Comparisons of Visual and Surgical Outcomes after Reuse or Replacement of Dislocated in-the-Bag Intraocular Lens

Purpose. To compare the visual and surgical outcomes after a reuse or a replacement of a dislocated in-the-bag intraocular lens (IOL). Methods. This was a retrospective, nonrandomized case series at a single ophthalmological institution. Cases with an in-the-bag dislocation of an IOL were treated by pars plana vitrectomy and the reuse or the replacement of the IOL. The lens was held by intrascleral fixation of the haptics of the IOL under both conditions. The same dislocated IOL was reused in 6 eyes (group A) or it was replaced with another IOL in the other 9 eyes (group B). The pre- and postoperative parameters analyzed included the visual acuity, refractive error, corneal endothelial cell density, and intraocular pressure (IOP). Results. There was no significant difference between the two groups in the postoperative visual acuity (P=0.388), refractive error (P=0.955), IOP (P=0.529), and endothelial cell loss (P=0.940). A breakage or a tilting of the IOL was observed and required replacement in three eyes in the reuse group (P=0.044). Conclusions. Half of the cases with reused in-the-bag dislocated IOL had a breakage or a tilting of the IOL. The replacement of the in-the-bag dislocated IOL is better than the reuse of the IOL with intrascleral haptics fixation.

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Corneal status following modified Blumenthal technique of manual small incision cataract surgery (MSICS) compared to phacoemulsification in treatment of grade III or more nuclear sclerosis-cohort study

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v7i1.13166 ◽

2015 ◽

Vol 7 (1) ◽

pp. 47-51 ◽

Cited By ~ 3

Author(s):

K Jain ◽

K PS Malik ◽

S Gupta

Keyword(s):

Endothelial Cell ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Cell Loss ◽

Specular Microscopy ◽

Endothelial Cell Loss ◽

Significant Difference ◽

Group A ◽

Group B ◽

Grade Iii

Objective: To evaluate the endothelial cell loss and central corneal thickness in modified Blumenthal technique of MSICS and Phacoemulsification. Method: A prospective study in which 50 cases of nuclear sclerosis grade III (LOCS III) or more were randomized in two groups of 25 each. Group A underwent modified Blumenthal MSICS. Lens expression was facilitated by viscoelastic injection through ACM and scleral pressure by iris repositor. Group B underwent 2.8 mm phacoemulsi¿cation. Specular microscopy and pachymetry were done at 1st POD, 1st, 3rd and 6th week.Results: No significant difference in endothelial cell loss and central corneal thickness between group A and group B (p > 0.05) was found.Conclusion: This technique of MSICS is not inferior, an innovative, safe and highly effective in hard cataracts.

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Effect of Hydroxypropylmethylcellulose versus Sodium Hyaluronate on corneal endothelial cell count in patients undergoing cataract surgery by phacoemulsification

10.53350/pjmhs211582064 ◽

2021 ◽

Vol 15 (8) ◽

pp. 2064-2066

Author(s):

Faisal Anwar ◽

Mohammad Hasan Bokhari ◽

Muhammad Tahir Ghaffar ◽

Ahsan Irshad ◽

M. Shoaib Khan ◽

...

Keyword(s):

