The closure of the macular holes with the use of autoplasty ILM: a comparative analysis of functional and morphological parameters

2021 ◽  
pp. 122-126
Author(s):  
O.А. Pavlovskiy ◽  
◽  
М.М. Shishkin ◽  
R.R. Fayzrakhmanov ◽  
E.A. Larina ◽  
...  
Keyword(s):  
Macular Hole ◽  
Statistical Processing ◽  
Internal Limiting Membrane ◽  
Original Method ◽  
Ophthalmological Examination ◽  
Macular Holes ◽  
Nasal Side ◽  
Before And After ◽  
Group 2 ◽  
Group 1

Actual. Peeling the internal limiting membrane when closing the macular tear is a fundamental procedure. However, recently, additional microtraumatization of the layers of neuroretinal tissue during peeling and changes in morphofunctional parameters have been proven. Purpose. The aim of this study was to propose a technique with autoplasty of the ILM and preservation of the papillomacular bundle in the area and to assess the dynamics of morphofunctional parameters after surgery for a macular hole. Materials and methods. Morphofunctional data of 200 patients (100 eyes) were studied.) Patients of group 1 (100 eyes) were operated on using the introverted flap technique Patients of group 2 (100 eyes) were operated on using the original method with the preservation of ILM in the foveolar zone. All patients underwent a standard ophthalmological examination before and after surgery. The assessment of morphometric data was carried out on the basis of the ACT-study. Statistical processing of the results was carried out using the IBM SPSS Statistics 23 program. Results. According to the results of surgical treatment on the 7th day and on the 30th day after the operation, higher indicators of functional parameters of the retina were revealed in patients of the 2nd group. In comparison with the data before surgery, BCVA increased 2.55 times in group 1, and 4.46 times in group 2. There was a significant decrease in MH height-n in patients of group 1 in comparison with data before surgery and group 2 in comparison with data before surgery by 1.68 and 2.12 times, respectively. This is due to the lack of additional microtraumatization of neuroretinal tissue (no peeling) on the nasal side of the macular hole. Keyword: macular hole, ILM peeling, vitrectomy.

Variants of the reparative activity of the foveolar zone in the closure of the macular hole by autoplasty in internal limiting membrane

2021 ◽  
pp. 126-131
Author(s):  
M.M. Shishkin ◽  
◽  
O.А. Pavlovskiy ◽  
E.A. Larina ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Macular Hole ◽  
Morphological Changes ◽  
Central Zone ◽  
Internal Limiting Membrane ◽  
Original Method ◽  
Internal Boundary ◽  
Ophthalmological Examination ◽  
Functional Parameters ◽  
Group 2

Purpose. Propose a new technique of operation macular discontinuity, which is based on the preservation of the internal limiting membrane (ILM), and to assess the dynamics of retinal morphological and functional parameters for different embodiments of wound healing. Material and methods. The results of surgical treatment of 240 patients (240 eyes) with the diagnosis of macular hole were analyzed. Group 1 (120 eyes) – patients who underwent surgical treatment according to the standard method. Group 2 (120 eyes) – patients who were operated on using the original method with partial exfoliation of ILM in the Central zone. All patients underwent ophthalmological examination before and after surgery, including visometry, biomicroscopy, ophthalmoscopy and OCT. Results. Preoperative functional parameters of the retina in patients of both groups were comparable. During the study, two types of closure of macular tears were identified. When studying the morphological changes in the «pseudocyst» type of macular rupture repair in patients of both groups, a more pronounced resistance of the neuroretinal tissue is observed in patients of the 1st group. In the 2nd group, a more pronounced dynamics of a decrease in the morphological parameters of the hyporeflexive defect was revealed throughout the entire observation period. With the complete closure of the macular gap, a higher rate of regression of edema of neuroepithelial tissue is observed in patients of the 2nd group. Conclusion. Based on this study, we can conclude that during this technique, the ILM is preserved, which reduces the risk of intraoperative damage to the retinal layers. Key words: macular rupture, peeling, internal boundary membrane, optical coherence tomography.

