Pac-Man Method: A New Technique for Nuclear Management Of Posterior Polar Cataract

2021 ◽  
pp. 112067212110662
Author(s):  
Sharah Rahman ◽  
Anisur Rahman ◽  
Jalal Ahmed ◽  
Ishtiaque Anwar ◽  
Bipul Kumar de Sarker ◽  
...  
Keyword(s):  
Visual Outcome ◽  
Dissipated Energy ◽  
Test Time ◽  
Surgical Time ◽  
Posterior Capsule Rupture ◽  
Group A ◽  
Cumulative Dissipated Energy ◽  
A New Technique ◽  
Posterior Polar Cataract

Purpose We introduce an innovative technique, “Pac-Man”, for the nuclear management of posterior polar cataracts and compare it with “Chop in situ” and “Fishbowl” techniques. Method A total of 60 eyes from 60 patients were randomly assigned to groups A, B, and C, with 20 eyes in each group. Pac-Man, Chop in situ, and Fishbowl techniques were used for groups A, B, and C. In the Pac-Man method, adequate single trench sculpts, and a right-sided lateral sculpt were performed and cracked. The triangular piece was emulsified, after which the rest of the nucleus looked like a “Pac-Man” cartoon. Techniques were compared by age, visual outcome, Posterior Capsule Rupture (PCR), Cumulative Dissipated Energy (CDE), and time of surgery. Result Postoperative BCVA was significantly improved after surgery ( P = 0.0001, paired t-test). Time taken for surgeries were 25 ± 2.57, 30 ± 3.78, 40 ± 3.25 min, the CDE were 10 ± 0.95, 20 ± 1.2, 15 ± 0.48, and the PCR were 0%, 5%, and 10% for group A,B,C respectively. The total number of PCR was 3 out of 60 patients, and the percentage was 5.00%. Conclusion The “Pac-Man” method is a recommended technique due to its visual outcome, reduced surgical time, less CDE, and less chance of PCR.

Comparison of Phacoemulsification Cataract Surgery with Low versus Standard Fluidic Settings and the Impact on Postoperative Parameters

2016 ◽  
Vol 27 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Anthony Chang ◽  
Alexander Fridberg ◽  
Maria Kugelberg
Keyword(s):  
Cataract Surgery ◽  
Corneal Thickness ◽  
Macular Thickness ◽  
Dissipated Energy ◽  
Prospective Clinical Study ◽  
Surgical Time ◽  
Corrected Distance Visual Acuity ◽  
Cumulative Dissipated Energy ◽  
The Impact ◽  
Phacoemulsification Cataract Surgery

Purpose To compare complications after cataract surgery using 2 different phacoemulsification fluidic settings. Methods One cataract surgeon (M.K.) performed phacoemulsification cataract surgery in one eye of 43 patients in this randomized prospective clinical study conducted at St. Erik Eye Hospital, Stockholm, Sweden. The patients were randomized to phacoemulsification with low fluidic settings in one group and standard fluidic settings in the other group. Corrected distance visual acuity (CDVA), central corneal thickness (CCT), endothelial cell density (ECD), anterior chamber flare, intraocular pressure (IOP), and macular thickness were measured preoperatively and postoperatively, with a final evaluation at 3 months. Surgical time, ultrasound energy, and amount of balanced saline solution used intraoperatively were recorded. Results Twenty-one patients were included in the group with standard settings and 22 patients were in the group with low settings. There were no significant differences between the groups in CDVA, CCT, flare, IOP, macular thickness, or ECD at 1 day, 3 weeks, or 3 months postoperatively. The surgical time was significantly (p = 0.009) longer and cumulative dissipated energy was significantly (p<0.001) higher in the group with low fluidic settings. Conclusions Although the surgical time and ECD were significantly higher in the group with low fluidic settings, there were no differences in the CCT, ECD, macular thickness, or inflammation postoperatively between the low and standard fluidic settings during phacoemulsification.

