scholarly journals Evaluation of Plasma Assisted Noninvasive Surgery (PANIS) As a New Approach for the Treatment of Conjunctival Concretions: A Clinical Case Series

2021 ◽  
Vol 6 (12) ◽  
pp. 899-903
Author(s):  
Farhad Nejat ◽  
Khosrow Jadidi ◽  
Shima Eghtedari ◽  
Nazanin-Sadat Nabavi ◽  
Pooneh Malekifar
Keyword(s):  
Visual Acuity ◽  
Case Series ◽  
Refractive Errors ◽  
Normal Range ◽  
Ocular Surface Disease Index ◽  
New Approach ◽  
Noninvasive Surgery ◽  
Before And After ◽  
Straightforward Approach

Background and Objective: Plasma is one of the newest therapies recently used. This study aimed to evaluate a quick treatment modality of conjunctival concretions using plasma as a noninvasive procedure. Methods: Six eyes of six patients with conjunctival concretions were evaluated. The procedure was performed using plasma spots generated by the white handpiece of the Plexr device. The eyelid was everted and concretions sublimated by plasma spots from the upper and lower eyelids. Refractive Errors, visual acuity (BCVA and UCVA), Ocular Surface Disease Index (OSDI), and Intraocular pressure (IOP) were measured before and after six months of the procedure. Results: The results of 6 months follow-up show that this effective method had no recurrence or side effects. Treatment was effective in all of the patients. No complication and recurrence was observed. The OSDI score was improved to the normal range. This method had no effects on Refractive Errors, Visual Acuity, and IOP. Conclusion: Based on the results, it seems that the PANIS method can be used as a practical, quick, and straightforward approach for the treatment of conjunctival concretions.

scholarly journals Evaluation of Plasma Assisted Noninvasive Surgery (PANIS) as a New Approach for the Treatment of Conjunctival Concretions; A Clinical Case Series

2021 ◽  
Author(s):  
Farhad Nejat ◽  
Khosrow Jadidi ◽  
shima eghtedari ◽  
Nazanin Sadat Nabavi ◽  
Pooneh Malekifar
Keyword(s):  
Visual Acuity ◽  
Clinical Case ◽  
Case Series ◽  
Refractive Errors ◽  
Ocular Surface Disease Index ◽  
New Approach ◽  
Noninvasive Surgery ◽  
Before And After ◽  
Straightforward Approach

Abstract Purpose: Plasma is one of the newest therapies recently used in Conjunctivochalasis, Conjunctival Cyst, and Blepharoplasty. This study aimed to evaluate a quick treatment modality of conjunctival concretions using plasma as a noninvasive procedure.Design: Six eyes of six patients with conjunctival concretions were evaluated in a clinical case series.Methods: The procedure was performed using plasma spots generated by the white handpiece of the Plexr device. The eyelid was everted and concretions sublimated by plasma spots from the upper and lower eyelids. Refractive Errors, visual acuity (BCVA and UCVA), Ocular Surface Disease Index (OSDI), and Intraocular pressure (IOP) were measured before and after six months of the procedure.Results: The results of 6 months follow-up show that this effective method had no recurrence or side effects. Treatment was effective in all of the patients. No complication and recurrence was observed. The OSDI score was improved to the normal range. This method had no effects on Refractive Errors, Visual Acuity, and IOP. Conclusions: Based on the results, it seems that the PANIS method can be used as a practical, quick, and straightforward approach for the treatment of conjunctival concretions.

