scholarly journals Optimization of surgical treatment of cataract in patients with diabetes mellitus

2010 ◽  
Vol 13 (2) ◽  
pp. 91-93
Author(s):  
Dmitriy Valentinovich Lipatov ◽  
Timofey Alexandrovich Chistyakov ◽  
Anatoliy Gennad'evich Kuz'min
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Combined Treatment ◽  
Functional Results ◽  
Early Postoperative Period ◽  
Lens Opacity ◽  
Research Centre ◽  
Diabetic Cataract ◽  
Ocular Tissues ◽  
Patients With Diabetes

Aim. To compare different methods for surgical treatment of cataract in patients with diabetes melli-tus (DM) and substantiate the choice of its optimalmodality. Materials and methods. Analysis included data on 209 patients (221 eyes) treated from January 2008 to December 2009 in the Department ofRetinopathy and Ophthalmosurgey, Endocrinological Research Centre. Diabetic cataract was managed using UNIVERSAL-II, LEGACY EVEREST,and INFINITI phacoemulsifiers. Parameters studied included time of ultrasound (US) ex-posure, US power, and retinal characteristics in the earlypostoperative period. In addition, analysis included data on the location of lens opacity in 1047 patients (1897 eyes) with diabetic cataract. Results. Relatively low corrected and uncorrected visual acuity in the early postoperative period was attributable to concomitant DM-related retinalpathology. Analysis of lenticular opacity showed that it in the first place affected collagen fibers beneath the posterior capsule. The use of torsional USin INFINITI for cataract phacoemulsification produced almost 4-fold reduction in the exposure time of ocular tissues. As a result, the postoperativeoedema was significantly smaller than in patients undergoing combined treatment (AQUALASE hydromonitoring and OZIL ultrasound system). Conclusion. Combination of ultrasound and hydromonitoring phacoemulsification for the treatment of cataract in DM patients reduces exposure timeof ocular tissues and postoperative oedema which creates prerequisites for faster recovery of visual acuity after surgery. Functional results of surgicaltreatment of diabetic cataract can be further improved by early diagnosis of lens opacity and the use of US and hydromonitoring phacoemulsificationtechniques.

Efficacy of surgical treatment of traumatic cataract with simultaneous intraocular lens implantation in children

2013 ◽  
Vol 4 (1) ◽  
pp. 37-40
Author(s):  
Diloram Asrarovna Zakirkhodzhayeva
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Early Postoperative Period ◽  
Eye Injury ◽  
Traumatic Cataract ◽  
Iol Implantation ◽  
Intraocular Injection ◽  
Lens Implantation ◽  
One Year

Background: eye injury is often accompanied by lens damage. Aim: To evaluate the efficacy of surgical treatment of traumatic cataract with simultaneous IOL implantation in children. Material and methods: The results of surgical treatment of traumatic cataract with simultaneous IOL implantation in 62 children were analyzed: in 48 boys (77.4%) and 14 girls (22.6%) with a mean age 8.1 years. Results: visual acuity after surgery gradually increased from 0.09 to 0.22 by the end of the first month, 0.43 in 6 months and 0.47 in one year of follow-up. In 85.5% of the operated children visual acuity in the late post-op period was accounted 0.3–1.0, and in 82.2% of cases binocular vision was recovered. In the early postoperative period following complications were observed: exudative iridocyclitis — 16.1%; deposits of fibrin in the pupil — 8%; pigment deposits on surface of the IOL — 19%; secondary cataract — 12%; IOL or its haptics dislocation — 3% cases. Conclusions: Early IOL implantation during traumatic cataract surgery in children is suitable. Use of viscoelastics allows minimizing the severity of postoperative inflammation and reducing a risk of complications. Intraocular injection of Gemasa during surgery is effective to resolve hyphema, intraocular hemorrhages and fibrinoid exudate.

