scholarly journals Modified Tectonic Corneoscleral Graft For Management of Devastating Corneoscleral Infections

2022 ◽  
Author(s):  
Xiaoyu Zhang ◽  
Xiaolin Qi ◽  
Miaolin Wang ◽  
Hua Gao
Keyword(s):  
Ocular Surface ◽  
Clinical Results ◽  
Choroidal Detachment ◽  
Immune Rejection ◽  
Pythium Insidiosum ◽  
Surface Stability ◽  
Corneal Epithelial ◽  
Corrected Visual Acuity ◽  
The Mean

Abstract Purpose To analyze the clinical results and the efficacy of modified tectonic corneoscleral graft (TCG) in patients with devastating corneoscleral infections.Methods Twenty-five eyes from 25 patients who underwent modified TCG were enrolled. The recurrence, best-corrected visual acuity (BCVA), ocular surface stability, postoperative complications and graft survival condition were recorded.Results Among 25 patients, 19 cases were fungal infection and 6 cases were bacterial. The rate of recurrence was 8% with Pythium Insidiosum as a corresponding pathogen. The rate of monocular blindness declined from 100% to 57%. Changes in BCVA from preoperative to postoperative values were significant ( Z=4.22, P＜0.001). The survival of ocular surface stability was 73.6% and 43.9% at 1 and 3 years after surgery, respectively. Within the mean follow-up period of 17.5 ± 8.9 months, 21eyes (84.0%) had a stable ocular surface. The incidence rate of immune rejection was 36%. Corneal epithelial defects occurred in 7 patients and choroidal detachment occurred in 3 patients. No elevation of intraocular pressure was detected.Conclusions The modified TCG is effective in eradicating infection, salvaging the eyeball and saving some useful vision for devastating corneoscleral infections. Regular application of tacrolimus, timely addition of glucocorticoid and good compliance may decrease the postoperative course challenging.

scholarly journals Abstaining from symptomatic implants of modified tension band wiring by nonabsorbable suture fixation for transverse patella fractures

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Puripun Jirangkul ◽  
Arkaphat Kosiyatrakul
Keyword(s):  
Steel Wire ◽  
Clinical Results ◽  
Tension Band ◽  
Fixation Technique ◽  
Nonabsorbable Suture ◽  
Patella Fractures ◽  
Sufficient Stability ◽  
The Mean ◽  
Conventional Stainless Steel

Abstract Background Modified tension band fixation has become commonly used for transverse patella fractures. The conventional stainless steel wire provides sufficient stability but may be associated with complications. Objective The study aimed to evaluate the effectiveness of a new modified tension band fixation technique for transverse patella fractures using a nonabsorbable suture. Material and methods We present the result of a prospective series using a nonabsorbable suture (FiberWire) for transverse patella fractures. The mean follow-up period totaled 12 months. A total of 16 patients were evaluated by radiographic and clinical review. The postoperative clinical evaluation employed Lysholm and Böstman scores. Result All clinical results on follow-up were good to excellent. Minimal intra-articular joint stepping and further fracture displacement were recorded. No patient needed re-operation, and functional outcomes of the knee were satisfactory. No significant differences were found between the injured and contralateral knee range of motion. No symptomatic implants and skin complications were noted, and all fractures were completed heal within 15 weeks. Conclusion FiberWire provided sufficient stability and reduced postoperative complications. The results proved appropriate, and the technique has merit, as it obviates the need for re-operation.

scholarly journals Use of Plasma Rich in Growth Factors and ReGeneraTing Agent Matrix for the Treatment of Corneal Diseases

Vision ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 34
Author(s):  
Ronald M. Sánchez-Ávila ◽  
Edmar Uribe-Badillo ◽  
Carlos Fernández-Vega González ◽  
Francisco Muruzabal ◽  
Borja de la Sen-Corcuera ◽  
...  
Keyword(s):  
Growth Factors ◽  
Corneal Ulcer ◽  
Disease Index ◽  
Eye Drops ◽  
Analog Scale ◽  
Ocular Surface Disease Index ◽  
Corneal Ulcers ◽  
Corrected Visual Acuity ◽  
The Mean

This study aimed to investigate the use of Plasma Rich in Growth Factors (PRGF) associated with tissue ReGeneraTing Agent (RGTA) drops for the treatment of noninfectious corneal ulcers. RGTA treatment was applied (one drop every two days); however, if ulcer closure was not achieved, PRGF eye drops treatment was added (four times/day). The time taken to reach the ulcer closure, the Best Corrected Visual Acuity (BCVA), intraocular pressure (IOP), Visual Analog Scale (VAS, in terms of frequency and severity of symptoms), and Ocular Surface Disease Index (OSDI) were evaluated. Seventy-four patients (79 eyes) were included, and the mean age was 56.8 ± 17.3 years. The neurotrophic corneal ulcer was the most frequent disorder (n = 27, 34.2%), mainly for herpes virus (n = 15, 19.0%). The time of PRGF eye drops treatment associated with the RGTA matrix was 4.2 ± 2.2 (1.5–9.0) months, and the follow-up period was 44.9 ± 31.5 months. The ulcer closure was achieved in 76 eyes (96.2%). BCVA, VAS and OSDI improved from the baseline (p < 0.001), and IOP remained unchanged (p = 0.665). RGTA and PRGF in noninfectious ulcers were effective and could be a therapeutic alternative for this type of corneal disease.

