scholarly journals STRABO care less traumatic strabismus surgery technique in the rehabilitation of patients with strabismus

2021 ◽  
pp. 38-44
Author(s):  
I.E. Aznauryan ◽  
◽  
V.O. Balasanyan ◽  
A.A. Shpak ◽  
M.I. Uzuev ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Surgical Technique ◽  
Postoperative Period ◽  
Suture Material ◽  
Anterior Segment ◽  
Rectus Muscle ◽  
Strabismus Surgery ◽  
Control Group ◽  
Palpebral Fissure ◽  
Conjunctival Flap

Purpose. Comparative evaluation of patients' rehabilitation using less traumatic STRABO care technique and traditional methods of strabismus surgery. Material and methods. Sixty-two patients with esotropia were included in the study. All participants underwent medial rectus muscle recession and lateral rectus muscle plication. Patients were divided into two groups. In the main group (38 patients), the surgery was performed with less traumatic technique. Radio-wave knife was used for dissecting the connective tissues. Vicryl 7-0 was used as suture material. Traditional surgical technique was used in control group (24 patients). Scissors were used as a cutting tool and Vicryl 6-0 as a suture material. In the postoperative period conjunctival hyperemia, and width of the palpebral fissure were assessed after the surgery. Conjunctival flap edema (thickness) was measured one day after surgery by the anterior segment optical coherence tomography (AS-OCT). Results. The 1st day after surgery the median thickness of the conjunctival flap above the recession site according to AS-OCT was on average 1.5 times thinner in the main group than in the control group: 405 (351–555) µm vs. 618 (513–732) µm; p<0.001. During the entire observation period in the eyes operated with less traumatic technique, hyperemia was less expressed and palpebral fissure was wider as compared to the control group, where the standard surgical technique was used. Conclusion. Less traumatic STRABO care surgical technique allows to reduce the inflammatory response of tissues in response to surgical intervention and to facilitate the course of the early postoperative period. Key words: strabismus surgery, low-traumatic technique, radio-wave knife, oculomotor muscles, rehabilitation, STRABO care, anterior segment optical coherence tomography

scholarly journals Pre-, Intra-, and Post-Operative Evaluation of Extraocular Muscle Insertions Using Optical Coherence Tomography: A Comparison of Four Devices

2019 ◽  
Vol 8 (10) ◽  
pp. 1732 ◽  
Author(s):  
Matthew S. Pihlblad ◽  
Andrew Troia ◽  
Sapna Tibrewal ◽  
Parth R. Shah
Keyword(s):  
Optical Coherence Tomography ◽  
Intraclass Correlation ◽  
Anterior Segment ◽  
Correlation Coefficients ◽  
Rectus Muscle ◽  
Strabismus Surgery ◽  
Optical Coherence ◽  
Intraclass Correlation Coefficients ◽  
Muscle Insertion ◽  
Operative Evaluation

OCT (optical coherence tomography) is widely used in ophthalmology and pediatric ophthalmology, but limited research has been done on the use of OCT in strabismus. This study investigates the use of different OCT machines to image rectus muscle insertions pre-, intra-, and post-operatively in pediatric strabismus patients. The OCT machines used in the study were a Bioptigen (Leica Microsystems Inc., Buffalo Grove, IL, USA), Spectralis HRA+OCT with Anterior Segment Module (Heidelberg Engineering, Heidelberg, Germany), Visante (Carl Zeiss, Oberkochen, Germany), and Zeiss Rescan 700 (Carl Zeiss, Oberkochen, Germany). Measurements from the machines were compared with the caliper distance measured during the strabismus surgery before disinsertion or after reattachment. The OCT machines had moderate (Bioptigen: 0.62) to good intraclass correlation coefficients (Rescan: 0.83, Spectralis: 0.85, Visante: 0.88) with intra-operative measurements. To our knowledge, this is the first study to use an operating microscope with integrated intra-operative OCT to image rectus muscle insertions. OCT is a useful tool in strabismus surgical patients in the pre-, intra-, and post-operative settings, particularly in patients who have had previous surgery, when the muscle insertion is unknown. The ability to accurately image rectus muscle insertions has significant implications for the management of strabismus patients.

