ND: YAG LASER CAPSULOTOMY AND COMPLICATIONS

Objectives: To evaluate the complications of Nd:Yag laser when applied onpostoperative posterior capsule opacification (PCO), following extra capsular cataract extraction (ECCE) with intraocularlens (IOL). Design: Analytical and descriptive study. Setting: Eye OPD of DHQ Hospital, PMC and Clinic of ProfessorZia ud Din Ahmad, Faisalabad. Period: From Jan 2006 to Jan 2007. Material & Methods. There were 120 patients;age ranged from 15 years to 80 years with post operated extra capsular cataract extraction with posterior capsularopacification. A Proforma was made which included detailed history of diabetes, hypertension, time period of cataractextraction, other relevant surgical or medical history, and examination e.g. Visual acuity, slit lamp examination,intraocular pressure measurement (applanation tonometry) dilated posterior capsule examination and slit lampbiomicroscopy etc. The patients were kept under observation for 5 hour and called for follow up after one week.Results. Out of 120 patients 70 eyes showed visual improvement from 6/18 to 6/6 (58.34%), while 30 Shown visualacuity improvement from count figures to 6/24 (25%), mild anterior uveitis occurred in 8 cases (6.67%), corneal damagein 2 cases (1.6%) while transient raised Intraocular Pressure (IOP) in 7 cases (5.83%). The damage to IOL observedin 3(2.5%), the corneal damage was seen in 2 cases (1.67%). Conclusions: The Nd; Yag Laser is very effective, cheapand easy mode of treatment for PCO with minimal post laser complications.

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Effect of brimonidine on central corneal thickness in normal tension glaucoma patients

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20192501 ◽

2019 ◽

Vol 7 (6) ◽

pp. 2216

Author(s):

Neethu K. V. ◽

Latha N. V. ◽

Praveena K. K.

Keyword(s):

Intraocular Pressure ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Topical Administration ◽

Normal Tension Glaucoma ◽

Thickness Measurement ◽

Applanation Tonometry ◽

Time Period ◽

Field Assessment ◽

History Of

Background: Brimonidine is a potent ocular hypotensive agent widely used in glaucoma treatment. A reduction in central corneal thickness can lead to an underestimation of intraocular pressure by Goldmann applanation tonometry and vice versa. The aim of this study is to determine whether brimonidine has an effect on central corneal thickness.Methods: 30 eyes of patients who attended the Ophthalmology OPD between the time period October 2017 and June 2018 who were newly diagnosed with normal tension glaucoma with no history of any systemic illness or not on any medication were included. Each patient underwent a complete ophthalmic evaluation including fundus examination, visual field assessment, intraocular pressure, central corneal thickness measurement by pachymetry before as well as 1 month and 6 months after starting treatment with 0.2% topical brimonidine twice daily.Results: Administration of brimonidine 0.2% resulted in an increase in central corneal thickness from 525±21 µm before starting brimonidine to 528±21 µm (p<0.05) after 1 month and 535±20 µm (p<0.001) after 6 months. It also resulted in a reduction in intraocular pressure from an initial value of 16±2 mmHg before starting brimonidine to 14±2 mmHg (p<0.05) and 13±2 mmHg (p<0.05), 1month and 6 months after starting treatment, respectively.Conclusions: The data presented in this study show that topical administration of 0.2% brimonidine twice daily results in a significant increase in central corneal thickness in patients with normal tension glaucoma.

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Ab interno 180-degree trabeculectomy with a dual blade in a patient with refractory primary congenital glaucoma

European Journal of Ophthalmology ◽

10.1177/11206721211010402 ◽

2021 ◽

pp. 112067212110104

Author(s):

Mehmet Talay Koylu ◽

Fatih Mehmet Mutlu ◽

Alper Can Yilmaz

Keyword(s):

Intraocular Pressure ◽

Female Patient ◽

Congenital Glaucoma ◽

Safe Procedure ◽

Primary Congenital Glaucoma ◽

History Of ◽

Kahook Dual Blade ◽

The Right ◽

Ab Interno

A 13-year-old female patient with refractory primary congenital glaucoma (PCG) in the right eye who had a history of multiple glaucoma operations underwent ab interno 180-degree trabeculectomy with the Kahook Dual Blade (KDB) targeting the nasal and inferior angles. On postoperative day 1, the intraocular pressure (IOP) of the right eye reduced from 43 to 15 mmHg while on medical therapy. The patient maintained this IOP level throughout the 6-month follow-up. Ab interno KDB trabeculectomy targeting both nasal and inferior angles may be an effective and safe procedure for the treatment of PCG even in eyes with a history of previously failed glaucoma procedures.

