Pub Date : 2020-01-01DOI: 10.35248/2155-9570.21.11.854
M. Arafa, El Sayed M Eltoukhy, M. Kamal, M. Said
Objective: This study aims at determining the efficacy of anterior and nasal transposition of Inferior Oblique to manage dissociated vertical deviation and vertically incomitant horizontal strabismus (V pattern). Method: This study was both prospective and uncontrolled; it included 60 patients who suffered from inferior oblique overaction. The participants were divided into two groups: Group A had 30 patients with vertically incomitant horizontal strabismus while group B had 30 patients with dissociated vertical deviation. Preoperative examination included: Assessment of vision, ductions and versions in the six cardinal directions of gaze and severity of IOOA graded from 0 to +4. The percentage of dissociated vertical deviation was measured using the prism under cover test in primary position. Follow-up visits occurred in the following intervals: After one week, one month, four months, and six months respectively. In each follow-up visit, the measurements of ductions, versions, and alignment in primary position were recorded. Results: Group A showed no pattern in 93.3% of cases postoperatively while 6.7% of cases developed insignificant V pattern (0.8 ± 2.9 ΔD), with statistically significant difference between the pre-and post-operative values (pvalue< 0.001). Meanwhile, group B showed a complete resolution of DVD in 100% of cases with preoperative (DVD<15 ΔD) and in 20% of cases with preoperative DVD ≥ 15 ΔD; the remaining cases had residual DVD (3.6 ± 4.1 ΔD). Conclusion: Anterior-nasal transposition of the Inferior Oblique muscle is an effective procedure for cases with severe or recurrent inferior oblique overaction when other standard procedures of Inferior Oblique muscle fail. For DVD ≥ 15 ΔD, we recommend a combined anterior-nasal transposition of inferior oblique with superior rectus recession.
{"title":"The Efficacy of Anterior-Nasal Surgery in Managing Inferior Oblique Overaction either with DVD or with V Pattern","authors":"M. Arafa, El Sayed M Eltoukhy, M. Kamal, M. Said","doi":"10.35248/2155-9570.21.11.854","DOIUrl":"https://doi.org/10.35248/2155-9570.21.11.854","url":null,"abstract":"Objective: This study aims at determining the efficacy of anterior and nasal transposition of Inferior Oblique to manage dissociated vertical deviation and vertically incomitant horizontal strabismus (V pattern). Method: This study was both prospective and uncontrolled; it included 60 patients who suffered from inferior oblique overaction. The participants were divided into two groups: Group A had 30 patients with vertically incomitant horizontal strabismus while group B had 30 patients with dissociated vertical deviation. Preoperative examination included: Assessment of vision, ductions and versions in the six cardinal directions of gaze and severity of IOOA graded from 0 to +4. The percentage of dissociated vertical deviation was measured using the prism under cover test in primary position. Follow-up visits occurred in the following intervals: After one week, one month, four months, and six months respectively. In each follow-up visit, the measurements of ductions, versions, and alignment in primary position were recorded. Results: Group A showed no pattern in 93.3% of cases postoperatively while 6.7% of cases developed insignificant V pattern (0.8 ± 2.9 ΔD), with statistically significant difference between the pre-and post-operative values (pvalue< 0.001). Meanwhile, group B showed a complete resolution of DVD in 100% of cases with preoperative (DVD<15 ΔD) and in 20% of cases with preoperative DVD ≥ 15 ΔD; the remaining cases had residual DVD (3.6 ± 4.1 ΔD). Conclusion: Anterior-nasal transposition of the Inferior Oblique muscle is an effective procedure for cases with severe or recurrent inferior oblique overaction when other standard procedures of Inferior Oblique muscle fail. For DVD ≥ 15 ΔD, we recommend a combined anterior-nasal transposition of inferior oblique with superior rectus recession.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"138 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86269375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2155-9570.20.11.823
M. Gupta, Manjunath Bh, Sachin S Shedole
