Purpose: To develop a clinical risk score for the prediction of urgency in patients with carotid cavernous sinus fistulas (CCFs) and test for the discriminative ability of the diagnostic prediction.
Methods: The medical charts of 60 patients with CCFs were retrospectively reviewed. The clinical characteristics of direct and dural CCFs were analyzed by logistic regression. The clinical risk score was developed from the coefficient in the multivariable regression model and used to predict direct CCFs which were more urgent than the dural type. The score prediction was reported as an area under the receiver operating characteristic (AuROC) curve and 95% confidence interval (95% CI).
Results: In a univariable analysis, the clinical characteristics which increased the risk of direct CCFs were age, gender, trauma, underlying diseases, visual acuity (VA) at presentation, bruit, chemosis, and dilated retinal vessels. However, in multivariable analysis, the significant predictors were limited to age, trauma, bruit, underlying diseases and logMAR VA. Regression coefficient of each predictor was converted to a risk score and summation of scores from these predictors for each patient was calculated. The total risk score predicted the urgent direct CCFs correctly with AuROC of 97.77% (95% CI; 93.57, 100).
Conclusion: The clinical risk score for the prediction of urgent direct CCFs has been developed and used in the patients with CCFs in our setting. The discriminative ability of the score prediction is high. This simple clinical risk score may help clinicians suspect direct CCFs and urgently refer the patients to have prompt angiography and treatment.
{"title":"Clinical Risk Score for Prediction of Urgency in Carotid Cavernous Sinus Fistulas.","authors":"Pawasoot Supasai, Kanwasee Kanjana, Yosanan Yospaiboon","doi":"10.2147/OPTH.S419844","DOIUrl":"https://doi.org/10.2147/OPTH.S419844","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a clinical risk score for the prediction of urgency in patients with carotid cavernous sinus fistulas (CCFs) and test for the discriminative ability of the diagnostic prediction.</p><p><strong>Methods: </strong>The medical charts of 60 patients with CCFs were retrospectively reviewed. The clinical characteristics of direct and dural CCFs were analyzed by logistic regression. The clinical risk score was developed from the coefficient in the multivariable regression model and used to predict direct CCFs which were more urgent than the dural type. The score prediction was reported as an area under the receiver operating characteristic (AuROC) curve and 95% confidence interval (95% CI).</p><p><strong>Results: </strong>In a univariable analysis, the clinical characteristics which increased the risk of direct CCFs were age, gender, trauma, underlying diseases, visual acuity (VA) at presentation, bruit, chemosis, and dilated retinal vessels. However, in multivariable analysis, the significant predictors were limited to age, trauma, bruit, underlying diseases and logMAR VA. Regression coefficient of each predictor was converted to a risk score and summation of scores from these predictors for each patient was calculated. The total risk score predicted the urgent direct CCFs correctly with AuROC of 97.77% (95% CI; 93.57, 100).</p><p><strong>Conclusion: </strong>The clinical risk score for the prediction of urgent direct CCFs has been developed and used in the patients with CCFs in our setting. The discriminative ability of the score prediction is high. This simple clinical risk score may help clinicians suspect direct CCFs and urgently refer the patients to have prompt angiography and treatment.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"1945-1952"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/53/ef/opth-17-1945.PMC10348375.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9826200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To compare the clinical characteristics of patients with direct and dural carotid cavernous sinus fistulas (CCFs).
Methods: The medical records of 60 patients diagnosed with CCFs were retrospectively reviewed. The collected data included demographic characteristics, clinical findings, and ocular manifestation. The clinical characteristics of the direct and the dural CCFs were compared on head-to-head basis. Logistic regression analysis was used to demonstrate the direction and magnitude of the difference and reported as odds ratio with its 95% confidence interval.
Results: There were 28 patients (46.67%) with direct CCFs, and 32 patients (53.33%) with dural CCFs. Patients with direct CCF were mostly male (p=0.023), younger age (p<0.001), had history of trauma (p<0.001), and more visual impairment at presentation (p=0.025), when compared to those with dural CCFs. In addition, patients with direct CCF had significantly more chemosis (p=0.005), proptosis (p=0.042), bruit (p<0.001) and dilated retinal vessels (p=0.008) than those with dural CCF. Thirty patients (50%) had increased intraocular pressure (IOP). Mean IOP of the affected eyes was significantly higher than the unaffected eyes (p<0.0001). In patients with normal IOP, mean IOP of the affected eyes was also higher than the unaffected eyes (p=0.0027).
