Pub Date : 2020-12-31DOI: 10.35119/ASJOO.V17I3.708
K. Myint, Ko Ko Shin Thant, Moe Thazin
Purpose: To describe a case of biopsy-confirmed bilateral orbital metastasis of previously undiagnosed hepatocellular carcinoma, presenting with bilateral proptosis. Case description: A 57-year-old man presented with painless bilateral proptosis over 2 months. At presentation, the best-corrected visual acuity was 20/60 in the right eye and 20/20 in the left eye. Ocular examination revealed bilateral asymmetrical non-axial proptosis with Hertel exophthalmometer reading of 24 mm in the right eye and 22 mm in the left eye. There was mild inferior displacement in both eyes. Apart from mild exposure keratopathy in the right eye, both anterior and posterior segment examinations were not remarkable. Orbital computerized tomography (CT) scan showed soft tissue masses in the superotemporal quadrants of both orbits associated with lytic bone lesions. An orbital biopsy confirmed that it was metastatic hepatocellular carcinoma (HCC). Ultrasound abdomen revealed multifocal HCC with underlying cirrhosis. We planned for further investigations such as hepatitis serology, alfa-fetoprotein, and CT abdomen, but he refused to proceed with investigations and treatment. Conclusion: Orbital metastasis, more so as a bilateral involvement, is a rare phenomenon. It may present as an initial manifestation of undiagnosed systemic cancer. Orbital metastasis should be considered when diagnosing patients with bilateral proptosis, and orbital biopsy is crucial for histopathological diagnosis.
{"title":"Bilateral orbital metastasis as an initial presentation of hepatocellular carcinoma","authors":"K. Myint, Ko Ko Shin Thant, Moe Thazin","doi":"10.35119/ASJOO.V17I3.708","DOIUrl":"https://doi.org/10.35119/ASJOO.V17I3.708","url":null,"abstract":"Purpose: To describe a case of biopsy-confirmed bilateral orbital metastasis of previously undiagnosed hepatocellular carcinoma, presenting with bilateral proptosis. \u0000Case description: A 57-year-old man presented with painless bilateral proptosis over 2 months. At presentation, the best-corrected visual acuity was 20/60 in the right eye and 20/20 in the left eye. Ocular examination revealed bilateral asymmetrical non-axial proptosis with Hertel exophthalmometer reading of 24 mm in the right eye and 22 mm in the left eye. There was mild inferior displacement in both eyes. Apart from mild exposure keratopathy in the right eye, both anterior and posterior segment examinations were not remarkable. Orbital computerized tomography (CT) scan showed soft tissue masses in the superotemporal quadrants of both orbits associated with lytic bone lesions. An orbital biopsy confirmed that it was metastatic hepatocellular carcinoma (HCC). Ultrasound abdomen revealed multifocal HCC with underlying cirrhosis. We planned for further investigations such as hepatitis serology, alfa-fetoprotein, and CT abdomen, but he refused to proceed with investigations and treatment. \u0000Conclusion: Orbital metastasis, more so as a bilateral involvement, is a rare phenomenon. It may present as an initial manifestation of undiagnosed systemic cancer. Orbital metastasis should be considered when diagnosing patients with bilateral proptosis, and orbital biopsy is crucial for histopathological diagnosis.","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":"17 1","pages":"302-310"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42895794","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 : 2020-12-31DOI: 10.35119/ASJOO.V17I3.800
Ben Limbu, B. Sim, M. Shrestha, G. Tabin, R. Saiju
Introduction: Many patients in Nepal travel vast distances to have their surgeries in Kathmandu. They often remain close by until their follow-up visit for their silicone tube removal, which contributes to a large financial burden on them and their families. Hence, reducing the time for which silicone tubes remain in situ following external dacryocystorhinostomy (DCR) provides significant benefits to patients. Furthermore, this is the first comparative study which has successfully demonstrated the earliest timeframe for which silicone tubes can be removed following DCR in the medical literature. Methods: A randomized controlled trial consisting of 144 patients was designed to compare patient outcomes after early (2 weeks postoperatively) versus standard (6 weeks postoperatively) removal of silicone stents. The success of their procedures was determined when patients were assessed both symptomatically and anatomically at their 6-month follow-up. Results: The surgical success in both groups was high at 97.8% collectively in both groups and there were only a small number of patients who were lost to follow-up (5 patients) at 6 months. There was no statistical difference at removing silicone stents at 2 or 6 weeks postoperatively. Conclusion: These results were consistent with our pilot study, which showed no statistical difference in long-term success following silicone tube removal at 2 and 6 weeks.
