scholarly journals Postoperative visual recovery following surgical treatment of suprasellar meningiomas

2012 ◽  
Vol 65 (7-8) ◽  
pp. 309-314
Author(s):  
Desanka Grkovic ◽  
Tatjana Bedov ◽  
Vladimir Canadanovic ◽  
Nikola Babic ◽  
Sava Barisic
Keyword(s):  
Visual Acuity ◽  
Optic Chiasm ◽  
Lower Number ◽  
Visual Recovery ◽  
Nerve Fibres ◽  
Mechanical Pressure ◽  
Irreversible Damage ◽  
Postoperative Visual Acuity ◽  
Visual Status ◽  
Ophthalmologic Examination

Introduction. The purpose of this study was to investigate pre- and postoperative visual acuity in patients with meningioma in the area of optic chiasm. Material and Methods. This retrospective study included 43 patients with meningioma in the area of optic chiasm, who had been found to have impaired visual function according to anamnestic data and neuro-ophthalmologic examination which excluded the presence of any other eye diseases. The visual status was analyzed both preoperatively and postoperatively, i.e. 10 days, one month and six months after surgery. Results. An improvement in visual acuity was recorded in 50% of the examined eyes (68.42% of patients), the most expressed changes being in terms of higher number of the eyes with normalized visual acuity and lower number of the eyes with severely reduced visual acuity after surgery. These changes were particularly prominent immediately after surgery, during the first ten days. Conclusion. The recovery of visual acuity after decompression in the area of optic chiasm is possible in cases where mechanical pressure on the nerve fibres and resulting fibre ischemia have not lasted long enough to lead to their irreversible damage.

scholarly journals Postoperative visual recovery following surgical treatment of craniopharygiomas

2016 ◽  
Vol 69 (3-4) ◽  
pp. 79-84
Author(s):  
Desanka Grkovic ◽  
Sava Barisic
Keyword(s):  
Visual Acuity ◽  
Mass Effect ◽  
Optic Chiasm ◽  
Visual Recovery ◽  
Normal Vision ◽  
Resonance Imaging ◽  
Progressive Loss ◽  
Visual Status ◽  
Suprasellar Region ◽  
Before And After

Introduction. Craniopharyngiomas are rare tumors which are typically focused in the sellar and suprasellar region. Secondary to mass effect, these tumors commonly mediate neurologic, endocrinologic or visual functions. The purpose of this study was to investigate the pre and postoperative visual acuity in patients with a craniopharyngioma in the area of the optic chiasm. Material and Methods. This retrospective study included 42 patients with a craniopharyngioma demonstrated by computerized tomography or magnetic resonance imaging. The visual status was analyzed both before and after surgery (10 days, one month and six months after surgery). Results. Progressive loss of visual acuity was a typical initial eye symptom. Postoperatively, improvement in visual acuity was seen in 47.2% of eyes. Normal vision was attained in the majority of eyes (from 27% preoperatively to 40% six months after surgery). The percentage of eyes with heavily reduced visual acuity decreased as well (from 38% preoperatively to 11% six months after surgery). Visual acuity improved at least in one eye in 36.58% of patients, and 28% of patients achieved normal visual acuity in both eyes, six months after surgery. The improvement of 0.5 and better at least in one eye was observed in 33% of patients. The majority of eyes showed immediate improvement after surgical decompression, during first ten postoperative days. Conclusions. The majority of patients with craniopharyngioma show a significant improvement of visual function, particularly in the first ten postoperative days.

scholarly journals Outcomes of Femtosecond Laser Assisted Cataract Surgery Performed by Resident and Attending Surgeons

2021 ◽  
Vol 13 (01) ◽  
pp. e26-e31
Author(s):  
Spencer C. Cleland ◽  
Daniel W. Knoch ◽  
Jennifer C. Larson
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Retrospective Chart Review ◽  
Dissipated Energy ◽  
Independent Practice ◽  
Postoperative Visual Acuity ◽  
Included Patient ◽  
Duration Of Surgery ◽  
The Difference

