Preservation of the Tenon’s capsule and Sub-Tenon’s space after the autologous limbal-conjunctival transplantation in pterygium surgery

Abstract Background No previous studies have evaluated the scarring of the conjunctiva and Tenon’s capsule (TC) separately when only the conjunctiva is removed, and TC is preserved in the upper part of the bulb: the site designated for trabeculectomy. Thus, this cohort interventional study aims to investigate the scarring of the donor area after autologous limbal-conjunctival transplantation (ALCT) using anterior segment optical coherence tomography (AS-OCT). Methods Twenty-three eyes with pterygium were submitted to resection and local reconstruction with ALCT. AS-OCT images obtained from each eye preoperatively served as postoperative control. ALCT was removed superiorly with preservation of TC. The cure of this donor area occurred by secondary intention. AS-OCT was performed preoperatively and 30 and 180 days postoperatively in the donor area, measuring the thickness of the conjunctiva (epithelium and stroma) and TC. The sub-Tenon’s space (STS) was clinically assessed. Results The mean thickness of the conjunctival epithelium was 48.04 ± 11.37µm in the preoperative period and 51.87±15.04µm 180 days after surgery, without statistically significant difference (P=0.282). A statistically significant increase (P=0.005) in the mean thickness of the conjunctival stroma, from 85.35±23.10µm in the preoperative period to 101.61±20.19µm 180 days after surgery was found. TC had no significant changes, slightly increasing from 117.13±24.26µm preoperatively to 118.09±19.24µm (P=0.808) 180 days after surgery. STS was found in 19 (82%) eyes 180 days after surgery. Conclusions Following ALCT with TC preservation, scarring took place in the conjunctiva, epithelium, and stroma. The TC and the STS were preserved not showing any significant changes.

Download Full-text

Anatomical and Visual Effects of Implantable Phakic Contact Lens on Correction of Myopia

10.21203/rs.3.rs-1245764/v1 ◽

2022 ◽

Author(s):

Mahmoud Ekram ◽

Ahmed Mohamed Kamal Elshafei ◽

Asmaa Anwar Mohamed ◽

Mohamed Farouk Sayed Othman Abdelkader

Keyword(s):

Visual Acuity ◽

Anterior Chamber ◽

Contact Lens ◽

Anterior Segment ◽

Anterior Chamber Depth ◽

Case Series ◽

Care Group ◽

Case Series Study ◽

Significant Difference ◽

The Mean

Abstract Purpose: To evaluate the anatomical effects of implantable phakic contact lens (IPCL) (Care Group, India) on anterior segment and its visual outcomes .Patients and methods: In a prospective interventional case series study, 60 highly myopic eyes of 32 patients were subjected to IPCL implantation in the Ophthalmology Department of Minia University Hospital, Egypt from January 2019 to June 2021. All patients had complete ophthalmic examination and were followed up for 1 year. Pentacam was used for preoperative and postoperative estimation of anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV) and IPCL vault in the 1st, 3rd, and 12th months. Assessment of corneal endothelium was done using specular microscope preoperatively and after 12 months. Preoperative and postoperative refraction and visual acuity were measured. Results: There was a statistically significant decrease in ACD, ACA, and ACV. There was no significant difference between preoperative and postoperative mean intraocular pressure (IOP) by the 12th month (P=0.163). The mean preoperative endothelial cell count (ECD) was significantly reduced from 2929.3±248 cells/mm2 to 2737.9±303 cells/mm2 at the 12th month (P<0.001). with a statistically highly significant improvement of mean Log Mar uncorrected visual acuity (UCVA) from 1.48±0.19 preoperatively to 0.46±0.11 by the end of follow up (P<0.001) with insignificant difference between preoperative best corrected visual acuity (BCVA) and postoperative UCVA (P=0.209). In the 12th month, the mean vault was 240±540 μm. No sight threatening complications occurred.Conclusion: Although IPCL induced anatomical changes, it was safe and effective for correction of high myopia.

