scholarly journals To evaluate the effects of Nd:YAG laser posterior capsulotomy on best corrected visual acuity (bcva) and intraocular pressure

2017 ◽  
Vol 8 (5) ◽  
pp. 93-97
Author(s):  
Ohm Vrajlal Patel ◽  
Neha Chandrakar ◽  
Piyush Bajaj ◽  
Sonam Mahajan

Background: Nd:YAG laser is non-invasive and effective means to deal with the posterior capsule opacification.However safe it may have some inherent complications. Rise of intraocular pressure is frequently encountered and incompletely understood complication of YAG laser capsulotomy and documented with conflicting results.Aims and Objective: To assess the efficacy of Nd: YAG laser capsulotomy in term of visual outcome(Best Corrected Visual Acuity) and also study the changes in IOP after the procedure.Materials and Methods: Study evaluated the changes in IOP and visual acuity after Nd-YAG laser capsulotomy in 100 eyes with significant PCO after uncomplicated cataract surgery with IOL implantation. Complete ocular examination including visual acuity, anterior segment examination with slit lamp, fundus and applanation tonometry were performed pre and post-laser in all cases. Posterior capsulotomy was done with VISULAS YAG III Q-switched Nd: YAG laser machine by ZEISS. IOP was recorded before and then at 1hour, 1 Day, 1 week and 1 month post-laser in order to determine the IOP changes.Results: Pre-laser visual acuity ranged from 1/60 to 6/12. Results showed statistically significant improvement in BCVA with 70% patients had BCVA 6/6, 21% had BCVA 6/9 and 8% having BCVA 6/12 post-laser at 1 month. It was observed that 36% of the patients showed no change in IOP while 64% patients showed elevated IOP. Among these 59% patients show rise in IOP that was ≤5 mm Hg while only 5% of the patients had a rise of more than IOP >5 mm Hg. Most of these patients achieved their baseline IOP within 1 day and only 7 % patient had rise in IOP compared to baseline IOP on day 1. None of the patients show elevated IOP after 1 week.Conclusion: Our study showed that Nd: YAG laser posterior capsulotomy provided excellent results in terms of visual improvement and most of the patients had a rise of <5mm Hg which was transient in nature and routine antiglaucoma medication may not be needed in all the patient undergoing Nd;Yag capsulotomy, however caution should be exercised in glaucomatous, aphakic, high myopic and other high risk patients.Asian Journal of Medical Sciences Vol.8(5) 2017 93-97

2018 ◽  
Vol 28 (5) ◽  
pp. 552-558 ◽  
Author(s):  
Priya Narang ◽  
Amar Agarwal ◽  
Dhivya Ashok Kumar

Purpose: To demonstrate the efficacy and initial results of single-pass four-throw pupilloplasty in cases of Urrets-Zavalia syndrome. Methods: In this prospective interventional study, single-pass four-throw was performed to reconstruct the pupil in all symptomatic cases with Urrets-Zavalia syndrome. Applanation tonometry, indentation gonioscopy, and anterior segment optical coherence tomography for anterior chamber angle assessment were performed in all the cases. Results: Out of 10 cases that were identified with Urrets-Zavalia syndrome, the procedure was performed in 7 cases, whereas 3 cases were left untreated, as they did not have any visual complaints. Five out of seven eyes had preoperative raised intraocular pressure with appositional closure of the angle. Postoperatively, intraocular pressure was controlled in all the eyes, whereas one eye required antiglaucoma medications to control the intraocular pressure. The mean preoperative and postoperative best-corrected visual acuity was 1.1 ± 1.2 and 0.4 ± 0.4 LogMar, respectively. There was a significant improvement in the best-corrected visual acuity (p = 0.0169) in the postoperative period. The mean preoperative and postoperative intraocular pressure was 26.6 ± 11.23 and 16.3 ± 2.98 mm Hg, respectively (p = 0.0168). All the patients had a minimum of 6-month follow-up period (range = 6–8 months). Conclusion: Single-pass four-throw can be employed for cases with Urrets-Zavalia syndrome, and single-pass four-throw helps to prevent the postoperative glare and narrows down the pupil size effectively. Single-pass four-throw helps to alleviate the anterior chamber angle apposition in patients with Urrets-Zavalia syndrome by mechanically pulling the peripheral iris centrally as demonstrated on anterior segment optical coherence tomography. The study also reports the occurrence of Urrets-Zavalia syndrome after glued intraocular lens surgery.