Abstract Objective The study aimed to evaluate the safety and efficacy of resident surgeons performing femtosecond laser assisted cataract surgery (FLACS). Methods A retrospective chart review was conducted at the University of Wisconsin-Madison from postgraduate year four residents performing FLACS between 2017 and 2019. Data were also collected from residents performing manual cataract surgery, and attending surgeons performing FLACS for comparison. Recorded data included patient demographics, pre- and postoperative visual acuity, pre- and postoperative spherical equivalent, nuclear sclerotic cataract grade, ocular and systemic comorbidities, intraocular lens, duration of surgery, cumulative dissipated energy (CDE), and intraoperative and postoperative complications. Results A total of 90 cases were reviewed with 30 resident manual cases, 30 resident FLACS cases, and 30 attending FLACS cases. Resident manual (25.5 ± 6.8 minutes) and resident FLACS (17.5 ± 7.1 minutes) cases took a significantly longer time to complete compared with attending FLACS cases (13.6 ± 4.4 minutes; p < 0.001). There was higher CDE in resident FLACS and resident manual cases compared with attending FLACS cases, but the difference was not statistically significant (p = 0.06). Postoperative visual acuity was not statistically different at 1-day and 1-month after surgery among the three groups. Resident FLACS complications, which included one case requiring an intraoperative suture to close the wound, two cases with intraoperative corneal abrasions, two cases with postoperative ocular hypertension, and one case with cystoid macular edema, were not significantly greater than attending FLACS complications (p = 0.30). Conclusion The FLACS performed by resident surgeons had comparable visual acuity outcomes to FLACS performed by attending surgeons, and to manual cataract surgery performed by resident surgeons. However, resident FLACS cases took significantly longer time to complete, and they were associated with a higher CDE and minor complication rate compared with attending FLACS cases. Introducing advanced technologies into surgical training curricula improves resident preparedness for independent practice, and this study suggests FLACS can be incorporated safely and effectively into resident education.

Corneal neurotisation by great auricular nerve transfer and scleral-corneal tunnel incisions for neurotrophic keratopathy

2018 ◽  
Vol 103 (9) ◽  
pp. 1235-1238 ◽  
Author(s):  
Nate Jowett ◽  
Roberto Pineda II
Keyword(s):  
Visual Acuity ◽  
Confocal Microscopy ◽  
Donor Site ◽  
Nerve Transfer ◽  
Donor Site Morbidity ◽  
Nerve Fibres ◽  
Novel Technique ◽  
Great Auricular Nerve ◽  
Early Results ◽  
Neurotrophic Keratopathy

Background/AimsMedical management of neurotrophickeratopathy is challenging and costly. Supra-orbital nerve transfer to thecornea has proven effective for management of keratopathy, but yieldsconsiderable donor site morbidity. Herein, a novel technique for reinnervationof the anaesthetic cornea is presented and early results characterised.MethodsSensory fibres of the ipsilateral greatauricular nerve were directed via an interposition graft to the anteriorcorneal stroma using scleral-corneal tunnel incisions in two patients withgrade III neurotrophic keratopathy.ResultsImprovements in visual acuity, cornealpachymetry, corneal esthesiometry, and corneal neurotisation as assessed by invivo confocal microscopy were observed within nine months of surgery in bothpatients.ConclusionCorneal neurotisation by interposition grafttransfer of great auricular nerve fibres via scleral-corneal tunnel incisionsappears effective in the management of neurotrophic keratopathy.

scholarly journals A preliminary study of the clinical application of optic pathway diffusion tensor tractography in suprasellar tumor surgery: preoperative, intraoperative, and postoperative assessment

2016 ◽  
Vol 125 (3) ◽  
pp. 759-765 ◽  
Author(s):  
Mohamadreza Hajiabadi ◽  
Madjid Samii ◽  
Rudolf Fahlbusch
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Diffusion Tensor ◽  
Tumor Resection ◽  
Visual Pathway ◽  
Optic Chiasm ◽  
Control Group ◽  
Optic Pathway ◽  
Dti Tractography ◽  
Mass Lesions

