scholarly journals Subconjunctival injections of triamcinolone acetonide to treat uveitic macular edema

2019 ◽  
Author(s):  
Yi Qu ◽  
Xinshu Liu ◽  
Anyi Liang ◽  
Chan Zhao ◽  
Fei Gao ◽  
...  

Abstract Background: To evaluate the efficacy and safety of subconjunctival triamcinolone acetonide (TA) injections for treating uveitic macular edema (UME). Methods: This retrospective case series study included patients with UME who received subconjunctival TA injections with a minimum follow-up period of 6 months. The main outcome was central macular thickness. The secondary outcomes included the best corrected visual acuity, recurrence rate and intraocular pressure. Results: In total, 68 patients (83 eyes) were enrolled in this study. The mean CMT decreased from 456.9 ± 171.1 μm at baseline to 324 ± 175.9 μm, 305.6 μm ± 147.7 μm, 331.8 ± 154.3 μm and 281.1 ± 147.6 μm at 1, 2, 3 and 6 months postinjection, respectively (all P < 0.01). A total of 21/83 eyes exhibited elevated IOPs, which was controlled with topical IOP-lowering agents in 14 eyes, whereas 7 eyes got subconjunctival TA deposit surgically removed. Conclusion: subconjunctival TA injections appear to be safe and effective for UME.Key Words: Triamcinolone acetonide; subconjunctival injection; uveitis; macular edema

2020 ◽  
Author(s):  
Yi Qu ◽  
Xinshu Liu ◽  
Anyi Liang ◽  
Chan Zhao ◽  
Fei Gao ◽  
...  

Abstract Background: To evaluate the efficacy and safety of subconjunctival triamcinolone acetonide (TA) injections for treating uveitic macular edema (UME). Methods: This retrospective case series study included patients with UME who received subconjunctival TA injections with a minimum follow-up period of 6 months. The main outcome measure was central macular thickness. The secondary outcome measures included best corrected visual acuity, recurrence rate and intraocular pressure. Results: In total, 68 patients (83 eyes) were enrolled in this study. The mean CMT decreased from 456.9 ± 171.1 μm at baseline to 324 ± 175.9 μm, 305.6 μm ± 147.7 μm, 331.8 ± 154.3 μm and 281.1 ± 147.6 μm at 1-, 2-, 3- and 6-months post injection, respectively (all P < 0.01). A total of 21/83 eyes exhibited elevated IOPs, of which 14 were controlled with topical IOP-lowering agents and 7 eyes underwent surgical removal of subconjunctival TA deposit. Conclusion: Subconjunctival TA injections appear to be safe and effective for UME.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Hossam M. Moharram ◽  
Shaaban Abd-Elhamid Mehany Elwan ◽  
Mahmoud M. Nassar ◽  
Mohamed F. Abdelkader

Purpose. One of the most difficult refractory glaucomas is the neovascular type (NVG), and its association with dense cataract adds to this difficulty. This study aimed to provide results of the triple surgical procedure for such conditions. Methods. 12 eyes of 12 patients with NVG and dense cataract were included in this case series study. The mean age of patients was 57.25 ± 5.9 years. The mean preoperative intraocular pressure (IOP) was 47.25 ± 4.04 mmHg with maximum antiglaucoma therapy. The mean best corrected distant visual acuity (BCDVA) in LogMAR was 2.13 ± 0.38. All patients received intravitreal injection of 1.25 mg (0.05 ml) bevacizumab followed by phacoemulsification, pars plana vitrectomy (PPV) including panretinal photocoagulation (PRP), and trabeculectomy with mitomycin C (MMC). Mean IOP and BCDVA changes were the main outcome results of this study. Results. The follow-up period was 2 years. The mean BCDVA was improved to 1.22 ± 0.35, 1.13 ± 0.34, 1.12 ± 0.37, 1.06 ± 0.38, and 1.01 ± 0.37 at 1, 3, 6, 12, and 24 months, respectively, after this procedure. This improvement was statistically significant when compared with preoperative BCDVA (P<0.0001). The mean postoperative IOP was dropped to 20.08 ± 4.1, 17.08 ± 2.1, 17.17 ± 5, 15.75 ± 4.7, and 16.17 ± 6.1 mmHg, respectively. At the last follow-up, the mean IOP was statistically significantly lower than preoperative IOP (P<0.0001) at the previously mentioned time points. The success rate was complete in 90.9% of eyes and qualified in 100% of eyes. Iris and angle neovascularization had regressed significantly in all patients, and no serious complications occurred during the follow-up period. Conclusions. This triple surgery can safely improve patients with NVG and dense cataract regarding BCDVA and IOP control. This trial is registered with NCT04143620.


