scholarly journals Deep Sclerectomy with Nonabsorbable Implant (T-Flux) in Patients with Pseudoexfoliation Glaucoma

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Pavel Studeny ◽  
Alina-Dana Baxant ◽  
Jana Vranova ◽  
Pavel Kuchynka ◽  
Jitka Pokorna

Purpose.To evaluate the effectiveness of deep sclerectomy with T-flux implant (DS T-flux) in patients with pseudoexfoliation glaucoma (PExG).Methods.20 eyes of 18 patients with medically uncontrolled PExG have undergone DS T-flux implantation. Postoperatively we evaluated the IOP values and the frequency of complications. The minimum follow-up time was 12 months (20 eyes) and the maximum 24 months (10 eyes).Results.The mean preoperative IOP was36.8±8.7 mmHg. The IOP significantly decreased throughout all postoperative periods (P<0.05) and reached 1 day after surgery11.45±6.6 mmHg; 3 months13.45±3.6 mmHg; 12 months14±2.8 mmHg; and 24 months14.80±2.4 mmHg. Complete success rate, defined as IOP ≤ 18 mmHg without medication, was 85% (17/20 eyes) at 12 months. Qualified success rate, defined as IOP ≤ 18 mmHg with or without medication, was 100% (20/20 eyes). The most frequent postoperative complications were mild hyphaema (9 patients, 45%), choroidal detachment (3 patients, 15%), and hypotony—IOP < 5 mmHg (2 patients, 10%).Conclusions.DS with T-flux implant is a safe and effective surgical treatment method for medically uncontrolled PExG. The number of complications is low.

2011 ◽  
Vol 22 (1) ◽  
pp. 70-76 ◽  
Author(s):  
Sylvain Roy ◽  
Huyen Do Thi ◽  
Michael Feusier ◽  
André Mermoud

Purpose To evaluate the efficacy and safety profile of a new crosslinked sodium hyaluronate drainage implant in nonpenetrating glaucoma surgery. Methods From July 2008 until January 2010, 55 eyes from 55 patients with glaucoma were operated upon. After a standard deep sclerectomy was performed, a crosslinked sodium hyaluronate (HEALAflow®) was injected under the superficial scleral flap and underneath the conjunctiva. The main outcomes measured were mean intraocular pressure (IOP), mean number of antiglaucoma medications, presence of postoperative complications, and clinical aspect of the filtering bleb. Results For the 55 eyes, the mean follow-up was 12.0±5.1 months, the mean preoperative IOP was 21.6±7.2 mmHg, and the mean number of antiglaucoma medications before surgery was 2.4±1.2. At final follow-up visits, the mean IOP went down to 11.5±3.0 mmHg; the mean number of antiglaucoma medications was reduced to 0.5±0.9. The filtering bleb was visible on 49 eyes (89%). There were 5 hypotonies (IOP < 6 mmHg) and 3 iris incarcerations. Complete success rate (IOP ≤18 mmHg without antiglaucoma medication) was 70% and the overall success rate (IOP ≤18 mmHg with and without antiglaucoma medication) was 91%. Conclusions The slow resorbable highly crosslinked sodium hyaluronate drainage implant fills up the intrascleral and subconjunctival space, preventing postoperative scarring and fibrosis of the filtering site and helping to maintain a functional filtration after nonpenetrating glaucoma surgery. The IOP was significantly lowered with few numbers of postoperative complications and less medication.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256670
Author(s):  
Matthias Nobl ◽  
Sigrid Freissinger ◽  
Stefan Kassumeh ◽  
Siegfried Priglinger ◽  
Marc J. Mackert