Introduction: Cataract extraction constitutes the largest workload through DBCS program in ophthalmic units in India. Both SICS & Phacoemulsification surgery are performed in a limited, confined space; however, securing adequate surgical space during cataract surgery can decrease the risk of corneal endothelial cell loss.1 Thus, anatomical and surgical factors, such as adequate Anterior Chamber Depth (ACD), are important for preserving these cells from the mechanical and thermal damage that can occur during the procedure. Under normal circumstances, corneal endothelial cells do not proliferate because they are stuck in G1 phase of cell cycle. The central corneal endothelial cell density gradually decreases at an average of about 0.6% per year, reducing approximately from 3400 cells/mm2 at age 15 to 2300 cells at age 80 years. Two important factors in maintaining corneal transparency are the number and the integrity of the corneal endothelial cells.3 Corneas with cell densities as low as 500 cells/mm2 and average cell area of approximately 2000-3000 μm2 can remain clear. Protection of corneal endothelium during cataract surgery is critical for achieving good visual outcomes. Objectives: To study the endothelial cell loss in SICS and Phacoemulsification and compare the cell loss between two surgeries and to compare morphological and functional changes in corneal endothelium between the two surgeries. Materials and methods: A comparative prospective study is performed in 200 eyes of 200 patients attending DBCS Camp at Babuji Eye Hospital and Chigateri General Hospital attached to JJM Medical College Hospital, Davanagere from July 2018 to October 2019 for cataract surgery. Patients were randomly allocated to two groups. One group underwent small incision cataract surgery and the other group underwent phacoemulsification. Corneal endothelial assessment was done for patients undergoing both the surgeries using non-contact specular microscopy Tomey EM 3000 preoperatively and postoperatively at 1 week and 6 weeks. Results: In SICS group, corneal endothelial count was 2303.0 ± 329.1 preoperatively, postoperatively it was reduced to 2068.9 ± 381.1 at 1 week and 1980.3 ± 401.5 at 6 weeks. In phacoemulsification group, it was found to be 2213.9 ± 442.3 preoperatively and which reduced to 1878.7 ± 458.3 at 1 week and 1796.4 ± 467.3 at 6 weeks postoperatively. Cases in SICS group showed 10.2% loss at 1 week and 14% cell loss at 6 weeks while phacoemulsification group showed 15.1% cell loss at 1 week and 18.9% cell loss at 6 weeks. Polymegathism was increased in both the groups while hexagonality was decreased in both groups. No significant difference in functional parameters like central corneal thickness (CCT) and best corrected visual acuity (BCVA) was observed in both SICS and Phacoemulsification group at the end of 6 weeks. Conclusion: The study shows that phacoemulsification is safe procedure in experienced hands. Compared to phacoemulsificati
导读:通过DBCS项目,白内障摘除是印度眼科单位最大的工作量。超声乳化术和超声乳化术都是在有限的空间内进行的;然而,在白内障手术中确保足够的手术空间可以降低角膜内皮细胞丢失的风险因此,解剖和手术因素,如足够的前房深度(ACD),对于保护这些细胞免受手术过程中可能发生的机械和热损伤是重要的。正常情况下,角膜内皮细胞处于细胞周期G1期,不能增殖。角膜中央内皮细胞密度以平均每年0.6%的速度逐渐下降,大约从15岁时的3400个细胞/mm2减少到80岁时的2300个细胞/mm2。维持角膜透明度的两个重要因素是角膜内皮细胞的数量和完整性当细胞密度低至500个细胞/mm2,平均细胞面积约为2000-3000 μm2时,角膜仍能保持清晰。白内障手术中角膜内皮的保护是获得良好视力的关键。目的:研究超声乳化术和超声乳化术中角膜内皮细胞的损失情况,比较两种手术中角膜内皮细胞的损失情况,比较两种手术中角膜内皮细胞形态和功能的变化。材料与方法:对2018年7月至2019年10月在Davanagere JJM医学院附属Babuji眼科医院和Chigateri总医院参加DBCS营的200例白内障手术患者的200只眼进行比较前瞻性研究。患者随机分为两组。一组行小切口白内障手术,另一组行超声乳化术。术前和术后1周和6周分别使用Tomey EM 3000非接触式镜面显微镜对接受手术的患者进行角膜内皮评估。结果:SICS组角膜内皮细胞计数术前为2303.0±329.1,术后1周为2068.9±381.1,6周为1980.3±401.5。超声乳化术组术前为2213.9±442.3,术后1周为1878.7±458.3,术后6周为1796.4±467.3。超声乳化术组1周细胞损失10.2%,6周细胞损失14%,超声乳化术组1周细胞损失15.1%,6周细胞损失18.9%。多形性在两组中都有所增加,而六边形在两组中都有所减少。6周结束时,超声乳化术组和超声乳化术组角膜中央厚度(CCT)、最佳矫正视力(BCVA)等功能参数均无显著差异。结论:超声乳化术在有经验的人手中是安全的。与超声乳化术相比,小切口白内障手术术后内皮损伤较低。我们建议在白内障手术中有内皮损伤风险的患者应使用SICS。
