scholarly journals The comparison of tunnel corneal incision performed with femtosecond laser and keratome

2016 ◽  
Vol 9 (2) ◽  
pp. 5-13 ◽  
Author(s):  
Yuriy V Takhtaev ◽  
Yulduz Sh Nizametdinova ◽  
Sergey V Shukhaev
Keyword(s):  
Femtosecond Laser ◽  
Postoperative Period ◽  
Anterior Segment ◽  
Early Postoperative Period ◽  
Corneal Incision ◽  
Incision Length ◽  
Descemet Membrane ◽  
The Mean ◽  
Tunnel Morphology ◽  
Descemet Membrane Detachment

Purpose. To compare and evaluate three-plane clear cornea incision (CCI) created with a femtosecond laser (Victus, B&L) and a metal keratome (2,2 mm steel). Materials and Mehtods. Sixty eyes of 60 patients were examined using anterior segment optical coherence tomography (AS-OCT) in early postoperative period (1 day, 1 week, 1 month) after phacoemulsification surgery. Images were used to measure incision length and incidence of epithelial or endothelial gaping, Descemet membrane detachment. Results. In the femtosecond group (34 eyes) the mean CCI length was 2.02 ± 0.05 mm versus keratome group (26 eyes) 2.04 ± 0.43mm. In laser group all incisions (100 %) were three-plane. In keratome group with manual incisions only 23 % were three-plane, 57.7 % were two-plane and 19.3 % were one-plane. Comparison of morphological features of femtosecond and keratome group: endothelial gaping 20.5 % versus 23 %, epithelial gaping 8.8 % versus 19 %. Descemet membrane detachment 17.6 % versus 34 %, respectively. Conclusion. All eyes in femtosecond group had three-plane profile visible on AS-OCT. Femtosecond CCIs showed better tunnel morphology compared to keratome group. Multiplane profile and minimal damaging of CCI will improve safety in the postoperative period.

Epithelial downgrowth after Descemet membrane endothelial keratoplasty

2020 ◽  
pp. 112067212091241
Author(s):  
Viet Nhat Hung Le ◽  
Florian Wabnig ◽  
Bjoern Bachmann ◽  
Claus Cursiefen
Keyword(s):  
Anterior Segment ◽  
Corneal Edema ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Visual Axis ◽  
Corneal Incision ◽  
Descemet Membrane ◽  
Clear Corneal Incision ◽  
Close Observation ◽  
Histopathologic Evaluation

Purpose: To describe a patient with epithelial downgrowth after Descemet membrane endothelial keratoplasty. Methods: Case report. Results: A 73-year-old woman underwent triple Descemet stripping automated endothelial keratoplasty for cataract and corneal edema secondary to Fuchs endothelial dystrophy in the left eye elsewhere. Three years later, Descemet membrane endothelial keratoplasty was performed at our department due to graft failure. One month after the operation, her vision improved to 20/32 and maintained stable. At the 14-month visit, her visual acuity decreased, and a routine examination revealed epithelial downgrowth at the posterior surface of the cornea and partly beneath the graft, accompanied by presumed graft rejection. Therefore, repeat Descemet membrane endothelial keratoplasty with epithelial scraping and intracameral injection of 5-fluorouracil was indicated. She recovered 20/25 vision by 1 month after the surgery. However, small sheet-like epithelial downgrowth recurred 1 month later. The epithelial downgrowth was limited to the peripheral margin of the Descemet membrane endothelial keratoplasty graft and did not affect the visual axis. Epithelial downgrowth showed “islands” with connection between epithelial downgrowth and clear corneal incision on anterior segment optical coherence tomography images. Histopathologic evaluation of the removed Descemet membrane endothelial keratoplasty graft confirmed conjunctival epithelium as the source. Under close observation at the current 4-year follow-up, the epithelial downgrowth remained stable and localized and her vision increased to 20/20. Conclusion: Epithelial downgrowth can occur after Descemet membrane endothelial keratoplasty. The limited progression of epithelial downgrowth in this patient suggests that this condition after Descemet membrane endothelial keratoplasty even in the recurrence stage may cause less damage than expected and may only need to be observed closely if no progression occurs.