scholarly journals Morphological change of the posterior pole following the horizontal strabismus surgery with swept source optical coherence tomography

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yooyeon Park ◽  
Yong Chan Kim ◽  
Ye Jin Ahn ◽  
Shin Hae Park ◽  
Sun Young Shin
Keyword(s):  
Optical Coherence Tomography ◽  
Refractive Error ◽  
Extraocular Muscle ◽  
Anterior Segment ◽  
Rectus Muscle ◽  
Strabismus Surgery ◽  
Posterior Segment ◽  
Reconstruction Technique ◽  
Optical Coherence ◽  
Swept Source

AbstractExtraocular muscle movement during strabismus surgery causes changes in eyeball shape. Because extraocular muscle insertion is in front of the equator, it is thought that changes due to strabismus surgery mainly occur in the anterior segment. However, changes in the posterior segment of eye may also occur, which may also result in changes in refractive error after strabismus surgery. Using a 3-dimensional reconstruction technique (en face imaging) of the swept source optical coherence tomography, we determined and quantitatively measured the posterior polar change. The deepest interface between Bruch’s membrane and the choroid could be identified as the deepest point of the eyeball (DPE), and the location of the DPE relative to the optic disc and the fovea was measured. After lateral rectus muscle recession, the DPE moved away from the fovea, but after medial rectus muscle recession, the DPE moved toward the fovea. The amount of DPE movement differed by age and preoperative refractive error. Our findings suggest that the positional shift of the rectus muscle in horizontal strabismus surgery causes a structural change in the posterior segment of the eye, and the postoperative refractive changes may be related to this shift.

Accuracy of anterior segment optical coherence tomography for pre-operative localization of insertions of extraocular recti muscles

2020 ◽  
pp. 112067212097119
Author(s):  
Sreeram Jayaraj ◽  
Anupam Singh ◽  
Ajai Agrawal ◽  
Rakesh Panyala ◽  
Ramanuj Samanta ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Observational Study ◽  
Anterior Segment ◽  
Accurate Method ◽  
Strabismus Surgery ◽  
Optical Coherence ◽  
Altman Analysis ◽  
Bland Altman Analysis ◽  
Squint Surgery ◽  
Level Of Agreement

Introduction: To study the accuracy of anterior segment optical coherence tomography (AS-OCT) function of Cirrus HD-OCT 500 (Carl Zeiss Meditec, Dublin, CA) in calculating the insertion of rectus muscles from the limbus in patients undergoing primary squint surgery. Methodology: A prospective, double-masked, observational study was conducted on 128 muscles of 46 patients with strabismus who were planned for strabismus surgery between January 2019 and December 2019. Insertion distance from limbus was measured using AS-OCT function of Cirrus HD-OCT 500 preoperatively. Intraoperative measurements were taken using Castroviejo caliper. A Bland-Altman analysis was performed to determine the agreement between the readings. Results: A total of 128 muscles were successfully imaged and evaluated, including 13 superior recti (10.15%), 23 inferior recti (17.96%), 35 medial recti (27.34%) and 57 lateral recti (44.53%). 124 muscles (96.9%) were within 1mm difference, which was considered clinically acceptable. Bland-Altman plots showed the level of agreement between the two methods was good. Conclusion: Anterior segment scan function of Cirrus HD-OCT 500 is an accurate method to detect the insertion of extraocular recti muscles in patients of primary strabismus surgery.

scholarly journals Automated Measurement of Iris Surface Smoothness Using Anterior Segment Optical Coherence Tomography  