Conclusion: Patients with direct CCF were younger age, associated with trauma, and more visual impairment at presentation. Chemosis, proptosis, bruit and dilated retinal vessels were detected more in the direct CCF than the dural CCF. Despite normal IOP, affected eyes had significantly higher IOP than the unaffected eyes. Information on these clinical characteristics may be helpful in discrimination of the direct type, which is more urgent for further investigation and treatment.
{"title":"Direct and Dural Carotid Cavernous Sinus Fistulas: Comparison of Clinical Characteristics.","authors":"Pawasoot Supasai, Kanwasee Kanjana, Yosanan Yospaiboon","doi":"10.2147/OPTH.S410930","DOIUrl":"https://doi.org/10.2147/OPTH.S410930","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the clinical characteristics of patients with direct and dural carotid cavernous sinus fistulas (CCFs).</p><p><strong>Methods: </strong>The medical records of 60 patients diagnosed with CCFs were retrospectively reviewed. The collected data included demographic characteristics, clinical findings, and ocular manifestation. The clinical characteristics of the direct and the dural CCFs were compared on head-to-head basis. Logistic regression analysis was used to demonstrate the direction and magnitude of the difference and reported as odds ratio with its 95% confidence interval.</p><p><strong>Results: </strong>There were 28 patients (46.67%) with direct CCFs, and 32 patients (53.33%) with dural CCFs. Patients with direct CCF were mostly male (p=0.023), younger age (p<0.001), had history of trauma (p<0.001), and more visual impairment at presentation (p=0.025), when compared to those with dural CCFs. In addition, patients with direct CCF had significantly more chemosis (p=0.005), proptosis (p=0.042), bruit (p<0.001) and dilated retinal vessels (p=0.008) than those with dural CCF. Thirty patients (50%) had increased intraocular pressure (IOP). Mean IOP of the affected eyes was significantly higher than the unaffected eyes (p<0.0001). In patients with normal IOP, mean IOP of the affected eyes was also higher than the unaffected eyes (p=0.0027).</p><p><strong>Conclusion: </strong>Patients with direct CCF were younger age, associated with trauma, and more visual impairment at presentation. Chemosis, proptosis, bruit and dilated retinal vessels were detected more in the direct CCF than the dural CCF. Despite normal IOP, affected eyes had significantly higher IOP than the unaffected eyes. Information on these clinical characteristics may be helpful in discrimination of the direct type, which is more urgent for further investigation and treatment.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"1207-1214"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6c/ce/opth-17-1207.PMC10149770.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9762979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Austin Pereira, R Damilola Adekunle, Michele Zaman, Michael J Wan
Vitamin deficiencies can have adverse effects on health, including on the visual system. The ocular manifestations of a vitamin deficiency are related to the underlying biochemical function of the particular nutrient. While vitamin deficiencies are not common in developed counties, they are still prevalent in parts of the developing world and in specific, vulnerable populations. Vitamin deficiencies can cause or contribute to many ophthalmological conditions and eye diseases may even be the first presenting finding of a vitamin deficiency. As such, it is important for ophthalmologists to be aware of the ocular manifestations of vitamin deficiencies, especially given that the complications can be severe and effectively treated if identified early. This review summarizes the literature on the main vitamins known to have characteristic ocular manifestations: vitamins A, B1, B2, B9, B12, C, D, E and K. The function, epidemiology, manifestations, workup, and management of each vitamin is discussed in detail.
