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Postoperative IOP prophylaxis practice following uncomplicated cataract surgery: a UK-wide consultant survey
Springer Science and Business Media LLC - - 2005
In order to minimise postoperative intraocular pressure (IOP) rise, after routine uncomplicated cataract surgery, prophylaxis may be adopted. Currently, there are no specific guidelines in this regard resulting in wide variation in practice across the UK. We sought to document these variations through a questionnaire survey. A questionnaire was sent to all consultant ophthalmic surgeons in the UK. 62.6% of surgeons did not use any IOP lowering agents. 37.4% surgeons routinely prescribed some form of medication. The majority (86.8%) used oral diamox. 20.6% of surgeons said they based their practice on evidence, 43.3% on personal experience, and 17.6% on unit policy. Surprisingly, among the two groups of surgeons (those who gave routine prophylaxis, and those who did not) the percentages of surgeons quoting personal experience, unit policy, or presence of evidence was strikingly similar. The timing of the first postoperative IOP check varied from the same day to beyond 2 weeks. Only 20.2% of surgeons had ever seen an adverse event related to IOP rise; this complication is thus very rare. This survey highlights a wide variation in the practice and postoperative management of phacoemulsification cataract surgery. What is very striking is that there is a similar proportion of surgeons in the diametrically opposite groups (those who give or do not give routine IOP lowering prophylaxis) who believe that there practice is evidence based. The merits of this study suggests that consideration must be given to drafting a uniform guideline in this area of practice.
Comparison of 5-year outcomes between trabeculectomy combined with phacoemulsification and trabeculectomy followed by phacoemulsification: a retrospective cohort study
Springer Science and Business Media LLC - Tập 21 - Trang 1-8 - 2021
We aimed to compare the outcomes of trabeculectomy combined with phacoemulsification and those of trabeculectomy followed by phacoemulsification. A total of 141 patients with primary open-angle glaucoma, exfoliation glaucoma, and glaucoma secondary to uveitis glaucoma who underwent trabeculectomy followed by (n = 48) or combined with (n = 93) phacoemulsification were included. We analyzed data collected from the Collaborative Bleb-Related Infection Incidence and Treatment Study, a prospective cohort study conducted in 34 clinical centers that included 1249 eyes. The main outcome was the cumulative probability of success based on intraocular pressure (IOP) within 5 years. Surgical failure was defined as a case in which additional glaucoma surgery is required or one of the following criteria are met: preoperative IOP > 21 (A), > 18 (B), or > 15 mmHg (C). The secondary outcomes were cumulative probability of success, risk factors of surgical failure, and Δ visual acuity. However, the data on phacoemulsification during the 5-year follow-up were censored. No significant difference was found in the cumulative probability of success as the main outcome. When the data on phacoemulsification during the 5-year follow-up were censored, the probabilities of success of trabeculectomy followed by phacoemulsification were significantly higher for criteria A (p = 0.02), B (p < 0.01), and C (p < 0.01). Lower preoperative IOP, younger age, and trabeculectomy combined with phacoemulsification were associated with poorer outcome. Trabeculectomy followed by phacoemulsification had significantly worse Δ logMAR visual acuity at 6 and 12 months (p < 0.01). The cumulative probability of success after trabeculectomy combined with or followed by phacoemulsification remained unchanged. Combining phacoemulsification with trabeculectomy adversely affected the cumulative probability of success after trabeculectomy. The visual acuity improvements observed in the early postoperative period after combining phacoemulsification with trabeculectomy disappeared within 5 years.