Purpose To compare the safety and efficacy of microshunt implantation augmented with Mitomycin C in patients with pseudoexfoliation glaucoma (PEXG) and primary open-angle glaucoma (POAG). Methods In this retrospective, single centre, interventional study, 46 eyes of 41 patients with PEXG (20 eyes) and POAG (26 eyes) underwent microshunt implantation. Definition of failure was an intraocular pressure (IOP) lower than 5 or higher than 17mmHg on two consecutive visits, an IOP reduction lower than 20% on two consecutive visits, the need of surgical revisions or reoperations or loss of light perception. Outcome was rated as complete success if achieved without medication, otherwise as qualified success. Furthermore, postoperative complications and interventions were compared between the two groups. Results Patient demographics were similar, except for older age in the PEXG group (70.9±8.6 versus 77.6±8; p = 0.02). Mean IOP dropped from 21.5±5.8mmHg (PEXG) and 18.2±4.5mmHg (POAG) at baseline to 12.8±3.0mmHg (p<0.0001) and 12.9±4.2mmHg (p<0.0001), respectively, at one year. Mean number of medications were reduced from 2.8±1.3 to 0.3±0.8 for PEXG patients (p<0.0001) and from 2.7±1.3 to 0.3±0.8 for POAG patients (p<0.0001). At one year of follow-up 75.0% of PEXG patients achieved complete success and 80.0% qualified success. In the POAG group rates were 73.1% and 76.9%, respectively. Postoperative complications were comparable between both groups, except for higher rates of hypotony (p = 0.04) and choroidal detachment (p = 0.03) in the PEXG group. Conclusion Microshunt implantation demonstrated similar efficacy results in PEXG and POAG eyes at a follow-up of 12 months. Higher rates of transient hypotony and choroidal detachment were observed in PEXG eyes.


Vascular ◽  
2021 ◽  
pp. 170853812110514
Author(s):  
Görkem Yiğit

Objectives The present study was aimed to evaluate the efficacy and early outcomes of n-butyl cyanoacrylate (NBCA) ablation in small saphenous vein (SSV) insufficiency. Methods In this single-center, retrospective, single-arm study, NBCA ablation was performed in 80 patients with SSV insufficiency between September 2018 and May 2020. Primary outcomes (anatomic success rate and occlusion rate) and secondary outcomes (VCSS and AVVQ scores) of the patients were analyzed. Results No technical failure and device-related complications were encountered. Anatomic success rate was 100% after procedures. Each treated SSV was occluded on colored Doppler ultrasonography immediately after the procedure, and all veins remained occluded at 2 weeks after the procedure. Partial recanalization was observed in five patients at 12-month follow-up. Kaplan–Meier analysis revealed an occlusion rates at 6 months and 12 months follow-up were 97.5% and 93.75%, respectively. The mean pretreatment VCSS (4.72 ± 2.04) decreased to 1.61 ± 0.93, 0.87 ± 0.58, and 0.73 ± 0.52 at 2 weeks, 6 months, and 12 months after treatment, respectively ( p < .001). The mean pretreatment AVVQ score (11.92 ± 2.23) decreased to 8.2 ± 1.89, 4.2 ± 1.16, and 3.32 ± 1.19 at 2 weeks, 6 months, and 12 months after treatment, respectively ( p < .001). The Clinical, Etiologic, Anatomic, and Pathophysiology clinical classification at 12 months demonstrated a significant reduction in disease severity compared with preoperative values ( p < .001). There was no mortality and major adverse events including anaphylaxis and pulmonary thromboembolism (PTE) related to procedure after follow-ups. Moreover, there were no symptoms or signs of any sural nerve injury and no cases of skin necrosis, infection, or hyperpigmentation. In addition, no hematoma, deep venous thrombosis, and hypersensitivity reactions were observed. Phlebitis-like abnormal reaction was observed in three patients (3.8%). Conclusions In conclusion, in patients with SSV insufficiency, NBCA ablation with VenaBlock® system appears to be an effective and reliable treatment method. At the 12-month follow-up, the NBCA of SSVs showed a low recanalization rate and had a satisfactory improvement on the VCSS and AVVQ scores.


2020 ◽  
pp. 145749692096433
Author(s):  
L. Liu ◽  
J. Zhang ◽  
G. Wang ◽  
C. Guo ◽  
Y. Chen ◽  
...  