2018 ◽  
Vol 25 (12) ◽  
pp. 1848-1851
Author(s):  
Mohammad Alam

Objectives: To find out the visual acuity outcome after Nd: YAG laser capsulotomy in posterior capsular opacification in pseudophakic patients after cataract surgery. Study Design: Analytical study. Setting: Department of Ophthalmology Khyber Medical University Institute of Medical Sciences / K.D.A Teaching Hospital Kohat. Period: January 2016 to June 2017. Materials and methods: Special proforma was designed for record of patients. PreNd:YAG laser posterior capsulotomy best corrected visual acuity was checked and noted. Anterior and posterior segments examination was done with slit lamp and indirect slit lamp bimicroscopy. Pupils were dilated with tropicamide eye drops. Nd:YAG laser capsulotomy was done. All these procedure were conducted as out door. Patients were put on topical steroid and antiglaucoma drops for ten days to control inflammation and rise in IOP. Post laser best corrected visual acuity was recorded after one month of laser. Results: Total 92 patients were selected with age range from 21 to 83 years. Out of these patients 43(46.74%) were male and 49(53.26%) were female. Post surgical laser period was from 7 months to 13 years. Prelaser best corrected visual acuity of 6/24-6/36 was present in 59(64.13%) patients, 6/60 in 24(26.08%) patients while 9(9.78%) patients had visual acuity of counting finger (CF). Post laser best corrected visual acuity after one month of 6/6-6/9 was recorded in 43(46.39%) patients ,6/12-6/18 in 27(29.34%), 6/24-6/36 in 13(14.13%)and 6/60 & below in 9(9.71%) patients. Conclusion: Post laser best corrected visual acuity is highly improved with Nd:YAG laser capsulotomy in posterior capsular opacification.


1998 ◽  
Vol 8 (3) ◽  
pp. 167-172
Author(s):  
S. Simsek ◽  
H. Ertürk ◽  
A. Demirok ◽  
A. Cinal ◽  
T. Yasar ◽  
...  

Purpose The efficacy and adverse effects of 0.25% apraclonidine on intraocular pressure (IOP) after Nd: YAG laser posterior capsulotomy were investigated, and the results were compared with placebo, 0.50% timolol maleate and 1% apraclonidine. Methods Eighty eyes were randomly assigned to four groups of 20 eyes. In a double-masked design, the groups were treated with placebo (group I), 0.50% timolol maleate (group 2), 1% apraclonidine (group 3), 0.25% apraclonidine (group 4) one hour before and five minutes after Nd:YAG laser posterior capsulotomy. IOP was measured by applanation tonometry 1 hour before (baseline IOP) and 1,3, 24 hours after capsulotomy. Results The average baseline IOP increased respectively 3.90 ± 5.35, 5.95 ± 5.32, 1.15 ± 3.20 mmHg in the first group 1, 3 and 24 hours post-treatment. There were significant differences between baseline IOP and 1 and 3 hours but not at 24 hours (p=0.004, p=0.001, p=0.13). IOP increased 0.40 ± 4.08, 0.75 ± 5.33, 0.80 ± 6.03 mmHg in the second group at the same times. The differences between the average baseline IOP and the 1, 3 and 24h measurement were not significant (p=0.83, p=0.65, p=0.93). In the third group, IOP decreased 3.70 ± 2.40, 3.30 ± 2.47, 2.65 ± 1.56 mmHg at the measurement times, with significant differences between the average baseline IOP and the 1, 3 and 24 hour measurements (p=0.001, p=0.0001, p=0.01). In the fourth group IOP increased 0.35 ± 3.32 mmHg at 1 hour, but decreased 1.25 ± 3.41, 0.90 ± 2.07 mmHg at 3 and 24 hours. The differences were not significant (p=0.94, p=0.16, p=0.08). When the 0.25% and 1% apraclonidine groups were compared, there were significant differences between the average IOP at 1 hour in both groups but not at 3 and 24 hours (p=0.01, p=0.17, p=0.21). Similarly, there were no significant differences between the average IOP at the same times when the 0.25% apraclonidine group was compared with the timolol group (p=0.30, p=0.08, p=0.16). Some systemic and local side effects were seen in the timolol and 1% apraclonidine groups, but none with 0.25% apraclonidine. Conclusions It was concluded that 0.25% apraclonidine is effective in preventing the early elevation of IOP after Nd:YAG laser posterior capsulotomy and may offer an alternative to 0.50% timolol maleate and 1% apraclonidine.