Corneal densitometry in patients with keratoconus undergoing intrastromal Ferrara ring implantation

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.

Outcomes of a Cardiac Rehabilitation (CRH) Program after phase II: what about our patients almost 4 years later?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
J Borrego Rodriguez ◽  
C Palacios Echevarren ◽  
S Prieto Gonzalez ◽  
JC Echarte Morales ◽  
R Bergel Garcia ◽  
...  
Keyword(s):  
Phase Ii ◽  
Hospital Readmissions ◽  
Clinical Results ◽  
Level Of Evidence ◽  
Coronary Syndrome ◽  
Funding Sources ◽  
The Mean ◽  
Acute Cardiovascular Event ◽  
Mean Time

Abstract Funding Acknowledgements Type of funding sources: None. INTRODUCTION CRH in patients with ischemic heart disease is recommended by the different clinical practice guidelines with an IA level of evidence, with an important role in reducing cardiovascular mortality and hospital readmissions during follow-up. OBJECTIVE The goal of this study is to show the 4-year clinical results of a population of patients who participated in an CRH program after an Acute Coronary Syndrome (ACS). METHODS Between May/2014 and September/2017, 221 patients who had recently presented an ACS completed the 12 weeks of phase II of the CRH program at our center. In May/2020 we collected epidemiological, clinical and echocardiographic information at the time of the acute cardiovascular event; and we evaluate the current vital status of the patients and the incidence of readmissions for: angina, HF, new ACS, or arrhythmic events. RESULTS Of the 221 patients, 182 were men (82%). The mean age of our population was 58.3 ± 7.8 years. 58% (129 patients) suffered from ST-elevation ACS. The mean time of hospital stay was 6.20 ± 2.9 days. An echocardiogram was performed at discharge, which showed an average LVEF of 56 ± 6%. Eight patients (4%) developed early Ventricular Fibrilation (VF) during the acute phase of ACS. Among the classic CVRF, smoking (79%) was the most prevalent, followed by dyslipidemia (53%) and hypertension (47%). The mean time from hospital discharge to the start of phase II RHC was 42 ± 16 days. The overall incidence of events was 9%: 10 patients suffered reinfarction during follow-up, and 7 were readmitted for unstable angina, all of whom underwent PCI; no patient was admitted for HF; and none of the 8 patients with early VF had a new tachyarrhythmia, registering a single admission for VT during follow-up. None of the patients had sustained ventricular tachyarrhythmias during exercise-training. At the mean 4.5-year follow-up, 218 patients were still alive (98%). CONCLUSION The incidence of CV events in the follow-up of our cohort was low, which can be explained by the fact that it is a young population, with an LVEF at low limits of normality at discharge, which is one of the most important predictors in the prognosis after an ischemic event. As an improvement, we must shorten the time until the start of phase II of the program. CRH shows once again its clinical benefit after an ACS, in consonance with the existing evidence. Abstract Figure. Outcomes of a CRH program.

Matrixplasty for the Treatment of Severe Incurved Toenail with Growth Plate Deformity

2012 ◽  
Vol 102 (3) ◽  
pp. 198-204
Author(s):  
J.-Young Kim
Keyword(s):  
Growth Plate ◽  
Clinical Results ◽  
New Technique ◽  
Partial Removal ◽  
Edge Angle ◽  
Results Of Treatment ◽  
The Mean ◽  
A New Technique ◽  
Ingrown Toenails

Background: Severely incurved toenails are accompanied by deformity of the toenail growth plate. In such a condition, partial removal of the nail and nail bed and simple unfolding of the nail itself frequently result in the recurrence of symptoms. We sought to design and develop a new technique for the treatment of incurved toenail with growth plate deformity and to report the results of treating this disease entity. Methods: Forty consecutive patients (52 cases) underwent treatment of symptomatic incurved toenails with a new technique named matrixplasty. The mean ± SD patient age was 40.3 ± 18.9 years. Last follow-up was at a mean ± SD of 18.0 ± 1.3 months. An American Orthopedic Foot and Ankle Society (AOFAS) forefoot hallux score was assigned, and patients were evaluated before treatment and at last follow-up. Patient satisfaction and the recurrence rate of the deformity were evaluated. For evaluation of improvement in toenail shape, the center to edge angle of the toenail was measured before treatment and at last follow-up. The complication rate was also evaluated. Results: All of the ingrown toenails healed, and the nail deformities were corrected within 3 weeks after the procedure. None of the incurved toenails had recurred by last follow-up. The mean pretreatment AOFAS forefoot hallux score was 72.9, and it improved to 99.6 by last follow-up (P &lt; .001). Every patient was very satisfied or satisfied with the results of treatment. The mean ± SD center to edge angle of the toenail improved from 53.3° ± 9.5° to 15.3° ± 5.2° by last follow-up (P &lt; .001). Minor paronychia, which was managed with local wound dressing and oral antibiotics, was identified in four cases. No other complication was identified. Conclusions: Matrixplasty showed excellent clinical results in the treatment of severe incurved toenail, and this newly developed procedure showed improvement of the deformed toenail and its growth plate. (J Am Podiatr Med Assoc 102(3): 198–204, 2012)