OBJECT Visual impairments are the most common objective manifestations of suprasellar lesions. Diffusion tensor imaging (DTI) is a noninvasive MRI modality that depicts the subcortical white matter tracts in vivo. In this study the authors tested the value of visual pathway tractography in comparison with visual field and visual acuity analyses. METHODS This prospective study consisted of 25 patients with progressive visual impairment due to suprasellar mass lesions and 6 control patients with normal vision without such lesions. Visual acuity, visual field, and the optic fundus were examined preoperatively and repeated 1 week and 3 months after surgery. Visual pathway DTI tractography was performed preoperatively, intraoperatively immediately after tumor resection, and 1 week and 3 months after surgery. RESULTS In the control group, pre- and postoperative visual status were normal and visual pathway tractography revealed fibers crossing the optic chiasm without any alteration. In patients with suprasellar lesions, vision improved in 24 of 25. The mean distance between optic tracts in tractography decreased after tumor resection and detectable fibers crossing the optic chiasm increased from 12% preoperatively to 72% postoperatively 3 months after tumor resection, and undetectable fibers crossing the optic chiasm decreased from 88% preoperatively to 27% postoperatively 3 months after tumor resection. Visual improvement after tumor removal 1 week and 3 months after surgery was significantly correlated with the distance between optic tracts in intraoperative tractography (p < 0.01). CONCLUSIONS Visual pathway DTI tractography appears to be a promising adjunct to the standard clinical and paraclinical visual examinations in patients with suprasellar mass lesions. The intraoperative findings, in particular the distance between optic tract fibers, can predict visual outcome after tumor resection. Furthermore, postoperative application of this technique may be useful in following anterior optic pathway recovery.

BKC and CME: Is benzalkonium chloride hindering our efforts to achieve the desired postoperative visual acuity?

2018 ◽  
Vol 39 (9) ◽  
pp. 2129-2136
Author(s):  
Harinder Singh Sethi ◽  
Sugourab Das ◽  
Mayuresh P. Naik ◽  
Rajshekhar Vemparala
Keyword(s):  
Visual Acuity ◽  
Benzalkonium Chloride ◽  
Postoperative Visual Acuity

scholarly journals Prognostic factors for postoperative visual outcome in surgically treated suprasellar meningiomas

2016 ◽  
Vol 69 (5-6) ◽  
pp. 146-152 ◽  
Author(s):  
Desanka Grkovic ◽  
Sofija Davidovic
Keyword(s):  
Visual Acuity ◽  
Tumor Size ◽  
Visual Function ◽  
Tumor Resection ◽  
Visual Outcome ◽  
Duration Of Symptoms ◽  
Postoperative Visual Acuity ◽  
Preoperative Visual Acuity ◽  
History Of ◽  
Meningioma Surgery

Introduction. The prognosis of postoperative visual acuity in patients with surgically treated suprasellar meningiomas is influenced not only by the size and precise localization of meningiomas in the optochiasmatic region and their compressive effect, but also by certain parameters, such as the age of patient, duration of symptoms, and preoperative visual acuity. The purpose of this study was to analyze the influence of these factors on postoperative visual acuity in the patients with surgically treated optochiasmatic meningioma as well as to determine their prognostic value in the recovery of visual function after surgery. Material and Methods. The study sample consisted of 43 patients operated for suprasellar meningioma. All tumors were diagnosed by computed tomography or nuclear magnetic resonance scans. Visual acuity was analyzed both before surgery and six months after surgery. The effects of age, preoperative visual loss, duration of visual symptoms and tumor size on visual outcome were analyzed. Results. Postoperative improvement of visual acuity was observed in 50% of eyes (68.4% of patients). Visual outcome was better in the younger patients. The patients with better preoperative visual acuity had better postoperative visual acuity outcome. Chances of achieving better postoperative visual function and favorable tumor resection outcome were inversely proportional to the increased length of history of disease and tumor size. Conclusion. Postoperative visual acuity prognosis in suprasellar meningioma surgery was favorably affected by the mean duration of symptoms of less than 24 months, tumor size less than 30 mm, and preoperative visual acuity loss below 0.1.