Conventional internal limiting membrane peeling versus temporal inverted internal limiting membrane flap for large macular holes

2019 ◽  
pp. 112067211989242 ◽  
Author(s):  
Remzi Avci ◽  
Aysegul Mavi Yildiz ◽  
Sami Yilmaz
Keyword(s):  
Case Series ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Flap Technique ◽  
Macular Holes ◽  
Complete Restoration ◽  
Group 2 ◽  
Papillomacular Bundle ◽  
Group 1

Purpose: To compare the functional, anatomical, and morphological results of conventional internal limiting membrane peeling versus temporal inverted internal limiting membrane flap technique for the treatment of macular holes larger than 400 μm. Design: Retrospective, comparative case series. Methods: A total of 33 patients were included, of whom 18 were treated with internal limiting membrane peeling (Group 1) and 15 were treated with temporal inverted internal limiting membrane flap technique (Group 2). Complete ophthalmic examination, such as microperimetry and optical coherence tomography, was performed preoperatively and at 12 months after surgery. Results: The closure rates accomplished in Groups 1 and 2 were 72.2% and 100%, respectively (p = 0.036). The mean improvement in best-corrected visual acuity was logMAR 0.49 ± 0.17 in Group 1 and logMAR 0.91 ± 0.15 in Group 2 (p = 0.037). U-shaped closure was achieved in one eye in Group 1 and 12 eyes in Group 2 (p < 0.001). Complete restoration of external limiting membrane and ellipsoid zone rates were significantly higher in Group 2 (p = 0.027 and p = 0.001, respectively). Conclusion: The single-layered temporal inverted internal limiting membrane flap technique improves not only anatomical and morphological but also functional outcomes of surgery for large macular holes. Furthermore, this technique seems to minimize the risk of iatrogenic trauma to the nasal part of the fovea and the corresponding papillomacular bundle fibers.

scholarly journals A retrospective analysis of the results of surgical treatment of large macular holes

2018 ◽  
Vol 99 (2) ◽  
pp. 341-344
Author(s):  
A N Samoylov ◽  
G A Fazleeva ◽  
T R Khaybrakhmanov ◽  
P A Samoylova ◽  
M A Fazleeva
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Retrospective Analysis ◽  
Ophthalmological Examination ◽  
Modified Technique ◽  
Complete Closure ◽  
Macular Holes ◽  
Idiopathic Macular Holes ◽  
Group 2 ◽  
Group 1

Aim. A retrospective analysis of the results of surgical treatment of large idiopathic macular holes depending on the technique of surgical intervention. Methods. The results of surgical treatment of 60 patients (60 eyes) with idiopathic macular holes with a diameter of more than 800 μm were studied in the Republican clinical ophthalmology hospital of Kazan. The average age of the patients was 66.2±5.37 (61-74) years. The patients underwent complex ophthalmological examination before the surgery and 10 days and 1 month after the surgery, including visometry, tonometry and optical coherence tomography. Patients were divided into two groups (30 subjects each), comparable in clinical and epidemiological parameters: group 1 - standard surgical tactics, group 2 - surgical treatment according to the method proposed by professor A.N. Samoylov. Visual acuity with correction before surgery in group 1 was 0.11±0.05, in group 2 - 0.12±0.06. Results. Ten days after the surgery, group 1 had anatomical closure in 23 (76.7%) patients, anatomical result was not achieved in 7 (23.3%) patients. In group 2, complete closure of the rupture was achieved in 27 (90.0%) patients, incomplete - in 3 (10.0%) patients. In 1 month in group 1, complete closure of the macular rupture was observed in 22 (73.3%) patients, in 8 (26.7%) patients the result was not achieved. In group 2, complete closure of the rupture was determined in 28 (93.3%) patients, incomplete closure - in 2 (6.7%) patients. Visual acuity 1 month after the surgery in group 1 was 0.15±0.08, and in group 2 - 0.32±0.11 (p <0.05). Conclusion. Surgical treatment of large idiopathic macular holes according to the modified technique of the inverted internal limiting membrane flap proposed by professor A.N. Samoylov, provides better anatomical and functional results in comparison with the standard technique (p <0.05).

scholarly journals The Effects of Ramadan Fasting on Anterior Segment Parameters, Visual Acuity and Intraocular Pressures of the Eye

2017 ◽  
Vol 11 (1) ◽  
pp. 152-155 ◽  
Author(s):  
Ozlem Barut Selver ◽  
Melis Palamar ◽  
Kevser Gerceker ◽  
Sait Egrilmez ◽  
Ayse Yagci
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Ophthalmological Examination ◽  
Significant Difference ◽  
Before And After ◽  
Group 2 ◽  
Group 1

Objective: It is aimed to determine whether fasting during Ramadan has any significant effect on anterior chamber parameters, visual acuity and intraocular pressures. Methods: 31 fasting (Group 1) and 30 non-fasting healthy volunteers (Group 2) were enrolled. All cases underwent an ophthalmological examination and anterior segment parameter evaluation (central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), pupil size) with Pentacam before and after the breaking of the Ramadan fast in Group 1, before and after dinner in Group 2. Results: The mean age was 43.35 ± 13.20 in Group 1, 43.17 ± 12.90 in Group 2 (p= 0.955). No significant difference was detected in any of the parameters in both groups. Conclusion: There is a need for more detailed and associated studies to understand better about the influence of Ramadan fast on various ocular parameters.