{"title":"Comparison of Morphological and Functional Corneal Endothelial Changes after Cataract Surgery under DBCS Program at a Tertiary Care Centre","authors":"M. Gupta, Manjunath Bh, Sachin S Shedole","doi":"10.35248/2155-9570.20.11.823","DOIUrl":"https://doi.org/10.35248/2155-9570.20.11.823","url":null,"abstract":"Introduction: Cataract extraction constitutes the largest workload through DBCS program in ophthalmic units in India. Both SICS & Phacoemulsification surgery are performed in a limited, confined space; however, securing adequate surgical space during cataract surgery can decrease the risk of corneal endothelial cell loss.1 Thus, anatomical and surgical factors, such as adequate Anterior Chamber Depth (ACD), are important for preserving these cells from the mechanical and thermal damage that can occur during the procedure. Under normal circumstances, corneal endothelial cells do not proliferate because they are stuck in G1 phase of cell cycle. The central corneal endothelial cell density gradually decreases at an average of about 0.6% per year, reducing approximately from 3400 cells/mm2 at age 15 to 2300 cells at age 80 years. Two important factors in maintaining corneal transparency are the number and the integrity of the corneal endothelial cells.3 Corneas with cell densities as low as 500 cells/mm2 and average cell area of approximately 2000-3000 μm2 can remain clear. Protection of corneal endothelium during cataract surgery is critical for achieving good visual outcomes. Objectives: To study the endothelial cell loss in SICS and Phacoemulsification and compare the cell loss between two surgeries and to compare morphological and functional changes in corneal endothelium between the two surgeries. Materials and methods: A comparative prospective study is performed in 200 eyes of 200 patients attending DBCS Camp at Babuji Eye Hospital and Chigateri General Hospital attached to JJM Medical College Hospital, Davanagere from July 2018 to October 2019 for cataract surgery. Patients were randomly allocated to two groups. One group underwent small incision cataract surgery and the other group underwent phacoemulsification. Corneal endothelial assessment was done for patients undergoing both the surgeries using non-contact specular microscopy Tomey EM 3000 preoperatively and postoperatively at 1 week and 6 weeks. Results: In SICS group, corneal endothelial count was 2303.0 ± 329.1 preoperatively, postoperatively it was reduced to 2068.9 ± 381.1 at 1 week and 1980.3 ± 401.5 at 6 weeks. In phacoemulsification group, it was found to be 2213.9 ± 442.3 preoperatively and which reduced to 1878.7 ± 458.3 at 1 week and 1796.4 ± 467.3 at 6 weeks postoperatively. Cases in SICS group showed 10.2% loss at 1 week and 14% cell loss at 6 weeks while phacoemulsification group showed 15.1% cell loss at 1 week and 18.9% cell loss at 6 weeks. Polymegathism was increased in both the groups while hexagonality was decreased in both groups. No significant difference in functional parameters like central corneal thickness (CCT) and best corrected visual acuity (BCVA) was observed in both SICS and Phacoemulsification group at the end of 6 weeks. Conclusion: The study shows that phacoemulsification is safe procedure in experienced hands. Compared to phacoemulsificati","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"431 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84904155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2155-9570.20.11.851
Khalid Kotb AbdAllah, M. Kamal, M. Abada, Amr Abdelaziz Azaab, Ragai Magdi Hatata
Purpose: To investigate the incidence of unintentional macular displacement by using fundus auto-fluorescence (FAF) imaging in eyes undergoing PPV for repair of primary rhegmatonous retinal detachment (RRD) and tamponated with either silicon oil (SO) or gas, its association with symptoms of visual disturbance. Methods: Prospective study including 40 eyes with fresh RRD. 3 port pars planavitrectomy was done with gas or silicon oil tamponade. Three months after surgery macular displacement was evaluated by fundus autofluorescence. Results: Of the 40 cases, After silicon oil removal or complete gas absorption, macular displacement was evaluated by fundus autofluorescence fundus autofluorescence images showed retinal displacement in 11 eyes (27.5%) after surgery. In SO group, 3 eyes showed retinal displacement upwards with incidence (15%). In Gas group, 8 eyes showed retinal displacement downwards with incidence (40%). In the patients with evidence of retinal displacement on FAF, metamorphopsia and micropsia were present in 81.8% (9/11) eyes and 18.2% (2/11) respectively, on the other hand in those with no evidence of retinal displacement on FAF , metamorphopsia and micropsia were present in 58.6% (17/29) eyes and 10.3% (3/29) respectively. Conclusion: Unintentional displacement of the retina after repair of primary and uncomplicated detachments with PPV may be observed using either SO or gas, but slightly more in gas tamponade, this displacement doesn’t affecting BCVA of patients.