Download Full-text

The Effect of Pterygium Surgery on Corneal Topography

QJM ◽

10.1093/qjmed/hcaa058.026 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

N M Welson ◽

M M M Samy ◽

A A Gaafar ◽

T A Badran

Keyword(s):

Visual Acuity ◽

Surgical Treatment ◽

Corneal Topography ◽

Surgical Removal ◽

Significant Difference ◽

Uncorrected Visual Acuity ◽

Pterygium Surgery ◽

The Mean ◽

Pterygium Excision ◽

Topographic Astigmatism

Abstract Objective To evaluate the effect of pterygium surgery on corneal topography by comparing wave front analysis before and one month after the surgical treatment. Methodology Fifty eyes of forty-one patients were included in this study. Twenty five male and sixteen female patients seeking pterygium surgery were recruited from the Ophthalmology Department Outpatient Clinic in Sohag Teaching Hospital during the period from July 2017 to May 2018. All eyes underwent pterygium excision with conjunctival autograft. Results In this study we found a highly statistically significant improvement in the mean uncorrected visual acuity from 0.44±0.21SD preoperatively to 0.62±0.18SD postoperatively (p < 0.001) and a highly statistically significant difference in the mean logMAR visual acuity as it was decreased from 0.43±0.28 SD preoperatively to 0.34±0.23 SD postoperatively (p < 0.001). Also, there was a highly statistically significant improvement in mean of manifest refractive astigmatism from -4.08±3.28 SD preoperatively to -1.46±1.40 SD postoperatively (p < 0.001). We also found a highly statistically significant improvement in the mean cycloplegic astigmatism from -4.00±3.01 SD preoperatively to -1.39±1.33 SD postoperatively (p < 0.001) and also there was a highly statistically significant improvement in the mean topographic astigmatism from -5.17±4.08 SD preoperatively to -2.20±2.31 SD postoperatively (p < 0.001). We also found a highly statistically significant improvement in the mean of ISV (Index of Surface Variance) from 76.22±36.86 SD preoperatively to 33.56±15.02 SD post operatively (p < 0.001) and also there was a highly statistically significant improvement in the mean IHD (Index of Height Decentration) from 0.042±0.027SD pre-operatively to 0.023±0.036 SD post operatively. Conclusion There was a highly statistically significant difference in the mean logMAR visual acuity and a highly statistically significant improvement in the mean uncorrected visual acuity. A highly statistically significant improvement in both refractive and topographic astigmatism after one month of the surgery was noted also. Here were also a highly statistically significant improvement in ISV and IHD that indicate improvement after pterygium removal. Recommendations Patient with pterygium that inducing astigmatism will benefit from surgical removal of the pterygium.

Download Full-text

One Quadrant Sub-Tenon's Capsule Anesthesia in Anterior Segment Surgery

European Journal of Ophthalmology ◽

10.1177/112067219600600206 ◽

1996 ◽

Vol 6 (2) ◽

pp. 131-136 ◽

Cited By ~ 12

Author(s):

Z. Kapran ◽

M. Uyar ◽

K. Eltutar ◽

N. Dinçer

Keyword(s):

Anterior Segment ◽

Tenon’S Capsule ◽

Tenon's Capsule ◽

Anterior Segment Surgery

Download Full-text

Outcome of Inferonasal Conjunctival Autograft in Pterygium Surgery

Nepal Medical College Journal ◽

10.3126/nmcj.v23i4.42223 ◽

2021 ◽

Vol 23 (4) ◽

pp. 319-323

Author(s):

Pragati Gautam Adhikari ◽

Sagun Narayan Joshi

Keyword(s):

Medical Records ◽

Demographic Variables ◽

Inclusion Criteria ◽

Conjunctival Autograft ◽

Donor Area ◽

Mean Size ◽

Pterygium Surgery ◽

The Mean ◽

Pterygium Excision

This study was done to evaluate the outcome of pterygium excision with inferonasal conjunctival autograft at a tertiary eye care centre. Retrospective analysis of medical records of primary pterygia patients operated by a single surgeon between 2017 to 2020 were analyzed. A total of 43 patients who met the inclusion criteria were included in the study. The demographic variables, along with size of pterygium and recurrence over a period of six month follow up was noted. The mean age of patients was 46.97 years (29-74 years). The mean size of pterygium was 3.17 mm. Recurrence was seen in 3 eyes over a period of 6 months. Graft edema was observed in 11 patients and graft hemorrhage along with congestion was seen in 8 cases which resolved over a 3 weeks follow up period. Mild conjunctival scarring was seen over donor area in 5 of the eyes. Pterygium excision with inferior conjunctival autograft is an effective alternative technique to superotemporal autograft technique.

