Non-Freeze Epikeratophakia in Children

1998 ◽  
Vol 8 (1) ◽  
pp. 8-11
Author(s):  
M.T. Aznabayev ◽  
M.M. Bikbov ◽  
R.A. Aznabayev
Keyword(s):  
Cataract Extraction ◽  
Spherical Equivalent ◽  
Efficacy And Safety ◽  
Donor Cornea ◽  
Traumatic Cataract ◽  
Original Design ◽  
Epithelial Growth

We describe the use of unfrozen tissue lenses in 42 cases of epikeratophakia in children aged 2-14 years. Fourteen operations were performed in an aphakic eye, 28 in combination with congenital or traumatic cataract extraction. The tissue lenses, made from unfrozen donor cornea according to an original design, healed in 91.5% of cases. The tissue lens was removed when epithelial growth was inadequate on its surface. A five-year follow-up showed that correction within 3.0 D of emmetropia was achieved in 73.7% of the eyes. Preoperatively, mean keratometry readings were 43.5±0.2 D, increasing postoperatively to 53.6±0.8 D. Mean spherical equivalent at the spectacle plane increased by 9.6±0.9 D. Our investigations show the efficacy and safety of non-freeze epikeratophakia in the correction of pediatric aphakia.

scholarly journals Posterior-Chamber Phakic Intraocular Lens Implantation in Patients over 40 Years of Age

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Pedro Tañá-Rivero ◽  
Francisco Pastor-Pascual ◽  
Marceliano Crespo ◽  
José L. Rodríguez-Prats ◽  
José J. Muñoz-Tomás ◽  
...  
Keyword(s):  
Crystalline Lens ◽  
Posterior Chamber ◽  
Spherical Equivalent ◽  
Efficacy And Safety ◽  
Phakic Intraocular Lens ◽  
Implantable Collamer Lens ◽  
Lens Implantation ◽  
Over 40 Years ◽  
Myopic Astigmatism

Purpose. To assess the efficacy, safety, and predictability of the Visian Implantable Collamer Lens (ICL) model having a central port in patients over 40 years of age. Methods. This study included 33 eyes from 21 patients who underwent V4c ICL implantation for the correction of myopia and myopic astigmatism. We assessed uncorrected (UDVA) and corrected (CDVA) distance visual acuity, refraction, intraocular pressure (IOP), endothelial cell density (ECD), vault, and adverse events occurring over a 1-year period. Results. Mean age of the patients at the time of implantation was 43.52 ± 4.49 years (range: 40 to 56 years). Efficacy and safety indexes were 1 and 1.09, respectively. Surgical outcomes for CDVA were as follows: no eye lost any lines, 19 eyes (57.58%) showed no CDVA changes, 7 eyes (21.21%) gained 1 line, 4 eyes (12.12%) gained 2 lines, and 3 eyes (9.09%) gained ≥3 lines. Mean postoperative spherical equivalent (SE) was −0.09 ± 0.47 D. A total of 29 eyes (87.8%) were within ±0.50 D and 31 eyes (93.9%) were within ±1.00 D of the desired SE. At 1-year, mean IOP was 15.27 ± 3.03 mmHg (range: 9 to 20 mmHg, p=0.12 pre vs. post) and mean ECD was 2516 ± 234 cells/mm2 (p=0.29 pre vs. post). Mean postoperative vault was 320 ± 136 μm, with 201–300 μm being the most prevalent vault range for 9 eyes (31.03%). None of the eyes showed a vault >701 μm. There were neither intraoperative nor postoperative complications; in fact, all ICL implantation procedures were uneventful. Conclusions. Our study’s findings support the use of this lens in patients over 40 years of age. A long follow-up period is advisable to monitor ICL position relative to the crystalline lens.

scholarly journals EXCIMER LASER

2008 ◽  
Vol 15 (01) ◽  
pp. 20-25
Author(s):  
M. ABDUL MOQEET ◽  
IMRAN AZAM BUTT
Keyword(s):  
Study Group ◽  
Safe Procedure ◽  
Spherical Equivalent ◽  
Efficacy And Safety ◽  
Short Term ◽  
Gradual Reduction ◽  
Severe Postoperative Pain ◽  
Lost To Follow Up ◽  
Study Setting

