Surgical correction of recurrent epiblepharon in Chinese children using modified skin re-draping epicanthoplasty

AIM: To evaluate the clinical efficacy of the modified skin re-draping epicanthoplasty procedure for correction of recurrent lower lid epiblepharon in Chinese children. METHODS: From 2016 to 2018, 18 children (10 males and 8 females, average age 6.2±1.7y; 30 eyes) with recurrent epiblepharon who attended Beijing Children’s Hospital were included in the study. All the children had undergone lower eyelid surgery for epiblepharon. Surgical design included using an additional incision along the upper palpebral margin, to avoid vertical scarring on the upper lid. The re-draping method was used to correct recurrent epiblepharon. Follow-up ranged from 3 to 24mo. Postoperative surgical outcomes, complications, and subjective satisfaction were evaluated. RESULTS: Complete correction of cilia touching the cornea was observed in all patients during an average follow-up of 7.1mo. No “dog ears” or obvious scars were formed after surgery. All parents were satisfied with the cosmetic results and none complained. Mean astigmatism decreased from 2.39±0.79 diopter (D) preoperatively to 2.19±0.79 D at 6mo after surgery; however, the difference was not significant. Best-corrected visual acuity improved, although the change in mean visual acuity was not significant. No recurrence occurred during the follow-up period. CONCLUSION: This surgical modified skin re-draping technique is effective and highly satisfactory for correction of recurrent epiblepharon. The approach is characterized by a simple design, a straightforward procedure, inconspicuous scarring, and good postoperative appearance.

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The effect of amblyopia on clinical outcomes of children with astigmatism

Therapeutic Advances in Ophthalmology ◽

10.1177/25158414211040898 ◽

2021 ◽

Vol 13 ◽

pp. 251584142110408

Author(s):

Burçin Çakır ◽

Nilgün Özkan Aksoy ◽

Sedat Özmen ◽

Özlem Bursalı

Keyword(s):

Visual Acuity ◽

Clinical Outcomes ◽

Medical Records ◽

Convergence Insufficiency ◽

Corrected Visual Acuity ◽

Ocular Deviation ◽

The Mean ◽

The Difference ◽

Best Corrected Visual Acuity

Background: Amblyopia is more common in children with high astigmatism, but factors contributing to development of amblyopia and visual outcomes are not fully understood. Objective: To evaluate the effect of amblyopia on the clinical outcomes in children with ⩾1.75 diopter (D) astigmatism. Methods: We reviewed the medical records of children with ⩾1.75 D astigmatism with and without amblyopia (amblyopes group and non-amblyopes group). The mean age, gender, amount and type of ocular deviation, presence of convergence insufficiency (CI), stereopsis, time of initial spectacle use and follow-up time, differences in best-corrected visual acuity (VoD) and spherical equivalent (SE) between eyes were assessed and compared between the groups. Best-corrected visual acuity (BCVA), mean SE, astigmatism measurements were assessed and compared between amblyopic, fellow, and non-amblyopic eyes. Results: The records included 68 eyes of 34 children with amblyopia and 56 eyes of 28 children without amblyopia. The mean age, gender, amount and type of ocular deviation, presence of CI, stereopsis, time of initial spectacle use, follow-up time, and the difference in SE did not differ between groups. In amblyopes, exodeviation was more common and statistically greater in near (33 cm) than at distance (6 m) (p = 0.005). The mean BCVA and astigmatism values were statistically different between amblyopic, fellow, and non-amblyopic eyes. Conclusion: A greater near than distance exodeviation and higher mean astigmatism value were found in amblyopic children with astigmatism.

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The efficacy of intravitreal conbercept for chronic central serous chorioretinopathy: a retrospective clinical study

10.21203/rs.2.232/v1 ◽

2019 ◽

Author(s):

Jianbo Mao ◽

Caiyun Zhang ◽

Chenyi Liu ◽

Lijun Shen ◽

Jimeng Lao ◽

...

