Krypton yellow laser for the treatment of macular hole in high myopia without retinal detachment

Purpose To evaluate the prophylactic effect of krypton yellow laser for the treatment of macular holes in high myopic eyes in order to reduce the risk of retinal detachment. Methods Twenty-seven eyes of 27 patients with high myopia and macular holes were randomly assigned to two groups. Fifteen patients (group A, 15 eyes) were subject to laser photocoagulation around the hole margin along with an oral placebo (vitamin B1), while 12 patients (group B, 12 eyes) were only given the oral placebo (vitamin B1). The incident rate of retinal detachment due to macular hole and the mean best-corrected visual acuity of the two groups before and after treatment were measured. The data were statistically tested by X2 test and Student’s t test. Results The incident rates of retina1 detachment in group A and group B were 20%(3/15) and 58.3%(7/12), respectively (X2=4.201, P0.05). The mean BCVA of group B on the initial examination was 24/200, while the mean BCVA at the final follow-up was 30/200 (P>0.05). No significant difference in initial visual acuity (P>0.05) or final visual acuity (P>0.05) was found between the two groups. Conclusion Krypton yellow laser photocoagulation could reduce the incidence of retinal detachment due to a macular hole in high myopia with acceptable functional results in this study.

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A New Sutureless Illuminated Macular Buckle Designed for Myopic Macular Hole Retinal Detachment

Journal of Ophthalmology ◽

10.1155/2017/6742164 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Ahmed M. Bedda ◽

Ahmed M. Abdel Hadi ◽

Mohamed Lolah ◽

Muhammad S. Abd Al Shafy

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Macular Hole ◽

High Myopia ◽

Terminal Part ◽

Macular Hole Retinal Detachment ◽

Myopic Macular Hole ◽

The Mean ◽

Visual Results

Purpose. To report the anatomic and visual results of a new sutureless illuminated macular buckle designed for patients with macular hole retinal detachment related to high myopia (MMHRD). Design. Prospective nonrandomized comparative interventional trial. Methods. Twenty myopic eyes of 20 patients (mean age, 51.4 years; range, 35–65 years) presenting with MMHRD with a posterior staphyloma, in whom the new buckle was used, were evaluated. The buckle used was assembled from a 5 mm wide sponge and a 7 mm wide silicone tire; it was fixed utilizing the sterile topical adhesive Histoacryl Blue (B Braun, TS1050044FP) which polymerizes in seconds upon being exposed to water-containing substances. The primary outcomes measured included aided visual acuity (BCVA) and optical coherence tomography (OCT) findings. The mean follow-up period was 6 months. Results. Postoperatively, the MH closure was identified by OCT in 8 (40%) eyes. The mean BCVA increased from 0.11 to 0.21 (p<0.005). The axial length of the eyes included decreased from 30.5 mm preoperatively to 29.8 mm (p=0.002) postoperatively. Conclusion. Preparation of the new sutureless macular buckle is simple and easy. Illumination of the terminal part of the buckle ensures proper placement. Histoacryl Blue is effective in fixing the buckle in its place for at least 6 months with no reported intra- or postoperative complications.

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Posterior scleral reinforcement using genipin-cross-linked sclera for macular hole retinal detachment in highly myopic eyes

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-311340 ◽

2018 ◽

Vol 102 (12) ◽

pp. 1701-1704 ◽

Cited By ~ 5

Author(s):

Shuang-Qian Zhu ◽

An-Peng Pan ◽

Lin-Yan Zheng ◽

Yue Wu ◽

An-Quan Xue

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Macular Hole ◽

High Myopia ◽

Corrected Visual Acuity ◽

Macular Hole Retinal Detachment ◽

Posterior Scleral Reinforcement ◽

The Mean ◽

Best Corrected Visual Acuity

Background/aimsTo investigate the surgical outcomes of posterior scleral reinforcement (PSR) using genipin-cross-linked sclera to treat macular hole retinal detachment (MHRD) in highly myopic eyes.MethodsNineteen patients with high myopia (19 eyes) with MHRD were treated sequentially with genipin-cross-linked PSR and were followed at least for 1 year after the surgery. The best corrected visual acuity (BCVA), axial length (AL), optical coherence tomography (OCT) outcomes and the complications were evaluated.ResultsMacular hole was closed in 73.7% of the eyes, foveal reattachment rate was 100%. The mean logMAR BCVA improved from 1.27±0.55 preoperatively to 0.88±0.55 postoperatively. The preoperative AL (29.88±1.97 mm) was decreased (27.73±1.84 mm) after the operation (p<0.001).ConclusionsFor at least a 1-year period of follow-up, PSR with genipin-cross-linked sclera should be considered as a preferred surgical approach to treat MHRD in highly myopic eyes, especially when foveal retinoschisis is also documented.

