scholarly journals Calzone-Like Traumatic Flap Dislocation Four Years after Laser in situ Keratomileusis

2019 ◽  
Vol 10 (2) ◽  
pp. 281-286
Author(s):  
Isaak Fischinger ◽  
Jascha Wendelstein ◽  
Matthias Bolz ◽  
Manfred Tetz
Keyword(s):  
Visual Acuity ◽  
Epithelial Cells ◽  
Laser In Situ Keratomileusis ◽  
New Approach ◽  
Epithelial Ingrowth ◽  
Mechanical Removal ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

A 46-year-old patient presented with a flip-folded partially dislocated flap after trauma caused by a sheet of paper, four years after a reportedly uneventful laser in situ keratomileusis procedure using microkeratome. Flap re-lift, mechanical debridement, and flap stretching were performed in a first interventional approach. Due to epithelial ingrowth two month after the first intervention, a flap re-lift and mechanical removal of epithelial cells from the stroma bed and flap were performed. In addition, triamcinolone was applied subconjunctivally. Thereafter, best corrected visual acuity of 20/20 was regained and no more epithelial ingrowth was observed. Only few cases of flap dislocation with epithelial ingrowth have been described in the literature following trauma, though none of a permanently inward folded flap. The use of subconjunctival triamcinolone is a new approach to prevent recurrent epithelial ingrowth.

scholarly journals Macular Hole after Laser In Situ Keratomileusis in a 26-Year-Old Patient

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Guzel Bikbova ◽  
Toshiyuki Oshitari ◽  
Madoka Sakurai ◽  
Takayuki Baba ◽  
Shuichi Yamamoto
Keyword(s):  
Visual Acuity ◽  
Informed Consent ◽  
Macular Hole ◽  
Final Visual Acuity ◽  
Laser In Situ Keratomileusis ◽  
Irregular Surface ◽  
Vitreoretinal Interface ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

The purpose of this study is to describe the 26-year-old patient with developed macular hole after bilateral laser in situ keratomileusis (LASIK). A macular hole with sharp margins and irregular surface of surrounding retina appeared in the left eye of the female 26-year-old patient two months after LASIK for correction of myopia (followup of 6 months). Although the best corrected visual acuity (BCVA) after LASIK was 1.0, after the macular hole has developed BCVA became 0.5. After surgery, the final visual acuity recovered to 0.7. Macular hole may develop after LASIK for myopia correction due to unknown changes of vitreoretinal interface. Complete informed consent must be obtained from patients with high myopic eyes before LASIK.

scholarly journals Management of a Traumatic Flap Dislocation Seven Years after LASIK

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Majid Moshirfar ◽  
Erik Anderson ◽  
Nathan Taylor ◽  
Maylon Hsu
Keyword(s):  
Visual Acuity ◽  
Laser In Situ Keratomileusis ◽  
Epithelial Ingrowth ◽  
Blurry Vision

Seven years after uneventful laser in situ keratomileusis (LASIK), a 48-year-old woman presented one week after being hit with an iron cord with blurry vision, pain, and irritation. The injury resulted in traumatic flap dislocation, epithelial ingrowth, and macrostriae. Following epithelial removal, the flap was refloated and repositioned. Nine interrupted sutures were used to secure the flap. Three-weeks after surgery with no sutures remaining, the epithelial ingrowth and macrostriae had resolved with a visual acuity of 20/20.

scholarly journals Scheimpflug Topography Oriented Adequate Repositioning of a Misaligned Free Flap after Laser in situ Keratomileusis

2021 ◽  
pp. 889-893
Author(s):  
Ha Eun Sim ◽  
Min Ji Kang ◽  
Jee Hye Lee ◽  
Seung Hwa Baik ◽  
Sun Young Kim ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Free Flap ◽  
Laser In Situ Keratomileusis ◽  
Clockwise Rotation ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
The Right ◽  
Original Configuration ◽  
Irregular Astigmatism

This report describes a case of Scheimpflug topography oriented adequate repositioning of a misaligned thick free flap after laser in situ keratomileusis (LASIK). A 24-year-old patient consulted for irregular astigmatism and disoriented free right eye flap. The patient previously underwent binocular LASIK at a private clinic. During the right eye surgery, the flap was repositioned after laser ablation due to the free flap. The free flap was not repositioned to its original configuration due to insufficient preoperative corneal marking. On examination, the uncorrected visual acuity was 0.4, and refractive power was +2.00 Dsph with −4.25 Dcyl axis 66 in the right eye. Scheimpflug topography revealed irregular right eye astigmatism. The sagittal curvature of topography showed a 40° counterclockwise misalignment of the steep axis of the cornea. The free flap was repositioned by 40° clockwise rotation. After this, the refractive corneal power improved to −1.00 Dsph with −1.00 Dcyl Axis 19 in the right eye. The uncorrected and best-corrected visual acuity improved to 20/30 and 20/25 (x − 0.25Dsph −1.25 Dcyl A20), respectively. This is the first report on free flap repositioning using Scheimpflug topography. As proper flap positioning was compromised because of the free LASIK flap with no preoperative corneal marking, the flap was effectively repositioned using Scheimpflug topography.