Results and Complications after Implantation of a Black Iris-Lens Diaphragm in Patients with Traumatically Induced Aphakia and Aniridia

2011 ◽  
Vol 21 (6) ◽  
pp. 754-759 ◽  
Author(s):  
Vasileios Petousis ◽  
Lothar Krause ◽  
Gregor Willerding ◽  
Michael H. Foerster ◽  
Nikolaos E. Bechrakis
Keyword(s):  
Anterior Chamber ◽  
Surgical Repair ◽  
Silicone Oil ◽  
Case Series ◽  
Corrected Visual Acuity ◽  
Time Out ◽  
Anatomic Results ◽  
The Mean ◽  
Positive Effect

Purpose. The black iris-lens diaphragm (ILD) can be used in the treatment of traumatic aniridia and aphakia. The aim of our study was to show postoperative functional and anatomic results and complications in a small case series. Methods. We retrospectively analyzed the files of 16 patients managed with a black ILD or a sole iris diaphragm in the period 1994–2007. Four of them were female and 12 were male. The mean age of the group was 50±17 years. At the time of the implantation, all of the eyes had already undergone primary surgical repair. Results. The preoperative best-corrected visual acuity in half of the patients was ≥0.1 and remained stable after the first postoperative year. During the follow-up years, one eye developed a subluxation of the implant and one eye an anterior chamber hemorrhage. At the same time, out of 8 eyes carrying a silicone tamponade in the vitreous cavity, silicone oil entered the anterior chamber in 3 cases. In one case, enucleation was undertaken due to phthisis. Conclusions. In the case of severely traumatized eyes with aniridia and aphakia, the implantation of a black ILD can have a positive effect on functional and anatomic stabilization.

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.

Comparison of the Effectiveness and Prognostic Factors of Intravitreal Ranibizumab between Typical Neovascular Age-Related Macular Degeneration and Polypoidal Choroidal Vasculopathy over 24 Months of Follow-Up

2015 ◽  
Vol 234 (1) ◽  
pp. 33-39 ◽  
Author(s):  
Wataru Matsumiya ◽  
Shigeru Honda ◽  
Keiko Otsuka ◽  
Akiko Miki ◽  
Takayuki Nagai ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Polypoidal Choroidal Vasculopathy ◽  
Age Related Macular Degeneration ◽  
Morphological Parameters ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
The Mean ◽  
Choroidal Vasculopathy

Purpose: To compare the response to ranibizumab between patients with typical neovascular age-related macular degeneration (tAMD) and those with polypoidal choroidal vasculopathy (PCV), and to determine the predictors for the outcomes. Methods: Fifty-nine eyes from 59 consecutive patients (tAMD: 27 eyes, PCV: 32 eyes) were treated with three monthly ranibizumab injections followed by as-needed retreatment. Best-corrected visual acuity (BCVA) and morphological parameters were evaluated over 24 months of follow-up. Results: The mean BCVA in tAMD and PCV patients was significantly improved at 3 months (-0.22 and -0.09 logMAR units, respectively). The improvement in BCVA was sustained up to 24 months in tAMD (p = 0.01) but not in PCV patients. The significant predictor for good response to ranibizumab in tAMD patients was the improvement of BCVA at 3 months, whereas that in PCV patients was the anatomical resolution at 3 months. Conclusions: Ranibizumab is an effective therapy for tAMD and PCV over 24 months. The predictors for good outcome might be different between tAMD and PCV.

Simple Decompression with Small Skin Incision for Cubital Tunnel Syndrome

2002 ◽  
Vol 27 (6) ◽  
pp. 559-562 ◽  
Author(s):  
Y. TANIGUCHI ◽  
M. TAKAMI ◽  
T. TAMAKI ◽  
M. YOSHIDA
Keyword(s):  
Clinical Results ◽  
Skin Incision ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Endoscopic Assistance ◽  
Tunnel Syndrome ◽  
Grade Ii ◽  
The Mean ◽  
Simple Decompression

Eighteen elbows in 17patients with cubital tunnel syndrome were treated by simple decompression using only a 1.5–2.5 cm skin incision with no endoscopic assistance. According to McGowan’s criteria, three elbows were classified preoperatively as grade I, six as grade II and nine as grade III. The mean follow-up period was 14 months (range 3–25). Clinical results were evaluated as excellent for four elbows, good for ten and fair for four. Improvement of symptoms occurred in all patients and dislocation of the ulnar nerve was not observed. Simple decompression through a small skin incision can be recommended for the treatment of cubital tunnel syndrome, if the indication is appropriate.

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