Endothelial Cell ◽

Cell Count ◽

Hydroxypropyl Methylcellulose ◽

Sodium Hyaluronate ◽

Cell Loss ◽

Corneal Endothelial Cell ◽

Endothelial Cell Count ◽

Significant Difference ◽

Group A ◽

Group B

Objective: To compare the effect of Hydroxypropyl methylcellulose versus Sodium Hyaluronate on corneal endothelial cell count in patients undergoing cataract surgery by phacoemulsification. Design: It was a randomized clinical trial. Study Settings: This study was conducted at the Eye Unit III, Mayo Hospital / KEMU, Lahore over 12 months period from June 2014 to May 2015. Hypothesis: There is a significant difference in protective effect on corneal endothelial cell loss with dispersive (Hydroxypropyl methylcellulose) viscoelastic agent as compared to cohesive (sodium hyaluronate) viscoelastic agent used during phacoemulsification with intraocular lens for the treatment of cataract. Material and Methods: Total 80 patients from both the genders aged between 40-70 years with cataract undergoing phacoemulsification surgery were involved in this study. Two equal treatment groups were made by random allocation. Patients in Group-A (n=40) received Hydroxypropyl methylcellulose as viscoelastic agent while patients in Group-B (n=40) received treatment with Sodium Hyaluronate. Surgery was carried out by phacoemulsification technique and follow-up was done at first week, 1st month and 3rd month post-operatively. Data was collected in terms of endothelial cell count by noncontact specular microscope. Results: Patients age was in the range of 40 to 70 years with a mean of 57.26 ± 8.00 years. There were 31 (38.75%) females and 49 (61.25%) male patients with a female to male ratio of 1.6:1. Both the groups had no statistically significant difference in the mean corneal cell count before surgery (2839.67±368.71 cells/mm2 vs. 2801.36 ± 332.52 cells/mm2; p-value= 06.27). Post-operative mean corneal cell count at 1 week, 1 month and 3 months was significantly higher in patients in Group-A compared to Group-B. Similarly, significant difference was noted across various subgroups of both the groups on the basis of patient’s age and gender. Conclusion: This study concluded that there is less corneal endothelial cell loss with dispersive Hydroxypropyl methylcellulose viscoelastic agent as compared to cohesive sodium hyaluronate viscoelastic agent used during phacoemulsification surgery with intraocular lens implant for the treatment of cataract. Keywords: Cataract, phacoemulsification, viscoelastic agents, corneal, endothelial cell.

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Tentorial Incision vs. Retraction of the Tentorial Edge during the Subtemporal Approach: Anatomical Comparison in Cadaveric Dissections and Retrospective Clinical Case Series

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0038-1676077 ◽

2018 ◽

Vol 80 (05) ◽

pp. 441-448

Author(s):

E. Archavlis ◽

L. Serrano ◽

F. Ringel ◽

S. R. Kantelhardt

Keyword(s):

Case Series ◽

Free Edge ◽

Superior Cerebellar Artery ◽

Fast Method ◽

Subtemporal Approach ◽

Cerebellar Artery ◽

Significant Difference ◽

Suture Group ◽

Group A ◽

Group B

Abstract Objective The aim of this study was to compare tentorial incision (group A) versus retraction and tack up suture (group B) of the tentorial edge during the subtemporal approach for surgery in the high basilar region. Design 24 cadaveric dissections and 4 clinical cases of aneurysms of the high basilar region are presented. Assessment included visibility and operability afforded by either tentorial incision creating a dural flap (group A) or retraction of the tentorial edge and tethering with a suture (group B). Four patients, two with superior cerebellar artery aneurysms and two with proximal posterior cerebral artery aneurysms were treated with each approach. Results In the quantitative evaluations, we found no significant difference in the exposure of the posterior cerebral, superior cerebellar, and perforant arteries as well as surgical working area provided by either approach. However, tentorial incision allowed a significantly greater exposure of the basilar artery and the fourth cranial nerve (both p < 0.001). Concerning operability, tentorial incision provided no objective advantage for direct clipping of the high basilar region (groups A vs. B, p > 0.05). Subjectively, clipping of the high basilar segment was feasible using tentorial tethering only. Conclusion Retraction of the free edge of the tentorium downward by tethering with a suture is simple and fast method for exposure of aneurysms in the high basilar region when the pathology does not require a proximal control. In our data the rather more invasive and time consuming tentorial incision provided an additional objectified advantage only for placement of a proximal temporary clip.

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Post Cataract Surgery Refractive Error in Myopic Patients Using SRK/T Versus Holladay 1 Formula for IOL Power Calculation

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v34i2.947 ◽

2019 ◽

Vol 34 (2) ◽

Author(s):

Sidra Anwar, Atif Mansoor Ahmad, Irum Abbas, Zyeima Arif

Keyword(s):