Objectives: To evaluate the efficacy and safety of excimer laserphotorefractive keratectomy for myopia in Pakistani people. Design: Prospective study. Setting: At Al-Shifa Trust EyeHospital Rawalpindi. Period: October, 1995 and Febrauray, 1996. Material & Methods: The study group of thirteenpatients, comprises of 25 eyes, with refractive error ranging from -1.50 to -3.50 D.S (diopters sphere) and less than-1.50 D.C (diopters cylinder).Results: Thirteen eyes (52%) lost to follow up after three months. Only twelve eyes (48%)could be reviewed at six months after photorefractive keratectomy. At one month, eleven eyes (44%) and at threemonths, eight eyes (32%) were hypermetropic within +0.25 to +1.00 diopters of spherical equivalent .At six months onlythree eyes (25%) had hypermetropia within +0.25 to +1.00 diopters spherical equivalent. None of the eyes had anykind of astigmatism more than 1.00 diopter. No over correction of more than +1.00 diopter of spherical equivalent wasobserved in any case. At one month, three months and six months after photo-refractive keratectomy, 88%, 80% and100% eyes had 6/6 visual acuity respectively, without any optical aid. Hundred percent of the eyes showed completehealing of the epithelium on third post operative day. Moderate to severe postoperative pain was experienced by everyone for three days with gradual reduction in intensity. Only one eye (8.33%) had grade 1 haze at six months. Restsof the eyes were clear .No vision threatening complications occurred. Despite the short term follow up, photorefractivekeratectomy appears to be an effective and safe procedure with good predictability for the correction of low myopia.Conclusion: Despite relatively short term follow up of the study; photo refractive keratectomy (PRK) appears to be safeand quite predictable procedure for correction of low myopia.

Eight-year follow-up of Artiflex and Artiflex Toric phakic intraocular lens

2021 ◽  
pp. 112067212110356
Author(s):  
Mariano Royo ◽  
Ángel Jiménez ◽  
Irene Martínez-Alberquilla ◽  
José F Alfonso
Keyword(s):  
Intraocular Lenses ◽  
Physiological Changes ◽  
Spherical Equivalent ◽  
Efficacy And Safety ◽  
Phakic Intraocular Lens ◽  
Uncorrected Distance Visual Acuity ◽  
Manifest Refraction ◽  
Phakic Intraocular Lenses

Purpose: To analyse long-term efficacy, safety, visual and refractive stability and physiological changes of Artiflex Myopia and Toric phakic intraocular lenses (pIOL) separately throughout an 8-year follow-up. Design: Retrospective cohort study. Methods: A total of 67 eyes of 37 patients underwent Artiflex Myopia (47 eyes) or Artiflex Toric (20 eyes) implantation for correcting myopia and/or astigmatism. Follow-up evaluations were performed 1, 3, 5 and 8 years after surgery. Preoperative and postoperative data included corrected (CDVA) and uncorrected distance visual acuity (UDVA), manifest refraction, endothelial cell density (ECD) and intraocular pressure (IOP) assessments. Efficacy and safety indexes were analysed. The vectorial analysis was performed using the Thibos method. Results: Mean CDVA and UDVA of both pIOLs significantly improved from preoperative to 1 year after implantation, and then it remained stable over the 8-year follow-up. The efficacy and safety indexes after 8 years were 0.94 ± 0.16 and 1.07 ± 0.18 for Artiflex Myopia and 1.00 ± 0.11 and 1.10 ± 0.15 for Artiflex Toric, respectively. The spherical equivalent (SE) significantly improved after surgery. J0, J45 and SE refractive components showed no changes between postoperative visits. A total ECD loss of 4.8% ( p < 0.001) and 10.4% ( p = 0.005) was found after 8 years for Artiflex Myopia and Toric, respectively. Conclusions: Artiflex Myopia and Toric pIOLs are a safe, efficient and predictable option for the correction of myopia and/or astigmatism. The vectorial analysis showed excellent rotation stability for the toric version.

