scholarly journals The number of intracorneal ring segments in asymmetric and central cones

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Canan Asli Utine ◽  
Denizcan Özizmirliler ◽  
Mustafa Kayabaşı ◽  
Üzeyir Günenç
Keyword(s):  
Corneal Astigmatism ◽  
Laser Device ◽  
Double Ring ◽  
Ring Segment ◽  
Corneal Asphericity ◽  
Intracorneal Ring Segment ◽  
Group 2 ◽  
Postoperative Improvement ◽  
Single Versus ◽  
Group 1

Abstract Background To compare the results of single versus double intracorneal ring segment (ICRS) (KeraRing) implantation in keratoconus with respect to different cone locations. Methods Twenty-two eyes of 18 patients with totally asymmetric cones (20–80% or 0–100% distribution along steep axis) were implanted with single ICRS (Group 1), 38 eyes of 32 patients with central or partially asymmetric cones (50–50% or 40–60% distribution along steep axis) were implanted with double ICRS (Group 2), at a depth of 80% of the site of implantation, in channels created with femtosecond laser device. All patients had uncorrected and corrected distance visual acuities (UDVA and CDVA, respectively) of ≤ 0.3 Snellen lines. Results In both groups, patients had median UDVA and CDVA gain of 3 Snellen lines (P > 0.05). Postoperative improvement in indices of vertical asymmetry and height decentration in Group 1; simulated keratometry, corneal astigmatism and anterior corneal asphericity values in Group 2 were greater (P < 0.05). A total of 10 eyes (45.5%) in Group 1 were recommended double ring implantation by the manufacturer’s nomogram, but underwent single ICRS implantation and achieved visual, refractive, tomographic outcomes comparable to that in Group 2, although corneal cylindrical correction was less and final topographic astigmatism was greater. Conclusion Double ICRS implantation seems to be superior in terms of keratometry, corneal astigmatism and anterior corneal asphericity improvement. Single ICRS implantation in totally asymmetric cones seems to provide satisfactory visual, refractive and tomographic results, similar to double ICRS implantation in central and partially asymmetric cones, by inducing central shift of the cone.

Single versus repetitive injection of lignocaine in the management of carpal tunnel syndrome – a randomized controlled trial

2014 ◽  
Vol 40 (2) ◽  
pp. 179-183 ◽  
Author(s):  
S. Akarsu ◽  
Ö. Karadaş ◽  
F. Tok ◽  
H. Levent Gül ◽  
E. Eroğlu
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Controlled Trial ◽  
Post Treatment ◽  
Randomized Controlled ◽  
Electrophysiological Findings ◽  
Tunnel Syndrome ◽  
Group 2 ◽  
Single Versus ◽  
Group 1

The aim of this study was to determine the efficacy of single versus repetitive injection of lignocaine into the carpal tunnel for the management of carpal tunnel syndrome. The 42 patients included were randomly assigned to two Groups: group 1 was injected with 4 mL of 1% lignocaine once and Group 2 was injected with 4 mL of 1% lignocaine twice a week for 2 weeks. Clinical and electrophysiological evaluations were performed at the study onset, and at 6 and 12 weeks following the final injection. Initially, the groups were similar with respect to clinical and electrophysiological findings. All parameters in Group 2 improved 6 weeks post treatment ( p < 0.05), and these improvements persisted at 12 weeks post treatment ( p < 0.05). Repetitive local lignocaine injection was effective in reducing the symptoms of carpal tunnel syndrome and improving electrophysiological findings.

scholarly journals Earlier Corneal Topographical Changes After Different Pterygium Surgical Techniques: a Comparative Pentacam Scheimpflug Imaging Study

2021 ◽  
Author(s):  
Şefik Can İpek ◽  
Yusuf Cem Yilmaz ◽  
Hamidu Hamisi Gobeka ◽  
Muhammet Derda Özer
Keyword(s):  
Visual Acuity ◽  
Group Analysis ◽  
Surgical Techniques ◽  
Corneal Astigmatism ◽  
Tissue Adhesive ◽  
Scheimpflug Imaging ◽  
Fibrin Tissue Adhesive ◽  
Rotational Flap ◽  
Group 2 ◽  
Group 1

