scholarly journals Surgical Treatment of Idiopathic Macular Hole Using Different Types of Tamponades and Different Postoperative Positioning Regimens

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
M. Veith ◽  
J. Vránová ◽  
J. Němčanský ◽  
J. Studnička ◽  
M. Penčák ◽  
...  
Keyword(s):  
Macular Hole ◽  
Prone Position ◽  
Subjective Evaluation ◽  
Idiopathic Macular Hole ◽  
Ilm Peeling ◽  
Intraocular Tamponade ◽  
Different Types ◽  
Air Tamponade ◽  
Group 2 ◽  
Group 1

Purpose. To compare the effect of different types of intraocular tamponade and different types of postoperative positioning on the closure of idiopathic macular hole (IMH). Methods. Prospective randomized clinical trial enrolling 104 eyes of 100 patients (age, 57–87 years) undergoing MH surgery. All patients were operated on by an experienced surgeon using 25-gauge pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling. Patients were randomized according to the type of intraocular tamponade and postoperative positioning into the following four groups: SF6 + nonsupine reading position (n = 26) (group 1), air + nonsupine reading position (n = 25) (group 2), air + prone position (n = 26) (group 3), or SF6 + prone position (n = 27) (group 4). The follow-up period was 6 months. Results. MH closure was achieved in 87 eyes (83.7 %) in the overall sample after the first surgery, with closure rates of 100%, 56%, 84.6%, and 92.6% in groups 1, 2, 3, and 4, respectively. The group 2 was significantly less successful compared to the other three groups ( p  < 0.05). MH of sizes ≤400 µm was closed in 97.2% of cases after the first surgery, with no significant differences between groups ( p  = 0.219). MH with sizes over 400 µm was closed in 70.9% of cases after the first surgery, with both groups with air tamponade being significantly less successful than group 1. The nonsupine reading position was subjected to a better subjective evaluation in terms of postoperative comfort and quality of sleep, with no differences between air and SF6 tamponade tolerance. Conclusion. PPV with ILM peeling, intraocular tamponade, and positioning remains the basic surgical approach in the treatment of IMH. For MH ≤ 400 µm, a high closure rate can be achieved by combining air tamponade and nonsupine reading position. For macular holes >400 µm, the greatest anatomical success can be achieved by using the SF6 tamponade in combination with the nonsupine reading position.

Retinal and Choroidal Thicknesses Measured with Swept-Source Optical Coherence Tomography after Surgery for Idiopathic Macular Hole

2016 ◽  
Vol 27 (3) ◽  
pp. 312-318 ◽  
Author(s):  
Handan Bardak ◽  
Murat Gunay ◽  
Yavuz Bardak ◽  
Yesim Ercalik
Keyword(s):  
Optical Coherence Tomography ◽  
Layer Thickness ◽  
Healthy Controls ◽  
Idiopathic Macular Hole ◽  
Ilm Peeling ◽  
Swept Source ◽  
Group 3 ◽  
Group 2 ◽  
Fellow Eyes ◽  
Group 1

Purpose To evaluate the changes in retinal nerve fiber layer thickness (RNFLT), ganglion cell layer thickness (GCLT), retinal thickness (RT), and subfoveal choroidal thickness (SFCT) in eyes that received pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for idiopathic macular hole (IMH) and to compare these data with data from fellow eyes and healthy controls. Methods This cross-sectional study included 49 subjects. Eighteen eyes that underwent surgery for IMH, 18 fellow eyes, and 31 eyes of the healthy controls were designated as group 1, group 2, and group 3, respectively. The RNFLT, GCLT, RT, and SFCT were measured by using the swept-source optical coherence tomography (SS-OCT) device at last postoperative visit. Results The RNFLT was significantly lower in group 1 than group 2 and group 3 (p<0.05). The GCLT was significantly reduced in all sectors in group 1 as compared to group 2 and group 3 (p<0.05). The RT was found to be significantly lower (except in central field) in group 1 than group 2 and group 3 (p<0.05). The SFCT was significantly decreased in group 1 as compared to group 2 and group 3 (p<0.05). Conclusions A reduction in the RNFLT, GCLT, RT, and SFCT was observed following PPV with ILM peeling for IMH detected by SS-OCT.