scholarly journals Five Years Follow-up of Riboflavin/Ultraviolet A (370 nm) Corneal Collagen Cross-linking to Halt the Progression of Keratoconus

2014 ◽  
Vol 3 (2) ◽  
pp. 63-68
Author(s):  
PS David O’Brart ◽  
Parul Patel ◽  
Naomi A O’Brart
Keyword(s):  
Cross Linking ◽  
Spherical Equivalent ◽  
Efficacy And Safety ◽  
Ultraviolet A ◽  
Cone Apex ◽  
Collagen Cross Linking ◽  
Corneal Collagen ◽  
Fellow Eyes

ABSTRACT Aims To determine the long-term efficacy and safety of riboflavin/ultraviolet a corneal cross-linking (CXL) to halt the progression of keratoconus. Materials and methods Thirty-five patients (35 eyes) who had undergone CXL with epithelial removal 5 or more years previously were examined. Results At 5 years, mean spherical equivalent (SEQ) increased by 0.78 diopters (D) (p < 0.001), mean simulated K (Sim K) reduced by 0.86D (p < 0.00001), cone apex power (CAP) reduced by 1.1D (p < 0.0002) and root mean square (RMS) (p < 0.0001), coma (p < 0.0001), and secondary astigmatism (p < 0.001) decreased compared to preoperative values. Compared to values at 1 year, mean refractive cylinder reduced by 0.26D (p < 0.05), mean Sim K reduced by 0.46D (p < 0.0005), CAP reduced by 0.81D (p < 0.01), RMS (p < 0.001), coma (p < 0.002) and secondary astigmatism (p < 0.02) reduced and central pachymetry increased (p < 0.05) at 5 years. No treated eyes showed evidence of progression at 5 years. None lost >1 line of CDVA. Eight untreated fellow eyes progressed during the follow-up period and underwent CXL. Conclusions Corneal cross-linking is an effective treatment to halt the progression of keratoconus at 5 years, with no sight-threatening complications. Improvements in topographic and wave-front indices present at 1 year continue to improve at 5 years. How to cite this article O’Brart PSD, Patel P, O’Brart NA. Five Years Follow-up of Riboflavin/Ultraviolet A (370 nm) Corneal Collagen Cross-linking to Halt the Progression of Keratoconus. Int J Kerat Ect Cor Dis 2014;3(2):63-68.

Gonioscopy-assisted transluminal trabeculotomy is an effective surgical treatment for uveitic glaucoma

2021 ◽  
pp. bjophthalmol-2021-320270
Author(s):  
Avner Belkin ◽  
Yuri Valere Chaban ◽  
Derek Waldner ◽  
Saba Samet ◽  
Iqbal Ike K Ahmed ◽  
...  
Keyword(s):  
Outcome Measure ◽  
Case Series ◽  
Cataract Extraction ◽  
Secondary Outcome ◽  
Efficacy And Safety ◽  
Medication Usage ◽  
Uveitic Glaucoma ◽  
Surgical Success ◽  
Lens Implantation

BackgroundTo assess the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in uveitic glaucoma (UG).MethodsA retrospective interventional case series in which 33 eyes of 32 patients with UG underwent GATT with or without concomitant cataract extraction and intraocular lens implantation (CE/IOL) at three Canadian treatment centres from October 2015 to 2020. The main outcome measure was surgical success defined as an intraocular pressure (IOP) ≤18 mm Hg and at least one of the following: IOP within one mm Hg of baseline on fewer glaucoma medications as compared with baseline or a 30% IOP reduction from baseline on the same or fewer medications. Secondary outcome measures were IOP, medication usage and surgical complications.ResultsMean patient age (mean±SD) was 49±16 years (range: 18–79) and 44% were female. GATT was performed as a standalone procedure in 52% of cases and the remainder were combined with CE/IOL. Surgical success was achieved in 71.8% (SE: 8.7%) of cases. Mean preoperative IOP (±SD) was 31.4±10.8 mm Hg on a median of 4 medications. 59% of patients were on oral carbonic anhydrase inhibitors (CAIs) prior to surgery. After 1 year, average IOP was 13.8 mm Hg on a median 1 medication, with 6% of patients being on oral CAIs. No sight threatening complications occurred during surgery or follow-up.ConclusionGATT is an effective surgical strategy in the management of UG. This microinvasive conjunctival-sparing procedure should be considered early in these patients.