Evaluation of Plasma-Assisted Noninvasive Surgery (PANIS) As a New Approach for Pterygium Removal with Amniotic Membrane Transplantation (AMT); a Clinical Case Series

2021 ◽  
Vol 6 (11) ◽  
pp. 808-813
Author(s):  
Farhad Nejat ◽  
Khosrow Jadidi ◽  
Shima Eghtedari ◽  
Nazanin Sadat Nabavi ◽  
Maryam Moradi
Keyword(s):  
Visual Acuity ◽  
Amniotic Membrane ◽  
Surgical Procedure ◽  
Clinical Case ◽  
Case Series ◽  
Cost Benefit ◽  
Amniotic Membrane Transplantation ◽  
Ocular Surface Disease Index ◽  
Noninvasive Surgery ◽  
Uncorrected Visual Acuity

Purpose: Medical plasma application has been used in different fields recently. In this study, we assess the outcome of using plasma-assisted noninvasive surgery (PANIS) with amniotic membrane transplantation (AMT) in pterygium surgical treatment. Methods: This clinical case series was conducted in 4 patients with primary grades 1, 2, and 3 pterygium (Table 1). After exclusion and inclusion criteria considerations, patients underwent different examinations. Various measurements were obtained such as uncorrected visual acuity (UCVA), refractive error (RE), the best-corrected visual acuity (BCVA), and ocular surface disease index (OSDI). The surgical procedure was pterygium removal from the cornea and then AMT attached to the conjunctival borders with plasma spots using a white handpiece of Plexr device (Plexr, GMV s.r.l Grottaferrata, Italy) instead (Table 2). After postoperative follow-ups within the first week of the surgery and in 1 month and 6 months later the results were obtained. Results: All patients have been fully recovered after the surgery without any complications. In all 4 cases, UCVA, BCVA, and RE parameters have improved during 6 months after the surgical procedure. Every patients’ OSDI decreased after the surgery. Recurrence has not been seen in any cases during 6 months follow-up. Conclusion: Pterygium removal surgery using the PANIS technique with AMT is safe, effective, fast, and cost-benefit.

scholarly journals Ophthalmological findings in children with non-syndromic craniosynostosis: preoperatively and postoperatively up to 12 months after surgery

2021 ◽  
Vol 6 (1) ◽  
pp. e000677
Author(s):  
Evangelia Ntoula ◽  
Daniel Nowinski ◽  
Gerd Holmstrom ◽  
Eva Larsson
Keyword(s):  
Visual Acuity ◽  
University Hospital ◽  
Cranial Sutures ◽  
Sagittal Craniosynostosis ◽  
Syndromic Craniosynostosis ◽  
Disc Oedema ◽  
Before And After ◽  
Congenital Condition ◽  
Skull Deformity

AimsCraniosynostosis is a congenital condition characterised by premature fusion of one or more cranial sutures. The aim of this study was to analyse ophthalmic function before and after cranial surgery, in children with various types of non-syndromic craniosynostosis.MethodsChildren referred to Uppsala University Hospital for surgery of non-syndromic craniosynostosis were examined preoperatively. Visual acuity was measured with Preferential Looking tests or observation of fixation and following. Strabismus and eye motility were noted. Refraction was measured in cycloplegia and funduscopy was performed. Follow-up examinations were performed 6–12 months postoperatively at the children’s local hospitals.ResultsOne hundred twenty-two children with mean age 6.2 months were examined preoperatively. Refractive values were similar between the different subtypes of craniosynostosis, except for astigmatism anisometropia which was more common in unicoronal craniosynostosis. Strabismus was found in seven children, of which four had unicoronal craniosynostosis.Postoperatively, 113 children were examined, at mean age 15.9 months. The refractive values decreased, except for astigmatism and anisometropia in unicoronal craniosynostosis. Strabismus remained in unicoronal craniosynostosis. Two new cases with strabismus developed in unicoronal craniosynostosis and one in metopic, all operated with fronto-orbital techniques. No child had disc oedema or pale discs preoperatively or postoperatively.ConclusionOphthalmic dysfunctions were not frequent in children with sagittal craniosynostosis and preoperative ophthalmological evaluation may not be imperative. Children with unicoronal craniosynostosis had the highest prevalence of strabismus and anisometropia. Fronto-orbital techniques used to address skull deformity may be related to a higher prevalence of strabismus postoperatively.

scholarly journals Combined pars plana glaucoma drainage device placement and vitrectomy using a vitrectomy sclerotomy site for tube placement: a case series

