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Oman Journal of Ophthalmology 2023We report a case of unilateral traumatic vitreous hemorrhage following injury to the anterior cranium. A 55-year-old female presented with gradual loss of vision in her...
We report a case of unilateral traumatic vitreous hemorrhage following injury to the anterior cranium. A 55-year-old female presented with gradual loss of vision in her left eye following trauma to the anterior cranium. Funduscopy revealed fresh vitreous hemorrhage. Conservative management was futile with further visual deterioration over the next 2 weeks. During pars plana vitrectomy, fresh retinal hemorrhages were noted along the superotemporal (ST) vein suggesting bleed due to vein rupture. Postoperative fundus fluorescein angiography indicated ST branch retinal vein occlusion. Since trauma can be an inciting factor for both, this case could be a variant of Terson's syndrome.
PubMed: 38059082
DOI: 10.4103/ojo.ojo_5_23 -
International Journal of Ophthalmology 2023To improve the standard three-port vitrectomy for establishing and evaluating an endotamponade model in rabbits.
AIM
To improve the standard three-port vitrectomy for establishing and evaluating an endotamponade model in rabbits.
METHODS
Three ports were prepared near the third eyelid of rabbits, and the infusion port was placed at the inferior nasal quadrant with the inserted cannula linking with a self-designed handheld rigid infusion catheter. All right eyes of rabbits underwent a modified 25-gauge vitrectomy and were subsequently filled with balanced salt solution, silicone oil, and eight-arm polyethylene glycols (8-arm PEGs) hydrogel separately for comparison. Ophthalmic examinations were performed regularly to record the changes after the surgery.
RESULTS
Successful vitrectomy was achieved among 44 chinchilla rabbits. The mean operation time was 4.51±1.25min. Four eyes (9.1%) presented limited lens touch and two eyes (4.5%) showed retinal touch during surgery. Incision leakage was found in three eyes (6.8%) after surgery. There was no endophthalmitis, hemorrhage, or retinal detachment during the observation period and ophthalmic examinations after the implantation of vitreous substitutes.
CONCLUSION
The modified technique of the standard vitrectomy applied in the endotamponade model in rabbits shows excellent safety and practicality.
PubMed: 37854378
DOI: 10.18240/ijo.2023.10.02 -
Medical Science Monitor : International... Dec 2023BACKGROUND Glaucoma, a vision-threatening condition, results from optic nerve damage and affects millions of people worldwide. Often asymptomatic, it is hereditary, with...
BACKGROUND Glaucoma, a vision-threatening condition, results from optic nerve damage and affects millions of people worldwide. Often asymptomatic, it is hereditary, with risk factors like hypertension, diabetes, and steroid use. Despite its link with intraocular pressure (IOP), not everyone with high IOP develops glaucoma. After pars plana vitrectomy (PPV), patients face increased IOP risks. Traditional treatment includes pharmacotherapy, and, when ineffective, surgical interventions. Continuous-wave transscleral cyclophotocoagulation (CW-TSCPC) is an alternative for refractory glaucoma but can have complications. Our study compares the efficacy and safety of CW-TSCPC after PPV. MATERIAL AND METHODS The study group consisted of 18 patients diagnosed with glaucoma who underwent the CW-TSCP procedure as the first-choice therapy after conservative treatment of glaucoma proved ineffective. The comparison group consisted of 12 patients who underwent the CW-TSCP procedure after conservative drug treatment and in whom surgical treatment of glaucoma had been unsuccessful. All patients had inadequate control of IOP after PPV. RESULTS Study and comparison group patients showed a decrease in IOP during the follow-up, independent of the type of endotamponade used (P<0.05). When the indication for PPV was retinal detachment hemorrhage into the vitreous chamber, a significant decrease in IOP between 0 days and 180 days was only found in the study group (P<0.05). In contrast, when the indication for PPV was the state after uveitis or proliferative diabetic retinopathy, a significant decrease in IOP was found at 180 days in the study and comparison groups (P<0.05). CONCLUSIONS The analysis showed that the CW-TSCPC procedure can be recommended as the first-choice invasive treatment in patients with increased IOP after PPV.