Keyword(s):

Visual Acuity ◽

Clinical Study ◽

Central Serous Chorioretinopathy ◽

Central Macular Thickness ◽

Chronic Central Serous Chorioretinopathy ◽

Corrected Visual Acuity ◽

Retrospective Clinical Study ◽

The Difference ◽

Best Corrected Visual Acuity

Abstract Background: To evaluate the efficacy and safety of conbercept for patients with chronic central serous chorioretinopathy (CSC). Methods: A retrospective clinical study. This study included twenty-seven patients (32 eyes) who were diagnosed with chronic CSC in our hospital from November 2015 to March 2018. All the patients received intravitreal conbercept with one intravitreal injection and pro re nata (PRN). Follow-up observations occurred at 1 week and 1, 2, 3, and 6 months after initial injection. Observed indicators included best-corrected visual acuity (BCVA), central macular thickness (CMT) and presence of subretinal fluid (SRF). Results: During the 6-month follow-up, the mean number of injections required and performed was 1.50±0.67. The BCVA at the first visit, 1-week, 1-, 2-, 3- and 6-month follow-ups after the first injection was 0.44±0.26, 0.39±0.29, 0.38±0.29, 0.33±0.29, 0.31±0.30, and 0.31±0.29, respectively. The difference between the BCVA at each follow-up and the first visit was statistically significant (F=9.717, P<0.05). CMT at the first visit, 1-week, 1-, 2-, 3- and 6- month after first injection was 323.25±158.49μm, 263.78±122.52μm, 222.34±92.46μm, 195.63±69.18μm, 189.25±68.71μm, and 200.47±86.30μm, respectively. The difference between the CMT at each follow-up and the first visit was also statistically significant (F=17.072, P<0.05). Full resolution of fluid was achieved in 7 (21.9%) eyes at 1 month, 14 (43.8%) eyes at 2 months, 19 (59.4%) eyes at 3 months and 23 (71.9%) eyes at 6 months after the initial treatment of anti-VEGF injection. No severe adverse event was noted relevant to the therapy. Conclusion: Intravitreal injection of conbercept can effectively reduce the CMT and improve the BCVA in chronic CSC in a short term of 6 months. Keywords: Chronic central serous chorioretinopathy, Conbercept, Best-corrected visual acuity, Central macular thickness.

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Comparative study on corneal cross-linking with isotonic and hypotonic riboflavin: can hypotonic riboflavin be applied in thinner corneas?

International Eye Research ◽

10.18240/ier.2021.01.03 ◽

2021 ◽

Vol 2 (1) ◽

pp. 14-19

Author(s):

Ana Sofia Lopes ◽

◽

Susana Henriques ◽

Peter Pêgo ◽

Cristina Vendrell ◽

...

Keyword(s):

Visual Acuity ◽

Retrospective Study ◽

Comparative Study ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Cross Linking ◽

Corrected Visual Acuity ◽

The Difference ◽

Best Corrected Visual Acuity

AIM: To compare the results of corneal cross-linking (CXL) with isotonic (IR) and hypotonic riboflavin (HR) in patients with keratoconus and to verify the efficacy of keratoconus in thinner corneas. METHODS: Retrospective study of 29 eyes/keratoconus patients submitted to CXL, 15 eyes with application of IR (IR group) and 14 eyes with application of HR (HR group). The parameters analysed included (1-year follow-up): best corrected visual acuity (BCVA), sphere and cylinder, central and finer pachymetry, mean and maximum keratometry (Km and Kmax respectively), complications and progression. RESULTS: An increase on the BCVA scale (logMAR, logarithm of the minimal angle of resolution) was observed in the two groups: 0.26±0.57 (IR) and 0.47±0.72 (HR) before treatment, and 0.13±0.79 (IR) and 0.29±1.52 (HR) at the 1y. Only at 1y, the difference was statistically significant (P=0.018, group IR with higher BCVA). The central pachymetry (μm) decreased at 1mo in both groups, and increased in the following months: 497±28 μm (IR) and 432±14 μm (HR) before treatment, and 480±31 μm (IR) and 424±15 μm (HR) to the 1y. The thinner pachymetry (μm) presented the same evolution: 487±29 μm (IR) and 410±20 μm (HR) before treatment, and 468±33 μm (IR) and 413±13μm (HR) at 1y. Km and Kmax decreased in both groups (P>0.05). Six eyes from each group presented transitory haze. No eye progressed to the 1y. CONCLUSION: The use of hypotonic riboflavin seems to be a valid alternative for performing the traditional corneal cross-linking technique in eyes with a central corneal thickness of <400 μm.