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Enchi Kristina Chang ◽  
Sanchay Gupta ◽  
Marika Chachanidze ◽  
John B. Miller ◽  
Ta Chen Chang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Tube Placement ◽  
Glaucoma Drainage Device ◽  
Drainage Device ◽  
Glaucoma Drainage Devices ◽  
Pars Plana ◽  
Sclerotomy Site

Abstract Purpose The purpose of this study is to report the safety and efficacy of pars plana glaucoma drainage devices with pars plana vitrectomy using one of the vitrectomy sclerotomy sites for tube placement in patients with refractory glaucoma. Methods Retrospective case series of 28 eyes of 28 patients who underwent combined pars plana glaucoma drainage device and pars plana vitrectomy between November 2016 and September 2019 at Massachusetts Eye and Ear. Main outcome measures were intraocular pressure (IOP), glaucoma medication burden, best corrected visual acuity, and complications. Statistical tests were performed with R and included Kaplan-Meier analyses, Wilcoxon paired signed-rank tests, and Fisher tests. Results Mean IOP decreased from 22.8 mmHg to 11.8 mmHg at 1.5 years (p = 0.002), and mean medication burden decreased from 4.3 to 2.1 at 1.5 years (p = 0.004). Both IOP and medication burden were significantly lower at all follow-up time points. The probability of achieving 5 < IOP ≤ 18 mmHg with at least 20% IOP reduction from preoperative levels was 86.4% at 1 year and 59.8% at 1.5 years. At their last visit, three eyes (10.7%) achieved complete success with IOP reduction as above without medications, and 14 eyes (50.0%) achieved qualified success with medications. Hypotony was observed in 1 eye (3.6%) prior to 3 months postoperatively and 0 eyes after 3 months. Visual acuity was unchanged or improved in 23 eyes (82.1%) at their last follow-up. Two patients had a visual acuity decrease of > 2 lines. Two eyes required subsequent pars plana vitrectomies for tube obstruction, and one eye had transient hypotony. Conclusions The results of pars plana glaucoma drainage device and pars plana vitrectomy using one of the vitrectomy sclerotomy sites for tube placement are promising, resulting in significant IOP and medication-burden reductions through postoperative year 1.5 without additional risk of postoperative complications. Inserting glaucoma drainage devices into an existing vitrectomy sclerotomy site may potentially save surgical time by obviating the need to create another sclerotomy for tube placement and suture one of the vitrectomy ports.

Orbital Hydatid Cyst: An Interventional Case Series

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Tajamul Khan ◽  
Ibrar Hussain ◽  
Zaman Shah
Keyword(s):  
Visual Acuity ◽  
Hydatid Cyst ◽  
Teaching Hospital ◽  
Case Series ◽  
Surgical Excision ◽  
P Value ◽  
Presumptive Diagnosis ◽  
Female Ratio ◽  
Orbital Imaging

Purpose:  To find out the demographics, presentation, and outcome of surgical treatment in patients of orbital hydatid cyst. Study Design:  Interventional case series. Place and Duration of Study:  Khyber Teaching Hospital Peshawar, Pakistan from 2009 to 2019. Methods:  This study included 11 patients with orbital hydatid cyst who presented in Khyber Teaching Hospital, Peshawar. Detailed history, ocular examination and Orbital imaging (Ophthalmic B-Scan, CT scan and/or MRI) was performed. The patients underwent Orbitotomy, cyst extirpated and sent for histopathology. Albendazole was given to the patients for 12 weeks after surgery. The preoperative and postoperative data until last follow-up was analyzed. Results:  Male to Female ratio was 5:6 and the mean age of the patients was 18.17 ± 17.4 years. Mean amount of proptosis was 26.27 ± 2.05mm and visual acuity was 0.23 ± 0.33 decimal in the affected eye at presentation. Eight patients (72.8%) had Relative Afferent Pupillary Defect with swollen discs. After imaging studies, presumptive diagnosis of hydatid cyst was made. Histopathology confirmed the diagnosis of hydatid cyst in all cases. Mean proptosis at the last follow up improved to 19.04 ± 1.45mm (P value = 0.00) and visual acuity to 0.47 ± 0.22 decimals (P value = 0.048). Only one patient (9.1%) had an associated hydatid cyst in the lung. There was no recurrence until last follow-up. Conclusion:  Hydatid cyst should be considered in differential diagnosis of proptosis in patients under 20. Surgical excision followed by a course of oral Albendazole is effective for the treatment of orbital hydatid cyst. Key Words:  Orbital hydatid cyst, Proptosis, Orbitotomy.

