scholarly journals Surgical Preferences in the Management of Primary Pterygium among Anterior Segment Specialists

2021 ◽  
Vol 15 (1) ◽  
pp. 322-328
Author(s):  
Abdulrahman Alfarhan ◽  
Albanderi Alhamzah ◽  
Abdulaziz Abuabat ◽  
Tariq Debasi ◽  
Tariq Almudhaiyan
Keyword(s):  
Current Practice ◽  
Response Rate ◽  
Anterior Segment ◽  
Surgical Techniques ◽  
Pharmacological Therapy ◽  
Tissue Adhesive ◽  
Practice Pattern ◽  
Visual Axis ◽  
Questionnaire Response ◽  
Primary Pterygium

Purpose: The purpose of this study is to reflect anterior segment specialists’ current practice pattern regarding the management of primary pterygium. Methods: A 24-item survey regarding indications for surgery, different surgical techniques, use of adjuvant pharmacological therapy, type of intraoperative and postoperative pharmacological therapy, and the preferred treatment of early recurrences was sent to members of the Saudi Ophthalmological Society (SOS) and practicing cornea experts including consultants, specialists, and fellows in Saudi Arabia. Results: A total of 61 cornea specialists completed the questionnaire (response rate 49%). More than 95% considered the proximity of the pterygium to the visual axis an indication for excision. The most frequent technique for pterygium excision was extensive head and conjunctival resection, including the base (69%) and intermediate resection of the Tenon's capsule (53%). For conjunctival replacement, conjunctival autograft was preferred by 79%, amniotic membrane (54%), and simple conjunctival closure (46%). Interrupted vicryl sutures, fibrin glue, and combined sutures and tissue adhesive were the preferred graft fixation conveyed by 85%, 46%, and 34% of our experts, respectively. An estimated recurrence rate of 1-5% was stated by 29% of respondents and 46% reported recurrence within 6 to 12 months. Half of the respondents specified using mitomycin C intraoperatively to prevent early pterygium recurrences. When recurrence occurred, corticosteroid was the agent of choice. Conclusion: This study set out to reflect the practice pattern of anterior segment specialists regarding the management of primary pterygium, and it may serve as an insight for further studies to define the optimal management of pterygium.

Pediatric Free-floating Anterior Chamber Cyst of the Iris Pigment Epithelium

2018 ◽  
Vol 1 ◽  
pp. 3
Author(s):  
Joshua S Agranat ◽  
Yoshihiro Yonekawa
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Chamber ◽  
Incidental Finding ◽  
Pigment Epithelium ◽  
Anterior Segment ◽  
Ultrasound Biomicroscopy ◽  
Optical Coherence ◽  
Visual Axis ◽  
Associated Malignancy ◽  
Anatomic Locations

Iris pigment epithelial (IPE) cysts are a subset of iris cysts that arise from the IPE. They are spontaneously erupting epithelial-lined cavities that are found in various anatomic locations of the iris, including the iris pupillary margin, midzone, periphery, and free floating in the vitreous or anterior chamber. We report the case of an asymptomatic 13-year-old boy with an incidental finding of a dislodged anterior chamber cyst diagnosed on routine examination. Modern multimodal image analysis of the cyst including anterior segment optical coherence tomography and ultrasound biomicroscopy (UBM) was utilized to characterize the microstructural anatomy of the lesion. The patient was managed conservatively without complications. Cysts of the IPE typically do not affect vision or ocular health and can be monitored and observed after ascertaining no associated malignancy. Initial diagnostic investigation can include UBM and anterior segment optical coherence tomography. Intervention should be reserved only for cases where the cyst growth leads to obstruction of the visual axis and/or other secondary complications.

A Comparative Study Between Preoperative Subconjunctival Bevacizumab Injection And Postoperative Topical Application In Prevention Of Recurrence After Excision Of Primary Pterygium In Egyptian Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Basma Helal Mohamed ◽  
Othman Ali Othman Ziko ◽  
Hisham M Khairy Abd El Dayem ◽  
Nancy Ezzelregal Khamis Ahmed
Keyword(s):  
Corneal Thickness ◽  
Anterior Segment ◽  
P Value ◽  
Eye Drops ◽  
Subconjunctival Injection ◽  
Fibrovascular Tissue ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1 ◽  
Primary Pterygium

