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[PMID]:29486755
[Au] Autor:Costa EF; Pinto LM; Campos MAG; Gomes TM; Silva GEB
[Ad] Endereço:Departamento de Medicina I, Universidade Federal do Maranhão, Praça Gonçalves Dias, 21 - Centro, São Luis,, MA, 65020-240, Brazil. elaine.pfc68@gmail.com.
[Ti] Título:Partial regression of large anterior scleral staphyloma secondary to rhinosporidiosis after corneoscleral graft - a case report.
[So] Source:BMC Ophthalmol;18(1):61, 2018 Feb 27.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Rhinosporidiosis is a rare chronic infection of the mucous membranes caused by the Rhinosporidium seeberi. Approximately 15% of cases of rhinosporidiosis are ocular, occurring mainly in the tarsal conjunctiva. There are only 11 cases of scleral melt with staphyloma formation associated with bulbar conjuctival oculosporidiosis and none of them was associated with partial regression of the scleral ectasia after a corneoscleral tectonic graft. CASE PRESENTATION: a 13-year-old girl with a progressively increasing black mass in the upper nasal part above the cornea of the left eye. The biomicroscopy revealed an oval, bluish mass measuring 10x10x5 mm with congestion of the overlying conjunctiva. Conjunctival biopsy showed sporoblasts of Rinosporidium seeberi. Treatment was conducted by conjunctival resection and tectonic corneoscleral graft (13x13mm) over the staphyloma. Within 1 year of follow-up the patient presented a partial staphyloma reduction, 9x9x2.5 mm, and the patch detached from the lesion. A novel surgical approach was done reducing the corneal patch and no recurrence was seen after 9 months. CONCLUSIONS: This case is one of the largest anterior scleral staphylomas secondary to rhinosporidiosis described in the literature. Scleral anterior staphyloma partial regression is an unusual outcome after a tectonic corneoscleral graft. Infection resolution and graft covering of thinned area contributed to scleral reepithelization.
[Mh] Termos MeSH primário: Transplante de Córnea
Rinosporidiose/parasitologia
Rinosporidiose/cirurgia
Esclera/transplante
Doenças da Esclera/parasitologia
Doenças da Esclera/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Animais
Túnica Conjuntiva/parasitologia
Transplante de Córnea/métodos
Feminino
Seres Humanos
Recidiva
Rhinosporidium/isolamento & purificação
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0725-2


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[PMID]:29486746
[Au] Autor:Rosentreter A; Lappas A; Widder RA; Alnawaiseh M; Dietlein TS
[Ad] Endereço:Department of Ophthalmology, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany. andre.rosentreter@googlemail.com.
[Ti] Título:Conjunctival repair after glaucoma drainage device exposure using collagen-glycosaminoglycane matrices.
[So] Source:BMC Ophthalmol;18(1):60, 2018 Feb 27.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To report the results of the repair of conjunctival erosions resulting from glaucoma drainage device surgery using collagen-glycosaminoglycane matrices (CGM). METHODS: Case series of 8 patients who underwent revision surgery due to conjunctival defects with exposed tubes through necrosis of the overlying scleral flap and conjunctiva after Baerveldt drainage device surgery. The defects were repaired by lateral displacement of the tube towards the sclera, with a slice of a CGM as a patch, covered by adjacent conjunctiva. RESULT: Successful, lasting closure (follow-up of 12 to 42 months) of the conjunctival defects was achieved without any side-effects or complications in all eight cases. CONCLUSIONS: Erosion of the drainage tube, creating buttonholes in the conjunctiva after implantation of glaucoma drainage devices, is a potentially serious problem. It can be managed successfully using a biodegradable CGM as a patch.
[Mh] Termos MeSH primário: Colágeno/uso terapêutico
Túnica Conjuntiva/lesões
Túnica Conjuntiva/cirurgia
Implantes para Drenagem de Glaucoma/efeitos adversos
Glaucoma/cirurgia
Glicosaminoglicanos/uso terapêutico
Procedimentos Cirúrgicos Oftalmológicos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Criança
Feminino
Seres Humanos
Pressão Intraocular
Masculino
Meia-Idade
Complicações Pós-Operatórias/cirurgia
Reoperação
Estudos Retrospectivos
Esclera/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glycosaminoglycans); 9007-34-5 (Collagen)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0721-6