scholarly journals Aphakia Correction by Injection of Foldable Intra Ocular Lens in the Anterior Chamber

2013 ◽  
Vol 5 ◽  
pp. OED.S12672
Author(s):  
Kagmeni Giles ◽  
Moukouri Ernest ◽  
Domngang Christelle ◽  
Nguefack-Tsague Georges ◽  
Cheuteu Raoul ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Teaching Hospital ◽  
Case Series ◽  
University Teaching ◽  
Case Series Study ◽  
The Mean ◽  
The University

We assessed the outcomes of the use of anterior chamber foldable lens for unilateral aphakia correction at the University Teaching Hospital of Yaounde. In this retrospective, non-comparative, consecutive case series study, we reviewed the records of patients who underwent an operation for aphakia correction by the means of injection of an angular supported foldable lens between January 2009 and December 2011 in the University Teaching Hospital Yaounde. Student's paired t-test was carried out to compare preoperative and postoperative visual acuity (VA) and intraocular pressure (TOP). P-values less than 0.05 were considered statistically significant. Twenty-one patients were included in the study; twelve were male (57.1%) and nine were female (42.9%). The mean age was 55.38 ± 17.67 years (range 9–75 years). The mean follow-up duration was 5.95 ± 3.14 months (range 2–12 months). The mean logMAR visual acuity was 1.26 ± 0.46 pre-operatively and 0.78 ± 0.57 post-operatively ( P = 0.003). The change in intraocular pressure was not statistically significant. Complications included intraocular hypertension (over 21 mmHg) in 3 patients (14.3%) and macular edema, pupillar ovalization, and retinal detachment in one patient each. The results indicate that injection of an angular support foldable lens in the anterior chamber is a useful technique for the correction of aphakia in eyes without capsular support. More extended follow-up, however, and a larger series of patients are needed to ascertain the effectiveness and safety of this procedure.

scholarly journals Combined Pars Plana Glaucoma Drainage Device Placement and Vitrectomy Using a Vitrectomy Sclerotomy Site for Tube Placement: A Case Series

2020 ◽  
Author(s):  
Enchi Kristina Chang ◽  
Sanchay Gupta ◽  
Marika Chachanidze ◽  
John B. Miller ◽  
Ta Chen Chang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Statistical Tests ◽  
Case Series ◽  
Tube Placement ◽  
Glaucoma Drainage Device ◽  
Retrospective Case ◽  
Tube Obstruction ◽  
Pars Plana ◽  
Sclerotomy Site