Di chuyển của trứng sán máng trong ổ mắt: một báo cáo trường hợp Dịch bởi AI
Springer Science and Business Media LLC - Tập 21 - Trang 1-4 - 2021
Tổn thương mắt, bao gồm tổn thương kết mạc, tuyến lệ, mí mắt và hốc mắt, do Schistosoma haematobium gây ra là hiếm gặp. Chúng tôi báo cáo một trường hợp lâm sàng về sự di chuyển của trứng sán trong ổ mắt. Một cậu bé 14 tuổi mang quốc tịch Mali đã đến khám với triệu chứng sưng không đau mí mắt trên bên phải, đã phát triển dần dần trong khoảng 3 tháng. Thị lực là logMAR 0.10 và 0.00 ở mắt phải và mắt trái, tương ứng. Khám bên ngoài cho thấy một khối u ở mí mắt bên phải, đẩy nhãn cầu hơi xuống và vào trong. Chụp cắt lớp vi tính cho thấy có một khối ở tuyến lệ bên phải. Phẫu thuật cắt bỏ hoàn toàn khối u được thực hiện thông qua phẫu thuật mở hốc mắt qua mí mắt. Kiểm tra tế bào học cho thấy có sự xâm nhập viêm hạt ở tuyến lệ bao gồm các tế bào lympho, bạch cầu ái kiềm, tế bào khổng lồ, tế bào biểu mô và các tế bào histiocytes, cùng với trứng Schistosoma đã được vôi hóa có gai ở đầu. Xét nghiệm nước tiểu cho thấy có trứng của S. haematobium. Praziquantel 40 mg/kg đã được cho bệnh nhân. Tình trạng tiểu máu dừng lại sau 1 tuần. Sau 3 năm theo dõi, không có dấu hiệu tái phát. Granuloma bilharzian của tuyến lệ là một vị trí dị tật của ký sinh trùng. Trong trường hợp này, granuloma đã được điều trị thành công bằng phẫu thuật cắt bỏ kết hợp với một liệu trình Praziquantel.
#Schistosoma haematobium #tổn thương mắt #mí mắt #tuyến lệ #granuloma bilharzian
Intraocular pressure-lowering effects of Ripasudil: a potential outcome marker for Trabeculotomy
Springer Science and Business Media LLC - Tập 19 - Trang 1-7 - 2019
To examine the use of ripasudil as a trabeculotomy outcome marker in patients with primary open-angle glaucoma (POAG). Between May 2015 and December 2018, 35 eyes underwent trabeculotomy and were postoperatively followed for over 3 months. Ripasudil was defined as effective if drug administration resulted in a greater than 10% reduction in intraocular pressure (IOP). Patients were divided into effective (effective group) or non-effective (non-effective group) ripasudil administration groups. The need for additional glaucoma surgery or an IOP ≥ 21 mmHg indicated surgical failure. In both groups, a Kaplan-Meier survival-analysis was used to evaluate success probabilities related to postoperative IOP levels. Effective IOP reduction occurred in 14 of 35 eyes after ripasudil administration, which was shown by a decrease of more than 10%. Postoperatively, both groups exhibited significant reductions of IOP and antiglaucoma medication use for up to 24 months. At 12 and 24 months after trabeculotomy, probabilities of success in the effective vs. non-effective group were 100% vs. 94.7 and 100% vs. 75.4%, respectively (P = 0.14). Trabeculotomy is effective for achieving an IOP < 21 mmHg in ripasudil effective POAG eyes. Examination of ripasudil’s IOP-lowering effects may be useful in predicting surgical outcomes after trabeculotomy.
Unilateral inferior oblique anterior transposition for markedly asymmetric dissociated vertical deviation with unilateral inferior oblique over-action
Springer Science and Business Media LLC - - 2019
To evaluate the results of unilateral inferior oblique anterior transposition (IOAT) for markedly asymmetric dissociated vertical deviation (DVD) combined with inferior oblique over-action (IOOA). Retrospective chart review of the records of all patients with asymmetric DVD combined with unilateral IOOA in the non-dominant eye who received unilateral IOAT on the non-dominant eye. No other muscles were operated on simultaneously. The amount of DVD and IOOA were measured before and after the operation and statistically analysed. Seventeen patients were included. The mean age at surgery was 23.5 ± 8.4 (range 12–38) years old. The mean postoperative follow-up period was 15.7 ± 7.2 (range 6–32) months. The primary position DVD was 19.6 ± 5.4 (range 14–36) PD preoperatively and decreased significantly to 2.9 ± 2.0 (range 0–8) PD postoperatively (P < 0.01). Preoperatively, there were 2, 7, and 8 patients with + 1, + 2, and + 3 IOOA, respectively, and these were reduced from 2.4 ± 0.7 to 0.3 ± 0.4 postoperatively (P < 0.01). None of the patients were complicated obvious hypotropia, anti-elevation syndrome or IOOA in the contralateral eye. Unilateral IOAT was recommended in patients with asymmetric DVD coexists with unilateral IOOA.
