scholarly journals Sutureless Amniotic Membranes (ProKera) for Filamentary Keratitis: A Case Series

2019 ◽  
Vol 2 (1) ◽  
pp. e10-e16
Author(s):  
Jennifer S Harthan ◽  
Lindsay A Sicks
Keyword(s):  
Amniotic Membrane ◽  
Ocular Surface ◽  
Management Strategies ◽  
Anterior Segment ◽  
Case Series ◽  
Signs And Symptoms ◽  
Traditional Therapies ◽  
Amniotic Membranes ◽  
Ocular Signs

Purpose To report a case series of refractory filamentary keratitis successfully managed with sutureless amniotic membranes resistant to other management strategies.   Methods Three cases are discussed with anterior segment photography who were diagnosed with filamentary keratitis and successfully managed with sutureless amniotic membranes, after experiencing limited relief with standard treatments.   Conclusions This case series demonstrates the complex management of patients with filamentary keratitis who had failed with traditional therapies and were successfully managed with sutureless amniotic membranes. All three patients demonstrated improvement in both ocular signs and symptoms following amniotic membrane application to the ocular surface. 

scholarly journals Tenonplasty Combined With Amniotic Membrane Transplantation for Patients With Severe Ocular Burns Induced Anterior Segment Necrosis

2020 ◽  
Vol 41 (3) ◽  
pp. 668-673
Author(s):  
Wen-yan Peng ◽  
Li-wen He ◽  
Peng Zeng ◽  
Dong-cui Chen ◽  
Shi-you Zhou
Keyword(s):  
Amniotic Membrane ◽  
Ocular Surface ◽  
Anterior Segment ◽  
Case Series ◽  
Corneal Opacity ◽  
Vascular Supply ◽  
Amniotic Membrane Transplantation ◽  
Final Visit ◽  
Prospective Case Series ◽  
Ocular Burns

Abstract This article describes a novel surgical technique for successful repair of intractable corneoscleral necrosis caused by severe ocular burns. In this prospective case series, 19 eyes of 15 consecutive patients with sectional scleral necrosis and persistent corneal epithelial defects were treated with tenonplasty and amniotic membrane transplantation. The main outcome measure was the stability of the ocular surface after reepithelialization and repair of defects. All patients underwent successful combined surgery involving tenonplasty and amniotic membrane transplantation, in which the conjunctival and corneal surfaces were reconstructed. The interval from injury to surgery was 37.4 ± 24.5 days (3–91 days), and the ocular surfaces became stabilized in 82.2 ± 35.4 days (26–156 days, median 87 days). At the final visit, all cases presented with corneal opacity and neovascularization to various degrees. The best-corrected visual acuity decreased from 2.83 ± 1.02 LogMAR preoperatively to 2.87 ± 1.31 LogMAR postoperatively. The results imply that tenonplasty combined with amniotic membrane transplantation could provide vascular supply to the ischemic sclera, repair defects in the conjunctiva, and promote corneal reepithelialization, thus facilitating ocular surface stabilization after burns.

scholarly journals Rosacea-associated Meibomian Gland Dysfunction – An Epidemiological Perspective

2014 ◽  
Vol 08 (01) ◽  
pp. 13 ◽  
Author(s):  
Eloy Viso ◽  
Alejandro Clemente Millán ◽  
María Teresa odríguez-Ares ◽  
◽  
◽  
...  
Keyword(s):  
Ocular Surface ◽  
Conventional Treatment ◽  
Signs And Symptoms ◽  
Population Based ◽  
Meibomian Gland ◽  
Clinical Suspicion ◽  
Meibomian Gland Dysfunction ◽  
Ocular Signs

The association between meibomian gland dysfunction (MGD) and rosacea is probably frequently underdiagnosed despite being one of the few associations of MGD that has been corroborated in population-based patients. Its diagnosis is not easy because the ocular signs and symptoms of this type of MGD are non specific and because the cutaneous signs may be minimal or absent; however, it is important because it may be associated with more severe manifestations such as keratitis, as several studies have shown, and a poorer prognosis. For this reason, clinical suspicion should be high especially in cases unresponsive to conservative measures and conventional treatment, and in those with inflammatory complications of the ocular surface.

