Earlier Corneal Topographical Changes After Different Pterygium Surgical Techniques: a Comparative Pentacam Scheimpflug Imaging Study

Abstract Purpose: To investigate earlier corneal topographical changes and visual acuity after different pterygium surgical techniques using the Pentacam Scheimpflug imaging system.Methods: This study enrolled 98 patients with unilateral primary nasal pterygium. Pterygium surgery with either a conjunctival autograft (group 1) or an anchored conjunctival rotational flap (group 2), with fibrin tissue adhesive was performed under topical anesthesia. Baseline and one-month post-operative best-corrected visual acuity (BCVA) in logarithm of the Minimum Angle of Resolution (logMAR) and anterior corneal astigmatism (ACA), flat keratometry (Kf), steep keratometry (Ks) and posterior corneal astigmatism (PCA) were analyzed.Results: Mean BCVA improved from baseline 0.119±0.113 to 0.082±0.086 logMAR in group 1, and from baseline 0.169±0.128 to 0.120±0.121 logMAR in group 2. There were no statistically significant differences between the two groups in pre-and post-operative ACA, PCA, Kf and Ks. (p=0.686; 0.9020.107; and 0.592, respectively). Intra-group analysis revealed statistically significant differences in both groups: ACA (p<0.001 for both groups), with a greater difference in group 1 (2.072), and Kf (p<0.001 for both groups), with a slightly greater change in group 2 (1.910). While there were no statistically significant Ks intra-group differences in both groups (group 1: p=0.091; group 2: 0.092), group 1 (0.0522) displayed more Ks changes. There were also no statistically significant intra-group PCA differences in both groups (p=0.061 for both groups). However, Group 2 (-0.020) displayed greater changes.Conclusions: Significantly improved anterior corneal topographical changes highly associated with conjunctival autografting. However, the conjunctival rotational flap was associated with relatively greater posterior corneal topographical changes.

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Combined use of Fibrin Tissue Adhesive and Acellular Dermis in Dural Repair

American Journal of Rhinology ◽

10.2500/ajr.2007.21.3078 ◽

2007 ◽

Vol 21 (5) ◽

pp. 619-621 ◽

Cited By ~ 11

Author(s):

Anil R. Shah ◽

Aaron N. Pearlman ◽

Kevin M. O'Grady ◽

Tappan K. Bhattacharyya ◽

Dean M. Toriumi

Keyword(s):

Tissue Adhesive ◽

Csf Leak ◽

Dural Repair ◽

Acellular Dermis ◽

Combined Use ◽

Fibrin Tissue Adhesive ◽

Group 2 ◽

Temporal Bones ◽

Acellular Dermal ◽

Group 1

Background The management of cerebrospinal fluid (CSF) leaks can be challenging. Acellular dermal grafts derived from human cadavers can be used as a replacement material when autogenous materials are unavailable. Fibrin tissue adhesive (FTA) is a wound support product that has been used for hemostatic and tissue fixation purposes. The combined use of acellular dermis in conjunction with FTA for dural repair remains a subject of study. The aim of this study was to evaluate wound healing and tissue compatibility characteristics of acellular dermal substitute material when used both with and without FTA, for repair of a dural tear in a chinchilla model. Methods Forty-nine chinchillas were included in this randomized case-control study. The squamous portion of the temporal bone was removed to expose the tegmen. A 2 X 2 mm dural defect was removed to create an iatrogenic CSF leak. Then, animals were randomly assigned to one of three treatment groups: group 1, acellular dermis alone; group 2, acellular dermis with FTA; group 3, fibrinogen, acellular dermis, and FTA. Surgical sites were examined grossly at 1- and 2-week intervals. Temporal bones were examined histologically. Results Grossly, groups 2 and 3 had significantly less visible CSF leak and brain herniation noted at both 1- and 2-week intervals when compared with group 1. Histological results confirmed the gross results showing the best seal in group 2 and 3. Conclusion Acellular dermis combined with FTA provided superior support compared with acellular dermis alone in repair of induced dural defects.

