scholarly journals Evaluation of the Effectiveness of Surgical Treatment of Malignant Glaucoma in Pseudophakic Eyes through Partial PPV with Establishment of Communication between the Anterior Chamber and the Vitreous Cavity

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Marek Rękas ◽  
Karolina Krix-Jachym ◽  
Tomasz Żarnowski
Keyword(s):  
Anterior Chamber ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Vitreous Cavity ◽  
Case Series Study ◽  
Malignant Glaucoma ◽  
Corrected Distance Visual Acuity ◽  
Efficacy Measures ◽  
Proposed Modification ◽  
One Year

Purpose. Determination of partial posterior vitrectomy (PPV) in the proposed modification for treatment of malignant glaucoma.Methods. The prospective, consecutive, single-center case series study involved patients in whom symptoms of malignant glaucoma occurred after combined cataract and glaucoma surgery or after glaucoma surgery in pseudophakic eye. When medical and laser treatment were not successful, partial PPV with establishment of communication between the anterior chamber and the vitreous cavity was performed. Efficacy measures were intraocular pressure (IOP) reduction, corrected distance visual acuity (CDVA), AND the number of antiglaucoma medications. Surgical success and occurring complications were also evaluated.Results. The study enrolled 20 eyes of 17 patients. Average IOP was reduced from 30.4 ± 14.2 (SD) mmHg to 14.6 ± 3.2 (SD) mmHg one year after surgery (P<0.00001). A statistically significant reduction of the number of antiglaucoma medications was obtained from 3.3 ± 1.1 (SD) preoperatively to 1.2 ± 1.1 (SD) at the end of follow-up. Statistically significant improvement of CDVA was observed 3, 6, and 12 months after surgery.Conclusions. Partial PPV with establishment of communication between the anterior chamber and the vitreous cavity enables effective IOP control over a 12-month observation; however, in most cases, it is necessary to use antiglaucoma medications for IOP control.

scholarly journals Malignant Glaucoma in a Pseudophakic Eye with Slack Lens Zonules

2021 ◽  
Vol 20 (3) ◽  
pp. 110-113
Author(s):  
Young Joo Choi ◽  
Chang Won Kee ◽  
Jong Chul Han
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Glaucoma Surgery ◽  
Aqueous Fluid ◽  
Vitreous Cavity ◽  
Anterior Chamber Angle ◽  
Initial Examination ◽  
Ahmed Valve ◽  
Malignant Glaucoma ◽  
Pars Plana

Purpose: To report a case of malignant glaucoma after glaucoma surgery in a pseudophakic eye with slack lens zonules.Case summary: An 83-year-old man presented with high intraocular pressure of the left eye. He underwent cataract surgery in the left eye ten years ago. He was diagnosed with glaucoma two years ago and had used anti-glaucoma medications. The initial examination of the left eye revealed intraocular pressure of 24 mmHg and zonular dehiscence. We performed Ahmed valve implant surgery because medical treatment failed to lower the intraocular pressure. The anterior chamber angle was nearly closed. After the surgery, over-filtration of aqueous fluid was observed. Injecting the balanced salt solution into the anterior chamber demonstrated misdirected flow of aqueous fluid into the vitreous cavity behind the unstable intraocular lens. The eye was diagnosed with malignant glaucoma; therefore, pars plana vitrectomy was performed. After the vitrectomy, the anterior chamber was not deep; therefore, we repositioned the tip of Ahmed valve implant from the anterior chamber to the vitreous cavity. Subsequently, the anterior chamber became deep and intraocular pressure normalized. The patient remained stable two months after the vitrectomy.Conclusions: Malignant glaucoma can occur in pseudophakic eyes with slack lens zonules after glaucoma surgery, due to misdirection of aqueous fluid. This case suggests that the tip of Ahmed valve implant should be located in the vitreous cavity after vitrectomy, to prevent misdirected flow of aqueous fluid.

scholarly journals One-year outcomes of fixed-dosing Aflibercept therapy for pre treated and naive polypoidal choroidal vasculopathy patient

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hun Gu Choo ◽  
Jin Hae Lee ◽  
Hyun Sub Oh ◽  
Soon Hyun Kim ◽  
Yong Sung You ◽  
...  
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Vision Loss ◽  
Case Series ◽  
Age Related Macular Degeneration ◽  
Research Information ◽  
Age Related ◽  
Case Series Study ◽  
Treatment Naïve ◽  
One Year ◽  
Choroidal Vasculopathy

