Vascular Density Changes after Nanosecond Laser Therapy in Dry AMD

2021 ◽  
Author(s):  
Mitova Daniela
Keyword(s):  
Visual Acuity ◽  
Clinical Results ◽  
Functional Improvement ◽  
Vascular Density ◽  
Nanosecond Laser ◽  
Social Significance ◽  
Functional Efficiency ◽  
Dry Amd ◽  
Treatment Analysis ◽  
Density Methods

Introduction: АМD is a disease of social significance and an increasing incidence. By 2040, patients are expected to reach 300 million. 90% of them have non-exudative form while only10% have exudative AMD. The nanosecond laser (2RT, Ellex) is the first patented therapy for dry AMD. It presents a new hope in the prophylaxis of the more aggressive exudative form. Aim: The aim of this study is to present an innovative treatment for dry AMD; to describe the mechanism of action of 2RT; to show first clinical results and to prove the functional efficiency of the therapy by pre and post treatment analysis of vascular density. Methods: Nanosecond laser (2RT, Ellex) was used. Patients were followed with visual acuity, contrast sensitivity (F.A.C.T.101), Fluorescein angiography (FA)Fundus auto-fluorescens (FAF), OCT, Angio-OCT. Statistical analysis of vascular density (foveal and peri-foveal superficial and deep) was done. Results: A significant improvement in vascular density in the macula was observed 3-6 months after the treatment in all patients with dry AMD. In 40% of cases a reduction of the drusen was observed. No increase of the atrophic changes was observed. Conclusions: The main goal of the treatment is to ameliorate the degenerative process by tissue stimulation and rejuvenation. Vascular density increase after 2RT treatment does prove the functional improvement and efficacy of the therapy.

scholarly journals Combined treatment modalities in wet AMD

2020 ◽  
Vol 5 (10) ◽  
Keyword(s):  
Visual Acuity ◽  
Alternative Treatment ◽  
Combined Treatment ◽  
Standard Of Care ◽  
Treatment Modalities ◽  
Nanosecond Laser ◽  
Social Significance ◽  
Degenerative Process ◽  
Anti Vegf ◽  
Wet Amd

Introduction: АМD is a disease of social significance and an increasing incidence. The patients with wet AMD need a life-long treatment in order to sustain useful vision. The Anti-VEGF treatment does not ameliorate the dry component of the disease. That’s why an alternative treatment is highly needed. Aim: To propose an alternative treatment as an adjunct to the standard of care in an attempt to prolong treatment-free intervals, to ameliorate the degenerative process and to suppress tachyphylaxis. Methods: Nanosecond laser (2RT, Ellex) was used as an adjunct to Anti-VEGF treatment in the first group of patients and Triamcynolon subtenonially and Anti-VEGF in the second group. Patients were followed with visual acuity, FA, FAF, OCT, Angio-OCT. Results: 20 patients were followed in the first group-AntiVEGF+2RT. Improvement of BCVA was achieved in 85% (1 to 3 lines on Snellen). In the follow-up-4 months of treatment-free period was maintained in 6 patient; 2 patients had 12 months of treatment free period; 6 patients had 6 months of treatment-free intervals. Ten patients were followed in the 2nd group. Improvement or stabilization of visual acuity and up to 6 months treatment-free intervals were achieved. Amelioration of degenerative cysts in 2/3 of the patients. Conclusion: The combined treatment of wet AMD with Anti-VEGF and 2RT or Anti-VEGF and Triamcynolone subtenonially can ameliorate the degenerative process by tissue stimulation, and suppression of inflammation. It also shows the potential to elongate treatment-free intervals and diminish tachifilaxis.

scholarly journals Long term results of accelerated 9 mW corneal crosslinking for early progressive keratoconus: the Siena Eye-Cross Study 2

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Cosimo Mazzotta ◽  
Frederik Raiskup ◽  
Farhad Hafezi ◽  
Emilio A Torres-Netto ◽  
Ashraf Armia Balamoun ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Continuous Light ◽  
Clinical Results ◽  
Asymmetry Index ◽  
Long Term Results ◽  
Distance Visual Acuity ◽  
Long Term Stability ◽  
Uncorrected Distance Visual Acuity