Abstract Background: The purpose of this study is to report the safety and efficacy of pars plana (PP) glaucoma drainage devices (GDDs) with pars plana vitrectomy (PPV) using one of the vitrectomy sclerotomy sites for tube placement in patients with refractory glaucoma.Methods: Retrospective case series of 28 eyes of 28 patients who underwent combined PP GDD and PPV between November 2016 and September 2019 at Massachusetts Eye and Ear. Main outcome measures were intraocular pressure (IOP), glaucoma medication burden, best corrected visual acuity (BCVA), and complications. Statistical tests were performed with R and included Kaplan-Meier analyses, Wilcoxon paired signed-rank tests, and Fisher tests.Results: Mean IOP decreased from 22.8 mmHg to 11.4 mmHg at 1.5 years (p = 0.009), and mean medication burden decreased from 4.3 to 1.7 at 1.5 years (p = 0.009). Both IOP and medication burden were significantly lower at all follow-up time points. The probability of achieving 5 ≤ IOP ≤ 18 mmHg with at least 20% IOP reduction from preoperative levels was 77.7% at 1 year and 45.8% at 1.5 years. At their last visit, four eyes (14.3%) achieved complete success with IOP reduction as above without medications, and 13 eyes (46.2%) achieved qualified success with medications. Visual acuity was unchanged or improved in 23 eyes (82.1%) at their last follow-up. Two patients had a visual acuity decrease of >2 lines. Two eyes required subsequent PPV for tube obstruction, and one eye had transient hypotony.Conclusions: The results of pars plana GDD and vitrectomy using one of the vitrectomy sclerotomy sites for tube placement are promising, resulting in significant IOP and medication-burden reductions through postoperative year 1.5 without additional risk of postoperative complications. Inserting GDDs into an existing vitrectomy sclerotomy site may potentially save surgical time by obviating the need to create another sclerotomy for tube placement and suture one of the vitrectomy ports.

scholarly journals Instantaneous Wave-Free Ratio Measurement During Intracranial Submaximal Angioplasty: Case Series and 2-Dimensional Operative Video

2020 ◽  
Vol 19 (4) ◽  
pp. 422-428
Author(s):  
Kunal Vakharia ◽  
Muhammad Waqas ◽  
Najya Fayyaz ◽  
Amanda Young ◽  
Elad I Levy ◽  
...  
Keyword(s):  
Case Series ◽  
Length Of Hospital Stay ◽  
Interventional Cardiology ◽  
Arterial Stenosis ◽  
Intracranial Arterial Stenosis ◽  
Ratio Measurement ◽  
Pressure Wire ◽  
Before And After ◽  
Stenosis Severity

Abstract BACKGROUND Instantaneous wave-free ratios (iFRs) are functional measures of arterial stenosis that have become essential to interventional cardiology procedures. Their use for intracranial submaximal angioplasty (angioplasty with an undersized balloon) has not been studied extensively. OBJECTIVE To describe the feasibility and technique of iFR measurement for stenosis assessment during intracranial angioplasty. METHODS We present a series of consecutive patients treated between January 1, 2017 and June 30, 2018 with submaximal intracranial angioplasty in whom pre- and postprocedure iFR measurements were obtained with a Verrata-Volcano pressure wire (Philips, Amsterdam, The Netherlands). We collected patient data on age, sex, comorbid conditions, presenting complaints, modified Rankin scale (mRS) score at admission, neurological findings, procedure duration, fluoroscopy time, intraprocedural complications, length of hospital stay, and mRS score at last clinical follow-up (favorable outcome, 0-2). Angiographic stenosis severity and iFR values were recorded before and after angioplasty. RESULTS A total of 12 patients underwent iFR-guided angioplasty during the study period. The median patient age was 69.5 yr (range 48-81 yr). All patients had symptomatic intracranial arterial stenosis (3-basilar, 2-vertebral, 6-middle cerebral, 1-internal carotid). Preangioplasty stenosis ranged from 55% to 90%. The median postangioplasty reduction in stenosis was 17% (range 9%-30%). Preangioplasty values ranged from 0.30 to 0.40 (n = 4). Postangioplasty values ranged from 0.6 to 0.9 (n = 5). iFR values improved considerably in all patients. No procedure-related complications occurred. The median follow-up was 8.9 mo (range 3-25 mo). Follow-up outcomes were favorable in 10 patients. CONCLUSION iFR measurement before and after intracranial angioplasty is feasible. It may be used to assess the adequacy of intracranial angioplasty.