{"title":"Macular Displacement Following Rhegmatogenous Retinal Detachment Repair Using either Silicone Oil or Gas Tamponade: A Comparative Study","authors":"Khalid Kotb AbdAllah, M. Kamal, M. Abada, Amr Abdelaziz Azaab, Ragai Magdi Hatata","doi":"10.35248/2155-9570.20.11.851","DOIUrl":"https://doi.org/10.35248/2155-9570.20.11.851","url":null,"abstract":"Purpose: To investigate the incidence of unintentional macular displacement by using fundus auto-fluorescence (FAF) imaging in eyes undergoing PPV for repair of primary rhegmatonous retinal detachment (RRD) and tamponated with either silicon oil (SO) or gas, its association with symptoms of visual disturbance. Methods: Prospective study including 40 eyes with fresh RRD. 3 port pars planavitrectomy was done with gas or silicon oil tamponade. Three months after surgery macular displacement was evaluated by fundus autofluorescence. Results: Of the 40 cases, After silicon oil removal or complete gas absorption, macular displacement was evaluated by fundus autofluorescence fundus autofluorescence images showed retinal displacement in 11 eyes (27.5%) after surgery. In SO group, 3 eyes showed retinal displacement upwards with incidence (15%). In Gas group, 8 eyes showed retinal displacement downwards with incidence (40%). In the patients with evidence of retinal displacement on FAF, metamorphopsia and micropsia were present in 81.8% (9/11) eyes and 18.2% (2/11) respectively, on the other hand in those with no evidence of retinal displacement on FAF , metamorphopsia and micropsia were present in 58.6% (17/29) eyes and 10.3% (3/29) respectively. Conclusion: Unintentional displacement of the retina after repair of primary and uncomplicated detachments with PPV may be observed using either SO or gas, but slightly more in gas tamponade, this displacement doesn’t affecting BCVA of patients.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"1 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90063181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2155-9570.20.11.865
P. Clark, D. McCartney, K. Mitchell, M. Shami
Purpose: One of the most feared complications of intraocular tumor biopsy with fine needle aspiration biopsy (FNAB) or vitrectomy-assisted biopsy is seeding of the tumor cells directly into the needle tract. We present a case of epibulbar seeding of uveal MALT lymphoma following vitrectomy. Observations: A 67-year-old male presented with painless loss of vision of the left eye and creamy yellow infiltrates at the level of the choroid. A diagnostic 25-gauge pars plana vitrectomy was performed using a standard 3-port approach. Choroidal biopsy of the lesion demonstrated the presence of Mucosa-Associated Lymphoid Tissue (MALT) lymphoma. Three weeks following vitrectomy, the patient developed a large fleshy subconjunctival mass centered over the prior superonasal sclerotomy site. The lesion was completely excised and histopathology of the lesion demonstrated MALT lymphoma with an identical immunohistochemical staining pattern to that of the choroidal lesion. Conclusions and Importance: Transvitreal biopsy with fine needle aspiration or vitrectomy is an increasingly common and safe procedure for clinical diagnosis of intraocular tumors. However, there is a risk of tumor seeding of the needle tract and precautions to reduce this risk are warranted.
{"title":"Epibulbar Seeding of Uveal MALT Lymphoma Following Vitrectomy","authors":"P. Clark, D. McCartney, K. Mitchell, M. Shami","doi":"10.35248/2155-9570.20.11.865","DOIUrl":"https://doi.org/10.35248/2155-9570.20.11.865","url":null,"abstract":"Purpose: One of the most feared complications of intraocular tumor biopsy with fine needle aspiration biopsy (FNAB) or vitrectomy-assisted biopsy is seeding of the tumor cells directly into the needle tract. We present a case of epibulbar seeding of uveal MALT lymphoma following vitrectomy. Observations: A 67-year-old male presented with painless loss of vision of the left eye and creamy yellow infiltrates at the level of the choroid. A diagnostic 25-gauge pars plana vitrectomy was performed using a standard 3-port approach. Choroidal biopsy of the lesion demonstrated the presence of Mucosa-Associated Lymphoid Tissue (MALT) lymphoma. Three weeks following vitrectomy, the patient developed a large fleshy subconjunctival mass centered over the prior superonasal sclerotomy site. The lesion was completely excised and histopathology of the lesion demonstrated MALT lymphoma with an identical immunohistochemical staining pattern to that of the choroidal lesion. Conclusions and Importance: Transvitreal biopsy with fine needle aspiration or vitrectomy is an increasingly common and safe procedure for clinical diagnosis of intraocular tumors. However, there is a risk of tumor seeding of the needle tract and precautions to reduce this risk are warranted.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"54 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86742268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2155-9570.21.11.855
ShishirVerghese, George J. Manayath, K. Kumarswamy
A 20-year-old gentleman presented with complaints of defective vision in the right eye (OD), with best corrected visual acuity of 20/60. His anterior segment was normal. Fundus examination revealed circumpapillaryangioid streaks radiating from the optic disc with one passing subfoveally along with a presence of a Choroidal neovascular membrane (CNVM) (Figure 1A). Ocular coherence tomography (OCT) confirmed the presence of a type II CNVM under the fovea (Figure 1B). Ocular coherence tomography angiography (OCTA) reveals the subfovealneovascular network at the level of the deep capillary plexus originating from below the RPE (Figures 1C and 1D). This case highlights the uniqueness of the angioid streak splitting through the fovea and the role of OCTA as a noninvasive alternative to dye based angiography for diagnosis of CNVM secondary to angioid streaks. Up to 50% of angioid streaks are idiopathic, with the rest having an association with systemic disease [1]. The incidence of CNVM is 72%-86% in various studies [2,3]. Our patient underwent Intravitreal Injection of Ranibizumab in OD and was referred to a physician for systemic examination and haematological workup.