Abstract Purpose: To investigate earlier corneal topographical changes and visual acuity after different pterygium surgical techniques using the Pentacam Scheimpflug imaging system.Methods: This study enrolled 98 patients with unilateral primary nasal pterygium. Pterygium surgery with either a conjunctival autograft (group 1) or an anchored conjunctival rotational flap (group 2), with fibrin tissue adhesive was performed under topical anesthesia. Baseline and one-month post-operative best-corrected visual acuity (BCVA) in logarithm of the Minimum Angle of Resolution (logMAR) and anterior corneal astigmatism (ACA), flat keratometry (Kf), steep keratometry (Ks) and posterior corneal astigmatism (PCA) were analyzed.Results: Mean BCVA improved from baseline 0.119±0.113 to 0.082±0.086 logMAR in group 1, and from baseline 0.169±0.128 to 0.120±0.121 logMAR in group 2. There were no statistically significant differences between the two groups in pre-and post-operative ACA, PCA, Kf and Ks. (p=0.686; 0.9020.107; and 0.592, respectively). Intra-group analysis revealed statistically significant differences in both groups: ACA (p<0.001 for both groups), with a greater difference in group 1 (2.072), and Kf (p<0.001 for both groups), with a slightly greater change in group 2 (1.910). While there were no statistically significant Ks intra-group differences in both groups (group 1: p=0.091; group 2: 0.092), group 1 (0.0522) displayed more Ks changes. There were also no statistically significant intra-group PCA differences in both groups (p=0.061 for both groups). However, Group 2 (-0.020) displayed greater changes.Conclusions: Significantly improved anterior corneal topographical changes highly associated with conjunctival autografting. However, the conjunctival rotational flap was associated with relatively greater posterior corneal topographical changes.

scholarly journals Descemet Membrane Endothelial Keratoplasty (DMEK) in Previously Vitrectomized Eyes: Complications and Clinical Outcomes

2021 ◽  
Author(s):  
Wissam Aljundi ◽  
Alaadin Abdin ◽  
Shady Suffo ◽  
Berthold Seitz ◽  
Loay Daas
Keyword(s):  
Corneal Thickness ◽  
Corneal Dystrophy ◽  
Control Group ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Group 2 ◽  
Postoperative Improvement ◽  
Group 1

Abstract Purpose To evaluate the results and complications of Descemet membrane endothelial keratoplasty (DMEK) in previously vitrectomized eyes. Design Retrospective study of 35 eyes that had undergone DMEK, due to Fuchs endothelial corneal dystrophy (FECD), at our department with a follow-up after 6 months postoperatively. We compared the intraoperative procedure, complications, and results of DMEK between 14 previously vitrectomized pseudophakic eyes (group 1) and a control group of 21 pseudophakic non-vitrectomized eyes (group 2). Results The unfolding time (in minutes) was significantly longer in group 1 than in group 2 (10.5 ± 6.4 vs. 3.2 ± 1.5, p < 0.01). A single re-bubbling was needed in 8 patients in group 1 (57.1%) and in 3 patients in group 2 (14.2%) (p < 0.01). Repeated re-bubbling (≥ 1 time) was performed in only 5 patients of group 1 (35.7%). There was significant postoperative improvement in best-corrected visual acuity (BCVA, in LogMAR) in both groups (p = 0.04 in group 1 and p < 0.01 in group 2). The central corneal thickness (CCT, in µm) did not differ significantly between the two groups preoperatively (p = 0.4) or postoperatively (p = 0.1). However, the CCT decreased significantly postoperatively in both groups (p < 0.01 in both groups). The postoperative endothelial cell density (ECD in cell/mm²) was significantly lower in group 1 than in group 2 (p = 0.03). Conclusion DMEK in previously vitrectomized eyes presents a surgical challenge, which requires special, and sometimes unpredictable, intraoperative maneuvers, but good functional and morphological results can be achieved. The use of the endothelial Descemet membrane lamellae (EDML) of older donors might be recommended to facilitate the intraoperative unfolding process.

scholarly journals Intracorneal Ring Segment Implantation for the Management of Keratoconus in Children

Vision ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 1
Author(s):  
Pablo Larco ◽  
Pablo Larco ◽  
Daniel Torres ◽  
David P. Piñero
Keyword(s):  
Spherical Aberration ◽  
Case Series ◽  
Corneal Astigmatism ◽  
Corneal Surface ◽  
Case Series Study ◽  
Corrected Distance Visual Acuity ◽  
Ring Segment ◽  
Intracorneal Ring Segment ◽  
Series Study

