Rebubbling rate in preloaded versus surgeon prepared DSAEK

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.

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Evaluation of Donor and Recipient Characteristics Involved in Descemet Stripping Automated Endothelial Keratoplasty Outcomes

Frontiers in Medicine ◽

10.3389/fmed.2021.605160 ◽

2021 ◽

Vol 8 ◽

Author(s):

Michele Lanza ◽

Rosa Boccia ◽

Adriano Ruggiero ◽

Paolo Melillo ◽

Mario Bifani Sconocchia ◽

...

Keyword(s):

Diabetes Mellitus ◽

Visual Acuity ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Bullous Keratopathy ◽

Endothelial Keratoplasty ◽

Eye Bank ◽

Corrected Visual Acuity ◽

Best Corrected Visual Acuity

Aims: To evaluate both donor and recipient features involved in visual acuity restoring and complication insurgence in eyes that have undergone Descemet stripping automated endothelial keratoplasty (DSAEK).Methods: In this retrospective study, charts of 111 eyes of 96 patients (mean age 70.25 ± 8.58 years) that underwent DSAEK were evaluated. Only Fuch's Distrophy (FD) or Bullous Keratopathy (BK) due to cataract surgery eyes were included. A complete ophthalmic check with endothelial cell density (ECD) and central corneal thickness (CCT) measurement was performed before surgery and at 1, 3, 6, and 12 months follow-up. Each DSAEK was performed by the same well-trained surgeon; only pre-cut lenticules, provided by same Eye Bank, were implanted.Results: A total of 48 (43%) complications have been observed (most of them were 22 partial graft detachments and 17 IOP spikes). At the last follow-up (mean: 8.58 ± 4.09 months), a significant increase (p < 0.05) of best corrected visual acuity (BCVA) was detected. Overall mean BCVA of the eyes evaluated was 0.40 ± 0.43 LogMAR with BK eyes showing a significantly higher improvement (p < 0.05) compared to FD eyes. The only factor showing a significant correlation (p < 0.05) with visual acuity enhancement was the implant of a lenticule thinner than 100 μm. Recipient features significantly (p < 0.05) associated with complications observed after surgery were glaucoma and diabetes mellitus.Conclusion: The use of a graft thinner than 100 μm can provide better visual acuity recovery while recipients affected by glaucoma or diabetes mellitus are more prone to develop complications after surgery.

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

Ophthalmologica ◽

10.1159/000446992 ◽

2016 ◽

Vol 236 (2) ◽

pp. 67-73 ◽

Cited By ~ 5

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.

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

Eye ◽

10.1038/s41433-021-01605-y ◽

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.

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Pseudoamblyopia in Congenital Cyclotropia

Journal of Ophthalmology ◽

10.1155/2017/1870290 ◽

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.”

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Foveal Exudative Macroaneurysm Treated with Intravitreal Ranibizumab

Case Reports in Ophthalmology ◽

10.1159/000431353 ◽

2015 ◽

Vol 6 (2) ◽

pp. 170-175 ◽

Cited By ~ 6

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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Detecting subclinical keratoconus by biomechanical analysis in tomographically regular keratoconus fellow eyes

European Journal of Ophthalmology ◽

10.1177/11206721211063740 ◽

2021 ◽

pp. 112067212110637

Author(s):

Victor A Augustin ◽

Hyeck-Soo Son ◽

Isabella Baur ◽

Ling Zhao ◽

Gerd U Auffarth ◽

...

Keyword(s):

Visual Acuity ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Case Series ◽

Biomechanical Analysis ◽

Corvis St ◽

Corrected Visual Acuity ◽

The Mean ◽

Best Corrected Visual Acuity ◽

Fellow Eyes

Purpose To analyze the tomographically non-affected second eyes of keratoconus patients using the Corvis ST to detect any biomechanical abnormalities or subclinical keratoconus. Methods In this retrospective, single-center, consecutive case series 244 eyes of 122 keratoconus patients were analyzed between November 2020 and February 2021. Fourteen fellow eyes fulfilled the inclusion criteria and showed no clinical or tomographic signs of keratoconus. Main outcome measures included best-corrected visual acuity, tomographic and biomechanical analyses using Scheimpflug imaging: Pentacam and Corvis ST (Oculus, Wetzlar, Germany). Tomographic analyses included anterior and posterior simulated keratometry, K-Max, central corneal thickness, thinnest corneal thickness, Belin/Ambrosio Ectasia Display, and the ABCD grading system. For biomechanical analyses, the corneal biomechanical index (CBI) and tomographic biomechanical index were used. Results The mean best-corrected visual acuity was 0.01 ± 0.10 logMAR. Mean K-Max was 43.79 ± 1.12 D, mean central corneal thickness 529 ± 25 µm, mean thinnest corneal thickness 524 ± 23 µm, and mean Belin/Ambrosio Ectasia Display 1.0 ± 0.32. The mean CBI was 0.30 ± 0.21. Regular CBI values were found in six of 14 patients. The mean tomographic biomechanical index was 0.47 ± 0.22 with regular values observed in only two of 14 patients. No signs of tomographic or biomechanical abnormalities were shown in only one of 14 keratoconus fellow eyes, with regular ABCD, Belin/Ambrosio Ectasia Display, CBI and tomographic biomechanical index values. Conclusions Tomographically normal fellow eyes of keratoconus patients are rare. In these cases, a biomechanical analysis of the cornea may help detect a subclinical keratoconus. The tomographic biomechanical index was the most sensitive index to verify a mild ectasia.