Topics: Humans; Retrospective Studies; Vitrectomy; Poland; Glaucoma; Intraocular Pressure; Treatment Outcome; Laser Coagulation
PubMed: 38130054
DOI: 10.12659/MSM.941770 -
Indian Journal of Ophthalmology Jan 2024In manual small incision cataract surgery (MSICS), the occurrence of intraoperative complications is a recognized concern that can impact both surgical outcomes and...
BACKGROUND
In manual small incision cataract surgery (MSICS), the occurrence of intraoperative complications is a recognized concern that can impact both surgical outcomes and patient safety. MSICS is widely practiced as a cost-effective alternative for cataract extraction, especially in resource-limited settings where access to phacoemulsification may be limited. However, it is important to acknowledge that MSICS is not entirely risk-free. Complications during the surgery can arise due to factors such as surgeon experience, surgical technique, instrument handling, and patient-specific anatomical variations. Common complications encountered in MSICS include posterior capsule rupture, corneal burns, iris trauma, wound-related issues, vitreous loss, and anterior chamber hemorrhage. It is crucial for surgeons to have a comprehensive understanding of the background and potential risks associated with these complications. This knowledge allows them to proactively implement preventive strategies, optimize surgical outcomes, and prioritize patient safety during MSICS procedures. Ongoing efforts in the field of cataract surgery aim to improve outcomes by advancing surgical techniques, refining equipment, and enhancing postoperative care. Through research and innovation, the goal is to minimize complications and achieve optimal visual outcomes for individuals undergoing cataract surgery.
PURPOSE
This video discusses the possible complications and provides practical strategies to minimize the same at each step of the MSICS procedure.
SYNOPSIS
The video demonstrates the potential complications that can occur intraoperatively during MSICS and highlights the significance of careful technique and practical strategies for prevention.
HIGHLIGHTS
In resource-poor settings, MSICS is widely used as the predominant technique for cataract surgeries. Despite being a cost-effective alternative, MSICS offers comparable visual outcomes to phacoemulsification with low complication rates. This video emphasizes the importance of proactive measures and careful technique in preventing complications, thereby improving patient safety and outcomes in MSICS.
VIDEO LINK
https://youtu.be/hOAMJpC67C0.
Topics: Humans; Visual Acuity; Cataract Extraction; Phacoemulsification; Intraoperative Complications; Surgical Wound; Cataract
PubMed: 38131599
DOI: 10.4103/IJO.IJO_1710_23 -
Retina (Philadelphia, Pa.) Dec 2023To report the results of a novel surgical four-point transscleral suture fixation of intraocular lens (IOL) with four hollow haptics using the double-suture technique.
PURPOSE
To report the results of a novel surgical four-point transscleral suture fixation of intraocular lens (IOL) with four hollow haptics using the double-suture technique.
METHODS
We retrospectively reviewed the medical records of 15 eyes of 15 patients who underwent 4-point transscleral suture fixation of a foldable IOL using the double-suture technique. Preoperative data and follow-up data for at least 4 months were collected for all patients.
RESULTS
The IOLs were fixed and centered well. The mean preoperative corrected distance visual acuity was 0.70 ± 0.54 logarithm of the minimum angle of resolution (Snellen 20/102), and it improved to 0.29 ± 0.26 logarithm of the minimum angle of resolution (Snellen 20/39) at the final follow-up ( P = 0.001). No vitreous hemorrhage, hypotony, suture breakage, retinal detachment, IOL dislocation, and iris capture was detected during the follow-up period in any of the patients.
CONCLUSION
We have developed a novel technique for 4-point transscleral suture fixation of IOL using the double-suture technique with 9-0 polypropylene suture. This technique seemed to be safe and it may not require the surgeon to learn any new technique.