Postoperative features of the macular zone structure after surgical treatment of large full-thickness macular hole using various surgical techniques

2021 ◽  
pp. 130-134
Author(s):  
D.V. Petrachkov ◽  
◽  
L. Alkharki ◽  
A.G. Matyuschenko ◽  
V.M. Filippov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Macular Hole ◽  
Functional Results ◽  
Full Thickness ◽  
Zone Structure ◽  
Full Thickness Macular Hole ◽  
Air Tamponade ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Purpose. Comparative assessment of the retinal macular zone structure after surgical treatment of full-thickness macular hole (FTMH) by various methods. Material and methods. Patients with Gass stage III-IV FTMH were divided into 3 groups. Group 1 patients (20 eyes) underwent a standard operation (subtotal vitrectomy (sVE), aspiration convergence of the FTMH edges, gas-air tamponade of the vitreous cavity). Patients in group 2 (20 eyes), after sVE and ILM peeling, autologous conditioned plasma (ACP) were applied to FTMH area followed by air tamponade. Patients of group 3 (20 eyes) after sVE underwent FTMH closure using an inverted ILM flap with the rupture edges approached, followed by air tamponade. Results. The increase in BCVA after 1 month averaged from 0.23±0.1 to 0.41±0.13, (p<0.05) in patients in group 1, in group 2 from 0.15±0, 07 to 0.75±0.09, (p<0.05), in patients in group 3 from 0.14±0.05 to 0.78±0.08, (p<0.05). Anatomical results: in group 1, 17 patients who received standard surgical treatment, a month after surgery, had a satisfactory anatomical result (complete closure of the FTMH with restoration of the correct retinal architectonics in the foveal zone). In 3 patients, additional endovitreal intervention was required with successful FTMH closure. In all patients in group 2, according to OCT data, 5 days after the operation, hyperreflective tissue was detected in the FTMH area ("platelet plug"). When OCT was performed 1 month later, in all cases, the platelet plug resolved, and in all cases, restoration of the foveal profile architectonics was observed. In group 3, the closure of the FTMH on the 5th day of observation was recorded in all patients. When performing OCT after 1 month, complete closure of the neuroepithelium layer was recorded in all cases: in 13 patients - U-shaped closure and in 7 cases – V-shaped. The functional results in both groups were comparable; there was no statistical difference between them. Conclusion: The data obtained demonstrate the morphological features of the retinal foveolar zone postoperative restoration. There was no significant difference in functional results between study groups. Key words: full-thickness macular hole, vitreoretinal surgery, internal limiting membrane, inverted ILM flap, autologous conditioned plasma, optical coherence tomography.

scholarly journals Reconstructing Foveola by Foveolar Internal Limiting Membrane Non-Peeling and Tissue Repositioning for Lamellar Hole-Related Epiretinal Proliferation

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Tzyy-Chang Ho ◽  
Allen Yi-Lun Ho ◽  
Muh-Shy Chen
Keyword(s):  
Visual Acuity ◽  
Clinical Characteristics ◽  
Internal Limiting Membrane ◽  
Lamellar Macular Hole ◽  
Ilm Peeling ◽  
Corrected Visual Acuity ◽  
Tangential Traction ◽  
Group 2 ◽  
Lamellar Hole ◽  
Group 1

Abstract Differences in the pathogenesis and clinical characteristics between lamellar macular hole (LMH) with and without LMH-associated epiretinal proliferation (LHEP) can have surgical implications. This study investigated the effects of treating LHEP by foveolar internal limiting membrane (ILM) non-peeling and epiretinal proliferative (EP) tissue repositioning on visual acuity and foveolar architecture. Consecutive patients with LHEP treated at our institution were enrolled. The eyes were divided into a conventional total ILM peeling group (group 1, n = 11) and a foveolar ILM non-peeling group (group 2, n = 22). In group 2, a doughnut-shaped ILM was peeled, leaving a 400-μm-diameter ILM without elevated margin over the foveola after EP tissue repositioning. The EP tissue was elevated, trimmed, and inverted into the LMH. Postoperatively, the LMH was sealed in all eyes in group 2, with significantly better best-corrected visual acuity (−0.26 vs −0.10 logMAR; p = 0.002). A smaller retinal defect (p = 0.003), a more restored ellipsoid zone (p = 0.002), and a more smooth foveal depression (p < 0.001) were achieved in group 2. Foveolar ILM non-peeling and EP tissue repositioning sealed the LMH, released the tangential traction, and achieved better visual acuity. The presumed foveolar architecture may be reconstructed surgically. LMH with LHEP could have a combined degenerative and tractional mechanism.