2020 ◽  
pp. 107110072096967
Author(s):  
Carlo Biz ◽  
Alberto Crimì ◽  
Ilaria Fantoni ◽  
Jacopo Tagliapietra ◽  
Pietro Ruggieri

Background: This study was aimed at assessing clinical and radiographic outcomes of the Minimally Invasive Intramedullary Nail Device (MIIND) to correct moderate to severe hallux valgus (HV) and the long-term persistence of its effects. Methods: This case series study involved 100 patients, 84 women and 16 men (mean age, 59 years), who underwent the MIIND procedure with a mean follow-up of 97 months. Assessment was performed preoperatively, postoperatively, at 6 and 12 months, and at last follow-up. Clinical outcomes were evaluated with American Orthopaedic Foot & Ankle Society (AOFAS) scores, visual analog scale (VAS), and patient satisfaction. Intermetatarsal angle (IMA), metatarsophalangeal hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), and tibial sesamoid position were assessed. Statistical analysis was performed. Results: The mean AOFAS score improved from 57.9 to 90.5 points, VAS scale was 1.5 ± 2.0, and patients’ satisfaction was 8.7 ± 1.4. The mean correction of the HVA and IMA showed a significant correction; however, the effect of time was not statistically significant on DMAA. Sex ( P = .047), severity ( P = .050), associated procedures ( P = .000), and preoperative angle ( P = .000) showed significant association with HVA correction and its persistence over time. Age was not statistically significant. Complications were 9 cases of superficial wound infection and 6 recurrences. Conclusions: The MIIND technique proved a viable procedure to correct moderate to severe HV with a low rate of complications and recurrence, producing significant correction of most radiographic parameters assessed and their persistence, even at long term. Level of Evidence: Level IV, case series study.


2014 ◽  
Vol 40 (9) ◽  
pp. 957-960 ◽  
Author(s):  
A. Citlak ◽  
U. Akgun ◽  
T. Bulut ◽  
M. Tahta ◽  
B. Dirim Mete ◽  
...  

The purpose of this study was to report our experience of partial capitate shortening in seven patients with a median 38 months follow-up. Staging was made by the Lichtman classification system and stage II and III-A patients were included in the study. The mean age was 34 years (range 22–52). Patients were assessed for pain, range of motion, grip and pinch strength, and satisfaction was recorded using a scale between 0 and 4. All these parameters showed improvement after surgery. The Lichtman stage, lunate height index and carpal height index were determined radiographically. Magnetic resonance images of the wrist were studied for lunate revascularization at the final follow-up and occurred in all patients. According to our study, partial capitate shortening seems an effective treatment for Lichtman stage II and III-A patients. Level IV case series study.


Author(s):  
Ahmed Mourad ◽  
Hussein Jaffal ◽  
Ismaeel El-Hakim ◽  
Hamdy El-Hakim

Abstract Background Inferior turbinoplasty (IT) and adenoidectomy (Ad) are frequently resorted to in children with chronic rhinitis (CR) refractory to medical therapy. The aim of this study is to document the long-term improvement in quality of life (QOL) in children with CR following endoscopic IT with or without Ad. Methods A retrospective case series study was conducted. We searched a prospectively kept surgical database for children ≤18 years old who had CR who underwent endoscopic IT with or without Ad between 2009 and 2016 at a tertiary care children’s center. Patients with sinonasal pathologies other than CR, had craniofacial syndromes or dysmorphism and had other sinonasal procedures or trauma were excluded. Collected data included demographics, secondary diagnoses, duration of follow-up, and complications of procedures. The Glasgow Children’s Benefit Inventory (GCBI) was administered by phone to assess QOL improvement. Results One hundred sixty-five eligible subjects were identified. Eighty-nine subjects met the inclusion criteria. Data was collected for the 60 subjects that were reached. Forty-two patients had IT only while 18 had IT and Ad. The mean age was 10.7 ± 2.7 years, with 31 males and 29 females. The median duration of follow-up (25th, 75th percentile) was 38.1 months (24.6, 55.8). The median GCBI score (25th, 75th percentile) was 22.9 (6.3, 39.6) revealing an overall positive benefit in all domains. There was only one complication. Conclusions This study validates prior findings regarding improvement of QOL and safety of IT with or without Ad for children with CR and indicates it is maintained in the long term.


