scholarly journals Optical reconstructive treatment of a patient with essential mesodermal dystrophy of the iris

2021 ◽  
Vol 14 (3) ◽  
pp. 88-92
Author(s):  
N. P. Sobolev ◽  
S. A. Borzenok ◽  
M. A. Soboleva ◽  
Yu. V. Shkandina ◽  
E. P. Sudakova
Keyword(s):  
Intraocular Pressure ◽  
Surgical Treatment ◽  
Anterior Chamber ◽  
Intraoperative Complications ◽  
Successful Outcome ◽  
High Tech ◽  
Visual Functions ◽  
Post Surgery ◽  
Iridocorneal Endothelial Syndrome ◽  
Cosmetic Effect

Essentially mesodermal iris dystrophy (EMID) is a type of iridocorneal endothelial syndrome and has a chronic progressing character. It is observable after a local fibrosis is formed in the outer border of the iris, which subsequently causes the peripheral iris to pull up and leads to pupil deformation.Purpose: to evaluate the outcome of modern high-tech surgical treatment, which improves visual functions, prevents the decompensation of intraocular pressure and ensures a cosmetic effect.Materials and methods. Patient R., 48 yrs, was diagnosed with OU EMID, low hyperopia, astigmatism, and presbyopia. In order to prevent the development of secondary glaucoma and correct refractive anomalies, the patient was subjected to phacoemulsification with implantation of a multifocal toric IOL, synechiotomy, and iris plastic surgery. MTIOL was calculated using the VERION™ Image Guided System navigation computing complex (Alcon, USA) and the IOLMaster® 700 optical biometer (Carl ZEISS, Germany).Results. In early post-surgery period, the patient noted an increase in visual acuity, stabilized by the 6th month, a significant decrease of undesirable optical phenomena (glare, halo) and was satisfied with the postoperative cosmetic result. The level of intraocular pressure also stabilized by the 6th month after surgery and remained within the reference range by the 9th month. No intraoperative complications were observed. Control UBM scans showed transparent OU cornea, anterior chamber being shallower than the average depth, exfoliated stroma of the iris, moderate anterior chamber angle, intact ciliary body, centrally located pupil, IOL in capsule bag.Conclusion. The case describes a successful outcome of surgical treatment of a rare variety of iridocorneal endothelial syndrome, increase in visual functions, achievement of the desired cosmetic effect, and improvement in the quality of life of the working age patient.

Factors affecting changes in the intraocular pressure after phacoemulsification surgery

2020 ◽  
Vol 1 (3) ◽  
pp. 166-172
Author(s):  
Rita Dhamankar ◽  
◽  
Suhas S Haldipurkar ◽  
Tanvi Haldipurkar ◽  
Vijay Shetty ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Axial Length ◽  
Anterior Chamber Depth ◽  
The Other ◽  
Factors Affecting ◽  
Factors Associated ◽  
Post Surgery ◽  
Unit Increase ◽  
The Mean

AIM: To assess the changes in anterior chamber parameters and examine the factors associated with changes in the intraocular pressure (IOP) in individuals who have undergone phacoemulsification surgery. METHODS: It is a longitudinal analysis of secondary clinical data collected from 105 non-glaucomatous eyes (82 patients) undergoing a cataract surgery. We studied the association between anterior chamber parameters, grade of cataract, demographics, and changes in the IOP over a period of three weeks. We also evaluated the association between the pressure-depth (PD) ratio and changes in the IOP during this time. RESULTS: The mean age (SD) of the 82 patients was 60.1±7.8y. The mean±standard deviation (SD) IOP was 15.06±3.36 mm Hg pre-operatively; it increased to 15.75±4.21 mm Hg on day one (P=0.20). In the multifactorial models, the mean IOP was -1.715 (95%CI: -2.795, -0.636) mm Hg on day 21±5 compared with the pre-operative values. The anterior chamber depth (ACD), axial length, age, sex, and grade of cataract were not significantly associated with changes in the IOP. Each unit increase in the PD ratio was associated with an increase in the mean IOP by 1.289 mm Hg (95%CI: 0.906, 1.671). After adjusting for pre-operative PD ratio, none of the other variables (ACD, axial length, temporal angle) were significantly associated with changes in mean IOP. CONCLUSION: The PD ratio was the single most important factor associated with the changes in post-operative IOP over three weeks post-surgery.