scholarly journals Long-Term Outcome of Vitrectomy with Suitable Internal Limiting Membrane Peeling and Air Tamponade for Highly Myopic Foveoschisis-Associated Lamellar Macular Hole

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Jia-lin Wang ◽  
Yan-ling Wang
Keyword(s):  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Lamellar Macular Hole ◽  
Ilm Peeling ◽  
Long Term Outcome ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Myopic Foveoschisis ◽  
Air Tamponade

Purpose. To investigate the outcome of pars plana vitrectomy (PPV) with suitable internal limiting membrane peeling (ILM) and air tamponade for patients with highly myopic foveoschisis-associated lamellar macular hole (MH). Methods. This retrospective interventional case series included 11 patients with highly myopic foveoschisis-associated lamellar MH who underwent PPV and indocyanine green-aided ILM peeling up to the temporal vascular arcades. Following air tamponade after surgery, all patients were instructed to maintain a face-down position. The patients were followed up for over 1 year and evaluated for MH closure and the best-corrected visual acuity before and after surgery. Results. The mean ± standard deviation values of patient age, axial length, and follow-up duration were 67.82 ± 6.54 years, 29.21 ± 1.95 mm, and 24.27 ± 8.11 months, respectively. After surgery, the lamellar MH closed in all eyes, and 10 eyes showed vision improvement at the 1-month, 3-month, and final follow-up evaluations. One patient showed decreased vision at 2 years after surgery, with patchy chorioretinal atrophy in the macular region. Myopic foveoschisis showed resolution in three eyes and alleviation in eight. Ten patients underwent cataract surgery during PPV. Conclusion. Extension of ILM peeling up to the temporal vascular arcades and air tamponade after PPV may improve the visual function and rate of MH closure for patients with highly myopic foveoschisis-associated lamellar MH.

23- and 20-Gauge Vitrectomy with Air Tamponade with Combined Phacoemulsification for Idiopathic Macular Hole: A Single-Surgeon Study

2011 ◽  
Vol 152 (1) ◽  
pp. 114-121.e1 ◽  
Author(s):  
Taiichi Hikichi ◽  
Shoko Kosaka ◽  
Kimitaka Takami ◽  
Hiroko Ariga ◽  
Hideo Ohtsuka ◽  
...  
Keyword(s):  
Macular Hole ◽  
Idiopathic Macular Hole ◽  
Air Tamponade

INTERNAL LIMITING MEMBRANE PEELING AND AIR TAMPONADE FOR STAGE III AND STAGE IV IDIOPATHIC MACULAR HOLE

Retina ◽  
2020 ◽  
Vol 40 (1) ◽  
pp. 66-74 ◽  
Author(s):  
Yanping Yu ◽  
Xida Liang ◽  
Zengyi Wang ◽  
Jing Wang ◽  
Xinxin Liu ◽  
...  
Keyword(s):  
Macular Hole ◽  
Stage Iv ◽  
Internal Limiting Membrane ◽  
Stage Iii ◽  
Idiopathic Macular Hole ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Air Tamponade

scholarly journals Comparative characteristics of the quality of life of asthma patients with different types of airway hyperresponsiveness to physical stimules