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Comparative evaluation of rotational stability of toric IOLs with four-eyelet vs two-eyelet capsular tension rings in eyes with high myopia

International Journal of Ophthalmology ◽

10.18240/ijo.2021.03.07 ◽

2021 ◽

Vol 14 (3) ◽

pp. 378-382

Author(s):

Hui-Min Jiang ◽

◽

Li-Ming Tao ◽

Keyword(s):

Visual Acuity ◽

High Myopia ◽

Visual Outcome ◽

Corneal Astigmatism ◽

Rotational Stability ◽

Toric Iol ◽

Toric Iols ◽

Group A ◽

The Mean ◽

Group B

AIM: To compare the rotational stability of Toric intraocular lens (IOLs) implantation combined with four-eyelet or two-eyelet capsular tension rings (CTRs) in eyes with high myopia and cataract. METHODS: This prospective randomized controlled interventional study included 33 eyes which had preoperative corneal astigmatism ≥1.5 D and ocular axial length ≥25.5 mm. These eyes were randomly divided into two groups to undergo phacoemulsification and toric IOL implantation with either four-eyelet CTR implantation (group A, n=16) or two-eyelet CTR implantation (group B, n=17). Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), phoropter examination results, and toric IOL rotation degrees were tested 6mo after the surgery. RESULTS: In both groups, the toric IOL was in the capsular sac 6mo after surgery. The difference between the two groups in terms of visual outcome was not found to be statistically significant (P>0.05) at a follow-up of 6mo. The mean residual astigmatism values were 0.56±0.22 D and 0.92±0.24 D in A and B groups, respectively (P<0.001). The mean rotation degree of IOL was 1.00°±0.73° in group A and 3.53°±1.46° in group B (P<0.001). CONCLUSION: In cataract patients with high myopia and astigmatism, four-eyelet CTR can effectively increase the rotation stability of toric IOLs, achieving the desired goal of correcting corneal astigmatism.

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Natural progression of lamellar macular holes in high myopia: a long-term follow-up study

10.21203/rs.3.rs-380036/v1 ◽

2021 ◽

Author(s):

Mary Ho ◽

Eugenie Mok ◽

Felix Lai ◽

Helena PY Sin ◽

Shaheeda Mohamed ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Macular Hole ◽

High Myopia ◽

Full Thickness ◽

Macular Holes ◽

Full Thickness Macular Hole ◽

The Mean

Abstract Background To determine the long-term prognosis of lamellar macular holes (LMH) in highly myopic eyes. Methods This was a retrospective observational study. Patients with LMH associated with high myopia (>-6 dioptres) were examined at regular 6-month intervals for a minimum of 36 months to detect for any structural and functional deterioration. Assessment included visual acuity checking, fundal examination, and optical coherence tomography (OCT) scanning. The risk factors for visual deterioration and progression to full-thickness macular hole (MH) were analysed using Kaplan-Meier survival analysis. The main outcome measures included the changes in mean best-corrected visual acuities, evidence of lamellar hole progression on OCT scans and complication rates of full-thickness macular hole (FTMH), and foveal detachment (FD) development. Results A total of 37 highly myopic eyes with optical coherence tomography confirmed LMH were recruited from 36 patients. The mean age was 63.4 ± 9.8 years and the mean spherical equivalent refractive error was − 9.01 ± 3.6 D with axial length of 27.74 ± 1.45 mm. The mean follow-up duration was 57.6 ± 10.9 months. The mean baseline visual acuity was 0.272 logMAR ± 0.22. A gradual decline in visual acuity was noted, and the change reached statistical significance from 36 months onwards. Visual acuity was 0.648 ± 0.41 logMAR at 36 months (p = 0.034) and 0.604 ± 0.455 at 48 months (p = 0.046). Twelve eyes (32.4%) had foveoschisis at baseline. Coexistence of a lamellar macular hole with foveoschisis was shown to be a risk factor for the development of a FTMH or FD (p = 0.002). Conclusion LMH in highly myopic eyes was generally stable, while a small proportion of patients progressed to full-thickness MH. Patients with coexisting LMH, foveoschisis, and vitreomacular traction had a higher risk of visual decline and progression to full-thickness MH.