scholarly journals Nontraumatic Epithelial Ingrowth 15 Years Post Laser In Situ Keratomileusis

2019 ◽  
Vol 2019 ◽  
pp. 1-2
Author(s):  
Joanna S. Saade ◽  
Baha’ Noureddin ◽  
Shady T. Awwad
Keyword(s):  
Optical Coherence Tomography ◽  
Case Report ◽  
Epithelial Cells ◽  
Conservative Treatment ◽  
Traumatic Event ◽  
Laser In Situ Keratomileusis ◽  
Optical Coherence ◽  
Epithelial Ingrowth

Purpose. Epithelial ingrowth occurring many years after primary Laser in Situ Keratomileusis (LASIK) without a preceding traumatic event is very rare. Case Report. We describe the case of a 61-year-old woman with epithelial ingrowth in her right eye 15 years after primary LASIK. She presented with right eye redness, pain, and decreased vision and denied any preceding trauma. An epithelial cells’ tract was visible on Optical Coherence Tomography. Conservative treatment lead to the stabilization of the epithelial nests. Discussion. Epithelial ingrowth can occur many years after LASIK and may be due to a microtrauma to the edge of the flap.

Comparison of the Effectiveness of Intravitreal Ranibizumab for Diabetic Macular Edema in Vitrectomized and Nonvitrectomized Eyes

2016 ◽  
Vol 236 (2) ◽  
pp. 67-73 ◽  
Author(s):  
Yoshito Koyanagi ◽  
Shigeo Yoshida ◽  
Yoshiyuki Kobayashi ◽  
Yuki Kubo ◽  
Muneo Yamaguchi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Treatment Option ◽  
Central Macular Thickness ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Purpose: To compare the effectiveness of intravitreal ranibizumab (IVR) for diabetic macular edema (DME) between eyes with and without previous vitrectomy. Procedures: We prospectively assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) after IVR for 6 months. Results: There were no significant differences in the baseline BCVA and CMT between both groups. In the nonvitrectomized group (n = 15), the mean changes of BCVA and CMT from baseline to month 6 were significant (p < 0.01). In the vitrectomized group (n = 10), the improvement appeared to be slower, and the mean BCVA improvement was not significant (p = 0.5), although the mean CMT decrease was significant (p < 0.05). There were no significant differences in the mean changes of BCVA and CMT between both groups at 6 months. Conclusions: The difference in the effectiveness of IVR between both groups was not significant. IVR can be a treatment option even for vitrectomized DME eyes.

Rebubbling rate in preloaded versus surgeon prepared DSAEK

2021 ◽  
pp. 112067212110143
Author(s):  
Luca Pagano ◽  
Kunal A Gadhvi ◽  
Giulia Coco ◽  
Matthew Fenech ◽  
Mitchell Titley ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Statistical Difference ◽  
Preparation Method ◽  
Eye Bank ◽  
Eye Banks ◽  
Corrected Visual Acuity ◽  
Detachment Rate ◽  
Pull Through ◽  
Graft Diameter ◽  
Best Corrected Visual Acuity

Purpose: To compare the clinical outcomes of eye bank preloaded Descemet stripping automated endothelial keratoplasty (DSAEK) grafts and surgeon prepared. Methods: In this retrospective study, the data were obtained from two groups (a) surgeon cut DSAEK where tissue was prepared by the surgeon immediately before surgery, and (b) preloaded DSAEK tissue shipped to the surgeon after preparation by the eye bank. Standard DSAEK preparations using Moria microkeratome with single pass method were performed. For the tissues prepared by the eye banks, they were preloaded in an iGlide device and shipped in transport media. Standard DSAEK surgery using bimanual pull-through technique was performed for all the grafts. Air was used as a tamponade. Main outcome measures included best corrected visual acuity (BCVA) and rebubbling rate. Result: Out of 107 eyes of 101 patients that underwent DSAEK surgery, 33 tissues were prepared by the surgeon (sc-DSAEK), while 74 were prepared by the eye bank (pl-DSAEK). sc-DSAEK showed a rebubbling rate of 9.1%, compared to the 16.2% for the preloaded DSAEK ( p = 0.11). There was no statistical difference in postoperative BCVA between the two groups. Logistic regression analysis showed no association between detachment rate and cataract surgery, graft preparation method, graft diameter and reason for graft. Conclusion: Preloaded grafts have similar rebubbling rate and visual acuity achieved compared with surgeon prepared grafts.

scholarly journals Intraoperative choroidal detachment during small-gauge vitrectomy: analysis of causes, anatomic, and visual outcomes