scholarly journals Safety and effectiveness of an iris hook assisted phacoemulsification in vitrectomized eyes

2021 ◽  
Vol 14 (11) ◽  
pp. 1735-1740
Author(s):  
Ling Bai ◽  
◽  
Farheen Tariq ◽  
Yu-Ping Zheng ◽  
Hai-Xiao Feng ◽  
...  
Keyword(s):  
Loss Rate ◽  
Dissipated Energy ◽  
Significant Difference ◽  
Single Centre Study ◽  
Group A ◽  
Cumulative Dissipated Energy ◽  
Pars Plana ◽  
Group B ◽  
Complications Rate ◽  
Surgery Duration

AIM: To introduce a simple iris hook assisted phacoemulsification (PE) procedure and evaluate the safety and efficacy of it in completely vitrectomized eyes. METHODS: A single centre study which included 65 previously completely vitrectomized eyes of 62 patients who underwent cataract surgery. Patients were randomly divided into 3 groups. Patients received PE, and intraocular lens (IOL) implantation with the assistance of iris hook (SynergetiesTM) as group A (25 eyes); patients who received PE assisted with a 25G pars plana irrigation as group B (20 eyes), and patients who received PE performed without the help of any instrument as group C (20 eyes). Main outcome measures were surgery duration, Ultrasound (U/S) total time, endothelial cell density (ECD), cumulative dissipated energy (CDE) and complications of the procedures. RESULTS: With the help of iris hook, the patients in group A had the lowest ECD loss rate (0.07±0.03, 0.09±0.03, and 0.10±0.03, P<0.05), shortest CDE (12.2±4.1, 15.8±6.0, and 16.0±6.0, P<0.05) and U/S total time (36.6±13.0s, 46.3±16.4s, and 47.6±16.1s, P<0.05), and minimal incidence of complications. The longest surgery duration was in group B (19.4±1.6min) and maximum complications rate in group C (20% miosis, 10% posterior capsular tears, 5% zonular dialysis, 5% cystoid macular edema). While best-corrected visual acuity (BCVA), intraocular pressure (IOP) and ECD did not show a significant difference among the three groups. CONCLUSION: Without prolonged surgery duration, the iris hook assistant method can minimize heat generation during surgery and incidence of complications, which transfer the challenged PE in vitrectomized eyes into a regular surgery. It does not need any change in the hydrodynamic parameters and in the bag PE technique, easy to operate even for junior surgeons.

scholarly journals Patterns of invasive recurrence among patients originally treated for ductal carcinoma in situ by breast-conserving surgery versus mastectomy

2021 ◽  
Vol 186 (3) ◽  
pp. 617-624
Author(s):  
Kate R. Pawloski ◽  
Audree B. Tadros ◽  
Varadan Sevilimedu ◽  
Ashley Newman ◽  
Lori Gentile ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Advanced Disease ◽  
Breast Conserving Surgery ◽  
Risk Profile ◽  
High Grade ◽  
Group A ◽  
First Recurrence

Abstract Purpose Local recurrence after treatment of ductal carcinoma in situ (DCIS) with breast-conserving surgery (BCS) is more common than after mastectomy, but it is unclear if patterns of invasive recurrence vary by initial surgical therapy. Among patients with invasive recurrence after treatment for DCIS, we compared patterns of first recurrence between those originally treated with BCS vs. mastectomy. Methods From 2000 to 2016, women with an invasive recurrence occurring ≥ 6 months after initial treatment for DCIS were retrospectively identified. Clinicopathologic features and adjuvant treatment of the initial DCIS, as well as characteristics of first invasive recurrences, were compared between patients who had undergone BCS vs. mastectomy. Results 452 patients with an invasive recurrence after surgery for DCIS were identified: 367 patients (81%) had initially undergone BCS and 85 patients (19%) mastectomy. Patients originally treated with mastectomy were younger and were more likely to have had high grade, necrosis, and multifocal or multicentric DCIS (p < 0.001) compared with the BCS group. A higher proportion of invasive recurrences were local after BCS (93%; 343/367), whereas 88% (75/85) of recurrences after mastectomy were regional or distant (p < 0.001). The median time to first invasive recurrence was not different between surgical groups (BCS: 6.4 years vs. mastectomy: 5.5 years; p = 0.12). Conclusions Among women who experienced a first invasive recurrence after treatment for DCIS, those who had originally undergone mastectomy more commonly presented with advanced disease compared to those treated with BCS, likely related to the absence of the breast and the higher risk profile of their initial DCIS.