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Evaluation of changes in choroidal thickness after implantable collamer lens surgery in high myopia patients with Graves’ Ophthalmopathy (inactive phase)

10.21203/rs.3.rs-27964/v1 ◽

2020 ◽

Author(s):

Fanglin He ◽

Yan Liu ◽

Renbing Jia ◽

Jing zhang

Keyword(s):

Visual Acuity ◽

High Myopia ◽

Choroidal Thickness ◽

Control Group ◽

Safety Index ◽

Implantable Collamer Lens ◽

Graves Ophthalmopathy ◽

Group A ◽

Efficacy Index ◽

Group B

Abstract Background To evaluate the safety and effectiveness of the Visian Implantable Collamer Lens (ICL) implantation in high myopic patients with inactive Graves’ ophthalmopathy (GO) by observing the changes of choroidal thickness (CT). Methods Eight patients (16 eyes) with high myopia accompanied with inactive GO were selected as the experimental group (group A) and 18 high myopic patients (36 eyes) without GO were selected as a control group (group B). The outcomes of uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BCVA), safety index, efficacy index, intraocular pressure (IOP), vault, corneal endothelial count, and choroidal thickness (CT) were observed. The values of CT were measured using swept-source optical coherence tomography (SS-OCT) scans. Results The UCVA and BCVA in all operated eyes were better than that before surgery. The postoperative safety index and efficacy index were 1.23 and 1.19 in the group A, respectively, and 1.26 and 1.21 in the group B, respectively. In both groups, foveal CT increased significantly in high myopic patients at 2 hours and at 3 months after surgery, compared to preoperative values. The same tendencies were observed in the inner nasal and outer nasal regions. Compared with patients without GO, the increase of CT was more obvious in GO patients, 2 hours postoperatively (P = 0.006) and 3 months postoperatively (P = 0.011). Conclusions The ICL implantation is safe and effective in high myopic patients with inactive GO. Subfoveal and nasal CT may be useful parameters for monitoring the activity of GO patients.

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Comparison of the visual outcome between macula-on and macula-off rhegmatogenous retinal detachment based on the duration of macular detachment

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2020-000615 ◽

2021 ◽

Vol 6 (1) ◽

pp. e000615

Author(s):

Chang Sup Lee ◽

Karl Shaver ◽

Samuel Huisok Yun ◽

Daniel Kim ◽

Sijin Wen ◽

...

Keyword(s):

Retinal Detachment ◽

Rhegmatogenous Retinal Detachment ◽

Visual Outcome ◽

Time Frame ◽

Macular Detachment ◽

Significant Difference ◽

The Status ◽

Group A ◽

The Mean ◽

Group B

ObjectiveTo compare the visual outcomes between macula-on and macula-off primary rhegmatogenous retinal detachment (RRD) based on the duration of macular detachment (DMD).Methods and AnalysisRetrospective study including 96 eyes with RRD (34 macula-on and 62 macula-off) repaired between June 2012 and March 2020. The final visual acuity (VA) was compared after the patients were divided by the status of the macula and their DMD.ResultsThe mean final VA of patients with macula-on RRD (group A) was logarithm of the minimum angle of resolution (logMAR) 0.04±0.07, which was not statistically different from that of individuals with macula-off RRD with DMD ≤3 days (group B; logMAR 0.05±0.06) (p=0.79). There were statistically significant differences in the final VA between group A and patients with macula-off RRD with DMD of 4–7 days (group C; logMAR 0.15±0.15) (p=0.017) as well as between group A and those with macula-off RRD with DMD ≥8 days (group D; logMAR 0.36±0.29) (p<0.001). There was no significant difference in the final VA between group B and C (p=0.33).ConclusionThe mean final VA of patients with macula-on RRD was comparable to that of the macula-off patients with DMD ≤3 days. Our findings suggest that if macula-on RRD could not be immediately repaired, a repair within 72 hours may result in similar outcomes, even if the macula detaches within that time frame. However, once the macula detaches, we do not observe statistically significant differences in outcome for repairs done within 7 days.

