Goniosynechialysis combined with multiple surgeries for secondary glaucoma in nanophthalmos: A case report

2020 ◽  
pp. 112067212097118
Author(s):  
Ruoshi Li ◽  
Mei Li ◽  
Shijie Zhang
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Axial Length ◽  
Secondary Glaucoma ◽  
Angle Closure ◽  
Case Presentation ◽  
Anterior Vitrectomy ◽  
Peripheral Iridectomy ◽  
Shallow Anterior Chamber

Background: Management of secondary glaucoma in nanophthalmos has always been challenging, especially for patients with extremely short axial length and extensive angle synechia. This case report discusses a nanophthalmic patient with secondary glaucoma and extensive angle synechia. Case presentation: A 60-year-old woman was referred to our hospital with uncontrolled intraocular pressure (IOP) in her left eye (LE). Slitlamp examination revealed small cornea and shallow anterior chamber (AC) in both eyes. Extensive angle synechia was seen on gonioscopy, and the IOP and axial length were 36 mmHg/15.79 mm in the left eye. She was diagnosed with nanophthalmos and secondary angle-closure glaucoma LE. Laser peripheral iridectomy (LPI) was performed, but the IOP LE remained elevated and uncontrolled on brinzolamide and brimonidine. The IOP LE was then normalized with the application of 2% pilocarpine. During the follow-up period, the AC of the LE showed progressive shallowing, and 5 months post LPI the IOP became uncontrollable. Goniosynechialysis combined with phacoemulsification, lamellar sclerectomy, sclerostomy, peripheral iridectomy, capsulotomy, and anterior vitrectomy were performed LE. Immediately after surgery, the AC deepened and the IOP stabilized. However, the IOP rose again post-surgically at 1 week and again at 2 months. A generally shallow AC and obstructed capsule hole were present. YAG laser capsulotomy was performed, and the IOP normalized and the AC deepened. Eighteen months after surgery, the IOP LE was 12 mmHg and the AC remained stable. Conclusion: Goniosynechialysis combined with multiple surgical procedures could be considered an alternative treatment regimen for nanophthalmos patients with secondary glaucoma and extensive angle synechia.

scholarly journals Retrospective Study of Vitreous Tap Technique Using Needle Aspiration for Management of Shallow Anterior Chamber during Phacoemulsification

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Ashraf Ahmed Nossair ◽  
Wael Ahmed Ewais ◽  
Lamia Samy Ali
Keyword(s):  
Retrospective Study ◽  
Anterior Chamber ◽  
Axial Length ◽  
Anterior Chamber Depth ◽  
Cost Effective ◽  
Needle Aspiration ◽  
Angle Closure ◽  
Safe Technique ◽  
Shallow Anterior Chamber

Purpose.To evaluate the technique of vitreous tap using needle aspiration for management of anterior chamber shallowness during phacoemulsification.Methods.A retrospective study included 26 eyes of 17 patients who underwent phacoemulsification in which vitreous tap was performed using a 27-gauge needle attached to a 5 ml syringe, inserted 3.5 mm from the limbus to aspirate 0.2 ml of liquefied vitreous if a cohesive (OVD) failed to sufficiently deepen the anterior chamber.Results.Preoperative anterior chamber depth was 2.31 ± 0.26 mm, axial length was 21.7 ± 0.67 mm, lens thickness was 4.5 ± .19 mm, and cataract grade was 3.77 ± 1.4. Preoperative CDVA in LogMAR units was 0.98 ± 0.75. Coexisting angle closure glaucoma was present in 7 patients (26.92%) preoperatively. Vitreous needle tap was successful in vitreous removal on the first attempt in 26 eyes (100%). Postoperative follow-up period was 22.88 ± 10.24 (4–39) months. The final postoperative CDVA in LogMAR units was 0.07 ± 0.1, while the final postoperative IOP was 16.54 ± 1.45 mmHg. No complications related to vitreous tap were noted.Conclusion.Vitreous needle tap is a simple, cost-effective, and safe technique for management of shallow anterior chamber in phacoemulsification.

scholarly journals Prevalence of Angle Closure Glaucoma in Vogt-Koyanagi-Harada Disease

2021 ◽  
Author(s):  
Carlos Alvarez-Guzman ◽  
Jorge E. Valdez-Garcia ◽  
Raul E. Ruiz-Lozano ◽  
Alejandro Rodriguez-Garcia ◽  
Carlos F. Navas-Villar ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Surgical Procedure ◽  
Demographic Data ◽  
Visual Outcome ◽  
Secondary Glaucoma ◽  
Disease Stage ◽  
Angle Closure ◽  
Posterior Synechiae ◽  
Vkh Disease