Download Full-text

Measurement of Iris Thickness at Different Regions in Healthy Chinese Adults

Journal of Ophthalmology ◽

10.1155/2021/2653564 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Qingchen Li ◽

Yuan Zong ◽

Huiming Wen ◽

Jian Yu ◽

Changbo Zhou ◽

...

Keyword(s):

Anterior Segment ◽

Final Analysis ◽

Middle Part ◽

Chinese Adults ◽

Swept Source ◽

Significant Difference ◽

The Mean ◽

Healthy Chinese ◽

And Gender ◽

The Right

Purpose. To study the variation of iris thicknesses in different regions and explore the possible correlations with age and gender. Methods. Healthy Chinese adults were recruited; the anterior segment of their eyes was imaged by swept-source optical coherence tomography (SS-OCT). The horizontal scan of the right eye was selected, and the thicknesses of both the nasal and temporal irises were measured at 199 evenly spaced points. Results. A total of 233 subjects with an average age of 36.79 ± 10.04 years (range 19 to 62) were included in the final analysis. The mean iris thicknesses of the temporal and nasal sides were 364.79 ± 47.58 μm and 372.44 ± 43.75 μm, respectively. The mean nasal iris thickness was positively correlated with age (β = 0.9 μm/year; P = 0.002), but the temporal one was not (β = 0.077 μm/year; P = 0.806). At 139 points of the nasal iris and 146 points of the temporal iris, the iris thickness was significantly correlated with age ( P < 0.05). The thicknesses of the peripheral and pupillary parts were positively correlated with age, while the middle part was negatively correlated with age. No significant difference was observed in the mean iris thickness between genders (temporal: t = 1.597, P = 0.112; nasal: t = 1.870, P = 0.063), but females had a thicker iris than males at 50 points in the temporal side and 49 points in the nasal side ( P < 0.05); no point in males was observed to have thicker iris compared to females. Conclusion. Using SS-OCT and the novel method, thicknesses of the iris at different regions were measured. The thicknesses of the peripheral and pupillary irises increase with age, while the thicknesses of the middle part decrease.

Download Full-text

Pterygia measurements are more accurate with anterior segment optical coherence tomography - A pilot study

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v3i1.4271 ◽

1970 ◽

Vol 3 (1) ◽

pp. 9-12 ◽

Cited By ~ 6

Author(s):

MN Welch ◽

CD Reilly ◽

K Kalwerisky ◽

A Johnson ◽

SG Waller

Keyword(s):

Optical Coherence Tomography ◽

Standard Deviation ◽

Pilot Study ◽

Clinical Assessment ◽

Anterior Segment ◽

Optical Coherence ◽

Slit Lamp ◽

Significant Difference ◽

The Mean ◽

The Difference

Introduction: Slit-lamp beam measurements of a pterygium can be difficult to reproduce accurately. Purpose: To compare standard slit-lamp beam measurements of pterygia to computer caliper measurements of Anterior Segment Optical Coherence Tomography (OCT) images. Subjects and methods: Thirteen pterygia of ten patients were evaluated. Two physicians independently measured each pterygium using the slit lamp beam. Caliper measurements of two different OCT images of each pterygium were obtained. All measurements determined the distance from the limbus to the pterygium apex. Results: The difference in the slit lamp beam measurements of each pterygium was calculated and the mean of the differences was 0.3 and the standard deviation was 0.32. The difference in the two OCT measurements of each pterygium was also calculated and the mean of the differences was 0.1 and the standard deviation was 0.12. A two-tailed t-test demonstrated a statistically significant difference in these measurements (p = 0.0256). Conclusion: Anterior Segment Optical Coherence Tomography (OCT) gives significantly more reproducible results than the slit lamp beam for measurements of the distance of a pterygium’s apex from the limbus. This tool may provide more accurate clinical assessment of extension of pterygia onto the cornea and may be useful for research purposes. Key words: pterygium; pterygia; anterior segment optical coherence tomography; OCT DOI: 10.3126/nepjoph.v3i1.4271Nepal J Ophthalmol 2011;3(5):9-12