2021 ◽  
pp. 55-61
Author(s):  
N. L. Perelman
Keyword(s):  
Quality Of Life ◽  
Airway Hyperresponsiveness ◽  
Group 4 ◽  
Sf 36 ◽  
Different Types ◽  
Asthma Patients ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. To compare the nature and degree of influence of different types of airway hyperresponsiveness (AHR) on the general and specific quality of life (QoL) of patients with asthma and control over the disease.Materials and methods. 234 patients with mild-to-moderate asthma, aged from 18 to 60 years old, were interviewed and examined. Depending on the presence of one or another type of AHR, 4 groups were formed: group 1 included 60 patients with cold AHR, group 2 – 75 patients with hypoosmotic AHR, group 3 – 35 patients with hyperosmotic AHR, group 4 – 64 patients with exercise-induced bronchoconstriction (EIB). QoL and the state of the emotional sphere were assessed using the SF-36, AQLQ, HADS questionnaires. The level of asthma control was determined using the ACT questionnaire. Lung function was assessed by spirometry.Results. When comparing QoL between groups, statistical differences were obtained for most of the SF-36 scales, with the exception of the domains “Role Physical” (RP) and “Bodily Pain” (BP), and their presence and significance varied depending on the types of AHR being compared. The lowest QoL indices were found in group 1 of patients with cold AHR according to the domains “Physical Activity” (PA), RP, BP, and “Role Emotional” (RE). The lowest indices for the domains “General Health” (GH), “Vitality” (V) and “Mental health” (MH) were found in the respondents of the 2nd group. Most of the highest QoL indicators in the compared groups were found in patients of group 4 with EIB in the domains PA, RP, V, RE, and MH. When carrying out a comparative analysis, the maximum number of significant differences was found between the groups with cold AHR and EIB. A comparative study of QoL using a special AQLQ questionnaire showed the lowest indices for the “Activity” and “Symptoms” domains in groups 1 and 2 of asthma patients. In addition, in group 1, the minimum QoL values were recorded for the “General QoL” domain (3.6±0.2 points), and in group 2, for the “Environment” domain (2.9±0.3 compared with 3.9±0.2 points in group 3, p<0.01).Conclusion. This study has demonstrated the multifaceted effect of AHR on health-related QoL, dependent on sensitivity to a particular physical stimulus and the season of maximum trigger action. The subjective assessment of psychosocial functioning is most differentiated according to the GH domain of the SF-36 questionnaire. The greatest negative impact on the QoL indices is exerted by the cold and hypoosmotic AHR, the least – by the EIB. The assessment of QoL allows to get a full picture of the perception of the patient's health level at the moment and in the given conditions.

Methods of Instrument Training and Effects on Pilots’ Performance With Different Types of Flight Instrument Displays

2012 ◽  
Vol 2 (2) ◽  
pp. 62-71 ◽  
Author(s):  
Roneil S. Lindo ◽  
John E. Deaton ◽  
John H. Cain ◽  
Celine Lang
Keyword(s):  
System Approach ◽  
The Other ◽  
Flight Training ◽  
Aircraft Control ◽  
Different Types ◽  
Display Technology ◽  
Group 2 ◽  
Glass Cockpit ◽  
Better Than ◽  
Group 1

As computer display technology has evolved, so have the aircraft instrument displays pilots use for aircraft control and navigation. With the aid of two different flight training devices – one configured with steam gauges and the other configured with glass cockpit – this study measured aircraft control and navigation differences between two pilot groups. Pilot Group 1 had earned their instrument rating in aircraft equipped with steam gauges, and Pilot Group 2 had earned their instrument rating in aircraft equipped with glass cockpits. Using displays for which they were not trained, each pilot was tested on aircraft control and navigation precision. The test required that pilots complete basic instrument maneuvers and an instrument landing system approach. Using MANOVA, deviations from assigned values were recorded and statistically compared. Study findings indicated that steam gauge pilots transitioning to glass cockpits perform better than glass cockpit pilots transitioning to steam gauge displays.

Impact of Introducing 2 Simple Technique Modifications on the Descemet Membrane Endothelial Keratoplasty Learning Curve

2016 ◽  
Vol 27 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Francisco Arnalich-Montiel ◽  
Ane Pérez-Sarriegui ◽  
Alfonso Casado
Keyword(s):  
Learning Curve ◽  
Graft Failure ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Primary Graft Failure ◽  
Air Tamponade ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Purpose To analyze the impact of performing premarking of the Descemet roll and using SF6 20% on a surgeon's Descemet membrane endothelial keratoplasty (DMEK) learning process. Methods A total of 30 consecutive eyes with endothelial dysfunction undergoing DMEK during the learning curve of a surgeon were retrospectively analyzed. Prior to the study, the surgeon had already performed 10 DMEKs. The first 15 consecutive patients were included in group 1 (no premarking and air tamponade) and the other 15 consecutive patients were included in group 2 (premarking and SF6 tamponade). Main outcome parameters were best-corrected visual acuity (BCVA), endothelial cell density (ECD) loss at 6 months, and intraoperative and postoperative complications. Results Among the 2 groups, BCVA and ECD loss at 6 months were similar. However, there was a statistically significant reduction in primary graft failure (40% vs 0%) and need of rebubbling due to complete or partial graft detachment (40% vs 6%) when comparing group 1 versus group 2. In group 1, half of the patients needing rebubbling had primary graft failure. Conclusions Based on our personal experience, premarking the graft to assess orientation and using a SF6 gas tamponade dramatically reduces the risk of primary graft failure and the need for rebubbling even during the first stages of the learning curve. These findings should encourage surgeons to safely change from Descemet stripping automated endothelial keratoplasty to DMEK.

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