Topographically Guided Two-Step LASIK and Standard LASIK in the Correction of Refractive Errors after Penetrating Keratoplasty

2009 ◽  
Vol 19 (4) ◽  
pp. 535-543 ◽  
Author(s):  
Leopoldo Spadea ◽  
Massimo Saviano ◽  
Angela Di Gregorio ◽  
Domenico Di Lodovico ◽  
Fabio De Sanctis
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Laser In Situ Keratomileusis ◽  
Refractive Errors ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Purpose To evaluate in a long-term period the effectiveness and safety of topographically guided two-step laser in situ keratomileusis (LASIK) and standard LASIK technique in the correction of refractive errors after successful penetrating keratoplasty (PKP) for keratoconus. Methods At least 2 years after PKP and 6 months after removal of all sutures, 15 eyes of 15 patients (Group 1; mean manifest refraction spherical equivalent (MRSE) −7.23 D ± 3.42 SD) were submitted to standard LASIK and 15 eyes of 15 patients (Group 2; mean MRSE −4.37 D ± 1.97 SD) to a topographically guided two-step LASIK procedure (first the flap and at least 2 weeks later the laser ablation). In all cases, a superior hinged corneal flap (160 μm/9.5 mm) was created. Results After a follow-up of 36 months, in Group 1 the mean uncorrected visual acuity (UCVA) was 0.51 logarithm of the minimum angle of resolution (logMAR) ± 0.41 SD and the mean best-corrected visual acuity (BCVA) was 0.03 logMAR ± 0.05 SD, with a mean MRSE of −1.57 D ± 2.65 SD. In Group 2, the mean UCVA was 0.28 logMAR ± 0.24 SD and the mean BCVA was 0.01 logMAR ± 0.03 SD, with a mean MRSE of −0.07 D ± 1.00 SD. In both groups, no complications were observed. Conclusions After a long follow-up period, both topographically guided two-step LASIK and standard LASIK could be considered effective and safe tools in the correction of refractive errors after successful PKP for keratoconus.

scholarly journals The Effect of Traditional Single Growing Rod Technique on the Growth of Unsegmented Levels in Mixed-Type Congenital Scoliosis

2020 ◽  
pp. 219256822097208
Author(s):  
Tianhua Rong ◽  
Jianxiong Shen ◽  
Yipeng Wang ◽  
Zheng Li ◽  
Youxi Lin ◽  
...  
Keyword(s):  
Mixed Type ◽  
Case Series ◽  
Congenital Scoliosis ◽  
Concave Side ◽  
Convex Side ◽  
Retrospective Case ◽  
Growing Rod ◽  
Before And After ◽  
Spine Radiographs

Study Design: Retrospective case series. Objectives: To present outcomes concerning patients with early-onset mixed-type congenital scoliosis (EOMTCS) treated with the traditional single growing rod (TSGR), focusing on the growth of unsegmented levels (USLs). Methods: Patients with EOMTCS who underwent TSGR and had a minimum of 4 USLs, 4 distractions, and 3-year follow-up were enrolled. Spine radiographs before and after index surgery and at the latest follow-up were evaluated. The length of the concave and convex side of USLs and thoracic parameters were measured. The absolute value and percentage of growth were calculated. Results: Fourteen patients (mean age, 7.3 ± 2.8 years) were enrolled. The average follow-up duration was 4.9 ± 1.2 years, during which time 84 distractions and 8 final fusions were performed. The average number of USLs was 6.3 ± 2.2. The total and annual percent growth of concave side of USLs was significantly higher than convex side (32.2 ± 13.3% vs. 23.9 ± 9.5%, p = 0.007; 6.8 ± 2.7%/year vs. 5.1% ± 2.2%/year, p = 0.007, respectively). The concave-to-convex ratio of USLs increased from 58.6 ± 6.4 ± 7.6% at baseline to 68.8 ± 9.3% at the latest follow-up (p < 0.001). The Campbell’s space available for lung ratio increased from 74.9 ± 11.1% at baseline to 89.6 ± 7.0% at the latest follow-up (p < 0.001). Conclusions: In patients with EOMTCS, unilateral repetitive lengthening with TSGR can accelerate the growth of the concave side of USLs and improve the symmetry of the thorax.

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