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Observational study of clinical characteristics of dome-shaped macula in Chinese Han with high myopia at Zhongshan Ophthalmic Centre

BMJ Open ◽

10.1136/bmjopen-2018-021887 ◽

2018 ◽

Vol 8 (12) ◽

pp. e021887 ◽

Cited By ~ 13

Author(s):

Xiujuan Zhao ◽

Xiaoyan Ding ◽

Cancan Lyu ◽

Shiyi Li ◽

Yu Lian ◽

...

Keyword(s):

Visual Acuity ◽

High Myopia ◽

Choroidal Thickness ◽

Clinical Characteristics ◽

Serous Retinal Detachment ◽

Protective Mechanism ◽

Chinese Han ◽

Corrected Visual Acuity ◽

Myopic Maculopathy ◽

Best Corrected Visual Acuity

PurposeTo evaluate the prevalence of dome-shaped macula (DSM) in highly myopic eyes among Chinese Han and to detect the correlation with myopic maculopathy and macular complications.MethodsA total of 736 Chinese Han patients (1384 eyes) with high myopia (refractive error≤6.0 diopters or axial length ≥26.5 mm) are reviewed based on information entered into a high-myopia database at Zhongshan Ophthalmic Centre. Subfoveal choroidal thickness (SFCT) and parafoveal choroidal thickness (PFCT) are measured. The prevalence of DSM in patients with myopic maculopathy is categorised from C0 to C4. Clinical features, including macular complications, SFCT and PFCT, are compared between myopic eyes with and without DSM.ResultsAmong the 1384 eyes, 149 (10.77%) show DSM. In highly myopic eyes without macular complications, the best corrected visual acuity is significantly worse in patients with DSM (p=0.002), and the ratio between subfoveal and parafoveal choroidal thickness (S/PCT) is significantly elevated in patients with DSM (p=0.021). The proportion of foveal schisis (17.24% vs 62.86%) is much lower in eyes with DSM compared with those without DSM. However, the proportions of extrafoveal schisis (39.66% vs 5.37%), foveal serous retinal detachment (SRD) (5.17% vs 0) and epiretinal membrane (ERM) (24.14% vs 10.74%) are much higher in eyes with DSM. The proportion of DSM was lower in C0 and C1, but higher proportion of DSM was found in C3 and C4.ConclusionsDSM is found in 10.77% of highly myopic eyes among Chinese Han. DSM might be a protective mechanism for foveal schisis and a risk factor for extrafoveal schisis, SRD and ERM.

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The RELIEF study: Tolerability and efficacy of preservative-free latanoprost in the treatment of glaucoma or ocular hypertension

European Journal of Ophthalmology ◽

10.1177/1120672118785280 ◽

2018 ◽

Vol 29 (2) ◽

pp. 210-215 ◽

Cited By ~ 6

Author(s):

Marta Misiuk-Hojlo ◽

Maria Pomorska ◽

Malgorzata Mulak ◽

Marek Rekas ◽

Joanna Wierzbowska ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Standard Deviation ◽

Ocular Hypertension ◽

Benzalkonium Chloride ◽

Tear Film ◽

Corrected Visual Acuity ◽

Break Up ◽

Preservative Free ◽

Best Corrected Visual Acuity

Purpose: To assess tolerability and efficacy following a switch from benzalkonium chloride–latanoprost to preservative-free latanoprost in patients with glaucoma or ocular hypertension. Methods: A total of 140 patients with glaucoma or ocular hypertension controlled with benzalkonium chloride-latanoprost for at least 3 months were switched to treatment with preservative-free latanoprost. Assessments were made on days 15, 45, and 90 (D15, D45, and D90) and included best-corrected visual acuity, intraocular pressure, slit lamp examination, fluorescein staining, tear film break-up time, patient symptom evaluation, and subjective estimation of tolerability. Results: Mean best-corrected visual acuity remained unchanged during the study. Mean intraocular pressure compared with baseline (D0) remained stable throughout the study (D0, 15.9 mmHg (standard deviation = 2.6); D90, 15.3 mmHg (standard deviation = 2.4); p < 0.006). Tear film break-up time improved or remained unchanged relative to baseline in 92% of patients at D45 and in 93% at D90. Moderate-to-severe conjunctival hyperemia was seen in 56.8% of patients at D0, but this figure decreased to 13.7%, 2.2%, and 1.6% at D15, D45, and D90, respectively. Subjective assessment of tolerability (0–10 scale) indicated improvement with change of therapy (mean score: 5.3 (standard deviation = 2.2) at D0 versus 1.9 (standard deviation = 1.7) at D90; p < 0.0001). Conclusion: Preservative-free latanoprost has at least the same intraocular pressure-lowering efficacy as benzalkonium chloride–latanoprost, with a better tolerability profile. This may translate into greater control of treatment and improved quality of life.