Changes in pupillometry associated with dissipated energy during phacoemulsification

2020 ◽  
pp. 112067212098437
Author(s):  
Giulia Coco ◽  
Pierluca Cremonesi ◽  
Nardine Menassa ◽  
Luca Pagano ◽  
Kunal A Gadhvi ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Generalized Linear Model ◽  
Pupil Diameter ◽  
University Hospital ◽  
Dissipated Energy ◽  
Dynamic Measurements ◽  
Operative Complications ◽  
Cumulative Dissipated Energy ◽  
Chamber Measurements ◽  
Phacoemulsification Cataract Surgery

Purpose: To investigate the effect of ultrasound level during phacoemulsification on pupil dynamics. Methods: Comparative retrospective study on patients who underwent routine cataract surgery at the Royal Liverpool University Hospital. Clinical parameters, anterior chamber measurements, axial length, surgeon grade, time of surgery, level of ultrasound used (cumulative dissipated energy, CDE), intra- and post-operative complications were collected. Pupil diameters were collected before and 4 ± 1 weeks after surgery in static scotopic, mesopic, photopic pupil conditions. Also, pupil dynamic measurements after luminous stimulus were recorded. Changes in static pupil diameters, relative dilation at 3.5 s after luminous stimulus, and time to reach 75% and 95% of maximum dilation were measured. Results: Forty-eight eyes of 24 patients (13 males) were included with a mean age of 73.1 ± 14.6 years. Mean CDE value was 18.11 ± 10.56. Mean scotopic pupil diameters decreased by 0.24 ± 0.48 mm ( p = 0.021) in the operated eye. Significant correlation was found between reduction in scotopic pupil diameter and CDE ( p = 0.05). A generalized linear model confirmed that the level of CDE was significantly associated with reduction in scotopic pupil diameter ( p = 0.026). Patients who underwent surgeries with lower CDE (0 < CDE ⩽ 10 and 10 < CDE ⩽ 20) did not experience significant changes in scotopic pupil diameter after surgery ( p = 0.28 and p = 0.79, respectively) as opposed to those with higher CDE (CDE > 20; p = 0.03). Conclusion: Phacoemulsification cataract surgery and the cumulative dissipated energy may be associated with changes in pupil behaviour.

Accuracy Computer-Guided Implant Placement using 3D Planning Software

2020 ◽  
Author(s):  
Gagik Hakobyan
Keyword(s):  
Survival Rate ◽  
3D Modeling ◽  
Treatment Time ◽  
Intraoperative Complications ◽  
Marginal Bone Loss ◽  
Surgical Time ◽  
Surgical Guide ◽  
Minimal Trauma ◽  
Group A ◽  
Group B