{"title":"The Foveal Splitter","authors":"ShishirVerghese, George J. Manayath, K. Kumarswamy","doi":"10.35248/2155-9570.21.11.855","DOIUrl":"https://doi.org/10.35248/2155-9570.21.11.855","url":null,"abstract":"A 20-year-old gentleman presented with complaints of defective vision in the right eye (OD), with best corrected visual acuity of 20/60. His anterior segment was normal. Fundus examination revealed circumpapillaryangioid streaks radiating from the optic disc with one passing subfoveally along with a presence of a Choroidal neovascular membrane (CNVM) (Figure 1A). Ocular coherence tomography (OCT) confirmed the presence of a type II CNVM under the fovea (Figure 1B). Ocular coherence tomography angiography (OCTA) reveals the subfovealneovascular network at the level of the deep capillary plexus originating from below the RPE (Figures 1C and 1D). This case highlights the uniqueness of the angioid streak splitting through the fovea and the role of OCTA as a noninvasive alternative to dye based angiography for diagnosis of CNVM secondary to angioid streaks. Up to 50% of angioid streaks are idiopathic, with the rest having an association with systemic disease [1]. The incidence of CNVM is 72%-86% in various studies [2,3]. Our patient underwent Intravitreal Injection of Ranibizumab in OD and was referred to a physician for systemic examination and haematological workup.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"1 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83007813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2155-9570.20.11.840
Shani Levy-Neuman, A. Marcovich, A. Bukelman, O. Reitblat, G. Kleinmann
Background: We aimed to compare the safety and efficacy of two techniques for the correction of subluxated posterior intraocular lens (IOL): scleral fixation (SFIOL) and iris fixation of IOL (IFIOL). Methods: 112 eyes of 105 patients that underwent SFIOL or IFIOL at the Kaplan Medical Center between 2008 and 2018 were retrospectively included, 73 eyes had SFIOL and 39 eyes had IFIOL. The main outcome measures were: operation time, postoperative visual acuity and intra and post-operative complications. Results: There was no significant difference in the mean operation time between SFIOL and IFIOL. The mean follow-up time was significantly longer for the IFIOL compared with the SFIOL (34 ± 31 vs. 14 ± 20 months, respectively [p>0.001]).Postoperative distance corrected visual acuity (DCVA) at the last follow-up was significantly better than the preoperative DCVA in both groups (SFIOL: 0.52 ± 0.49 vs. 1.20 ± 0.84, [p<0.001], and IFIOL: 0.75 ± 0.88 vs. 1.31 ± 0.81 [p<0.001], respectively [LogMar]). No difference in DCVA was found between the groups. Irregular pupil was found in 59% IFIOL vs. 20.5% of the SFIOL [p<0.001] and corneal edema was found in 10.3% of the IFIOL vs. 1.4% of the SFIOL [p=0.05]. No other differences in intra and post-operative complications were found between the two groups. Conclusion: Both IFIOL and SFIOL are effective and safe for the secure of IOL in the absence of adequate capsular support. Both techniques resulted in a significant improvement in DCVA. Pupil ovalization and corneal edema were more common in the IFIOL group. Longer follow-up was noticed at the IFIOL group.
{"title":"Clinical Outcomes of Iris vs. Scleral Intraocular Lens Fixation","authors":"Shani Levy-Neuman, A. Marcovich, A. Bukelman, O. Reitblat, G. Kleinmann","doi":"10.35248/2155-9570.20.11.840","DOIUrl":"https://doi.org/10.35248/2155-9570.20.11.840","url":null,"abstract":"Background: We aimed to compare the safety and efficacy of two techniques for the correction of subluxated posterior intraocular lens (IOL): scleral fixation (SFIOL) and iris fixation of IOL (IFIOL). Methods: 112 eyes of 105 patients that underwent SFIOL or IFIOL at the Kaplan Medical Center between 2008 and 2018 were retrospectively included, 73 eyes had SFIOL and 39 eyes had IFIOL. The main outcome measures were: operation time, postoperative visual acuity and intra and post-operative complications. Results: There was no significant difference in the mean operation time between SFIOL and IFIOL. The mean follow-up time was significantly longer for the IFIOL compared with the SFIOL (34 ± 31 vs. 14 ± 20 months, respectively [p>0.001]).Postoperative distance corrected visual acuity (DCVA) at the last follow-up was significantly better than the preoperative DCVA in both groups (SFIOL: 0.52 ± 0.49 vs. 1.20 ± 0.84, [p<0.001], and IFIOL: 0.75 ± 0.88 vs. 1.31 ± 0.81 [p<0.001], respectively [LogMar]). No difference in DCVA was found between the groups. Irregular pupil was found in 59% IFIOL vs. 20.5% of the SFIOL [p<0.001] and corneal edema was found in 10.3% of the IFIOL vs. 1.4% of the SFIOL [p=0.05]. No other differences in intra and post-operative complications were found between the two groups. Conclusion: Both IFIOL and SFIOL are effective and safe for the secure of IOL in the absence of adequate capsular support. Both techniques resulted in a significant improvement in DCVA. Pupil ovalization and corneal edema were more common in the IFIOL group. Longer follow-up was noticed at the IFIOL group.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"1 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76546136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2155-9570.20.11.847
S. E. Sayed, M. Kamal, S. Sadek, R. Hatata