Abstract Background Polypoidal choroidal vasculopathy (PCV) is a type of age-related macular degeneration that can cause permanent vision loss. The purpose of this paper was to report the one-year outcomes of fixed-dosing aflibercept therapy for the treatment of PCV. Methods This was a prospective, single-arm, interventional case series study of 25 PCV patients; 12 pre-treated and 13 treatment-naïve patients. The patients were treated and monitored for 12 months. Each patient was administered with an aflibercept (2.0 mg) injection every month for the first 3 months (the loading phase), and thereafter, once every 2 months. At every follow-up visit, best-corrected visual acuity (BCVA) test, fundus examination, and optical coherence tomography for measuring the central subfield macular thickness (CSMT) were performed. Fluorescein and indocyanine green angiography were conducted at baseline and at 4 and 12 months. Results After 12 months of aflibercept therapy, the mean BCVA of the patients significantly improved from 65.48 letters at baseline to 69.91 letters (p=0.001), and the CSMT significantly decreased from 406.92 um at baseline to 276.12 um (p< 0.001). Additionally, ten patients (40%) showed complete polyp regression. The treatment-naïve patients showed a statistically significant improvement in BCVA from 66.58 letters at baseline to 76.36 letters at 12 months, and a significant decrease in CSMT, from 462 to 243 um. In the pre-treated group, there was no change in BCVA (64.46 letters), and the decrease in CSMT from 356.08 to 303.69 um was not statistically significant. Conclusions The fixed-dosing aflibercept regimen is effective for treating patients with PCV and is more effective in treatment-naïve patients than in pre-treated patients. Trial registration Clinical Research Information Service (CRiS), Republic of Korea. Identifer: KCT0005798, Registered: Jan 20, 2021. Retrospectively registered, URL: https://cris.nih.go.kr/cris/en/search/search_result_st01.jsp?seq=18546

scholarly journals Aphakia Correction by Injection of Foldable Intra Ocular Lens in the Anterior Chamber

2013 ◽  
Vol 5 ◽  
pp. OED.S12672
Author(s):  
Kagmeni Giles ◽  
Moukouri Ernest ◽  
Domngang Christelle ◽  
Nguefack-Tsague Georges ◽  
Cheuteu Raoul ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Teaching Hospital ◽  
Case Series ◽  
University Teaching ◽  
Case Series Study ◽  
The Mean ◽  
The University

We assessed the outcomes of the use of anterior chamber foldable lens for unilateral aphakia correction at the University Teaching Hospital of Yaounde. In this retrospective, non-comparative, consecutive case series study, we reviewed the records of patients who underwent an operation for aphakia correction by the means of injection of an angular supported foldable lens between January 2009 and December 2011 in the University Teaching Hospital Yaounde. Student's paired t-test was carried out to compare preoperative and postoperative visual acuity (VA) and intraocular pressure (TOP). P-values less than 0.05 were considered statistically significant. Twenty-one patients were included in the study; twelve were male (57.1%) and nine were female (42.9%). The mean age was 55.38 ± 17.67 years (range 9–75 years). The mean follow-up duration was 5.95 ± 3.14 months (range 2–12 months). The mean logMAR visual acuity was 1.26 ± 0.46 pre-operatively and 0.78 ± 0.57 post-operatively ( P = 0.003). The change in intraocular pressure was not statistically significant. Complications included intraocular hypertension (over 21 mmHg) in 3 patients (14.3%) and macular edema, pupillar ovalization, and retinal detachment in one patient each. The results indicate that injection of an angular support foldable lens in the anterior chamber is a useful technique for the correction of aphakia in eyes without capsular support. More extended follow-up, however, and a larger series of patients are needed to ascertain the effectiveness and safety of this procedure.

scholarly journals Intraocular lens dislocation: a novel in-situ scleral refixation technique using a 25 Gauge trocar in the anterior chamber

2018 ◽  
Vol 3 (1) ◽  
pp. e000174
Author(s):  
Fabrizio Giansanti ◽  
Ruggero Tartaro ◽  
Tomaso Caporossi ◽  
Vittoria Murro ◽  
Alfonso Savastano ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Intraocular Lens ◽  
Case Series ◽  
Cystoid Macular Oedema ◽  
Closed Chamber ◽  
Intraocular Lens Dislocation ◽  
Case Series Study ◽  
Single Piece ◽  
Pars Plana ◽  
Corneal Decompensation