Abstract Purpose to compare between recurrence incidence after primary pterygium excision when using preoperative subconjunctival injection of Bevacizumab (Avastin) and using it as a postoperative eye drops. Methods thirty two eyes of thirty patients (two patients had bilateral pterygium) with primary pterygia were clinically examined, classified into 3 groups and operated by simple excision with bare sclera technique. Group 1 included 10 patients received Bevacizumab (Avastin) in the form of eye drops (10 mg/ml) 3 times daily for 6 days postoperative. Group 2 included 10 patients received preoperative Bevacizumab in the form of subconjunctival injection (1.25 mg/0.05ml) single dose 1 week preoperative. Group 3 included 10 patients (12 eyes) 2 patients with bilateral Pterygium didn’t receive any form of Bevacizumab. Postoperative follow up was done clinically and by serial photography at 1 week, 1 month, 3 months and 6 months searching for signs of recurrence and/or complications. Results The results showed different grades of recurrence in 18 eyes of 32.True recurrence was seen in 7 patients of 18 (1 patient in group 1, 2 in group 2 and 4 in group3).Recurrence grades in group 1and 2 who used the Bevacizumab (20%grade II, 50% grade III, and 30% grade IV). Recurrence could be predicted by 100% depending on fibrovascular tissue appearing in the surgical bed at 3 months postoperative (P value 0.038).Preoperative fleshy pterygium has high statistical significance in realation to recurrence(P value = 0.006).Patient’s sex, residence and occupation had no statistically significant value in the process of recurrence (P value > 0.05). Patients with recurrent Pterygia (in group 1&2) had statistically significant changes in the corneal K- readings at 3 months and 6 months.No significant difference in the limbal or central corneal thickness in the operated eye and the other eye (Pvalue > 0.05). Conclusion Bevacizumab (Avastin) is a well tolerated drug with multiple drug delivery methods.The eye drops give better results than the subconjunctival injection.Appearance of fibrovascular tissue in the surgical bed at 3 months predict the recurrence by 100%. Preoperative fleshy pterygia will mostly recur again whatever Bevacizumab form was used .The corneal thickness by anterior segment OCT has no role in prediction or detection of early pterygium recurrence.

Ice-Cream Headache - A Large Survey of 8359 Adolescents

Cephalalgia ◽  
2003 ◽  
Vol 23 (10) ◽  
pp. 977-981 ◽  
Author(s):  
Jong-Ling Fuh ◽  
Shuu-Jiun Wang ◽  
Shiang-Ru Lu ◽  
Kai-Dih Juang
Keyword(s):  
High Schools ◽  
Response Rate ◽  
Junior High ◽  
Ice Cream ◽  
Target Population ◽  
Junior High Schools ◽  
Questionnaire Response ◽  
Large Survey ◽  
Self Administered Questionnaire

We conducted a self-administered questionnaire to investigate ice-cream headache in school adolescents aged 13-15 in Taiwan. The target population was 8789 students in 6 public junior high schools. A total of 8359 students completed the questionnaire (response rate 95.1%). The prevalence of ice-cream headache was 40.6%. It was significantly higher in boys than in girls, and increased with grade. Students with migraine had a higher frequency of ice-cream headache compared with the students without migraine (55.2% vs. 39.6%, P < 0.0001). The prevalence of ice-cream headache increased among students with more migrainous features. Approximately one third of students decreased their intake of ice cream, or abstained completely, especially the younger students. Our study suggests icecream headache is very common in Taiwanese adolescents, and it is more common in students who experienced migraine.

Epithelial downgrowth after Descemet membrane endothelial keratoplasty

2020 ◽  
pp. 112067212091241
Author(s):  
Viet Nhat Hung Le ◽  
Florian Wabnig ◽  
Bjoern Bachmann ◽  
Claus Cursiefen
Keyword(s):  
Anterior Segment ◽  
Corneal Edema ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Visual Axis ◽  
Corneal Incision ◽  
Descemet Membrane ◽  
Clear Corneal Incision ◽  
Close Observation ◽  
Histopathologic Evaluation