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The number of intracorneal ring segments in asymmetric and central cones

Eye and Vision ◽

10.1186/s40662-021-00234-6 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Canan Asli Utine ◽

Denizcan Özizmirliler ◽

Mustafa Kayabaşı ◽

Üzeyir Günenç

Keyword(s):

Corneal Astigmatism ◽

Laser Device ◽

Double Ring ◽

Ring Segment ◽

Corneal Asphericity ◽

Intracorneal Ring Segment ◽

Group 2 ◽

Postoperative Improvement ◽

Single Versus ◽

Group 1

Abstract Background To compare the results of single versus double intracorneal ring segment (ICRS) (KeraRing) implantation in keratoconus with respect to different cone locations. Methods Twenty-two eyes of 18 patients with totally asymmetric cones (20–80% or 0–100% distribution along steep axis) were implanted with single ICRS (Group 1), 38 eyes of 32 patients with central or partially asymmetric cones (50–50% or 40–60% distribution along steep axis) were implanted with double ICRS (Group 2), at a depth of 80% of the site of implantation, in channels created with femtosecond laser device. All patients had uncorrected and corrected distance visual acuities (UDVA and CDVA, respectively) of ≤ 0.3 Snellen lines. Results In both groups, patients had median UDVA and CDVA gain of 3 Snellen lines (P > 0.05). Postoperative improvement in indices of vertical asymmetry and height decentration in Group 1; simulated keratometry, corneal astigmatism and anterior corneal asphericity values in Group 2 were greater (P < 0.05). A total of 10 eyes (45.5%) in Group 1 were recommended double ring implantation by the manufacturer’s nomogram, but underwent single ICRS implantation and achieved visual, refractive, tomographic outcomes comparable to that in Group 2, although corneal cylindrical correction was less and final topographic astigmatism was greater. Conclusion Double ICRS implantation seems to be superior in terms of keratometry, corneal astigmatism and anterior corneal asphericity improvement. Single ICRS implantation in totally asymmetric cones seems to provide satisfactory visual, refractive and tomographic results, similar to double ICRS implantation in central and partially asymmetric cones, by inducing central shift of the cone.

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Changes in Higher Order Aberrations after Wavefront-Guided Prk for Correction of Low to Moderate Myopia and Myopic Astigmatism: Two-Year Follow-Up

European Journal of Ophthalmology ◽

10.1177/112067210701700405 ◽

2007 ◽

Vol 17 (4) ◽

pp. 507-514 ◽

Cited By ~ 14

Author(s):

D. Wygledowska-Promienska ◽

I. Zawojska

Keyword(s):

Visual Acuity ◽

Excimer Laser ◽

Spherical Aberration ◽

Higher Order ◽

Control Group ◽

Higher Order Aberrations ◽

Order Root ◽

Group 2 ◽

Myopic Astigmatism ◽

Group 1

Purpose To assess efficacy, safety, and changes in higher order aberrations after wavefront-guided photorefractive keratectomy (PRK) in comparison with conventional PRK for low to moderate myopia with myopic astigmatism using a WASCA Workstation with the MEL 70 G-Scan excimer laser. Methods A total of 126 myopic or myopic-astigmatic eyes of 112 patients were included in this retrospective study. Patients were divided into two groups: Group 1, the study group; and Group 2, the control group. Group 1 consisted of 78 eyes treated with wavefront-guided PRK. Group 2 consisted of 48 eyes treated with spherocylindrical conventional PRK. Results Two years postoperatively, in Group 1, 5% of eyes achieved an uncorrected visual acuity (UCVA) of 0.05; 69% achieved a UCVA of 0.00; 18% of eyes experienced enhanced visual acuity of −0.18 and 8% of −0.30. In Group 2, 8% of eyes achieved a UCVA of 0.1; 25% achieved a UCVA of 0.05; and 67% achieved a UCVA of 0.00 according to logMAR calculation method. Total higher-order root-mean square increased by a factor 1.18 for Group 1 and 1.6 for Group 2. There was a significant increase of coma by a factor 1.74 in Group 2 and spherical aberration by a factor 2.09 in Group 1 and 3.56 in Group 2. Conclusions The data support the safety and effectiveness of the wavefront-guided PRK using a WASCA Workstation for correction of low to moderate refractive errors. This method reduced the number of higher order aberrations induced by excimer laser surgery and improved uncorrected and spectacle-corrected visual acuity when compared to conventional PRK.

