scholarly journals Cyanoacrylate tissue glue for wound repair in early posttrabeculectomy conjunctival bleb leak: a case series

2015 ◽  
pp. 145 ◽  
Author(s):  
Embong Zunaina ◽  
Abdul-Rahim Haslinda ◽  
Yaakub Azhany ◽  
Rasid Noor-Khairul ◽  
Ahmad-Tajudin Liza-Sharmini
Keyword(s):  
Wound Repair ◽  
Case Series ◽  
Tissue Glue ◽  
Bleb Leak ◽  
Conjunctival Bleb

Bleb reconstruction using donor scleral patch graft for late bleb leak and hypotony

2020 ◽  
pp. 112067212092434
Author(s):  
Michael O’Rourke ◽  
Sarah Moran ◽  
Niamh Collins ◽  
Aoife Doyle
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Standard Deviation ◽  
Late Complication ◽  
Case Series ◽  
Filtration Surgery ◽  
Glaucoma Filtration Surgery ◽  
Operative Care ◽  
Patch Graft ◽  
Bleb Leak

Purpose Bleb dysfunction may occur as a late complication following glaucoma filtration surgery. Over-filtering, thinning and cystic blebs can lead to hypotony, leak and corneal dellen. We report our surgical management and outcomes of this specific entity using donor scleral patch grafts. Methods This is a 10-year non-comparative, retrospective interventional case series. Bleb reconstruction involved excision of encysted conjunctiva and sclera to identify the original fistula. A functioning donor scleral patch graft was sited over this with fixed and releasable sutures and the conjunctiva advanced. Intraocular pressure, visual acuity and post-operative issues were assessed. Results A total of 18 eyes of 17 patients with mean age 65 years (standard deviation 13.5) were included. Trabeculectomy was the primary procedure in 72% ( n = 13) and deep sclerectomy in 28% ( n = 5). Bleb leak accounted for 61% ( n = 11), hypotony 33% ( n = 6) and corneal dellen 6% ( n = 1). Mean pre-operative intraocular pressure was 7 mm Hg (standard deviation 4.6) which increased to 18.5 mm Hg (standard deviation 12) at day 1 ( p < 0.001), 11.8 mm Hg (standard deviation 4.6) at 3 months ( p < 0.05), 12.1 mm Hg (standard deviation 4.2) at 1 year ( p < 0.01) which was maintained at 12.1 mm Hg (standard deviation 5.3) at last follow-up ( p < 0.001). Post-operative interventions included bleb needling, re-suturing, suture removal, further glaucoma management, bleb leak and cataract surgery. Visual acuity also improved post-operatively and was maintained. Conclusion Reconstruction of the filtering bleb architecture with donor sclera results in improved intraocular pressure while maintaining visual acuity. Post-operative care is required to support the restored bleb function. Our findings support the use of scleral patch graft as an effective and safe method for the long-term management of hypotony and bleb leak as a late complication of glaucoma filtration surgery.

Conjunctival bleb compression as a treatment for hypotony post XEN45 implant in uveitic glaucoma

2019 ◽  
Vol 30 (1) ◽  
pp. 217-220
Author(s):  
Jonathan Thur Sian Yu ◽  
Leon Au
Keyword(s):  
Intraocular Pressure ◽  
Case Series ◽  
Retrospective Case ◽  
Uveitic Glaucoma ◽  
Inflammatory Status ◽  
Effective Option ◽  
Successful Resolution ◽  
Persistent Hypotony ◽  
Conjunctival Bleb

Purpose: Over-filtration and subsequent hypotony are recognised complications of penetrating glaucoma procedures, especially when augmented with antimetabolites. Patients with uveitis are especially at risk of hypotony and this can reduce the final acuity achieved, compromise surgical outcomes and adversely affect the inflammatory status. The incidence of hypotony following XEN45 implant insertion is higher for uveitic patients and we present a method of surgically addressing this hypotony with transconjunctival compression sutures that are placed over the overdraining XEN45 implant. Methods: We present a retrospective case series of consecutive uveitic glaucoma patients who had conjunctival compression sutures between 2015 and 2018 following XEN45 insertion, at the Manchester Royal Eye Hospital, UK. Two 9/0 nylon sutures were placed in a horizontal figure-of-eight conformation transconjunctivally across the overdraining bleb: one directly over the XEN45 implant and one at the posterior limit of the implant in order to restrict flow. Results: Three patients underwent conjunctival compression sutures following XEN45 implant-related hypotony and all three had successful resolution of their hypotony and visual symptoms. No patients required long-term topical agents to control their intraocular pressure. Conclusion: Conjunctival compression sutures are an effective option for addressing persistent hypotony following XEN45 implant insertion in patients with uveitic glaucoma.