{"title":"Results of early versus standard silicone stent removal following external dacryocystorhinostomy under local anesthesia","authors":"Ben Limbu, B. Sim, M. Shrestha, G. Tabin, R. Saiju","doi":"10.35119/ASJOO.V17I3.800","DOIUrl":"https://doi.org/10.35119/ASJOO.V17I3.800","url":null,"abstract":"Introduction: Many patients in Nepal travel vast distances to have their surgeries in Kathmandu. They often remain close by until their follow-up visit for their silicone tube removal, which contributes to a large financial burden on them and their families. Hence, reducing the time for which silicone tubes remain in situ following external dacryocystorhinostomy (DCR) provides significant benefits to patients. Furthermore, this is the first comparative study which has successfully demonstrated the earliest timeframe for which silicone tubes can be removed following DCR in the medical literature. \u0000Methods: A randomized controlled trial consisting of 144 patients was designed to compare patient outcomes after early (2 weeks postoperatively) versus standard (6 weeks postoperatively) removal of silicone stents. The success of their procedures was determined when patients were assessed both symptomatically and anatomically at their 6-month follow-up. \u0000Results: The surgical success in both groups was high at 97.8% collectively in both groups and there were only a small number of patients who were lost to follow-up (5 patients) at 6 months. There was no statistical difference at removing silicone stents at 2 or 6 weeks postoperatively. \u0000Conclusion: These results were consistent with our pilot study, which showed no statistical difference in long-term success following silicone tube removal at 2 and 6 weeks.","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44579149","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 : 2020-12-31DOI: 10.35119/ASJOO.V17I3.887
C. Tan
{"title":"Never waste a good crisis: lessons from the COVID-19 pandemic","authors":"C. Tan","doi":"10.35119/ASJOO.V17I3.887","DOIUrl":"https://doi.org/10.35119/ASJOO.V17I3.887","url":null,"abstract":"","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41991202","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 : 2020-12-31DOI: 10.35119/ASJOO.V17I3.702
Arjit Mitra, D. Chaudhury, S. Choudhury, Suchanda Sar, SM Ghosh
A 50-year-old woman presented with conjunctival melanosis, scleral pigmentation, and Lisch nodules in her left eye. Intraocular pressure was 24 mmHg in the right eye and 14 mmHg in the left eye. She had open angles on gonioscopy. Fundus examination showed a cup-to-disc ratio of 0.7 in the right eye, with an inferior notch and a splinter hemorrhage, and 0.6 in the left eye, with a deep cup with sloping rims. Humphrey visual fields showed an evolving superior arcuate scotoma in her right eye; the left eye was normal. Systemic examination showed axillary freckling. The patient had a family history of neurofibromatosis type 1 (NF-1), her father having been diagnosed with the condition. She had hyperpigmentation of the skin over the forehead and periocular skin on the left side. These unique ocular and systemic features were suggestive of two phakomatoses, NF-1 and nevus of Ota, in one eye, and primary open-angle glaucoma (POAG) in the other eye. that is, three pathologies present together in the same individual, which is an extremely rare occurrence.