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Reconstructing Foveola by Foveolar Internal Limiting Membrane Non-Peeling and Tissue Repositioning for Lamellar Hole-Related Epiretinal Proliferation

Scientific Reports ◽

10.1038/s41598-019-52447-4 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Tzyy-Chang Ho ◽

Allen Yi-Lun Ho ◽

Muh-Shy Chen

Keyword(s):

Visual Acuity ◽

Clinical Characteristics ◽

Internal Limiting Membrane ◽

Lamellar Macular Hole ◽

Ilm Peeling ◽

Corrected Visual Acuity ◽

Tangential Traction ◽

Group 2 ◽

Lamellar Hole ◽

Group 1

Abstract Differences in the pathogenesis and clinical characteristics between lamellar macular hole (LMH) with and without LMH-associated epiretinal proliferation (LHEP) can have surgical implications. This study investigated the effects of treating LHEP by foveolar internal limiting membrane (ILM) non-peeling and epiretinal proliferative (EP) tissue repositioning on visual acuity and foveolar architecture. Consecutive patients with LHEP treated at our institution were enrolled. The eyes were divided into a conventional total ILM peeling group (group 1, n = 11) and a foveolar ILM non-peeling group (group 2, n = 22). In group 2, a doughnut-shaped ILM was peeled, leaving a 400-μm-diameter ILM without elevated margin over the foveola after EP tissue repositioning. The EP tissue was elevated, trimmed, and inverted into the LMH. Postoperatively, the LMH was sealed in all eyes in group 2, with significantly better best-corrected visual acuity (−0.26 vs −0.10 logMAR; p = 0.002). A smaller retinal defect (p = 0.003), a more restored ellipsoid zone (p = 0.002), and a more smooth foveal depression (p < 0.001) were achieved in group 2. Foveolar ILM non-peeling and EP tissue repositioning sealed the LMH, released the tangential traction, and achieved better visual acuity. The presumed foveolar architecture may be reconstructed surgically. LMH with LHEP could have a combined degenerative and tractional mechanism.

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Topographically Guided Two-Step LASIK and Standard LASIK in the Correction of Refractive Errors after Penetrating Keratoplasty

European Journal of Ophthalmology ◽

10.1177/112067210901900404 ◽

2009 ◽

Vol 19 (4) ◽

pp. 535-543 ◽

Cited By ~ 4

Author(s):

Leopoldo Spadea ◽

Massimo Saviano ◽

Angela Di Gregorio ◽

Domenico Di Lodovico ◽

Fabio De Sanctis

Keyword(s):