Abstract Purpose To assess clinical results of the 9 mW/5.4 J/cm2 accelerated crosslinking (ACXL) in the treatment of progressive keratoconus (KC) over a span of 5 years. Methods The prospective open non-randomized interventional study (Siena Eye-Cross Study 2) included 156 eyes of 112 patients with early progressive KC undergoing the Epi-Off 9 mW/5.4 J/cm2 ACXL at the Siena Crosslinking Centre, Italy. The mean age was 18.05 ± 5.6 years. The 20-min treatments were performed using the New KXL I (Avedro, Waltham, USA), 10 min of 0.1% HPMC Riboflavin soaking (VibeX Rapid, Avedro, Waltham, USA) and 10 min of continuous-light UV-A irradiation. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), Kmax, coma, minimum corneal thickness (MCT), surface asymmetry index (SAI), endothelial cell count (ECC) were measured, and corneal OCT performed. Results UDVA and CDVA improved significantly at the 3rd (P = 0.028), Δ + 0.17 Snellen lines and 6th postoperative month, respectively (P < 0.001), Δ + 0.23 Snellen lines. Kmax improved at the 6th postoperative month (P = 0.03), Δ − 1.49 diopters from the baseline value. Also, coma aberration value improved significantly (P = 0.004). A mild temporary haze was recorded in 14.77% of patients without affecting visual acuity and without persistent complications. Corneal OCT revealed a mean demarcation line depth at 332.6 ± 33.6 μm. Conclusion The 5-year results of Epi-Off 9 mW/5.4 J/cm2 ACXL demonstrated statistically significant improvements in UCVA and CDVA, corneal curvature and corneal higher-order aberrations which confers a long-term stability for progressive ectasia. Based on the results of the Siena Eye-Cross Study 2, the 9 mW/5.4 J/cm2 ACXL is a candidate to be  the natural evolution of Epi-Off CXL treatment for the management of early progressive corneal ectasia, and thus optimize clinic workflow.

Contemporary Treatment for Central Serous Chorioretinopathy

2021 ◽  
Author(s):  
Mitova D
Keyword(s):  
Subretinal Fluid ◽  
Functional Results ◽  
Clinical Results ◽  
Long Term Results ◽  
Nanosecond Laser ◽  
Success Rates ◽  
Invasive Treatment ◽  
Non Invasive ◽  
Short And Long Term

Aim: To study the short-and long-term results of 2RT nanosecond laser treatment for CSC. To compare clinical results with those with AntiVEGF. Methods: Nanosecond laser (2RT, Ellex) was used. Patients were followed by BCVA, FAF, OCT, Angio-OCT. Results: 90% of the patient treated with 2RT had improvement of visual acuity and contrast sensitivity. 19 % [1] patients showed no improvement. 81% of the 2RT treated patients had total resorbtion of subretinal fluid against 60% treated with AntiVEGF. Functional results correlated with the atrophy of RPE in the macula. 46% (19 patients) had resolution on the first month, 23% [2]-on the third and 12% [3]-on the sixth month. The time of resolution shows no relation to the baseline pigment epithelial atrophy. Four patients presented with a recurrency of the disease in the follow-up period. 19% [1] were non responders. 60% of AntiVEGF treated eyes were responders and 40% were non responders. Those who responded to treatment needed between 3 and 10 injections. Conclusion: 2 RT is a non-invasive treatment modality with no adverse effects and high success rates.

Can Revision TKA Patients Achieve Similar Clinical Functional Improvement Compared to Primaries?

