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Journal of Refractive Surgery... May 2024To discuss factors influencing corneal aberrations that might influence the optical quality after intraocular lens (IOL) implantation. (Review)
Review
PURPOSE
To discuss factors influencing corneal aberrations that might influence the optical quality after intraocular lens (IOL) implantation.
METHODS
PubMed and Scopus were the main resources used to search the medical literature. An extensive search was performed to identify relevant articles concerning factors influencing the level of corneal aberrations as of August 27, 2023. The following keywords were used in various combinations: corneal, aberrations, defocus, astigmatism, spherical aberration, coma, trefoil, quadrafoil, intraocular lens, and IOL.
RESULTS
Conclusive evidence is lacking regarding the correlation between age and changes in corneal aberrations. Patients with astigmatism have greater corneal higher-order aberrations than those with minimal astigmatism, particularly concerning trefoil and coma. Increased levels of corneal higher-order aberrations are noted following contact lens wear, in patients with dry eye disease, and with pterygium. Increased higher-order aberrations have been reported following corneal refractive surgery and for 3 months following trabeculectomy; regarding intraocular lens surgery, the results remain controversial.
CONCLUSIONS
Several factors influence the level of corneal higher-order aberrations. Multifocal and extended depth-of-focus IOLs can share similarities in their optical properties, and the main difference arises in their design and performance with respect to spherical aberration. Preoperative evaluation is critical for proper IOL choice, particularly in corneas with risk of high levels of aberrations. .
Topics: Humans; Corneal Wavefront Aberration; Risk Factors; Lens Implantation, Intraocular; Visual Acuity; Refraction, Ocular; Multifocal Intraocular Lenses; Depth Perception; Corneal Topography; Cornea
PubMed: 38848055
DOI: 10.3928/1081597X-20240416-01 -
Indian Journal of Dermatology,... May 2024
PubMed: 38841935
DOI: 10.25259/IJDVL_77_2024 -
Journal of Medical Physics 2024Beta irradiation after bare scleral surgery of primary pterygium is an effective and safe treatment, which reduces the risk of local recurrence.
INTRODUCTION
Beta irradiation after bare scleral surgery of primary pterygium is an effective and safe treatment, which reduces the risk of local recurrence.
PURPOSE
Obtaining the reference dose rate for a radioactive applicator consisting of a plate as a 32P absorber, a steel window and a steel capsule.
METHODS
Relative dosimetry and dose profile were measured using two types of radiochromic films, HD-810 and EBT1, for the P applicator and were compared with Monte Carlo simulation data. Dose uniformity in the P applicator was obtained with radiochromic HD-810 film.
RESULTS
The measurement depth dose distribution data at distances up to 3.8 mm were compared with calculation data, and the values were not found to differ statistically. Depth dose distribution with a large dose gradient was determined and the dose rate data obtained 0.0053 ± 9.9% in unit of Gy/s.mCi at a 0.1 mm depth distance. Practical results indicated that the dose nonuniformity and the maximum symmetrical for the P applicator were 11.5% and 9.2%, respectively.
CONCLUSIONS
Our experiments show that the use of the radiochromic film to perform the relative dosimetric checks is feasible and the activity value with acceptable error can be determined through this indirect method.
PubMed: 38828074
DOI: 10.4103/jmp.jmp_99_23 -
Asian Journal of Surgery May 2024
PubMed: 38811329
DOI: 10.1016/j.asjsur.2024.05.086 -
Cornea May 2024The aim of this study was to evaluate Viscoll collagen membrane (VCM) for lamellar keratoplasty.
PURPOSE
The aim of this study was to evaluate Viscoll collagen membrane (VCM) for lamellar keratoplasty.
METHODS
A 54-year-old man with grade 4 recurrent pterygium underwent lamellar keratoplasty using VCM as the graft material. Standard keratoplasty postoperative treatments, including topical antibiotic-corticosteroid and artificial tears, were administered.
RESULTS
Complete graft epithelialization was achieved after 4 days of the surgery. Follow-up at 9 months showed no pterygium recurrence as well as good integration of the VCM graft into the surrounding tissues with preserved transparency.
CONCLUSIONS
This case demonstrated that VCM possesses great potential as an alternative to the human donor cornea for lamellar keratoplasty; however, the application of VCM for lamellar keratoplasty still needs additional evaluation.
PubMed: 38780428
DOI: 10.1097/ICO.0000000000003583 -
International Journal of Ophthalmology 2024To report a technique used with intermittent sliding-lock-knot (ISLK) fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine...
AIM
To report a technique used with intermittent sliding-lock-knot (ISLK) fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent (RI) fixation.
METHODS
Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed. Primary outcome measures were mean duration of surgery and suture removal, degree of conjunctival hyperemia on postoperative day 1, pain score at suture removal, postoperative symptoms at 6mo, including conjunctival hyperemia, foreign body sensation, and graft stability.
RESULTS
Ninety-eight patients underwent monocular surgery and were divided into ISLK (51 eyes) and RI (47 eyes) groups according to the type of conjunctiva autograft fixation method planned. There was no significant difference in mean duration of surgery between the two groups (18.59±2.39min 18.15±2.20min, =0.417); however, compared to the RI group, shorter suture removal times were observed in the ISLK group [0.58min (0.42-0.87) 3.00min (2.21-4.15), <0.001]. The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group (<0.001). Pain scores at suture removal were lower in the ISLK group than in RI group [1 (0-3) 2 (1-4), <0.001]. Postoperative symptoms at 6mo were comparable between the groups (=0.487), with no recurrence.