Topics: Humans; Lens Implantation, Intraocular; Polypropylenes; Retrospective Studies; Lenses, Intraocular; Sclera; Suture Techniques; Sutures
PubMed: 35982505
DOI: 10.1097/IAE.0000000000003601 -
Diabetes, Metabolic Syndrome and... 2023[This corrects the article DOI: 10.2147/DMSO.S429938.].
[This corrects the article DOI: 10.2147/DMSO.S429938.].
PubMed: 37849979
DOI: 10.2147/DMSO.S443845 -
Cureus Oct 2023We report on a case of Purtscher-like retinopathy (PLR) secondary to systemic lupus erythematosus, which caused retinal ischemia, retinal neovascularization, vitreous...
We report on a case of Purtscher-like retinopathy (PLR) secondary to systemic lupus erythematosus, which caused retinal ischemia, retinal neovascularization, vitreous hemorrhage, and, ultimately, a combined tractional and rhegmatogenous retinal detachment. A 23-year-old male presented with decreased visual acuity in the left eye (OS). He had a recent history of systemic lupus erythematosus and was being treated with systemic corticosteroids. At presentation, his visual acuity was counting fingers in the OS; a fundus examination of the OS revealed the presence of macular edema associated with flame hemorrhages, diffuse cotton-wool spots surrounding the macula, and vascular sheathing with the retina attached, all of which were consistent with PLR. Five months later, his fundus examination (OS) showed severe retinal ischemia and active neovascularization. The patient was scheduled for pan-retinal photocoagulation (PRP) laser therapy, but he was lost to follow-up. Subsequently, he returned two months later with progressive damage and was treated with PRP in the OS. An additional two months after PRP treatment, an examination revealed combined tractional and rhegmatogenous retinal detachment. Ultimately, the patient required a pars plana vitrectomy.
PubMed: 38021720
DOI: 10.7759/cureus.47837 -
Indian Journal of Ophthalmology Jan 2024To analyze the outcome of intervention versus observation for vitreous cavity hemorrhage occurring after a 2-month period of blood-free cavity (late postoperative... (Observational Study)
Observational Study
PURPOSE
To analyze the outcome of intervention versus observation for vitreous cavity hemorrhage occurring after a 2-month period of blood-free cavity (late postoperative vitreous cavity hemorrhage-POVCH) in eyes operated by vitrectomy for complications of proliferative diabetic retinopathy (PDR).
METHODS
This study was a 10-year retrospective, observational, multi-center study involving eight major vitreoretinal surgical centers across India from January 2010 to December 2019. The primary objective of the study was to assess the visual and clinical outcomes of various management approaches for late POVCH. The key secondary objective was to determine the best management option that prevented recurrence. Patients with follow-up of less than 6 months of POVCH management were excluded.
RESULTS
The occurrence of late POVCH was studied in 261 eyes. The median time to occurrence was 7 months (range: 2-87) postvitrectomy/silicone oil removal. The majority (58%) experienced a single, nonrecurring POVCH event. Visual acuity outcome was independent of all management approaches (P = 0.179; mean follow-up 20.7 ± 14.1 months). With watchful observation, spontaneous resolution was noted in 83% (60/72 eyes) of eyes in 81.5 days (interquartile range, 169.75). Silicone oil injection was most effective in preventing recurrence (P < 0.001).
CONCLUSION
The current treatment practice of late POVCH management in PDR suggests that watchful observation for at least 3 months could be as efficacious as any surgical intervention.
Topics: Humans; Vitrectomy; Diabetic Retinopathy; Retrospective Studies; Silicone Oils; Vitreous Hemorrhage; Postoperative Complications; Postoperative Hemorrhage; Diabetes Mellitus
PubMed: 38131537
DOI: 10.4103/IJO.IJO_311_23 -
International Ophthalmology Feb 2024The most common retinal complications after glaucoma surgery are choroidal detachment, hypotony maculopathy, malignant glaucoma, vitreous hemorrhage, endophthalmitis and...