{"title":"Multiple phakomatoses and primary open-angle glaucoma in one individual","authors":"Arjit Mitra, D. Chaudhury, S. Choudhury, Suchanda Sar, SM Ghosh","doi":"10.35119/ASJOO.V17I3.702","DOIUrl":"https://doi.org/10.35119/ASJOO.V17I3.702","url":null,"abstract":"A 50-year-old woman presented with conjunctival melanosis, scleral pigmentation, and Lisch nodules in her left eye. Intraocular pressure was 24 mmHg in the right eye and 14 mmHg in the left eye. She had open angles on gonioscopy. Fundus examination showed a cup-to-disc ratio of 0.7 in the right eye, with an inferior notch and a splinter hemorrhage, and 0.6 in the left eye, with a deep cup with sloping rims. Humphrey visual fields showed an evolving superior arcuate scotoma in her right eye; the left eye was normal. Systemic examination showed axillary freckling. The patient had a family history of neurofibromatosis type 1 (NF-1), her father having been diagnosed with the condition. She had hyperpigmentation of the skin over the forehead and periocular skin on the left side. These unique ocular and systemic features were suggestive of two phakomatoses, NF-1 and nevus of Ota, in one eye, and primary open-angle glaucoma (POAG) in the other eye. that is, three pathologies present together in the same individual, which is an extremely rare occurrence.","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":"17 1","pages":"290-301"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44527257","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 : 2020-12-31DOI: 10.35119/ASJOO.V17I3.753
R. Natarajan, A. Harwani, Ramya Ravindran
We hereby report two cases of the emerging and devastating Pythium keratitis for their different presentations, prolonged clinical course, and suspicion of recurrence after therapeutic penetrating keratoplasty (TPK). The history, clinical presentation, investigations including smears, cultures, polymerase chain reaction (PCR) and confocal microscopy, the tumultuous course of the infection, and outcome of TPK have been discussed for two cases having this unusual and severe emerging infection. These two cases demonstrate that Pythium keratitis can present as a central reticular or peripheral guttering corneal ulcer with dense infiltration. PCR is a valuable tool for diagnosis. Pythium keratitis has a severe and prolonged clinical course. Response to antibiotics is modest and needs to be closely monitored. It can present with inflammation after TPK that mimics the dreaded recurrence of the infection. Pythium keratitis presents variably and can be suspected from typical clinical and microbiological findings. It needs protracted treatment with close follow-up. Although the infection is known torecur in the therapeutic graft, not all recurrences are what they seem.
{"title":"Pythium keratitis: clinical course of an emerging scourge","authors":"R. Natarajan, A. Harwani, Ramya Ravindran","doi":"10.35119/ASJOO.V17I3.753","DOIUrl":"https://doi.org/10.35119/ASJOO.V17I3.753","url":null,"abstract":"We hereby report two cases of the emerging and devastating Pythium keratitis for their different presentations, prolonged clinical course, and suspicion of recurrence after therapeutic penetrating keratoplasty (TPK). The history, clinical presentation, investigations including smears, cultures, polymerase chain reaction (PCR) and confocal microscopy, the tumultuous course of the infection, and outcome of TPK have been discussed for two cases having this unusual and severe emerging infection. These two cases demonstrate that Pythium keratitis can present as a central reticular or peripheral guttering corneal ulcer with dense infiltration. PCR is a valuable tool for diagnosis. Pythium keratitis has a severe and prolonged clinical course. Response to antibiotics is modest and needs to be closely monitored. It can present with inflammation after TPK that mimics the dreaded recurrence of the infection. Pythium keratitis presents variably and can be suspected from typical clinical and microbiological findings. It needs protracted treatment with close follow-up. Although the infection is known torecur in the therapeutic graft, not all recurrences are what they seem.","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41884045","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 : 2020-12-31DOI: 10.35119/ASJOO.V17I3.816
V. Murumkar, Karthik Kulanthaivelu, Sheetal Goyal, S. Biswas
Background: Orbital cellulitis is characterized by the infective inflammation of orbital structures, usually posterior to the orbital septum. Extension of infection from the paranasal sinuses is the most common etiology for orbital cellulitis. Intracranial complications of orbital cellulitis include meningitis, subdural empyema, brain abscess, and cavernous sinus thrombosis. Case presentation: A 33-year-old man presented with acute onset of foul-smelling mucopurulent nasal discharge and swelling of the left eye followed by altered sensorium. On examination of the left eye, chemosis, eyelid edema, and proptosis were present. Computed tomography (CT) of the brain revealed non-axial left proptosis with inflammatory reticulation in the intra- and extraconal fat alongside sinusitis. Magnetic resonance imaging of the brain confirmed the CT findings and additionally showed meningitis and subdural empyema along the left frontoparietal convexity with parenchymal signal changes, suggesting venous infarction in the left frontal lobe. Susceptibility weighted imaging (SWI) confirmed thrombus in the frontal polar vein on the left side, suggesting septic isolated septic cortical venous thrombosis (ICVT) as a complication of orbital cellulitis. Cerebrospinal fluid showed polymorphonuclear cell pleocytosis with elevated protein and lowered sugar. Blood and conjunctival swab cultures were negative. He was subsequently treated with intravenous broad-spectrum antibiotics and antifungals to which he responded and was discharged in stable condition. Conclusions: Our case highlights the presentation of septic ICVT complicating orbital cellulitis and paranasal sinusitis. It also underscores the higher sensitivity of SWI as a crucial tool in diagnosing ICVT. Appropriate and prompt medical treatment in orbital cellulitis can prevent further complications.