2021 ◽  
Author(s):  
Mohammad Zarei ◽  
Tahereh Mahmudi ◽  
Hamid Riazi-Esfahani ◽  
Behnam Mousavi ◽  
Nazanin Ebrahimiadib ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Correlation Coefficient ◽  
Anterior Segment ◽  
Control Group ◽  
Optical Coherence ◽  
Interclass Correlation Coefficient ◽  
Interclass Correlation ◽  
Automated Measurements ◽  
And Control ◽  
Fellow Eyes

Abstract Fuchs uveitis (FU) is a chronic and often unilateral ocular inflammation and characteristic iris atrophic changes, other than heterochromia, are common in FU and are key to the correct diagnosis in many cases. With the advent of anterior segment optical coherence tomography (AS-OCT), some investigators attempted to quantitatively study these atrophic changes; mostly by introducing various methods to measure iris thickness in AS-OCT images. We aimed to present an automated method in a observational case series to measure the smoothness index (SI) of iris surface in AS-OCT images. The ratio of the length of the straight line connecting the most peripheral and central points of the anterior iris border (in nasal and temporal sides) to the actual length of this border on AS-OCT images, was defined as SI. In a uveitis referral center twenty-two eyes of 11 patients with unilateral Fuchs uveitis (FU) (7 female) and 22 eyes of 11 healthy control subjects underwent AS-OCT imaging. Image J and a newly developed MATLAB algorithm were used for manual and automated SI measurements, respectively. Agreement between manual and automated measurements was evaluated with Bland-Altman analysis and interclass correlation coefficient. The inter-eye difference of SI was compared between FU group and control group. Automated mean overall SI was 0.868 ± 0.037 and 0.840 ± 0.039 in FU and healthy fellow eyes, respectively (estimated mean difference = -0.028, 95% CI [-0.038, -0.018], p<0.001). Bland- Altman plots showed good agreement between two methods in both healthy and FU eyes. Interclass correlation coefficient between the manual and automated measurements in the FU and healthy fellow eyes was 0.958 and 0.964, respectively. Inter-eye difference of overall SI was 0.029 ± 0.015 and 0.012 ± 0.008 in FU group and control group, respectively (p=0.01). We concluded that he automated algorithm can rapidly and conveniently measure SI with results comparable to manual method.

scholarly journals Corneal Hydrops in Keratoconus

2015 ◽  
Vol 4 (2) ◽  
pp. 52-55
Author(s):  
Namrata Sharma ◽  
Ritu Nagpal ◽  
Prafulla K Maharana
Keyword(s):  
Optical Coherence Tomography ◽  
Surgical Technique ◽  
Confocal Microscopy ◽  
Gas Injection ◽  
Anterior Segment ◽  
Corneal Edema ◽  
Corneal Neovascularization ◽  
Visual Rehabilitation ◽  
Corneal Hydrops ◽  
Difficult Situations

ABSTRACT Purpose The purpose of this review is to outline the etiology, clinical features, and management of acute corneal hydrops (CH) in cases of keratoconus (KC). Recent findings The advent of newer investigative modalities like ultra biomicroscopy, anterior segment optical coherence tomography and confocal microscopy has contributed toward the diagnosis, treatment planning and following the course of therapy in cases of acute hydrops. Summary Corneal hydrops is an acute complication of keratoconus which in most instances resolves spontaneously. However, prolonged corneal edema can lead to complications, such as corneal neovascularization which can jeopardise a future corneal graft. Hence, timely intervention is required in most cases to prevent such complications as well as for early visual rehabilitation. Intracameral gas injection is the most commonly performed surgical procedure for hydrops. Modifications in surgical technique can help to tackle difficult situations. How to cite this article Maharana PK, Nagpal R, Sharma N. Corneal Hydrops in Keratoconus. Int J Kerat Ect Cor Dis 2015;4(2):52-55.

