Triple Procedure for Dense Cataractous Neovascular Glaucoma Patients

Purpose. One of the most difficult refractory glaucomas is the neovascular type (NVG), and its association with dense cataract adds to this difficulty. This study aimed to provide results of the triple surgical procedure for such conditions. Methods. 12 eyes of 12 patients with NVG and dense cataract were included in this case series study. The mean age of patients was 57.25 ± 5.9 years. The mean preoperative intraocular pressure (IOP) was 47.25 ± 4.04 mmHg with maximum antiglaucoma therapy. The mean best corrected distant visual acuity (BCDVA) in LogMAR was 2.13 ± 0.38. All patients received intravitreal injection of 1.25 mg (0.05 ml) bevacizumab followed by phacoemulsification, pars plana vitrectomy (PPV) including panretinal photocoagulation (PRP), and trabeculectomy with mitomycin C (MMC). Mean IOP and BCDVA changes were the main outcome results of this study. Results. The follow-up period was 2 years. The mean BCDVA was improved to 1.22 ± 0.35, 1.13 ± 0.34, 1.12 ± 0.37, 1.06 ± 0.38, and 1.01 ± 0.37 at 1, 3, 6, 12, and 24 months, respectively, after this procedure. This improvement was statistically significant when compared with preoperative BCDVA (P<0.0001). The mean postoperative IOP was dropped to 20.08 ± 4.1, 17.08 ± 2.1, 17.17 ± 5, 15.75 ± 4.7, and 16.17 ± 6.1 mmHg, respectively. At the last follow-up, the mean IOP was statistically significantly lower than preoperative IOP (P<0.0001) at the previously mentioned time points. The success rate was complete in 90.9% of eyes and qualified in 100% of eyes. Iris and angle neovascularization had regressed significantly in all patients, and no serious complications occurred during the follow-up period. Conclusions. This triple surgery can safely improve patients with NVG and dense cataract regarding BCDVA and IOP control. This trial is registered with NCT04143620.

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Functional and Radiographic Outcomes of Minimally Invasive Intramedullary Nail Device (MIIND) for Moderate to Severe Hallux Valgus

Foot & Ankle International ◽

10.1177/1071100720969676 ◽

2020 ◽

pp. 107110072096967

Author(s):

Carlo Biz ◽

Alberto Crimì ◽

Ilaria Fantoni ◽

Jacopo Tagliapietra ◽

Pietro Ruggieri

Keyword(s):

Hallux Valgus ◽

Case Series ◽

Radiographic Outcomes ◽

Case Series Study ◽

Significant Correction ◽

The Mean ◽

Series Study ◽

Severe Hallux Valgus

Background: This study was aimed at assessing clinical and radiographic outcomes of the Minimally Invasive Intramedullary Nail Device (MIIND) to correct moderate to severe hallux valgus (HV) and the long-term persistence of its effects. Methods: This case series study involved 100 patients, 84 women and 16 men (mean age, 59 years), who underwent the MIIND procedure with a mean follow-up of 97 months. Assessment was performed preoperatively, postoperatively, at 6 and 12 months, and at last follow-up. Clinical outcomes were evaluated with American Orthopaedic Foot & Ankle Society (AOFAS) scores, visual analog scale (VAS), and patient satisfaction. Intermetatarsal angle (IMA), metatarsophalangeal hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), and tibial sesamoid position were assessed. Statistical analysis was performed. Results: The mean AOFAS score improved from 57.9 to 90.5 points, VAS scale was 1.5 ± 2.0, and patients’ satisfaction was 8.7 ± 1.4. The mean correction of the HVA and IMA showed a significant correction; however, the effect of time was not statistically significant on DMAA. Sex ( P = .047), severity ( P = .050), associated procedures ( P = .000), and preoperative angle ( P = .000) showed significant association with HVA correction and its persistence over time. Age was not statistically significant. Complications were 9 cases of superficial wound infection and 6 recurrences. Conclusions: The MIIND technique proved a viable procedure to correct moderate to severe HV with a low rate of complications and recurrence, producing significant correction of most radiographic parameters assessed and their persistence, even at long term. Level of Evidence: Level IV, case series study.

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Partial capitate shortening for Kienböck’s disease

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193414562355 ◽

2014 ◽

Vol 40 (9) ◽

pp. 957-960 ◽

Cited By ~ 18

Author(s):

A. Citlak ◽

U. Akgun ◽

T. Bulut ◽

M. Tahta ◽

B. Dirim Mete ◽

...