Dynamics of changes in microperimeric parameters of retina in various methods of closing macular breaks based on autoplasty of internal limiting membrane

2021 ◽  
pp. 132-136
Author(s):  
M.M. Shishkin ◽  
◽  
O.А. Pavlovskiy ◽  
E.A. Larina ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Vitreoretinal Surgery ◽  
Functional Results ◽  
Internal Limiting Membrane ◽  
Light Sensitivity ◽  
Original Method ◽  
Retinal Layers ◽  
Macular Holes ◽  
Group 2 ◽  
A New Technique

Currently, vitreoretinal surgery is one of the most effective methods of treating macular holes that can improve the quality of vision, and the most common method of such treatment is vitrectomy with the removal of the internal border membrane around the rupture and the use of autoplasty of the internal border membrane. Microperimetric retinal testing measures the sensitivity of the retina at certain points on a larger surface and detects relative or absolute microscotomas, which allows you to objectively assess the state of the central part of the retina. At the same time, the search for ways to reduce the risk of macular surgery complications and improve functional results continues. Purpose. To propose a new technique for macular tear surgery, which is based on autoplasty of the VPM and reduction of microtraumatization of the retinal layers. Material and methods. The results of surgical treatment of 240 patients (240 eyes) with a diagnosis of macular holes were analyzed. All patients underwent surgical treatment for MH. Depending on the method of closing the macular hole, the patients were divided into two groups: group 1 – patients who underwent surgical treatment using the standard introverted flap technique. Group 2 – patients who were operated on according to the original method with partial peeling of ILM in the macular area. All parameters in the preoperative period were statistically comparable. Results. The most significant are the results obtained on the 30th day after surgical treatment. According to the results of surgical treatment, there was a significant excess of light sensitivity parameters in the nasal part of the pattern used: the upper-nasal and lower-nasal quadrants, where peeling was not performed. Conclusion. During this technique, there is a preservation ILM, which reduces the risk of intraoperative damage to the retinal layers. A higher functional result was obtained. Key words: microperimetry, macular rupture, ILM peeling.

scholarly journals Conventional Internal Limiting Membrane Peeling Versus Temporal Inverted Internal Limiting Membrane Flap Technique for Large Macular Holes: A Comparative Study

2021 ◽  
Author(s):  
Nurullah Koçak ◽  
Volkan Yeter ◽  
Hakkı Birinci
Keyword(s):  
Functional Outcomes ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Closure Rate ◽  
Internal Limiting Membrane Peeling ◽  
Flap Technique ◽  
Macular Holes ◽  
Group 2 ◽  
Hole Closure ◽  
Group 1

Abstract Purpose: To compare the anatomical, morphological, and functional outcomes of the conventional internal limiting membrane (ILM) peeling versus temporal inverted internal limiting membrane flap technique for large full-thickness macular holes (FTMHs). Subjects and Methods: Forty-six eyes of 44 patients with a minimum base diameter > 600 µm were included in this retrospective interventional study. The patients were divided into Group 1 (conventional ILM peeling) and Group 2 (temporal inverted ILM flap). The hole closure rate, best-corrected visual acuity (BCVA), ellipsoid zone (EZ), and external limiting membrane (ELM) defects were analyzed at baseline and 6 months after surgery.Results: Hole closure was achieved in 17/25 (68%) cases of Group 1 and 20/21 (95.2%) cases of Group 2. The hole closure rate was significantly higher in the temporal inverted ILM flap group (p = 0.022). The mean BCVA (logMAR) changed from 1.12 ± 0.43 to 0.72 ± 0.31 in Group 1 and from 1.07 ± 0.34 to 0.51 ± 0.26 in Group 2 at six months (p < 0.001 in both cases). U-shaped closure was observed in 3 (12%) eyes in Group 1 and 15 (71.4%) eyes in Group 2 (p < 0.001). The total restoration rates of ELM and EZ were significantly higher in the temporal inverted ILM flap group (p = 0.009, p = 0.001, respectively).Conclusion: The temporal inverted ILM flap technique is more effective than conventional ILM peeling for larger than 600 µm macular holes and improves anatomical, morphological, and functional outcomes.