The short-term safety and efficacy of intracorneal ring segment (ICRS) implantation in keratoconus eyes of children are investigated in this study. A retrospective interventional case series study including a total of 33 keratoconus eyes (age 8 to 17 years) that had undergone ICRS (Keraring segments, Mediphacos) implantation was conducted. Information about visual, refractive, pachymetric, corneal topographic and aberrometric, and corneal endothelial changes during a 3-month follow-up were extracted and analysed. A significant improvement was observed in logMAR corrected distance visual acuity (p = 0.005), combined with a statistically significant reduction in keratometric readings (p < 0.001). A reduction in the magnitude of corneal astigmatism of ≥1 D was observed in 52.8% of eyes. No significant changes were observed in corneal endothelial density (p = 0.317). Significant changes were found in the anterior vertical coma component (p = 0.002) as well as in the spherical aberration of the posterior corneal surface (p = 0.004). Only two relevant complications were described: one corneal microperforation with penetration of the ring segment into the anterior chamber (1 eye, 2.8%), and a case of ring extrusion (1 eye, 2.8%). ICRS implantation in children keratoconus eyes allows a reduction of corneal astigmatism, irregularity, and aberrations, leading to a significant visual improvement.

scholarly journals Refractive and visual outcome of toric intraocular lens implantation following cataract surgery

1970 ◽  
Vol 4 (1) ◽  
pp. 37-44 ◽  
Author(s):  
JB Ale ◽  
J Power ◽  
K Zohs ◽  
F Cunningham
Keyword(s):  
Cataract Surgery ◽  
Visual Outcome ◽  
Corneal Astigmatism ◽  
Toric Iol ◽  
Factors Affecting ◽  
Iol Implantation ◽  
Paired Student ◽  
Corrected Distance Visual Acuity ◽  
Group 2 ◽  
Group 1

Purpose: To evaluate the refractive and visual outcome of toric IOL implantation for correction of pre-existing corneal astigmatism following cataract surgery. Materials and methods: In this retrospective study, 56 eyes of 30 patients who underwent implantation of toric IOL following regular phacoemulsification were divided into two groups based on the types of toric IOL implanted: group 1 patients received Acrysof toric (Alcon) and group 2 patients received AT-Torbi (Zeiss Meditech) IOLs. Pre-and post-operative corneal and refractive astigmatisms, and post-operative distance vision were investigated. Statistical analysis was carried out using the paired student t-test when necessary. Factors affecting the success of toric IOL implantation are discussed and recommendations are made to optimize the outcome. Results: The mean age of all patients was 75.56 ± 9.87 years. No statistical difference was observed between pre-and post-operative corneal astigmatism (p = 0.819). Postoperative refractive astigmatism was significantly less in both groups (Group 1: p = 0.0014; Group 2: p=<0.00001). The best-corrected distance visual acuity was 6/12 or better in 95 % of group 1 and 100 % of group 2 patients. Conclusion: Toric IOL implantation is a viable and highly predictable method of correcting the corneal astigmatism. It allows correction without compromising the integrity of the cornea. Careful selection of the patient, accurate keratometry and precise alignment of the cylindrical axes are some of the factors to be considered for a superior outcome. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5848 NEPJOPH 2012; 4(1): 37-44

scholarly journals The comparative analysis of the effectiveness of implantation of toric, spherical and aspherical intraocular lenses for the surgical treatment of congenital cataract

2016 ◽  
Vol 11 (4) ◽  
pp. 184-191
Author(s):  
K. B Pershin ◽  
N. F Pashinova ◽  
Alina Vasil’evna Cherkashina ◽  
A. Yu Tsygankov
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Congenital Cataract ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Astigmatism Correction ◽  
Vector Difference ◽  
Group 2 ◽  
Incision Technique ◽  
Group 1

