽  
Good Visual Outcome ◽  
Induced Astigmatism ◽  
The Mean ◽  
The Stability ◽  
Scleral Fixated Intraocular Lens

Introduction: This study was conducted to report the refractive and visual outcome after Scleral Fixated Intraocular Lens (SFIOL) implantation in children with nontraumatic ectopia lentis. Methods: Retrospective review of the medical records of 25 eyes of 15 patients who underwent SFIOL implantation in children with non-traumatic ectopia lentis. Results: The mean best corrected visual acuity (BCVA) before SFIOL implantation was 1.07 ± 0.9 logMar units [median: 0.9, Interquartile range (ΙQR): 0.415 to 1.555] which improved to 0.41 ± 0.33 logMar units (median: 0.22, ΙQR: 0.180 to 1.555) at two months postoperative follow up. In phakic group, the mean spherical refraction preoperatively was -12.04 ± 7.82 DS (dioptre sphere) (IQR: +16 to -5.875) and postoperatively was +0.93 ± 2.67DS (IQR: -0.375 to +2). In aphakic group, the mean spherical refraction preoperatively was +12.22 ± 2.05 DS and postoperatively was +1.2 ± 1.9 DS. The mean total astigmatism preoperatively was -6.44 ± 4.95 DC (dioptre cylinder) (median: 6, IQR: -10.50 to +2) and postoperatively was -1.47 ± 0.98 DC (median: -1.5, IQR: -2 to - 0.625 ). The mean IOL induced astigmatism was -1.01 ± 0.95 DC (median -0.75, IQR: -1.33 to - 0.25). The spherical refractive equivalent was within 2 Diopter (D) of the target refraction calculated preoperatively in 20 eyes and in five eyes it was more than 2 D. Conclusion: SFIOL implantation is associated with good visual outcome with a significant improvement in the refractive error. However, a longer follow up is required to assess the change of refraction and the stability of the SFIOL.

scholarly journals Long-term follow-up of neodymium:YAG laser anterior capsulotomy for the treatment of anterior capsular phimosis

2018 ◽  
Vol 46 (9) ◽  
pp. 3692-3697 ◽  
Author(s):  
Hehua Ye ◽  
Jiming Zhang ◽  
Yiyong Qian
Keyword(s):  
Nd:Yag Laser ◽  
Case Series ◽  
Anterior Capsule ◽  
Long Term Study ◽  
Before And After ◽  
Long Term Follow Up ◽  
The Mean ◽  
Anterior Capsulotomy

Objective To investigate the long-term safety and efficacy of Nd:YAG laser anterior capsulotomy for the treatment of anterior capsular phimosis. Methods We retrospectively analyzed a consecutive case series of Nd:YAG laser anterior capsulotomy in patients with anterior capsular phimosis, who were treated between November 2012 and April 2014. Data collected included risk factors, interval between surgery and capsulotomy, best-corrected visual acuity (BCVA), and diameter of anterior capsule opening before and after Nd:YAG laser anterior capsulotomy. Results Eleven eyes of 11 patients were included in the study. The mean follow-up time was 30.1 ± 4.5 months (range: 26–42 months). At the last follow-up, the mean diameter of the anterior capsule opening was 5.1 ± 0.2 mm, which was significantly greater than the diameter before laser capsulotomy (2.2 ± 0.8 mm). BCVA remained stable or improved in nine eyes (81.8%) following capsulotomy. No patients experienced recurrence of phimosis. Conclusions In a long-term study of >2 years, we found that Nd:YAG laser anterior capsulotomy is safe and effective for the treatment of anterior capsule phimosis.

Outcomes of sutureless and sutured scleral fixated intraocular lens in paediatric population

2020 ◽  
pp. 112067212096549
Author(s):  
Manavi D Sindal ◽  
Arthi M
Keyword(s):  
Case Series ◽  
Vitreous Hemorrhage ◽  
Paediatric Population ◽  
Intraocular Lenses ◽  
Final Visit ◽  
Retrospective Case ◽  
Operative Complications ◽  
The Mean ◽  
Post Operative Complications