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Comparison of the Effectiveness of Intravitreal Ranibizumab for Diabetic Macular Edema in Vitrectomized and Nonvitrectomized Eyes

Ophthalmologica ◽

10.1159/000446992 ◽

2016 ◽

Vol 236 (2) ◽

pp. 67-73 ◽

Cited By ~ 5

Author(s):

Yoshito Koyanagi ◽

Shigeo Yoshida ◽

Yoshiyuki Kobayashi ◽

Yuki Kubo ◽

Muneo Yamaguchi ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Treatment Option ◽

Central Macular Thickness ◽

Intravitreal Ranibizumab ◽

Corrected Visual Acuity ◽

The Mean ◽

The Difference ◽

Best Corrected Visual Acuity

Purpose: To compare the effectiveness of intravitreal ranibizumab (IVR) for diabetic macular edema (DME) between eyes with and without previous vitrectomy. Procedures: We prospectively assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) after IVR for 6 months. Results: There were no significant differences in the baseline BCVA and CMT between both groups. In the nonvitrectomized group (n = 15), the mean changes of BCVA and CMT from baseline to month 6 were significant (p < 0.01). In the vitrectomized group (n = 10), the improvement appeared to be slower, and the mean BCVA improvement was not significant (p = 0.5), although the mean CMT decrease was significant (p < 0.05). There were no significant differences in the mean changes of BCVA and CMT between both groups at 6 months. Conclusions: The difference in the effectiveness of IVR between both groups was not significant. IVR can be a treatment option even for vitrectomized DME eyes.

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Corneal densitometry in patients with keratoconus undergoing intrastromal Ferrara ring implantation

European Journal of Ophthalmology ◽

10.1177/11206721211020631 ◽

2021 ◽

pp. 112067212110206

Author(s):

Pablo Felipe Rodrigues ◽

Bernardo Kaplan Moscovici ◽

Guilherme Ferrara ◽

Luciano Lamazales ◽

Marcela Mara Silva Freitas ◽

...

Keyword(s):

Visual Acuity ◽

Medical Records ◽

Spherical Equivalent ◽

Interventional Study ◽

Data Comparison ◽

Corneal Densitometry ◽

Corrected Visual Acuity ◽

Ring Segment ◽

The Mean

Objective: Evaluation of central corneal densitometry changes following Ferrara corneal ring segment implantation in patients with keratoconus, especially the correlation between corneal densitometry and keratometry. Methods: Retrospective, non-comparative, interventional study based on the review of medical records of patients diagnosed with keratoconus who underwent Ferrara corneal ring segment implantation. Pre and post-operative corneal densitometry measurements obtained with Pentacam HR (Oculus, Wetzlar, Germany) were analyzed. The follow-up time was 3 months, and data comparison was made, using specific statistical analysis, with the data of 3 months postoperatively. Results: The study sample consisted of 43 eyes of 36 patients. The mean corrected visual acuity improved from 0.82 LogMAR preoperatively (SD ± 0.33) to 0.19 LogMAR (SD ± 0.13) postoperatively. The mean spherical equivalent varied from −4.63 (SD ± 3.94) preoperatively to −2.16 (SD ± 2.63) postoperatively. Asphericity varied from −0.69 (SD ± 0.32) preoperatively to −0.27 (SD ± 0.31) postoperatively. The mean maximum K was 54.01D (SD ± 3.38) preoperatively and 51.50D (SD ± 2.90) postoperatively. The mean anterior densitometric value was 18.26 (SD ± 2.03) preoperatively and 17.66 (SD ± 1.84) postoperatively. Conclusion: Corneal densitometry is an interesting technology that should be studied in keratoconus patients. Our results suggest that the corneal densitometry in the cornea’s anterior layer reduces after ICRS implantation and correlates with corneal keratometry. Further studies should be performed to increase the knowledge in this field.

