scholarly journals Phacoemulsification Without Hydro-procedure: A Novel Technique to Deal with Posterior Polar Cataracts.

2021 ◽  
Author(s):  
Narayan Bardoloi ◽  
Sandip Sarkar ◽  
Himanshu Das ◽  
Pankaj Suresh Burgute
Keyword(s):  
Visual Acuity ◽  
Retrospective Study ◽  
Visual Outcome ◽  
Postoperative Outcomes ◽  
Novel Technique ◽  
Corrected Visual Acuity ◽  
Study Population ◽  
The Mean ◽  
Best Corrected Visual Acuity ◽  
Posterior Polar Cataract

Abstract Purpose: To describe a new phacoemulsification technique without hydro-procedures in patients of posterior polar cataract (PPC) and determine the posterior capsular rate (PCR) and postoperative outcomes.Methods: After capsulorhexis, we insert the phacoemulsification probe inside the eye and shave the cortex and epinucleus within the capsulorhexis area. Then the phaco probe is buried deep into the center, and an anteroposterior crack is fashioned. Then the probe is placed at 7’ o clock to chop away a triangular piece of the nucleus. A similar maneuver is done at a 4' o clock position to take out another piece. The phacoemulsification tip and the chopper are now positioned at the cracked site of the lower fragments. Using the 2 instruments, the fragments are now pushed away and easily emulsified.Results: We conducted a retrospective study with 115 eyes of 77 patients. The mean age of the study population was 51.87 + 14.19 years (range 22-87 years). Out of 77 patients, 39 (50.64%) patients had unilateral PPC, and 38 (49.35%) had bilateral PPC. PCR occurred in 9 eyes (7.82%). Two patients had fragment drop, and only 1 (0.87%) patient was left aphakic. Best-corrected visual acuity (BCVA) at postoperative day 30 was 20/20 or better in 102 (88.69%) eyes, 20/32-20/80 was in 11(9.56%) eyes, and BCVA 20/80-20/200 was in 2 (1.73%) eyes.Conclusion: Phacoemulsification without hydro-procedure is a novel technique that can be successfully implemented in PPC cases and expect an excellent visual outcome.

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

2016 ◽  
Vol 236 (2) ◽  
pp. 67-73 ◽  
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.

Detecting subclinical keratoconus by biomechanical analysis in tomographically regular keratoconus fellow eyes

2021 ◽  
pp. 112067212110637
Author(s):  
Victor A Augustin ◽  
Hyeck-Soo Son ◽  
Isabella Baur ◽  
Ling Zhao ◽  
Gerd U Auffarth ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Case Series ◽  
Biomechanical Analysis ◽  
Corvis St ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Best Corrected Visual Acuity ◽  
Fellow Eyes

Purpose To analyze the tomographically non-affected second eyes of keratoconus patients using the Corvis ST to detect any biomechanical abnormalities or subclinical keratoconus. Methods In this retrospective, single-center, consecutive case series 244 eyes of 122 keratoconus patients were analyzed between November 2020 and February 2021. Fourteen fellow eyes fulfilled the inclusion criteria and showed no clinical or tomographic signs of keratoconus. Main outcome measures included best-corrected visual acuity, tomographic and biomechanical analyses using Scheimpflug imaging: Pentacam and Corvis ST (Oculus, Wetzlar, Germany). Tomographic analyses included anterior and posterior simulated keratometry, K-Max, central corneal thickness, thinnest corneal thickness, Belin/Ambrosio Ectasia Display, and the ABCD grading system. For biomechanical analyses, the corneal biomechanical index (CBI) and tomographic biomechanical index were used. Results The mean best-corrected visual acuity was 0.01 ± 0.10 logMAR. Mean K-Max was 43.79 ± 1.12 D, mean central corneal thickness 529 ± 25 µm, mean thinnest corneal thickness 524 ± 23 µm, and mean Belin/Ambrosio Ectasia Display 1.0 ± 0.32. The mean CBI was 0.30 ± 0.21. Regular CBI values were found in six of 14 patients. The mean tomographic biomechanical index was 0.47 ± 0.22 with regular values observed in only two of 14 patients. No signs of tomographic or biomechanical abnormalities were shown in only one of 14 keratoconus fellow eyes, with regular ABCD, Belin/Ambrosio Ectasia Display, CBI and tomographic biomechanical index values. Conclusions Tomographically normal fellow eyes of keratoconus patients are rare. In these cases, a biomechanical analysis of the cornea may help detect a subclinical keratoconus. The tomographic biomechanical index was the most sensitive index to verify a mild ectasia.