scholarly journals Non-Recurrence Complications of Fibrin Glue Use in Pterygium Surgery: Prevention and Management

2015 ◽  
Vol 9 (1) ◽  
pp. 159-163 ◽  
Author(s):  
Halil Hüseyin Cagatay ◽  
Gökçen Gökçe ◽  
Alper Mete ◽  
Yaran Koban ◽  
Metin Ekinci
Keyword(s):  
Fibrin Glue ◽  
Amniotic Membrane ◽  
Ocular Surface ◽  
Management Strategies ◽  
Cyst Formation ◽  
Amniotic Membrane Transplantation ◽  
Topical Steroids ◽  
Graft Removal ◽  
Pterygium Surgery ◽  
Pterygium Excision

Purpose : To present complications of using fibrin glue in conjunctival-limbal autografting in pterygium surgeries other than recurrences and discuss their prevention and management strategies. Materials and Methodology: The charts of all patients who underwent fibrin glue assisted pterygium excision surgery with conjunctival-limbal autograft transplantation from 2010 to 2013 were reviewed. Patients who developed complications except recurrence postoperatively were included in this study. Results : Sixteen (17.39%) of the 92 patients were detected with a complication. Graft dehiscence was diagnosed in 7 (7.6%) patients with 5 of them treated conservatively and 2 patients requiring suturing. Five (5.43%) patients were diagnosed with cyst formation between the graft and conjunctiva or in the graft-removal area; these cysts were primarily excised and no additional problems occurred. Corneal dellen developed in 3 (3.26%) patients and 2 of them regressed after cessation of topical steroids and application of lubricant therapy while one was treated with amniotic membrane transplantation. Residual fibrin glue particles had stiffened on the ocular surface, which resulted in intensive pain and irritation in one (1.08%) patient on the same day of the surgery. The patient’s complaints were reduced by removing these particles from the ocular surface under topical anesthesia. Conclusion : Complications in fibrin glue assisted pterygium surgery are relatively different from other techniques. To avoid potential complications of fibrin glue in pterygium surgery, peroperatively ophthalmologists should ensure the conjunctival autograft and conjunctiva are properly adhered, fibrin glue remnants are completely removed from the ocular surface, and no Tenon’s capsule remains between the graft and the conjunctiva.

scholarly journals AMNIOTIC MEMBRANE TRANSPLANTATION IN OCULAR SURFACE DISORDERS – A CASE SERIES

2016 ◽  
Vol 3 (30) ◽  
pp. 1376-1379
Author(s):  
Umesh Harakuni ◽  
Smita K.S ◽  
Sanya Garg ◽  
Patil S.B ◽  
Shivanand C Bubanale ◽  
...  
Keyword(s):  
Amniotic Membrane ◽  
Ocular Surface ◽  
Case Series ◽  
Amniotic Membrane Transplantation

scholarly journals Presentation and management of N-acetylglutamate synthase deficiency: a review of the literature

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Aileen Kenneson ◽  
Rani H. Singh
Keyword(s):  
Current Knowledge ◽  
Case Reports ◽  
Management Strategies ◽  
Clinical Signs ◽  
Case Series ◽  
Signs And Symptoms ◽  
Protein Restriction ◽  
Therapeutic Trials ◽  
Acetylglutamate Synthase ◽  
Clinical Signs And Symptoms