Objective: To detect qualitative and quantitative analysis of the choroidal neovascular membrane based on opticalcoherence tomography angiography OCTA in response to treatment with anti-angiogenesis. Patients and methods: This is a prospective observational study recruited 20 eyes of 20 patients with treatment-naiveCNVM. Patients were examined using the OCTA before and after treatment with Ranibizumab. Patients werefollowed-up monthly over 3 successive months and 1 month after the last injection. The collected data werestatistically analyzed using SPSS software version 22. Repeated measures ANOVA was performed and a paired t-testwas also used for comparison. Main outcome measures: membrane types, patterns, corrected visual acuity, retinalfluids, membrane size, and flow area; all were measured pre and post-intervention. Results: Five patients were males and 15 were females (50.6 ± 17.7 years). Different configuration were detected; adensenet configuration in 6 eyes, a loosenet configuration in 6 eyes, mixed net in 3 eyes, and an unidentifiablepattern in 5 eyes. Visual acuity improved post-injection in all membrane patterns (p value 0.002 in loose-net andunidentifiable types). Signs of membrane activity, size, and flow area; all decreased in all patterns following treatment(p value 0.001). Conclusions: OCTA in conjunction with OCT is both needed for more precise evaluation of differentmorphological and functional membrane criteria at which treatment strategy is based. Detection of blood flowchanges within the membrane itself can be considered as reliable biomarkers in monitoring the membrane activity.
{"title":"Optical Coherence Tomography Angiography Evaluation of Morphological andVascular Changes in Choroidal Neovascularization in Response to Anti-Angiogenic Treatment","authors":"S. E. Sayed, M. Kamal, S. Sadek, R. Hatata","doi":"10.35248/2155-9570.20.11.847","DOIUrl":"https://doi.org/10.35248/2155-9570.20.11.847","url":null,"abstract":"Objective: To detect qualitative and quantitative analysis of the choroidal neovascular membrane based on opticalcoherence tomography angiography OCTA in response to treatment with anti-angiogenesis. Patients and methods: This is a prospective observational study recruited 20 eyes of 20 patients with treatment-naiveCNVM. Patients were examined using the OCTA before and after treatment with Ranibizumab. Patients werefollowed-up monthly over 3 successive months and 1 month after the last injection. The collected data werestatistically analyzed using SPSS software version 22. Repeated measures ANOVA was performed and a paired t-testwas also used for comparison. Main outcome measures: membrane types, patterns, corrected visual acuity, retinalfluids, membrane size, and flow area; all were measured pre and post-intervention. Results: Five patients were males and 15 were females (50.6 ± 17.7 years). Different configuration were detected; adensenet configuration in 6 eyes, a loosenet configuration in 6 eyes, mixed net in 3 eyes, and an unidentifiablepattern in 5 eyes. Visual acuity improved post-injection in all membrane patterns (p value 0.002 in loose-net andunidentifiable types). Signs of membrane activity, size, and flow area; all decreased in all patterns following treatment(p value 0.001). Conclusions: OCTA in conjunction with OCT is both needed for more precise evaluation of differentmorphological and functional membrane criteria at which treatment strategy is based. Detection of blood flowchanges within the membrane itself can be considered as reliable biomarkers in monitoring the membrane activity.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"18 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73662810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2155-9570.20.11.834
Andrew Wekesa, A. Ragot, Walter Yego
Aim: Corneal ulcerations are immediate risks to avoidable blindness. In many developing countries, their treatment present huge challenges, often due to increased resistance to anti-bacterial drugs, costs and accessibility issues. Bee bread is a valuable apitherapeutic product greatly appreciated by the natural medicine because of its potential medical and nutritional applications. In this study, we investigated the pharmacological effect of extract from M. ferriguinea on chemical-induced and bacterial-infected corneal ulceration of rabbit’s eyes. Method: A randomized-controlled experiment, was conducted on 15 New Zealand rabbits weighing 1.4 ± 0.42 kgrandomly assigned to 3 groups; A (Experimental group), B (Positive Control group) and C (Negative control group) of five animals each. All rabbits were adapted for 2 weeks. The right eye corneas were then injured using a drop of 1 Molar sodium hydroxide (NaOH). After 12 hours, animals in all groups in their injured corneas were infected with 1 drop of a laboratory prepared solution of P Aeruginosa. Treatment with extracts of M. ferriguinea-groups A group B treated with ciprofloxacin then group C treated with atropine alone commenced after 24 hours and continued every 4 hours for 7 days. Results: Although the mean healing effect of extracts of M. ferriguinea was not significantly (p>0.05) better after the 168th hour of treatment compared to its effect after the 24th hour, the effect size however, was clinical significant (57%). Furthermore, we found no significant difference (p>0.05) between the mean healing effects of the standard treatment protocol and the extracts of M. ferriguinea, but the standard treatment protocol showed a better clinical effect (33%) over the experimental extract. Also, the healing effects of atropine alone showed a better clinical effect (22%) than that of the experimental extract, but again, these were not statistically significant (p>0.05). Conclusion: Extracts of M. ferriguinea shows anti-inflammatory and anti-infective effects on chemical-induced and bacterial-infected corneal ulcers in rabbit ’s eyes. We found these effects to be comparable to that of standard treatment protocol for bacterial corneal ulcers. We thus conclude that in resource-constrained areas where M. ferriguinea is richly available, their extracts may provide alternative and/or complementary treatment option for chemical-induced and bacterial-infected corneal ulcers.