{"title":"Association Between Vitamin Deficiencies and Ophthalmological Conditions.","authors":"Austin Pereira, R Damilola Adekunle, Michele Zaman, Michael J Wan","doi":"10.2147/OPTH.S401262","DOIUrl":"https://doi.org/10.2147/OPTH.S401262","url":null,"abstract":"<p><p>Vitamin deficiencies can have adverse effects on health, including on the visual system. The ocular manifestations of a vitamin deficiency are related to the underlying biochemical function of the particular nutrient. While vitamin deficiencies are not common in developed counties, they are still prevalent in parts of the developing world and in specific, vulnerable populations. Vitamin deficiencies can cause or contribute to many ophthalmological conditions and eye diseases may even be the first presenting finding of a vitamin deficiency. As such, it is important for ophthalmologists to be aware of the ocular manifestations of vitamin deficiencies, especially given that the complications can be severe and effectively treated if identified early. This review summarizes the literature on the main vitamins known to have characteristic ocular manifestations: vitamins A, B1, B2, B9, B12, C, D, E and K. The function, epidemiology, manifestations, workup, and management of each vitamin is discussed in detail.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"2045-2062"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/d8/opth-17-2045.PMC10363387.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9870083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wyatt M Corbin, Carter J Payne, Hamed Momeni-Moghaddam, Yasmyne C Ronquillo, Phillip C Hoopes, Majid Moshirfar
Increasing popularity and utility of epithelial thickness mapping (ETM) in keratorefractive surgery screening may begin to inappropriately devalue the use of tomography. An increasing body of research suggests that the interpretation of ETM based solely on the corneal resurfacing function may be insufficient to screen and select patients for refractive surgery. ETM and tomography are complementary and, when used together, may provide the safest and most optimal tools for keratorefractive surgery screening.
{"title":"The Combined Utilization of Epithelial Thickness Mapping and Tomography in Keratorefractive Surgery Screening: One Imaging Modality is Not Sufficient.","authors":"Wyatt M Corbin, Carter J Payne, Hamed Momeni-Moghaddam, Yasmyne C Ronquillo, Phillip C Hoopes, Majid Moshirfar","doi":"10.2147/OPTH.S404019","DOIUrl":"https://doi.org/10.2147/OPTH.S404019","url":null,"abstract":"<p><p>Increasing popularity and utility of epithelial thickness mapping (ETM) in keratorefractive surgery screening may begin to inappropriately devalue the use of tomography. An increasing body of research suggests that the interpretation of ETM based solely on the corneal resurfacing function may be insufficient to screen and select patients for refractive surgery. ETM and tomography are complementary and, when used together, may provide the safest and most optimal tools for keratorefractive surgery screening.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"1457-1463"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5a/bd/opth-17-1457.PMC10225140.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9901819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To evaluate patient preferences in regards to the timing of the initial postoperative examination after undergoing cataract surgery.
Methods: A retrospective, consecutive case series analysis from a single private practice institution was performed using a standardized phone survey on patients who underwent cataract surgery. Subjects were classified into one of two possible study groups according to the timing of their initial postoperative cataract surgery examination: Group A received the initial postoperative cataract surgery examination on the same day as the surgery, whereas Group B received the initial postoperative cataract surgery examination on the day following the operation.
Results: There were 80 subjects contacted for the phone survey of which 70 (35 in each study group) completed the survey and therefore were included in the analysis. Group A subjects responded favorably in regards to preference and realizing reduced time and cost savings compared to Group B (p < 0.0001 for both). There were no subjects in Group A who would have preferred next-day initial postoperative care, whereas 31.4% of subjects in Group B would have preferred same-day care if given the opportunity.
Conclusion: Patients undergoing cataract surgery both prefer and report time and cost savings with same-day initial postoperative care compared to next-day initial postoperative care. Patient preferences regarding their postoperative care should be one of the many factors that a surgeon ought to take into consideration when providing follow-up care after cataract surgery.
{"title":"Timing of the Initial Postoperative Care After Cataract Surgery: A Patient's Perspective.","authors":"Sloan W Rush, Samuel Huseman, Ryan B Rush","doi":"10.2147/OPTH.S413602","DOIUrl":"https://doi.org/10.2147/OPTH.S413602","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate patient preferences in regards to the timing of the initial postoperative examination after undergoing cataract surgery.</p><p><strong>Methods: </strong>A retrospective, consecutive case series analysis from a single private practice institution was performed using a standardized phone survey on patients who underwent cataract surgery. Subjects were classified into one of two possible study groups according to the timing of their initial postoperative cataract surgery examination: Group A received the initial postoperative cataract surgery examination on the same day as the surgery, whereas Group B received the initial postoperative cataract surgery examination on the day following the operation.</p><p><strong>Results: </strong>There were 80 subjects contacted for the phone survey of which 70 (35 in each study group) completed the survey and therefore were included in the analysis. Group A subjects responded favorably in regards to preference and realizing reduced time and cost savings compared to Group B (p < 0.0001 for both). There were no subjects in Group A who would have preferred next-day initial postoperative care, whereas 31.4% of subjects in Group B would have preferred same-day care if given the opportunity.</p><p><strong>Conclusion: </strong>Patients undergoing cataract surgery both prefer and report time and cost savings with same-day initial postoperative care compared to next-day initial postoperative care. Patient preferences regarding their postoperative care should be one of the many factors that a surgeon ought to take into consideration when providing follow-up care after cataract surgery.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"1475-1479"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ae/a4/opth-17-1475.PMC10226547.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9908573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bjørn Gjerdrum, Kjell Gunnar Gundersen, Christian Nilsen, Morten Gundersen, Per Jensen
RI)
{"title":"Axial Length Correction in Evaluation of Refractive Predictability and Biometry Agreement [Response to Letter].","authors":"Bjørn Gjerdrum, Kjell Gunnar Gundersen, Christian Nilsen, Morten Gundersen, Per Jensen","doi":"10.2147/OPTH.S435340","DOIUrl":"https://doi.org/10.2147/OPTH.S435340","url":null,"abstract":"RI)","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"2631-2632"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b5/e1/opth-17-2631.PMC10493141.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10241094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joaquin O De Rojas, Helga P Sandoval, Richard Potvin, Kerry D Solomon
Purpose: To evaluate vision, visual quality, patient satisfaction and spectacle independence after bilateral implantation of the TECNIS Synergy™ intraocular lens.
