Nd:YAG capsulotomy for Ahmed glaucoma drainage implant occlusion by the anterior capsule: a case report

Abstract Background Glaucoma drainage implants have been used with increasing frequency for the management of glaucoma. Patients who are candidates for glaucoma drainage devices often have more severe disease and are at risk of vision loss with post-operative elevations in intraocular pressure (IOP). One post-operative complication that can result in IOP elevation after glaucoma drainage device implantation is occlusion of the tube lumen. Case presentation Here, we present a novel case of tube occlusion by the anterior capsule in a patient who underwent combined phacoemulsification and Ahmed glaucoma valve implantation. The tube occlusion was successfully managed with Nd:YAG capsulotomy with immediate IOP lowering. Conclusions While there have been previous reports of occlusion of the tube lumen by vitreous, iris, blood and fibrin, to our knowledge this is the first report of tube occlusion by the anterior lens capsule and the first report to describe its successful management.

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Outcomes of Glaucoma Drainage Device Implantation and Trabeculectomy with Mitomycin C in Glaucoma Secondary to Aniridia

American Journal of Ophthalmology ◽

10.1016/j.ajo.2021.03.008 ◽

2021 ◽

Author(s):

Indira Durai ◽

Srilekha Pallamparthy ◽

George Varghese Puthuran ◽

Hiruni Kaushalya Wijesinghe ◽

Mohammed Sithiq Uduman ◽

...

Keyword(s):

Mitomycin C ◽

Glaucoma Drainage Device ◽

Drainage Device ◽

Device Implantation

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Vitrectorhexis in penetrating eye injuries in adults

European Journal of Ophthalmology ◽

10.1177/1120672118804387 ◽

2018 ◽

Vol 29 (6) ◽

pp. 689-693

Author(s):

Miklós D Resch ◽

Anikó Balogh ◽

Gábor L Sándor ◽

Zsuzsanna Géhl ◽

Zoltán Zsolt Nagy

Keyword(s):

Foreign Body ◽

Pars Plana Vitrectomy ◽

Anterior Segment ◽

Posterior Chamber ◽

Ocular Injury ◽

Eye Injuries ◽

Anterior Capsule ◽

Safe Alternative ◽

Anterior Lens Capsule ◽

Pars Plana

Introduction: Vitrectorhexis is an alternative for manual continuous curvilinear capsulorhexis originally developed for paediatric cataract surgery. The aim of our study was the evaluation of the technique in adult patients with penetrating ocular injury and traumatic cataracts. Methods: Eight eyes of 8 patients (23–41 years, all males) had penetrating mechanical corneal trauma. Anterior lens capsule was penetrated in all cases and additional posterior capsule defect in five cases. Intraocular foreign body was detected in one case in the crystalline lens and in two cases in the posterior segment. Standard 23G infusion cannula and vitreous cutter were applied to perform anterior capsule opening, removal of lens material, anterior vitrectomy and pars plana vitrectomy if needed. No phacoemulsification or irrigation/aspiration probe was used. Results: Vitrectorhexis could be performed in 7 out of 8 cases with the preservation of peripheral anterior capsule; primary implantation of posterior chamber intraocular lens was possible in all cases (in the bag in three eyes and into the sulcus in five eyes). Anterior chamber was stable in all cases intraoperatively, and no dropped nucleus or lens fragment loss was observed. Surgery was combined with pars plana vitrectomy in three cases, with foreign body removal (when necessary). No postoperative complication occurred. Conclusion: Vitrectorhexis was found to be an effective and safe alternative method in the management of complex anterior segment trauma cases. With its use, traditional cataract surgical devices can be substituted and additional benefits of vitreous cutter can be utilized in selected cases, especially in young adults.

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Operation of traumatic cataract with metal foreign body in the lens

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1104216v ◽

2011 ◽

Vol 139 (3-4) ◽

pp. 216-220

Author(s):

Dragan Veselinovic ◽

Ivan Stefanovic ◽

Milos Jovanovic ◽

Aleksandar Veselinovic ◽

Marija Trenkic-Bozinovic ◽

...