Purpose: To describe a patient with epithelial downgrowth after Descemet membrane endothelial keratoplasty. Methods: Case report. Results: A 73-year-old woman underwent triple Descemet stripping automated endothelial keratoplasty for cataract and corneal edema secondary to Fuchs endothelial dystrophy in the left eye elsewhere. Three years later, Descemet membrane endothelial keratoplasty was performed at our department due to graft failure. One month after the operation, her vision improved to 20/32 and maintained stable. At the 14-month visit, her visual acuity decreased, and a routine examination revealed epithelial downgrowth at the posterior surface of the cornea and partly beneath the graft, accompanied by presumed graft rejection. Therefore, repeat Descemet membrane endothelial keratoplasty with epithelial scraping and intracameral injection of 5-fluorouracil was indicated. She recovered 20/25 vision by 1 month after the surgery. However, small sheet-like epithelial downgrowth recurred 1 month later. The epithelial downgrowth was limited to the peripheral margin of the Descemet membrane endothelial keratoplasty graft and did not affect the visual axis. Epithelial downgrowth showed “islands” with connection between epithelial downgrowth and clear corneal incision on anterior segment optical coherence tomography images. Histopathologic evaluation of the removed Descemet membrane endothelial keratoplasty graft confirmed conjunctival epithelium as the source. Under close observation at the current 4-year follow-up, the epithelial downgrowth remained stable and localized and her vision increased to 20/20. Conclusion: Epithelial downgrowth can occur after Descemet membrane endothelial keratoplasty. The limited progression of epithelial downgrowth in this patient suggests that this condition after Descemet membrane endothelial keratoplasty even in the recurrence stage may cause less damage than expected and may only need to be observed closely if no progression occurs.

scholarly journals Prevalence of amblyopia and strabismus in Hani school children in rural southwest China: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e025441 ◽  
Author(s):  
Hui Zhu ◽  
Chenwei Pan ◽  
Qigang Sun ◽  
Dan Huang ◽  
Zhujun Fu ◽  
...  
Keyword(s):  
School Children ◽  
Prevalence Rate ◽  
Southwest China ◽  
Response Rate ◽  
Anterior Segment ◽  
Cross Sectional Study ◽  
Intermittent Exotropia ◽  
Chinese Han ◽  
Cross Sectional ◽  
And Gender

PurposeTo determine the prevalence rate of amblyopia and strabismus in Chinese Hani ethnic school-aged children.MethodsAll grade 1 and grade 7 students in Mojiang Hani Autonomous County, located in southwest China, were invited for comprehensive eye examinations performed by experienced ophthalmologists and optometrists, including visual acuity, ocular alignment and movements, cycloplegic autorefraction, anterior segment and fundus examinations. Standard definitions of amblyopia and strabismus were applied to calculate their prevalence rate.ResultsA total of 1656 (91.0% response rate) grade 1 Hani students and 1394 (92.8% response rate) grade 7 Hani students participated in the study. Amblyopia was present in 25 Hani students (0.82%, 95% CI 0.55% to 1.20%), with no significant differences in grade (p=0.42) and gender (p=0.69). Among these 25 amblyopic children, 17 had unilateral amblyopia and eight had bilateral amblyopia, including 16 anisometropic, eight binocular refractive and one strabismic. Strabismus was found in 59 Hani students (1.93%, 95% CI 1.50% to 2.48%), including 47 with intermittent exotropia, six with constant exotropia, five with constant esotropia and one with unilateral superior oblique palsy. The prevalence rate of strabismus was higher in grade 7 students than grade 1 students with borderline significance (2.44%vs1.50%, p=0.07), but was similar by gender (2.16% in boys vs 1.68% in girls, p=0.36).ConclusionThe prevalence of amblyopia and strabismus in Chinese Hani school children are both lower than that previously reported for Chinese Han children in China and for many other racial/ethnic populations from non-China studies. Refractive error is the major cause for amblyopia and intermittent exotropia is the primary strabismus type.

scholarly journals Cataract management in children: a review of the literature and current practice across five large UK centres

Eye ◽  
2020 ◽  
Vol 34 (12) ◽  
pp. 2197-2218 ◽  
Author(s):  
J. E. Self ◽  
R. Taylor ◽  
A. L. Solebo ◽  
S. Biswas ◽  
M. Parulekar ◽  
...  
Keyword(s):  
Visual Loss ◽  
Current Practice ◽  
Surgical Techniques ◽  
Multidisciplinary Teams ◽  
Review Of The Literature ◽  
Close Collaboration ◽  
Optical Correction ◽  
Paediatric Ophthalmology ◽  
The Uk ◽  
Paediatric Cataract