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Dry eye syndrome and cataract surgery

Medicinski pregled ◽

10.2298/mpns1904105b ◽

2019 ◽

Vol 72 (3-4) ◽

pp. 105-109

Author(s):

Stefan Brunet ◽

Vladimir Canadanovic ◽

Nikola Babic ◽

Aleksandar Miljkovic ◽

Sandra Jovanovic ◽

...

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Dry Eye ◽

Dry Eye Syndrome ◽

Schirmer Test ◽

Corrected Visual Acuity ◽

Body Sensation ◽

Eye Symptoms ◽

Best Corrected Visual Acuity ◽

Dry Eye Symptoms

Introduction. Dry eye syndrome has become a common problem after ocular surgeries with a significant impact on the quality of life. Many patients, who have undergone cataract surgery, postop?eratively developed dry eye symptoms. Dry eye syndrome is one of the risk factors associated with cataract surgery. Material and Methods. The prospective study included 80 patients. We recorded the self-reported dry eye symptoms, the values of Schirmer test, tear breakup time, and best corrected visual acuity preoperatively, as well as 7 days and 1 month after the surgery. Results. A total of 80 patients were included in the study, 45 (56.2%) females and 35 (43.8%) males. The mean age of patients was 61.5 years (SD ? 6.2, range 57 - 70 years). The best corrected visual acuity at the time of surgery was 0.4 or less in 70 patients (87.5%). Most patients reported a significant improvement in visual acuity after surgery; 68 (85%) eyes achieved a best corrected visual acuity of 0.5 or higher (median 0.7; range 0.5 - 1.0). The mean tear breaking time in cata?ract patients before surgery was 12.4 sec, 7 days after the surgery it was 8.2 sec (p < 0.05) and 1 moth after the surgery 11.1 sec. The majority of patients had mild (47.5%) and moderate (33.75%) Schirmer test values. Dry eye with wetting < 5 mm after 5 minutes was found in 16.2% of patients before cataract surgery; 7 days after the surgery (p < 0.05) it was found in 23.75% of patients and one month after surgery 11.1 sec. A foreign body sensation and watery eye were the most reported symptoms before cataract surgery. Seven days after the surgery foreign body sensation was present in 48.75% and watery eyes in 40% of patients. Conclusion. Significant increase in dry eye symptoms after cataract surgery was found with increasing age. Self reported dry eye problems are more common in patients with lower Schirmer test and best corrected visual acu?ity values before cataract surgery. Patients with concomitant dry eye disease require preoperative and postoperative treatment of dry eye to prevent aggravation of the existing symptoms that may affect the visual outcome after cataract surgery.

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Surgical Outcomes of Phacoemulsification Surgery in a Restructured Asian Training Hospital

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v12i4.318 ◽

1970 ◽

Vol 12 (4) ◽

pp. 201-207

Author(s):

David Zhiwei Law ◽

Seng Chee Loon ◽

Wan Ling Wong ◽

Marilou Sevilla Ebreo ◽

Xiang Li ◽

...

Keyword(s):

Visual Acuity ◽

Surgical Outcomes ◽

Perioperative Complications ◽

University Hospital ◽

Complication Rates ◽

Corrected Visual Acuity ◽

Duration Of Surgery ◽

National University ◽

Chi Squared ◽

Best Corrected Visual Acuity

Aim: To evaluate the surgical outcomes of phacoemulsification performed at National University Hospital, Singapore, with emphasis on the results achieved by residents.Methods: This was a retrospective analysis of surgical outcomes of patients who underwent phacoemulsification in a restructured hospital in 2008. The study included 318 eyes of patients of predominantly Asian descent. Pre- and postoperative best-corrected visual acuity, perioperative complications and associations of patient, surgical and surgeon factors were studied. One-way analysis of variance for means, chi-squared test for proportions, and multivariate analyses were performed to determine factors associated with postoperative best-corrected visual acuity outcomes. Main outcome measures included postoperative best-corrected visual acuity, degree of improvement in best-corrected visual acuity, and achievement of specific best-corrected visual acuity targets of 6/9 and 6/12 at postoperative months 1 and 3.Results: Duration of surgery of less than 20 minutes was found to be significantly associated with better postoperative best-corrected visual acuity. Level of surgical experience was also associated with betterpostoperative best-corrected visual acuity at postoperative months 1 (p < 0.001) and 3 (p = 0.004). While senior consultants produced the best postoperative best-corrected visual acuity outcomes, the results achieved by residents were comparable to those reported in prior resident-only studies. For surgeries performed by residents, the overall rate of posterior capsule rupture was 3.1% with a 0.0% rate of vitreous loss.Conclusions: The continued close guidance and training of ophthalmology residents in a restructured Asian training hospital will ensure that complication rates remain low while maintaining postoperative outcomes at safe levels.

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