{"title":"Effects of Bee Bread Extract from Meliponula Ferriguinea on Chemical Induced and Bacterial Infected Corneal Ulcers of Rabbit Eyes","authors":"Andrew Wekesa, A. Ragot, Walter Yego","doi":"10.35248/2155-9570.20.11.834","DOIUrl":"https://doi.org/10.35248/2155-9570.20.11.834","url":null,"abstract":"Aim: Corneal ulcerations are immediate risks to avoidable blindness. In many developing countries, their treatment present huge challenges, often due to increased resistance to anti-bacterial drugs, costs and accessibility issues. Bee bread is a valuable apitherapeutic product greatly appreciated by the natural medicine because of its potential medical and nutritional applications. In this study, we investigated the pharmacological effect of extract from M. ferriguinea on chemical-induced and bacterial-infected corneal ulceration of rabbit’s eyes. Method: A randomized-controlled experiment, was conducted on 15 New Zealand rabbits weighing 1.4 ± 0.42 kgrandomly assigned to 3 groups; A (Experimental group), B (Positive Control group) and C (Negative control group) of five animals each. All rabbits were adapted for 2 weeks. The right eye corneas were then injured using a drop of 1 Molar sodium hydroxide (NaOH). After 12 hours, animals in all groups in their injured corneas were infected with 1 drop of a laboratory prepared solution of P Aeruginosa. Treatment with extracts of M. ferriguinea-groups A group B treated with ciprofloxacin then group C treated with atropine alone commenced after 24 hours and continued every 4 hours for 7 days. Results: Although the mean healing effect of extracts of M. ferriguinea was not significantly (p>0.05) better after the 168th hour of treatment compared to its effect after the 24th hour, the effect size however, was clinical significant (57%). Furthermore, we found no significant difference (p>0.05) between the mean healing effects of the standard treatment protocol and the extracts of M. ferriguinea, but the standard treatment protocol showed a better clinical effect (33%) over the experimental extract. Also, the healing effects of atropine alone showed a better clinical effect (22%) than that of the experimental extract, but again, these were not statistically significant (p>0.05). Conclusion: Extracts of M. ferriguinea shows anti-inflammatory and anti-infective effects on chemical-induced and bacterial-infected corneal ulcers in rabbit ’s eyes. We found these effects to be comparable to that of standard treatment protocol for bacterial corneal ulcers. We thus conclude that in resource-constrained areas where M. ferriguinea is richly available, their extracts may provide alternative and/or complementary treatment option for chemical-induced and bacterial-infected corneal ulcers.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"1 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86706418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2155-9570.20.11.844
M. D. Keyser, Jonas De Belder, Brice Ballet, E. Mertens
Purpose: Examine the need and the timeframe to redo selective laser trabeculoplasty (SLT) that was applied in open angle glaucoma or ocular hypertensive patients. Methods: Patients received SLT as primary, adjunctive or replacement therapy. Data were recorded up to 5.5 years after SLT treatment. Target pressure was defined as intraocular pressure at least 20% lowered. On exceeding the target pressure, patients received a second SLT. Primary outcome were the need and the time to redo the SLT. We examined differences between the groups (primary, replacement or adjunct SLT) and correlations between time and need to redo and pre-SLT parameters. Results: 108 patients (194 eyes) could be followed for at least 0.5 year and up to 4.5 years, with a mean follow up of 22.35 ± 18.94 months. Our population at start was a varied one; 34% of patients received primary SLT, 50% had replacement SLT, 16% had SLT as adjunctive treatment. These three groups showed no difference in evolution of IOP or medication in time. Time to redo varied, with a mean of 31.13 ± 11.24 months. Conclusion: We set out to have a general idea of how many patients could be expected to need a retreatment with SLT after a first successful SLT in a private clinic setting. In our population, the percentage of redo needed was 5.6% after 2 years, 35.4% after 3 years and 45.4% after 4 years. No differences could be measured with regard to the type of SLT performed nor could any significant correlation be found between need to redo and pre-SLT characteristics.
