scholarly journals The effects of laser displacement on femtosecond laser-assisted conjunctival autograft preparation for pterygium surgery

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245223
Author(s):  
Valencia Hui Xian Foo ◽  
Yu-Chi Liu ◽  
Hon Shing Ong ◽  
Marcus Ang ◽  
Jodhbir S. Mehta
Keyword(s):  
Femtosecond Laser ◽  
Horizontal Displacement ◽  
Prospective Analysis ◽  
Conjunctival Autograft ◽  
Intraoperative Optical Coherence Tomography ◽  
Graft Thickness ◽  
Traction Suture ◽  
Pterygium Surgery ◽  
Grade 3

Aims To evaluate the effects of no-suction femtosecond laser (FSL) stability on conjunctival autograft (CAG) dissection in pterygium surgery. Methods Prospective analysis of 35 eyes from 34 subjects who underwent femtosecond laser-assisted pterygium surgery with the Ziemer Z8 laser (Ophthalmic Systems AG, Switzerland). Intraoperative absolute FSL displacements were measured and correlated with the duration and ease of CAG peel, CAG thickness, measured with intraoperative optical coherence tomography, and deviation from intended graft thickness. Results The median absolute FSL displacement was 22 μm (interquartile range [IQR] 14.7 to 60.8), while median vertical FSL displacement was 14.7 μm (IQR 7.3 to 44) and median horizontal FSL displacement was 22.0 μm (IQR 14.7 to 44). 65.7% had a grade 1 peel, 11.4% had grade 2 peel, 14.3% had grade 3 peel and 8.6% had grade 4 peel. The median duration of CAG peel was 5.4 seconds (IQR 3 to 21.4). The median CAG thickness was 69 μm (IQR 60.3 to 78.5), and the median deviation from targeted graft thickness was 9 μm (IQR 1 to 16). Eyes with more difficult peels and longer duration of CAG peels had significantly greater vertical FSL displacements (p = 0.04 and 0.02 respectively), but not horizontal displacement, age, ethnicity, CAG thickness or deviation from original thickness, compared to those with better quality and shorter duration peels. 1 eye (2.9%) had an incomplete CAG peel with a buttonhole and 2 eyes had graft tears (5.7%). Conclusion Micro-displacements during the suction-free CAG preparation are common but they did not affect the quality of the CAG peel, duration of peel, or CAG thickness. However, vertical globe displacement during FSL-assisted CAG creation was significantly associated with a more difficult and longer CAG peel duration. This highlights the importance of the cornea traction suture fixation to ensure stability of the eye during FSL application.

scholarly journals Inverted Posterior Femto-Keratoplasty: Quality of the Surface of the Corneal Section and Preliminary Clinical Outcomes

2020 ◽  
Vol 17 (2) ◽  
pp. 216-222
Author(s):  
A. N. Pashtaev ◽  
B. E. Malyugin ◽  
S. B. Izmailova ◽  
N. P. Pashtaev ◽  
K. N. Kuzmichev ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Femtosecond Laser ◽  
Central Zone ◽  
Corneal Edema ◽  
Clinical Results ◽  
Control Group ◽  
Bullous Keratopathy ◽  
Center Edge ◽  
Graft Thickness