Keyword(s):

Magnetic Resonance ◽

Case Series ◽

Magnetic Resonance Images ◽

Stage Ii ◽

Pinch Strength ◽

Case Series Study ◽

The Mean ◽

Series Study ◽

Carpal Height

The purpose of this study was to report our experience of partial capitate shortening in seven patients with a median 38 months follow-up. Staging was made by the Lichtman classification system and stage II and III-A patients were included in the study. The mean age was 34 years (range 22–52). Patients were assessed for pain, range of motion, grip and pinch strength, and satisfaction was recorded using a scale between 0 and 4. All these parameters showed improvement after surgery. The Lichtman stage, lunate height index and carpal height index were determined radiographically. Magnetic resonance images of the wrist were studied for lunate revascularization at the final follow-up and occurred in all patients. According to our study, partial capitate shortening seems an effective treatment for Lichtman stage II and III-A patients. Level IV case series study.

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Subconjunctival injections of triamcinolone acetonide to treat uveitic macular edema

10.21203/rs.2.16180/v1 ◽

2019 ◽

Author(s):

Yi Qu ◽

Xinshu Liu ◽

Anyi Liang ◽

Chan Zhao ◽

Fei Gao ◽

...

Keyword(s):

Macular Edema ◽

Triamcinolone Acetonide ◽

Case Series ◽

Subconjunctival Injection ◽

Retrospective Case ◽

Case Series Study ◽

Uveitic Macular Edema ◽

The Mean ◽

Series Study

Abstract Background: To evaluate the efficacy and safety of subconjunctival triamcinolone acetonide (TA) injections for treating uveitic macular edema (UME). Methods: This retrospective case series study included patients with UME who received subconjunctival TA injections with a minimum follow-up period of 6 months. The main outcome was central macular thickness. The secondary outcomes included the best corrected visual acuity, recurrence rate and intraocular pressure. Results: In total, 68 patients (83 eyes) were enrolled in this study. The mean CMT decreased from 456.9 ± 171.1 μm at baseline to 324 ± 175.9 μm, 305.6 μm ± 147.7 μm, 331.8 ± 154.3 μm and 281.1 ± 147.6 μm at 1, 2, 3 and 6 months postinjection, respectively (all P < 0.01). A total of 21/83 eyes exhibited elevated IOPs, which was controlled with topical IOP-lowering agents in 14 eyes, whereas 7 eyes got subconjunctival TA deposit surgically removed. Conclusion: subconjunctival TA injections appear to be safe and effective for UME.Key Words: Triamcinolone acetonide; subconjunctival injection; uveitis; macular edema

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Volar Scaphoid Plating for Nonunion: A Multicenter Case Series Study

Journal of Wrist Surgery ◽

10.1055/s-0040-1702199 ◽

2020 ◽

Vol 09 (03) ◽

pp. 225-229

Author(s):

Kevin Eng ◽

Stephen Gill ◽

Simon Hoy ◽

Vivek Shridar ◽

Natasha Van Zyl ◽

...

Keyword(s):

Case Series ◽

Visual Analogue Score ◽

Rotational Stability ◽

Volar Aspect ◽

Number Of Patients ◽

Case Series Study ◽

Structural Graft ◽

The Mean ◽

Series Study

Abstract Background The volar scaphoid plate from Medartis (Medartis AG, Austrasse, Basel, Switzerland) is a variable angle titanium locking plate, preformed for the volar aspect of the scaphoid. It does not have compressive capability, and may act as a bridging device. It may provide an advantage over a compression screw where the pathoanatomy is less favorable to such a device with increased rotational stability. It may act as a buttress plate for correction of humpback deformity for example. It has been used in nonunions and with vascularized grafts. Questions Our study aims to assess the results of our patients with scaphoid nonunion treated with scaphoid volar plating over a larger number of patients. We aim to identify techniques to increase the success of plating. Methods Patients from our cohort were retrospectively reviewed. Operations were performed by three hand fellowship trained surgeons and in two centers. Inclusion involved a scaphoid plate procedure for a nonunion of the scaphoid with a minimum of 6 months of follow-up. Exclusions were those who had less than 6 months of follow-up. Data included demographics, patient-rated wrist evaluation (PRWE), a quick disabilities of the arm, shoulder, and hand (qDASH), visual analogue score, and range and grip. Radiology was reviewed. Results Thirty-two eligible patients were assessed. The mean age was 25 years (range 13–46), 2 were female and 15 were smokers. Mean follow-up postsurgery was 18 months. Twenty-nine of 32 patients united (90.6%) on computed tomography scan. Clinical assessment was performed in the 25 patients. The mean qDASH score was 12.5 (range 0–42) and mean PRWE was 11 (range 0–54). The mean arc of motion was 115 degrees. The mean grip strength was 39 kg compared with 41 kg on the nonoperated side. Conclusion We postulate that the plate acts like an internal bridging device, acting over a small distance, and inherent stability of the construct with structural graft and accurate reduction prior to plating is advantageous. Potential problems include plate impingement on the volar lip of the radius, particularly when trying to plate more proximal fractures. Ideally, it is utilized for mid to distal waist fractures.