ObjectiveIntraocular lens (IOL) repositioning using a closed-eye approach could be carried out in some selected cases. Our study focuses on the efficacy and safety of a IOL closed-eye repositioning technique using scleral suture, which is performed using a trocar as an intrastromal limbal guide.Methods and analysisThirty-one eyes of 31 patients with late IOL dislocation operated on between January 2015 and May 2017 were included in this retrospective non-comparative consecutive case series study. The patients had a single-piece in-the-bag dislocation or a 3-pieces in-the-bag or out-of-the-bag dislocation. The patients underwent an anterior vitrectomy and a scleral refixation in a closed chamber using a 10/0 polypropylene suture passed through a 25 Gauge trocar inserted in the anterior chamber.ResultsThe mean follow-up time was 19.54 months. Average preoperative best-corrected visual acuity (BCVA) was 0.73 LogMar (±0.21 SD); while average postoperative BCVA was 0.27 LogMar (±0.23 SD). Fifteen patients underwent anterior pars plana vitrectomy (PPV) while 16 patients did not; moreover, two patients underwent PPV. Six patients had an increase of postoperative intraocular pressure, two patients had postoperative decentration, two patients had postoperative cystoid macular oedema, none of the patients had major complications such as retinal detachment, choroidal detachment, malignant glaucoma, irreversible corneal decompensation and endophthalmitis.ConclusionWe can affirm that our technique may be safe and useful in the case of 3-piece in-the bag or out-of the bag dislocated IOLs and also in the case of in-the-bag single-piece dislocated IOLs.

scholarly journals Anatomical and Visual Effects of Implantable Phakic Contact Lens on Correction of Myopia

2022 ◽  
Author(s):  
Mahmoud Ekram ◽  
Ahmed Mohamed Kamal Elshafei ◽  
Asmaa Anwar Mohamed ◽  
Mohamed Farouk Sayed Othman Abdelkader
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Contact Lens ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Case Series ◽  
Care Group ◽  
Case Series Study ◽  
Significant Difference ◽  
The Mean

Abstract Purpose: To evaluate the anatomical effects of implantable phakic contact lens (IPCL) (Care Group, India) on anterior segment and its visual outcomes .Patients and methods: In a prospective interventional case series study, 60 highly myopic eyes of 32 patients were subjected to IPCL implantation in the Ophthalmology Department of Minia University Hospital, Egypt from January 2019 to June 2021. All patients had complete ophthalmic examination and were followed up for 1 year. Pentacam was used for preoperative and postoperative estimation of anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV) and IPCL vault in the 1st, 3rd, and 12th months. Assessment of corneal endothelium was done using specular microscope preoperatively and after 12 months. Preoperative and postoperative refraction and visual acuity were measured. Results: There was a statistically significant decrease in ACD, ACA, and ACV. There was no significant difference between preoperative and postoperative mean intraocular pressure (IOP) by the 12th month (P=0.163). The mean preoperative endothelial cell count (ECD) was significantly reduced from 2929.3±248 cells/mm2 to 2737.9±303 cells/mm2 at the 12th month (P<0.001). with a statistically highly significant improvement of mean Log Mar uncorrected visual acuity (UCVA) from 1.48±0.19 preoperatively to 0.46±0.11 by the end of follow up (P<0.001) with insignificant difference between preoperative best corrected visual acuity (BCVA) and postoperative UCVA (P=0.209). In the 12th month, the mean vault was 240±540 μm. No sight threatening complications occurred.Conclusion: Although IPCL induced anatomical changes, it was safe and effective for correction of high myopia.

scholarly journals HIRSCHSPRUNG’S DISEASE

2010 ◽  
Vol 17 (02) ◽  
pp. 223-231
Author(s):  
MUHAMMAD ZAFAR IQBAL ◽  
Hammad Azam ◽  
MUHAMMAD JAHANGIR ◽  
Muhammad Tahir ◽  
MUHAMMAD ANWAR ◽  
...  
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Case Series ◽  
Abdominal Distension ◽  
Functional Results ◽  
International Studies ◽  
Stool Incontinence ◽  
Case Series Study ◽  
Duhamel Procedure ◽  
One Year