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[PMID]:29343222
[Au] Autor:Liu B; Li Y; Li T; Lin Y; Ma W; Lu L
[Ad] Endereço:State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China.
[Ti] Título:Transscleral tunnel incision related arterial hemorrhage in 23-gauge Vitrectomy: case report.
[So] Source:BMC Ophthalmol;18(1):9, 2018 Jan 17.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Transscleral tunnel incisions are commonly made to avoid postoperative leakage in small gauge sutureless vitrectomy. We present an unreported intraoperative complication, tunnel incision related arterial hemorrhage from sclerotomy, in 23-gauge (23G) vitrectomy. CASE PRESENTATION: Two cases of intraocular arterial hemorrhage from superonasal sclerotomy were observed at the beginning of vitrectomy. The bleeding filled the vitreous cavity quickly and gushed out from the incision port after the involved supronasal cannula was removed. The active bleeding seemed not to stop spontaneously. We controlled the active bleeding by relocating the involved cannula, elevating the intraocular pressure and compressing the sclera wound. Post-operative intraocular hemorrhage from the sclerotomy was not found in any of the two cases. CONCLUSIONS: We suggest that the bleeding was from injured ciliary artery when the incision crossed 3 or 9 o'clock accidently. Surgeons might avoid this complication by locating the superior incisions away from the horizontal axis, and should be aware the proper management.
[Mh] Termos MeSH primário: Perda Sanguínea Cirúrgica
Artérias Ciliares/lesões
Perfurações Retinianas/cirurgia
Esclera/cirurgia
Esclerostomia/efeitos adversos
Lesões do Sistema Vascular/complicações
Vitrectomia/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Hemostasia Cirúrgica/métodos
Seres Humanos
Pressão Intraocular
Masculino
Microcirurgia/efeitos adversos
Meia-Idade
Perfurações Retinianas/diagnóstico
Técnicas de Sutura/instrumentação
Tomografia de Coerência Óptica
Lesões do Sistema Vascular/diagnóstico
Lesões do Sistema Vascular/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180119
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0677-6


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[PMID]:29310612
[Au] Autor:Song YJ; Kim S; Yoon GJ
[Ad] Endereço:Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea.
[Ti] Título:Impending extrusion of Ex-PRESS shunt treated by shunt-position adjustment: a case report.
[So] Source:BMC Ophthalmol;18(1):4, 2018 Jan 08.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To report a case of impending extrusion of Ex-PRESS shunt treated by shunt-position adjustment. CASE PRESENTATION: A 56-year-old Asian woman presented with impending extrusion and malposition of Ex-PRESS shunt in her left eye. The bleb of the left eye was shallow and diffuse. In the past, the patient was treated by Ex-PRESS shunt implantation under the scleral flap in both eyes. There had been no Ex-PRESS shunt-related complication in her right eye, and she reported no history of left-eye trauma. Based on these findings, we hypothesized that the source of the left-eye problem was a loosely fixed Ex-PRESS shunt spur. It was thought, furthermore, that this inadequate scleral resistance during the Ex-PRESS shunt implantation was due to the low scleral rigidity resulting from high myopia and insufficient maintenance of the anterior chamber. We proceeded to make an incision in the area adjacent to the Ex-PRESS shunt using a super sharp blade. The shunt was then pushed into the anterior chamber with forceps, and the spur was fixed firmly. Pushing the shunt to the anterior chamber was found to have been sufficient to fix it firmly. In fact, when the sclera was palpated with a sponge, aqueous outflow was observed with no shunt displacement. Postoperative intraocular pressure (IOP) was managed well, and the bleb had formed with diffuse, prominent shapes. The Ex-PRESS shunt was well sustained with good positioning. CONCLUSIONS: When an Ex-PRESS shunt operation is performed on a patient who shows a tendency for low scleral rigidity, shunt implantation should be accomplished carefully and with force adequate for firm spur fixation.
[Mh] Termos MeSH primário: Implantes para Drenagem de Glaucoma/efeitos adversos
Glaucoma/cirurgia
Pressão Intraocular/fisiologia
Esclera/cirurgia
Retalhos Cirúrgicos
Trabeculectomia/métodos
[Mh] Termos MeSH secundário: Câmara Anterior
Feminino
Glaucoma/fisiopatologia
Seres Humanos
Meia-Idade
Período Pós-Operatório
Falha de Prótese
Reoperação
Tonometria Ocular
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-017-0665-2