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

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.

scholarly journals The effect of amblyopia on clinical outcomes of children with astigmatism

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.

scholarly journals Efficacy of Burst Mode Torsional Phacoemulsification in Age-Related Cataract

2020 ◽  
Vol 15 (1) ◽  
pp. 94-97
Author(s):  
Md Abdullah Al Masum ◽  
Md Kamrul Hasan Khan ◽  
Zulfikar Hasan ◽  
Natasha Kajmina
Keyword(s):  
Visual Acuity ◽  
Visual Outcome ◽  
Posterior Capsule ◽  
Burst Mode ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Corneal Wound ◽  
Descemet's Membrane ◽  
Descemet’S Membrane ◽  
Best Corrected Visual Acuity

Introduction: Torsional ultrasound energy and burst mode interrupted energy delivery system are recent advancementsin the technique of phacoemulsification surgery. It has been reported that both these advancementshelpto reduce corneal wound burn and thermal induced endothelial cell loss and thereby helps to achieve excellent early postoperative visual outcome Objectives: To evaluate the efficacy of burst mode torsional phacoemulsification surgery in age-related cataract. Materials and Methods: Prospective observational study of 120 cases that underwent phacoemulsificationcataract surgery in which torsional energy was used in burst mode. Phacoemulsification was performed by “vertical –chop” technique. Intraoperatively corneal wound burn, Descemet’s membrane detachment, posterior capsule ruptureetc.were evaluated. Postoperatively corneal oedema, best corrected visual acuity, cystoid macular oedema were evaluated. Postoperatively eyes were examined at day 1, 1 week, 6 weeks and 3 months. Results: Mean age of the patients was 57.28± 8.20 years. Most of the patients 81(67.5%) had nuclear sclerosis grade-II cataract.Intraoperatively, moderate wound burn occurred in 02(1.6%) eyes, localized Descemet’s membrane detachmentin 03(2.5%) eyes and posterior capsule rupture occurred in 03(2.5%) cases. Postoperatively, moderate and severe corneal edema was found in 06(5.0%) and 04(3.3%) eyes respectively at day 1. At the end of 3 months follow-up, 114(95%) eyes maintained a best corrected visual acuity of ≥ 6/18, of which 109(90.8%) eyes achieved ≥ 6/9. Conclusion: Burst mode torsional phacoemulsfication is a very effective and advanced technique of cataract surgery. Intraoperative complications are very less and visual outcome is excellent. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 94-97

scholarly journals Real-world outcomes of two-year Conbercept therapy for diabetic macular edema

2021 ◽  
Vol 14 (3) ◽  
pp. 416-422
Author(s):  
Yong Cheng ◽  
◽  
Ming-Wei Zhao ◽  
Tong Qian ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Adverse Events ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vision Loss ◽  
Retinal Thickness ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Number Of Injections ◽  
Best Corrected Visual Acuity

AIM: To evaluate the two-year outcomes of patients treated for diabetic macular edema (DME) with intravitreal Conbercept (IVC). METHODS: The clinical data of 30 DME patients (36 eyes) were retrospectively reviewed. The patients were treated with IVC for 3mo. Additional IVC was given at subsequent monthly visits, if needed (3+PRN). The patients were followed up for 24mo. RESULTS: The best-corrected visual acuity (BCVA) at 24mo significantly increased (66.7±15.3 letters) in comparison with the baseline (54.4±15.4 letters, P<0.0001). The mean improvement in BCVA was 11.0±2.9 letters. At 24mo, 44.1% of the eyes surveyed gained ≥15 letters, 52.9% of the eyes gained ≥10 letters, and 70.6% of the eyes gained ≥5 letters. No vision loss was noted in 96.8% of the eyes, and 5.9% of the eyes lost ≥5 letters, but ≤10 letters. The central retinal thickness (CRT) at 24mo was significantly reduced (277.1±122.9 μm) in comparison with the baseline (510.9±186.1 μm, P<0.0001). At 24mo, 43.3% of the patients had a CRT ≤250 μm. The mean number of injections over 24mo was 10.6±2.0. No severe eye or systemic adverse events related to either the drug or injection were noted. CONCLUSION: IVC is safe and effective for the treatment of DME.