Objective. The comparative analysis of the outcomes of the surgical treatment of the children presenting with congenital cataract and astigmatism following the implantation of toric, spherical, and aspherical intraocular lenses (IOLs). Materials and methods. A total of 97 children (127 eyes) presenting with congenital cataract were selected for the present study. Group 1 consisted of the patients suffering from corneal astigmatism of more than 1,0 D who had undergone toric IOLs implantation (25 children, 38 eyes). Group 2 was comprised of the patients with corneal astigmatism of more than 1,0 D who had undergone implantation of spherical and aspherical intraocular lenses (40 children, 48 eyes). Group 3 was composed of 32 children (41 eyes) with corneal astigmatism of less than 1,0 D who had undergone implantation of non-toric intraocular lenses. Lensectomy was performed with the use of the small (1,8 mm and 2,2 mm) incision technique. Various IOL models (Alcon, USA) were used for implantation. The vector analysis of astigmatic correction (Alpinus) was employed to evaluate the quality of astigmatism correction. Results. The patients of all groups experienced a significant improvement of postoperative non-correctable and maximally correctable visual acuity during the long-term follow-up period (over 3 years in duration). In the children comprising group 1, the estimated value of vector astigmatism (-0,72) was close to the actual postoperative value (-0,81). The TIA axis was 113,7 degrees and the SIA axis 92,6 degrees. The vector difference was 0,18 diopters which suggested the high precision of astigmatism correction. The correction index averaged 1,12 ± 0,14. The IOL index was 0,25 ± 0,16 in comparison with its ideal value of 0.0. In the children of group 2, the estimated value of vector astigmatism (-0,87) was significantly higher than the actual postoperative values (-0,56). The TIA axis was 134,3 degrees and the SIA axis 77,1 degrees (p

scholarly journals Efficacy and Predictability of Muller's Muscle-conjunctival Resection with Different Tarsectomy Lengths for Unilateral Blepharoptosis Treatment

2020 ◽  
Author(s):  
So Hung Yeh ◽  
Shu-Lang Laio ◽  
Yi-Hsuan Wei
Keyword(s):  
Retrospective Study ◽  
Cut Point ◽  
Photographic Documentation ◽  
The Mean ◽  
Group 2 ◽  
Postoperative Improvement ◽  
Müller’S Muscle ◽  
Group 1

Abstract Background: To investigate the efficacy and predictability of Muller's muscle-conjunctival resection (MMCR) with different lengths of tarsectomy for the treatment of unilateral mild-to-moderate blepharoptosis.Methods: A retrospective study of patients who underwent MMCR with tarsectomy for unilateral mild-to-moderate blepharoptosis between January 2016 and December 2019 was performed. Individuals with adequate photographic documentation and good levator function were included. Data on age, gender, surgical designs, pre-operative and post-operative marginal reflex distance 1 (MRD1) and tarsal platform show (TPS), and complications were retrieved. Results: Sixty patients underwent 8-mm MMCR with 1- or 2-mm tarsectomy; 53 patients (88.3%) showed postoperative symmetry of MRD1 within 1 mm. The average postoperative improvement in MRD1 was 2.15±0.8 mm. Thirty-two patients received 8-mm MMCR with 1-mm tarsectomy (group 1), and 28 patients underwent 8-mm MMCR with 2-mm tarsectomy (group 2). In group 1, postoperative symmetry rate was 90.6%, and the mean elevation of MRD1 was 1.66±0.6 mm. In group 2, postoperative symmetry rate was 85.7%, and the mean elevation of MRD1 was 2.72±0.6 mm. Both groups showed postoperative symmetry of TPS and significant improvement in eyelid position (p<0.0001). No complications or overcorrections were noted.Conclusions: MMCR with tarsectomy was proven to be a safe, rapid, and effective method for patients with mild-to-moderate ptosis. Predictability and symmetry of the outcome were statistically confirmed. We further suggest a 2.1-mm expected MRD1 elevation as a cut point for choosing between 1- or 2-mm tarsectomy.

scholarly journals Comparative study of single versus multiple gallstone disease in KGH, Visakhapatnam

2020 ◽  
Vol 7 (10) ◽  
pp. 3370
Author(s):  
C. Dharma Kishore Raja ◽  
Dondapati Keerthi ◽  
Adikari Sai Kiran ◽  
Gunto Aravind ◽  
Sreerama Raja ◽  
...  
Keyword(s):  
Incidental Finding ◽  
Gallstone Disease ◽  
Gall Stone ◽  
Stone Disease ◽  
Disease Group ◽  
Gall Stone Disease ◽  
Group 2 ◽  
A Prospective Study ◽  
Single Versus ◽  
Group 1

Objective: To evaluate the differences in the presentation, their operative implications and difficulties of single stone versus multiple gall stone disease.Methods: This is a prospective study of a minimum of 60 patients with gall stone disease (Group 1-single, Group 2-multiple) from January 2019 to December 2019 in KGH, Visakhapatnam.Results: More common in females, 40-50 years symptoms and complications, TC count difficult cholecystectomies were more in multiple gall stone pts.Conclusion: Multiple gall stones have led to more severe symptoms and complications and difficult surgery. should be motivated for early surgery even in incidental finding and should not opt for conservative management.

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