Aim: To audit the YAG Laser Capsulotomy procedures done over a 12 month period from January to December 2017.
Objective: To review YAG LASER capsulotomies done over a 12 months period from January 2017 – December 2017.
Methods: The audit was retrospective in nature, involving collation of parameters such as age, sex, presenting visual acuity, post laser visual acuity, complications and post operative management from the patient records. The lasers were performed with SYL 9000 Ophthalmic yttrium aluminum garnet (YAG) Laser systems [Lightmed Corporation, Taiwan]. This is a class 3b Laser with a wavelength of 1064 nm and Q-switched operational mode and a spot size of 8 um.
Results: The audit involved 106 subjects. The mean age was 56.76 years. Fifty nine (55.7%) subjects were females while 44.3% were males. Eleven (10.4%) subjects had bilateral neodymium‐doped yttrium aluminum garnet ND YAG laser treatment while 89.6% had unilateral treatment. Seventy five (72.8%) of the subjects had visual improvement following treatment. Seventy four (69.8%) had less than 3 mJ quantum of energy and only 5.7% required repeat treatment. Fifty (47.2%) had between one to three days post op treatment with anti-inflammatory and/or pressure reducing drugs.
Conclusion: Use of low energy in ND YAG laser treatment of Posterior Capsule Opacification offers good visual outcome, precludes the complication associated with higher energy treatment and does not necessarily lead to repeat treatment.
The article describes results of laser treatment applied in seven patients (eleven eyes) due to capsulorhexis margin shrinkage and the subsequent wrinkling of the anterior capsule in eyes with pseudophakia. Almost total loss of the anterior capsulorhexis aperture caused a significant decrease in visual acuity, to the level of counting fingers right in front of the eyes in three patients (four eyes). The laser cut of the anterior capsulorhexis margin using the Nd-Yag laser led to an immediate increase in the capsulorhexis size in each case. Visual acuity improved in the eyes with an extreme decrease in the capsulorhexis size. In the remaining eyes, where the decrease of the capsulorhexis size did not lead to the appearance of anterior capsule wrinkling, visual acuity did not change. The progressive decrease in the capsulorhexis size, accompanied by the appearance of white tissue on its margin, containing shrinking elements, constitutes an indication for the implementation of laser therapy.
Purpose:
To report one year outcomes of focal Navigated Retina Laser Therapy (NAVILAS) for diabetic macular edema (DME).
Methods:
Retrospective cohort series of 7 diabetic patients treated with NAVILAS focal laser. Statistical analysis included descriptive and continuous variables (Best-corrected logMAR Visual Acuity and time-domain optical coherence tomography (OCT) parameters) which were compared using a non-parametric procedure, the Friedman tests for repeated measures. A p-value of less than 0.05 was considered to denote statistical significance.
Results:
diabetic patients (4 male; 3 female) with an average age of 60.8 years (range 48-85 years) were included. All treated eyes were phakic; patients had an average hemoglobin A1C of 9.1 (range 7.8-11.7) at baseline and 8.0 (range 7.4-8.4) at 12 months. Six of the 7 patients had intravitreal bevacizumab injections prior to focal laser treatment with 1 patient having had more than 1 prior injection (total 3). At 12 months, median logMAR improved from 0.695 (± interquartile range 0.574) to 0.477 (± 0.573, p <0.001). OCT median central foveal thickness decreased from 248 (± 112) to 220 µm (± 41, p <0.001); total macular volume decreased from 7.84 (± 0.8) to 7.44 mm3 (± 0.7, p = 0.117); and largest macular subfield thickness decreased from 354 (± 116) to 289 µm (± 42, p <0.001). All patients were treated without complications.
Conclusions:
Focal NAVILAS showed to be safe and effective in treating DME with improvement in visual acuity and macular edema on OCT over 12 months in this case series. In clinical practice, combined treatment with focal laser including NAVILAS and anti-vascular endothelial growth factor may provide long-term improvement in DME.
Abstract
Purpose: To investigate longer-term functional and morphological outcomes and their predictors in diabetic macular edema (DME) following a treat and extend regimen (TER) without loading dose under ranibizumab.
Methods: Patient data were reviewed and analyzed retrospectively over a period of 24 months after initiation of TER. Best-corrected visual acuity (BCVA), treatment frequency as well as quantitative and qualitative Spectral-domain Optical Coherence Tomography parameters were assessed.
Results: 118 eyes of 87 patients were included. A mean of 9.742.13 injections in the first and 7.632.29 in the second year were applied. There were significant gains of BCVA and reductions in central retinal thickness from baseline to month 12 and 24 (all p<0.001). Percentage of eyes with an intact inner-/outer segment (IS/OS) junction increased from 15.3% at baseline to 42.1% at month 24 (p<0.001). An intact IS/OS junction at baseline increased the probability of having a dry retina after 12 months by 79.3% (p=0.017) and after 24 months by 88.1% (p=0.040). Less IS/OS disruption at baseline predicted longer maximum recurrence-free treatment intervals at 2 years (r=-0.345, p<0.001) and better BCVA at one year (r=-0.347, p<0.001). Baseline bigger intraretinal cysts were associated with more IS/OS disruption at 24 months (r=0.305, p=0.007). Younger age and lower BCVA at baseline were predictive for a higher BCVA gain at 24 months (p=0.046, p<0.001).
Conclusion: Ranibizumab applied in a TER without loading dose in DME significantly improves visual acuity and retinal anatomical structure throughout two years. The evaluated predictors might help to guide routine clinical treatment in DME.
AbstractGold eyelid implantation is widely considered the procedure of choice to reanimate the upper eyelid in paralytic lagophthalmos. Commercially supplied implants are not readily available in all places and are sometimes cumbersome to import.Objective:We aimed to devise a method whereby every surgeon performing gold eyelid implantation could have easy and quick access to the implant. Furthermore, we aimed to develop a means of creating an implant of the exact weight required for complete eyelid closure.Study design and setting:A prospective study was performed from 1997 to 2005 in a tertiary research hospital, involving 50 subjects requiring gold upper eyelid implantation and using the technique in question.Results:Only patients with a minimum follow up of one year were included in the study group. Symptoms improved in 96 per cent of subjects, who were able to dispense with eyedrops and eye ointments. Visual acuity improved in 92 per cent of patients. There were two extrusions amongst the early cases.Conclusion and significance:Customised gold eyelid implantation offers an alternative in regions where commercial implants are not easily obtained.
Epithelial Ingrowth: Visual Acuity and Astigmatism Results One Year after YAG Laser Treatment
