Comparison of Percent Tissue altered in Topography Guided and Wavefront Optimized Laser-assisted in situ Keratomileusis using Zeiss MEL 80 Excimer Laser

2021 ◽  
Vol 13 (2) ◽  
pp. 69-76
Author(s):  
Shwetambari Singh ◽  
Neha Shilpy ◽  
Dipali Purohit ◽  
Zalak Shah
Keyword(s):  
Excimer Laser ◽  
Visual Outcome ◽  
Laser Materials ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Group I ◽  
Tissue Alteration ◽  
Group Ii

Introduction: Laser-assisted in situ Keratomileusis (LASIK) is the most commonly performed refractive surgical procedure. The amount of tissue ablated in LASIK affects the safety and long-term outcome. The objective of this study was to compare the percent tissue altered (PTA) in topography guided (TG) and wavefront optimized (WFO) LASIK using Zeiss MEL 80 excimer laser. Materials and methods: This retrospective observational study was conducted at a tertiary eye center. Patients with moderate myopia who underwent LASIK between June 2016 and January 2019 were divided into two groups (Group I: TG LASIK, 69 eyes; Group II: WFO LASIK, 70 eyes). The groups were compared for preoperative parameters [spherical equivalent (SE), keratometry and pachymetry], intraoperative parameters [ablation depth (AD), PTA and residual stromal bed thickness (RSBT)] and postoperative parameters (vision, SE). Results: Among preoperative parameters, SE and keratometry were similar while thinnest pachymetry was significantly less in group I. Among the intraoperative parameters, PTA (P < 0.01) and AD (P < 0.01) were significantly less in group I while RSBT (P = 0.54) was not significantly different. Postoperatively at 6 months, 92.75% (64) eyes in group I and 90% (63) eyes in group II had visual acuity of 6/6 or better (P = 0.57). 98.55% (68) and 97.14% (68) eyes in group I and group II respectively had SE refraction within ± 0.5 dioptres. Conclusion: TG LASIK induces less tissue alteration for given refractive error with similar visual outcome as compared to WFO LASIK which makes TG apparently safer and is the preferred technique for borderline thin corneas.

Incidence of Post-Thrombotic Syndrome Following Asymptomatic Thrombosis in Survivors of Childhood Acute Lymphoblastic Leukemia.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1631-1631
Author(s):  
Stefan Kuhle ◽  
Maria Spavour ◽  
Jacqueline Halton ◽  
Patricia Massicotte ◽  
Irene Cherrick ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Group I ◽  
Arm Circumference ◽  
History Of ◽  
Group Ii