The first experience of using autologous conditioned plasma in the surgery of complete macular ruptures in the Voronezh Regional Clinical Ophthalmological Hospital

2021 ◽  
pp. 140-143
Author(s):  
A.A. Roldugin ◽  
◽  
O.V. Donkareva ◽  
S.Y. Shcherbakov ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Clinical Observation ◽  
High Efficiency ◽  
Standard Technique ◽  
Functional Results ◽  
Dark Spot ◽  
High Tech ◽  
Early Results

Purpose. To evaluate the effectiveness of the use of autologous conditioned plasma in the surgical treatment of complete macular ruptures. Material and methods. During 2021, 4 patients with complete macular rupture were operated on at the center of ophthalmic microsurgical high-tech care of the Voronezh Regional Clinical Ophthalmological Hospital using autologous conditioned plasma. The BCVA was 0.01–0.3. The diameter of the macular breaks ranged from 214 to 817 µm. Blood samples were taken from the patients before the operation. Autologous conditioned plasma was prepared by centrifuging the patient's blood in a patented Arthrex ACP (Germany) double-circuit syringe. Surgical treatment was carried out according to the standard technique - microinvasive three-port 25G vitrectomy with removal of the BMR to the extreme periphery and IPM in the central part of the retina. After tamponade of the vitreous cavity with air, autologous conditioned plasma was injected intravitreally into the central and peripheral rupture in several layers until a visual film appeared. The follow-up period for patients after surgical treatment was 2 months. Results. When examining patients after 1 week, the edges of the macular foramen remained closed in all cases. All studied patients noted an improvement in visual functions, the absence of metamorphopsia, a decrease in the dark "spot" in front of the eye, visual acuity ranged from 0.2 to 0.7 (0.5 + 0.2) after surgery for a complete macular rupture, and 0.02 in patients after surgery for recurrent macular rupture. After 1 month, the visual acuity after the full macular rupture was repaired after 1 month was 0.3–0.8 (0.6 ± 0.2), which was significantly higher than the preoperative values, and did not change in the patient with recurrent macular rupture. Two months later - the results of optical coherence tomography and visometry without negative dynamics. Conclusions. The early results of clinical observation confirmed the high efficiency of the use of autologous conditioned plasma in the surgical treatment of complete macular ruptures, which allows to obtain high functional results and anatomical closure of the macular rupture, to increase the efficiency and safety of rehabilitation. Key words: macular rupture, autologous conditioned plasma.

Our experience in the surgical treatment of congenital cataract

Reflection ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 25-27
Author(s):  
I. V. Kuznetsov ◽  
◽  
N. V. Pasikova ◽  
Keyword(s):  
Surgical Treatment ◽  
General Anesthesia ◽  
Congenital Cataract ◽  
Functional Results ◽  
Clinical Analysis ◽  
Early Postoperative Period ◽  
Congenital Cataracts ◽  
Initial Appointment ◽  
Examination Methods ◽  
Preoperative Examination

Aim. To present our experience and evaluate the results of surgical treatment of congenital cataracts. Methods. A clinical analysis of the results of congenital cataract aspiration in 16 children (22 eyes) aged 2 months to 5 years is performed. Bilateral cataract was determined in 6 children, unilateral – in 10. Preoperative examination of children aged 3–5 years was carried out in a standard way. Children younger than 3 years of age at the initial appointment underwent non-contact examination methods, the remaining studies were performed under general anesthesia in the operating room immediately before surgery. Congenital cataract phacoaspiration was performed under general anesthesia using the Stellaris microsurgical system (Bausch and Lomb, USA) through a 1.2-mm paracentesis in the lens irrigation-aspiration regime. Hydrophobic IOL models were implanted. The posterior lens capsule was preserved in all cases. Mandatory was the appointment of cycloplegics in drops in the early postoperative period. Results. An increase in visual acuity (from 0.03 to 0.7) occurred in all cases. However, presence of obscuration amblyopia of varying degrees required regular courses of pleoptic treatment. Conclusions. The effectiveness of congenital cataracts phacoaspiration is ensured by the fulfillment of federal clinical recommendations, however, sutureless surgery allows achieving high functional results in the treatment of this pathology. Key words: congenital cataract; phacoaspiration; intraocular lens.

scholarly journals LETTER TO THE EDITOR Excision of Congenital Bilateral Persistent Pupillary Membrane in a Child with Exotropia

2015 ◽  
Vol 9 (1) ◽  
pp. 33-35
Author(s):  
Michiko Iida ◽  
Tatsuya Mimura ◽  
Mari Goto ◽  
Yuko Kamei ◽  
Aki Kondo ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Surgical Treatment ◽  
Histopathological Examination ◽  
Crystalline Lens ◽  
Ocular Tissues ◽  
Corrected Visual Acuity ◽  
The Right ◽  
Best Corrected Visual Acuity ◽  
High Hyperopia