scholarly journals Visual Outcomes of Macula-Involving Rhegmatogenous Retinal Detachment in Patients with and Without Age-Related Macular Degeneration

2022 ◽  
Author(s):  
P. Barrett Paulk ◽  
Dala Eloubeidi ◽  
John O. Mason III ◽  
Christine A. Curcio ◽  
Jason N. Crosson ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Macular Degeneration ◽  
Rhegmatogenous Retinal Detachment ◽  
Age Related Macular Degeneration ◽  
Light Perception ◽  
Postoperative Visual Acuity ◽  
Age Related ◽  
Functional Vision ◽  
Better Than

Abstract Background Patients presenting with macula-off rhegmatogenous retinal detachment (RRD) with concomitant age-related macular degeneration (AMD) and their treating physicians would benefit from knowledge regarding the visual prognosis after repair. The prognosis for such patients is not well known. The purpose of this study is to compare visual outcomes in macula-off RRD in eyes with AMD versus a group of comparison eyes without AMD. Methods This was a retrospective chart review of 1,149 patients. A total of 191 eyes met study criteria, 162 non-AMD eyes (controls) and 29 AMD eyes. The main outcome measure was postoperative visual acuity in control eyes versus AMD eyes, and this was compared using Fisher’s exact test. Results There was a statistically significant difference in postoperative visual acuity by AMD status, with those without AMD having a higher frequency of Count Fingers (CF), Hand Motion (HM), Light Perception (LP), or No Light Perception (NLP) vision (p = 0.023). More specifically 5.56% of non-AMD eyes and 3.45% of AMD eyes were 20/40 or better, 77.16% of non-AMD and 55.17% of AMD eyes were worse than 20/40 and better than 20/200, 10.49% of non-AMD eyes and 37.93% of AMD eyes were 20/200 or worse, and there were 11 eyes in the non-AMD group with CF, HM, LP, or NLP vision while there was only 1 eye in the AMD group with CF vision. Conclusions Though postoperative visual acuity was worse in the non-AMD group with a higher frequency of patients having final vision of CF, HM, LP, or NLP, this is not likely a clinically significant finding. Rather, it is a function of the difference in sample size and composition between the two groups. Importantly, this study suggests AMD patients can expect similar outcomes to non-AMD patients after RRD repair. Our study suggests that approximately 58% of patients with AMD can expect to maintain functional vision better than 20/200. We conclude that AMD patients can achieve functional vision after RRD surgery, similar to those without AMD. These findings may be helpful in guiding realistic expectations of AMD patients with RRD.

scholarly journals MOG Antibody Positive Optic Perineuritis: an Observational Study in Han Chinese

2021 ◽  
Author(s):  
CHAO MENG ◽  
Jia-wei Wang ◽  
Lei Liu ◽  
Wen-jing Wei ◽  
Jian-hua Tao ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Loss ◽  
Clinical Symptoms ◽  
Optic Chiasm ◽  
Han Chinese ◽  
Younger Patients ◽  
Brainstem Lesions ◽  
Severe Visual Loss ◽  
Mri Changes ◽  
Magnet Resonance