Methods: Patients with a history of uneventful bilateral femtosecond laser assisted cataract surgery with the study IOL implanted, targeted for emmetropia, at least 3 months prior to the study visit were enrolled. Monocular and binocular visual acuity (VA) were measured at distance, intermediate and near, along with binocular mesopic VA. Low contrast binocular VA and reading speed in mesopic and photopic conditions were also measured. Patient satisfaction, spectacle independence, visual symptoms, and functional vision questionnaires were completed.
Results: Results from 52 subjects were available for analysis. Mean binocular unaided visual acuity was ~0.1 logMAR (20/20) from distance to 33 cm, with 81% of subjects having 0.2 logMAR (20/25) vision or better at all test distances and 92% reporting never needing glasses at any distance. Average reading speed at 40 cm was only 10 words/minute slower in dim light (p = 0.03). Mesopic and low contrast acuity appeared good. Halos were the most frequent and bothersome visual disturbances, with the greatest effect on driving at night. Eighty-eight percent of subjects reported being "completely" or "mostly" satisfied with their overall unaided vision.
Conclusion: This hybrid technology IOL provided a range of binocular visual acuity from distance to 33 cm and good functional vision, even in dim light. Patients should be advised of the likelihood of visual disturbances, particularly halos.
{"title":"Visual Outcomes, Quality of Vision, Patient Satisfaction and Spectacle Independence After Bilateral Implantation of the Synergy™ Intraocular Lens.","authors":"Joaquin O De Rojas, Helga P Sandoval, Richard Potvin, Kerry D Solomon","doi":"10.2147/OPTH.S421185","DOIUrl":"https://doi.org/10.2147/OPTH.S421185","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate vision, visual quality, patient satisfaction and spectacle independence after bilateral implantation of the TECNIS Synergy™ intraocular lens.</p><p><strong>Setting: </strong>Two clinical practices in the USA.</p><p><strong>Design: </strong>Ambispective unmasked non-randomized clinical trial.</p><p><strong>Methods: </strong>Patients with a history of uneventful bilateral femtosecond laser assisted cataract surgery with the study IOL implanted, targeted for emmetropia, at least 3 months prior to the study visit were enrolled. Monocular and binocular visual acuity (VA) were measured at distance, intermediate and near, along with binocular mesopic VA. Low contrast binocular VA and reading speed in mesopic and photopic conditions were also measured. Patient satisfaction, spectacle independence, visual symptoms, and functional vision questionnaires were completed.</p><p><strong>Results: </strong>Results from 52 subjects were available for analysis. Mean binocular unaided visual acuity was ~0.1 logMAR (20/20) from distance to 33 cm, with 81% of subjects having 0.2 logMAR (20/25) vision or better at all test distances and 92% reporting never needing glasses at any distance. Average reading speed at 40 cm was only 10 words/minute slower in dim light (p = 0.03). Mesopic and low contrast acuity appeared good. Halos were the most frequent and bothersome visual disturbances, with the greatest effect on driving at night. Eighty-eight percent of subjects reported being \"completely\" or \"mostly\" satisfied with their overall unaided vision.</p><p><strong>Conclusion: </strong>This hybrid technology IOL provided a range of binocular visual acuity from distance to 33 cm and good functional vision, even in dim light. Patients should be advised of the likelihood of visual disturbances, particularly halos.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"2277-2285"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c6/27/opth-17-2277.PMC10423583.