Download Full-text

Bleb Morphology Using Anterior-Segment Optical Coherence Tomography after Ahmed Glaucoma Valve Surgery with Tenon Capsule Resection

Journal of Ophthalmology ◽

10.1155/2020/8386135 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Faried M. Wagdy

Keyword(s):

Wall Thickness ◽

Anterior Segment ◽

Preoperative Period ◽

Refractory Glaucoma ◽

Internal Morphology ◽

Group I ◽

Hypertensive Phase ◽

The Mean ◽

Group Ii

Objectives. To evaluate the internal morphology of blebs using anterior-segment optical coherence tomography (AS-OCT) and the surgical outcomes of Ahmed glaucoma valve (AGV) surgery with Tenon capsule resection compared to conventional AGV surgery in patients with refractory glaucoma. Patients and Methods. This randomised prospective study included 30 eyes from 30 patients (age range: 42–55 y) with refractory glaucoma from March 2018 to February 2020. The study included two groups: AGV with the Tenon capsule resection group (n = 15) and the conventional AGV surgery group (n = 15). Follow-up continued until 6 months after surgery. The primary outcome was intraocular pressure (IOP) and its association with the number of postoperative glaucoma medications, best corrected visual acuity, visual field, and postoperative complications. The internal morphology of the blebs in both groups was evaluated at 1-day, 1-week, 1-month, 3-month, and 6-month follow-up using AS-OCT in terms of the consequent changes in bleb wall thickness, bleb wall reflectivity, and bleb cavity morphology throughout the 6-month follow-up period. Results. A significant reduction in IOP was found in both groups, with a greater reduction in group I, where the mean IOP decreased from 32.73 ± 2.12 mmHg in the preoperative period to 13.33 ± 1.59 mmHg after 6 months, whereas in group II, the mean IOP decreased from 33.2 ± 2.21 mmHg in the preoperative period to 14.27 ± 1.44 mmHg after 6 months ( p value <0.05). The difference between the 2 groups in terms of the decrease in IOP was insignificant except at 1 and 3 months, where there was a significant difference ( p value = 0.016 and 0.01 at 1 and 3 months, respectively). The bleb analysis revealed a significant reduction in the wall thickness in both groups at 1 and 3 months, which was mostly associated with the hypertensive phase. In group I, the bleb wall thickness decreased from 754.67 ± 53.93 μm in the first postoperative day to 684 ± 81.66 μm and 671.6 ± 69.48 μm at 1 and 3 months, respectively, while in group II, the bleb wall thickness decreased from 707.13 ± 31.7 μm in the first postoperative day to 499.53 ± 99.1 μm and 506 ± 76.91 μm at 1 and 3 months, respectively. There was a significant reduction in AS‐OCT, and bleb reflectivity was insignificant throughout the follow-up period ( p value >0.05). Regarding postoperative complications, the hypertensive phase occurred more frequently in group II (6 eyes, 40%) than in group I (2 eyes, 13.3%). Other complications were also reported more frequently in group II such as hypotony, shallow anterior chamber (AC), and tube exposure. Conclusion. AS-OCT was beneficial in the analysis of bleb morphology after AGV surgery where there were more diffuse functioning multicystic blebs and less thinning in the bleb wall thickness during the hypertensive phase after resection of the Tenon capsule, which might be related to the less incidence of fibrosis around the surgical site.

Download Full-text

Sealing the gap between conjunctiva and Tenon’s capsule in primary pterygium surgery

Revista Brasileira de Oftalmologia ◽

10.5935/0034-7280.20140062 ◽

2014 ◽

Vol 73 (5) ◽

Author(s):

Ricardo Alexandre Stock ◽

Luan Felipe Lückmann ◽

Gabriel Alexander Ken-Itchi Kondo ◽

Elcio Luiz Bonamigo

Keyword(s):

Tenon’S Capsule ◽

Tenon's Capsule ◽

Pterygium Surgery ◽

Primary Pterygium

Download Full-text

Umbilical cord-derived mesenchymal stem cell implantation in patients with optic atrophy

European Journal of Ophthalmology ◽

10.1177/1120672120977824 ◽

2020 ◽

pp. 112067212097782

Author(s):