Introduction: Hirschsprung’s Disease is one of the most common congenital anomalies that Pediatric Surgeons manage. In spite of the various modifications of pull through procedures available, the long term functional results are less than ideal. However, Modified Duhamel Procedure is one which has relatively good functional results and that is the reason we have selected this procedure for Hirschsprung’s disease in Sheikh Zayed Hospital, Rahim Yar Khan. Objectives: To evaluate the outcome of patients after Modified Duhamel Procedure for Hirschsprung’s Disease. Design: This is case series study. Settings: Department of Pediatric Surgery Sheikh Zayed Medical College/ Hospital Rahim Yar Khan. Period: Seventeen cases were studied over a period of two year i.e. from November 2006 to December, 2008. Material and Method: Seventeen (17) cases from both sexes were operated for Hirschsprung’s Disease over a period of one year and Modified Duhamel Procedure was adopted for all these cases. All patients were diagnosed cases of rectosigmoidal aganglionosis and follow up was done over a period of one year according to a comprehensive Proforma. Four parameters like normal stool evacuation, abdominal distension, soiling and stool incontinence were followed and then the results were compared with other national and international studies. Results: Fever 19.4% (n=04), wound infection 19.4% (n=04), vomiting 9.52% (n=02), abdominal distension 4.76% (n=01), and bleeding per rectum 4.76% (n=01), were the immediate post operative complications. Fourteen patients (82.35%), used to pass stool once daily. Abdominal distension was observed occasionally in six patients (28.57%). Soiling was seen in five patients (29.41%). Out of Seventeen, stool incontinence was seen in only three patients (17.64%). Conclusion: Modified Duhamel Procedure with the help of linear cutter stapler device is quite safe, easy and less time consuming. Infact Modified Duhamel is a procedure of choice for Hirschsprung’s Disease. 

scholarly journals Combined Corneal Cross-Linking and Myoring Implantation in Advanced Keratoconus: Femtosecond Laser versus Manual Dissection

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Ahmed Ibrahim Basiony ◽  
Moataz Fayez ElSawy ◽  
Mahmoud Mohamed Ismail ◽  
Mohamed Samy Abd ElAziz ◽  
Mahmoud Tawfik KhalafAllah ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Statistical Significance ◽  
Case Series ◽  
Cross Linking ◽  
Case Series Study ◽  
Corrected Distance Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Manual Group ◽  
Red Flag ◽  
Dissection Techniques

Background. Intrastromal corneal ring segments are widely adopted for keratoconus management. However, the complete ring (Myoring) was proposed to be superior in advanced cases. Myoring can be implanted either via femtoassisted or manual dissection techniques. A comparison between both techniques can delineate any differences in the outcomes. Methods. This was a prospective interventional case series study. Sixty-four eyes with progressive advanced keratoconus were enrolled: 36 and 28 had femtoassisted or manual Myoring, respectively. Uncorrected visual acuity (UCVA), corrected distance visual acuity (CDVA), maximal keratometry (Kmax), spherical equivalent (SE) and corneal thinnest location were measured in all eyes preoperatively and at one, six, and 12 months postoperatively. Epi-off corneal cross-linking (CXL) was performed eight weeks after Myoring implantation for all cases. Results. Femtoassisted Myoring dissection significantly improved UCVA and CDVA from 0.1 ± 0.06 and 0.18 ± 0.1 preoperatively to 0.29 ± 0.08 and 0.43 ± 0.1 at 12 months. Also, manual technique similarly enhanced UCVA and CDVA from 0.11 ± 0.05 and 0.2 ± 0.1 preoperatively to 0.27 ± 0.2 and 0.4 ± 0.2 at 12 months. In terms of safety, while no cases of ring extrusion were encountered with the femtoassisted technique, six (21.4%) cases of extrusion were encountered in the manual group. Conclusion. Femtoassisted or manual Myoring technique followed by CXL is an effective choice for advanced progressive keratoconus. Although it did not reach a statistical significance, the high extrusion rate with manual dissection is a red flag to be considered.

scholarly journals P0258EVALUATION OF ACUTE - PHASE REACTANTS IN MONITORING DISEASE ACTIVITY AND RESPONSE TO IMMUNOSUPPRESSIVE THERAPY IN IDIOPATHIC RETROPERITONEAL FIBROSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Katarina Obrencevic ◽  
Marijana Petroviä‡ ◽  
Nemanja Rancic ◽  
Jelena Tadiä‡ ◽  
Neven Vavic ◽  
...  
Keyword(s):  
Retroperitoneal Fibrosis ◽  
Case Series ◽  
Immunosuppressive Drugs ◽  
Obstructive Nephropathy ◽  
Mass Reduction ◽  
Retrospective Case ◽  
Idiopathic Retroperitoneal Fibrosis ◽  
Acute Phase Reactants ◽  
Case Series Study ◽  
One Year