{"title":"Isolated cortical vein thrombosis complicating orbital cellulitis","authors":"V. Murumkar, Karthik Kulanthaivelu, Sheetal Goyal, S. Biswas","doi":"10.35119/ASJOO.V17I3.816","DOIUrl":"https://doi.org/10.35119/ASJOO.V17I3.816","url":null,"abstract":"Background: Orbital cellulitis is characterized by the infective inflammation of orbital structures, usually posterior to the orbital septum. Extension of infection from the paranasal sinuses is the most common etiology for orbital cellulitis. Intracranial complications of orbital cellulitis include meningitis, subdural empyema, brain abscess, and cavernous sinus thrombosis. \u0000Case presentation: A 33-year-old man presented with acute onset of foul-smelling mucopurulent nasal discharge and swelling of the left eye followed by altered sensorium. On examination of the left eye, chemosis, eyelid edema, and proptosis were present. Computed tomography (CT) of the brain revealed non-axial left proptosis with inflammatory reticulation in the intra- and extraconal fat alongside sinusitis. Magnetic resonance imaging of the brain confirmed the CT findings and additionally showed meningitis and subdural empyema along the left frontoparietal convexity with parenchymal signal changes, suggesting venous infarction in the left frontal lobe. Susceptibility weighted imaging (SWI) confirmed thrombus in the frontal polar vein on the left side, suggesting septic isolated septic cortical venous thrombosis (ICVT) as a complication of orbital cellulitis. Cerebrospinal fluid showed polymorphonuclear cell pleocytosis with elevated protein and lowered sugar. Blood and conjunctival swab cultures were negative. He was subsequently treated with intravenous broad-spectrum antibiotics and antifungals to which he responded and was discharged in stable condition. \u0000Conclusions: Our case highlights the presentation of septic ICVT complicating orbital cellulitis and paranasal sinusitis. It also underscores the higher sensitivity of SWI as a crucial tool in diagnosing ICVT. Appropriate and prompt medical treatment in orbital cellulitis can prevent further complications.","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45624235","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 : 2020-12-31DOI: 10.35119/ASJOO.V17I3.755
K. I. Tiong, A. ShiivaaManjare, P. Birapadian
The purpose of this paper is to illustrate a case of large conjunctival nevus in a 10-year-old boy which was successfully treated with surgical excision and amniotic membrane transplant (AMT) reconstruction. The conjunctival nevus was initially noticed by the parents 1 year prior to presentation; they reported it had increased in size over the past 3 months. Slit-lamp examination revealed a pigmented conjunctival nevus measuring 5.5 mm vertically and 6.5 mm horizontally, with well-demarcated margins and presence of an intralesional cyst at the temporal bulbar conjunctiva, involving the limbus and encroaching onto the cornea. Complete resection of the conjunctival lesion and bulbar conjunctival reconstruction were performed. The histopathological examination showed conjunctival nevus. The wound healed well with vision of 6/6 and no recurrence. Surgical resection combined with AMT is a successful and an effective way to treat conjunctivalnevus.