Abstract ObjectiveTo shed light on the clinical characteristics, magnet resonance imaging(MRI) changes, and prognosis of myelin oligodendrocyte glycoprotein antibody (MOG-IgG) positive OPN in Han Chinese.MethodsWe observed 39 MOG-IgG positive patients in our ward from January 1, 2017 , to December 31, 2019. Twenty patients met OPN inclusion criteria included contrast enhancement surrounding the optic nerve, and at least one of the following clinical symptoms: 1) reduction of visual acuity, 2) impairment of visual field, and 3) eye pain. Single course group(n=11) and recurrence group(n=9) were used for comparison. Outcome variables included Wingerchuk visual acuity classification.Results Of the 20 patients with MOG-IgG positive OPN, 12(60%) were women. Ten cases (50%) presented with bilateral and 17 eyes (56.67%) with severe visual loss (SVL,≤ 0.1). Twenty-one(70.00%) eyes showed edema of optic disc. Twenty-five eyes (83.3%) had longitudinally extensive perineural enhancement. At follow-up, 4 (13%) eyes still had SVL, while 26 (87%) eyes had no SVL, and of the 19 ON patients, 3 (9%) eyes still had SVL. Seven patients (35.00%) experienced at least a relapse(median interval 13.5 months ), and of the 19 ON cases, 4 (21%) patients experienced relapse. The relapse occurred more often in younger patients than the older (mean year: 38.00 vs. 45.54 years; P = 0.025). There were no optic chiasm and brainstem lesions.ConclusionsMOG-IgG positive OPN in Han Chinese often causes severe bilateral visual loss and longitudinally extensive perineural lesion. Younger patients are more likely to relapse. Optic chiasm and brainstem lesions were relatively rare.

scholarly journals Influence of scleral lenses on visual acuity and aberrations in patients with irregular cornea

The Eye ◽  
2019 ◽  
Vol 126 (2019-2) ◽  
pp. 32-39
Author(s):  
Olga Tikhonova ◽  
Nikolai Pashtaev ◽  
Nadezhda Pozdeyeva ◽  
Alexander Myagkov ◽  
Svetlana Bodrova ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Laser Surgery ◽  
Contact Lenses ◽  
Lens Space ◽  
Astigmatism Correction ◽  
Intrastromal Corneal Ring ◽  
Stable Vision ◽  
Ring Segment ◽  
Ophthalmologic Examination ◽  
Fitting In

Purpose: To analyze changes of functional parame¬ters and aberrations before fitting and after using rigid gas-permeable scleral lenses (RGPSCL) in patients with irregular cornea. Material and methods. 21 patients (29 eyes) with irregular astigmatism of various etiology were enrolled in this study. The patients could not achieve good visual aсuity in glasses, standard soft or rigid corneal contact lenses. Complex ophthalmologic examination was per¬formed: autorefractometry, visometry, biomicroscopy, computer corneal topography, aberrometry on “OPD-Scan II” (“Nidek”, Japan) before fitting scleral lenses and during the period of their wearing. Results and discussion. The results demonstrat¬ed significant visual acuity improvement after RGP¬SCL fitting in all observed patients. UCVA amounted to 0.1±0.18, BCVA in glasses amounted to 0.4±0.26, BCVA in RGPSCL amounted to 0.7±0.1. An increase of best-corrected visual acuity in RGPSCL was statistically significant in patients after keratoplasty, after intra-stromal corneal ring segments (ICRS) implantation, af¬ter refractive laser surgery (RLS) and in cases of mixed astigmatism. We have found that the correction of ker¬atoconus with the use of RGPSCL resulted in a decrease of the root mean square value (RMS), measured in the 3 mm and 5 mm zones by 2.5 times and 4 times, re¬spectively. In patients wearing RGPSCL after kerato¬plasty, statistically significant decrease in RMS was observed in the 3 mm zone (by 3.85 times) and in the 5 mm zone (by 2.99 times). In patients wearing RGPSCL after implantation of intrastromal corneal ring segment (ICRS), RMS in the 3 mm zone decreased by 1.5 times. In patients wearing RGPSCL after refractive laser surgery (RLS) RMS was 2.5 times lower in the 3 mm zone and 2.8 times lower in the 5 mm zone. In case of mixed astigmatism correction with RGPSCL, RMS increased by 1.6 times in the 3 mm zone and practically did not change in the 5 mm zone. Conclusion. The results obtained demonstrated significant visual acuity improvement in all observed patients. The sub-lens-space filled with tear forms a unified “cornea-tear-scleral contact lens” optic system that corrects unevenness of cornea, decreases amount of high-order aberrations (HOA) and provides a clear stable vision.

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