{"title":"Need and Time to Redo Selective Laser Trabeculoplasty in Glaucoma Patients","authors":"M. D. Keyser, Jonas De Belder, Brice Ballet, E. Mertens","doi":"10.35248/2155-9570.20.11.844","DOIUrl":"https://doi.org/10.35248/2155-9570.20.11.844","url":null,"abstract":"Purpose: Examine the need and the timeframe to redo selective laser trabeculoplasty (SLT) that was applied in open angle glaucoma or ocular hypertensive patients. Methods: Patients received SLT as primary, adjunctive or replacement therapy. Data were recorded up to 5.5 years after SLT treatment. Target pressure was defined as intraocular pressure at least 20% lowered. On exceeding the target pressure, patients received a second SLT. Primary outcome were the need and the time to redo the SLT. We examined differences between the groups (primary, replacement or adjunct SLT) and correlations between time and need to redo and pre-SLT parameters. Results: 108 patients (194 eyes) could be followed for at least 0.5 year and up to 4.5 years, with a mean follow up of 22.35 ± 18.94 months. Our population at start was a varied one; 34% of patients received primary SLT, 50% had replacement SLT, 16% had SLT as adjunctive treatment. These three groups showed no difference in evolution of IOP or medication in time. Time to redo varied, with a mean of 31.13 ± 11.24 months. Conclusion: We set out to have a general idea of how many patients could be expected to need a retreatment with SLT after a first successful SLT in a private clinic setting. In our population, the percentage of redo needed was 5.6% after 2 years, 35.4% after 3 years and 45.4% after 4 years. No differences could be measured with regard to the type of SLT performed nor could any significant correlation be found between need to redo and pre-SLT characteristics.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"27 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90731989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2155-9570.20.11.853
Koslowe Kc, L. Rozentzvaig, U. Yinon, M. Rosner
Background: The current concept of eye growth and emmetropization is thought to be dependent on visual stimulation of the mid-peripheral retinal cells. The aim of the current study was to examine whether damage to this part of the retinal tissue can affect the growth and function of the eye during development. Methods: We had two groups of domestic fowl chicks. One group was normal (N) and the other had a laser burn on 10% of the nasal retinal area of one eye. The optical components of the eye were examined by retinoscopy while physical measurements were made using ultrasonography and micrometry. The function of the retina was examined by standard flash ERG test. There were no differences in the refractive and the ultrasonographic results between the two groups. Results: The experimental group (right eye) showed a significant decrease in the amplitude and the latency results of both a and b wave compared to the other eye (left) and to the control group. However, there were no differences in the refractive and the ultrasonographic results between the two groups. Conclusion: This study found that the ERG in damaged eye was significantly affected by the laser as compared to that of control eye, while there was no difference in the refractive status and growth between the experimental and control groups. Therefore we concluded that burning only a 10% of the retina has no influence on the eye's growth or refractive development, notwithstanding the ensuing decrease in retinal function.
{"title":"The Involvement of the Retina in the Development of Myopia in a Model Eye of Chicks","authors":"Koslowe Kc, L. Rozentzvaig, U. Yinon, M. Rosner","doi":"10.35248/2155-9570.20.11.853","DOIUrl":"https://doi.org/10.35248/2155-9570.20.11.853","url":null,"abstract":"Background: The current concept of eye growth and emmetropization is thought to be dependent on visual stimulation of the mid-peripheral retinal cells. The aim of the current study was to examine whether damage to this part of the retinal tissue can affect the growth and function of the eye during development. Methods: We had two groups of domestic fowl chicks. One group was normal (N) and the other had a laser burn on 10% of the nasal retinal area of one eye. The optical components of the eye were examined by retinoscopy while physical measurements were made using ultrasonography and micrometry. The function of the retina was examined by standard flash ERG test. There were no differences in the refractive and the ultrasonographic results between the two groups. Results: The experimental group (right eye) showed a significant decrease in the amplitude and the latency results of both a and b wave compared to the other eye (left) and to the control group. However, there were no differences in the refractive and the ultrasonographic results between the two groups. Conclusion: This study found that the ERG in damaged eye was significantly affected by the laser as compared to that of control eye, while there was no difference in the refractive status and growth between the experimental and control groups. Therefore we concluded that burning only a 10% of the retina has no influence on the eye's growth or refractive development, notwithstanding the ensuing decrease in retinal function.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"70 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87219423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}