2019 ◽  
Vol 33 (12) ◽  
pp. 1219-1224 ◽  
Author(s):  
Shikha Sachdeva ◽  
James F. Baker ◽  
Jesse E. Bauwens ◽  
Langan S. Smith ◽  
Nipun Sodhi ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Primary Total Knee Arthroplasty ◽  
Clinical Results ◽  
Implant Design ◽  
Functional Improvement ◽  
P Value ◽  
Average Improvement ◽  
Aseptic Revision ◽  
Revision Tka

AbstractThe etiology of failure following primary total knee arthroplasty (TKA) leading to revision surgery are multifactorial, including infection, instability, loosening, contracture, and wear. Although the majority of patients have successful outcomes following revision TKA, postoperative complications are still increased in these patients when compared to primary patients. For this reason, there has been a continued search to identify options, including prosthesis types, to potentially improve outcomes. Therefore, the purpose of this study was to determine if the clinical results achieved following revision TKA are comparatively similar to primaries using the same implant design. Specifically, we compared (1) Knee Society Functional and Range-of-Motion Knee Scores and (2) component survivorship. This was a retrospective analysis of 100 patients undergoing revision TKA due to an aseptic etiology, who were matched to a cohort of 100 patients who underwent primaries with the same prosthesis. There were no differences in the groups with respect to age at surgery, sex, and body mass index. The mean follow-up was 57 months in the revision group (range 24–105 months) and 67 months in the primary TKA group (range 55–123 months). American Knee Society Scores (KSS) and range of motion measurements recorded preoperatively and at the most recent postoperative visit were compared between both cohorts in order to compare postoperative outcomes. A p value of 0.05 was used for significance. The average improvement between the pre- and postoperative KSS function scores in both groups was similar, with both cohorts demonstrating a 28-point improvement. At 2-year follow-up, all-cause survivorship of the aseptic revision surgeries was 87%. Patients undergoing revision TKA for aseptic loosening can potentially expect similar improvements in clinical function scores and survivorship compared to primary TKA when controlling for implant type.

scholarly journals Systematic review: non-adherence and non-persistence in intravitreal treatment

2020 ◽  
Vol 258 (10) ◽  
pp. 2077-2090 ◽  
Author(s):  
Christoph Ehlken ◽  
Focke Ziemssen ◽  
Nicole Eter ◽  
Ines Lanzl ◽  
Hakan Kaymak ◽  
...  
Keyword(s):  
Systematic Review ◽  
Visual Acuity ◽  
Intravitreal Injection ◽  
Real Life ◽  
Clinical Results ◽  
Qualitative Studies ◽  
Treatment Center ◽  
Contributing Factors ◽  
Vegf Inhibitors ◽  
Intravitreal Treatment

Abstract Purpose Intravitreal injection of VEGF inhibitors has become the standard of care for different macular diseases within the last years resulting in improved visual outcomes. Under real-life conditions, however, the necessity for frequent retreatments and reexaminations poses a burden for patients and treatment centers. Non-adherence and non-persistence to intravitreal treatment may lead to inferior clinical outcomes, and knowledge of contributing factors is crucial to improve adherence. This systematic review analyzes current literature for potential factors involved in non-adherence and non-persistence. Methods A systematic search was conducted in PubMed and Embase including three different aspects of intravitreal injection therapy: (1) diseases with intravitreal injections as treatment, (2) intravitreal injection, and (3) aspects of therapy adherence or therapy persistence. Data from identified quantitative studies were further extracted and grouped according to WHO criteria (condition, socio-economy, therapy, patient, and health system). The methodological quality of identified studies was graded. Identified qualitative studies (i.e., interviews) were descriptively analyzed and their findings narratively reported. Results Twenty-four publications were included. In 16 of those publications, a quantitative data analysis was conducted, analyzing factors associated with non-adherence. Worse visual acuity at baseline and unfavorable development of visual acuity, higher age, and greater distance to the treatment center were associated with non-adherence, while there was inconsistent evidence for an association of comorbidity. In qualitative studies, high follow-up/treatment burden, fear and anxiety, disappointed patient expectations, and lack of motivation to continue treatment were reported as reasons for non-persistence. Conclusions Knowledge of potential barriers in IVT treatment may improve adherence and potentially clinical results. Improvements can be achieved particularly in the healthcare complex (organizational improvements) and the “patient” complex by establishing realistic expectations. Recurrent education of the patient may be necessary.