Keyword(s):

Visual Acuity ◽

Foreign Body ◽

Anterior Part ◽

Central Area ◽

Traumatic Cataract ◽

Metal Object ◽

Anterior Capsule ◽

Anterior Lens Capsule ◽

Uncorrected Visual Acuity ◽

Metal Foreign Body

Introduction. We present a patient with perforative eye injury, a metal foreign body in the lens and traumatic cataract. The paper emphasises the importance of phacoemulsification in case of patients with a traumatic cataract and the presence of a metal foreign body. Case Outline. A 41-year-old patient had a perforative wound of the cornea caused by a metal foreign body that also perforated the anterior lens capsule and remained in the paracentral anterior part of the lens. The injury, which happened upon hitting of a hammer against a metal object, showed the presence of a tangential wound of the cornea adapted edges, and a formed anterior eye chamber. The presence of a metal spear-shaped foreign body was partly inside the anterior eye chamber and partly in the central area of the lens. The visual acuity of the injured eye was 0.2. The technique of removing the foreign body out of the lens and the phacoemulsification of the lens with the implantation of intraocular lens is presented. The paracentral wound on the cornea was not sutured because of well-adapted edges. On the first postoperative day there were no inflammatory signs, and best uncorrected visual acuity of 0.8. Conclusion. Posttraumatic cataracts with a metal foreign body in the lens require operative treatment in order to remove the foreign body, phacoemulsification and implantation of artificial lens. Because of anterior capsule lesion, special care should be taken in regard to anterior capsulorhexis and appropriate hydrodisection. Ocular hypotonia and possible damage of the posterior capsule in some cases can make phacoemulsification more difficult to perform.

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First Report of Sclerotinia Stem Rot and Watery Soft Rot Caused by Sclerotinia sclerotiorum on Sand Rocket (Diplotaxis tenuifolia) in Italy

Plant Disease ◽

10.1094/pd-89-1241c ◽

2005 ◽

Vol 89 (11) ◽

pp. 1241-1241 ◽

Cited By ~ 4

Author(s):

A. Garibaldi ◽

A. Minuto ◽

M. L. Gullino

Keyword(s):

Relative Humidity ◽

Sclerotinia Sclerotiorum ◽

Severe Disease ◽

Soil Surface ◽

Soft Rot ◽

Sclerotinia Stem Rot ◽

First Report ◽

Initial Symptoms ◽

Stem Necrosis ◽

White Mycelium

Several species of Diplotaxis (D. tenuifolia, D. erucoides, and D. muralis), known as wild or sand rocket, are widely cultivated in Italy. Rocket is used in Mediterranean cuisine as salad, a component of packaged salad products, and as a garnish for food. In winter 2003, a severe disease was observed on D. tenuifolia grown in unheated glasshouses on commercial farms near Albenga in northern Italy. Initial symptoms included stem necrosis at the soil level and darkening of leaves. As stem necrosis progressed, infected plants wilted and died. Wilt, characterized by the presence of soft and watery tissues, occurred within a few days on young plants. The disease was extremely severe in the presence of high relative humidity and mild temperature (15°C). Necrotic tissues became covered with white mycelium that produced dark sclerotia. Diseased stem tissue was disinfested for 1 min in 1% NaOCl and plated on potato dextrose agar (PDA) amended with 100 ppm streptomycin sulfate. Sclerotinia sclerotiorum (1) was consistently recovered from infected stem pieces. Sclerotia observed on infected plants measured 1.23 to 3.00 × 1.40 to 5.38 mm (average 2.10 × 2.85 mm). Sclerotia produced on PDA measured 1.00 to 4.28 × 1.00 to 6.01 mm (average 2.38 × 3.23 mm). Pathogenicity of three isolates obtained from infected plants was confirmed by inoculating 30-day-old plants of D. tenuifolia grown in 18-cm-diameter pots in a glasshouse. Inoculum, 2 g per pot of wheat kernels infested with mycelium and sclerotia of each isolate, was placed on the soil surface around the base of each plant. Three replicates of five pots each were used per isolate. Noninoculated plants served as controls. The inoculation trial was repeated once. All plants were kept at temperatures ranging between 10 and 26°C (average 15°C) with an average relative humidity of 80% and were watered as needed. Inoculated plants developed symptoms of leaf yellowing within 12 days, soon followed by the appearance of white mycelium and sclerotia, and eventually wilted. Control plants remained symptomless. S. sclerotiorum was reisolated from inoculated plants. To our knowledge, this is the first report of infection of D. tenuifolia by S. sclerotiorum in Italy as well as worldwide. The disease currently has been observed in the Liguria Region but not yet in other areas where sand rocket is cultivated. The economic importance of this disease for the crop can be considered medium at the moment, but is expected to increase in the future. Reference: (1) N. F. Buchwald. Den. Kgl. Veterin.er-og Landbohojskoles Aarsskrift, 75, 1949.