2019 ◽  
pp. 112067211987715
Author(s):  
Pablo Sanjuán ◽  
Borja Salvador-Culla ◽  
Maria Isabel Canut ◽  
Rafael I Barraquer

Purpose: To report a case of a unilateral spontaneous filtering bleb dissecting into the cornea in a patient with high myopia. Clinical case: A 33-year-old woman with high myopia (–18 D) presented with discomfort in the left eye. Ocular history included pars plana vitrectomy and cataract extraction and posterior chamber intraocular lens implantation in the left eye. Best-corrected visual acuity was 0.65 and intraocular pressure was 20 mmHg. Slit-lamp examination showed a filtering bleb in the upper-temporal quadrant, which extended and dissected the proximal cornea without affecting the visual axis. The morphology and content of the bleb was studied with anterior segment optical coherence tomography, which ruled out a corneal-scleral fistulization into the subconjunctival space. The spontaneous filtering bleb was resected surgically. Due to her high myopia, two strips of fascia lata were used to strengthen the area. In the postoperative period, a complete resection of the bleb was confirmed, without apparent leaking points and with a well-vascularized conjunctiva. No complications were noted. The patient maintained the same best-corrected visual acuity and intraocular pressure than before surgery. Conclusion: The formation of a spontaneous filtering bleb is a rare entity in patients with high myopia, whose risk increases due to their thinned sclerae. The risk is even greater if they have undergone ocular surgeries. Resection of the filtering bleb in our case halted the progression of the corneal dissection, therefore respecting the transparency of the visual axis and preserving visual acuity.


2018 ◽  
Vol 29 (2) ◽  
pp. 210-215 ◽  
Author(s):  
Marta Misiuk-Hojlo ◽  
Maria Pomorska ◽  
Malgorzata Mulak ◽  
Marek Rekas ◽  
Joanna Wierzbowska ◽  
...  

Purpose: To assess tolerability and efficacy following a switch from benzalkonium chloride–latanoprost to preservative-free latanoprost in patients with glaucoma or ocular hypertension. Methods: A total of 140 patients with glaucoma or ocular hypertension controlled with benzalkonium chloride-latanoprost for at least 3 months were switched to treatment with preservative-free latanoprost. Assessments were made on days 15, 45, and 90 (D15, D45, and D90) and included best-corrected visual acuity, intraocular pressure, slit lamp examination, fluorescein staining, tear film break-up time, patient symptom evaluation, and subjective estimation of tolerability. Results: Mean best-corrected visual acuity remained unchanged during the study. Mean intraocular pressure compared with baseline (D0) remained stable throughout the study (D0, 15.9 mmHg (standard deviation = 2.6); D90, 15.3 mmHg (standard deviation = 2.4); p < 0.006). Tear film break-up time improved or remained unchanged relative to baseline in 92% of patients at D45 and in 93% at D90. Moderate-to-severe conjunctival hyperemia was seen in 56.8% of patients at D0, but this figure decreased to 13.7%, 2.2%, and 1.6% at D15, D45, and D90, respectively. Subjective assessment of tolerability (0–10 scale) indicated improvement with change of therapy (mean score: 5.3 (standard deviation = 2.2) at D0 versus 1.9 (standard deviation = 1.7) at D90; p < 0.0001). Conclusion: Preservative-free latanoprost has at least the same intraocular pressure-lowering efficacy as benzalkonium chloride–latanoprost, with a better tolerability profile. This may translate into greater control of treatment and improved quality of life.


2013 ◽  
Vol 13 (2) ◽  
pp. 33-41
Author(s):  
Devendra Maheshwari ◽  
Rengappa Ramakrishanan ◽  
Mohideen Abdul Kader ◽  
Neelam Pawar ◽  
Ankit Gupta

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p < 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.


2019 ◽  
Author(s):  
fei you

Abstract Background: malignant glaucoma after cataract surgery is still one of the serious complications, if not handled properly,it may lead to serious consequences. It is notoriously difficult to treat. 25G vitrectomy was performed to evaluate the safety and efficacy for the treatment of malignant glaucoma in pseudophakia. Methods: This is a retrospective, comparative case series study. A total of 20 eyes of 20 patients with malignant glaucoma after phacoemulsification were analyzed retrospectively in The First Affiliated Hospital Of Anhui Medical University from May 2015 to January 2018. All Medical Data including the best corrected visual acuity (BCVA), Change of intraocular pressure (IOP), the length of eye axis, and the depth of anterior chamber were recorded. SPSS 17.0 statistical software was used for analysis .Before surgery, the best corrected visual acuity (BCVA) was 1.8±0.6. The intraocular pressure was between 18-57mmHg, with an average of 35.2±10.4mmHg.The depth of anterior chamber was between 0.9-1.9mm, with an average of 1.3±0.2mm.The length of eye axis was 19.7-22.5mm,with an average of 20.6±0.5mm.All the patients were accomplished with 25G vitrectomy. Besides, anterior chamber inflammatory reaction and other complications were also observed postoperation. Results: The patients were followed up for 6-12 months with an average of 9 months. BCVA at the last follow up improved to 0.8±0.1, and there was significant difference compared to that before operation (P<0.01).IOP was from 12-19mmHg, an average of 16.1±2.5mmHg, there was significant difference compared to that before operation (t=7.6, p<0.01).Only one patient occurred low IOP (6mmHg) after surgery, IOP returned to normal level (14mmHg) after conservative treatment. No serious complications including corneal endothelium decompensation, intraocular lens (IOL) capture, intraocular hemorrhage, endophthalmitis and uncontrolled IOP were observed. Conclusions: 25G minimally invasive vitrectomy can treat malignant glaucoma after cataract surgery safely and effectively