{"title":"Successful surgical management of large conjunctival nevus in a 10-year-old child with resection and amniotic membrane transplantation","authors":"K. I. Tiong, A. ShiivaaManjare, P. Birapadian","doi":"10.35119/ASJOO.V17I3.755","DOIUrl":"https://doi.org/10.35119/ASJOO.V17I3.755","url":null,"abstract":"The purpose of this paper is to illustrate a case of large conjunctival nevus in a 10-year-old boy which was successfully treated with surgical excision and amniotic membrane transplant (AMT) reconstruction. The conjunctival nevus was initially noticed by the parents 1 year prior to presentation; they reported it had increased in size over the past 3 months. Slit-lamp examination revealed a pigmented conjunctival nevus measuring 5.5 mm vertically and 6.5 mm horizontally, with well-demarcated margins and presence of an intralesional cyst at the temporal bulbar conjunctiva, involving the limbus and encroaching onto the cornea. Complete resection of the conjunctival lesion and bulbar conjunctival reconstruction were performed. The histopathological examination showed conjunctival nevus. The wound healed well with vision of 6/6 and no recurrence. Surgical resection combined with AMT is a successful and an effective way to treat conjunctivalnevus.","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":"17 1","pages":"324-328"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47210646","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 : 2020-12-31DOI: 10.35119/ASJOO.V17I3.720
P. Donthineni, S. Murthy, J. Joseph, P. Garg, Manisha Acharya, V. Sangwan
We report three cases of bilateral microsporidial keratitis, which is an unusual presentation. All three patients presented with bilateral, simultaneous, asymmetrical, deep stromal corneal infiltrates with symptoms ranging from 5 to 12 months. Predisposing factors were noted in two of three patients. Corneal scrapings for microbiology and histopathology of corneal tissue revealed microsporidial spores from both eyes of all patients. There was no response to medical therapy and all underwent bilateral corneal transplantation. Case one additionally had recurrences in the graft and underwent repeat keratoplasties and eventually keratoprosthesis. Microsporidial stromal keratitis is a possible cause of keratitis in cases of very long-standing, indolent, culture-negative, deep stromal corneal infiltrates. So far, this infection has been reported as unilateral; however, we report these cases of bilateral infection, which is rare. Corneal transplantation is the preferred line of management due to lack of response to medical therapy.
{"title":"Microsporidial stromal keratitis: an uncommon etiology of bilateral simultaneous corneal infection","authors":"P. Donthineni, S. Murthy, J. Joseph, P. Garg, Manisha Acharya, V. Sangwan","doi":"10.35119/ASJOO.V17I3.720","DOIUrl":"https://doi.org/10.35119/ASJOO.V17I3.720","url":null,"abstract":"We report three cases of bilateral microsporidial keratitis, which is an unusual presentation. All three patients presented with bilateral, simultaneous, asymmetrical, deep stromal corneal infiltrates with symptoms ranging from 5 to 12 months. Predisposing factors were noted in two of three patients. Corneal scrapings for microbiology and histopathology of corneal tissue revealed microsporidial spores from both eyes of all patients. There was no response to medical therapy and all underwent bilateral corneal transplantation. Case one additionally had recurrences in the graft and underwent repeat keratoplasties and eventually keratoprosthesis. Microsporidial stromal keratitis is a possible cause of keratitis in cases of very long-standing, indolent, culture-negative, deep stromal corneal infiltrates. So far, this infection has been reported as unilateral; however, we report these cases of bilateral infection, which is rare. Corneal transplantation is the preferred line of management due to lack of response to medical therapy.","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":"17 1","pages":"311-317"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42835386","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 : 2020-12-31DOI: 10.35119/ASJOO.V17I3.845
Rachel Xuan, K. Ong
The aim of this retrospective study was to evaluate whether intraocular (IOP) elevation post-cataract surgery can be reduced by using tropicamide and phenylephrine only, without cyclopentolate. Medical records across two surgical facilities were analyzed. One surgical facility (Cohort A) used a combination of tropicamide, cyclopentolate, and phenylephrine preoperatively, while the other (Cohort B) used tropicamide and phenylephrine only. Of patients in Cohort A, 63.6% (n = 7) had a higher IOP in the operated eye, while it was only 27.3% (n = 3) in Cohort B. Therefore, it is preferable to exclude the use of cyclopentolate in the preoperative dilation regimen of patients undergoing cataract surgery. However, a study with a larger sample population is required to further evaluate the significance of these results.