Visual Acuity ◽

Penetrating Keratoplasty ◽

Laser In Situ Keratomileusis ◽

Refractive Errors ◽

Manifest Refraction ◽

Uncorrected Visual Acuity ◽

The Mean ◽

Group 2 ◽

Group 1

Purpose To evaluate in a long-term period the effectiveness and safety of topographically guided two-step laser in situ keratomileusis (LASIK) and standard LASIK technique in the correction of refractive errors after successful penetrating keratoplasty (PKP) for keratoconus. Methods At least 2 years after PKP and 6 months after removal of all sutures, 15 eyes of 15 patients (Group 1; mean manifest refraction spherical equivalent (MRSE) −7.23 D ± 3.42 SD) were submitted to standard LASIK and 15 eyes of 15 patients (Group 2; mean MRSE −4.37 D ± 1.97 SD) to a topographically guided two-step LASIK procedure (first the flap and at least 2 weeks later the laser ablation). In all cases, a superior hinged corneal flap (160 μm/9.5 mm) was created. Results After a follow-up of 36 months, in Group 1 the mean uncorrected visual acuity (UCVA) was 0.51 logarithm of the minimum angle of resolution (logMAR) ± 0.41 SD and the mean best-corrected visual acuity (BCVA) was 0.03 logMAR ± 0.05 SD, with a mean MRSE of −1.57 D ± 2.65 SD. In Group 2, the mean UCVA was 0.28 logMAR ± 0.24 SD and the mean BCVA was 0.01 logMAR ± 0.03 SD, with a mean MRSE of −0.07 D ± 1.00 SD. In both groups, no complications were observed. Conclusions After a long follow-up period, both topographically guided two-step LASIK and standard LASIK could be considered effective and safe tools in the correction of refractive errors after successful PKP for keratoconus.

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Treatment of Optic Canal Decompression Combined with Umbilical Cord Mesenchymal Stem (Stromal) Cells for Indirect Traumatic Optic Neuropathy: A Phase 1 Clinical Trial

Ophthalmic Research ◽

10.1159/000512469 ◽

2020 ◽

Vol 64 (3) ◽

pp. 398-404

Author(s):

Jia Li ◽

Xu Bai ◽

Xiaoyue Guan ◽

Hongfeng Yuan ◽

Xiang Xu

Keyword(s):

Visual Acuity ◽

Adverse Events ◽

Phase 1 ◽

Optic Canal ◽

Traumatic Optic Neuropathy ◽

Corrected Visual Acuity ◽

Group 2 ◽

Best Corrected Visual Acuity ◽

Group 1

Purpose: This study was aimed to investigate the safety and feasibility of umbilical cord-derived mesenchymal stem cell (MSC) transplantation in patients with traumatic optic neuropathy (TON). Methods: This is a single-center, prospective, open-labeled phase 1 study that enrolled 20 patients with TON. Patients consecutively underwent either optic canal decompression combined with MSC local implantation treatment (group 1) or only optic canal decompression (group 2). Patients were evaluated on the first day, seventh day, first month, third month, and sixth month postoperatively. Adverse events, such as fever, urticarial lesions, nasal infection, and death, were recorded at each visit. The primary outcome was changes in best-corrected visual acuity. The secondary outcomes were changes in color vision, relative afferent pupillary defect, and flash visual evoked potential. Results: All 20 patients completed the 6-month follow-up. None of them had any systemic or ocular complications. The change in best-corrected visual acuity at follow-up was not significantly different between group 1 and group 2 (p > 0.05); however, group 1 showed better visual outcome than group 2. Both groups showed significant improvements in vision compared with the baseline (p < 0.05); however, there were no statistically significant differences between the groups (p > 0.05). In addition, no adverse events related to local transplantation were observed in the patients. Conclusions: A single, local MSC transplantation in the optic nerve is safe for patients with TON.

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Comparison of Visual Outcomes after Bilateral Implantation of Extended Range of Vision and Trifocal Intraocular Lenses

European Journal of Ophthalmology ◽

10.5301/ejo.5000935 ◽

2017 ◽

Vol 27 (4) ◽

pp. 460-465 ◽

Cited By ~ 40

Author(s):

Ramón Ruiz-Mesa ◽

Antonio Abengózar-Vela ◽

Ana Aramburu ◽

María Ruiz-Santos

Keyword(s):