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10358895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose To compare magnification and refocusing during phacoemulsification with the NGENUITY® 3-D Visualization System (3-D) versus the conventional microscope (CM) OPMI LUMERA 700. Setting This study was performed in the Department of Anterior Segment of the Fundación Hospital Nuestra Señora de la Luz. Design Prospective, randomized, cross-sectional, multi-surgeon, and comparative study. Methods This study enrolled 100 patients (eyes) scheduled for phacoemulsification to measure the number of times changes in focusing and magnification were needed during cataract surgery. Results Our study included 100 patients. From the endpoints evaluated, “zoom-in” showed statistically significant differences for all of the four predefined cataract surgery steps (means: Step 1, 0.38 (CM) vs 0.08 (3-D); Step 2, 0.36 (CM) vs 0.06 (3-D); Step 3, 0.54 (CM) vs 0.22 (3-D); Step 4, 0.56 (CM) vs 0.24 (3-D); all comparisons, p <0.05). In Step 4, there was a statistically significant increased use of “focus-out” for the 3-D system (mean 0.16 (CM) vs 0.58 (3-D); p <0.05). “Focus-in” and “zoom-out” showed no group differences for all steps. The duration of surgery with the 3-D system was longer at each step and overall. The percentage of light intensity did not show a statistically significant difference between both systems, with a mean of 99.45 for CM vs 98.43% for the heads-up system. Conclusion The heads-up 3-D system is a safe option that offers excellent magnification for anterior segment visualization. The surgical time is longer, but adjusting settings like light intensity and brightness may facilitate some surgical steps early in the learning curve.
目的:比较NGENUITY® 3-D可视化系统(3-D)和传统显微镜(CM) OPMI LUMERA 700在超声乳化术中的放大和再聚焦效果。背景:本研究在Fundación Nuestra Señora de la Luz医院前段科进行。设计:前瞻性、随机、横断面、多外科医生、比较研究。方法:本研究纳入100例拟行超声乳化手术的患者(眼),测量白内障手术过程中需要改变聚焦和放大倍率的次数。结果:我们的研究纳入了100例患者。从评估的终点来看,“放大”在所有预定义的四个白内障手术步骤中显示出统计学上的显著差异(平均值:步骤1,0.38 (CM) vs 0.08 (3d);步骤2,0.36 (CM) vs 0.06 (3d);步骤3,0.54 (CM) vs 0.22 (3d);步骤4,0.56 (CM) vs 0.24 (3d);结论:平视三维系统是一种安全的选择,为前段可视化提供了良好的放大倍率。手术时间较长,但调整光线强度和亮度等设置可能有助于在学习曲线的早期进行一些手术步骤。
{"title":"Magnification and Refocusing Comparison in Cataract Surgery Using a Heads-Up Three-Dimensional Visualization System versus Conventional Binocular Microscopy.","authors":"Mariana Ramírez Mejía, Leticia Arroyo Muñoz, Ana Beatriz Medina Perez, Cristina Mendoza Velasquez, Jimena Ceja Martínez, Azyadeh Camacho Ordonez, Oscar Guerrero-Berger","doi":"10.2147/OPTH.S423372","DOIUrl":"https://doi.org/10.2147/OPTH.S423372","url":null,"abstract":"Purpose To compare magnification and refocusing during phacoemulsification with the NGENUITY® 3-D Visualization System (3-D) versus the conventional microscope (CM) OPMI LUMERA 700. Setting This study was performed in the Department of Anterior Segment of the Fundación Hospital Nuestra Señora de la Luz. Design Prospective, randomized, cross-sectional, multi-surgeon, and comparative study. Methods This study enrolled 100 patients (eyes) scheduled for phacoemulsification to measure the number of times changes in focusing and magnification were needed during cataract surgery. Results Our study included 100 patients. From the endpoints evaluated, “zoom-in” showed statistically significant differences for all of the four predefined cataract surgery steps (means: Step 1, 0.38 (CM) vs 0.08 (3-D); Step 2, 0.36 (CM) vs 0.06 (3-D); Step 3, 0.54 (CM) vs 0.22 (3-D); Step 4, 0.56 (CM) vs 0.24 (3-D); all comparisons, p <0.05). In Step 4, there was a statistically significant increased use of “focus-out” for the 3-D system (mean 0.16 (CM) vs 0.58 (3-D); p <0.05). “Focus-in” and “zoom-out” showed no group differences for all steps. The duration of surgery with the 3-D system was longer at each step and overall. The percentage of light intensity did not show a statistically significant difference between both systems, with a mean of 99.45 for CM vs 98.43% for the heads-up system. Conclusion The heads-up 3-D system is a safe option that offers excellent magnification for anterior segment visualization. The surgical time is longer, but adjusting settings like light intensity and brightness may facilitate some surgical steps early in the learning curve.","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"2333-2339"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/0b/opth-17-2333.PMC10439775.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10405105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marie Jeremy B San Pedro, James Paul S Gomez, Edgar U Leuenberger
Purpose: This study aimed to compare the success and complication rates among patients implanted with Ahmed Glaucoma Valve (AGV) using the short and long tunnel technique through retrospective chart review.