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Effect of phacoemulsification with intraocular lens implantation in eyes with cataract and functioning filtering blebs

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v13i2.44 ◽

2013 ◽

Vol 13 (2) ◽

pp. 33-41

Author(s):

Devendra Maheshwari ◽

Rengappa Ramakrishanan ◽

Mohideen Abdul Kader ◽

Neelam Pawar ◽

Ankit Gupta

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Intraocular Lens ◽

Intraocular Lens Implantation ◽

Corrected Visual Acuity ◽

Lens Implantation ◽

The Mean ◽

One Year ◽

Best Corrected Visual Acuity

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p < 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.

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Cataract Surgery and Uveitis

Annals of King Edward Medical University ◽

10.21649/akemu.v9i3.1332 ◽

2016 ◽

Vol 9 (3) ◽

Author(s):

Mumtaz Hussain ◽

Muhammad Moin ◽

Nazir Ahmad Aasi ◽

Muhammad Waqas ◽

Jawaid Mughal

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

General Hospital ◽

Cataract Extraction ◽

Extracapsular Cataract Extraction ◽

Iol Implantation ◽

Corrected Visual Acuity ◽

Best Corrected Visual Acuity

The study of 30 patients was performed at Lahore General Hospital, and Institute Of Ophthalmology Mayo Hospital, Lahore from June 1989 to June 2003 for 14 years. Total number of eyes were 34 where 2 patients had both eyes. Age ranged from 12-65 years. Males were 11 and females were 19. all the patients had planned extracapsular cataract extraction with IOL implantation. Total follow up period ranged from 1-5 years and best corrected visual acuity in these patients after surgery was 6/12 to 6/6. Post operatively, eyes had vitreous membranes and glaucomatous reaction.

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Femtosecond laser-assisted deep anterior lamellar keratoplasty: A safer option in keratoconus surgery

European Journal of Ophthalmology ◽

10.1177/11206721211059023 ◽

2021 ◽

pp. 112067212110590

Author(s):

Cristina Monterosso ◽

Marco Antonini ◽

Antonio Di Zazzo ◽

Daniele Gaudenzi ◽

Luigi Caretti ◽

...

Keyword(s):

Visual Acuity ◽

Femtosecond Laser ◽

Lamellar Keratoplasty ◽

Deep Anterior Lamellar Keratoplasty ◽

Persistent Epithelial Defect ◽

Corrected Visual Acuity ◽

Anterior Lamellar Keratoplasty ◽

Best Corrected Visual Acuity ◽

Persistent Epithelial Defects

Purpose To evaluate postoperative safety of femtosecond laser deep anterior lamellar keratoplasty performed with an innovative anvil profile in keratoconus patients. Methods This is a single-center, retrospective cohort study. We reviewed medical records of 89 keratoconus patients that underwent femtosecond laser deep anterior lamellar keratoplasty surgery (46 eyes) and manual deep anterior lamellar keratoplasty (47 eyes). Inclusion criteria required: age > 18 years old, best-corrected visual acuity < 0.3 LogMAR, continuous suture of the graft, postoperative immunomodulant regimen with dexamethasone 0.1% for 6 months and at least 12 months follow-up. Previous eye surgery, hydrops, and other ocular disease were excluded. The main outcome measures were postoperative events: rejections, persistent epithelial defects, and graft failures. Results During the follow-up (20 ± 6 months) graft rejection was diagnosed in 0 of femtosecond laser deep anterior lamellar keratoplasty versus 6 (17%) of manual deep anterior lamellar keratoplasty [ p 0.027], persistent epithelial defect in 0 of femtosecond laser deep anterior lamellar keratoplasty versus in 4 (11%) of manual deep anterior lamellar keratoplasty [ p 0.048] and graft failure occurred in 4 (11%) of manual deep anterior lamellar keratoplasty. The best-corrected visual acuity, after removal of sutures, was better in the femtosecond laser deep anterior lamellar keratoplasty group 0.09 ± 0.08 LogMAR versus 0.16 ± 0.13 LogMAR in manual deep anterior lamellar keratoplasty [ p 0.035] group although refractive spherical equivalent and cylinder, topographic average keratometry and cylinder were similar. Conclusions Anvil-shaped femtosecond laser deep anterior lamellar keratoplasty in keratoconus surgery increases safety and readiness of recovery, decreasing the incidence of corneal rejection, epithelial defects, graft failures, and producing better best-corrected visual acuity after removal of sutures.