Abstract BACKGROUND: Asymptomatic deep venous thrombosis (DVT) are well-known complications of treatment of acute lymphoblastic leukemia (ALL) in children. However, the clinical significance of radiographically detected, asymptomatic DVT is unclear and controversial, as there are no studies on long-term outcome of asymptomatic DVT in children available. There are two likely reasons for the studies not being done in this area. First, there is a lack of defined cohorts of pediatric patients screened for DVT and secondly, there is a great deal of difficulty in following patients over many years. The study, Prophylaxis with Antithrombin Replacement in Kids with ALL treated with L-Asparaginase (PARKAA) was a multicentre randomized controlled trial in which children with ALL were screened for DVT. As survivors of childhood cancer, the PARKAA cohort continues to be followed in their respective centers. Therefore, establishment of the PARKAA cohort (1997–99) and the ability to locate these patients provided a unique opportunity to study the long-term outcome of asymptomatic DVT. OBJECTIVE: To assess the incidence of PTS in children with ALL who previously had an asymptomatic DVT. The objective were approached in two ways. Firstly, to assess the outcome of asymptomatic DVT by determining the prevalence of PTS in children with a history of ALL with radiographically diagnosed DVT (PARKAA cohort); secondly, to corroborate the findings by determining the prevalence of PTS in an unselected group of survivors of childhood ALL. METHODS: Cross-sectional study in two separate populations: Group I comprised of children enrolled in the PARKAA multicentre study who had been screened for, and diagnosed with, DVT in the upper venous system. Group II consisted of non-selected patients &lt; 21 years with a history of ALL followed at Stollery Children’s Hospital, Edmonton. Patients were invited for a follow-up at their treatment centre (Group I) or were assessed for PTS childhood cancer survivor clinic (Group II). PTS was assessed by two of the investigators (Group I) or by the attending oncologist (Group II), respectively, using a standardized scoring sheet. RESULTS: Group I: 13 PARKAA patients with a history of ALL and objectively diagnosed DVT were assessed for PTS (4 males; median age 11.9 years; median age at diagnosis of ALL 4.4 years). 7/13 patients had PTS (54%, 95%CI 25;81). All patients with PTS had collaterals on examination, 3 also had increased arm circumference. Group II: 41 patients with a history of ALL were enrolled (61% males; median age at diagnosis 3.0 years; 28% high-risk, 67% standard risk). Mean length of follow-up since diagnosis was 9.5 years. PTS was diagnosed in 10/41 (24%; 95%CI 11–38) patients. All patients with PTS had collaterals on examination, 5 (50%) also had increased arm circumference. CONCLUSIONS: There is a clinically significant prevalence of PTS in children with a history of ALL and radiographically diagnosed DVT. A significant proportion of survivors of ALL develop PTS, indicating previously undiagnosed DVT in this population.

Abstract 52: Short and Long Term Outcomes of Patients Admitted with Unexplained Syncope Using a Simple Novel SELF-Pathway

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Emad F Aziz ◽  
Chaithanya K Pamidimukala ◽  
Joseph H Bastawrose ◽  
Terrence Park ◽  
Balai Pratap ◽  
...  
Keyword(s):  
Structural Heart Disease ◽  
Common Disease ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Group I ◽  
Short Period ◽  
Short And Long Term ◽  
Group Ii

Background: According to the design of our SELF pathway, patients are stratified twice using the acronyms SELF-A (Short period, Early-rapid onset, Loss of consciousness, Full recovery) and SELF-B (Structural heart disease, abnormal Ecg, and arrhythmia Fib/FL). We assessed the short and Long-term outcome according to this approach. Methods: 1468 patients were prospectively followed after presenting to our emergecy department for the evaluation of syncope. Patients were divided into Group I (SELF +/+) who met both SELF A and B criteria and group II (SELF -/-) who didnot meet these criteria.The primary endpoint was a composite of readmission for syncope, myocardial infarction (MI), stroke or death. Follow-up was 494 ± 120 days. Results: 644 (44%) patients were included in group I and 824 (64%) patients in group II. Group I were older (73 ± 15 years vs. 58 ± 22 years), with more evidence of hypertension (74% vs. 41%), diabetes (24% vs. 15%), heart failure (15% vs. 5%), and coronary disease (26% vs. 10%); p<0.001. During hospital stay group I underwent more procedures. At the end of 7, 30 and 180 days follow up, group I patients had 9 (2%), 33 (5%), 96 (15%) vs. 7 (0.8%), 19 (2%), 55 (6%) events respectively; p <0.001 (Figure). Conclusions: Using the SELF-pathway for patients presenting with syncope effectively identifies high risk patients who merit hospitalization for further work-up. This has important implications for the evaluation of a common disease that poses a significant economic burden on healthcare systems.