Features of postoperative period in patients with chronic venous insufficiency: phlebectomy versus thermal ablation

2020 ◽  
pp. 64-75
Author(s):  
E. Burleva ◽  
O. Smirnov ◽  
S. Tyurin
Keyword(s):  
Postoperative Period ◽  
Chronic Venous Insufficiency ◽  
Thermal Ablation ◽  
Venous Insufficiency ◽  
Clinical Symptoms ◽  
Varicose Veins ◽  
Statistical Processing ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The purpose of the study was to conduct a comparative assessment of the course of the postoperative period after phlebectomy and thermal ablation in patients with varicose veins of the lower extremities in the system of the great saphenous vein (GSV) with class C2 of chronic venous insufficiency (CVI) — CEAP class C2. Materials and methods: 455 patients (455 limbs) with CEAP class C2. Group 1 (n = 154) received stripping + minimally invasive phlebectomy; Group 2 — endovenous laser ablation (EVLA) of GSV trunk + sclerotherapy of varicose veins; 3 group (n = 150) — radiofrequency ablation (RFA) of the GSV + sclerotherapy. All patients were united by a single tactical solution — the elimination of pathological vertical reflux in GSV. In each group, patients were with similar hemodynamic profile were selected (Group 1 = 63; Group 2 = 61; Group 3 = 61). The course of the postoperative period (from 2 days to 2 months) was compared for pain (visual analog scale — VAS), clinical symptoms of chronic venous insufficiency, degree of satisfaction (Darvall questionnaire), and duration of disability. Statistical processing was carried out using Excel programs for Windows XP, MedCalc® (version 11.4.2.0., Mariakerke, Belgium). Results: Postoperative pain is more pronounced (during day 1 for Group 1–4.0, Group 2–3.0, Group 3–2.0) and more prolonged (up to 4 days) after open surgeries (p < 0.05). The dynamics of the clinical symptoms of CVI (including varicose syndrome and use of compression therapy) could not be fully evaluated in connection with the ongoing sclerotherapy procedures for patients of Groups 2 and 3. Satisfaction of patients with aesthetic aspects was higher than expected in all groups. Reliable statistical differences proved decrease in days of disability (Group 1–14; Group 2–4; Group 3–3) and earlier return to physical activities and work in patients after thermal ablation in comparison with phlebectomy. Conclusion: The study shows that all three methods for eliminating vertical reflux in the GSV can be proposed for a large category of patients with CEAP of class C3 and C2. Medical and social rehabilitation of patients using endovascular thermal ablation technologies proceeds faster, which is beneficial both for the patients and for society.

Comparison of 24-Hour Electrocardiogram Parameters in Patients with Graves Disease Before and After Anti-Thyroid Therapy

2020 ◽  
Vol 20 ◽  
Author(s):  
Gamze Akkuş ◽  
Yeliz Sökmen ◽  
Mehmet Yılmaz ◽  
Özkan Bekler ◽  
Oğuz Akkuş
Keyword(s):  
Treatment Group ◽  
Medical Treatment ◽  
Surgical Therapy ◽  
Graves Disease ◽  
Before And After ◽  
Euthyroid Status ◽  
Ectopic Beats ◽  
Group 2 ◽  
Electrocardiographic Parameters ◽  
Group 1

Background: We aimed prospectively investigate the laboratory and electrocardiographic parameters (hearth rate, QRS, QT, QTc, Tpe, Tpe/QTc, arrhythmia prevalance) in patients with graves disease before and after antithyroid therapy. Methods: 71 patients (48 female, 23 male), age between 18-50 (mean±SD: 36.48±12.20 ) with GD were included into the study. Patients treated with antithyroid therapy (thionamids and/or surgical therapy) to maintain euthyroid status. Patients were examined in terms of electrocardiographic parameters before and after the treatment. Results: Mean TSH, free thyroxin (fT4) and tri-iodothyrionine (fT3) levels of all patients were 0.005±0.21, 3.27± 1.81, 11.42±7.44, respectively. While 9 patients (group 2) underwent surgical therapy, had suspicious of malignant nodule or large goiter and unresponsiveness to medical treatment; the other patients (n=62, group 1) were treated with medical therapy. Patients with surgical therapy had more increased serum fT4 (p=0.045), anti-thyroglobulin value (p=0.018) and more severe graves orbitopathy (n=0.051) before treatment when compared to medical therapy group. Baseline Tpe duration and baseline Tpe/QTc ratio and frequency of supraventricular ectopic beats were found to be significantly higher in group 2 when compared to group 1 (p=0.00, p=0.005). Otherwise baseline mean heart rate, QRS duration, QTc values of both groups were similar. Although the patients became their euthyroid status, group 2 patients had still suffered from more sustained supraventricular ectopics beats than group 1. Conclusion: Distinct from medical treatment group, surgical treatment group with euthyroidism at least 3 months had still suffered from an arrhythmia (Tpe, Tpe/QTc, supraventricular and ventricular ectopic beats).