Background and Aims: Although thymoma is inextricably linked to autoimmune disease, its best treatment method remains unclear. In this study, we sought to evaluate therapeutic effect of surgical resection of thymoma on non-myasthenia gravis autoimmune diseases. Materials and Methods: This was a retrospective study covering 32 patients with thymoma accompanied with non-myasthenia gravis autoimmune disease. The relationships between surgical treatment, thymoma pathological type, and prognosis of autoimmune diseases were analyzed from postoperative follow-up data. Results: In total, 32 patients in this study underwent surgical treatment. The mean age of the patients was 51.7 years. By the last follow-up, 2 patients had died, while the other 30 patients showed no sign of tumor recurrence and metastasis. According to the postoperative follow-up data, 22 patients (68.75%) showed improvement or even complete recovery of autoimmune disease symptoms, 9 patients (28.13%) showed no significant change, and only 1 patient’s (3.12%) postoperative symptom was aggravated. Female patients and patients aged 50 and older were more likely to combine with non-organ-specific autoimmune diseases (p = 0.036, p = 0.017). Conclusion: In conclusion, this study presents that surgical treatment achieves a satisfactory prognosis for thymoma combined with non-myasthenia gravis autoimmune disease.


2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Abdelhamid Elhofi ◽  
Hany Ahmed Helaly

Purpose. To evaluate the outcome of primary nonpenetrating deep sclerectomy (NPDS) in patients with steroid-induced glaucoma. Methods. This was a retrospective interventional clinical study that included 60 eyes of 60 steroid-induced glaucoma patients that had undergone NPDS. Patients were followed up for 4 years. Data from the records was retrieved as regards corrected distance visual acuity (CDVA), intraocular pressure (IOP), visual field mean defect (dB), and number of antiglaucoma medications needed if any. Complete success of the surgical outcome was considered an IOP ≤ 21 mmHg with no antiglaucoma medications. Qualified success was considered an IOP ≤ 21 mmHg using antiglaucoma medications. Results. The mean age was 21.2 ± 8.5 years (ranged from 12 to 35 years). At 48 months, mean IOP was 13.6 ± 2.8 mmHg (range 11–23 mmHg). This represented 60% reduction of mean IOP from preoperative levels. One case had YAG laser goniopuncture. Three cases required needling followed by ab interno revision. Using ANOVA test, there was a statistically significant difference between preoperative and postoperative mean IOP values (P=0.032). Twelve, 16, and 20 patients required topical antiglaucoma medications at 24, 26, and 48 months postoperative, respectively. Conclusion. Primary nonpenetrating deep sclerectomy is a safe and an effective method of treating eyes with steroid-induced glaucoma. No major complications were encountered. After 4 years of follow-up, complete success rate was 56.7% and qualified success rate was 70%.


2011 ◽  
pp. 100-104
Author(s):  
Thi Thu Nguyen ◽  
Viet Hien Vo ◽  
Thi Em Do

The study use intralesional triamcinolone acetonide injection proceduce for chalazion treatment.1. Objectives: To evaluate results of intralesional triamcinolone acetonide injection for chalazion treatment. 2. Method: This noncomparative prospective interventional trial included 72 chalazions of 61 patients. 3. Results: 61 patients (72 chalazions) with 19 males (31.1%) và 42 females (68.9%), the mean age was 24 ± 9,78 years. 31.1% patients was the first time chalazion and 68.9% patients was more than one times chalazion including 78.6% patients was recurrent at the first position and 21.4% patients occur at new position. 72 chalazions with 16 (22.2%) chalazions was treated before and 56 (77.8%) chalazions wasn’t done that. 72 chalazions with 49 chalazions (68.1%) are local in upper eyelid and 23 chalazions (31.9%) are local in lower eyelid. The mean of chalazion diameter is 6.99 ± 3.03mm. Intralesional triamcinolone acetonide is injected to treat 72 chalazions with 16 (22.2%) chalazions are injected through the route of skin and 56 (77.8%) chalazions are injected through the route of conjunctiva. After 2 weeks follow-up, the success rate was 93.1% and 6.9% failed. 4. Conclusion: intralesional triamcinolone acetonide injection for chalazion treatment is really effective. Key words: chalazion, intralesional triamcinolone acetonide.