Long-term outcome of bacilles Calmette-Guerin perfusion therapy for upper urinary tract urothelial carcinoma in situ.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 265-265
Author(s):  
Takahiro Yoneyama ◽  
Naoki Sugiyama ◽  
Yuuichirou Suzuki ◽  
Akiko Okamoto ◽  
Hayato Yamamoto ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Side Effects ◽  
Urothelial Carcinoma ◽  
Carcinoma In Situ ◽  
Upper Urinary Tract ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Urinary Tract Urothelial Carcinoma

265 Background: Bacillus Calmette-Guerin (BCG) therapy has already been established as a treatment for muscle noninvasive bladder cancer. Although there are several reports indicating the effectiveness of BCG perfusion therapy for the upper urinary tract urothelial carcinoma in situ (CIS), it is not well established yet. We conducted a retrospective study to assess the long-term outcome of BCG perfusion therapy for the upper urinary tract CIS. Methods: Twenty-six subjects (20 male, 6 female) who received BCG perfusion therapy for the upper urinary tract CIS from December 1997 to December 2011 were enrolled. Ten subjects had the entire urinary tract CIS, seven had bilateral, nine had unilateral CIS of the urinary tract. The average period of observation was 52.6 months (ranging from 5 to 156 months), and the average subject age was 73.6 years (ranging from 56 to 90 years). We used a double-J catheter for 17 cases, a transvesical single-J catheter whose curl was positions in an upper calyx for eight cases, and a straight ureteral catheter inserted for ureterocutaneostomy for one case. We used 80 mg of BCG for the first five cases, 40 mg for the late twenty-one cases. Urine cytology was performed to assess the treatment validity. Results: Of the 26 cases, the treatment protocol was completed in 21 cases. Urine cytology tests became negative in 22 of the 26 subjects (84.6%) who underwent upper urinary tract perfusion. Among these 22 subjects who had negative tests, five subjects had a recurrence in their upper urinary tracts. Side effects were observed in 25 subjects (96.5%), and the most common side effect was bladder irritation. Localized renal tuberculosis which was successfully treated with conservative therapy was seen in two cases. Conclusions: BCG perfusion therapy for the upper urinary tract CIS is active. However, severe side effects are possible, and careful observation is essential while using this therapy.

scholarly journals A comparative study of the results of endoscopic dacryocystorhinostomy with and without stent placement

2021 ◽  
Vol 7 (3) ◽  
pp. 525
Author(s):  
Shaili S. Shah ◽  
Shruti G. Ganvit ◽  
Kirti P. Ambani ◽  
Ashish U. Katarkar
Keyword(s):  
Stent Placement ◽  
Small Sample ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Endoscopic Dacryocystorhinostomy ◽  
Group I ◽  
Significant Difference ◽  
Silicone Stent ◽  
Endoscopic Dcr

<p class="abstract"><strong>Background:</strong> Aim and objectives were to evaluate and compare the outcomes of endoscopic dacryocystorhinostomy (DCR) with and without silicone stenting. Surgical success was assessed both subjectively and objectively.  </p><p class="abstract"><strong>Methods:</strong> A retrospective study was conducted. Total 30 patients with acquired NLD obstruction were enrolled in the study. The patients who underwent the surgery were randomly assigned into two groups: group I: with silicone stent placement, group II: without stent placement. The patients were evaluated in terms of symptoms relief (subjective assessment) and patency of neo-ostium (objective assessment).   </p><p class="abstract"><strong>Results:</strong> In our study, success rate for patients with placement of stent was 91.66% and without stenting was 77.77%. Statistical data proved that, there was no significant difference between two groups. Endoscopic DCR with stenting had good long term outcome. It maintains patency and prevents re-closer of neo-ostium. With stenting cases cause of failure was synechiae formation and in without stenting cases causes was infection, granulation formation and stoma closer. So both cases had their own merits and demerits.</p><p class="abstract"><strong>Conclusions:</strong> The endoscopic DCR is minimally invasive and simple procedure. Patient’s discomfort, synechiae, granulations are drawbacks of stenting but stents had given good long term outcome in maintaining patency of neo-ostium. Still data proved, there was no significant difference in both groups. This was due to our small sample size. Regular follow up is necessary for better post-operative outcome and prevention of further complications. So ultimately it is surgeon choice and level of expertise decides use of stent in DCR.  </p>

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