Purpose: To evaluate the effectiveness of implant treatment using computer 3D modeling and surgical guided. Materials and Methods: The study included 148 patients who underwent prosthodontics rehabilitation using dental implants in 2015-2020. 3D computer-aided modeling and surgical guide were used to plan the operation. To conduct a comparative analysis of the treatment results, two groups were formed: In group A (included 75 patients, fully guided surgery), in group B (included 73 patients). Results: In patients Group A intraoperative or immediate postoperative complications were noted (errors in the position, inclination), anatomical risk structures were invaded, after 3 years producing a survival rate of 96.2% In patients Group B, intraoperative complications were recorded; membrane perforation 4, errors in the position of the implants 16, the inclination of the implants 18, fenestration 12, after 3 years producing a survival rate of 97.6%. Mean marginal bone loss (MBL) patients in Group A were significantly higher than patients in group B (p < 0.05). In patients Group A the average surgical time from time of anesthesia to the placement of the healing abutment was 10.6 ± 2.9 min per implant, in patients Group B, the average surgical time was 16.4 ± 1.5 min per implant. Conclusion: The 3D modeling method and the controlled positioning of the implant allows surgical access with minimal trauma, reducing treatment time and complications.

CHARACTERIZING ANOMALIES IN DISTRIBUTED STRAIN MEASUREMENTS OF CAST-IN-SITU BORED PILES

2016 ◽  
Vol 78 (8-5) ◽  
Author(s):  
Hisham Mohamad ◽  
Bun Pin Tee ◽  
Koh An Ang ◽  
Mun Fai Chong
Keyword(s):  
Load Transfer ◽  
Load Test ◽  
Strain Sensing ◽  
Strain Profile ◽  
A New Technique ◽  
Optical Time ◽  
Distributed Optical Fiber ◽  
Non Destructive ◽  
Distributed Strain

This paper describes the method of identifying typical defects of bored cast-in-situ piles when instrumenting using Distributed Optical Fiber Strain Sensing (DOFSS). The DOFSS technology is based on Brillouin Optical Time Domain Analyses (BOTDA), which has the advantage of recording continuous strain profile as opposed to the conventional discrete based sensors such as Vibrating Wire strain gauges. In pile instrumentation particularly, obtaining distributed strain profile is important when analysing the load-transfer and shaft friction of a pile, as well as detecting any anomalies in the strain regime. Features such as defective pile shaft necking, discontinuity of concrete, intrusion of foreign matter and improper toe formation due to contamination of concrete at base with soil particles, among others, may cause the pile to fail. In this study, a new technique of detecting such defects is proposed using DOFSS technology which can potentially supplement the existing non-destructive test (NDT) methods. Discussion on the performance of instrumented piles by means of maintained load test are also presented

scholarly journals Photopolymerizable Injectable Cartilage Mimetic Hydrogel for the Treatment of Focal Chondral Lesions: A Proof of Concept Study in a Rabbit Animal Model

2018 ◽  
Vol 47 (1) ◽  
pp. 212-221 ◽  
Author(s):  
Cecilia Pascual-Garrido ◽  
Elizabeth A. Aisenbrey ◽  
Francisco Rodriguez-Fontan ◽  
Karin A. Payne ◽  
Stephanie J. Bryant ◽  
...  
Keyword(s):  
Animal Model ◽  
Chondrogenic Differentiation ◽  
Osteochondral Lesions ◽  
Chondral Defect ◽  
Group A ◽  
Group B ◽  
Safranin O