2021 ◽  
pp. 112067212199575
Author(s):  
Lei Zhang ◽  
Mingyu Ren ◽  
Yuqing Yan ◽  
Wenjuan Zhai ◽  
Lihong Yang ◽  
...  

Purpose: To describe our experience with a modified frontal muscle advancement flap to treat patients with severe congenital ptosis. Methods: Analysis of the clinical charts of 154 patients who underwent a modified frontal muscle advancement flap. The FM was exposed by a crease incision. The FM flap was created by deep dissection between the orbicularis muscle and orbital septum from the skin crease incision to the supraorbital margin and subcutaneous dissection from the inferior margin of the eyebrow to 0.5 cm above the eyebrow. No vertical incision was made on the FM flap to ensure an intact flap wide enough to cover the entire upper tarsal plate. Contour, symmetry of height, marginal reflex distance (MRD1), and complications were assessed. Mean follow-up was 10 months. Results: The mean patient age was 7.6 ± 5.6 (range, 2–18) years. The mean MRD1 was 3.2 ± 1.3 mm after the operation. All bilateral cases achieved symmetry and optimal lid contour; 17 unilateral cases were under corrected, with a success rate of 89.0%. Complications such as entropion, exposure keratitis, FM paralysis, frontal hypoesthesia, severe haematoma, and entropion were not observed in our series. Conclusion: A modified frontal muscle advancement flap produced a high success rate with a clear field of vision, mild trauma, and few complications. This technique is relatively simple and should be considered for correcting severe congenital ptosis. Date of registration: 29-03-2020 Trial registration number: ChiCTR2000031364 Registration site: http://www.chictr.org/


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Oriel Spierer ◽  
Abraham Spierer

Abstract Background Different surgical methods have been suggested for the correction of intermittent exotropia. Unilateral lateral rectus recession has been described as a surgical alternative for small and moderate-angle exotropia. In general, previous studies did not focus on the outcomes of unilateral lateral rectus recession in young children with intermittent exotropia. The purpose of this study is to evaluate the surgical outcomes of unilateral lateral rectus recession in the treatment of moderate-angle exotropia (≤ 25 PD (prism diopters)) in children. Methods The charts of all patients younger than 12 years of age with moderate-angle exotropia (up to 25 PD) who were operated during the years 2006–2018 were retrospectively reviewed. Fifty-eight patients underwent unilateral lateral rectus recession and had a minimum follow up of 6 months. The angle of exotropia (PD) before and after surgery and the success rate were documented. Results Mean age at surgery was 6.4 ± 1.9 (range 3.5–11.0) years. Exotropia improved from a preoperative angle of 21.4 ± 4.0 PD to 3.5 ± 5.9 PD postoperatively (p < 0.001). Success rate, defined as deviation of ≤ 10 PD, was achieved in 86.2%. There were 2 (3.4%) cases of overcorrection (consecutive esotropia). There were no intra- or postoperative complications. The mean follow-up duration after surgery was 2.3 ± 1.7 years. Conclusions In children with moderate angle exotropia, good postoperative success rate was achieved by performing unilateral lateral rectus recession.


2009 ◽  
Vol 46 (4) ◽  
pp. 288-293 ◽  
Author(s):  
Daniel Reis Waisberg ◽  
Antonio Sergio Fava ◽  
Lourdes Conceição Martins ◽  
Leandro Luongo Matos ◽  
Maria Isete Fares Franco ◽  
...  