scholarly journals Association of foveal avascular zone with the metamorphopsia in epiretinal membrane

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hideki Shiihara ◽  
Hiroto Terasaki ◽  
Shozo Sonoda ◽  
Naoko Kakiuchi ◽  
Hidetaka Yamaji ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Superficial Layer ◽  
University Hospital ◽  
Foveal Avascular Zone ◽  
Service Unit ◽  
Corrected Visual Acuity ◽  
Avascular Zone ◽  
The Mean ◽  
The Relationship ◽  
Best Corrected Visual Acuity

Abstract This study was to investigate the relationship between the metamorphopsia and foveal avascular zone (FAZ) parameter in eyes with epiratinal membrane (ERM). We studied patients with an ERM visited retinal service unit at the Kagoshima University Hospital or Shirai Hospital. The best-corrected visual acuity (BCVA), and the degree of metamorphopsia by M -CHARTS™ were evaluated. The 3 × 3 mm optical coherence tomography angiography (OCTA) images of the superficial layer were obtained. Area (mm2), the circularity, eigen value were calculated using ImageJ software. The relationship between visual function, such as best corrected visual acuity (BCVA) and metamorphopsia, and FAZ parameters were studied by Pearson’s correlational coefficient. Fifty-four eyes of 51 patients (24 men and 27 women) with an ERM were studied. The mean age of the patients was 69.6 ± 8.20 years. The mean BCVA and metamorphopsia score was 0.31 ± 0.29 logMAR units and 0.49 ± 0.42. There was no significant relationship between BCVA and FAZ parameters. While, metamorphopsia score was significantly and negatively correlated with all of FAZ parameters (area R = − 0.491, P < 0.001; circularity R = − 0.385, P = 0.004; eigenvalue ratio R = − 0.341; P = 0.012). Multiple regression analysis showed the FAZ area was solely and significantly correlated with metamorphopsia score (β − 0.479, P < 0.001). The size but not the shape of the FAZ was significantly correlated with the degree of metamorphopsia suggesting that it could be an objective parameter of metamorphopsia in ERM patients.

Single-pass four-throw pupilloplasty for Urrets-Zavalia syndrome

2018 ◽  
Vol 28 (5) ◽  
pp. 552-558 ◽  
Author(s):  
Priya Narang ◽  
Amar Agarwal ◽  
Dhivya Ashok Kumar
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Intraocular Pressure ◽  
Anterior Segment ◽  
Anterior Chamber Angle ◽  
Single Pass ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Chamber Angle ◽  
Best Corrected Visual Acuity

Purpose: To demonstrate the efficacy and initial results of single-pass four-throw pupilloplasty in cases of Urrets-Zavalia syndrome. Methods: In this prospective interventional study, single-pass four-throw was performed to reconstruct the pupil in all symptomatic cases with Urrets-Zavalia syndrome. Applanation tonometry, indentation gonioscopy, and anterior segment optical coherence tomography for anterior chamber angle assessment were performed in all the cases. Results: Out of 10 cases that were identified with Urrets-Zavalia syndrome, the procedure was performed in 7 cases, whereas 3 cases were left untreated, as they did not have any visual complaints. Five out of seven eyes had preoperative raised intraocular pressure with appositional closure of the angle. Postoperatively, intraocular pressure was controlled in all the eyes, whereas one eye required antiglaucoma medications to control the intraocular pressure. The mean preoperative and postoperative best-corrected visual acuity was 1.1 ± 1.2 and 0.4 ± 0.4 LogMar, respectively. There was a significant improvement in the best-corrected visual acuity (p = 0.0169) in the postoperative period. The mean preoperative and postoperative intraocular pressure was 26.6 ± 11.23 and 16.3 ± 2.98 mm Hg, respectively (p = 0.0168). All the patients had a minimum of 6-month follow-up period (range = 6–8 months). Conclusion: Single-pass four-throw can be employed for cases with Urrets-Zavalia syndrome, and single-pass four-throw helps to prevent the postoperative glare and narrows down the pupil size effectively. Single-pass four-throw helps to alleviate the anterior chamber angle apposition in patients with Urrets-Zavalia syndrome by mechanically pulling the peripheral iris centrally as demonstrated on anterior segment optical coherence tomography. The study also reports the occurrence of Urrets-Zavalia syndrome after glued intraocular lens surgery.

