Managing Ahmed Glaucoma Valve tube exposure: Surgical technique

2020 ◽  
pp. 112067212092564
Author(s):  
Marco Nardi ◽  
Maria Novella Maglionico ◽  
Chiara Posarelli ◽  
Michele Figus

Purpose: To describe a new surgical technique for managing Ahmed Glaucoma Valve tube exposure. The technique is simple, safe, easy to perform and may be an interesting alternative to conventional covering of the tube. This technique allows unlike the classical ones to act on the cause and not only on the complication of extrusion. Materials and Methods: This study was a retrospective case series that included four eyes of four patients who presented with an Ahmed Glaucoma Valve tube exposure. Results: Surgery was uneventful in all cases and we did not observe any intraoperative or postoperative complications. After at least 1-year follow-up, no case of tube re-exposure was detected. Conclusions: Many techniques have been proposed in order to cover the extruded tubes, and different materials may be used to reinforce the coverage, but re-exposure of the tube is a possible scenario. Indeed, our technique attempts not only to cover the exposed tube but also to solve the cause of the extrusion.

2013 ◽  
Vol 56 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Vladimir Boschi ◽  
Zenon Pogorelic ◽  
Gordan Gulan ◽  
Katarina Vilovic ◽  
Hrvoje Stalekar ◽  
...  

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Mustafa Erman Dörterler

Objective. To present the clinical profile and outcomes of esophageal button battery ingestion cases treated at our institution over an 8-year period. Methods. A total of 17 children who presented after ingesting a button battery and were treated at a tertiary care clinic over an 8-year period were included in this retrospective case series study. Data on patient demographics and esophageal location of the battery, time from ingestion to admission, symptoms, grade of mucosal injury, size of the battery, management, complications, and follow-up outcome were recorded. Results. Median age was 29 months (range, 2–99 months). Boys comprised (n=11, 64.7%) of the study population. The most common location was the proximal esophagus (n=10, 58.8%). The median time from ingestion to admission was 6 h (range, 3–24 h). Hypersalivation alone (n=6, 35.3%) or together with vomiting (n=5, 29.4%) was the most common symptom. Grade IIA mucosal injury was noted in six (n=6, 35.3%) patients. The diameter of the battery was a median of 18.0 mm (range, 14–22 mm). We did not observe any correlation between the size of the battery and the grade of the injury. Early postoperative complications were encountered in one patient (n=1, 5.8%) and late postoperative complications were noted in eight patients (n=8, 47.1%) which required further esophageal dilatations, and follow-up revealed normal findings in eight patients (n=8, 47.1%) and mortality occurred in one patient. Conclusion. The current case series study describing the clinical profiles and outcomes of 17 children who had ingested an esophageal button battery revealed male predominance, young patient age, and admission after a median of 6 h (3–24 h) of ingestion with nonspecific symptoms. Our findings confirm the success of rigid endoscopy to remove esophageal button batteries and indicate the likelihood of severe complications after removal.


2017 ◽  
Vol 11 (3) ◽  
pp. 223-229 ◽  
Author(s):  
Zachariah W. Pinter ◽  
Kenneth S. Smith ◽  
Parke W. Hudson ◽  
Caleb W. Jones ◽  
Ryan Hadden ◽  
...  

Distal fibula fractures represent a common problem in orthopaedics. When fibula fractures require operative fixation, implants are typically made from stainless steel or titanium alloys. Carbon fiber implants have been used elsewhere in orthopaedics for years, and their advantages include a modulus of elasticity similar to that of bone, biocompatibility, increased fatigue strength, and radiolucency. This study hypothesized that carbon fiber plates would provide similar outcomes for ankle fracture fixation as titanium and steel implants. A retrospective chart review was performed of 30 patients who underwent fibular open reduction and internal fixation (ORIF). The main outcomes assessed were postoperative union rate and complication rate. The nonunion or failure rate for carbon fiber plates was 4% (1/24), and the union rate was 96% (23/24). The mean follow-up time was 20 months, and the complication rate was 8% (2/24). Carbon fiber plates are a viable alternative to metal plates in ankle fracture fixation, demonstrating union and complication rates comparable to those of traditional fixation techniques. Their theoretical advantages and similar cost make them an attractive implant choice for ORIF of the fibula. However, further studies are needed for extended follow-up and inclusion of larger patient cohorts. Levels of Evidence: Level IV: Retrospective Case series


2020 ◽  
Vol 13 (12) ◽  
pp. 2007-2011
Author(s):  
Jongyeop Park ◽  
Jinhyun Kim

AIM: To introduce a new surgical technique, air-bubble technique for the management of posterior capsule rupture (PCR) and to evaluate the safety and efficacy of the technique. METHODS: A retrospective case series analysis of 24 eyes of 24 patients, in which the air bubble technique was used for the management of PCR, was performed. Once PCR occurred, a dispersive ophthalmic viscosurgical device (OVD) was injected into the tear. And small volumes (0.2-0.3 mL) of air bubbles were injected beneath the OVD. The air bubble served as a physical barrier and supported the posterior capsule. RESULTS: After surgery, none of the patients had serious complications during the follow-up period of 1y. Extension of the PCR size occurred in only 2 cases, and additional OVD injection was required only in 3 cases. Air bubbles imparted great stability to the nuclear pieces and the posterior capsule. CONCLUSION: The air-bubble technique may be considered a safe and effective procedure for managing a PCR. It may be of value to the inexperienced cataract surgeon.