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[PMID]:29465569
[Au] Autor:Kang MJ; Joo CK
[Ad] Endereço:Department of Ophthalmology and Catholic Institute for Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
[Ti] Título:Three cases of a torn haptic after scleral fixation using a hydrophobic acrylic intraocular lens: Case reports.
[So] Source:Medicine (Baltimore);97(8):e9853, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: We report 3 cases of a torn haptic after successful scleral fixation with a hydrophobic acrylic intraocular lens. PATIENT CONCERNS: Patients complained of decreased visual acuity about 1 week to 1 month after scleral fixation. DIAGNOSES: In all 3 cases, the direction of the damaged haptic correlated with the direction of the pulling force made by the hung suture material. Observation of a cheese-wiring effect on scanning electron microscopy suggested that the haptic was cut by the suture. INTERVENTIONS: Patients underwent re-scleral fixation with caution. OUCTOMES: There was no complication of broken haptic after re-scleral fixation. LESSONS: To avoid unexpected haptic tears, great caution is needed; surgeons should avoid applying excessive pulling force to the intraocular lens when performing scleral fixation using a hydrophobic acrylic intraocular lens.
[Mh] Termos MeSH primário: Implante de Lente Intraocular/métodos
Lentes Intraoculares
Esclera/cirurgia
[Mh] Termos MeSH secundário: Acrilatos
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Complicações Pós-Operatórias
Reoperação
Técnicas de Sutura
Transtornos da Visão/etiologia
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Acrylates)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009853


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[PMID]:29422749
[Au] Autor:Al Somali AI; Al-Dossari FN; Emara KE; Al Habash A
[Ad] Endereço:Department of Ophthalmology, King Faisal University, Al Ahsa, Kingdom of Saudi Arabia.
[Ti] Título:Outcomes of Scleral-fixated Intraocular-lens in Children with Idiopathic Ectopia Lentis.
[So] Source:Middle East Afr J Ophthalmol;24(4):167-170, 2017 Oct-Dec.
[Is] ISSN:0975-1599
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The purpose of the study was to review the safety and stability of scleral-fixated intraocular lens (IOL) 2 years after implantation in children with idiopathic ectopia lentis (EL). METHODS: This retrospective case series enrolled children with EL managed between 2011 and 2015 at a tertiary eye hospital in the eastern of Saudi Arabia. Data were collected on age, gender, vision, isolated or syndromic pathology, intraoperative and postoperative complications, spherical equivalent refraction, and final best-corrected visual acuity (BCVA). RESULTS: The series included 18 eyes of 11 children with EL (6 males and 5 females). There were 7 bilateral and 4 unilateral cases. The median age was 3.5 years (25% quartile 1 year; range: 1-8 years). Preoperatively, fixation was absent in 3 eyes, 8 eyes were fixating but vision could not be recorded. In the remaining seven eyes, median distant visual acuity was 0.1 (25% quartile: 0.08). The median postoperative follow-up was 24 months (25% quartile, 7 months). Complications included two eyes with iris capture and one eye with lens subluxation requiring re-implantation. Postoperative BCVA was better than 20/60 in 15 (83%) eyes. At last follow-up, 6 eyes required myopic correction, 1 eye was emmetropic, and 11 eyes were hypermetropic. One eye with glaucoma was managed medically. CONCLUSION: Scleral fixated IOL in eyes of young children with EL had good visual outcomes and high stability. However, there is a high incidence of residual refractive error.
[Mh] Termos MeSH primário: Ectopia do Cristalino/cirurgia
Implante de Lente Intraocular/métodos
Lentes Intraoculares
Esclera/cirurgia
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Ectopia do Cristalino/fisiopatologia
Feminino
Seguimentos
Seres Humanos
Lactente
Masculino
Estudos Retrospectivos
Resultado do Tratamento
Acuidade Visual/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE
[do] DOI:10.4103/meajo.MEAJO_105_16