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Safety and Efficacy of Pterygium Extended Removal Followed by Extended Conjunctival Transplant for Recurrent Pterygia

10.21203/rs.3.rs-303034/v1 ◽

2021 ◽

Author(s):

Walid Allam ◽

Ahmed Roshdy Alagorie ◽

Mohammed Nasef ◽

Molham El-Bakary

Keyword(s):

Donor Site ◽

Case Series ◽

Surgical Excision ◽

Safety And Efficacy ◽

Case Series Study ◽

Corrected Distance Visual Acuity ◽

The Mean ◽

Prospective Case Series ◽

Series Study

Abstract Purpose To study the safety and efficacy of pterygium extended removal followed by extended conjunctival transplant for recurrent pterygia. Methods Thirty-three eyes of 33 subjects with recurrent pterygia were enrolled in this prospective case series study. Pterygium extended removal followed by extended conjunctival transplantation was done for all subjects. One surgeon (WA) performed all surgeries. All subjects completed follow-up for at least 12 months and were evaluated for recurrence and complications. Results The mean age of the participants was 41.2 ± 10.3 years (range 22–60), 7 females (21.2%). The mean duration of follow-up was 25.64 ± 9.24 months (range 12–43). Corrected distance visual acuity (decimal notation) improved from 0.69 ± 0.22 (range 0.2–1.0) at presentation to a 1-year postoperative value of 0.83 ± 0.2 (range 0.3–1.0). No recurrence was reported in all subjects throughout the follow-up period. Transient graft swelling was recorded in 14 cases (42.4%) and resolved in all cases by the first week. All patients developed variable degrees of transient postoperative diplopia that resolved completely by the first 6 weeks. Donor site granuloma developed in 4 cases (12.1%). Spontaneous resolution was observed in 3 cases, while in one case, surgical excision was performed 2 months after the procedure. Conclusions In this study of eyes with recurrent pterygia, pterygium extended removal followed by extended conjunctival transplant was found safe and effective with no recurrence and minimal postoperative complications.

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Five Years Prospective Study on Implant Failure and Marginal Bone Remodeling Expected Using Bone Level Implants with Sandblasted/Acid-Etched Surface and Conical Connection

10.20944/preprints202107.0563.v1 ◽

2021 ◽

Author(s):

Marco Tallarico ◽

Aurea Immacolata Lumbau ◽

Silvio Mario Meloni ◽

Irene Ieria ◽

Chang-Joo Park ◽

...

Keyword(s):

Bone Remodeling ◽

Case Series ◽

Insertion Torque ◽

Case Series Study ◽

The Mean ◽

Prospective Case Series ◽

One Year ◽

The One ◽

Series Study

Aim: the purpose of the present prospective, case series study were to report implant survival rate and marginal bone remodeling expected five years after loading using dental implants placed in in the daily practice. Material and Methods: this research was designed as an open-cohort, prospective case series study. Any completely or partially edentulous patients scheduled to receive at least one bone leve were considered eligible for this study. Primary outcomes were: cumulative implant (ISR) and prosthetic (PSR) survival rates, and any complications experienced up the five years follow-up. Secondary outcomes were: marginal bone remodeling, implant insertion torque, implant stability quotient (ISQ), and thickness of gingival biotype. Results: ninety consecutive patients (34 males and 56 females; mean age 53.2±15.4 years; range of 24–81 years), 243 implants were placed and followed for at least five years after loading (mean of 65.4±3.1 months; range of 60–72 months). The mean implant insertion torque was 42.9±4.8 Ncm (range from 15 to 45 Ncm). Overall, 83.5% of the implants (n=203) were placed with an insertion torque between 35 and 45 Ncm. At the one year follow-up, no drop-outs were recorded, but 17 patients (18.9%) with 18 restorations (12.6%) delivered on 34 implants (14%) were lost at the five years examination. At the five-year examination, six implants failed in six patients, resulting in a cumulative ISR of 97.5%. At the five-year follow-up, four prostheses failed (2.8%) resulting in a cumulative PSR of 97.2%. At the five-year examination, five complications were reported by five different patients, resulting in a prosthetic success rate of 96.5%, measured at patient level. Five years after loading, mean MBL was 0.41 ± 0.30 mm (95% CI: 0.26–0.34). Difference from the one year data was 0.04 ± 0.19 mm (95% CI: 0.01–0.07). The mean ISQ value at implant placement was 71.6 ± 5.5 (range of 45–88). Six months later, the mean ISQ was 76.7 ± 4.4 (range of 66–89). The difference was statistically significant (P=0.0001). Statistically significant higher MBL was found for smokers, and patient with thin gingival biotype. Conclusions: High implant survival and success rates could be expected with stable marginal bone remodeling up to five years after loading. Smoking and thin tissue biotype were the most important variabilities associated with higher MBL. Further research are needed to confirm these results.