Long noncoding RNA expression profile in HLE B-3 cells during TGF-β2-induced epithelial-mesenchymal transition
Springer Science and Business Media LLC - Tập 17 - Trang 1-9 - 2017
Recent evidence has shown that long noncoding RNAs (lncRNAs) are involved in the process of epithelial-mesenchymal transition (EMT). However, little research has focused on the expression profile of lncRNAs during EMT in human lens epithelial cells (LECs) and their functions have not yet been described. Dysregulated lncRNAs and mRNAs in normal human lens epithelial B-3(HLE B-3) cells and during transforming growth factor β2(TGF-β2)-induced EMT were analyzed via lncRNA microarray. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) Pathway analyses of differentially expressed mRNAs were performed to identify their functions and pathologic pathways. Six candidate lncRNAs were validated via quantitative real-time reverse transcription polymerase chain reaction(qRT-PCR) to confirm the microarray data. A total of 775 lncRNAs (325 up-regulated and 450 down-regulated) and 935 mRNAs (329 up-regulated and 606 down-regulated) were differentially expressed in HLE B-3 cells during TGF-β2-induced EMT compared to normal HLE B-3 cells. GO and KEGG Pathway analyses indicated the functions of differentially expressed mRNAs in the TGF-β2-induced EMT in HLE B-3 cells. qRT-PCR confirmed the trends indicated in microarray analysis for all 6 candidate lncRNAs. Our study lays the foundation for future research in lncRNAs related to EMT in HLE B-3 cells and could provide new avenues for the prevention and treatment of posterior capsule opacification (PCO).
Comparison of ocular biometric measurements in patients with cataract using three swept-source optical coherence tomography devices
Springer Science and Business Media LLC - Tập 21 - Trang 1-7 - 2021
Precise measurement of ocular biometry is critical for determining intraocular lens power. Newly developed swept-source optical coherence tomography (SS-OCT) - based ocular biometric devices, ANTERION and CASIA2 provide ocular biometric measurements as IOLMaster 700. This study aimed to assess agreement between three devices. This retrospective comparative study includes patients with cataract who underwent ocular biometric measurements with three devices, ANTERION, CASIA2, and IOLMaster 700, at Seoul National University Hospital, in April 2020. Anterior keratometry, total keratometry, central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), and axial length (AL) were the main parameters for the comparison. To assess the agreement between the devices, intraclass coefficient (ICC) and Bland-Altman analysis with 95% limits of agreement (LoA) were used. A total of 47 eyes of 29 patients were measured with three devices. Average anterior keratometry showed excellent agreement (ICC ≥ 0.989), and the mean difference was less than 0.1 D. However, the ICC of the total average keratometry ranged from 0.808 to 0.952, and the difference was more than 0.43 D. The AL measured by ANTERION and IOLMaster 700 showed excellent agreement (ICC = 0.999), and the mean difference was 0.005 mm. The ANTERION and IOLMaster 700 did not obtain AL in six (12.8%) and three (6.4%) cases, respectively (P = 0.001 by Fisher’s exact test). The CCT, ACD, and LT also showed excellent agreement (ICC > 0.9). The new SS-OCT-based devices, ANTERION, and CASIA2 showed a good agreement with IOLMaster 700 in measuring ocular biometry except for the total keratometry. The AL of ANTERION and IOLMaster 700 showed excellent agreement.