Intraocular Lens ◽

Refractive Error ◽

Axial Length ◽

Power Calculation ◽

Mean Error ◽

Iol Power Calculation ◽

Group A ◽

Iol Power ◽

The Mean ◽

Group B

Purpose: To compare post-operative mean refractive error with SandersRetzlaff-Kraff/theoretical (SRK-T) and Holladay 1 formulae for intraocular lens (IOL) power calculation in cataract patients with longer axial lengths. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Ophthalmology, Shaikh Zayed Hospital Lahore from 01 January 2017 01 January, 2018. Material and Methods: A total of 80 patients were selected from Ophthalmology Outdoor of Shaikh Zayed Hospital Lahore. The patients were randomly divided into two groups of 40 each by lottery method. IOL power calculation was done in group A using SRK-T formula and in group B using Holladay1 formula after keratomery and A-scan. All patients underwent phacoemulsification with foldable lens implantation. Post-operative refractive error was measured after one month and mean error was calculated and compared between the two groups. Results: Eighty cases were included in the study with a mean age of 55.8 ± 6.2 years. The mean axial length was 25.63 ± 0.78mm, and the mean keratometric power was 43.68 ± 1.1 D. The mean post-operative refractive error in group A (SRK/T) was +0.36D ± 0.33D and in group B (Holladay 1) it was +0.68 ± 0.43. The Mean Error in group A was +0.37D ± 0.31D as compared to +0.69D ± 0.44D in group B. Conclusion: SRK/T formula is superior to Holladay 1 formula for cases having longer axial lengths. Key words: Phacoemulsification, intraocular lens power, longer axial length, biometry.

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HAEMOSTATIC PARAMETERS, ENDONEURIAL OXYGEN TENSION AND SURAL NERVE HISTOLOGY IN DIABETES MELLITUS

10.1055/s-0038-1643107 ◽

1987 ◽

Author(s):

I Ford ◽

P G Newrick ◽

R Malik ◽

F E Preston ◽

J D Ward ◽

...

Keyword(s):

Endothelial Cell ◽

Oxygen Tension ◽

Sural Nerve ◽

Clot Lysis ◽

Diabetic Patients ◽

Membrane Thickness ◽

Basement Membrane Thickness ◽

Significant Difference ◽

Group A ◽

Group B

We have examined coagulation parameters in 15 neuropathic (Group A) and 10 complication-free diabetic patients (Group B). Venesection and sample testing were performed under standard conditions. Group A underwent sural nerve biopsy and 14 also had measurements of endoneurial oxygen tension. Factor VIII related antigen was higher in Group A (l-617u/ml ± 0.67) compared to Group B (0.944u/ml ± 0.26); (mean ± SD; p<.0.05) perhaps suggesting endothelial cell damage, although this did not correlate with capillary basement membrane thickness or endothelial cell number nor with endoneurial oxygen levels. Platelets from Group A were more sensitive to arachidonate than those of Group B, showing aggregation thresholds in platelet rich plasma of 0.36 ± 0.17mM and 0.57 ± 0.9mM respectively compared with 0.65 ± 0.37mM in non-diabetic controls.Platelets from Group A subjects also produced more thromboxane B2 in response to arachidonate than Group B or normal controls (37.95 ± 27.5; 25.5 ± 13.0; 16.55 ± 15-5pmol/107 platelets). Blood fibrinolytic capacity measured by euglobulin clot lysis time, was diminished in NIDDs (post-occlusion ECLT 165.7 mins ± 116.0), compared to IDDs (55.5 ± 34.5) (p<0.05) due at least in part to excess of tissue plasminogen-activator inhibitor, although we found no significant difference in ECLT between Group A and Group B. Interaction between haemostatic and microvascular abnormalities in diabetes may contribute to the pathogenesis of diabetic neuropathy.

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Peripheral Anterior Chamber Depth and Angle Measurements Using Pentacam After Implantation of Toric and Non-toric Implantable Collamer Lenses

Frontiers in Medicine ◽

10.3389/fmed.2021.610590 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jiao Zhao ◽

Jing Zhao ◽

Wen Yang ◽

Huamao Miao ◽

Lingling Niu ◽

...

Keyword(s):

Anterior Chamber ◽

Anterior Chamber Depth ◽

Case Series ◽

Angle Measurements ◽

Significant Difference ◽

Group A ◽

Icl V4c ◽

Contralateral Eye ◽

Group B ◽

Safety Indices

Purpose: To evaluate the characteristics of peripheral anterior chamber measurements by Pentacam after posterior implantable collamer lenses (ICL) and toric ICL (TICL) with central hole (V4c) implantation.Methods: Prospective, non-randomized consecutive case series. Forty-six patients undergoing ICL implantation in one eye (Group A) and identically sized TICL in the contralateral eye (Group B) in the Refractive Surgery Center of Eye and ENT Hospital of Fudan University were prospectively included. According to ICL/TICL size, these eyes were further divided into four subgroups. Peripheral anterior chamber depth (PACD) and angle (ACA) in nasal and temporal sides were measured using Pentacam pre-operatively and 12-month post-operatively.Results: The safety indices were 1.34 ± 0.32 and 1.25 ± 0.16 and the efficacy indices were 1.20 ± 0.24 and 1.19 ± 0.19 for ICL and TICL groups, respectively. There was no significant difference in pre-operative PACD or ACA between the two groups. Post-operative PACD and ACA were significantly lower than pre-operative values. Variations of PACD and ACA of TICL group were significantly larger than those of ICL group. The change of ACA for 13.2 mm lenses was significantly larger than that of 12.6 mm lenses. Pre-operative CACD and vault were significantly associated with post-operative PACD, while pre-operative ACA and vault were significantly associated with post-operative ACA.Conclusions: Variations of PACD and ACA were greater in eyes after TICL (V4c) implantation compared with identically sized ICL (V4c) implantation and with larger size than smaller size lens implantation. Pre-operative anterior chamber structure and vault affect post-operative PACD and ACA.