Purpose : To report the clinical and histopathological findings of a patient who had bilateral persistent pupillary membrane with exotropia and high hyperopia. Methods : Case Report: A 7-year-old boy presented with a persistent pupillary membrane in both eyes. His best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/32 in the left eye with exotropia of 18 prism diopters. He underwent surgical resection of both membranes. At 5 months postoperatively, BCVA was 20/20 with final bilateral refraction of +6.5 D in both eyes. Exotropia and photophobia showed improvement immediately after surgery. Histopathological examination revealed typical features of normal iris tissue in the excised membranes. Conclusion : Bilateral persistent pupillary membranes were excised successfully without injury to other ocular tissues, including the crystalline lens. Surgical treatment may be required for the management of persistent pupillary membrane associated with visual impairment such as exotropia or photophobia.

scholarly journals Autologous Plasma Enriched with Platelet Lysate for the Treatment of Idiopathic Age-Related Macular Degeneration: A Prospective Study

2018 ◽  
Vol 73 (1) ◽  
pp. 40-48
Author(s):  
A. P. Lykov ◽  
O. V. Poveshchenk ◽  
M. A. Surovtseva ◽  
O. M. Stanishevskaya ◽  
D. V. Chernykh ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Growth Factors ◽  
Surgical Treatment ◽  
Macular Degeneration ◽  
Clinical Efficacy ◽  
Early Postoperative Period ◽  
Platelet Lysate ◽  
Age Related Macular Degeneration ◽  
Autologous Plasma ◽  
Age Related

Background: Plasma enriched in growth factors is widely used in medical practice. However, the clinical efficacy of its application in the treatment of age-related retinal integrity violations is investigated insufficiently. Aims: The aim of the study was to evaluate the clinical efficacy of autologous plasma enriched with platelet lysate for treating age-related macular degeneration. Materials and methods: A three-port subtotal transconjunctival vitrectomy was performed and administration of the autologous plasma enriched with platelet lysate was indicated. Autologous plasma enriched with platelet lysate was received from the peripheral blood. We assessed visual acuity, intraocular pressure; conducted optical coherent tomography examination of the eye on the side of the pathological process. Results: The study demonstrated that the combination of a standard 3-port transconjunctival subtotal vitrectomy followed by tamponade of the gap using the autologous plasma enriched with platelet lysate with the injections of the autologous plasma enriched with platelet lysate in the area of pterygopalatine fossa on the side of the operated eyes statistically significantly promoted recovery of the visual acuity in the early postoperative period (15 days) and late period (90 days) if compared with patients who received only surgical treatment (p≤0.05). Use of the autologous plasma enriched with platelet lysate in the treatment increased the closing rate of the tearing of the retina in the macular region up to 62,5%, while only surgical treatment leads to the closure of the defect of the retina in 37.5% of cases. The study showed that autologous plasma enriched with platelet lysate contains cytokines, growth factors, and nitric oxide which are involved in the regeneration/reparation of the retina. Conclusions: Additional administration of the autologous plasma enriched with platelet lysate in the scheme of treatment patients with age-related macular degeneration is accelerating the closure of retinal tears of the eye and improves visual acuity.

Evaluation of effectiveness of a new combined method of treatment of primary progressive pterygium

2021 ◽  
pp. 221-225
Author(s):  
A.N. Bochkareva ◽  
◽  
V.V. Egorov ◽  
O.V. Kolenko ◽  
G.P. Smoliakova ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Ultraviolet Irradiation ◽  
Combined Treatment ◽  
Disease Recurrence ◽  
Surgical Removal ◽  
Initial Growth ◽  
Ophthalmological Examination ◽  
Combined Method ◽  
Primary Progressive

Purpose. Evaluation of the effectiveness of the combined method in the surgical treatment of pterygium. Material and methods. There were 30 patients (30 eyes) under observation for primary progressive pterygium. To assess the condition of the ocular surface and the functional effectiveness of the new combined method of treating pterygium, the patients were divided into two groups. The main group consisted of 15 patients (15 eyes) who underwent surgical treatment of the pterygium according to the developed method. The comparison group consisted of 15 patients (15 eyes), who underwent pterygium removal using standard technology. Standard ophthalmological examination included: visometry, autorefractokeratometry, biomicroscopy with fluorescence test. The criteria for evaluating the effectiveness of treatment were: maximally corrected visual acuity; the degree of corneal astigmatism; the presence and degree of turbidity in the operation area; the frequency of relapse. Results. The use of the proposed method of combined treatment of pterygium, including surgical removal with plasty of the amnion in the zone of initial growth in combination with ultraviolet irradiation of the de-epithelialized corneal bed in the postoperative period, leads to the restoration of transparency and the correct shape of the cornea, therefore, and minimization of induced astigmatism, which is accompanied by an increase in functional parameters eyes. Conclusion. The results obtained, the simplicity and availability of the method developed by us allow us to recommend it for wider use in the surgical treatment of pterygium in order to increase the functional, cosmetic effect, surgical rehabilitation and prevention of disease recurrence. Key words: pterygium, combined treatment, visual acuity, ultraviolet irradiation.