2018 ◽  
Vol 46 (9) ◽  
pp. 3819-3823 ◽  
Author(s):  
Abdulwahid M. Salih

Objective To investigate the prevalence of hypothyroidism following thyroid lobectomy with isthmus preservation. Methods This retrospective, case series study included patients who had undergone thyroid lobectomy with preserved isthmus that was reversed onto the contralateral lobe. Neck ultrasound was performed in all patients and the patients were followed for 2 years. Results Out of 170 patients enrolled into the study, three were excluded due to preoperative hypothyroidism and one due to isthmusectomy; of the remaining 166 included in the final analyses, 139 patients (83.7%) were female, 27 (16.3%) were male, and patient age ranged between 17 and 77 years. The indication for intervention was thyroid swelling in 141 patients (84.9%). Final diagnoses following histopathological examination comprised benign lesion in 145 cases (87.3%), malignancy (follicular carcinoma and papillary thyroid carcinoma) in 12 cases (7.2%) and thyroiditis in nine cases (5.4%). During the 2-year post-surgery follow-up, 165 patients (99.4%) were euthyroid and one patient (0.6%) developed hypothyroidism. Conclusion Postoperative hypothyroidism following thyroid lobectomy appears to be very rare when the isthmus is preserved and reversed onto the contralateral lobe.


2020 ◽  
Vol 09 (03) ◽  
pp. 225-229
Author(s):  
Kevin Eng ◽  
Stephen Gill ◽  
Simon Hoy ◽  
Vivek Shridar ◽  
Natasha Van Zyl ◽  
...  

Abstract Background The volar scaphoid plate from Medartis (Medartis AG, Austrasse, Basel, Switzerland) is a variable angle titanium locking plate, preformed for the volar aspect of the scaphoid. It does not have compressive capability, and may act as a bridging device. It may provide an advantage over a compression screw where the pathoanatomy is less favorable to such a device with increased rotational stability. It may act as a buttress plate for correction of humpback deformity for example. It has been used in nonunions and with vascularized grafts. Questions Our study aims to assess the results of our patients with scaphoid nonunion treated with scaphoid volar plating over a larger number of patients. We aim to identify techniques to increase the success of plating. Methods Patients from our cohort were retrospectively reviewed. Operations were performed by three hand fellowship trained surgeons and in two centers. Inclusion involved a scaphoid plate procedure for a nonunion of the scaphoid with a minimum of 6 months of follow-up. Exclusions were those who had less than 6 months of follow-up. Data included demographics, patient-rated wrist evaluation (PRWE), a quick disabilities of the arm, shoulder, and hand (qDASH), visual analogue score, and range and grip. Radiology was reviewed. Results Thirty-two eligible patients were assessed. The mean age was 25 years (range 13–46), 2 were female and 15 were smokers. Mean follow-up postsurgery was 18 months. Twenty-nine of 32 patients united (90.6%) on computed tomography scan. Clinical assessment was performed in the 25 patients. The mean qDASH score was 12.5 (range 0–42) and mean PRWE was 11 (range 0–54). The mean arc of motion was 115 degrees. The mean grip strength was 39 kg compared with 41 kg on the nonoperated side. Conclusion We postulate that the plate acts like an internal bridging device, acting over a small distance, and inherent stability of the construct with structural graft and accurate reduction prior to plating is advantageous. Potential problems include plate impingement on the volar lip of the radius, particularly when trying to plate more proximal fractures. Ideally, it is utilized for mid to distal waist fractures.


2021 ◽  
Vol 12 (1) ◽  
pp. 217
Author(s):  
Pietro Gentile ◽  
Simone Garcovich ◽  
Soo-Ik Lee ◽  
Sangbum Han

A new biotechnology based on micro-needling (MND) with low-level light/laser therapy (LLLT) that is used for hair re-growth (HR-G) needs to be standardized. The study aims to report the clinical outcomes resulting from a multicentric, retrospective, observational, case-series study in which MND with LLLT was used on patients affected by androgenic alopecia (AGA). Twenty-six patients were initially enrolled of which 15 males were classified as stages I–III of vertex by the Norwood–Hamilton scale, and 11 females was classified in stages I–II by the Ludwig scale. Twenty patients (10 females and 10 males) were analyzed after their screening (the exclusion and inclusion criteria evaluation). The HR-G assessment was evaluated with photography, as well as the physician’s and patient’s global assessment scales, in addition to standardized phototrichograms, during a short follow-up at T0-baseline, T1-16 weeks. Encouraging results represented by a hair density increase of 12 ± 2 hairs/cm2 at T1 after 16 weeks (16 weeks vs. 0 weeks) in the targeted area, compared with the baseline results (59 ± 2 hairs/cm2 at T1 versus 47 ± 2 hairs/cm2 at baseline), were observed using computerized trichograms with a statistically significant difference in hair re-growth (p = 0.0238). The effectiveness of MND with LLLT use has been demonstrated in mild to moderate AGA patients.