Neslihan Sinim Kahraman ◽

Ayşe Öner

Keyword(s):

Stem Cell ◽

Optic Nerve ◽

Umbilical Cord ◽

Optic Atrophy ◽

Anterior Segment ◽

Mean Deviation ◽

Fundus Fluorescein Angiography ◽

Significant Difference ◽

The Mean

Background: Optic nerve cells can be irreversibly damaged by common various causes. Unfortunately optic nerve and retinal ganglion cells have no regenerative capacity and undergo apoptosis in case of damage. In this study, our aim is to investigate the safety and efficacy of suprachoroidal umbilical cord-derived MSCs (UC-MSCs) implantation in patients with optic atrophy. Methods: This study enrolled 29 eyes of 23 patients with optic atrophy who were followed in the ophthalmology department of our hospital. BCVA, anterior segment, fundus examination, color photography, and optical coherence tomography (OCT) were carried out at each visit. Fundus fluorescein angiography and visual field examination were performed at the end of the first, third, sixth months, and 1 year follow-up. Results: After suprachoroidal UC-MSCs implantation there were statistically significant improvements in BCVA and VF results during 12 months follow-up ( p < 0.05). When we evaluate the results of VF tests, the mean deviation (MD) value at baseline was −26.11 ± 8.36 (range −14.18 to −34.41). At the end of the first year it improved to −25.01 ± 8.73 (range −12.56 to −34.41) which was statistically significant ( p < 0.05). When we evaluate the mean RNFL thickness measurements at baseline and at 12 month follow-up the results were 81.8 ± 24.9 μm and 76.6 ± 22.6 μm, respectively. There was not a significant difference between the mean values ( p > 0.05). Conclusion: Stem cell treatment with suprachoroidal implantation of UCMSCs seems to be safe and effective in the treatment for optic nerve diseases that currently have no curative treatment options

Download Full-text

Correlation of Anterior Segment Parameters in Keratoconus Patients

International Journal of Keratoconus and Ectatic Corneal Diseases ◽

10.5005/jp-journals-10025-1017 ◽

2012 ◽

Vol 1 (2) ◽

pp. 87-91 ◽

Cited By ~ 1

Author(s):

Leonardo Torquetti

Keyword(s):

Pearson Correlation ◽

Corneal Thickness ◽

Anterior Segment ◽

Inverse Correlation ◽

Q Value ◽

Significant Difference ◽

Severe Group ◽

Corneal Asphericity ◽

The Mean ◽

Anterior Segment Parameters

ABSTRACT Purpose To evaluate the corneal asphericity, volume, thickness and keratometry and the correlation among these variables in keratoconus patients. Materials and methods A total of 1,071 eyes of 810 patients diagnosed with keratoconus were evaluated with a Pentacam (Oculus Optikgerate GmbH). Five groups were established according to the mean keratometry readings: Very mild [K < 44.0 diopters (D)], mild (K = 44.0-47.0D), moderate (K = 47.0-52.0D), severe (K = 52.0-60.0D) and very severe (K = 60.0 or higher). The following parameters were obtained: Anterior corneal asphericity (Q), corneal volume (CV) and thinnest corneal thickness (TCT). Results Sixty-six eyes had very mild keratoconus, 269 had mild keratoconus, 465 had moderate keratoconus, 233 had severe keratoconus and 38 had very severe keratoconus. As the severity of disease increases, there is an increment in K and CV values and reduction of Q and TCT. There was a statistically significant difference in values for all parameters, except the CV. The Pearson correlation index showed an inverse correlation between the degree of keratoconus and the asphericity (Q), i.e. the more severe the keratoconus the more negative the Q-value. Only in the very severe group there was no statistically significant correlation between K and Q. There was no correlation between severity of keratoconus and CV. There was an inverse correlation between keratoconus grade and TCT; the more advanced the disease the less the TCT value. Only in the very mild group there was no correlation between K and TCT. Conclusion The corneal asphericity and pachymetry are inversely correlated to keratometry in keratoconus patients. There is no correlation between CV and severity of keratoconus. How to cite this article Torquetti L, Ferrara G, Ferrara P. Correlation of Anterior Segment Parameters in Keratoconus Patients. Int J Kerat Ect Cor Dis 2012;1(2):87-91.

Download Full-text