2020 ◽  
Vol 10 ◽  
pp. 204512532095956
Author(s):  
Matthew Butler ◽  
Felicity Bano ◽  
Marilia Calcia ◽  
Isabel McMullen ◽  
Chun Chiang Sin Fai Lam ◽  
...  

There is both uncertainty regarding the safety of clozapine in COVID-19 patients owing to limited published data and a lack of consensus on continuing clozapine in patients with severe respiratory infections. COVID-19 is known to induce an acute immune response which can affect haematological parameters associated with clozapine monitoring, and systemic infection may reduce clozapine clearance. Clozapine, which has been associated with worse outcomes in some pneumonias, may in theory worsen outcomes in COVID-19. Despite these concerns, there are some data to indicate it is safe to continue clozapine in COVID-19 infection. In this retrospective case series, we describe our experiences of clozapine prescribing and disease progression of eight SARS-CoV-2 positive patients on medical wards in a major London teaching hospital. In four cases clozapine was stopped during the hospital admission. A COVID-19 pneumonia developed in four patients: three of these required intensive care unit admission for an average of 34 days. At the time of writing, three patients had died (two directly from COVID-19 pneumonia), two remained in general hospital wards, two were recovering in the community and one had been transferred to an inpatient psychiatric hospital. Follow-up length varied but in each case was not more than 104 days. Delirium was the most common adverse neuropsychiatric event, and in one case a relapse of psychosis occurred after cessation of clozapine. This retrospective case series illustrates the safe use of clozapine during COVID-19 infection. Our experiences suggest that consideration should be made to continuing clozapine even in those most unwell with COVID-19. We also identify areas which require larger scale hypothesis-testing research.


2019 ◽  
Vol 13 (5) ◽  
pp. 397-403 ◽  
Author(s):  
Derek Stenquist ◽  
Brian T. Velasco ◽  
Patrick K. Cronin ◽  
Jorge Briceño ◽  
Christopher P. Miller ◽  
...  

Background. Syndesmotic disruption occurs in 20% of ankle fractures and requires anatomical reduction and stabilization to maximize outcomes. Although screw breakage is often asymptomatic, the breakage location can be unpredictable and result in painful bony erosion. The purpose of this investigation is to report early clinical and radiographic outcomes of patients who underwent syndesmotic fixation using a novel metal screw designed with a controlled break point. Methods. We performed a retrospective review of all patients who underwent syndesmotic fixation utilizing the R3lease Tissue Stabilization System (Paragon 28, Denver, CO) over a 12-month period. Demographic and screw-specific data were obtained. Postoperative radiographs were reviewed, and radiographic parameters were measured. Screw loosening or breakage was documented. Results. 18 patients (24 screws) met inclusion criteria. The mean follow-up was 11.7 months (range = 6.0-14.7 months). 5/24 screws (21%) fractured at the break point. No screw fractured at another location, nor did any fracture prior to resumption of weight bearing; 19 screws did not fracture, with 8/19 intact screws (42.1%) demonstrating loosening. There was no evidence of syndesmotic diastasis or mortise malalignment on final follow-up. No screws required removal during the study period. Conclusion. This study provides the first clinical data on a novel screw introduced specifically for syndesmotic fixation. At short-term follow up, there were no complications and the R3lease screw provided adequate fixation to allow healing and prevent diastasis. Although initial results are favorable, longer-term follow-up with data on cost comparisons and rates of hardware removal are needed to determine cost-effectiveness relative to similar implants. Level of Evidence: Level IV: Retrospective case series


2007 ◽  
Vol 144 (6) ◽  
pp. 844-849.e1 ◽  
Author(s):  
Stacy P. Ardoin ◽  
Deborah Kredich ◽  
Egla Rabinovich ◽  
Laura E. Schanberg ◽  
Glenn J. Jaffe

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Momina Faisal ◽  
Saadia Farooq ◽  
Hajra Farooq

Purpose:  To find out the outcomes of Ahmed Glaucoma Valve (AGV) implantation in a tertiary care hospital. Study Design:  Retrospective case series. Place and Duration of Study:  Shifa International Hospital Islamabad from January 2018 to July 2020. Methods:  This retrospective case series of 19 eyes of 17 patients with refractory glaucoma included patients who underwent AGV implantation with a follow-up period of 6 months to 01 year. AGV was done as a primary procedure in 3 patients and secondary procedure in 17 patients after a previously failed trabeculectomy. All patients underwent complete eye examination, before surgery and then at 1 month, 2months, 6 months and 1 year. Goldman tonometer was used to check IOP. Complications, interventions and the number of anti-glaucoma medications (in post-operative period) needed to achieve the target pressure were noted. Success was defined as an IOP of less than 18 mm Hg, with or without a single anti-glaucoma medication. Results:  Complete success was achieved in 57.9% and conditional success in 42.2%. The most common complication was encapsulated cyst formation in 31.6% and post-operative interventions were bleb deroofing in 10.5%, tube readjustment and tube wash in 10.5% and YAG vitreolysis in 5.3%. Conclusion:  AGV is an effective and relatively safe procedure in refractory glaucoma irrespective of initial diagnosis and age of the patient. Encapsulated bleb was the commonest complication. Key Words:  Ahmad Glaucoma valve, Glaucoma, Intra Ocular Pressure.


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