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Real world treatment patterns in chronic myeloid leukemia patients newly initiated on tyrosine kinase inhibitors in an U.S. integrated healthcare system

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155217697484 ◽

2017 ◽

Vol 24 (4) ◽

pp. 253-263

Author(s):

Nazia Rashid ◽

Han A Koh ◽

Kathy J Lin ◽

Brian Stwalley ◽

Eugene Felber

Keyword(s):

Chronic Myelogenous Leukemia ◽

Index Date ◽

Stem Cell Transplant ◽

Study Time ◽

Myelogenous Leukemia ◽

Prior History ◽

Cell Transplant ◽

Time Period ◽

History Of

Purpose To evaluate treatment patterns in patients diagnosed with incident chronic myelogenous leukemia (CML) newly initiating therapy with imatinib, dasatinib, or nilotinib. Patients were followed to determine switching and discontinuation rates. Factors associated with switching or discontinuation from index TKI therapy, reasons for discontinuation based on electronic chart notes, and frequency of laboratory monitoring were assessed during the follow-up period. Methods A retrospective cohort study was conducted in chronic myelogenous leukemia patients aged ≥ 18 years who were identified from the Kaiser Permanente Southern California (KPSC) Cancer Registry database during the study time period of 1 January 2007 to 12 December 2013. The index date was defined as the date of the first TKI prescription (imatinib, dasatinib, or nilotinib) identified during the study time period with no prior history of TKI use within 12 months. Patients had to have continuous membership with drug benefit eligibility and no prior history of stem cell transplant (SCT) or other cancers during the 12 months prior to the index date. Baseline characteristics were identified during 12 months prior to the index date and outcomes were identified during the follow-up period after the index date. All patients were followed from index TKI therapy until end of study time period (12 December 2014), death, stem cell transplant, or disenrollment from the health plan unless one of the following occurred first: a patient switched their index therapy, or a patient discontinued their index therapy. Forward stepwise selection multivariable logistic regression models were used to evaluate factors associated with patients who continued therapy compared to those who switched or discontinued therapy with the index TKI. Chart notes were reviewed 30 days prior and 30 days post index TKI discontinuation to evaluate reasons for discontinuation. Molecular and cytogenetic testing frequency was also assessed during the follow-up period among the different patient groups. Results Two hundred sixteen patients were identified with incident chronic myelogenous leukemia and use of TKI therapy: 189 (87.5%) received imatinib, 19 (8.8%) received dasatinib, and 8 (3.7%) received nilotinib. The mean age on index date was 53 years and 63% were male; 103 patients (48%) continued on their index therapy, while 62 patients (28%) switched, and 51 patients (24%) discontinued.

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Cured primary hyperparathyroidism after fine-needle aspiration biopsy-induced parathyroid disappearance

Endocrinology Diabetes and Metabolism Case Reports ◽

10.1530/edm-17-0125 ◽

2017 ◽

Vol 2017 ◽

Cited By ~ 1

Author(s):

Elda Kara ◽

Elisa Della Valle ◽

Sara De Vincentis ◽

Vincenzo Rochira ◽

Bruno Madeo

Keyword(s):

Primary Hyperparathyroidism ◽

Fine Needle Aspiration ◽

Needle Aspiration ◽

Complete Disappearance ◽

List Type ◽

Fine Needle ◽

Time Period ◽

History Of

Summary Spontaneous or fine-needle aspiration (FNAB)-induced remission of primary hyperparathyroidism (PHPT) may occur, especially for cystic lesions. However, the disease generally relapses over a short time period. We present a case of PHPT due to an enlarged hyperfunctioning parathyroid that underwent long-term (almost 9 years) clinical and ultrasonographic remission after the disappearance of the lesion following ultrasound (US)-assisted FNAB. A 67-year-old woman with PHPT underwent biochemical and US examinations that confirmed the diagnosis and showed a lesion suggestive for parathyroid adenoma or hyperplasia. US-FNAB of the lesion confirmed its parathyroid nature by means of elevated levels of parathyroid hormone within the needle washing fluid. At the second visit, the patient referred slight neck swelling that resolved spontaneously in the days after the US-FNAB. At subsequent follow-up, the enlarged parathyroid was not found; it was visible neither with US nor with magnetic resonance imaging. Biochemical remission persists after 9 years. This is the first reported case of cure of PHPT after US-FNAB performed on a hyperfunctioning parathyroid resulting in its complete disappearance over a period of 9 years of negative biochemical and ultrasonographic follow-up. Learning points: Spontaneous or fine-needle aspiration-induced remission of primary hyperparathyroidism can occur. Both circumstances may present disease relapse over a variable time period, but definite remission is also possible even though long-term periodic follow-up should be performed. Parathyroid damage should be ruled out in case of neck symptomatology after parathyroid fine-needle aspiration or spontaneous symptomatology in patients with history of primary hyperparathyroidism.