Ex-PRESS mini-shunt implanted in a pregnant patient with iridocorneal endothelial syndrome

2019 ◽  
Vol 30 (1) ◽  
pp. NP25-NP28 ◽  
Author(s):  
Teresa Colás-Tomás ◽  
Elena López Tizón
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Young Patients ◽  
Pregnant Patient ◽  
Corneal Epithelial ◽  
Aqueous Shunt ◽  
Post Surgery ◽  
Iridocorneal Endothelial Syndrome ◽  
First Case ◽  
Filtration Area

Introduction: The failure rate of both filtration surgery and of aqueous shunt implantation is higher for iridocorneal endothelial syndrome than in other scenarios, due to the continuous proliferation of abnormal endothelial cells over the trabecular meshwork and the filtration area and also due to the more pronounced cicatrizing response shown by these young patients. We present the first case ever described in the literature of a pregnant patient with iridocorneal endothelial syndrome and uncontrolled ocular hypertension who was implanted an Ex-PRESS mini-shunt. Clinical case: A 35-year-old female presented with diminution of vision in the left eye for 2 months. She was 20 weeks pregnant. Her visual acuity was 20/20 in right eye and 20/25 in left eye, and intraocular pressure was 11 mmHg in right eye and 34 mmHg in left eye. Slit lamp biomicroscopic examination revealed no alterations in right eye, whereas left eye showed corectopia and uveal ectropion, stroma of iris’ sectoral atrophy and moderate corneal epithelial edema. Gonioscopy showed some anterior iris synechiae in left eye. Fundus evaluation was normal. Based on clinical features and examination, the diagnosis of left eye iridocorneal endothelial syndrome with decompensated intraocular pressure was made. She was prescribed topical timolol (0.5%) and dorzolamide. As a result of uncontrolled intraocular pressure and the impossibility to prescribe other hypotensive treatment available due to her being pregnant, it was decided to perform surgery in left eye using an Ex-PRESS mini-shunt and Ologen®; 6 months post surgery, intraocular pressure was 9 mmHg with no need for hypotensive treatment. The cornea was transparent, and the patient maintained her left eye visual acuity. Conclusions: Ex-PRESS mini-shunt can be considered a surgical option for iridocorneal endothelial syndrome. Its composition allows the ostium to remain open and the device triggers a milder postoperative inflammatory response. In our particular case, taking into account that the subject was a young, phakic, pregnant woman, whose intraocular pressure had to be closely controlled and we had to ensure that her postoperative care included as few drugs and as few reoperations as possible, we thought that using this device was the most appropriate option.

Temporary “liquid” Implant for Congenital Glaucoma (long-term results)

2020 ◽  
pp. 49-65
Author(s):  
N Bobrova ◽  
N Trofimova
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Hypotensive Effect ◽  
Congenital Glaucoma ◽  
Long Term Results ◽  
General Will ◽  
Visual Functions ◽  
Advanced Stages ◽  
Intraocular Fluid

The aim of the work was to analyze the long-term results of using a temporary “liquid” implant in the surgery of congenital glaucoma in children. The basis of the developed method of filtrative antiglaucomatous surgery (Patent of Ukraine No. 45099 of 2009) – viscosinusotrabeculotomy – has been set the task of reducing the risk of developing intra- and postoperative complications, reducing the scarring rate and maintaining the newly created ways of the intraocular fluid outflow, which in general will increase the effectiveness of surgical treatment of congenital glaucoma in children. 54 children (91 eyes) with simple congenital glaucoma at the age of 1 to 36 months were operated on average (8.7 ± 8.2) months. The persistent and long-lasting hypotensive effect achieved due to viscosinusotrabeculotomy in children with developed and far-advanced stages of congenital glaucoma stops the processes of stretching of the membranes of the eye and stabilizes their size, which in general allows preserving and visual functions improving, in infancy – creating conditions for their formation.

Hidden, visceral and traumatic: a dramaturgical approach to men talking about their penis after surgery for penile cancer

2018 ◽  
Author(s):  
Peter Branney ◽  
Karl Witty
Keyword(s):  
Body Image ◽  
Surgical Treatment ◽  
Thematic Analysis ◽  
Penile Cancer ◽  
Stage Of Disease ◽  
Self And Other ◽  
Post Surgery ◽  
Maximum Variation ◽  
Sexual Object

Drawing upon concepts of expressive equipment and body image, the aim of this study is to explore how men diagnosed and treated for penile cancer construct their penis and its surgical disfigurement (penectomy). Using maximum variation sampling with the intention to acquire the broadest range of experiences of stage of disease and treatment, 27 cisgender men (aged 48-83, x=63) who had surgical treatment consented for their data to be archived for analysis. From a dramaturgical perspective, the constructionist thematic analysis explored direct and indirect talk about the penis after surgery. The analysis showed that through graphic and sequential narratives of dismemberment revealed, participants constructed a post-surgery period in which they both wanted and did-not-want to see their penis. Additionally, participants constructed themselves managing difficult emotions through others and seeing themselves being rejected by a potentially desiring (female) Other. The findings extend research on male genitals by showing how the post-surgery penis can function as something hidden but visceral and traumatic when revealed. Importantly, this paper illustrates body image as expressive equipment where body and identity are formed in the image of manhood, which is an intersubjective (sexual) object between self and other.