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Safety and feasibility of laparoscopic surgery for colorectal cancer in elderly patients (YSURG1401 study).

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.4_suppl.725 ◽

2016 ◽

Vol 34 (4_suppl) ◽

pp. 725-725

Author(s):

Yosuke Atsumi ◽

Masakatsu Numata ◽

Toru Aoyama ◽

Tsutomu Hayashi ◽

Naoto Yamamoto ◽

...

Keyword(s):

Colorectal Cancer ◽

Laparoscopic Surgery ◽

Elderly Patients ◽

Surgical Outcomes ◽

Operation Time ◽

University Hospital ◽

Age Group ◽

Significant Difference ◽

Group A ◽

Group B

725 Background: The safety and feasibility of laparoscopic surgery (LAP) for colorectal cancer has not yet been fully evaluated in elderly patients. The aim of this study was to compare the short term surgical outcomes of LAP and evaluate the safety and feasibility of LAP in colorectal cancer patients aged > 75 years. Methods: This retrospective study enrolled consecutive patients who underwent laparoscopic surgery for colorectal cancer between April 2013 and March 2014 at Yokohama City University Hospital and its related general hospitals. The patients were categorized into two groups: elderly patients (≧75 years of age: group A) and non-elderly patients ( < 75 years of age: group B). Surgical outcomes and postoperative complications were compared between the two groups. The severity of complications was evaluated using the Clavien–Dindo classification. Results: A total of 237 patients were evaluated in the present study. Eighty-four patients were classified into group A, and 153 into group B. Preoperative clinicopathological outcomes demonstrated no significant differences except for the ASA score. When comparing the surgical outcomes between group A and group B, the rate of conversion to open procedure (3.6 % vs 5.2 %, P = 0.751), median operation time (232 min vs 232 min, P = 0.318), median blood loss (20 ml vs 12 ml, P = 0.353). There was no significant difference in the surgical outcomes. Although the incidence of Japanese D3 dissection was significantly lower in Group A (56 % vs 69.3 %, P = 0.047), the incidences of postoperative surgical complications of grade ≧ Ⅱ were similar between two groups (15.5 % vs 11.8 %, p = 0.427). The length of postoperative hospital stay was also similar (10days vs 10days, p = 0.347). Conclusions: The present study suggested that laparoscopic surgery for colorectal cancer is safe and feasible, regardless of the age of the patient, especially for elderly patients who may be candidates for colorectal cancer surgery.

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Clinical results of Visian implantable collamer lens implantation according to various sizes and implantation angles

European Journal of Ophthalmology ◽

10.1177/11206721211033468 ◽

2021 ◽

pp. 112067212110334

Author(s):

Bu Ki Kim ◽

Young Taek Chung

Keyword(s):

Case Series ◽

Clinical Results ◽

Implantable Collamer Lens ◽

Retrospective Case ◽

Significant Difference ◽

Lens Implantation ◽

Group A ◽

The Mean ◽

Group B

Purpose: To investigate the clinical outcomes of Visian implantable collamer lens (ICL) implantation according to lens size and implantation angle. Setting: Onnuri Smile Eye Clinic, Seoul, Republic of Korea. Design: Retrospective case series. Methods: This study included 566 eyes of 283 patients treated with ICL implantation. Patients were divided into three groups: horizontally implanted same-sized ICL (group A), horizontally implanted different sized-ICL (group B: large ICL and small ICL) and same sized-ICL implanted with a different implantation angle (group C: horizontal and vertical). Results: At 12-month follow-up, the mean vault was 0.78 ± 17, 0.48 ± 0.13, 0.71 ± 0.18 and 0.44 ± 0.16 mm when large and small sized ICL was used in group B ( p < 0.001), and when ICL was horizontally and vertically implanted in group C ( p = 0.021), respectively. And the mean SE was −0.11 ± 0.30, −0.34 ± 0.42, −0.3 ± 0.56 and −0.64 ± 0.66 dioptres (D), when the large and the small sized ICL was used group B ( p = 0.039), and when the ICL was horizontally and vertically implanted in group C ( p = 0.036), respectively. No significant difference in UDVA, IOP and ECD between both eyes in groups B and C was observed. No statistical difference was found in the vault between both eyes for groups B and C. Conclusions: The vault was significantly higher and the SE was significantly more hyperopic when a larger-sized ICL was used or the ICL was horizontally implanted compared to when the ICL was vertically implanted.