Descemet Membrane Detachment in Femtosecond Laser-Assisted Cataract Surgery

Cornea ◽  
2016 ◽  
Vol 35 (4) ◽  
pp. 562-564 ◽  
Author(s):  
Ricardo M. Nosé ◽  
Maria Daniela Rivera-Monge ◽  
Adriana S. Forseto ◽  
Walton Nosé
Keyword(s):  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Descemet Membrane ◽  
Descemet Membrane Detachment

scholarly journals One-Stage Repair of Aortic Arch Hypoplasia Associated With Ventricular Septal Defect

2020 ◽  
pp. 52-56
Author(s):  
Y. Truba ◽  
R. Sekelyk ◽  
I. Dzyurii ◽  
L. Prokopovych ◽  
O. Golovenko ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Postoperative Period ◽  
Balloon Dilation ◽  
Early Postoperative Period ◽  
Long Term Results ◽  
One Stage ◽  
The Mean ◽  
Aortic Arch Hypoplasia

  Background. Aortic arch hypoplasia is a congenital anomaly of the development of the aortic arch characterized by ground. Aortic arch hypoplasia is a congenital anomaly of the development of the aortic arch characterized by hemodynamically significant narrowing of one or more segments of the aortic arch. Aortic arch hypoplasia combined ynamically significant narrowing of one or more segments of the aortic arch. Aortic arch hypop with ventricular septal defect (VSD) characterizes a special category of children who are in serious condition and need ptal defect (VSD) characterizes a special category immediate surgery. Despite the improvement in the results of surgical treatment of this abnormality in recent years, the gery. Despite the imp issue of choosing treatment tactics remains debatable. g The aim. To analyze immediate and long-term results of one-stage aortic arch hypoplasia repair and VSD repair in infants. Materials and methods. From 2011 to 2019, 55 infants underwent simultaneous aortic arch hypoplasia repair in ypoplasia rep conjunction with VSD repair at the National Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine and junction with VSD repair at the National Amosov Institute of Cardiovascular Surgery Ukrainian Children’s Cardiac Center. There were 30 (55%) male patients and 25 (45%) female patients. The mean age of (55%) male patients and 25 (45%) female patients. The mean ag the patients was 1.3 ± 1.2 months (from 0.1 to 9.1 months), the average body weight was 3.9 ± 1.3 kg (from 2.4 to 8.7 patients was 1.3 ± 1.2 months (from 0.1 to 9.1 months), the average body weight was 3.9 ± 1.3 kg ( kg). The mean body surface area was 0.27 ± 0.1 m2. Antegrade selective cerebral perfusion was performed in 23 (42%) g). The mean body patients during the aortic arch reconstruction. g Results.The hospital mortality rate was 1.8% (n = 1). The average duration of artificial circulation was 108.5 ± 38.6 minpital mortality rate was 1.8% (n = 1). The averag utes (from 55 to 204 minutes), aortic clamping time was 56.9 ± 36.4 minutes (from 21 to 126 minutes), the time of selec(from 55 to 204 minutes), aortic clamping time was 56.9 ± 36.4 minutes (from 21 to 126 minutes) tive cerebral perfusion was 26.4 ± 11.5 minutes (14 to 49 minutes). In eight patients (14.5%) the sternum was spread perfusion was 26.4 ± 11.5 minutes (14 to 49 minutes). In eight patients (14.5%) the sternum was sp apart in the early postoperative period. Echocardiography before discharge revealed the average pressure gradient at the part in the early postoperative period. Echocardiograp site of plasticity of the aortic arch of 20.5 ± 14.9 mm Hg. plasticity of the aortic arch of 20.5 ± 14.9 mm Hg. The mean long-term follow-up was 2.6 ± 2.1 years (from two months to 8.1 years). There were no fatal cases in the reg-term follow-up was 2.6 ± 2.1 years (from two months to 8.1 years) mote period. In 5 (9.1%) patients aortic arch restenosis occurred in the postoperative period; it was successfully treated period. In 5 (9.1%) patients aortic arch restenosis occurred in the postoperative period; it was successfully endovascularly by balloon dilation in 3 patients, the other 2 of them underwent repeated aortic arch repair. Long-term y by balloon dilation in 3 patients, the other 2 of them underwent repeated aortic arch repair. Long follow-up of other patients showed good results with respect to the pressure gradient at the aortic arch. There were p of other patients showed good results with respect to the pressure g no hemodynamically significant gradient after VSD closure. There were no neurological complications in the long-term follow-up. p Conclusions. One-stage complete repair is an effective and safe treatment for infants which provides good immedige complete repair is an effective and safe treatment for infants which provides g ate and long-term results. This surgical strategy may be an acceptable alternative to two-stage surgical treatment of this g complex pathology.