Visual Acuity ◽

Contrast Sensitivity ◽

Intraocular Lenses ◽

Patient Questionnaire ◽

Visual Outcomes ◽

Uncorrected Distance Visual Acuity ◽

Extended Range ◽

Near Visual Acuity ◽

Group 2 ◽

Group 1

Purpose To compare visual outcomes after cataract surgery with bilateral implantation of 2 intraocular lenses (IOLs): extended range of vision and trifocal. Methods Each group of this prospective study comprised 40 eyes (20 patients). Phacoemulsification followed by bilateral implantation of a FineVision IOL (group 1) or a Symfony IOL (group 2) was performed. The following outcomes were assessed up to 1 year postoperatively: binocular uncorrected distance visual acuity (UDVA), binocular uncorrected intermediate visual acuity (UIVA) at 60 cm, binocular uncorrected near visual acuity (UNVA) at 40 cm, spherical equivalent (SE) refraction, defocus curves, mesopic and photopic contrast sensitivity, halometry, posterior capsule opacification (PCO), and responses to a patient questionnaire. Results The mean binocular values in group 1 and group 2, respectively, were SE -0.15 ± 0.25 D and -0.19 ± 0.18 D; UDVA 0.01 ± 0.03 logMAR and 0.01 ± 0.02 logMAR; UIVA 0.11 ± 0.08 logMAR and 0.09 ± 0.08 logMAR; UNVA 0.06 ± 0.07 logMAR and 0.17 ± 0.06 logMAR. Difference in UNVA between IOLs (p<0.05) was statistically significant. There were no significant differences in contrast sensitivity, halometry, or PCO between groups. Defocus curves were similar between groups from 0 D to -2 D, but showed significant differences from -2.50 D to -4.00 D (p<0.05). Conclusions Both IOLs provided excellent distance and intermediate visual outcomes. The FineVision IOL showed better near visual acuity. Predictability of the refractive results and optical performance were excellent; all patients achieved spectacle independence. The 2 IOLs gave similar and good contrast sensitivity in photopic and mesopic conditions and low perception of halos by patients.

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Intraoperative Neuromonitoring in Thyroid Surgery: An Efficient Tool to Avoid Bilateral Vocal Cord Palsy

Ear Nose & Throat Journal ◽

10.1177/0145561320906325 ◽

2020 ◽

pp. 014556132090632

Author(s):

Kinyas Kartal ◽

Nurcihan Aygun ◽

Mustafa Fevzi Celayir ◽

Evren Besler ◽

Bulent Citgez ◽

...

Keyword(s):

Vocal Cord ◽

Thyroid Surgery ◽

Health Care Professionals ◽

Surgical Techniques ◽

Vocal Cord Palsy ◽

Intraoperative Neuromonitoring ◽

Efficient Tool ◽

Group 2 ◽

Neural Monitoring ◽

Group 1

Objectives: This study aimed to analyze the effects of intraoperative neuromonitoring (IONM) on the prevalence of vocal cord palsy (VCP) in thyroid surgery. Methods: Data from 493 patients (839 nerves at risk [NAR]) who underwent thyroid surgery between July 2014 and May 2016 were retrospectively evaluated. The patients were divided into 2 groups: Group 1 (G1) consisted of patients who underwent surgery without IONM, whereas group 2 (G2) consisted of patients who underwent surgery with IONM. The surgical techniques were identical, and experienced surgeons performed the procedures in both groups. Intraoperative neuromonitoring was performed in compliance with the International Neural Monitoring Guidelines. Results: In total, 211 patients (170 female, 41 male) with 360 NAR were included in G1, and 282 patients (220 female, 62 male) with 479 NAR were included in G2. The number of VCP per NAR in G1 and G2 was 33 (9.2%) and 27 (5.6%), respectively ( P = .005). The number of transient VCP per NAR in G1 and G2 was 27 (7.5%) and 23 (4.8%; P = .230), respectively. The number of permanent VCP per NAR in G1 and G2 was 6 (1.7%) and 4 (0.8%; P = .341), respectively. Bilateral VCP was detected in 4 (2.7%) patients in G1, whereas there was no patient with bilateral VCP in G2 ( P = .033). Conclusions: Intraoperative neuromonitoring may decrease the incidence of total VCP and prevent the development of bilateral VCP, which has unfavorable results for both patients and health-care professionals.