2012 ◽  
Vol 43 (5) ◽  
pp. 395-400 ◽  
Author(s):  
Seyhmus Ari ◽  
Abdullah Kürsat Cingü ◽  
Alparslan Sahin ◽  
Yasin Çinar ◽  
Ihsan Çaça

2020 ◽  
Vol 7 (3) ◽  
pp. 145-149
Author(s):  
MIRAY LOUIS DE GONZAGUE

Optic neuritis (ON) is an inflammation of the optic nerve and one of the most common manifestations of central nervous system involvement caused by various etiologies. Lyme optic neuritis  is a rare ocular manifestation of Lyme Disease. We report a case of a 13-year-old male patient, previously healthy, with decreased central visual acuity on his both eyes . On examination, best-corrected visual acuity on both eyes was 0,3 LogMar. Anterior segment biomicroscopy showed no inflammatory signs and the intraocular pressure was normal. A fundus examination performed under mydriasis revealed a swollen optic disk on both eyes confirmed by fluorescein angiography. The cerebrospinal fluid examination and Lyme Disease blood findings were positive. The diagnosis of Lyme disease-related optic neuritis was made. Treated with Ceftriaxone and Doxicycline, there was a vision recovery. We can state that isolated bilateral optic neuritis is uncommon and exceptional especially in children during Lyme disease.


2021 ◽  
Vol 7 (2) ◽  
pp. 415-418
Author(s):  
Subramanya K Giliyar ◽  
Ravi Bypareddy ◽  
Kamakshi N Moger ◽  
Vinutha Moger ◽  
Deeksha Bekal

To evaluate post operative visual outcome and complications of retro-pupillary iris fixated Intracoular lens (IOL) in aphakia. This is a prospective interventional case study conducted at our tertiary eye care centre from March 2018 to February 2019 All monocular aphakias secondary to any cause with no capsular support, good iris diaphragm support and BCVA of better than 6/60 were included. Patients who required combined procedures like trabeculectomy and retinal procedure were excluded. Patients with poor endothelial count/ corneal decompensation, any posterior segment pathologies, pre existing glaucoma and any form of uveitis were also excluded from the study. Pre operative visual acuity, slit lamp examination and fundus examination were carried out. Anterior vitrectomy and retropupillary fixation of iris claw lens were done. The primary outcome was to assess the post operative visual acuity and secondary outcome was to analyse post operative complications at various intervals up to 6 months after surgery. Our study comprised of thirty eyes of 30 aphakic patients. RPIFIOL was inserted as primary intraocular lens in 18 patients (%) and secondary intraocular lens in 12 patients(%). Baseline best corrected visual acuity was 0.831±0.66 logMAR. Four patients had light perception at baseline. The mean best corrected visual acuity was 0.77±0.35 logMAR at month 1, 0.64±0.36logmAR at month 3 and 0.53±0.33logmAR at month 6 respectively. Mean intraocular pressure at baseline was 16mmHg. Mean intraocular pressure at month 1, 3 and 6 were 17mmHg, 16mmHg, and 16mmHg. Among the complications, twelve eyes (40%) had significant ovalisation of pupil at post operative month 1 which persisted at month 6, two eyes(6.66%) had transient ocular hypertension (OHT), and none of the eyes progressed to glaucoma. Choroidal detachment was noted in 2 eyes (6.66%), CME in 3 eyes (9.99%), 1 eye (3.33%) had retinal detachment and 2 eyes (6.66%) had one haptic disenclavation. Among the complications, ovalisation of pupil was the most common observed one. Retro-pupillary Iris fixated IOL is an effective, safe and simple procedure for management of aphakia in eyes with no posterior capsular support.


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