Treatment of varicose tributaries with sclerotherapy with polidocanol 0.5 % foam

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Reich-Schupke ◽  
Weyer ◽  
Altmeyer ◽  
Stücker
Keyword(s):  
Scientific Evidence ◽  
Daily Practice ◽  
Severe Adverse Effect ◽  
Safe Procedure ◽  
Efficacy And Safety ◽  
Foam Sclerotherapy ◽  
History Of ◽  
One Year ◽  
Additional Therapy

Background: Although foam sclerotherapy of varicose tributaries is common in daily practice, scientific evidence for the optimal sclerosant-concentration and session-frequency is still low. This study aimed to increase the knowledge on foam sclerotherapy of varicose tributaries and to evaluate the efficacy and safety of foam sclerotherapy with 0.5 % polidocanol in tributaries with 3-6 mm in diameter. Patients and methods: Analysis of 110 legs in 76 patients. Injections were given every second or third day. A maximum of 1 injection / leg and a volume of 2ml / injection were administered per session. Controls were performed approximately 6 months and 12 months after the start of therapy. Results: 110 legs (CEAP C2-C4) were followed up for a period of 14.2 ± 4.2 months. Reflux was eliminated after 3.4 ± 2.7 injections per leg. Insufficient tributaries were detected in 23.2 % after 6.2 ± 0.9 months and in 48.2 % after 14.2 ± 4.2 months, respectively. Only 30.9 % (34 / 110) of the legs required additional therapy. In 6.4 % vein surgery was performed, in 24.5 % similar sclerotherapy was repeated. Significantly fewer sclerotherapy-sessions were required compared to the initial treatment (mean: 2.3 ± 1.4, p = 0.0054). During the whole study period thrombophlebitis (8.2 %), hyperpigmentation (14.5 %), induration in the treated region (9.1 %), pain in the treated leg (7.3 %) and migraine (0.9 %) occurred. One patient with a history of thrombosis developed thrombosis of a muscle vein (0.9 %). After one year there were just hyperpigmentation (8.2 %) and induration (1.8 %) left. No severe adverse effect occurred. Conclusions: Foam sclerotherapy with injections of 0.5 % polidocanol every 2nd or 3rd day, is a safe procedure for varicose tributaries. The evaluation of efficacy is difficult, as it can hardly be said whether the detected tributaries in the controls are recurrent veins or have recently developed in the follow-up period. The low number of retreated legs indicates a high efficacy and satisfaction of the patients.

Efficacy and safety of long-acting pasireotide in acromegalic patients in the real life: The reappraisal of the first-dose follow-up visit

2020 ◽  
Author(s):  
Claudio Urbani ◽  
Francesca Dassie ◽  
Benedetta Zampetti ◽  
Di Certo Agostino Maria ◽  
Renato Cozzi ◽  
...  
Keyword(s):  
Real Life ◽  
Efficacy And Safety ◽  
The Real ◽  
Long Acting

scholarly journals Pregnancy and neonatal outcomes in fresh and frozen cycles using blastocysts derived from ovarian stimulation with follitropin delta

2021 ◽  
Author(s):  
Jon Havelock ◽  
Anna-Karina Aaris Henningsen ◽  
Bernadette Mannaerts ◽  
Joan-Carles Arce ◽  
Keyword(s):  
Ovarian Stimulation ◽  
Implantation Rate ◽  
Neonatal Outcomes ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Relative Contribution ◽  
Follitropin Alfa ◽  
Start Up ◽  
Comparative Trials