CONTEXT: Colonic carcinoids, excluding those arising in the appendix, have proved to be extremely rare. Due to their rarity, the characteristics and behavior of this unusual malignancy remain unclear. OBJECTIVE: To review the clinicopathologic features of patients operated on carcinoid tumors of the colon. METHODS: Twenty-three patients (12 males and 11 females) were operated on colonic carcinoids. The mean age of the patients was 63.0 ± 12.9 years (42 to 85 years). The clinical and histopathological data of patients who were pathologically diagnosed as having carcinoid tumors and submitted to surgical treatment over a 30-year period (1977-2007) were gathered. Actuarial patient survival was estimated using the Kaplan-Meier method, with carcinoid-specific death as the outcome. RESULTS: The mean time elapsed between onset of symptoms and surgical treatment was 8.3 months (1.5 to 20 months). The most frequent symptoms or signs encountered were abdominal pain followed by anorexia or weight loss, diarrhea, abdominal tenderness, palpable abdominal mass, and rectal bleeding. No carcinoid syndrome was noted. The lesion was located in the cecum in 16 (69.6%) patients, in the sigmoid in 3 patients (13.0%), in the ascending colon in 3 patients (13.0%), and in the transverse colon in one patient (4.3%). Twenty-one (91.3%) patients were operated on curative intent. Spreading of the disease to the liver and peritoneum was found in two (8.7%) patients who submitted to intestinal bypass. The mean size of the largest mass was 3.7 ± 1.2 cm (1.5 to 6.2 cm). There were multiple (two or more) lesions in three cases (13.0%). In the resected cases, the lymph nodes were compromised in 10 patients (47.6%) and disease-free in 11 (52.4%). Venous invasion and neural infiltration were both present in five (23.8%) patients. The tumors had penetrated the muscularis propria in all resected cases. Four (17.4%) patients had a second non-carcinoid primary tumor. Three (13.0%) patients died due to postoperative complications and five (21.7%) patients died from metachronous metastases or local recurrence. Fifteen patients (65.2%) remain alive without evidence of active disease. The mean follow-up period was 12 years (1.2 to 18 years), whereas the mean global survival was 50.7 ± 34.2 months and the crude survival rate at 5 years was 62.7%. CONCLUSIONS: Carcinoid tumors of the colon are frequently right-sided and may be clinically occult until an advanced stage is reached. Based on the relatively poor survival rates reported, it is recommended that, in addition to standard surgical resection, vigorous surveillance for metastatic disease must be performed, particularly during the first 2 years after surgery. In addition, these patients require evaluation of the entire gastrointestinal tract for evidence of coexisting malignancy, along with an extended period of follow-up, because tumor recurrences after 5 years are not uncommon.


Author(s):  
Fadil Gradica ◽  
Lutfi Lisha ◽  
Dhimitraq Argjiri ◽  
Fahri Kokici ◽  
Alma Cani ◽  
...  

Background: Bronchiectasis is usually caused by pulmonary infections and bronchial obstructions. It is still a serious problem in developing countries, as our country. We reviewed the morbidity and mortal-ity rates and outcomes of bronchiectasis surgical treatment. Patients and methods: Between years 2000 and 2016, one hundred and seven (107) patients, sixty nine (69) of whom female and thirty eight (38) male underwent pulmonary resection for bronchiecta-sis. The mean age was 35years (range, 13–66 years). Mean duration of symptoms was 12 years. Results: Symptoms were copious amount of purulent sputum in 84 patients, expectoration of foul-smelling sputum in 72, haemoptysis in 21 and cough in all patients. The indications for pulmonary resection were: medical therapy failure in eighty two (82) patients, massive haemoptysis in eighteen and lung abscess in seven (7) patients. The disease was bilateral in twenty seven (27) patients and mainly confined in the lower lobe. Eighty six (86) patients had a lobectomy, 7 had a segmentectomy, two patients right pneumonectomy. Operative morbidity was seen in 47 patients (43.9 %) and mor-tality in two (2) patients. Follow-up was complete in 97 patients with a mean of 5 years. Overall, 78 patients were asymptomatic after surgical treatment; symptoms were improved in 24, and unchanged or worse in 5. Conclusions: Surgical treatment of bronchiectasis is more effective in patient with localized disease. It is satisfactory with acceptable ratio of morbidity and mortality.


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