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Correction of refractive disorders in the surgical treatment of keratoconus by MyoRing implantation

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-5-188-191 ◽

2021 ◽

pp. 188-191

Author(s):

S.V. Milova ◽

◽

A. Daxer ◽

Keyword(s):

Visual Acuity ◽

Surgical Treatment ◽

Key Words ◽

Corneal Stroma ◽

Degenerative Disease ◽

Corrected Visual Acuity ◽

Corneal Deformation ◽

Biomechanical Strength ◽

Observation Period

Keratoconus is a progressive degenerative disease in which, due to the weakening of the biomechanical strength of the cornea, its cone-shaped deformation occurs, leading to the development of induced myopia and astigmatism, as well as to a decrease in corrected visual acuity. Treatment of this disease consists in achieving stabilization of the process by strengthening the structure of the cornea, as well as in correcting refractive disorders caused by corneal deformation. Purpose. The purpose is to evaluate the effectiveness of correction of refractive disorders by implanting a closed MyoRing ring in the corneal stroma of patients with keratoconus. Material and methods. The data of 98 MyoRing implantation operations using CISIS technology using the PoketMaker ultraceratom for stage 3-4 keratoconus were analyzed. The observation period is up to 9 years. The initial myopia averaged -9.23 D ±3.82, astigmatism-6.13 ±2.51. Results. Stabilization of the refractive effect occurred usually within 3-6 months after surgery. On average, the following correction of refractive disorders was achieved: myopia-8.14 D ± 2.67 and astigmatism-4.28 D ± 2.12. Keratometry indicators also in most cases stabilized within 3-6 months after surgery and remained unchanged throughout the entire follow-up period. Conclusions. Implantation of a closed MyoRing ring in keratoconus makes it possible to significantly correct refractive disorders and prevents further progression of the disease. Key words: keratoconus, MyoRing, SISI, ring implantation in keratoconus.

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Comparison of aflibercept and ranibizumab in diabetic macular edema associated with subretinal detachment

European Journal of Ophthalmology ◽

10.1177/1120672119827855 ◽

2019 ◽

Vol 30 (2) ◽

pp. 363-369 ◽

Cited By ~ 1

Author(s):

Abdullah Ozkaya ◽

Gokhan Demir ◽

Asli Kirmaci

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Secondary Outcome ◽

Intravitreal Ranibizumab ◽

Corrected Visual Acuity ◽

Intravitreal Aflibercept ◽

Best Corrected Visual Acuity

Purpose: To compare the efficacy of ranibizumab and aflibercept in the treatment of diabetic macular edema associated with subfoveal retinal detachment. Methods: This is a retrospective, comparative study. The treatment-naïve diabetic macular edema patients who had diabetic macular edema associated with subfoveal retinal detachment and underwent intravitreal aflibercept or intravitreal ranibizumab treatment were included. The patients were treated on a pro re nata treatment regimen after a loading dose of 3-monthly injections and the follow-up time was 12 months. The primary outcome measure of this study was the presence of subfoveal retinal detachment after treatment at different time points. The secondary outcome measures were the change in best corrected visual acuity and central retinal thickness. Results: A total of 46 eyes of 46 patients were included. The aflibercept group consisted of 20 and the ranibizumab group consisted of 26 eyes. During the follow-up period of 12 months, subfoveal retinal detachment was completely resolved in 75% versus 57.7% of the eyes at month 3 (p = 0.2), 90% versus 76.9% at month 6 (p = 0.2), 90% versus 65.4% at month 9 (p = 0.05), and 100% versus 80.8% at month 12 (p = 0.03) in the intravitreal aflibercept versus intravitreal ranibizumab groups. The change in best corrected visual acuity was not statistically different between the groups at months 3, 6, 9, and 12, respectively (p > 0.05 for all). Conclusion: Both intravitreal aflibercept and intravitreal ranibizumab were effective in regards to anatomical and functional outcomes of diabetic macular edema patients associated with subfoveal retinal detachment. Interestingly, intravitreal aflibercept seemed more effective than intravitreal ranibizumab in the resolution of subfoveal retinal detachment at month 12.

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