Abstract Purpose To describe the pregnancy and neonatal outcomes using fresh and vitrified/warmed blastocysts obtained from ovarian stimulation with follitropin delta in controlled trials versus follitropin alfa. Methods This investigation evaluated the outcome from 2719 fresh and frozen cycles performed in 1326 IVF/ICSI patients who could start up to three ovarian stimulations in the ESTHER-1 (NCT01956110) and ESTHER-2 (NCT01956123) trials, covering 1012 fresh cycles and 341 frozen cycles with follitropin delta and 1015 fresh cycles and 351 frozen cycles with follitropin alfa. Of the 1326 first cycle patients, 513 continued to cycle 2 and 188 to cycle 3, and 441 patients started frozen cycles after the fresh cycles. Pregnancy follow-up was continued until 4 weeks after birth. Results The overall cumulative take-home baby rate after up to three stimulation cycles was 60.3% with follitropin delta and 60.7% with follitropin alfa (−0.2% [95% CI: −5.4%; 5.0%]), of which the relative contribution was 72.8% from fresh cycles and 27.2% from frozen cycles in each treatment group. Across the fresh cycles, the ongoing implantation rate was 32.1% for follitropin delta and 32.1% for follitropin alfa, while it was 27.6% and 27.8%, respectively, for the frozen cycles. Major congenital anomalies among the live-born neonates up until 4 weeks were reported at an incidence of 1.6% with follitropin delta and 1.8% with follitropin alfa (−0.2% [95% CI: −1.9%; 1.5%]). Conclusions Based on comparative trials, the pregnancy and neonatal outcomes from fresh and frozen cycles provide reassuring data on the efficacy and safety of follitropin delta. Trial registration ClinicalTrials.gov Identifier: NCT01956110 registered on 8 October 2013; NCT01956123 registered on 8 October 2013.

OP270 Why The Haute Autorité de Santé Rejects the Widespread Use Of “Mini-Bypass”/One Anastomosis Gastric Bypass For Obesity In France

2020 ◽  
Vol 36 (S1) ◽  
pp. 4-4
Author(s):  
Jean-Charles Lafarge ◽  
Denis-Jean David ◽  
Cédric Carbonneil
Keyword(s):  
Esophageal Cancer ◽  
Gastric Bypass ◽  
Adverse Events ◽  
Severe Obesity ◽  
One Anastomosis Gastric Bypass ◽  
Close Monitoring ◽  
Efficacy And Safety ◽  
Multicenter Rct ◽  
Nutritional Complications

IntroductionOne anastomosis gastric bypass (OAGB) has become a widespread technique over the last few years in France, without any prior assessment and despite existing controversies among bariatric surgeons. An older bypass technique for treating obesity, the Roux-en-Y gastric bypass (RYGB), is available and reimbursed, having been assessed and approved for use in 2005. In 2019, the French Haute Autorité de Santé (HAS) assessed OAGB for the treatment of severe and massive obesity. This assessment, the first in the world, was undertaken for OAGBs carried out with a 200- or 150-centimeter biliopancreatic-limb (BP-limb) length.MethodsA systematic review (SR) of the literature and consultation of a working group consisting of both healthcare professionals (clinician and surgeons) and patients were carried out. The primary aim of our assessment was to determine whether the OAGB technique can replace RYGB. The efficacy and safety profile of OAGB was compared with RYGB in adult patients with massive, severe obesity. Complications and postoperative follow up specific to OAGB were identified.ResultsThe three selected randomized controlled trials (RCTs) could not confirm the superiority or the non-inferiority of OAGB, compared with RYGB, on the selected efficacy endpoints of weight loss, resolution of comorbidities, and quality of life. Adverse events reported for OAGB included severe nutritional complications and bile reflux that could potentially lead to lower esophageal cancer. In one RCT, the frequency of serious adverse events in the OAGB group was almost two times higher than in the RYGB group.ConclusionsHAS considered that OAGB carried out with a longer (200 centimeter) BP-limb is not a validated technique for the surgical treatment of massive, severe obesity. Thus, it cannot be considered an alternative to RYGB. There were insufficient data available on OAGB performed with a 150-centimeter BP-limb. Thus, HAS recommended undertaking a multicenter RCT to assess the efficacy and safety of OAGB. Patients who have already undergone OAGB should receive the same follow up as patients who have received RYGB, including close monitoring for nutritional complications and lower esophageal cancer and an endoscopic examination five years after surgery.

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