Purpose: To analyse the outcomes of sutureless and sutured scleral fixated intraocular lenses (SFIOL) in paediatric population. Setting: Vitreoretina department of a tertiary eye care institute in Southern India Design: Retrospective case series Methods: Data were collected from January 2010 to December 2018 for children less than 18 years of age, based on the following parameters: demographics, pre-operative characteristics, duration between aphakia and surgery, previous amblyopia treatment, the uncorrected (UCVA) and the best corrected visual acuity (BCVA) at baseline and, 1,6 and 12 months or final visit. Early and late post-operative complications along with details of any resurgery was recorded. Results: The study included 45 eyes of 43 patients. The mean age when children became aphakic was 8.8±3.6 years and the mean age at SFIOL implantation 10.1 ± 3.9 years. Sutureless SFIOL was performed for 36 (80%) eyes. The improvement in UCVA was statistically significant at 1-month follow up. Transient hypotony (n = 3), vitreous hemorrhage ( n = 7) and raised IOP ( n = 4) were the most observed early post-operative complications, while haptic exposure or disinsertion ( n = 4, 9%) was a delayed postoperative complication. The mean spherical equivalent at the last follow up was 1.96 ± 0.83D and mean postoperative cylinder 2.32 ± 1.3D. The children were followed up for a mean duration of 20 ± 21.7 months. History of previous vitrectomy was found to be associated with two line reduction in UCVA (95% CI = 0.03–0.5 logMAR, p = 0.008). Conclusion: SFIOLs- sutured and sutureless; both were suitable for the rehabilitation of paediatric aphakia. Sutureless scleral fixation is a safe alternative for children but prospective studies with longer follow-up are needed.

scholarly journals Vitreous Hemorrhage in Pediatric Age Group

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Dora H. AlHarkan ◽  
Eman S. Kahtani ◽  
Priscilla W. Gikandi ◽  
Ahmed M. Abu El-Asrar
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Vitreous Hemorrhage ◽  
Visual Outcome ◽  
Age Group ◽  
Pediatric Age ◽  
Pediatric Age Group ◽  
Good Visual Outcome ◽  
Negative Predictor

Purpose.To identify and study causes of vitreous hemorrhage (VH) in pediatric age group and to investigate factors predicting visual and anatomical outcomes.Procedure.A retrospective review of patients aged 16 years or less with the diagnosis of vitreous hemorrhage from January 2005 until December 2010.Results.A total number of 230 patients (240 eyes) were identified. Traumatic vitreous hemorrhage accounted for 82.5%. In cases of accidental trauma, final visual acuity of 20/200 was significantly associated with visual acuity of ≥20/200 at presentation and the absence of retinal detachment at last follow-up. Patients with nontraumatic vitreous hemorrhage were significantly younger with higher rates of enucleation/evisceration/exenteration and retinal detachment at last follow-up compared to traumatic cases.Conclusion.Trauma is the most common cause of VH in pediatric age group. In this group, initial visual acuity was the most important predictor for visual outcome, and the presence of retinal detachment is a negative predictor for final good visual outcome. The outcome is significantly worse in nontraumatic cases compared to traumatic cases.

scholarly journals Clinical Study of Scleral Fixated Intraocular Lens Implantation in Blunt Ocular Trauma

2021 ◽  
pp. 86-91
Author(s):  
Girish Gadre ◽  
Neha Maheshwari ◽  
V. H. Karambelkar
Keyword(s):  
Intraocular Pressure ◽  
Postoperative Complications ◽  
Vitreous Hemorrhage ◽  
Corneal Edema ◽  
Visual Outcome ◽  
P Value ◽  
Cataractous Lens ◽  
Pars Plana ◽  
The Mean

Aim: to assess visual outcome and complications associated with SFIOL implantation in traumatic lens subluxation/ dislocation cases. Methods: This is a retrospective study of 45 patients who were managed for traumatic dislocation/subluxation of clear or cataractous lenses from June 2019 to July 2020 in a Krishna hospital, Karad, Satara. All cases underwent anterior vitrectomy/3 port pars plana vitrectomy + removal of lens and ab externo 2 point scleral fixation with rigid or foldable sfiol. In posteriorly dislocated/subluxated lens, vitrectomy was done and the lens was removed using pick forceps and retrieved by hand shake technique. In anteriorly dislocated cataractous lens, the lens was removed through the tunnel incision. Results: Majority of the patients were between 55-65 years of age with male pre-ponderance (73.3%).Out of 45 cases, 21 cases (46.6%) were traumatic dislocated lens and 24 cases (53.3%) were traumatic subluxated lens. The mean preoperative BCVA was 0.13 ± 0.24 logMAR, which improved 0.39 ± 0.366 logMAR postoperatively (P <0.0001 ).Preoperatively BCVA in logMAR in 39 cases (86.6%) was 0.3 or better, 6 cases (13.3%) was 0.3 to 1.0 . Postoperatively BCVA in logMAR in 21 cases (46.67%) was 0.3 or better, 24 cases (53.3%) was 0.3 to 1. P-value is 0.00057 which is significant. Early postoperative complications noted were raised intraocular pressure in 12 cases (26.6%), corneal edema in 9 cases (20%), vitreous hemorrhage in 8 cases (17.7%)  and hypotony in 3 cases (6.67%).Late postoperative complications were persistent elevation of intraocular pressure in 10 cases (22.2%), cystoid macular edema in 3 cases (6.67%), epiretinal membrane in 3 cases (6.67%). Conclusion: In every horrendous case, long haul follow-up is needed to distinguish confusions and start treatment at the most punctual.