Abstract Background and Aims Idiopathic retroperitoneal fibrosis (IRF) is a rare disease characterized by fibroinflammatory periaortic tissue that affects the ureters, causing obstructive nephropathy and impairment of renal function. Findings strongly suggest an autoimmune etiology. Medical treatment includes immunosuppressive drugs, but the optimal treatment has not been established. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) represent markers of active inflammation in the early phase of the disease, and hence could be sensitive predictors of the treatment response. Method This retrospective case series study includes patients with IRF treated with two different protocols: corticosteroids in combination with mycophenolate mofetil (MMF) and corticosteroids combined with azathioprine (AZA). The total number of 28 patients (13 in the first group and 15 in the second group) were treated and followed in the Clinic of nephrology in Military Medical Academy. Results At presentation 92.3% of patients had elevated levels of ESR and CRP, and 67.8% of them had acute renal insufficiency. Systemic symptoms resolved after four weeks in all patients. The kidney function improved significantly in both groups after first moth of treatment, although the creatinine level was higher in the MMF group because of the disease recurrence in 23% of the patients. In MMF group was observed faster reduction in the periaortic mass after six months and 53.8% of patients achieve 100% of the mass reduction at the end of the treatment while 33.3% in AZA group. The levels of ESR and CRP after one month of treatment in AZA group correlated with the fibrotic mass reduction after six months and after one year. In MMF group, only the CRP level after one month correlated with the fibrotic mass reduction achieved after one year. Conclusion MMF had more rapid and complete effect in hydrnephrosis withdrawal and total reduction of the fibrotic tissue, comparing with AZA whose effect was slower and without complete mass reduction. CRP strongly correlated with the remission of the disease in both therapeutic protocols.

scholarly journals Clinicopathological study of thyroid swellings in HSK hospital in Karnataka, India

2018 ◽  
Vol 5 (2) ◽  
pp. 420
Author(s):  
Subhash N. Halbhavi ◽  
Mahantayya Ganjigatti ◽  
Shrikant B. Kuntoji ◽  
Mohammedgouse A. Karikazi
Keyword(s):  
Clinical Diagnosis ◽  
Pressure Effect ◽  
Malignant Lesion ◽  
Case Series ◽  
Nodular Goiter ◽  
First Line ◽  
Case Series Study ◽  
One Year ◽  
Series Study ◽  
Rule Out

Background: A thyroid enlargement whether diffuses or in the form of nodules have to be investigated to rule out neoplasm. FNAC is the first line of investigation. USG and TFT are also used. The cases which are at high risk are considered for surgery. Aims and objectives of the study was the clinical presentation of thyroid swellings, incidence of various thyroid swelling, benign versus malignant lesion and to correlate the clinical diagnosis with that of pathological diagnosis.Methods: A case series study of 60 patients attending surgical OPD IPD with symptoms of thyroid in SNMRC and HSK hospital Bagalkot between 1-1-2015 to 30-6-2016. After detailed history thorough, clinical examination was carried out all the patients underwent routine investigations TFT FNAC USG neck. Few patients underwent surgery and all the thyroid specimens were sent for HPE and the clinical diagnosis is correlated with that of pathological diagnosis.Results: Of 60 cases female to male ratio was 9:1. The age group involved is between 31-40 years (31.67%). Duration of goiter is less than one year in 60% of cases. The chief complaint was swelling in front of the neck 100%. Duration of swelling ranged from 15 days to 15 years. Toxic features were present in 18.33% of cases, but after TFT the toxic cases were only 6.67%. Most of the patient showed colloid goiter (43.33%) on FNAC. Out of 60 cases only 22 cases did undergo surgery histopathological specimen were colloid versus nodular goiter in 81.88% out of 22 cases only.Conclusions: Thyroid swellings are common in females they occur in 3rd and 4th decade most commonly. FNAC is very useful in the diagnosis. The main indications of surgery are cosmetic problems, pressure effect symptoms are suspicion of malignancy.

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