Purpose. To evaluate the quality of the surface of an ultra-thin donor transplant prepared from the endothelial surface of the cornea using a femtosecond laser and to demonstrate the preliminary clinical results. Patients and Methods. 4 eyes were operated: 3 with Fuch`s endothelial dystrophy and 1 with pseudophakic bullous keratopathy. All patients were treated with DSEK with an ultrathin graft prepared by Alcon Wavelight FS 200 femtosecond laser (Germany). Before and after surgery UCVA, BSCVA, astigmatism, ECD were measured. EC death, graft thickness and CCT were evaluated at 12 months` observation. Atomic force microscopy was used for examination of 10 samples. Control group was 5 corneal flaps obtained by mechanical microkeratome (Moria SLK-2, France). Main group — 5 corneal flaps, obtained by femtosecond laser. Nonparametric Mann-Whitney test was used for statistical analysis. Coefficient of reliability p < 0.05 was considered to be significant. Results. RMS value of femto-laser group samples was 18.6 ± 7.8 um. RMS of microkeratome group samples was 22.3 ± 18.3 um. Statistical analysis did not reveal significant differences between the values of the studied parameter in these groups (p > 0.05). Transparent engraftment was observed in all cases, no corneal edema was identified. BSCVA ranged from 0.2 to 0.6, which was associated with the presence of concomitant pathology. Astigmatism was 1.35 ± 1.0 D. ECD = 1526 ± 434 cells/mm2. EC loss = 48.0 ± 12.8 %. Graft thickness in the central zone was 78.0 ± 18.1 µm. Center-Edge Index — 0.84 ± 0.12. CCT = 600 ± 31 um. No postoperative complications were found. Conclusion. The developed settings allowed to obtain high-quality ultra-thin graft with a sufficiently uniform surface without a risk of perforation. Preliminary clinical results showed the method potential for restoration of corneal transparency. ECD loss corresponded to the one achievable by DSAEK.

scholarly journals Femtosecond Laser-assisted Preparation of Conjunctival Autograft for Pterygium Surgery

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yu-Chi Liu ◽  
Angel Jung Se Ji ◽  
Tien-En Tan ◽  
Matthias Fuest ◽  
Jodhbir S. Mehta
Keyword(s):  
Femtosecond Laser ◽  
Conjunctival Autograft ◽  
Pterygium Surgery

Femtosecond laser-assisted conjunctival autograft preparation for pterygium surgery

2017 ◽  
Vol 15 (2) ◽  
pp. 211-217 ◽  
Author(s):  
Matthias Fuest ◽  
Yu-Chi Liu ◽  
Gary Hin-Fai Yam ◽  
Ericia Pei Wen Teo ◽  
Hla Myint Htoon ◽  
...  
Keyword(s):  
Femtosecond Laser ◽  
Conjunctival Autograft ◽  
Pterygium Surgery

219: Functional Outcomes and Quality of Life Following Laparoscopic Radical Prostatectomy: Prospective Analysis Over a 4-Year Experience

2006 ◽  
Vol 175 (4S) ◽  
pp. 72-72
Author(s):  
Andrew A. Wagner ◽  
Richard E. Link ◽  
Aron Sulman ◽  
Wendy Sullivan ◽  
Christian P. Pavlovich ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radical Prostatectomy ◽  
Functional Outcomes ◽  
Laparoscopic Radical Prostatectomy ◽  
Prospective Analysis

Prospective Randomized Trial Comparing Mitomycin, Cisplatin, and Protracted Venous-Infusion Fluorouracil (PVI 5-FU) With Epirubicin, Cisplatin, and PVI 5-FU in Advanced Esophagogastric Cancer

2002 ◽  
Vol 20 (8) ◽  
pp. 1996-2004 ◽  
Author(s):  
P. Ross ◽  
M. Nicolson ◽  
D. Cunningham ◽  
J. Valle ◽  
M. Seymour ◽  
...  
Keyword(s):  
Randomized Study ◽  
Squamous Carcinoma ◽  
Undifferentiated Carcinoma ◽  
Palmar Erythema ◽  
Esophagogastric Cancer ◽  
Equivalent Efficacy ◽  
Venous Infusion ◽  
Grade 3 ◽  
To Receive