{"title":"Using tropicamide and phenylephrine without cyclopentolate for pupil dilation in cataract surgery reduces postoperative intraocular pressure rise","authors":"Rachel Xuan, K. Ong","doi":"10.35119/ASJOO.V17I3.845","DOIUrl":"https://doi.org/10.35119/ASJOO.V17I3.845","url":null,"abstract":"The aim of this retrospective study was to evaluate whether intraocular (IOP) elevation post-cataract surgery can be reduced by using tropicamide and phenylephrine only, without cyclopentolate. Medical records across two surgical facilities were analyzed. One surgical facility (Cohort A) used a combination of tropicamide, cyclopentolate, and phenylephrine preoperatively, while the other (Cohort B) used tropicamide and phenylephrine only. Of patients in Cohort A, 63.6% (n = 7) had a higher IOP in the operated eye, while it was only 27.3% (n = 3) in Cohort B. Therefore, it is preferable to exclude the use of cyclopentolate in the preoperative dilation regimen of patients undergoing cataract surgery. However, a study with a larger sample population is required to further evaluate the significance of these results.","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48890433","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 : 2020-04-30DOI: 10.35119/ASJOO.V17I2.575
Kalpa Negiloni, R. George, S. Sudharshan, Shwetha Tripathi
A 50-year-old female presented with profound vision loss and was previously advised injection Ozurdex in the left eye. In the left eye, the anterior chamber was quiet, intraocular pressure (IOP) was 58 mmHg and cataractous changes were noted with Ozurdex implant inside the lens substance. The left eye had glaucomatous cupping (0.9:1 CDR), bipolar rim thinning, inferior notch and healed choroiditis. The patient underwent phacoemulsification, trabeculectomy and mitomycin-C in the left eye. Visual acuity improved and IOP was under control. Although Ozurdex is effective, there are reports of complications related to the drug and implantation procedure. This case highlights an uncommon complication of an uncontrolled, persistent steroid response leading to glaucomatous optic atrophy and profound vision loss due to an accidental intralenticular implantation of Ozurdex. Our case reinforces the need for caution about the decision regarding the judicious use of intravitreal steroids and employment of appropriate technique.
{"title":"Successful management of intralenticular Ozurdex injection causing cataract and intractable glaucoma","authors":"Kalpa Negiloni, R. George, S. Sudharshan, Shwetha Tripathi","doi":"10.35119/ASJOO.V17I2.575","DOIUrl":"https://doi.org/10.35119/ASJOO.V17I2.575","url":null,"abstract":"A 50-year-old female presented with profound vision loss and was previously advised injection Ozurdex in the left eye. In the left eye, the anterior chamber was quiet, intraocular pressure (IOP) was 58 mmHg and cataractous changes were noted with Ozurdex implant inside the lens substance. The left eye had glaucomatous cupping (0.9:1 CDR), bipolar rim thinning, inferior notch and healed choroiditis. The patient underwent phacoemulsification, trabeculectomy and mitomycin-C in the left eye. Visual acuity improved and IOP was under control. Although Ozurdex is effective, there are reports of complications related to the drug and implantation procedure. This case highlights an uncommon complication of an uncontrolled, persistent steroid response leading to glaucomatous optic atrophy and profound vision loss due to an accidental intralenticular implantation of Ozurdex. Our case reinforces the need for caution about the decision regarding the judicious use of intravitreal steroids and employment of appropriate technique.","PeriodicalId":39864,"journal":{"name":"Asian Journal of Ophthalmology","volume":"17 1","pages":"216-221"},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42521552","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}
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