CONCLUSION
ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision. Compared to RI fixation, ISLK facilitates suture removal and reduces discomfort, with comparable surgery duration and less conjunctival hyperemia.
PubMed: 38766334
DOI: 10.18240/ijo.2024.05.07 -
Ocular Immunology and Inflammation May 2024To analyze the clinical course and outcomes of autoimmune vs. non-autoimmune surgically induced scleral necrosis (SISN).
BACKGROUND
To analyze the clinical course and outcomes of autoimmune vs. non-autoimmune surgically induced scleral necrosis (SISN).
METHODS
Multicentric, retrospective, comparative cohort study. Eighty-two eyes of 70 patients with SISN were classified according to pathogenic mechanism into autoimmune vs. non-autoimmune. Main outcome measures included necrosis onset, type of surgery, associated systemic disease, visual acuity, and treatment were analysed in patients followed for ≥ 6 months.
RESULTS
Forty-six (65.7%) patients were women, and the median age was 66 (range: 24-90) years. Most patients (82.9%) had unilateral disease. The median time between surgery and SISN onset was 58 (1-480) months. Thirty-one (37.8%) eyes were classified as autoimmune, and 51 (62.2%) as non-autoimmune SISN. Autoimmune SISN was associated with a shorter time between the surgical procedure and SISN onset than non-autoimmune cases (median of 26 vs. 60 months, = 0.024). Also, autoimmune SISN was associated with cataract extraction (93.5% vs. 25.5%, < 0.001), severe scleral inflammation (58.1% vs. 17.6%, < 0.001), and higher incidence of ocular complications (67.7% vs. 33.3%, = 0.002) than non-autoimmune cases. Remission was achieved with medical management alone in 44 (86.3%) eyes from the non-autoimmune and in 27 (87.1%) from the autoimmune group ( = 0.916). Surgical management was required in 11 (13.4%) eyes, including two requiring enucleations due to scleral perforation and .
CONCLUSIONS
Eyes with autoimmune SISN had a higher rate of cataract surgery, severe scleral inflammation, and ocular complications. Early SISN diagnosis and appropriate management, based on clinical features and pathogenic mechanisms, are critical to avoid sight-threatening complications.
PubMed: 38759224
DOI: 10.1080/09273948.2024.2349914 -
Vestnik Oftalmologii 2024Pterygium is a common inflammatory-proliferative disease characterized by the invasion of degeneratively altered fibrovascular tissue into the cornea. This literature... (Review)
Review
Pterygium is a common inflammatory-proliferative disease characterized by the invasion of degeneratively altered fibrovascular tissue into the cornea. This literature review analyzes the etiological factors and pathogenetic concepts of its development, describes modern methods of diagnostics and surgical treatment of pterygium, and pays particular attention to the assessment of structural and functional changes in the cornea occurring during the growth of pterygium and after its excision.
Topics: Pterygium; Humans; Ophthalmologic Surgical Procedures; Cornea; Conjunctiva
PubMed: 38739143
DOI: 10.17116/oftalma2024140022136 -
International Journal of Molecular... Apr 2024A pterygium is a common conjunctival degeneration and inflammatory condition. It grows onto the corneal surface or limbus, causing blurred vision and cosmetic issues....
A pterygium is a common conjunctival degeneration and inflammatory condition. It grows onto the corneal surface or limbus, causing blurred vision and cosmetic issues. Ultraviolet is a well-known risk factor for the development of a pterygium, although its pathogenesis remains unclear, with only limited understanding of its hereditary basis. In this study, we collected RNA-seq from both pterygial tissues and conjunctival tissues (as controls) from six patients (a total of twelve biological samples) and retrieved publicly available data, including eight pterygium samples and eight controls. We investigated the intrinsic gene regulatory mechanisms closely linked to the inflammatory reactions of pterygiums and compared Asian (Korea) and the European (Germany) pterygiums using multiple analysis approaches from different perspectives. The increased expression of antioxidant genes in response to oxidative stress and DNA damage implies an association between these factors and pterygium development. Also, our comparative analysis revealed both similarities and differences between Asian and European pterygiums. The decrease in gene expressions involved in the three primary inflammatory signaling pathways-JAK/STAT, MAPK, and NF-kappa B signaling-suggests a connection between pathway dysfunction and pterygium development. We also observed relatively higher activity of autophagy and antioxidants in the Asian group, while the European group exhibited more pronounced stress responses against oxidative stress. These differences could potentially be necessitated by energy-associated pathways, specifically oxidative phosphorylation.
Topics: Pterygium; Humans; Oxidative Stress; Inflammation; Oxidative Phosphorylation; RNA-Seq; Conjunctiva; Male; Female; Gene Expression Regulation; Middle Aged; Signal Transduction
PubMed: 38732006
DOI: 10.3390/ijms25094789 -
Cureus Apr 2024Pterygium is a degenerative eye condition marked by the abnormal growth of conjunctival tissue over the cornea, primarily affecting individuals near the equator. When it...
Pterygium is a degenerative eye condition marked by the abnormal growth of conjunctival tissue over the cornea, primarily affecting individuals near the equator. When it reaches the cornea's center, patients may experience obstructed and blurry vision, necessitating pterygium surgery. The standard surgical approach involves excision with a blade, using a conjunctival autograft to address the defect, and securing it with fibrin glue. Recurrence rates exhibit variability, with approximately half occurring within the initial three months. In this case, we present a more cost-effective surgical approach, avoiding the use of a blade to minimize intraoperative complications. Additionally, autologous blood is employed instead of fibrin glue. We evaluate immediate and post-operative complications, as well as the incidence of recurrence rates at the three-month mark.
PubMed: 38721195
DOI: 10.7759/cureus.57786