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The case for skin camouflage in the management of upper limb scarring – A case series

Hand Therapy ◽

10.1177/17589983211007875 ◽

2021 ◽

pp. 175899832110078

Author(s):

Laura Adamson ◽

Anna Selby

Keyword(s):

Upper Limb ◽

Case Series ◽

Primary Objective ◽

Self Confidence ◽

Published Evidence ◽

Case Series Study ◽

Visual Impact ◽

Series Study ◽

Increasing Function

Introduction For some people the appearance of their hands is as important as function. Upper limb scarring can cause some patients distress. Skin camouflage is an intervention that can be used to reduce the visual impact of a scar but there is limited published evidence for its use for hand scarring. Methods This is a case series study with a primary objective to determine whether skin camouflage reduces distress in patients with an upper limb scar and to evaluate this new service. Patients experiencing distress from an upper limb scar were recruited from a hand therapy outpatient clinic. The intervention delivered was a one hour skin camouflage session. Photographs of the upper limb pre and post skin camouflage intervention were taken. The patient-rated Michigan Hand Questionnaire (MHQ) and Derriford Appearance Scale (DAS24) were completed before treatment, at 1 week and 1 month after treatment. Results Six participants reporting distress from an upper limb scar received skin camouflage intervention. Only three out of six participants completed all follow-up. All three showed improvement in at least two domains of the MHQ (function and aesthetics) at one month post treatment. Increased confidence during functional and work-based activities was also reported on the DAS24. Participants reported increased engagement in daily activities as a result of being able to camouflage their scars. Conclusions This small case series shows that skin camouflage intervention may be beneficial for some patients who are experiencing distress related to an upper limb scar by increasing function and self-confidence.

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The Association Between the Rotator Cuff Status and the Severity and Recovery of Weakness in the Shoulder Abductor Strength in a Case of Proximal Type Cervical Spondylotic Amyotrophy

Global Spine Journal ◽

10.1177/2192568220980441 ◽

2020 ◽

pp. 219256822098044

Author(s):

Sho Ishiwata ◽

Yoichi Iizuka ◽

Hitoshi Shitara ◽

Tokue Mieda ◽

Eiji Takasawa ◽

...

Keyword(s):

Rotator Cuff ◽

Biceps Brachii ◽

Case Series ◽

Manual Muscle Test ◽

Cuff Tear ◽

Cervical Spondylotic Amyotrophy ◽

Case Series Study ◽

Shoulder Abductor ◽

Series Study

Study Design: Case series study. Objective: We aimed to clarify the prevalence of rotator cuff tear (RCT), and the association between RCT and the severity and prognosis in patients with proximal type cervical spondylotic amyotrophy (CSA). Methods: We retrospectively analyzed 35 proximal type CSA patients who were treated conservatively. The following data was collected: age, rotator cuff status on MRI, manual muscle test (MMT) score of shoulder abductor and biceps brachii muscles both at the first visit and final follow-up. We investigated the prevalence of RCT and the association between the rotator cuff status, and the severity and recovery of upper extremity weakness in patients with proximal type CSA. Results: Of the 35 patients, 21 had an RCT on MRI, indicating that the prevalence of RCT in patients with proximal type CSA was 60%. An age-adjusted analysis showed that the presence of RCT was significantly associated with the MMT score of the shoulder abductor muscles both at the first visit and at the final follow-up. The presence of RCT was significantly associated with the recovery of the shoulder abductor muscles. The size of the RCT was negatively correlated with the MMT score of the shoulder abductor muscles at the final follow-up. The size of the RCT was independently correlated with the change of the MMT score of the shoulder abductor muscles. Conclusion: RCT was detected in >50% in patients with proximal type CSA, and the presence and severity of RCT can be used as prognostic factors for proximal type CSA patients who are treated conservatively.

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

Ophthalmology and Eye Diseases ◽

10.4137/oed.s12672 ◽

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.

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