Patients and methods: We reviewed 54 charts of adult patients who underwent AGV implantation using a Short-Needle Track (SNT) or Long-Needle Track (LNT) technique. Intraocular pressures (IOP), Best Corrected Visual Acuity (BCVA) and number of medications were recorded pre-operatively, and at Day 1, 3, 7, Month 1, 3, 6 post-operatively. Treatment success, occurrence of Hypertensive Phase (HP), complication and procedures done after AGV implantation were compared between the two groups using one-tailed Z-test of proportions.
Results: A total of 20 (LNT) and 21 (SNT) charts were included in the study. There was no significant difference between the median postoperative IOP, BCVA, and number of anti-glaucoma medications between the two groups at each time interval. The comparison between the occurrence of HP (P = 0.435) and success rates (P = 0.476) between the two groups yielded no significant difference. Flat/shallow anterior chamber (AC) was seen exclusively in three eyes (14%) in the SNT group (P = 0.039). There was one occurrence of plate exposure in the LNT group (P = 0.149).
Conclusion: The LNT technique of AGV Implantation may be used as an alternative to the traditional SNT (with autologous graft). The long needle track offers the advantage reducing the risk of complications arising from shallow anterior chamber post-operatively.
{"title":"Comparison of Short and Long-Tunnel Needle Track for Ahmed Glaucoma Valve Implantation in a Private Eye Center in the Philippines: A Retrospective Study.","authors":"Marie Jeremy B San Pedro, James Paul S Gomez, Edgar U Leuenberger","doi":"10.2147/OPTH.S405924","DOIUrl":"https://doi.org/10.2147/OPTH.S405924","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the success and complication rates among patients implanted with Ahmed Glaucoma Valve (AGV) using the short and long tunnel technique through retrospective chart review.</p><p><strong>Patients and methods: </strong>We reviewed 54 charts of adult patients who underwent AGV implantation using a Short-Needle Track (SNT) or Long-Needle Track (LNT) technique. Intraocular pressures (IOP), Best Corrected Visual Acuity (BCVA) and number of medications were recorded pre-operatively, and at Day 1, 3, 7, Month 1, 3, 6 post-operatively. Treatment success, occurrence of Hypertensive Phase (HP), complication and procedures done after AGV implantation were compared between the two groups using one-tailed Z-test of proportions.</p><p><strong>Results: </strong>A total of 20 (LNT) and 21 (SNT) charts were included in the study. There was no significant difference between the median postoperative IOP, BCVA, and number of anti-glaucoma medications between the two groups at each time interval. The comparison between the occurrence of HP (P = 0.435) and success rates (P = 0.476) between the two groups yielded no significant difference. Flat/shallow anterior chamber (AC) was seen exclusively in three eyes (14%) in the SNT group (P = 0.039). There was one occurrence of plate exposure in the LNT group (P = 0.149).</p><p><strong>Conclusion: </strong>The LNT technique of AGV Implantation may be used as an alternative to the traditional SNT (with autologous graft). The long needle track offers the advantage reducing the risk of complications arising from shallow anterior chamber post-operatively.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"1691-1699"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/35/7f/opth-17-1691.PMC10290859.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10095449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Catarina Castro, João Heitor Marques, Nisa Silva, Ana Carolina Abreu, Maria João Furtado, Miguel Lume
Purpose: To evaluate the agreement between conventional fundus photography (CFP) and multicolor fundus imaging (MFI) for the detection of lesions of diabetic retinopathy (DR) and retinal vein occlusion (RVO).