2021 ◽  
Author(s):  
Walid Allam ◽  
Ahmed Roshdy Alagorie ◽  
Mohammed Nasef ◽  
Molham El-Bakary

Abstract Purpose To study the safety and efficacy of pterygium extended removal followed by extended conjunctival transplant for recurrent pterygia. Methods Thirty-three eyes of 33 subjects with recurrent pterygia were enrolled in this prospective case series study. Pterygium extended removal followed by extended conjunctival transplantation was done for all subjects. One surgeon (WA) performed all surgeries. All subjects completed follow-up for at least 12 months and were evaluated for recurrence and complications. Results The mean age of the participants was 41.2 ± 10.3 years (range 22–60), 7 females (21.2%). The mean duration of follow-up was 25.64 ± 9.24 months (range 12–43). Corrected distance visual acuity (decimal notation) improved from 0.69 ± 0.22 (range 0.2–1.0) at presentation to a 1-year postoperative value of 0.83 ± 0.2 (range 0.3–1.0). No recurrence was reported in all subjects throughout the follow-up period. Transient graft swelling was recorded in 14 cases (42.4%) and resolved in all cases by the first week. All patients developed variable degrees of transient postoperative diplopia that resolved completely by the first 6 weeks. Donor site granuloma developed in 4 cases (12.1%). Spontaneous resolution was observed in 3 cases, while in one case, surgical excision was performed 2 months after the procedure. Conclusions In this study of eyes with recurrent pterygia, pterygium extended removal followed by extended conjunctival transplant was found safe and effective with no recurrence and minimal postoperative complications.


Author(s):  
Marco Tallarico ◽  
Aurea Immacolata Lumbau ◽  
Silvio Mario Meloni ◽  
Irene Ieria ◽  
Chang-Joo Park ◽  
...  

Aim: the purpose of the present prospective, case series study were to report implant survival rate and marginal bone remodeling expected five years after loading using dental implants placed in in the daily practice. Material and Methods: this research was designed as an open-cohort, prospective case series study. Any completely or partially edentulous patients scheduled to receive at least one bone leve were considered eligible for this study. Primary outcomes were: cumulative implant (ISR) and prosthetic (PSR) survival rates, and any complications experienced up the five years follow-up. Secondary outcomes were: marginal bone remodeling, implant insertion torque, implant stability quotient (ISQ), and thickness of gingival biotype. Results: ninety consecutive patients (34 males and 56 females; mean age 53.2&plusmn;15.4 years; range of 24&ndash;81 years), 243 implants were placed and followed for at least five years after loading (mean of 65.4&plusmn;3.1 months; range of 60&ndash;72 months). The mean implant insertion torque was 42.9&plusmn;4.8 Ncm (range from 15 to 45 Ncm). Overall, 83.5% of the implants (n=203) were placed with an insertion torque between 35 and 45 Ncm. At the one year follow-up, no drop-outs were recorded, but 17 patients (18.9%) with 18 restorations (12.6%) delivered on 34 implants (14%) were lost at the five years examination. At the five-year examination, six implants failed in six patients, resulting in a cumulative ISR of 97.5%. At the five-year follow-up, four prostheses failed (2.8%) resulting in a cumulative PSR of 97.2%. At the five-year examination, five complications were reported by five different patients, resulting in a prosthetic success rate of 96.5%, measured at patient level. Five years after loading, mean MBL was 0.41 &plusmn; 0.30 mm (95% CI: 0.26&ndash;0.34). Difference from the one year data was 0.04 &plusmn; 0.19 mm (95% CI: 0.01&ndash;0.07). The mean ISQ value at implant placement was 71.6 &plusmn; 5.5 (range of 45&ndash;88). Six months later, the mean ISQ was 76.7 &plusmn; 4.4 (range of 66&ndash;89). The difference was statistically significant (P=0.0001). Statistically significant higher MBL was found for smokers, and patient with thin gingival biotype. Conclusions: High implant survival and success rates could be expected with stable marginal bone remodeling up to five years after loading. Smoking and thin tissue biotype were the most important variabilities associated with higher MBL. Further research are needed to confirm these results.


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