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A-74 COVID-19 and Post-Acute Sequelae of SARS-CoV-2 Infection (PASC): Acute and Longitudinal Analysis of Anosmia and Ageusia with Delayed Sudden-Onset Neuropsychiatric Symptoms

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab062.92 ◽

2021 ◽

Vol 36 (6) ◽

pp. 1116-1116

Author(s):

Patricia A Pimental ◽

Anna Ciampanelli ◽

Eisha H Vora

Keyword(s):

Depressive Disorders ◽

Neuropsychiatric Symptoms ◽

Neuropsychological Testing ◽

Sudden Onset ◽

Diagnostic Specificity ◽

Total Recovery ◽

Time Period ◽

Smell Test ◽

History Of

Abstract Objective Patients with COVID-19 and PASC may exhibit chemosensory dysfunction associated with acute neuroinflammation from immune system overactivation (Uzunova, Pallanti, & Hollander, 2021). Neuropsychiatric disturbances in patients with no history of anxiety or depression have also been reported. These central nervous system manifestations of COVID-19 may be sequelae of trans-olfactory and infralimbic tract penetration (Speth et al., 2020). Methods Our case involved a 52-year-old, right-handed, American Indian female, who at three months post neuropsychological evaluation, was diagnosed with laboratory confirmed COVID-19 with onset of complete anosmia and ageusia. Two months later, a sudden-onset of panic and depression occurred with no precipitating event. All symptoms were documented daily until return of function. Results Pre-COVID-19 neuropsychological testing revealed findings consistent with ophthalmologic/vestibular migraine and ruled out dementia, and formal anxiety and depressive disorders. Post-COVID-19 neuropsychological analysis and follow-up revealed that anosmia and ageusia had largely resolved after 8-months, and that the delayed sudden-onset panic and depression also resolved within that same time period. Conclusions A paucity of data exists concerning COVID-19 and PASC anosmia and ageusia, and sudden-onset neuropsychiatric symptoms. Our case is unique since neuropsychological testing preceded the COVID-19 infection, which provided a baseline of functioning (e.g., Pocket Smell Test: 3/3 baseline and 0/3 acute COVID-19) and pre-morbid diagnostic specificity. The present case findings align with Cappali and Gatti (2021) whereby 91% of patients reported olfactory recovery, with 53% total recovery after 8-months. No other known reports simultaneously documented detailed recovery of anosmia, ageusia and delayed sudden-onset panic and depression, and COVID-19 antibody laboratory testing.

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Effect of preoperative YAG laser anterior capsulotomy on the incidence of posterior capsule opacification: Ten year follow-up

Journal of Cataract & Refractive Surgery ◽

10.1016/s0886-3350(13)80442-7 ◽

1992 ◽

Vol 18 (6) ◽

pp. 559-561 ◽

Cited By ~ 13

Author(s):

Danièle S. Aron-Rosa ◽

J. J. Aron

Keyword(s):

Posterior Capsule Opacification ◽

Posterior Capsule ◽

Yag Laser ◽

Anterior Capsulotomy

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Cataract extraction in patients with primary congenital glaucoma

European Journal of Ophthalmology ◽

10.1177/1120672119841190 ◽

2019 ◽

Vol 30 (3) ◽

pp. 525-532

Author(s):

Laura Morales-Fernández ◽

José María Martínez-de-la-Casa ◽

Blanca Benito-Pascual ◽

Federico Saénz-Francés ◽

Enrique Santos-Bueso ◽

...