Abstract Background N-Acetylglutamate synthase (NAGS) deficiency is an extremely rare autosomal recessive metabolic disorder affecting the urea cycle, leading to episodes of hyperammonemia which can cause significant morbidity and mortality. Since its recognition in 1981, NAGS deficiency has been treated with carbamylglutamate with or without other measures (nutritional, ammonia scavengers, dialytic, etc.). We conducted a systematic literature review of NAGS deficiency to summarize current knowledge around presentation and management. Methods Case reports and case series were identified using the Medline database, as well as references from other articles and a general internet search. Clinical data related to presentation and management were abstracted by two reviewers. Results In total, 98 cases of NAGS deficiency from 79 families, in 48 articles or abstracts were identified. Of these, 1 was diagnosed prenatally, 57 were neonatal cases, 34 were post-neonatal, and 6 did not specify age at presentation or were asymptomatic at diagnosis. Twenty-one cases had relevant family history. We summarize triggers of hyperammonemic episodes, diagnosis, clinical signs and symptoms, and management strategies. DNA testing is the preferred method of diagnosis, although therapeutic trials to assess response of ammonia levels to carbamylglutamate may also be helpful. Management usually consists of treatment with carbamylglutamate, although the reported maintenance dose varied across case reports. Protein restriction was sometimes used in conjunction with carbamylglutamate. Supplementation with citrulline, arginine, and sodium benzoate also were reported. Conclusions Presentation of NAGS deficiency varies by age and symptoms. In addition, both diagnosis and management have evolved over time and vary across clinics. Prompt recognition and appropriate treatment of NAGS deficiency with carbamylglutamate may improve outcomes of affected individuals. Further research is needed to assess the roles of protein restriction and supplements in the treatment of NAGS deficiency, especially during times of illness or lack of access to carbamylglutamate.

scholarly journals INTENSE PULSED LIGHT (IPL) TREATMENT FOR DUPILUMAB INDUCED OCULAR SURFACE DISEASE (DIOSD)

2022 ◽  
Vol 5 (1) ◽  
pp. e1-e11
Author(s):  
Sathi Maiti ◽  
Laura M Periman ◽  
Natasha Balani
Keyword(s):  
Ocular Surface ◽  
Anterior Segment ◽  
Signs And Symptoms ◽  
Intense Pulsed Light ◽  
Ocular Surface Disease ◽  
Topical Steroids ◽  
Pulsed Light ◽  
Traditional Treatment ◽  
Adjunct Therapy ◽  
Effective Adjunct

PurposeTo report a case of dupilumab induced ocular surface disease (DIOSD) managed with intense pulsed light (IPL) as an effective adjunct therapy to topical steroids and topical immunomodulator lifitegrast.MethodsDiscussion of a patient’s case with accompanying anterior segment and meibography photos with diagnosed DIOSD for which adjunct therapy with IPL was an effective treatment after limited relief from and difficulty with adherence to traditional treatment with topical steroids and lifitegrast ophthalmic solutions. ConclusionThis case demonstrates the complexity of management required to treat patients with DIOSD and its chronic nature. IPL as a nonpharmaceutical adjunct therapy to topical steroids and immunomodulators in the treatment of DIOSD showed improved signs and symptoms of DIOSD.

Reversal of DIRECT-ACTING Oral Anticoagulants in Urgent Surgery of the Proximal Aorta: case Series and Review of the literature

2019 ◽  
Vol 24 (38) ◽  
pp. 4534-4539 ◽  
Author(s):  
Eric Zimmermann ◽  
Fawzi Ameer ◽  
Berhane Worku ◽  
Dimitrios Avgerinos
Keyword(s):  
Oral Anticoagulants ◽  
Aortic Surgery ◽  
Management Strategies ◽  
Case Series ◽  
Published Data ◽  
Review Of Literature ◽  
Clotting Factors ◽  
Urgent Surgery ◽  
Direct Acting ◽  
Direct Acting Oral Anticoagulants

Introduction: Proximal aorta interventions impose significant bleeding risk. Patients on concomitant anticoagulation regimens compound the risk of bleeding in any surgery, but especially cardiothoracic interventions. The employment of direct-acting oral anticoagulants (DOAC), namely those that target clotting factors II or X, has expanded at a precipitous rate over the last decade. The emergence of their reversal agents has followed slowly, leaving clinicians with management dilemmas in urgent surgery. We discuss current reversal strategies based on the available published data and our experience with proximal aortic surgery in patients taking DOACs. Literature Search: We performed a review of literature and present three cases from our experience to offer insight into management strategies that have been historically successful. A review of literature was conducted via PubMed with the following search string: (NOAC or DOAC or TSOAC) and (aorta or aortic or (Stanford and type and a)). Case Presentation: We present three case presentations that illustrate the importance of DOAC identification and offer management strategies in mitigating associated bleeding risks in urgent or emergent surgeries. Conclusion: Treatment teams should be aware of the technical limitations of identifying and reversing DOACs. In view of the tendency toward publishing positive outcomes, more scientific rigor is required in the area of emergency DOAC reversal strategies.