PURPOSE: We report the results of a prospectively randomized study that compared the combination of epirubicin, cisplatin, and protracted venous-infusion fluorouracil (PVI 5-FU) (ECF) with the combination of mitomycin, cisplatin, and PVI 5-FU (MCF) in previously untreated patients with advanced esophagogastric cancer. PATIENTS AND METHODS: Five hundred eighty patients with adenocarcinoma, squamous carcinoma, or undifferentiated carcinoma were randomized to receive either ECF (epirubicin 50 mg/m2 every 3 weeks, cisplatin 60 mg/m2 every 3 weeks and PVI 5-FU 200 mg/m2/d) or MCF (mitomycin 7 mg/m2 every 6 weeks, cisplatin 60 mg/m2 every 3 weeks, and PVI 5-FU 300 mg/m2/d) and analyzed for survival, response, toxicity, and quality of life (QOL). RESULTS: The overall response rate was 42.4% (95% confidence interval [CI], 37% to 48%) with ECF and 44.1% (95% CI, 38% to 50%) with MCF (P = .692). Toxicity was tolerable, and there were only two toxic deaths. ECF resulted in more grade 3/4 neutropenia and grade 2 alopecia, but MCF caused more thrombocytopenia and plantar-palmar erythema. Median survival was 9.4 months with ECF and 8.7 months with MCF (P = .315); at 1 year, 40.2% (95% CI, 34% to 46%) of ECF and 32.7% (95% CI, 27% to 38%) of MCF patients were alive. Median failure-free survival was 7 months with both regimens. Global QOL scores were better with ECF at 3 and 6 months. CONCLUSION: This study confirms response, survival, and QOL benefits of ECF observed in a previous randomized study. The equivalent efficacy of MCF was demonstrated, but QOL was superior with ECF. ECF remains one of the reference treatments for advanced esophagogastric cancer.

scholarly journals Intraoperative optical coherence tomography guided corneal sweeping for removal of remnant Interface fluid during ultra-thin Descemet stripping automated endothelial keratoplasty

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michael Mimouni ◽  
Martin Kronschläger ◽  
Manuel Ruiss ◽  
Oliver Findl
Keyword(s):  
Optical Coherence Tomography ◽  
Retrospective Study ◽  
Optical Coherence ◽  
Endothelial Keratoplasty ◽  
Intraoperative Optical Coherence Tomography ◽  
Graft Thickness

Abstract Background Remnant interface fluid following Descemet stripping automated endothelial keratoplasty (DSAEK) is associated with postoperative detachments. The aim of this study was to assess outcomes of intraoperative optical coherence tomography (iOCT) guided meticulous peripheral corneal sweeping for removal of interface fluid during ultra-thin (UT) DSAEK. Methods This retrospective study included all eyes underwent iOCT guided UT-DSAEK from October 2016 to February 2018 at the Hanusch Hospital, Vienna, Austria. Peripheral meticulous corneal sweeping was performed to remove excess fluid. Central graft thickness (CGT) was measured prior to surgery, after graft bubbling and after corneal sweeping. Remnant interface fluid rates were compared between eyes that underwent rebubbling and those that did not. Results Overall, 28 eyes of 28 patients with a mean age of 73.9 ± 10.0 years were included. An iOCT guided meticulous peripheral sweeping was performed in 89.3% (n = 25) of the cases. Following 84% (n = 21) of the peripheral sweeping performed, remnant fluid was no longer identified. Following peripheral sweeping the interface fluid height was reduced from 17.31 ± 15.96 μm to 3.46 ± 9.52 μm (p < 0.001) and CGT was reduced by 7% (p < 0.001). Rebubbling was performed in 17.9% (n = 5) of the cases. The rebubbling group had a greater proportion of patients that had remnant fluid identified with iOCT at the end of surgery despite meticulous peripheral sweeping (60.0% versus 4.4%, p = 0.01). Conclusion The iOCT identified subclinical remnant fluid in nearly 90% of UT-DSAEK cases. An iOCT guided peripheral corneal sweeping led to resolution of interface fluid in a majority of cases. Eyes with persistent remnant fluid despite peripheral corneal sweeping are more likely to require subsequent rebubbling.