Changes in conjunctival–scleral thickness after strabismus surgery measured with anterior segment optical coherence tomography

2018 ◽  
Vol 62 (5) ◽  
pp. 554-559 ◽  
Author(s):  
Hiroko Suzuki ◽  
Akiko Hikoya ◽  
Miwa Komori ◽  
Risako Inagaki ◽  
Takashi Haseoka ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Segment ◽  
Strabismus Surgery ◽  
Optical Coherence

scholarly journals A pilot study of scleral thickness in central serous chorioretinopathy using anterior segment optical coherence tomography

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yun Ji Lee ◽  
Yeon Jeong Lee ◽  
Jae Yeon Lee ◽  
Suhwan Lee
Keyword(s):  
Optical Coherence Tomography ◽  
Central Serous Chorioretinopathy ◽  
Anterior Segment ◽  
Venous Drainage ◽  
Enhanced Depth Imaging ◽  
Control Group ◽  
Study Group ◽  
Optical Coherence ◽  
Swept Source ◽  
Significant Difference

AbstractThe aim of this study is to compare the scleral thickness of central serous chorioretinopathy (CSC) eyes with controls using anterior segment optical coherence tomography (AS OCT). This prospective case control study included 15 patients (15 eyes) with CSC and 15 age and gender matched healthy subjects. All subjects underwent spectral domain OCT with enhanced depth imaging and swept source AS OCT of temporal sclera. We investigated difference in scleral thickness between the two groups and relationship between choroidal and scleral thickness. Among the 15 eyes in the study group, 1 eye had acute CSC, 4 had recurrent CSC, 7 had inactive CSC, and 3 had chronic CSC. There was no significant difference in terms of age, gender, axial length and spherical equivalent between the two groups. The choroidal and scleral thickness of the study group were significantly greater than those of the control group (P < 0.001, P = 0.034). Choroidal thickness was positively correlated with scleral thickness (P = 0.031). A thick sclera along with a thick choroid were demonstrated in CSC eyes using AS OCT. Scleral characteristics might be involved in the pathogenesis of CSC by affecting outflow resistance of venous drainage in choroidal circulation.

Corneal optical density in Fuchs endothelial dystrophy determined by anterior segment optical coherence tomography

2020 ◽  
pp. 112067212094479
Author(s):  
Christian M Wertheimer ◽  
Carolin Elhardt ◽  
Andreas Wartak ◽  
Nikolaus Luft ◽  
Stefan Kassumeh ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Density ◽  
Anterior Segment ◽  
Corneal Edema ◽  
Diagnostic Tools ◽  
Control Group ◽  
Distilled Water ◽  
Optical Coherence ◽  
Corneal Surgery ◽  
Disease Characteristics

Purpose: In this study, we propose a method to grade corneal stromal opacity using optical density measurements by anterior segment optical coherence tomography (AS-OCT) and validate the approach in Fuchs endothelial corneal dystrophy (FECD). Methods: A retrospective analysis of human corneal OCT scans was performed on 48 eyes of 32 patients with FECD and 33 control eyes of 21 patients using the Carl Zeiss Cirrus HD-OCT 5000. In addition, corneal edema in fresh rabbit cadaver eyes was artificially induced by distilled water and imaged with the Thorlabs TELESTO-II spectral domain OCT at different time points during saturation. The increase of opacity due to corneal edema was proposed to directly correlate with enhanced reflectivity sites in the OCT images, corresponding to higher optical density. The increase was determined as the image area above a statistically established gray-scale value using ImageJ and correlated with other disease characteristics. Results: Optical densities in human corneas showed significant differences between FECD patients and the control group ( p = 0.002). The increased optical densities determined in FECD corneas correlated well with other disease characteristics such as corneal pachymetry or visual acuity. Likewise, rabbit corneas showed a time dependent increase in thickness and in corneal optical density during soaking in distilled water. Conclusion: This study presents corneal optical density by AS-OCT as an objective value for corneal changes in FECD. Complementing other diagnostic tools in FECD the assessment of corneal optical density may identify progression of FECD, gauge novel therapeutic strategies and support risk and benefit analyses for corneal surgery.

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