rolldecade53
rolldecade53
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Aim To evaluate the clinical efficacy of a selective, partial, pedicle conjunctival flap in the treatment of deep corneal ulcers with or without perforation, resistant to medical treatment. Method This interventional self-controlled retrospective study included 31 eyes of 31 patients with deep corneal ulcers who underwent conjunctival flap surgery in a tertiary eye care unit between 2017 and 2019. Of these, 9 eyes exhibited corneal perforation. The follow-up period was 12 months. The primary outcome measures were restoring ocular surface integrity and secondary outcome measures were improvement in visual acuity and postoperative complications encountered. Results Out of the total of 31 patients, 17 patients (55%) were males and 14 patients (45%) were females. The mean age was 56.03 ± 15.46 years. The mean disease duration was 64.10 ± 35.01 days, the mean diameter of the ulcer was 3.61 ± 1.02 mm and the mean depth of the ulcer was 70.65 ± 20.28% of the thickness of the cornea. The etiology was extensive and the corneal ulcers were categorized as infectious (12), noninfectious (16), and unknown (3). An anatomic cure was obtained in 29 (94%) of 31 eyes. Conjunctival flap surgery was unsuccessful in 2 eyes that required evisceration. The postoperative visual acuity (BCVA) improved in 13 (42%) of the 31 eyes, decreased in 9 eyes (29%) and remained unchanged in 9 eyes (29%). The most frequent complications after conjunctival flap surgery were pseudopterygium, cataract and corneal opacity and less frequent complications were glaucoma, astigmatism, flap retraction, corneal perforation and endophthalmitis. Conclusions Conjunctival flap surgery can successfully treat refractory deep corneal ulcers. It can restore ocular surface integrity and provide metabolic and mechanical support for corneal healing. Also, it can avoid emergency penetrating keratoplasty or create appropriate conditions for a future optic keratoplasty.Objective Refractive management in keratoconus is challenging. Although some kinds of phakic intraocular lenses have been studied in keratoconus so far, no study evaluated the results of EyeCryl Phakic Toric intraocular lenses in this kind of patients. Materials and Methods This is a retrospective chart review study, including all keratoconus patients implanted with an EyeCryl Phakic Toric intraocular lens in at least one of their eyes by an experienced cornea surgeon in Colombia. Follow-up to 6 months after surgery was also included. Results A total of 20 eyes of 14 patients were included, with an average age of 29.3 ± 4.2 years. Spherical equivalent improved from a pre-surgical value of -10.31 D to +0.09 D at 6 months. 65% of the patients improved at least one line in the best-corrected distance visual acuity. At 6 months, 70% of the patients were within ± 0.50 D of spherical equivalent emmetropia. No complications occurred in any of the patients. Conclusion EyeCryl Phakic intraocular lenses are an excellent option in keratoconus patients with high refractive error. Abbreviations KC = Keratoconus, P-IOL = phakic intraocular lenses, ICL = Implantable Collamer Lens, WTW = White to White, SD = standard deviation, ANOVA = an analysis of variance, UDVA = monocular uncorrected distance visual acuity, CDVA = corrected distance visual acuity.Objective To evaluate the effect of pterygium excision on intraocular lens (IOL) power and refraction. Methods The present study was carried out on patients with combined cataract and pterygium excision (combined group) and pterygium surgery first and cataract surgery after one month (sequential group). Dihexa chemical Parameters such as mean keratometry (K) values, axial length, IOL power, and corneal astigmatism were compared pre and postoperatively in the combined and sequential groups. Results 70 eyes of 70 patients were included in the present study. The mean age of the participants in the combined group was 70.46±10.12, whereas that in the sequential group was 68.68±11.22 (p=0.243). The mean horizontal length of the pterygium in the combined group was 2.64±0.17 mm and 2.57±0.17 mm in the sequential group. The mean postoperative K values (p=0.03) and IOL power (p=0.04) in the combined group were significantly higher than the preoperative values. The estimated postoperative refractive error in the combined group was -0.50±1.00 D and 0.25±0.5 D in the sequential group (p=0.04). On the other hand, the postoperative refraction in the sequential group was predictable. Corneal visibility was diminished on the nasal side in almost all the patients in the combined group as compared to the sequential group. Conclusion The postoperative refraction errors were positively correlated with the length of pterygium in the combined group. The unpredictability of these errors recommends sequential surgery in cases with concurrent pterygium and cataract.Purpose To investigate the implantation of Polytetrafluoroethylene (PTFE) as a glaucoma drainage device. Methods This study has been done in two steps. First, the constructed implants have been used in 4 rabbits and the histopathologic response was evaluated. In the second step, the implants were used in the 6 eyes of 6 patients with end-stage glaucoma with uncontrolled IOP and poor visual acuity. The tube was made of two-layer of PTFE membrane measuring 8 * 6 mm with a thickness of 1.8 mm and a silicone tube. The rabbits and the human eyes underwent surgical implantation of the tube in the anterior chamber. The histopathologic evaluation was done using H&E staining. Visual acuity, intraocular pressure and the number of glaucoma medications were assessed before and after the surgery. Results In the histopathologic evaluation, subconjunctival polarizing fibers of a synthetic mesh infiltrated by fibrovascular septa was seen. A granulomatous inflammatory reaction composed of histiocytes, lymphocytes, and multinucleated giant cells were seen around and between the synthetic bundles. The average age of patients was 63 ± 5.5 years. The mean IOP reached from 36.6 ± 5.7 mmHg at baseline to 16.2 ± 8.9 mmHg at the final follow-up. Patients were followed for an average of 6.6 ± 4.5 months. One patient found hypotony refractory to medical and surgical treatment, which led to implant removal. One patient had uncontrolled IOP and finally led to phthisis bulbi following slow CPC. The remaining four eyes did well during the follow-up. Conclusion The use of PTFE as a new polymer in tube shunt construction was reported. Larger studies, modification of the PTFE membranes like changing the porosity amount, and size of PTFE membranes might result in different conclusions.

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