Abstract Background: This study aims to determine the prevalence, clinical characteristics, and mechanisms of secondary glaucoma in Vogt-Koyanagi-Harada (VKH) disease. We performed a retrospective, observational, and longitudinal study in VKH patients seen from 2001 to 2019. Demographic data, disease stage, glaucoma development, visual outcome, and management were analyzed. Results: A total of 305 eyes from 155 VKH patients, including 114 (74.4%) females and 39 (25.6%) males with a mean age of 38.8± 12.8 years, were analyzed. The median follow-up time was 22 months (range 7-60 months). Secondary glaucoma developed in 67 (22.0%) eyes, most of which had chronic recurrent VKH disease at presentation 43 eyes (62.4 %). Angle-closure was the most observed mechanism of glaucoma in 55 (82.1%) eyes, as shown by the development of peripheral anterior synechiae in 58 (86.6%) eyes and posterior synechiae in 51 eyes (76.1%). The combination of pupillary block and posterior synechiae resulted in iris bombé in 17 (25.4%) eyes with glaucoma. Forty-one (61.2%) eyes with glaucoma required either a laser or surgical procedure to control the intraocular pressure. At the last visit, visual acuity was significantly worse in eyes with glaucoma (p<0.001).Conclusions: As evidenced by the development of anterior and posterior synechiae, the angle-closure disease is a significant cause of secondary glaucoma in eyes with VKH. Eyes with glaucoma are more likely to present in the chronic recurrent stage of the disease. Most of the eyes with glaucoma required a surgical procedure to control intraocular pressure.

scholarly journals Perforation of the atrial wall and aortic sinus after closure of an atrial septal defect with an Atriasept occluder: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zai-Qiang Zhang ◽  
Jia-Wang Ding
Keyword(s):  
Case Report ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Emergency Operation ◽  
Atrial Wall ◽  
Aortic Sinus ◽  
Case Presentation ◽  
Lethal Complications ◽  
Life Threatening

Abstract Background While the perforation of the atrial wall and aortic sinus after closure of an atrial septal defect (ASD) is rare, it’s life-threatening, with rapid progress and high mortality. To the best of our knowledge, 21 similar cases have been reported since 1976. Case presentation We report a 16-year-old male whose atrial septal defect (ASD) was closed using a 12-mm Amplatzer septal occluder (ASO). Atrial wall and aortic sinus perforation occurred 3 months after transcatheter closure, and the patient was discharged after emergency operation. He was discharged on the 12th postoperative day in good overall condition. Conclusions With this case report, we want to illustrate that although percutaneous closure of ASD is regarded as a routine procedure, we should not forget the potentially lethal complications, especially cardiac erosion. Therefore, we should carefully evaluate the risk of erosion before surgery, and careful lifelong follow-up is needed.

scholarly journals The Use of Anterior-Segment Optical-Coherence Tomography for the Assessment of the Iridocorneal Angle and Its Alterations: Update and Current Evidence

2021 ◽  
Vol 10 (2) ◽  
pp. 231
Author(s):  
Giacinto Triolo ◽  
Piero Barboni ◽  
Giacomo Savini ◽  
Francesco De Gaetano ◽  
Gaspare Monaco ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Clinical Relevance ◽  
Anterior Segment ◽  
Angle Closure ◽  
Current Evidence ◽  
Optical Coherence ◽  
Iridocorneal Angle ◽  
Wide Range

The introduction of anterior-segment optical-coherence tomography (AS-OCT) has led to improved assessments of the anatomy of the iridocorneal-angle and diagnoses of several mechanisms of angle closure which often result in raised intraocular pressure (IOP). Continuous advancements in AS-OCT technology and software, along with an extensive research in the field, have resulted in a wide range of possible parameters that may be used to diagnose and follow up on patients with this spectrum of diseases. However, the clinical relevance of such variables needs to be explored thoroughly. The aim of the present review is to summarize the current evidence supporting the use of AS-OCT for the diagnosis and follow-up of several iridocorneal-angle and anterior-chamber alterations, focusing on the advantages and downsides of this technology.

scholarly journals First reported case of penile prosthesis infection from brucellosis: case report

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Nabil Nabil Moohialdin ◽  
Ahmad Shamsodini ◽  
Steven K. Wilson ◽  
Osama Abdeljaleel ◽  
Ibrahim Alnadhari ◽  
...  
Keyword(s):  
Case Report ◽  
Broad Spectrum ◽  
Surgical Intervention ◽  
Penile Prosthesis ◽  
Raw Milk ◽  
Prosthesis Infection ◽  
Case Presentation ◽  
First Case ◽  
Milk Ingestion