scholarly journals A 12-month, multicenter, parallel group comparison of dexamethasone intravitreal implant versus ranibizumab in branch retinal vein occlusion

2018 ◽  
Vol 28 (6) ◽  
pp. 697-705 ◽  
Author(s):  
Francesco Bandello ◽  
Albert Augustin ◽  
Adnan Tufail ◽  
Richard Leaback
Keyword(s):  
Visual Acuity ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Dexamethasone Intravitreal Implant ◽  
Vein Occlusion ◽  
Corrected Visual Acuity ◽  
Increased Risk ◽  
Intravitreal Implant ◽  
The Mean ◽  
Best Corrected Visual Acuity

Purpose: Dexamethasone intravitreal implant and intravitreal ranibizumab are indicated for the treatment of macular edema secondary to retinal vein occlusion. This non-inferiority study compared dexamethasone with ranibizumab in patients with branch retinal vein occlusion. Methods: In this randomized, 12-month head-to-head comparison, subjects with branch retinal vein occlusion were assigned to dexamethasone 0.7 mg at day 1 and month 5 with the option of retreatment at month 10 or 11, or ranibizumab 0.5 mg at day 1 and monthly through month 5 with subsequent as-needed injections at month 6–month 11. The primary efficacy outcome was the mean change from baseline in best-corrected visual acuity at month 12; secondary outcomes included average change in best-corrected visual acuity, proportion of eyes with ≥10- and ≥15-letter gain/loss, change in central retinal thickness, and change in Vision Functioning Questionnaire-25 score. Results: In all, 307 of a planned 400 patients were enrolled in the study and received (mean) 2.5 dexamethasone injections (n = 154) and 8.0 ranibizumab injections (n = 153) over 12 months. The mean change from baseline in best-corrected visual acuity at month 12 was 7.4 letters for dexamethasone versus 17.4 letters for ranibizumab (least-squares mean difference (dexamethasone minus ranibizumab), −10.1 letters; 95% confidence interval, −12.9, −7.2; p = 0.0006). Conclusion: Dexamethasone and ranibizumab improved best-corrected visual acuity and anatomical outcomes; however, dexamethasone did not show non-inferiority to ranibizumab in this under-powered study. Dexamethasone was associated with an increased risk of intraocular pressure elevation and cataract progression, but a lower injection burden, compared to ranibizumab.

Evaluating Central Serous Chorioretinopathy with Multifocal Electroretinogram

2009 ◽  
Vol 03 (01) ◽  
pp. 71
Author(s):  
Marilita M Moschos ◽  
Michael Moschos ◽  
◽  
Keyword(s):  
Visual Acuity ◽  
Fluorescein Angiography ◽  
Central Serous Chorioretinopathy ◽  
Multifocal Electroretinogram ◽  
Ophthalmological Examination ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Retinal Response ◽  
Normal Controls ◽  
Best Corrected Visual Acuity

Purpose: To evaluate central serous chorioretinopathy (CSCR) by multifocal electroretinogram (mf-ERG). Patients and methods: Twenty-one patients (21 eyes) with unilateral CSCR were examined. Both eyes of each patient underwent complete ophthalmological examination, including measurement of best corrected visual acuity, fluorescein angiography and mf-ERG recording. Our results were compared with the corresponding findings of 33 age-matched normal volunteers. Results: At presentation, the mean retinal response density (RRD) of the affected eyes in area 1 was 50.8% lower compared with normal controls (p<0.001). After CSCR regression, the mean RRD of the affected eyes was 30.1% lower compared with normal controls (p<0.001). Six fellow unaffected eyes showed a mean RRD in area 1 equal to 12nV/deg2. Conclusion: During the acute phase of CSCR, the mean RRD of the fovea was significantly abnormal. After its regression, mf-ERG values ameliorate, but they remain significantly abnormal. Abnormal values in area 1 were also found in the unaffected eyes.

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