Keyword(s):

Risk Factors ◽

Visual Acuity ◽

Intraocular Pressure ◽

Cataract Extraction ◽

Hazard Ratio ◽

High Rate ◽

Congenital Glaucoma ◽

Primary Congenital Glaucoma ◽

Corneal Decompensation

Objective: To assess incidence and risk factors of cataract extraction in patients with primary congenital glaucoma, surgical outcome, and complications. Material and method: Retrospective cohort study, in which 108 patients with primary congenital glaucoma were included. Data collected were need for cataract extraction and at what age, intraocular pressure at diagnosis of primary congenital glaucoma, required antiglaucomatous surgeries, possible mutation in the CYP1B1 gene, and final visual acuity. Among the patients who required cataract extraction were visual acuity, intraocular pressure, and complications, evaluated preoperatively and postoperatively. The data were analysed with STATA. Results: A total of 198 eyes of 108 patients were included, with a median follow-up of 8 years (range: 5–53). In all, 32 eyes (16.2%) of 24 patients (22%) required cataract extraction. The median age for cataract extraction was 12.94 years (interquartile range: 2.42–22). The main identified risk factors associated with cataract extraction were antiglaucomatous surgeries (hazard ratio 1.48, p < 0.001) and valvular implant (hazard ratio 2.78, p < 0.001). Lens was implanted in 30/32 eyes and the main complications were intraocular pressure decontrol ( n = 13), capsular fibrosis ( n = 7), corneal decompensation ( n = 4), lens subluxation ( n = 4), and endophthalmitis ( n = 1). Visual acuity improvement was observed after cataract extraction in 66.67% of eyes. Conclusions: There is a high incidence of cataract surgery in patients with primary congenital glaucoma, but generally outside of pediatric age. A greater risk of cataract extraction was identified in those patients with a greater number of antiglaucomatous surgeries, especially after valvular implantation. Despite the high rate of complications related to cataract extraction in primary congenital glaucoma, good visual improvement was observed after surgery.

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Predicting factors for early and long-term mortality after thoracotomy in patients with primary lung cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e18562 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e18562-e18562

Author(s):

Cynthia van Arkel ◽

Daphne Dumoulin ◽

Bart van Straten ◽

Joost ter Woorst ◽

Saskia Houterman ◽

...

Keyword(s):

Lung Cancer ◽

Regression Analysis ◽

Primary Lung Cancer ◽

Early Mortality ◽

Predicting Factors ◽

Time Period ◽

History Of ◽

Long Term Mortality

e18562 Background: To determine factors predicting early and long term mortality in patients who underwent a thoracotomy because of primary lung cancer. Methods: Data of patients who underwent a thoracotomy in the Catharina Hospital Eindhoven between 1 January 1995 and 1 January 2011 have been collected retrospectively from the medical files. Early mortality was defined as mortality <30 days after surgery. Last date of follow up was 1 January 2013. Patients were divided in three periods according to date of surgery (1: 1995-1999, 2: 2000-2004 and 3: 2005-2010). Predicting factors for early mortality were assessed with uni- and multivariate logistic regression analysis. For long term mortality and survival predicting factors were assessed using the Cox proportional hazards model and Kaplan-Meier survival curves. Results: In total 501 patients underwent a thoracotomy due to primary lung cancer. Overall 30 day mortality was 5.8% (n=29). Early mortality was 3.0% for lobectomy (n=289), 0.2% for bilobectomy (n=29) and 11% for pneumonectomy (n=109). Multivariate analysis showed that age over 70 (p=0.002), pneumonectomy (p=0.008) and a pre-operative VO2max of <15 ml/kg/min (p=0.02) were significant predictors of early mortality. With respect to long term survival, 308 (62%) patients had died at the end of the follow-up period. Median survival time was 44 months, with an overall 5- and 10- year survival of 45% and 27% respectively. The 5- and 10-year survival for stage I, II and III-IV was 61% and 37%; 46% and 30%;16% and 6.6%, respectively (p<0.0001, log rank test). Finally Cox regression analysis showed that stage (stage I (HR 0.30; 95% CI 0.22-0.42), stage II (HR 0.38; 95% CI 0.26-0.57) compared to stage III-IV, FEV1% ≤70% (HR 1.57; 95% CI 1.61-2.11), a history of cerebrovascular disease (CVD) (HR 1.97; 95% CI 1.20-3.23) and surgery in an earlier time period (1 (HR 1.50; 95% CI 1.04-2.17); 2 (HR 1.46; 95% CI 1.05-2.02) compared to 3) were significant predictors of long term mortality. Conclusions: In this cohort age, pneumonectomy and pre-operative VO2max are significant predictors of early mortality. Significant predictors of long term mortality are disease stage, FEV1%, a history of CVD and surgery in an earlier time period.

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