scholarly journals A 6-year experience of the Ross procedure in children with congenital aortic valve disease

2020 ◽  
Vol 48 (4) ◽  
pp. 240-245
Author(s):  
D. S. Akatov ◽  
V. A. Belov ◽  
D. E. Khomich ◽  
O. N. Bukhareva ◽  
A. A. Makarov ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Pulmonary Artery ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Ross Procedure ◽  
Optimal Method ◽  
Advantages And Disadvantages ◽  
The Mean

Background: The choice of an optimal method for correction of aortic valve stenosis or insufficiency remains the matter of debate. Some clinicians prefer transluminal balloon angioplasty, some would perform an open type commissurotomy, or aortic valve replacement, or to valve leaflets repair with various materials, while others opt for the Ross procedure. Each of these techniques has its advantages and disadvantages both in the early postoperative period and in the long-term.Aim: To assess the results of the Ross procedure, its complications, survival, and probability of reoperations in the long-term.Materials and methods: We retrospectively analyzed the results of 32 Ross procedures performed from the end of 2012 to the beginning of 2019 in children aged from 3 days to 18 years. Eight children were below 1 year of age, including one newborn. A pulmonary autograft was placed into the aortic position in all children. In 31 children, a homograft was placed into the pulmonary artery. In one patient, an aortic autograft was implanted instead of the pulmonary artery valve. The mean patient age was 6.8 years, mean bodyweight 27.7 kg (range, 3.9–74.6 kg).Results: Two patients died in the early postoperative period (mortality 6.25%). We examined 26 patients at the follow-up, with its mean duration of 2.5 years. There were no indications for replacement of the homograft during the follow-up. One patient, in whom we had implanted an aortic autograft into the pulmonary position, required its replacement after 4.5 years. We have no data on death rates in the long-term.Conclusion: The Ross procedure provides satisfactory results in the early and intermediate postoperative period. Continuous follow-up is needed to determine the time points and the proportion of repeated interventions with a pulmonary homograft and aortic valve.

scholarly journals The Results of Hemivertebra Resection by the Posterior Approach in Children with a Mean Follow-Up of Five Years

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Ramazan Erden Erturer ◽  
Bekir Eray Kilinc ◽  
Bahadir Gokcen ◽  
Sinan Erdogan ◽  
Kursat Kara ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Sagittal Plane ◽  
Operating Time ◽  
Deformity Correction ◽  
Pedicle Screws ◽  
Early Postoperative Period ◽  
X Rays ◽  
Hemivertebra Resection ◽  
The Mean

Aim. To evaluate the radiologic and clinical results of patients who underwent deformity correction and stabilization for congenital spinal deformities using pedicle screws after hemivertebra resection. Material and Method. Nine patients, mean age 9.2, who underwent posterior hemivertebrectomy and transpedicular fixation for congenital spinal deformity and had longer than five years of follow-up were evaluated retrospectively. The hemivertebrae were located in the thoracic region in 4 patients and thoracolumbar transition region in 5 patients. The patients were evaluated radiologically and clinically in the postoperative period. Results. Mean length of follow-up was 64.2 months. The mean operating time was 292 minutes. The mean blood loss was 236 mL. The average hospitalization time was 7 days. The amount of correction on the coronal planes was measured as 31%. The mean segmental kyphosis angle was 45.7 degrees preoperatively and it was measured 2.7 degrees in the follow-up period. There were no statistically significant differences between the early postoperative period and final follow-up X-rays with respect to coronal and sagittal plane deformities. Conclusion. The ability to obtain a sufficient and balanced correction in the cases accompanied by long compensator curvatures that have a structural character in hemivertebra may require longer fusion levels.

Anterior Segment Optical Coherence Tomography–Guided Management Algorithm for Descemet Membrane Detachment After Intraocular Surgery

Cornea ◽  
2015 ◽  
Vol 34 (9) ◽  
pp. 1170-1174 ◽  
Author(s):  
Namrata Sharma ◽  
Sandeep Gupta ◽  
Prafulla Maharana ◽  
Prakash Shanmugam ◽  
Ritu Nagpal ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Segment ◽  
Optical Coherence ◽  
Intraocular Surgery ◽  
Descemet Membrane ◽  
Management Algorithm ◽  
Descemet Membrane Detachment
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