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First Report of Powdery Mildew Caused by Golovinomyces biocellatus on Agastache rugosa in Korea

Plant Disease ◽

10.1094/pdis-03-14-0298-pdn ◽

2014 ◽

Vol 98 (9) ◽

pp. 1278-1278 ◽

Cited By ~ 1

Author(s):

S. E. Cho ◽

J. H. Park ◽

S. H. Hong ◽

I. Y. Choi ◽

H. D. Shin

Keyword(s):

Powdery Mildew ◽

Severe Disease ◽

Morphological Characteristics ◽

Control Measures ◽

Control Treatment ◽

Width Ratio ◽

Korean Isolate ◽

Pathogenicity Test ◽

Agastache Rugosa ◽

First Report

Agastache rugosa (Fisch. & C.A. Mey.) Kuntze, known as Korean mint, is an aromatic plant in the Lamiaceae. It is widely distributed in East Asian countries and is used as a Chinese traditional medicine. In Korea, fresh leaves are commonly added to fish soups and stews (3). In November 2008, several dozen Korean mints plants growing outdoors in Gimhae City, Korea, were found to be severely infected with a powdery mildew. The same symptoms had been observed in Korean mint plots in Busan and Miryang cities from 2008 to 2013. Symptoms first appeared as thin white colonies, which subsequently developed into abundant hyphal growth on stems and both sides of the leaves. Severe disease pressure caused withering and senescence of the leaves. Voucher specimens (n = 5) were deposited in the Korea University Herbarium (KUS). Appressoria on the mycelium were nipple-shaped or nearly absent. Conidiophores were 105 to 188 × 10 to 13 μm and produced 2 to 4 immature conidia in chains with a sinuate outline, followed by 2 to 3 cells. Foot-cells of the conidiophores were straight, cylindrical, slightly constricted at the base, and 37 to 58 μm long. Conidia were hyaline, ellipsoid to barrel-shaped, measured 25 to 40 × 15 to 23 μm (length/width ratio = 1.4 to 2.1), lacked distinct fibrosin bodies, and showed reticulate wrinkling of the outer walls. Primary conidia were obconically rounded at the apex and subtruncate at the base. Germ tubes were produced at the perihilar position of conidia. No chasmothecia were observed. The structures described above were typical of the Oidium subgenus Reticuloidium anamorph of the genus Golovinomyces. The measurements and morphological characteristics were compatible with those of G. biocellatus (Ehrenb.) V.P. Heluta (1). To confirm the identification, molecular analysis of the sequence of the internal transcribed spacer (ITS) region of ribosomal DNA (rDNA) of isolate KUS-F27200 was conducted. The complete ITS rDNA sequence was amplified using primers ITS5 and P3 (4). The resulting 514-bp sequence was deposited in GenBank (Accession No. KJ585415). A GenBank BLAST search of the Korean isolate sequence showed >99% similarity with the ITS sequence of many G. biocellatus isolates on plants in the Lamiaceae (e.g., Accession Nos. AB307669, AB769437, and JQ340358). Pathogenicity was confirmed by gently pressing diseased leaf onto leaves of five healthy, potted Korean mint plants. Five non-inoculated plants served as a control treatment. Inoculated plants developed symptoms after 7 days, whereas the control plants remained symptomless. The fungus present on inoculated plants was identical morphologically to that observed on the original diseased plants. The pathogenicity test was repeated with identical results. A powdery mildew on A. rugosa caused by G. biocellatus was reported from Romania (2). To our knowledge, this is the first report of powdery mildew caused by G. biocellatus on A. rugosa in Korea. The plant is mostly grown using organic farming methods with limited chemical control options. Therefore, alternative control measures should be considered. References: (1) U. Braun and R. T. A. Cook. Taxonomic Manual of the Erysiphales (Powdery Mildews), CBS Biodiversity Series No. 11. CBS, Utrecht, 2012. (2) D. F. Farr and A. Y. Rossman. Fungal Databases. Syst. Mycol. Microbiol. Lab., online publication, USDA ARS, retrieved 17 February 2014. (3) T. H. Kim et al. J. Sci. Food Agric. 81:569, 2001. (4) S. Takamatsu et al. Mycol. Res. 113:117, 2009.

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Modified capsulorhexis for fluid-filled mature cataracts

Medical hypothesis discovery and innovation in ophthalmology ◽

10.51329/mehdioptometry1422 ◽

2021 ◽

Vol 10 (2) ◽

pp. 17-24

Author(s):

Ehab M. Ghoneim

Keyword(s):