Methods: Cross-sectional analysis of eyes with DR or RVO who underwent CFP and MFI. All images were independently analyzed by two observers (O1 and O2), and the evaluated lesions were classified as "present" or "absent". Then, a paired comparison between both exams of the same eye was performed, to assess which made it easier to detect the lesions.
Results: Considering DR, the agreement was substantial for cotton wool spots and photocoagulation scars for both observers (O1: κ=0.75 and κ=0.67; O2: κ=0.71 and κ=0.64, respectively) and for hard exudates for O1 (κ=0.80). These lesions were detected more frequently on MFI. Regarding RVO, the agreement was considered substantial for venous sheathing by O1 (κ=0.64) and moderate for optociliary shunts by O2 (κ=0.60). Optociliary shunts were detected more frequently in CPF by both observers and venous sheathing on MFI by O1. For microaneurysms, retinal hemorrhages, retinal neovascularization, and proliferative membranes, in DR, and retinal hemorrhages, venous engorgement, and retinal neovascularization in RVO, the agreement was almost perfect (κ>0.82). In the paired analysis, both observers considered that, in DR, microaneurysms and retinal hemorrhages were easier to detect on CFP and that retinal neovascularization, cotton wool spots, and photocoagulation scars were easier to identify on MFI. Regarding RVO, optocilliary shunts were easier to identify on CFP and venous engorgement on MFI.
Conclusion: The agreement of MFI and CFP was substantial to almost perfect for most lesions. MFI seems better to detect cotton wool spots and photocoagulations scars in DR and venous sheathing in RVO. Optocilliary shunts seem easier to detect on CFP.
{"title":"Comparison of Color Fundus Photography and Multicolor Fundus Imaging for Detection of Lesions in Diabetic Retinopathy and Retinal Vein Occlusion.","authors":"Catarina Castro, João Heitor Marques, Nisa Silva, Ana Carolina Abreu, Maria João Furtado, Miguel Lume","doi":"10.2147/OPTH.S414603","DOIUrl":"https://doi.org/10.2147/OPTH.S414603","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the agreement between conventional fundus photography (CFP) and multicolor fundus imaging (MFI) for the detection of lesions of diabetic retinopathy (DR) and retinal vein occlusion (RVO).</p><p><strong>Methods: </strong>Cross-sectional analysis of eyes with DR or RVO who underwent CFP and MFI. All images were independently analyzed by two observers (O1 and O2), and the evaluated lesions were classified as \"present\" or \"absent\". Then, a paired comparison between both exams of the same eye was performed, to assess which made it easier to detect the lesions.</p><p><strong>Results: </strong>Considering DR, the agreement was substantial for cotton wool spots and photocoagulation scars for both observers (O1: <i>κ</i>=0.75 and <i>κ</i>=0.67; O2: <i>κ</i>=0.71 and <i>κ</i>=0.64, respectively) and for hard exudates for O1 (<i>κ</i>=0.80). These lesions were detected more frequently on MFI. Regarding RVO, the agreement was considered substantial for venous sheathing by O1 (<i>κ</i>=0.64) and moderate for optociliary shunts by O2 (<i>κ</i>=0.60). Optociliary shunts were detected more frequently in CPF by both observers and venous sheathing on MFI by O1. For microaneurysms, retinal hemorrhages, retinal neovascularization, and proliferative membranes, in DR, and retinal hemorrhages, venous engorgement, and retinal neovascularization in RVO, the agreement was almost perfect (<i>κ</i>>0.82). In the paired analysis, both observers considered that, in DR, microaneurysms and retinal hemorrhages were easier to detect on CFP and that retinal neovascularization, cotton wool spots, and photocoagulation scars were easier to identify on MFI. Regarding RVO, optocilliary shunts were easier to identify on CFP and venous engorgement on MFI.</p><p><strong>Conclusion: </strong>The agreement of MFI and CFP was substantial to almost perfect for most lesions. MFI seems better to detect cotton wool spots and photocoagulations scars in DR and venous sheathing in RVO. Optocilliary shunts seem easier to detect on CFP.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"2515-2524"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/3e/opth-17-2515.PMC10460587.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10102759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}