scholarly journals Slowly resorbable biosynthetic mesh: 2-year results in VHWG grade 3 hernia repair

Hernia ◽  
2021 ◽  
Author(s):  
M. M. J. Van Rooijen ◽  
T. Tollens ◽  
L. N. Jørgensen ◽  
T. S. de Vries Reilingh ◽  
G. Piessen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Hernia Recurrence ◽  
Recurrence Rates ◽  
Elective Repair ◽  
Significant Difference ◽  
Grade 3

Abstract Introduction Information on the long-term performance of biosynthetic meshes is scarce. This study analyses the performance of biosynthetic mesh (Phasix™) over 24 months. Methods A prospective, international European multi-center trial is described. Adult patients with a Ventral Hernia Working Group (VHWG) grade 3 incisional hernia larger than 10 cm2, scheduled for elective repair, were included. Biosynthetic mesh was placed in sublay position. Short-term outcomes included 3-month surgical site occurrences (SSO), and long-term outcomes comprised hernia recurrence, reoperation, and quality of life assessments until 24 months. Results Eighty-four patients were treated with biosynthetic mesh. Twenty-two patients (26.2%) developed 34 SSOs, of which 32 occurred within 3 months (primary endpoint). Eight patients (11.0%) developed a hernia recurrence. In 13 patients (15.5%), 14 reoperations took place, of which 6 were performed for hernia recurrence (42.9%), 3 for mesh infection (21.4%), and in 7 of which the mesh was explanted (50%). Compared to baseline, quality of life outcomes showed no significant difference after 24 months. Despite theoretical resorption, 10.7% of patients reported presence of mesh sensation in daily life 24 months after surgery. Conclusion After 2 years of follow-up, hernia repair with biosynthetic mesh shows manageable SSO rates and favorable recurrence rates in VHWG grade 3 patients. No statistically significant improvement in quality of life or reduction of pain was observed. Few patients report lasting presence of mesh sensation. Results of biosynthetic mesh after longer periods of follow-up on recurrences and remodeling will provide further valuable information to make clear recommendations. Trial registration Registered on clinicaltrials.gov (NCT02720042), March 25, 2016.

Comparison of 4 Techniques for Limbal-Conjunctival Autograft Fixation in Primary Pterygium Surgery

2017 ◽  
Vol 27 (4) ◽  
pp. 466-469 ◽  
Author(s):  
Luis F. Mejía ◽  
Juan P. Santamaría ◽  
Miguel Cuevas ◽  
Andrea Córdoba ◽  
Sergio A. Carvajal
Keyword(s):  
Recurrence Rate ◽  
Fibrin Glue ◽  
Ocular Inflammation ◽  
Postoperative Patient ◽  
Patient Discomfort ◽  
Conjunctival Autograft ◽  
Significant Difference ◽  
Fixation Techniques ◽  
Pterygium Surgery ◽  
Limbal Conjunctival Autograft

Purpose To compare 4 limbal-conjunctival autograft fixation techniques—conventional suture, commercial fibrin glue, autologous fibrin glue, and cautery—in primary nasal pterygium surgery. Methods This is a retrospective and descriptive study. The postoperative patient discomfort, graft edema, ocular inflammation, and other complications of 4 limbal-conjunctival autograft fixation techniques in primary nasal pterygium surgery were evaluated. Results Postoperative patient discomfort was significantly lower with the sutureless techniques (p<0.001), with fixation with cautery having the lowest rate of discomfort. Graft edema and ocular inflammation during the early postoperative period were significantly higher when fibrin glue techniques were used (p<0.001). The recurrence rate did not show a statistically significant difference (p = 0.682) among the 4 groups. Conclusion In primary nasal pterygium surgery, limbal-conjunctival autograft fixation using cautery is the technique with the lowest postoperative discomfort rate and without a statistically significant increase in recurrence rate when compared to conventional suture and fibrin glue techniques.

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