scholarly journals Polypharmacy-associated potential contraindications of drug prescriptions in patients with primary angle closure disease in a real-world setting

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Fumiaki Tanaka ◽  
Naoki Shibatani ◽  
Kazumi Fujita ◽  
Hiroaki Ikesue ◽  
Satoru Yoshimizu ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Anterior Chamber Depth ◽  
Japanese Patients ◽  
Median Number ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Number Of Patients ◽  
Multiple Drugs

Abstract Background Primary angle closure disease (PACD) is a type of glaucoma in which the intraocular pressure (IOP) is increased because of the blockage of the anterior chamber angle. Medications contraindicated for patients with PACD, such as anticholinergics, cause mydriasis, and can elevate IOP. However, anticholinergics are currently contraindicated only for primary angle closure glaucoma (PACG) in Japanese package inserts. In this study, we investigated the prescription status of medications contraindicated for PACD, such as anticholinergics, in patients with PACD scheduled for eye surgeries. Methods Forty-three Japanese patients diagnosed with PACD at Kobe City Eye Hospital, Japan, and scheduled hospitalization for eye surgeries between December 2017 and July 2018, were included. Data, including sex, age, diagnosis, IOP, anterior chamber depth, and patients’ regular medications prior to hospitalization, were collected for each patient from the electronic medical records. Results The number of patients with chronic primary angle closure (CPAC) and acute primary angle closure (APAC) was 35 (81.4%) and 8 (18.6%), respectively. Among all the 43 patients with PACD, 8 (18.6%) received 15 medications that are potentially contraindicated for PACD by non-ophthalmologist. According to medication categories, benzodiazepine hypnotics were the most commonly prescribed. Among the 8 patients with APAC, 2 (25.0%) had routinely received medications contraindicated for PACD. The median number of all kinds of prescriptions on the day of hospitalization was significantly higher for patients who received medications contraindicated for PACD than for those who did not receive them (p = 0.010). Conclusions About 20% of patients with PACD received medications potentially contraindicated for PACD, such as anticholinergics. Attention should be paid to patients prescribed multiple drugs for adverse events, such as increase in intraocular pressure.

scholarly journals Urrets-Zavalia Syndrome Following Cataract Surgery

2021 ◽  
pp. 659-663
Author(s):  
Shimon Kurtz ◽  
Maayan Fradkin
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Inflammatory Reaction ◽  
Intraocular Lens Implantation ◽  
Postoperative Course ◽  
Lens Implantation ◽  
The Right

We describe a case of Urrets-Zavalia syndrome (UZS) in a healthy 56-year-old woman who underwent femtosecond-assisted phacoemulsification with intraocular lens implantation in both eyes. One month after an uneventful postoperative course in the left eye, the right eye was operated. Dilated pupil which was nonreactive to light appeared on day 21 postoperatively. This was discovered upon examination following anterior chamber inflammatory reaction which occurred 2 weeks following her surgery. Our case report emphasizes the importance and danger in developing UZS even if the reaction in the anterior chamber does not occur immediately after surgery. In addition, the importance of intraocular pressure follow-up in the period after UZS is acknowledged.

Psychiatric and psychosocial morbidity 1 year after epilepsy surgery

2020 ◽  
pp. 1-8
Author(s):  
S. Patel ◽  
M. Clancy ◽  
H. Barry ◽  
N. Quigley ◽  
M. Clarke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Epilepsy Surgery ◽  
Refractory Epilepsy ◽  
Post Surgery ◽  
Axis I ◽  
Patients With Epilepsy ◽  
The Impact

Abstract Objectives: There is a high rate of psychiatric comorbidity in patients with epilepsy. However, the impact of surgical treatment of refractory epilepsy on psychopathology remains under investigation. We aimed to examine the impact of epilepsy surgery on psychopathology and quality of life at 1-year post-surgery in a population of patients with epilepsy refractory to medication. Methods: This study initially assessed 48 patients with refractory epilepsy using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life in Epilepsy Inventory 89 (QOLIE-89) on admission to an Epilepsy Monitoring Unit (EMU) as part of their pre-surgical assessment. These patients were again assessed using the SCID-I, QOLIE-89 and HADS at 1-year follow-up post-surgery. Results: There was a significant reduction in psychopathology, particularly psychosis, following surgery at 1-year follow-up (p < 0.021). There were no new cases of de novo psychosis and surgery was also associated with a significant improvement in the quality of life scores (p < 0.001). Conclusions: This study demonstrates the impact of epilepsy surgery on psychopathology and quality of life in a patient population with refractory surgery. The presence of a psychiatric illness should not be a barrier to access surgical treatment.

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