Background: In this study, we investigate the in vitro and in vivo chondrogenic capacity of a novel photopolymerizable cartilage mimetic hydrogel, enhanced with extracellular matrix analogs, for cartilage regeneration. Purpose: To (1) determine whether mesenchymal stem cells (MSCs) embedded in a novel cartilage mimetic hydrogel support in vitro chondrogenesis, (2) demonstrate that the proposed hydrogel can be delivered in situ in a critical chondral defect in a rabbit model, and (3) determine whether the hydrogel with or without MSCs supports in vivo chondrogenesis in a critical chondral defect. Study Design: Controlled laboratory study. Methods: Rabbit bone marrow–derived MSCs were isolated, expanded, encapsulated in the hydrogel, and cultured in chondrogenic differentiation medium for 9 weeks. Compressive modulus was evaluated at day 1 and at weeks 3, 6, and 9. Chondrogenic differentiation was investigated via quantitative polymerase reaction, safranin-O staining, and immunofluorescence. In vivo, a 3 mm–wide × 2-mm-deep chondral defect was created bilaterally on the knee trochlea of 10 rabbits. Each animal had 1 defect randomly assigned to be treated with hydrogel with or without MSCs, and the contralateral knee was left untreated. Hence, each rabbit served as its own matched control. Three groups were established: group A, hydrogel (n = 5); group B, hydrogel with MSCs (n = 5); and group C, control (n = 10). Repair tissue was evaluated at 6 months after intervention. Results: In vitro, chondrogenesis and the degradable behavior of the hydrogel by MSCs were confirmed. In vivo, the hydrogel could be delivered intraoperatively in a sterile manner. Overall, the hydrogel group had the highest scores on the modified O’Driscoll scoring system (group A, 17.4 ± 4.7; group B, 13 ± 3; group C, 16.7 ± 2.9) ( P = .11) and showed higher safranin-O staining (group A, 49.4% ± 20%; group B, 25.8% ± 16.4%; group C, 36.9% ± 25.2%) ( P = .27), although significance was not detected for either parameter. Conclusion: This study provides the first evidence of the ability to photopolymerize this novel hydrogel in situ and assess its ability to provide chondrogenic cues for cartilage repair in a small animal model. In vitro chondrogenesis was evident when MSCs were encapsulated in the hydrogel. Clinical Relevance: Cartilage mimetic hydrogel may offer a tissue engineering approach for the treatment of osteochondral lesions.

scholarly journals Prophylactic corneal cross-linking in LASIK surgery: effects on visual outcome and recovery time

2020 ◽  
Vol 17 (1) ◽  
pp. 61-68
Author(s):  
Dominique Clare Oh ◽  
Yiong Huak Chan ◽  
Sao Bing Lee ◽  
Jovina Li Shuen See
Keyword(s):  
Visual Acuity ◽  
Side Effects ◽  
Recovery Time ◽  
Visual Outcome ◽  
Cross Linking ◽  
Safe Procedure ◽  
Distance Visual Acuity ◽  
Visual Outcomes ◽  
Group A ◽  
Group B

Introduction: Collagen cross-linking is a useful adjunct in preventing corneal ectasia after laser-assisted in situ keratomileusis (LASIK). This study aimed to evaluate whether prophylactic cross-linking in IntraLase LASIK affects optimum visual outcome and recovery time in the immediate post-surgery period and is associated with any side effects. Methods: This was a retrospective case study on the right eyes of 100 Chinese subjects aged 18 to 40 years who underwent IntraLase LASIK. Fifty subjects who underwentcross-linking after completing LASIK (Group A) were compared with 50 subjects who did not undergo LASIK (Group B). Cases were evaluated for pre- and post-operative spherical equivalent, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), recovery time and presence of side effects. Results: At 1 week post-LASIK, mean (SD) UDVA of Group A subjects was poorer than Group B, at 1.05 (0.19) vs 1.17 (0.19) (p = 0.036); however, there was no significant difference in CDVA (p = 0.095). By 1 month post-LASIK, differences in both UDVA and CDVA were insignificant (p = 0.055, 0.106, respectively). Mean recovery time was 2.72 (95% confidence interval [CI] = 0.64-4.7) days longer in Group A (p = 0.010), although by 1 month post-LASIK, both groups were able to achieve CDVA equal to or better than that achieved pre-LASIK. Incidence of mild inflammation and dry eyes post-LASIK was similar in both groups (p = 1.00, 0.749, respectively); no other complications were observed. Conclusion: No differences in visual outcomes at and occurrence of side effects at 1 month post-LASIK were observed between subjects who underwent cross-linking prior to refractive surgery and those who did not. However, the group that underwent cross-linking had a slightly longer mean recovery time. Our study supports prophylactic cross-linking as a safe procedure that does not affect immediate visual outcomes among the Chinese population when used in adjunct with LASIK surgery.

Sign in / Sign up

Export Citation Format

Share Document