Operative Management of Foot and Ankle Equinovarus Associated with Focal Dystonia

1998 ◽  
Vol 19 (4) ◽  
pp. 229-231 ◽  
Author(s):  
Thomas J. Moore ◽  
William Evans ◽  
Douglas Murray
Keyword(s):  
Tendon Transfer ◽  
Operative Management ◽  
Clinical Results ◽  
Focal Dystonia ◽  
Functional Improvement ◽  
Foot And Ankle ◽  
Tendon Transfers ◽  
Anterior Tibial ◽  
Clinically Significant

Six surgical procedures, consisting of tendon transfers and releases, were performed in five patients with idiopathic focal dystonia involving the lower extremity. All patients were female. Surgical management was performed to correct clinically significant foot abnormalities. The goal of each procedure was functional improvement and obtaining a plantigrade foot. The SPLATT (split anterior tibial tendon transfer) procedure was performed in each foot with a flexible equinovarus foot abnormality. Follow up at a mean of 27.2 months (range, 8–40 months) yielded satisfactory clinical results without significant complications. Clinical equinovarus has not recurred after this procedure. All patients remain brace-free ambulators.

scholarly journals Comparative Analysis of Double and Trifocal IOL Implantation in Femtosecond Laser-Assisted Cataract Surgery

2019 ◽  
Vol 16 (1S) ◽  
pp. 68-73 ◽  
Author(s):  
O. I. Orenburkina
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Average Distance ◽  
Clinical Results ◽  
Main Group ◽  
Intraocular Lenses ◽  
Control Group ◽  
Lighting Conditions ◽  
Near Visual Acuity

Purpose: to compare the clinical results of implantations of bi-and trifocal intraocular lenses (IOL) in femtosecond laser-assisted cataract surgery. Patients and methods. The article presents the results of the Acrysof IQ Panoptix trifocal lens implantations in 84 patients (112 eyes) — the main group and Acrysof IQ Restor bifocal IOL implantations in 52 patients (98 eyes) — the control group. All patients underwent femtosecond laser-assisted cataract surgery (FLACS). The following data were evaluated: uncorrected distance visual acuity (UCDVA) , uncorrected near visual acuity (30–45 cm) and at an average distance (50–70 cm) at discharge, after 14 days, 1 and 3 months after the surgery under photopic and mesopic lighting conditions. Postoperative refractometry data; the defocusing curve was performed in patients with a high UCDVA (0.9–1.0) monocularly under photopic conditions using standard optotypes 14 days after surgery; aberrometry indicators. Results. It was shown that both lenses provided high uncorrected distance and near visual acuity in photopic lighting conditions. At the same time, the Acrysof IQ Panoptix lens provided significantly better visual acuity at an intermediate distance and was more resistant to defocusing conditions. Refraction data: after 1 month, emmetropia was observed in 87 % of patients in the main group and in 85 % of control group, after 6 months — 92 and 89 % respectively. There were no significant differences in high order aberrations and total aberrations between patients of the compared groups. Conclusion. The use of the PanOptix trifocal lens made it possible to obtain maximum visual acuity at different distances, regardless of the level of illumination.

scholarly journals Efficacy of YAG Laser Embolysis in Retinal Artery Occlusion

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Mohammad Asim Mehboob ◽  
Asfandyar Khan ◽  
Ahsan Mukhtar
Keyword(s):  
Visual Acuity ◽  
Nd:Yag Laser ◽  
Yttrium Aluminum Garnet ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Functional Improvement ◽  
Yag Laser ◽  
Visual Improvement ◽  
Retinal Artery ◽  
Anatomical Success