BACKGROUND
The most common retinal complications after glaucoma surgery are choroidal detachment, hypotony maculopathy, malignant glaucoma, vitreous hemorrhage, endophthalmitis and retinal detachment. However, if glaucoma surgery is a risk factor for the ERM development needs to be clarified. This study aims to assess the incidence of epiretinal membrane (ERM) in 2 years of follow-up in patients with primary open-angle glaucoma (POAG) treated with Ex-Press shunt implant.
METHODS
A prospective, consecutive, single-center, case-control study. We enrolled patients affected by POAG and scheduled for Ex-Press device implant with or without concomitant cataract surgery. The control group was the contralateral eyes which continues anti-glaucomatous eyedrops. Complete ophthalmologic evaluation and spectral-domain optical coherence tomography were performed before surgery, at 6 months and 24 months of follow-up.
RESULTS
Eighty-two eyes of 41 consecutive patients, 18 males and 23 females with a mean age of 70, 29 ± 8,45, were analyzed at 24 months. 39.1% of eyes developed ERM: 29.3% were cellophane macular reflex (CMR) and 9.8% were pre-macular fibrosis (PMF). In the control group, 19.5% of eyes developed ERM: 17.1% were CMR and 2.4% were PMF. No statistically significant difference was reported (p = 0.121) between treated and control group. ERM development did not affect significantly the central foveal thickness (260.13 ± 35.01 μm at baseline, 265.03 ± 34.90 μm at 6 months and 275.18 ± 33.31 μm at 24 months) and macular volume (7.75 ± 0.43 mm at baseline, 7.77 ± 0.48 mm at 6 months and 7.77 ± 0.46 mm at 24 months), remained comparable to reported average measures in healthy individuals during the follow-up. Concomitant cataract surgery did not increase the ERM incidence.
CONCLUSION
Ex-Press implant may increase the ERM incidence regardless concomitant cataract surgery, accelerating or inducing a posterior vitreous detachment, such as other ocular surgical procedure. Nevertheless, the vast majority of ERM are CMR, not affecting the macular profile.
Topics: Male; Female; Humans; Infant, Newborn; Epiretinal Membrane; Case-Control Studies; Glaucoma, Open-Angle; Prospective Studies; Retrospective Studies; Glaucoma; Tomography, Optical Coherence; Cataract
PubMed: 38367121
DOI: 10.1007/s10792-024-02958-5 -
Scientific Reports Mar 2024We evaluated the distribution and types of retinal hemorrhages (RHs) and other damages in eyes with abusive head trauma (AHT). This retrospective, consecutive case...
We evaluated the distribution and types of retinal hemorrhages (RHs) and other damages in eyes with abusive head trauma (AHT). This retrospective, consecutive case series of AHT and non-AHT conditions involved 54 children with AHT, 43 children with head bruises, and 49 children with blunt eye trauma, each of non-AHT supported by reliable witness accounts. RHs and other damage were evaluated using ophthalmoscopy and wide-field fundus photography. A variety of RH types and other damage were identified in the AHT group but not in the non-AHT group. RHs in AHT extended from the posterior pole to the far periphery in 77% of eyes and on/near the veins in 86% and arteries in 85%, most of which were in the far periphery. Retinoschisis, white-dot lesions, and retinal folds were seen even in the far periphery. RHs on/near the veins and arteries, retinoschisis, and retinal folds suggest a traumatic mechanism of the tractional force of the vitreous that is attached to the entire retinal surface. Identifying the distribution and arterio and venous origins of RHs is a key factor in determining the association with trauma. Thus, wide-field fundus photography is useful to record and evaluate the origin of the RHs and other retinal damage.
Topics: Child; Humans; Retinal Hemorrhage; Retinoschisis; Retrospective Studies; Craniocerebral Trauma; Retinal Diseases; Eye Injuries; Retina
PubMed: 38438406
DOI: 10.1038/s41598-024-54664-y