scholarly journals Adaptive functional change of the contralateral kidney after partial nephrectomy

2017 ◽  
Vol 313 (2) ◽  
pp. F192-F198 ◽  
Author(s):  
Se Young Choi ◽  
Sangjun Yoo ◽  
Dalsan You ◽  
In Gab Jeong ◽  
Cheryn Song ◽  
...  
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Functional Change ◽  
Functional Changes ◽  
Contralateral Kidney ◽  
Before And After ◽  
Group 2 ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Group 1

Partial nephrectomy aims to maintain renal function by nephron sparing; however, functional changes in the contralateral kidney remain unknown. We evaluate the functional change in the contralateral kidney using a diethylene triamine penta-acetic acid (DTPA) renal scan and determine factors predicting contralateral kidney function after partial nephrectomy. A total of 699 patients underwent partial nephrectomy, with a DTPA scan before and after surgery to assess the separate function of each kidney. Patients were divided into three groups according to initial contralateral glomerular filtration rate (GFR; group 1: <30 ml·min−1·1.73 m−2, group 2: 30–45 ml·min−1·1.73 m−2, and group 3: ≥45 ml·min−1·1.73 m−2). Multiple-regression analysis was used to identify the factors associated with increased GFR of the contralateral kidney over a 4-yr postoperative period. Patients in group 1 had a higher mean age and hypertension history, worse American Society of Anesthesiologists score, and larger tumor size than in the other two groups. The ipsilateral GFR changes at 4 yr after partial nephrectomy were −18.9, −3.6, and 3.9% in groups 1, 2, and 3, respectively, whereas the contralateral GFR changes were 10.8, 25.7, and 38.8%. Age [β: −0.105, 95% confidence interval (CI): −0.213; −0.011, P < 0.05] and preoperative contralateral GFR (β: −0.256, 95% CI: −0.332; −0.050, P < 0.01) were significant predictive factors for increased GFR of the contralateral kidney after 4 yr. The contralateral kidney compensated for the functional loss of the ipsilateral kidney. The increase of GFR in contralateral kidney is more prominent in younger patients with decreased contralateral renal function.

A cross-sectional research conducted in Malatya province, Turkey: Knowledge levels and awareness about rational antibiotic use and antimicrobial resistance before and after graduation

2019 ◽  
Author(s):  
ADEM KOSE
Keyword(s):  
Antimicrobial Resistance ◽  
Family Physicians ◽  
Antibiotic Use ◽  
Theoretical Knowledge ◽  
Cross Sectional ◽  
Before And After ◽  
Group 2 ◽  
Senior Students ◽  
Rational Antibiotic Use ◽  
Group 1

Abstract Background Irrational antibiotic use can adversely affect treatment outcomes or even lead to increased antimicrobial resistance. We aimed to determine antimicrobial prescribing habits and to evaluate the level of theoretical knowledge of rational antibiotic use and awareness about antimicrobial resistance among the senior students of medical faculty and the family physicians in Malatya province in Turkey. Methods This study was cross-sectional research and was carried out between dates of 01 February-30 April 2019, in Malatya province. Power analysis was calculated as minimum 240 participants when considering a proportion difference of 0.18 between the groups, a type I error of 0.05 and a type II error of 0.20. A total 225 senior students in Inonu University Medical Faculty (Group 1) and 230 actively-working family physicians in Malatya primary healthcare services who were found eligible (Group 2) were included in to this study. A questionnaire form was prepared including seven sections and thirty questions. All of the participants were interviewed face to face. Before the questions, the purpose of the study and the contents of the questions were explained to participants. Qualitative data were analyzed by Pearson chi-square test. A p<0.05 value was considered to be statistically significant. Results The group 1 had a tendency to apply to specialist physician when starting to themselves antibiotic treatment, they were more cautious when making antibiotic decision, and their theoretical knowledge level was better. They argued that penal sanctions could be more effective by developing strict use policies to raise awareness of resistance to antibiotics. The group 2 had higher self-confidence and it was also concluded that forgot their theoretical antibiotic knowledge over time and could not follow the novel information because of the intensity of working life. Both groups stated that post-graduation trainings could be used effectively for reducing the antibiotic resistance. Conclusion This study highlighted the need for immediate action of training and corrective actions and might create awareness to determine the difference in theoretical knowledge levels and behavior models of physicians before and after graduation and to reduce higher use rates to lower levels. Key words: Antimicrobial resistance, antibiotic, awareness, rational use

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