scholarly journals Clinical Features and Surgical Outcomes of Posterior Segment Intraocular Foreign Bodies in Children in East China

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Ting Zhang ◽  
Hong Zhuang ◽  
Keyan Wang ◽  
Gezhi Xu
Keyword(s):  
Clinical Features ◽  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Visual Outcome ◽  
Posterior Segment ◽  
Poor Visual Outcome ◽  
Long Term Follow Up ◽  
The Mean

Purpose. To report the long-term follow-up results of posterior segment intraocular foreign body (IOFB) removal in children and to determine the prognostic factors for visual outcome. Methods. Design: retrospective, noncomparative, interventional case series; a single tertiary care center study. Participants or samples: eleven eyes (11 patients) under 16 years of age with posterior segment IOFB injuries from May 2014 to November 2017. Main outcome measures: clinical features of injury, visual acuity, and complications. Results. The mean age was 6.8 years, and the mean follow-up was 20.2 months. The main IOFB sources were accidental penetration of the eye by materials in the playground (6 cases) or by pencil lead at school (4 cases). The mean IOFB size was 3.8 (range 1–6) mm. At the last visit, the visual acuities were 20/40 or better in 40.0% of patients and better than 20/200 in 70.0%. Poor visual outcome was correlated with intraoperative rhegmatogenous retinal detachment (P=0.0083). Postoperative complications included elevated transient intraocular pressure, retinal redetachment, and secondary glaucoma. Conclusions. The clinical features of pediatric posterior segment IOFBs suggest insufficient awareness of such injuries both on the playground and at school. Visual outcomes from surgical treatment were relatively favorable in this series.

scholarly journals Clinical Outcomes of Primary Posterior Continuous Curvilinear Capsulorhexis in Postvitrectomy Cataract Eyes

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Mengting Yu ◽  
Duan Yan ◽  
Wenjie Wu ◽  
Yingbin Wang ◽  
Xinna Wu
Keyword(s):  
Case Series ◽  
Posterior Capsular Opacification ◽  
Retrospective Case ◽  
Cell Counts ◽  
Corrected Distance Visual Acuity ◽  
Lens Implantation ◽  
The Mean ◽  
Epithelium Cells ◽  
Capsular Bag

Purpose. To evaluate the safety and outcomes of primary posterior continuous curvilinear capsulorhexis (PPCCC) combined with phacoemulsification in postvitrectomy eyes. Design. Retrospective case series. Methods. Twenty-one postvitrectomy eyes of 21 patients with cataract between April 2017 and December 2019 were enrolled. PPCCC through the cornea incision was performed before in-the-bag intraocular lens implantation. All patients were followed up for at least 3 months postoperatively. The outcome measures were corrected distance visual acuity (CDVA), intraocular pressure (IOP), corneal endothelium cell counts (CECC), central macular thickness (CMT), the occurrence of intraoperative or postoperative complications, and the incidence of posterior capsular opacification (PCO). Results. The mean age was 56.14 ± 9.76 years (ranging from 31 to 68). The mean Snellen CDVA was 20/400 preoperatively and improved to 20/67 postoperatively P<0.001. No significant differences were found between IOP P=0.96 and CMT P=0.42 preoperatively and postoperatively. The mean CECC was 2571.8 ± 319.3 cells/mm2 preoperatively and 2498.2 ± 346.3 cells/mm2 postoperatively P<0.05. Lens epithelium cells proliferation was confined to the peripheral capsular bag during a mean follow-up of 12.9 ± 10.5 months (ranging from 3 to 28 months). Intraoperative posterior capsule extension occurred in 1 eye (4%), although it did not affect the patient’s vision. No serious complications, including retinal detachment or endophthalmitis, were detected in any of the 21 cases. Conclusion. PPCCC through cornea incision combined with phacoemulsification may be a safe and practical alternative to prevent PCO in postvitrectomy eyes with cataract.

scholarly journals Outcomes of implantable collamer lens V4 and V4c for correction of high myopia – a case series

2016 ◽  
Vol 7 (2) ◽  
pp. 164-172 ◽  
Author(s):  
Smita Karandikar ◽  
Vipul Bhandari ◽  
Jagdeesh Reddy
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
High Myopia ◽  
Case Series ◽  
Visual Outcome ◽  
Visual Disability ◽  
Implantable Collamer Lens ◽  
Distant Visual Acuity ◽  
The Mean