The Other ◽

Slit Lamp ◽

Interventional Study ◽

Anterior Capsule ◽

Anterior Lens Capsule ◽

Radial Tear ◽

Peribulbar Anesthesia ◽

Difficult Cases ◽

Made In ◽

Ophthalmic Viscosurgical Device

Background: The aim of this study was to develop a modified capsulorhexis technique featuring a new maneuver for the removal of subcortical fluid in fluid-filled mature cataracts to avoid high intralenticular pressure. Methods: This prospective interventional study included 33 eyes with mature cataracts and evidence of subcapsular fluid spaces by slit lamp examination. For each patient, 20% mannitol was administered intravenously according to the bodyweight 1 h preoperatively. Under peribulbar anesthesia, a 2.2-mm main incision was made, and the anterior chamber was filled with a dispersive ophthalmic viscosurgical device. Using a bent-tip cystotome, a 2-mm curved incision was made in the center of the anterior capsule, which released subcortical fluid and was drained through compression of the posterior lip of the main incision using a spatula. Then, fine gentle milking in all quadrants around the puncture on the anterior lens capsule from the periphery toward the site of puncture using the blunt-edged spatula further assists drainage of subcortical fluid and breaks fine septa inside the lens to remove fluid from intralenticular fluid pocket collections. Results: The study included 15 (45.5%) men and 18 (54.5%) women with a mean ± standard deviation (SD) of age of 63.2 ± 5.33 and 64.4 ± 6.21 years, respectively. The modified capsulorhexis technique was performed for 33 intumescent cataracts. Capsulorhexis was completed in all cases; capsulorhexis was easy in 31 (94%) eyes and difficult in 2 (6%) eyes. In the two difficult cases, radial extension occurred in one eye, and it was retrieved using the Little technique; the other case with radial tear was completed successfully using a retinal micro scissor from the other edge of the capsulorhexis until reaching an oval, continuous capsulorhexis. Conclusions: This modified capsulorhexis technique with compression on the posterior lip of the main incision and capsule milking allowed for a safe, continuous curvilinear capsulorhexis. Further comparative studies are necessary to confirm our preliminary results. How to cite this article: Ghoneim EM. Modified capsulorhexis for fluid-filled mature cataracts. Med Hypothesis Discov Innov Ophthalmol. 2021 Summer; 10(2): 17-24. https://doi.org/10.51329/mehdioptometry1422

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First Report of Colletotrichum boninense Causing Anthracnose on Pepper in China

Plant Disease ◽

10.1094/pdis-04-12-0403-pdn ◽

2013 ◽

Vol 97 (1) ◽

pp. 138-138 ◽

Cited By ~ 7

Author(s):

Y. Z. Diao ◽

J. R. Fan ◽

Z. W. Wang ◽

X. L. Liu

Keyword(s):

Internal Transcribed Spacer ◽

Severe Disease ◽

Causal Agent ◽

Its Sequences ◽

Universal Primers ◽

Pathogenicity Test ◽

Conidial Suspension ◽

Single Spore ◽

First Report ◽

Species Specific

Anthracnose, caused by Colletotrichum spp., is a severe disease and results in large losses in pepper (Capsicum frutescens) production in China (4). Colletotrichum boninense is one of the Colletotrichum species in pepper in China. In August 2011, anthracnose symptoms (circular, sunken lesions with orange to black spore masses) were observed on pepper fruits in De-Yang, Sichuan Province, China. Three single-spore isolates (SC-6-1, SC-6-2, SC-6-3) were obtained from the infected fruits. A 5-mm diameter plug was transferred to potato dextrose agar (PDA); the isolates formed colonies with white margins and circular, dull orange centers. The conidia were cylindrical, obtuse at both ends, and 10.5 to 12.6 × 4.1 to 5.0 μm. The colonies grew rapidly at 25 to 28°C, and the average colony diameter was 51 to 52 mm after 5 days on PDA at 25°C. Based upon these characters, the causal agent was identified as C. boninense. To confirm the identity of the isolates, the internal transcribed spacer (ITS) regions were amplified with the ITS1/ITS4 universal primers (1). The internal transcribed spacer (ITS) sequences (Accession No. JQ926743) of the causal fungus shared 99 to 100% homology with ITS sequences of C. boninense in GenBank (Accession Nos. FN566865 and EU822801). The identity of the causal agent as C. boninense was also confirmed by species-specific primers (Col1/ITS4) (2). In a pathogenicity test, five detached ripe pepper fruits were inoculated with 1 μl of a conidial suspension (106 conidia/mL) or five fruits with 1 μl of sterile water were kept as control. After 7 days in a moist chamber at 25°C, typical anthracnose symptoms had developed on the five inoculated fruits but not on control fruits. C. boninense was reisolated from the lesions, and which was confirmed by morphology and molecular methods as before. There have reports of C. boninense infecting many species of plants, including pepper (3). To our knowledge, this is the first report of C. boninense causing anthracnose on pepper in China. References: (1) A. K. Lucia et al. Phytopathology 93:581, 2002. (2) S. A. Pileggi et al. Can. J. Microbiol. 55:1081, 2009. (3) H. J. Tozze et al. Plant Dis. 93:106, 2009. (4) M. L. Zhang. J. Anhui Agri. Sci. 2:21, 2000.

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