Review of Prelabor Rupture of the Membranes: Pathophysiologic Concepts and Novel Therapeutic Strategies

2020 ◽  
Vol 16 ◽  
Author(s):  
Saadia Ghafoor
Keyword(s):  
Management Strategies ◽  
Signs And Symptoms ◽  
Cochrane Library ◽  
Main Body ◽  
Scientific Publications ◽  
Timely Diagnosis ◽  
Narrative Literature Review ◽  
Contemporary Management ◽  
Online Library ◽  
Novel Therapeutic Strategies

Background:: Prelabor rupture of membrane (PROM) refers to the breakage of fetal membranes before the onset of labor, resulting in the leakage of amniotic fluid. PROM affects approximately 3% and 8% of preterm and term pregnancies. Because of associated high maternal and perinatal mortality, correct and timely diagnosis together with effective management is highly recommended to prevent adverse fetal and maternal outcomes. Objective:: To provide an overview of the novel concepts in the understanding of PROM including etiology, pathophysiology, risk factors, complications, assessment, diagnostic modalities, and contemporary management strategies for PROM at preterm and term. Methodology:: This narrative literature review was conducted through a literature search using the Cochrane library and electronic databases including PubMed, Web of Science, Medline, Scopus, Crossref, Google Scholar, Wiley online library, ScienceDirect with specific search terms in scientific publications published from March 1980 to March 2020. Main Body:: Preterm PROM has the potential to cause prenatal morbidity and mortality. It is imperative to monitor the signs and symptoms of an impending infection due to the risk of infectious morbidity with PROM at preterm and preterm. PROM at preterm and term requires prompt diagnosis followed by an appropriate management strategy. Conclusion:: The correct and timely diagnosis of PROM is essential for efficacious management. Furthermore, it can reduce avoidable emergent health care visits and related costs in a clinical setting subjected to pregnancy with suspected PROM. Further studies are needed to fill the gaps in identifying better diagnostic predictive tools in high- risk pregnancies.

scholarly journals Etiologies and clinical characteristics of young patients with angle-closure glaucoma: a 15-year single-center retrospective study

2021 ◽  
Author(s):  
Feng Gao ◽  
Jiajian Wang ◽  
Junyi Chen ◽  
Xiaolei Wang ◽  
Yuhong Chen ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Anterior Segment ◽  
Young Patients ◽  
Case Series ◽  
Neovascular Glaucoma ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Uncommon Presentation ◽  
Underlying Causes

Abstract Purpose To investigate the etiologies and the clinical characteristics of angle-closure glaucoma (ACG) patients younger than 40 years old in Chinese. Methods Inpatients with diagnosis of ACG and diagnosed age younger than or equal to 40 years old, who were admitted in Eye, Ear, Nose, and Throat Hospital Fudan University from 2002 to 2017, were included in this retrospective non-comparative case series. The underlying causes and clinical features for all the patients were analyzed by comprehensive review of medical charts. Results A total of 298 patients (463 eyes) met the criteria, including 153 females (51.3%) and 145 males (48.7%); the mean age was 25.6 ± 13.0 years. Primary angle-closure glaucoma (PACG), uveitis, and anterior segment dysgenesis (ASD) were the top three etiologies in our patients, which accounted for 32.6%, 20.3%, and 15.1% of the total patients respectively. PACG mainly occurs after 30 years of age and ASD is the top reason of ACG in patients younger than 20 years old. Other known etiologies include iridocorneal endothelial syndrome, neovascular glaucoma, nanophthalmos, retinitis pigmentosa, spherophakia, bestrophinopathy, persistent fetal vasculature, iridociliary cysts, congenital retinoschisis, Marfan’s syndrome, retinopathy of prematurity, familial exudative vitreoretinopathy, congenital retinal folds, Coat’s disease, and neurofibromatosis. Conclusions We described the uncommon presentation of ACG in Chinese young patients. Although unusual, most of the etiologies could be identified. Therefore, more careful and comprehensive examinations are needed for early detection and timely treatment for young ACG patients.

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