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Cystoid macular oedema and iris-fixated intraocular lens treated with intraocular lens exchange: A case series and review

Journal of International Medical Research ◽

10.1177/0300060518799004 ◽

2018 ◽

Vol 47 (1) ◽

pp. 188-195 ◽

Cited By ~ 2

Author(s):

Horace F. Massa ◽

Iona Gobej ◽

Paul Jacquier ◽

Christian Jonescu-Cuypers ◽

Olivier Le Quoy

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Macular Oedema ◽

Case Reports ◽

Case Series ◽

Cell Loss ◽

Cystoid Macular Oedema ◽

Posterior Fixation ◽

Ocular Coherence Tomography ◽

Iol Exchange

This series of case reports describes six eyes from five patients that underwent intraocular lens (IOL) exchange with scleral-fixated IOLs for cystoid macular oedema associated with iris-fixated IOLs between 2005 and 2015. Macular oedema was assessed using ocular coherence tomography (OCT). The six eyes in this series were treated by IOL removal and implantation of a scleral -sutured IOL with four points of fixation in the sulcus. Visual acuity improved in all six eyes. On OCT, macular oedema resolved after 3 months in all eyes. There were no surgical complications from the IOL exchange. One eye had a pupilloplasty and another had a diaphragm IOL to treat a major iris impairment from prior surgeries. The cause of cystoid macular oedema in these cases remains controversial but has been well recognized in eyes with iris-sutured IOLs. The absence of sutures with posterior fixation of an iris claw IOL prevents progressive corneal endothelial cell loss but does not prevent macular oedema, even in vitrectomized eyes. In conclusion, macular oedema resolved and visual acuity improved after implant exchange with a secondary scleral-fixated IOL in these cases. This procedure should be considered as a solution to persistent symptomatic cystoid macular oedema from an iris-fixated implant.

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Inhibitory effect of adenosine on intimal hyperplasia and proliferation of smooth muscle cells in a carotid arterial anastomosis animal model

Vascular ◽

10.1177/1708538114533962 ◽

2014 ◽

Vol 23 (2) ◽

pp. 124-131 ◽

Cited By ~ 2

Author(s):

Gokhan Albayrak ◽

Erdem Silistreli ◽

Bekir Ergur ◽

Sule Kalkan ◽

Ozalp Karabay ◽

...

Keyword(s):

Cell Proliferation ◽

Smooth Muscle ◽

Endothelial Cell ◽

Neointimal Hyperplasia ◽

Inhibitory Effect ◽

Endothelial Cell Proliferation ◽

Positive Staining ◽

Significant Difference ◽

Group A ◽

Group B

Purpose The effect of adenosine (9-β-0-ribifuranosyladenine) on the endothelial cell proliferation and neointimal hyperplasia is investigated in the rabbit carotid artery anastomosis model. Methods Twenty-eight New Zealand white rabbits were arranged in four groups of seven animals each. The right carotid arteries of each animal were transsected and re-anastomosed. The left sides remained as control. In Group A, no medication was used. In Group B, subcutaneous Adenosine was applied for 3 days. In Group C, the same dose was applied for 7 days, and in Group D for 21 days. After 28 days, the luminal diameters, luminal areas, intima/media ratios were all measured by using histopathological evaluation. Findings The mean luminal diameters and areas of the four groups were smaller than the control ones. Massive thickening of smooth muscle cell proliferation and dense intensifying in the connecting tissues were observed most prominently in Group A, in decreasing degrees within other groups. Intima/media ratio was highest in Group A. Scoring the quantity of e-NOS positive staining also revealed a significant difference between the experimental groups and their control associates. Conclusion The process of endothelial cell proliferation and neointimal hyperplasia can be significantly reduced by the use of adenosine.

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