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Role of Concomitant Internal Limiting Membrane (ILM) Peeling during Rhegmatogenous Retinal Detachment (RRD) Surgery in Preventing Postoperative Epiretinal Membrane (ERM) Formation

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.3.3576 ◽

2021 ◽

Vol 37 (3) ◽

Author(s):

Asaad Mahmood Syed ◽

Fawad Rizvi Syed ◽

Burhan Abdul Majid Khan ◽

Tanweer Hasan Khan

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Epiretinal Membrane ◽

Rhegmatogenous Retinal Detachment ◽

Internal Limiting Membrane ◽

Ilm Peeling ◽

Group A ◽

Group B ◽

Sd Oct

Objective: To investigate the role of concomitant Internal Limiting Membrane (ILM) peeling during surgery for macula off Rhegmatogenous Retinal Detachment (RRD) in preventing postoperative Epiretinal Membrane (ERM) formation; and its effect on the visual acuity. Methods: This was a prospective, quasi-experimental study conducted from August 2018 to July 2019 at LRBT Tertiary Eye Care hospital, Karachi. Fifty-six patients with macula off RRD were divided into groups A (with ILM peeling) and B (without ILM peeling) via non-probability convenience sampling. All patients underwent standard 3 ports pars plana vitrectomy with silicon oil tamponade. In Group-A, ILM was stained using 0.5% ICG. Patients were evaluated clinically and by spectral domain optical coherence tomography (SD-OCT), pre- and post-operatively. Main outcomes recorded were best corrected visual acuity (BCVA) and occurrence of ERM on SD-OCT. Results: There were 26 patients in Group-A and 30 patients in Group-B. At six months’ follow-up, ERM had not developed in any case in Group-A compared to five patients (16.7%) in Group-B. There was no statistical difference in mean BCVA change from baseline. Conclusion: ILM peeling during vitrectomy for RRD prevents the formation of macular ERM post-operatively. This may reduce the need of a second vitrectomy. However, visual outcomes were comparable to the non-ILM peeling vitrectomy. doi: https://doi.org/10.12669/pjms.37.3.3576 How to cite this:Mahmood SA, Rizvi SF, Khan BAM, Khan TH. Role of Concomitant Internal Limiting Membrane (ILM) Peeling During Rhegmatogenous Retinal Detachment (RRD) Surgery in Preventing Postoperative Epiretinal Membrane (ERM) Formation. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3576 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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COMPARISON OF PATCHING DURATION ON AMBLYOPIC CHILDREN IN CMH MUZAFFARABAD

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v33i1.868 ◽

2019 ◽

Vol 33 (1) ◽

Author(s):

Sidra Malik ◽

Iqra Zaib ◽

Omer Farooq ◽

Kanwal Hanif

Keyword(s):

Visual Acuity ◽

Randomized Control Trial ◽

Early Stage ◽

Personal Information ◽

Factors Affecting ◽

Group A ◽

The Mean ◽

Randomized Control ◽

Group B

Objective: To Compare the efficacy of 2 different patching regimens in amblyopic children and highlight the factors affecting compliance. Materials & Methods: The randomized control trial was conducted in Eye OPD SKBZ Hospital Muzaffarabad from September 2017- March 2018. Analysis was limited to children 4 to 16 years of age with unilateral amblyopia. Personal information, visual acuity with and without correction, Cycloplegic refraction & subjective refraction was noted. Children with amblyopic eye acuity of 20/40 to 20/200 (mean 0.56 log MAR, approximately 20/63) and inter ocular acuity difference of 2 or more lines were specified to get either 2 hours (Group A) or 6 hours (Group B) of daily patching, combined with 1 hour of near visual activities per day. Follow up period was 2 weeks, 4 weeks and 3 months. Results: Out of 72 children 44(61.1%) were males and 28(38.9%) were females. The mean age was 10.25 ± 0.67 years. Mean visual acuity was 20/63(+0.5 log Mar) in both groups. In group A, 66.7 % and in group B 83.3% of patients showed improvement. The mean difference of BCVA was 2.77 ± 1.28 SD and 3.41±3.16 SD in group ‘A’ and group ‘B’ respectively. Group A and B showed improvement of 3.0 and 2.0 lines respectively. Both groups showed a poor compliance of 11.2 %. Conclusion: 2 hours of patching along with 1 hour of near activity is sufficient to treat amblyopia as compared to 6 hours of patching. Firstly, screening should be done to diagnose amblyopia at early stage. Secondly compliance is found to be a single most important factor to improve outcomes.