Abstract Background Infection after the penile prosthesis can be devastating to both the patient and surgeon with various complications and consequences. After introduction of antibiotic-coated implants, the rate of infection has dramatically decreased, but still we see uncommon organisms causing infection. We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. To our knowledge, this is the first reported case of brucellosis penile prosthesis infection. Case presentation We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. A 75-year-old, diabetic male patient presented with penile prosthesis infection 5 months post-penile exchange surgery due to mechanical malfunctioning of 2-piece penile prosthesis which was inserted 11 years ago. The initial treatment with broad spectrum antibiotics did not subside the infection. After diagnosis of brucellosis, the antibiotic was changed to anti-brucellosis (Rifampicin + Tetracycline). The patient improved dramatically and was discharged home with smooth follow-up course. Conclusion Brucellosis can cause infection of penile prosthesis and can be treated with anti-brucellosis antibiotics without necessitating surgical intervention and removal of prosthesis.

scholarly journals Small intestine duplication cyst with recurrent hematochezia: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhicheng Zhang ◽  
Xiaowei Huang ◽  
Qian Chen ◽  
Demin Li ◽  
Qi Zhou ◽  
...  
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Literature Review ◽  
Ct Scan ◽  
Duplication Cyst ◽  
Abdominal Ct ◽  
Case Presentation ◽  
Abdominal Ct Scan ◽  
Capsule Endoscopes

Abstract Background Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia. Case presentation We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period. Conclusion SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.

scholarly journals Urrets-Zavalia Syndrome Following Cataract Surgery

2021 ◽  
pp. 659-663
Author(s):  
Shimon Kurtz ◽  
Maayan Fradkin
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Inflammatory Reaction ◽  
Intraocular Lens Implantation ◽  
Postoperative Course ◽  
Lens Implantation ◽  
The Right

We describe a case of Urrets-Zavalia syndrome (UZS) in a healthy 56-year-old woman who underwent femtosecond-assisted phacoemulsification with intraocular lens implantation in both eyes. One month after an uneventful postoperative course in the left eye, the right eye was operated. Dilated pupil which was nonreactive to light appeared on day 21 postoperatively. This was discovered upon examination following anterior chamber inflammatory reaction which occurred 2 weeks following her surgery. Our case report emphasizes the importance and danger in developing UZS even if the reaction in the anterior chamber does not occur immediately after surgery. In addition, the importance of intraocular pressure follow-up in the period after UZS is acknowledged.

scholarly journals The spontaneous resolution of a vortex vein varix: case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara L Weidmayer ◽  
Hakan Demirci
Keyword(s):  
Case Report ◽  
Natural History ◽  
Extended Period ◽  
Spontaneous Resolution ◽  
Case Presentation ◽  
Clinical Resolution ◽  
History Of ◽  
Vortex Vein ◽  
Insight Into

Abstract Background The natural course of a vortex vein varix, though not well understood, has been known to remain stable. However, here we report a novel case of a vortex vein varix that resolved after an extended period of monitoring. Case presentation An asymptomatic 96-year-old Caucasian man was found to have a vortex vein varix. At his previous examination 13 months prior, his fundus was normal. At 13 months of observation, his vortex vein varix become clinically undetectable. Further follow-up confirmed continued absence of the varix. Conclusion This case demonstrates the development then clinical resolution of a vortex vein varix with no clear identifiable factors for its evolution. This case is novel and offers new insight into the natural history of some vortex vein varices, implicating venous congestion as an instigator and venous collateralization as its alleviator, suggesting that vortex vein varices are likely more common than previously reported since some may be temporary and under-identified.

scholarly journals Iridoplasty for plateau iris syndrome: a systematic review

2019 ◽  
Vol 4 (1) ◽  
pp. e000340
Author(s):  
Hugo Bourdon ◽  
Vittoria Aragno ◽  
Christophe Baudouin ◽  
Antoine Labbé
Keyword(s):  
Systematic Review ◽  
Intraocular Pressure ◽  
Retrospective Studies ◽  
Scientific Evidence ◽  
Argon Laser ◽  
Angle Closure ◽  
Current Evidence ◽  
Iridocorneal Angle

Plateau iris syndrome (PIS) is a frequent cause of angle closure. Argon laser peripheral iridoplasty (ALPI) has been proposed in PIS to widen the iridocorneal angle. The objective of the present study was to perform a systematic review of the available studies evaluating the efficacy of ALPI on intraocular pressure (IOP), iridocorneal angle opening and the number of medications in patients with chronic angle-closure associated with PIS. One prospective and seven retrospective studies with a minimum 1 month of follow-up were included. Although ALPI seemed to lower IOP, to decrease the number of topical antiglaucoma medications and widen the iridocorneal angle shortly after the procedure, there is no current evidence of long-term efficacy. To date, there is no robust scientific evidence to advocate ALPI as a treatment for chronic angle-closure caused by PIS.

Sign in / Sign up

Export Citation Format

Share Document