scholarly journals Degenerative lamellar macular holes: tractional development and morphological alterations

2021 ◽  
Author(s):  
Andreas Bringmann ◽  
Jan Darius Unterlauft ◽  
Renate Wiedemann ◽  
Thomas Barth ◽  
Matus Rehak ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Wound Repair ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Case Series ◽  
Retrospective Case ◽  
Epiretinal Membranes ◽  
Morphological Alterations ◽  
Macular Holes ◽  
Foveal Center

Abstract Purpose The development of degenerative lamellar macular holes (DLH) is largely unclear. This study was aimed at documenting with spectral-domain optical coherence tomography the tractional development and morphological alterations of DLH. Methods A retrospective case series of 44 eyes of 44 patients is described. Results The development of DLH is preceded for months or years by tractional deformations of the fovea due to the action of contractile epiretinal membranes (ERM) and/or the partially detached posterior hyaloid, or by cystoid macular edema (CME). DLH may develop after a tractional stretching and thickening of the foveal center, from a foveal pseudocyst, after a detachment of the foveola from the retinal pigment epithelium, a disruption of the foveal structure due to CME, and after surgical treatment of tractional lamellar or full-thickness macular holes (FTMH). The foveal configuration of a DLH can be spontaneously reestablished after short transient episodes of CME and a small FTMH. A DLH can evolve to a FTMH by traction of an ERM. Surgical treatment of a DLH may result in an irregular regeneration of the foveal center without photoreceptors. Conclusions Tractional forces play an important role in the development of DLH and in the further evolution to FTMH. It is suggested that a DLH is the result of a retinal wound repair process after a tractional disruption of the Müller cell cone and a degeneration of Henle fibers, to prevent a further increase in the degenerative cavitations.

Abstract #856 A Case Series Review of Clinical and Biochemical Characteristics of Pituitary Abcess in Mexican Patients

2018 ◽  
Vol 24 ◽  
pp. 202-203
Author(s):  
Mireya Perez-Guzman ◽  
Alfredo Nava de la Vega ◽  
Arturo Pena Velarde ◽  
Tania Raisha Torres Victoria ◽  
Froylan Martinez-Sanchez ◽  
...  
Keyword(s):  
Case Series ◽  
Biochemical Characteristics ◽  
Mexican Patients

Cannabis-associated arteritis

VASA ◽  
2010 ◽  
Vol 39 (1) ◽  
pp. 43-53 ◽  
Author(s):  
Grotenhermen
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Case Series ◽  
Cardiovascular Effects ◽  
Causative Factor ◽  
Cannabis Use ◽  
Thromboangiitis Obliterans ◽  
Pathological Features ◽  
Scientific Support ◽  
Clinical And Pathological Features

Background: To investigate the hypothesis that cases of arteritis similar to thromboangiitis obliterans (TAO) and associated with the use of cannabis were caused by cannabis or THC (dronabinol), or that cannabis use is a co-factor of TAO. Patients and methods: A systematic review on case reports and the literature on so-called cannabis arteritis, TAO, and cardiovascular effects of cannabinoids was conducted. Results: Fifteen reports with 57 cases of an arteritis associated with the use of cannabis and two additional case series of TAO, in which some patients also used cannabis, were identified. Clinical and pathological features of cannabis-associated arteritis do not differ from TAO and the major risk factor of TAO, tobacco use, was present in most, if not in all of these cases. The proposed pathophysiological mechanisms for the development of an arteritis by cannabis use are not substantiated. Conclusions: The hypothesis of cannabis being a causative factor or co-factor of TAO or an arteritis similar to TAO is not supported by the available evidence. The use of the term “cannabis arteritis” should be avoided until or unless more convincing scientific support is forthcoming.

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