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A pilot study on vitrectomy combined with scleral shortening for eyes with myopic macular retinoschisis—2y follow-up results

International Journal of Ophthalmology ◽

10.18240/ijo.2021.02.13 ◽

2021 ◽

Vol 14 (2) ◽

pp. 263-268

Author(s):

Peng Zhang ◽

◽

Ling-Xin Hou ◽

Yu-Hua Hao ◽

Kun Wang ◽

...

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Macular Hole ◽

Pars Plana Vitrectomy ◽

Macular Retinoschisis ◽

Corrected Visual Acuity ◽

Pars Plana ◽

The Mean ◽

Best Corrected Visual Acuity

AIM: To evaluate the effect of vitrectomy combined with scleral shortening for eyes with myopic macular retinoschisis. METHODS: Thirty-seven patients with myopic macular retinoschisis who underwent pars plana vitrectomy (PPV) combined with scleral shortening were reviewed. Axial length (AL), the height of macular retinoschisis, the height of retinal detachment if existed, the diameter of macular hole if existed and best corrected visual acuity (BCVA) were obtained. The preoperative and postoperative parameters were compared. RESULTS: At postoperative 24mo, the mean AL and height of macular retinoschisis were reduced significantly by 0.79 mm and 256.51 μm (t=8.064, P<0.0001; Z=-5.086, P<0.0001) respectively. In addition, the mean height of retinal detachment and diameter of macular hole were also reduced significantly by 365.38 μm and 183.68 μm (Z=-4.457, P=0.000008; Z=-2.983, P=0.003) respectively. Meanwhile, the postoperative BCVA was improved markedly (Z=-2.126, P=0.033). CONCLUSION: Vitrectomy combined with scleral shortening is an effective surgical method for eyes with myopic macular retinoschisis, whether or not macular hole and retinal detachment are present.

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Long-term silicone oil tamponade in eyes with complicated retinal detachment

European Journal of Ophthalmology ◽

10.1177/11206721211019551 ◽

2021 ◽

pp. 112067212110195

Author(s):

Orit Vidne-Hay ◽

Eva Platner ◽

Amir Alhalel ◽

Joseph Moisseiev

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Silicone Oil ◽

Final Visual Acuity ◽

Complication Rates ◽

Ocular Surgery ◽

Group A ◽

Silicone Oil Tamponade ◽

Group B

Purpose: To report the visual and anatomic outcomes of eyes with exceedingly long-term silicone oil tamponade. Methods: A retrospective chart review of 43 eyes of 41 patients with silicone oil tamponade for 5 years or more. Rates of retinal reattachment, visual acuity, and complications are presented. Further analysis was performed to identify if silicone oil complications are more common in eyes with lower vision. For this, cases were divided into group A-visual acuity of 20/400 or better and group B-visual acuity of less than 20/400. Results: Mean silicone oil duration was 12.6 ± 6.3 years. The etiology at presentation included: recurrent RRD (60.46%), RRD secondary to trauma (25.58%), and TRD (13.95%). Ninety-three percent of eyes underwent at least one ocular surgery before the vitrectomy with silicone oil tamponade. The retinal attachment rate was 55.8%. Mean visual acuity at presentation was 2.03 ± 0.6 logMAR, and at the final follow-up, 1.85 ± 0.78 logMAR ( p = 0.166). Emulsification developed in 33.3% of cases, glaucoma in 28.6%, band keratopathy in 21.4%, and corneal decompensation in 16.7%. In 26.2% of eyes, the final visual acuity was 20/400 or better (group A). In 73.8% of eyes, final visual acuity was worse than 20/400 (group B). The rates of silicone oil emulsification and glaucoma were not statistically significant between groups. Conclusions: Long-term silicone oil tamponade is a possible option in eyes with complicated retinal detachment following multiple intravitreal procedures, although the complication rates are relatively high. In 26.2% of eyes, visual acuity of 20/400 or better can be preserved for many years.

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