Objective: To evaluate the visual outcomes and intraocular pressure changes after Visian Implantable Collamer Lens (ICL) implantation V4b and V4c (with centraflow technology) for correction of myopia. Materials and methods: A prospective, consecutive, comparative interventional case series of V4b and V4c ICL implantation done for correction of high myopia (>-6 diopter D) in patients unsuitable for laser vision correction. The outcome measures that were evaluated included preoperative and postoperative uncorrected distant visual acuity (UDVA), best spectacle corrected distant visual acuity (CDVA), endothelial cell count (ECC), presence of lens opacification, intraocular pressure (IOP) and ICL vaulting. A follow-up of upto 1 year was done. A questionnaire was given at the end of follow-up period. Results: A total of 30 eyes (24.56±4.8 years) underwent V4b ICL implantation (10 non-toric, 20 toric ICL-TICL) with intraoperative peripheral iridectomy (PI) and 34 eyes (26.13±3.8 years) had implantation of V4c ICL with centraflow (12 non-toric, 22 TICL). The mean preoperative manifest spherical equivalent (MSE) was 8.98±2.8 D and 9.24±2.4 D in the V4b and V4c groups respectively which reduced to postoperative values of -0.28±1.3 D and -0.19±1.18 D respectively. The mean preoperative astigmatism was -1.8±1.2 diopter cylinder (Dcyl) and -1.9±1.6 Dcyl which respectively reduced to -0.8±0.8 Dcyl and -0.9±0.3 Dcyl. At the end of 1 year follow up, mean ECC loss was 7.6% and 7.1%, mean vault was 583.12±231.12 μ and 602±241.24μ respectively in the V4b and V4c groups. Anterior subcapsular opacities were present in 6.66% and 2.94% of eyes with V4b and V4c groups respectively. Two eyes from both V4b (10%) and V4c (8.33%) had rotation of more than 30 degrees and required re-rotation surgery done successfully. Two eyes (6.66%) with V4b ICL implantation had high postoperative IOP (>35 mm Hg) and required Nd:Yag laser iridotomy later done with successful control of IOP. The safety indices were 1.12 and 1.15 and efficacy indices were 1.5 and 1.6 in the V4b and V4c groups respectively at the end of 1 year. The most common visual complaint was glare and haloes in 24% and 27% in the two groups respectively. However, they were not annoying enough to cause visual disability. Conclusions: Both V4b and V4c Visian ICL implantations are comparable in terms of visual outcome and safety profile for correction of high myopia. However, V4c ICL offers these advantages without the requirement of an additional PI. 

scholarly journals Combination of Intravitreal Injection of Ranibizumab and Photocoagulation for the Treatment of Aggressive Posterior Retinopathy of Prematurity with Vitreous Hemorrhage

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Yu Xu ◽  
Xiaoli Kang ◽  
Qi Zhang ◽  
Qiujing Huang ◽  
Jiao Lv ◽  
...  
Keyword(s):  
Laser Therapy ◽  
Retinopathy Of Prematurity ◽  
Case Series ◽  
Vitreous Hemorrhage ◽  
Primary Treatment ◽  
Intravitreal Ranibizumab ◽  
Case Series Study ◽  
The Mean ◽  
Mean Time

To investigate the efficacy of intravitreal ranibizumab (IVR) combined with laser photocoagulation for aggressive posterior retinopathy of prematurity (AP-ROP) patients with vitreous hemorrhage, we conducted a retrospective observational case series study. A total of 37 eyes of 20 patients’ medical records were reviewed. Patients first received IVR (0.25 mg/0.025 mL) and later photocoagulation. The mean postconceptual age of injection was 34.6 ± 1.4 weeks, and the mean follow-up period was 39.3 ± 8.3 weeks. During the follow-up, 96.6% eyes had various degree of rapid absorption of vitreous hemorrhage after IVR. The mean time of received first photocoagulation after IVR was 4.8 ± 2.9 weeks. Ten (27.0%) eyes received second laser therapy and the mean time of second laser therapy after IVR was 3.2 ± 0.8 weeks. All eyes exhibited adequate regression of ROP and were stable with attached retina. Fibrosis membrane was observed in seven eyes (18.9%) and three of them demonstrated mild ectopic macula. No significant side effects related to IVR were observed. So IVR could be conducted as primary treatment of AP-ROP associated with vitreous hemorrhage, which can improve the fundus visibility, followed by conventional photocoagulation. Further randomized controlled trials are necessary to compare the clinical efficacy and safety with conventional interventions.

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