scholarly journals Surgical Treatment of Previously Unclosed Macular Holes

2020 ◽  
Vol 17 (3) ◽  
pp. 368-374
Author(s):  
R. R. Faizrakhmanov ◽  
E. A. Larina ◽  
O. A. Pavlovskii
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Macular Hole ◽  
Free Flap ◽  
Inverse Correlation ◽  
Functional Results ◽  
Internal Limiting Membrane ◽  
Morphological Parameters ◽  
Photoreceptor Layer ◽  
Macular Holes

Macular holes are the most often pathology leading to reduced vision among persons after 60 years. The macular hole is the acquired disease which is a defect of a foveola part of retina on all thickness from an internal limiting membrane to an external segment of a photoreceptor layer. The standard method of treatment is surgery method: a microinvasive vitrectomy with membrane peeling in macular area. There is a number of the techniques increasing efficiency of operative intervention. Even in case of successful surgical intervention macular holes are not always closed.The purpose: development and assessment of morphological parameters of the central retina with a new surgical method of closing earlier operated macula hole using a free flap.Material and methods. 40 patients (40 eyes, 28 women and 12 men) had participated in this study. All patients were operated about macular hole with negative anatomic result. By technology which were used earlier, patients were divided into 3 studied groups (with PRP mass using, with introverted flap using, with mechanical matching of edges of a hole). The main method of research was the optical coherent tomography. All patients were operated by an original technique. It’s purpose was a closing of earlier operated rigid macular hole using a free flap.Results. The defect of a photoreceptor component was closed with an additional expansion of earlier created macular rexis in patients of the 1st and 3rd groups at reoperation. The earlier created flap of an internal limiting membrane was used in patients of the 2nd group. In the analysis of dependence of change of visual acuity from morphological parameters of a macular hole after primary surgical treatment the inverse correlation relation from diameter of a macular hole on small and big radiuses is revealed. The highest visual acuity after a reoperation was reached at patients of the second group.Conclusions. It is necessary to consider the technique which was used earlier, diameter of a macular hole on small and big radiuses, postoperative edema in a parafovea zone for planning the surgical treatment and a forecast of functional results. 

scholarly journals Transorbital Endoscopic Medial Orbitotomy and Decompression of the Optic Nerve in Patients with Endocrine Ophthalmopathy Complicated by Optical Neuropathy

2020 ◽  
Vol 9 (1) ◽  
pp. 167-172
Author(s):  
O. V. Levchenko ◽  
A. A. Kalandari ◽  
N. Y. Kutrovskaya ◽  
K. V. Revazyan
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Optic Nerve ◽  
Optic Neuropathy ◽  
Satisfactory Result ◽  
Postoperative Period ◽  
Conservative Therapy ◽  
Early Postoperative Period ◽  
Medial Wall ◽  
Endocrine Ophthalmopathy

AIM OF STUDY: to improve the results of surgical treatment of patients with endocrine ophthalmopathy complicated by optical neuropathy. For this, medial orbitotomy and decompression of the optic nerve were performed for a patient with endocrine ophthalmopathy, CAS<3, OD=18 mm, OS=23 mm and visual acuity OD=1.0 OS=0.2, using transorbital transconjunctival endoscopic access. The first step was a retro caruncular incision. After that, we defined an access to the medial wall of the orbit with its subsequent resection. Then, we performed ethmoidectomy and approach to the optic nerve canal. Upon completion of bone decompression, we opened periorbitis.RESULTS. The postoperative period was uneventful. In the early postoperative period, regression of exophthalmos was observed OD=18 mm, OS=20 mm, improvement in visual acuity OD=1.0 OS=0.5 . No complications were recorded. A satisfactory result was obtained.CONCLUSION. Transorbital endoscopic medial orbitotomy and optic decompression can be effectively used in the treatment of patients with endocrine ophthalmopathy complicated by optic neuropathy, refractory to conservative therapy. The technique is promising and requires further randomized studies.