Comparison of the monocular Humphrey visual field and the binocular Humphrey esterman visual field test for driver licensing in glaucoma subjects in Sweden
Springer Science and Business Media LLC - Tập 12 - Trang 1-7 - 2012
The purpose of this study was to compare the monocular Humphrey Visual Field (HVF) with the binocular Humphrey Esterman Visual Field (HEVF) for determining whether subjects suffering from glaucoma fulfilled the new medical requirements for possession of a Swedish driver’s license. HVF SITA Fast 24–2 full threshold (monocularly) and HEVF (binocularly) were performed consecutively on the same day on 40 subjects with glaucomatous damage of varying degrees in both eyes. Assessment of results was constituted as either “pass” or “fail”, according to the new medical requirements put into effect September 1, 2010 by the Swedish Transport Agency. Forty subjects were recruited and participated in the study. Sixteen subjects passed both tests, and sixteen subjects failed both tests. Eight subjects passed the HEFV but failed the HVF. There was a significant difference between HEVF and HVF (χ2, p = 0.004). There were no subjects who passed the HVF, but failed the HEVF. The monocular visual field test (HVF) gave more specific information about the location and depth of the defects, and therefore is the overwhelming method of choice for use in diagnostics. The binocular visual field test (HEVF) seems not be as efficient as the HVF in finding visual field defects in glaucoma subjects, and is therefore doubtful in evaluating visual capabilities in traffic situations.
Childhood glaucoma profile in a Southwestern Ethiopia tertiary care center: a retrospective studyAbstract
Background
Methods
Results
Conclusion
Springer Science and Business Media LLC - Tập 24 Số 1
Childhood glaucoma is a major cause of childhood blindness worldwide. The profile of childhood glaucoma has not been well characterized in sub-Saharan Africa. Thus, this study was designed to describe demographics, clinical features, managements of childhood glaucoma, and improvements in visual acuity (VA) and intraocular pressure (IOP) from baseline to final visit.
This retrospective study included glaucoma patients below 18 years old who were diagnosed between September 2019 to August 2022. Childhood glaucoma diagnosis and classification was made as per the Childhood Glaucoma Research Network Classification (CGRN).
A total of 105 children (181 eyes) were diagnosed with glaucoma. The most common type of childhood glaucoma was primary congenital glaucoma (PCG) constituting (42%,
PCG was the most common type of childhood glaucoma. One of a well-recognized challenge in developing countries, late presentation of patients with PCG, was also observed in our study. Which highlights, the need of increasing access to eye-care service and awareness of childhood glaucoma as a major public health issue. Steroid-induced glaucoma was the most common type of secondary glaucoma; appropriate measures should be taken to prevent this preventable glaucoma.
Closantel; a veterinary drug with potential severe morbidity in humans
Springer Science and Business Media LLC - Tập 16 - Trang 1-5 - 2016
Closantel is a halogenated salicylanilide with a potent anti parasitic activity. It is widely used in management of parasitic infestation in animals, but is contraindicated in humans. A 34-year-old man with depression was referred to our center with progressive loss of vision in both eyes 10 days after unintentional ingestion of three 500 mg tablets of Closantel. On fundus examination, left optic disc margin was blurred. His bilateral visual acuity was no light perception (NLP) despite prescribed IV erythropoietin injections 20,000 units daily for 3 days and 1gr intravenous methylprednisolone acetate for 3 days followed by 1 mg/kg oral prednisolone. On macular optical coherence tomography (OCT), a disruption in outer retina was observed. Electroretinogram and visual evoked potential tests showed visual pathway involvement. Destruction of neurosensory retina and visual pathways after accidental Closantel use is related to severe visual loss. This case alerts us about the destructive effect of this drug on humans even in low dosage which necessitates preventive efforts to reduce the chance of this morbid side effect.
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