AbstractCongenital and childhood cataracts are uncommon but regularly seen in the clinics of most paediatric ophthalmology teams in the UK. They are often associated with profound visual loss and a large proportion have a genetic aetiology, some with significant extra-ocular comorbidities. Optimal diagnosis and treatment typically require close collaboration within multidisciplinary teams. Surgery remains the mainstay of treatment. A variety of surgical techniques, timings of intervention and options for optical correction have been advocated making management seem complex for those seeing affected children infrequently. This paper summarises the proceedings of two recent RCOphth paediatric cataract study days, provides a literature review and describes the current UK ‘state of play’ in the management of paediatric cataracts.

scholarly journals Spiritual care in the training of hospice volunteers in Germany

2015 ◽  
Vol 14 (5) ◽  
pp. 532-540 ◽  
Author(s):  
Margit Gratz ◽  
Piret Paal ◽  
Moritz Emmelmann ◽  
Traugott Roser
Keyword(s):  
Spiritual Care ◽  
Online Survey ◽  
Current Practice ◽  
Statistical Evaluation ◽  
Response Rate ◽  
Training Programs ◽  
Self Reflection ◽  
Hospice Volunteers ◽  
Care Training ◽  
Hospice Palliative Care

AbstractObjective:Hospice volunteers often encounter questions related to spirituality. It is unknown whether spiritual care receives a corresponding level of attention in their training. Our survey investigated the current practice of spiritual care training in Germany.Method:An online survey sent to 1,332 hospice homecare services for adults in Germany was conducted during the summer of 2012. We employed the SPSS 21 software package for statistical evaluation.Results:All training programs included self-reflection on personal spirituality as obligatory. The definitions of spirituality used in programs differ considerably. The task of defining training objectives is randomly delegated to a supervisor, a trainer, or to the governing organization. More than half the institutions work in conjunction with an external trainer. These external trainers frequently have professional backgrounds in pastoral care/theology and/or in hospice/palliative care. While spiritual care receives great attention, the specific tasks it entails are rarely discussed. The response rate for our study was 25.0% (n = 332).Significance of results:A need exists to develop training concepts that outline distinct contents, methods, and objectives. A prospective curriculum would have to provide assistance in the development of training programs. Moreover, it would need to be adaptable to the various concepts of spiritual care employed by the respective institutions and their hospice volunteers.

Reprocessing and Reuse of Single-Use Medical Devices Used During Hemodynamic Procedures in Brazil: A Widespread and Largely Overlooked Problem

2008 ◽  
Vol 29 (9) ◽  
pp. 854-858 ◽  
Author(s):  
Jorge M. Buchdid Amarante ◽  
Cristiana M. Toscano ◽  
Michele L. Pearson ◽  
Virginia Roth ◽  
William R. Jarvis ◽  
...  
Keyword(s):  
Adverse Events ◽  
Medical Devices ◽  
Surveillance System ◽  
Response Rate ◽  
Limited Resource ◽  
Interventional Cardiology ◽  
Questionnaire Response ◽  
Brazilian Society ◽  
Cardiac Catheters ◽  
Single Use

Background.Several medical devices used during hemodynamic procedures, particularly angiographic diagnostic and therapeutic cardiac catheters, are manufactured for single use only. However, reprocessing and reuse of these devices has been reported, to determine the frequency of reuse and reprocessing of single-use medical devices used during hemodynamic procedures in Brazil and to evaluate how reprocessing is performed.Design.National survey, conducted from December 1999 to July 2001.Methods.Most of the institutions affiliated with the Brazilian Society of Hemodynamic and Interventional Cardiology were surveyed by use of a questionnaire sent in the mail.Results.The questionnaire response rate was 50% (119 of 240 institutions). Of the 119 institutions that responded, 116 (97%) reported reuse of single-use devices used during hemodynamic procedures, and only 26 (22%) reported use of a standardized reprocessing protocol. Cleaning, flushing, rinsing, drying, sterilizing and packaging methods varied greatly and were mostly inadequate. Criteria for discarding reused devices varied widely. Of the 119 institutions that responded, 80 (67%) reported having a surveillance system for adverse events associated with the reuse of medical devices, although most of these institutions did not routinely review the data, and only 38 (32%) described a training program for the personnel who reprocessed single-use devices.Conclusions.The reuse of single-use devices used during hemodynamic procedures was very frequent in hospitals in Brazil. Basic guidance on how to reuse and reprocess single-use medical devices is urgently needed, because, despite the lack of studies to support reusing and reprocessing single-use medical devices, such devices are necessary in limited-resource areas in which these practices are current.

Sign in / Sign up

Export Citation Format

Share Document