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Assessment of Preoperative and Postoperative Changes in Corneal Astigmatism after Pterygium Excision by Diﬀerent Techniques

Asian Journal of Medical Research ◽

10.47009/ajmr.2020.9.2.ot1 ◽

2020 ◽

Vol 9 (2) ◽

pp. 1-4

Author(s):

Madhavi Chevuturu

Keyword(s):

Visual Acuity ◽

Amniotic Membrane ◽

Surgical Techniques ◽

Corneal Astigmatism ◽

Group Iii ◽

Conjunctival Autograft ◽

Postoperative Changes ◽

Group I ◽

Pterygium Excision ◽

Group Ii

Background: Pterygium causes visual problems due to induced corneal astigmatism or direct encroachment onto the visual axis. The present study was conducted to compare preoperative and postoperative changes in corneal astigmatism after pterygium excision by different techniques. Subjects and Methods: The present study was conducted from May 2018 to August 20018 on 69 patients of age range 20-55 years of primary Pterygium. Patients were divided into three groups of 23 each. Group I was treated with bare sclera (BS) technique, Group II with conjunctival autograft (CAG) technique and Group III with amniotic membrane graft (AMG) technique. All the patients were preoperatively assessed for visual acuity, anterior and posterior segments, autorefraction, and autokeratometry. After surgery, the patients were recalled on day 5, 1 month, and 3 months for the analysis. Results: Uncorrected visual acuity (UCVA) preoperatively was 0.57, on the 5th day was 0.45 after 1 month was and after 3 months was 35. The mean preoperative astigmatism value in group I was 3.45, in group II was 3.52 and in group III was 3.49. Postoperative astigmatism value in group I was 1.60, in group II was 0.92 and in group III was 0.81. The difference was significant (P< 0.05). Conclusion: Authors found that amniotic membrane graft and a conjunctival autograft is better surgical techniques than bare sclera in reducing astigmatism.

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Effect of Cap-Lenticule Diameter Difference on the Visual Outcome and Higher-Order Aberrations in SMILE: 0.4 mm versus 1.0 mm

Journal of Ophthalmology ◽

10.1155/2017/8259546 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7

Author(s):

Banu Torun Acar ◽

Suphi Acar

Keyword(s):

Visual Acuity ◽

Visual Outcome ◽

Higher Order ◽

Early Postoperative Period ◽

Higher Order Aberrations ◽

Corrected Distance Visual Acuity ◽

Lenticule Extraction ◽

Group 2 ◽

Group 1

Purpose. To evaluate the effect of cap-lenticule diameter difference (CLDD) on the visual outcome and higher-order aberrations (HOAs) of small-incision lenticule extraction (SMILE). Methods. A total of 132 patients who had bilateral SMILE for myopia or myopic astigmatism were included. The CLDD was 0.4 mm in 54 patients (group 1) and 1.0 mm in 78 patients (group 2). The refractive parameters, uncorrected (UDVA) and corrected distance visual acuity (CDVA), and HOAs were determined preoperatively and during six months follow-up. Results. Group 1 had better CDVA (in logMAR) compared to group 2 at day 1 (−0.07 ± 0.07 versus 0.04 ± 0.07, resp.; p<0.001) and week 1 (−0.07 ± 0.07 versus –0.04 ± 0.07, resp.; p=0.001). The visual acuity improved more in group 1 than in group 2. The UDVA (in logMAR) was 0.07 ± 0.07 and 0.29 ± 0.09 at day 1 (p<0.001) and −0.08 ± 0.07 and −0.06 ± 0.06 at six months (p=0.038) in group 1 and group 2, respectively. Group 1 was associated with significantly less induction of HOAs (0.24 ± 0.08 μm and 0.32 ± 0.26 μm, resp.; p=0.002). Conclusions. In SMILE, 0.4 mm CLDD is associated with better visual outcome and less induction of HOAs than 1.0 mm. Narrow CLDD should be considered in SMILE to increase the visual acuity particularly in the early postoperative period.

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