scholarly journals Simultaneous topography-guided photorefractive keratectomy with accelerated collagen cross-linking in the treatment of stage I keratoconus

2019 ◽  
Vol 12 (4) ◽  
pp. 28-34
Author(s):  
A. V. Ivanova ◽  
A. S. Sklyarova ◽  
K. B. Letnikova ◽  
A. T. Khandzhyan ◽  
N. V. Khodzhabekyan
Keyword(s):  
Visual Acuity ◽  
Combined Treatment ◽  
Functional Results ◽  
Biomechanical Properties ◽  
Stage I ◽  
Photorefractive Keratectomy ◽  
Cross Linking ◽  
Uncorrected Visual Acuity ◽  
Corneal Collagen Crosslinking ◽  
Collagen Cross Linking

Purpose: to evaluate the efficiency of simultaneous topography-guided photorefractive keratectomy (PRK) with accelerated collagen cross-linking in the treatment of stage I keratoconus.Material and methods. 38 patients (49 eyes) aged 18 to 44 with stage I keratoconus were treated with simultaneous topography-guided PRK combined with accelerated corneal collagen crosslinking. Along with standard ophthalmological testing, patients underwent aberrometry, confocal microscopy, optical coherence tomography of the cornea, imaging of the anterior eye section on a Scheimpflug analyzer, and examination of the biomechanical properties of the cornea. The follow-up period was 2 years.Results. Two years after surgery, uncorrected visual acuity which originally was 0.23 ± 0.03 showed a statistically significant increase and reached 0.72 ± 0.02; best corrected visual acuity improved from 0.44 ± 0.03 to 0.89 ± 0.02; the refractive power of the cornea fell from 45.03 ± 0.28 to 42.55 ± 0.31 D; the spherical component of refraction reduced from -2.00 ± 0.19 to -0.73 ± 0.09 D; the cylinder component reduced from 2.46 ± 0.14 to 0.79 ± 0.07 mm, the thinnest point of the cornea reduced from 486.30 ± 4.78 to 406.80 ± 6.51 μm. The highest order aberrations showed the following results: Coma index reduced from 0.27 ± 0.12 to 0.08 ± 0.07, Tilt reduced from 0.53 ± 0.11 to 0.10 ± 0,09, and Trefoil reduced from 0.13 ± 0.04 to 0.05 ± 0.02.Conclusion. The analysis of clinical and functional results, biomechanical properties and structures of the cornea confirmed the efficacy and safety of the combined treatment of patients with stage I keratoconus.

scholarly journals Functional results of surgical treatment of retinal detachment

2020 ◽  
Vol 24 (2) ◽  
pp. 156-162
Author(s):  
O. E. Ilyukhin ◽  
M. A. Frolov ◽  
K. V. Ignatenko
Keyword(s):  
Blood Flow ◽  
Visual Acuity ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Photoreceptor Cells ◽  
Functional Results ◽  
Scleral Buckling ◽  
The State ◽  
Visual Functions ◽  
Outer Segments

The article analyzes the state of patients visual acuity after successful surgical treatment of retinal detachment. On the basis of gathered data, it was concluded that in case of detachment of the macula only in 50% of cases it is possible to increase visual acuity to 0.4 and higher. Restoration of visual functions continues for at least 6 months after the operation and is determined by the restoration of the structure of the outer segments of the photoreceptor cells. During this time, it is advisable to conduct drug therapy aimed at normalizing blood flow and functional activity of the retina. Visual functions recovery continues for at least 6 months after the operation and is connected with the restored structure of the outer segments of the photoreceptor cells. Important prognostic factors of central vision restoration in the postoperative period are visual acuity before surgery, duration of existence and height of macular detachment. Data on which of the methods of surgical treatment of retinal detachment allows to achieve higher visual acuity are contradictory. There is practically no data on the comparison of the effect on visual acuity of scleral buckling and vitrectomy in the long-term period, in patients with phakic eyes and with artiphakia. On visual acuity after fitting detachment of the macula may affect macular edema, epiretinal membrane formation and retinal folds, and edema of the peripapillary optic nerve head, progressive deterioration of blood flow in the basin of the central retinal artery, short posterior ciliary arteries and ophthalmic artery. It is believed that these factors are significantly more pronounced after scleral buckling than after vitrectomy. Some indicators of optical coherence tomography correlate with visual acuity after surgical treatment of retinal detachment: the state of the articulation line of the external and internal segments of the photoreceptors, as well as the state of the external limiting membrane.

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