Objective: To compare the anatomical and functional success between conventional medical method and Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) laser embolysis in retinal artery occlusion. Methods: This randomized control trial was conducted at Armed Forces Institute of Ophthalmology (AFIO) Rawalpindi from July 2018 to May 2020. A total of 14 eyes of 14 patients were received with fovea involving branch or hemiretinal artery occlusion within 24 hours of onset of symptoms. They were divided randomly in two groups. Initial treatment was given to all cases, and seven eyes received Nd:YAG laser treatment for embolysis. Both groups were analysed for anatomical success (reperfusion) and functional success (defined as improvement in visual acuity to better than 6/60 on Snellen’s visual acuity chart from baseline visual acuity). Results: In conventional group, anatomical success was achieved in 2 (28.6%) eyes, while significant visual improvement was seen in 3 (42.8%) eyes. In Nd:YAG laser embolysis group, anatomical success was achieved in 5 (71.4%) eyes, while significant visual improvement was seen in 6 (85.7%) eyes. All eyes which showed functional improvement underwent Nd:YAG laser embolysis within 6 hours of onset of symptoms. Conclusions: Nd:YAG laser embolysis is more effective in management of fovea threatening retinal artery occlusion, as compared to conventional medical treatment, if performed within six hours of onset of symptoms. doi: https://doi.org/10.12669/pjms.37.1.3196 How to cite this:Mehboob MA, Khan A, Mukhtar A. Efficacy of YAG Laser Embolysis in Retinal Artery Occlusion. Pak J Med Sci. 2021;37(1):71-75.  doi: https://doi.org/10.12669/pjms.37.1.3196 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Efficacy of LASIK and LASEK methods in achieving the predicted result in excimer laser correction of myopia and myopic astigmatism

2021 ◽  
Vol 8 (3) ◽  
pp. 19-23
Author(s):  
N.G. Zavgorodnia ◽  
Yu.Yu. Doroshenko ◽  
T.S. Zavgorodnia ◽  
I.O. Poplavska ◽  
K.O. Kostrovska ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Excimer Laser ◽  
Anterior Segment ◽  
Young Patients ◽  
Surgical Techniques ◽  
Social Significance ◽  
Uncorrected Visual Acuity ◽  
Working Age ◽  
The Difference ◽  
Myopic Astigmatism

Excimer laser correction of refraction anomalies has entered ophthalmological practice as one of the most effective surgical techniques, which allows us to correct refractive errors by changing corneal curvature, including with myopia and myopic astigmatism. Usually, such correction is applied in young patients of working age that acquires special social significance and requires the use of the most accurate and safe technologies, which would guarantee the achievement of a rapid effect with the shortest period of rehabilitation. The results of surgical treatment of 60 patients (103 eyes) with myopia of various degrees and myopic astigmatism were analyzed. Among patients, there were 28 men (41 %) and 32 women (59 %) aged 18 to 47 (mean of 25.0 ± 2.5) years. They were divided into 2 groups. The first group consisted of 29 people (50 eyes) who underwent vision correction by laser-assisted in situ keratomileusis (LASIK). All patients underwent standard ophthalmological examinations (visometry, autorefractometry, biomicroscopy, direct ophthalmoscopy, tonometry, perimetry) and refractive diagnosis, which included corneal topography with pachymetry (Orbscan, Bausch + Lomb Inc., USA), aberrometry (Zywave, Bausch + Lomb Inc., USA), anterior segment optical coherence tomography (Visante OCT, Carl Zeiss Meditec, Germany) and optical biometry by optical biometer IOLMaster (Carl Zeiss Meditec, Germany). The refractive result achievement was assessed on day 1, as well as 1 month, 6 months and 1 year after surgery. All surgeries were performed on an excimer laser Allegretto WaveLight EX500 (Alcon, USA). One month after excimer laser correction by the LASIK method, the expected result of visual acuity was achieved in 46 eyes (80.7 %), and when using the laser epithelial keratomileusis (LASEK) technique — in 31 eyes (58.5 %) that indicates a longer rehabilitation period. Six months later, the predicted visual acuity without correction in the group where surgery was performed by LASEK was achieved in 46 eyes (86.8 %), while in the group operated by LASIK — in 50 eyes, 100 % (the difference is not reliable, p > 0.05). One year after excimer laser correction, uncorrected visual acuity, regardless of the degree of myopia, was 0.92 ± 0.04 U in the first group at maximum visual acuity with correction in these eyes before surgery 0.86 ± 0.05 U (the difference is not significant, p > 0.05) and 0.74 ± 0.10 U in the second group at the maximum indicators of corrected visual acuity before surgery of 0.92 ± 0.03 U (the difference is significant, p < 0.05). A slightly larger difference in the achieved results of maximum uncorrected visual acuity before surgery when performing excimer laser correction by the LASEK method is explained by the development of subepithelial fibroplasia in 3.77 % of cases, which affected the average end result.

Sign in / Sign up

Export Citation Format

Share Document