Eye ◽  
2021 ◽  
Author(s):  
Ting Zhang ◽  
Yantao Wei ◽  
Zhaotian Zhang ◽  
Wei Chi ◽  
Lujia Feng ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Medical Records ◽  
Demographic Characteristics ◽  
Choroidal Detachment ◽  
Fluid Exchange ◽  
Visual Outcomes ◽  
Corrected Visual Acuity ◽  
Ocular Hypotony ◽  
Small Gauge ◽  
Best Corrected Visual Acuity

Abstract Introduction To investigate the incidence and causes of intraoperative choroidal detachment (CD) during small-gauge vitrectomy, as well as the anatomic and visual outcomes. Methods We retrospectively reviewed the medical records of 1026 consecutive patients who underwent small-gauge vitrectomy from June 2017 to December 2018 at Zhongshan Ophthalmic Centre, Guangzhou, China. Data on the presence, location, and extent of intraoperative CD and its relationship to the infusion cannula were collected. Patient demographic characteristics and postoperative anatomic and visual outcomes were also assessed. Results A total of six cases were found to have intraoperative CD, including two with serous CD, three with limited haemorrhagic CD, and one with CD caused by inadvertent perfusion of gas during air/fluid exchange. Retraction of the infusion cannula and acute ocular hypotony were found to be the main causes of intraoperative CD in five out of the six cases. The best-corrected visual acuity of all cases significantly improved after the surgery. Conclusion The incidence of intraoperative CD during small-gauge vitrectomy is low; the predominant causes are retraction of the infusion cannula and acute ocular hypotony. Immediate awareness and timely closure of the incision may contribute to a better surgical prognosis.

scholarly journals Pseudoamblyopia in Congenital Cyclotropia

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Antonio Frattolillo ◽  
Filippo Tassi ◽  
Valentina Di Croce ◽  
Costantino Schiavi
Keyword(s):  
Visual Acuity ◽  
Surgical Correction ◽  
Visual Performance ◽  
Time Study ◽  
Superior Oblique Palsy ◽  
Fixation Pattern ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity ◽  
Superior Oblique

Purpose. To study the effect of surgery on amblyopia and suppression associated with congenital cyclovertical strabismus. Methods. The fixation pattern was investigated with microperimetry before and soon after surgery in ten consecutive children operated for congenital superior oblique palsy at the S. Martino Hospital, Belluno, Italy, between September 2014 and December 2015. Changes in visual performance in terms of best-corrected visual acuity (BCVA) and stereopsis between the day before and one week after surgery were also evaluated. No other amblyopia treatment has been administered during the time study. Results. Surgical correction of the excyclodeviation in congenital SO palsy determined monocular and binocular sensory consequences: monocularly, in the cyclodeviated amblyopic eye, BCVA (0.46–0.03 LogMAR; p<0.0001) and the fixation pattern improved, as demonstrated by microperimetry examination. Binocularly, stereopsis improved or emerged while suppression at the Worth four-dot test disappeared. Conclusions. In the absence of further amblyopic factors such as coexisting constant vertical and/or horizontal deviation and anisometropia, the amblyopia encountered in congenital SO palsy may resolve soon after the surgical alignment. Therefore, it may be considered and defined “pseudoamblyopia.”

scholarly journals Foveal Exudative Macroaneurysm Treated with Intravitreal Ranibizumab

2015 ◽  
Vol 6 (2) ◽  
pp. 170-175 ◽  
Author(s):  
Carlos Menezes ◽  
Rui Carvalho ◽  
Carla Teixeira ◽  
José Alberto Lemos ◽  
Rita Gonçalves ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Macular Edema ◽  
Morphological Data ◽  
Foveal Avascular Zone ◽  
Optical Coherence ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
Retinal Macroaneurysm ◽  
Best Corrected Visual Acuity

Purpose: We report a case of a foveal macroaneurysm with long-standing macular edema in a rare location, successfully treated with intravitreal ranibizumab. Methods: We report the case of a 52-year-old man with left eye long-term visual loss due to macular edema caused by a retinal macroaneurysm, localized about 400 μm from the center of the fovea, and its response to 6 monthly ranibizumab intravitreal injections. His best-corrected visual acuity and morphological data evaluated by optical coherence tomography and fluorescein angiography are presented. Results: His best-corrected visual acuity improved from 1/10 to 3/10 after the 3rd injection, and from 1/10 to 4/10 after the 6th one. The central retinal thickness was evaluated by optical coherence tomography and improved from 310 to 233 μm, with the resolution of both the associated serous detachments and the cystoid macular edema; an almost complete reabsorption of the hard exudates at the end of the treatment was also observed. The macroaneurysm lumen almost obliterated after the 3rd injection and completely collapsed at the end of treatment. Conclusions: Intravitreal ranibizumab may be effective in the treatment of long-standing macular edema associated with foveal macroaneurysms. To the best of our knowledge, this is the first report of a retinal macroaneurysm located so close to the foveal avascular zone.

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