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[PMID]:29206652
[Au] Autor:Vinod K
[Ad] Endereço:Department of Ophthalmology, Icahn School of Medicine at Mount Sinai and New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA.
[Ti] Título:Suprachoroidal shunts.
[So] Source:Curr Opin Ophthalmol;29(2):155-161, 2018 Mar.
[Is] ISSN:1531-7021
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE OF REVIEW: This article reviews recent studies evaluating the efficacy and safety of ab externo and ab interno suprachoroidal shunts designed to augment uveoscleral outflow in patients with open angle glaucoma. RECENT FINDINGS: The Gold Shunt and STARflo are placed into the suprachoroidal space via an ab externo approach, while the CyPass Micro-Stent and iStent Supra are inserted ab interno through a clear corneal incision. A small randomized clinical trial suggested similar efficacy among two different models of the Gold Shunt and the Ahmed glaucoma valve. The pivotal multicenter, randomized COMPASS trial showed that the CyPass Micro-Stent combined with cataract surgery is more effective than cataract surgery alone through 2 years. Study results suggest a favorable safety profile for each suprachoroidal device and intraocular pressure-lowering to the mid-to-high teens with an associated reduction in medication burden. Given the relative novelty of these procedures, it is currently unknown whether fibroblastic proliferation within the suprachoroidal space may limit their long-term success. SUMMARY: Renewed interest in the suprachoroidal space has led to the development of new biocompatible glaucoma implants. Ab interno devices are easily combined with cataract surgery and preserve conjunctiva for future incisional glaucoma surgery. Additional data regarding the long-term efficacy and late complications of suprachoroidal shunts are needed.
[Mh] Termos MeSH primário: Corioide/cirurgia
Implantes para Drenagem de Glaucoma
Glaucoma de Ângulo Aberto/cirurgia
[Mh] Termos MeSH secundário: Humor Aquoso/fisiologia
Materiais Biocompatíveis
Corioide/fisiologia
Glaucoma de Ângulo Aberto/fisiopatologia
Seres Humanos
Pressão Intraocular/fisiologia
Implante de Prótese
Esclera/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Biocompatible Materials)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1097/ICU.0000000000000458


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[PMID]:29260410
[Au] Autor:Szurman P; Januschowski K; Boden KT; Seuthe AM
[Ad] Endereço:Eye Clinic Sulzbach, Knappschaft Hospital Saar, An der Klinik 10, 66280, Sulzbach, Saar, Germany.
[Ti] Título:Suprachoroidal drainage with collagen sheet implant- a novel technique for non-penetrating glaucoma surgery.
[So] Source:Graefes Arch Clin Exp Ophthalmol;256(2):381-385, 2018 Feb.
[Is] ISSN:1435-702X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Our purpose was both to introduce the new technique of suprachoroidal drainage with collagen sheet implantation as a novel technique of non-penetrating glaucoma surgery and to present first results of a prospective pilot study. METHODS: A superficial rectangular sclera flap of half-scleral thickness sized 4 × 4.5 mm is dissected anteriorly until clear cornea. Then, a second scleral flap is created underneath the first one sized 3.5x4mm and is cut down full-thickness to the choroid exposing the suprachoroidal space. The flap is then bluntly prepared until the scleral spur is reached. Sharp dissection above the sclera spur exposes Schlemm's canal, which is located directly anteriorly. Schlemm's canal is unroofed, juxtacanalicular meshwork is peeled and the deep flap is cut off at its base. An absorbable collagen sheet (Ologen®, Dahlhausen, Cologne, Germany) is placed into the suprachoroidal space at the level of the ciliary body, and the superficial sclera flap is sutured tightly to prevent leakage. RESULTS: We prospectively analyzed 65 eyes that underwent suprachoroidal drainage with collagen sheet implantation. Mean reduction of intraocular pressure after 3 months was 35.1% (from 21.0 ± 4.3 mmHg to 13.5 ± 3.4 mmHg)(p < 0.01) and after 12 months 35.6% (from 21.0 ± 4.3 mmHg to 13.5 ± 3.0  mmHg)(p < 0.01). The number of topical IOP-reducing medication decreased significantly from 3.5 ± 0.7 to 0.6 ± 0.9 and to 0.9 ± 1.1 after 3 and 12 months, respectively (p < 0.01). No serious complications occurred. CONCLUSION: Suprachoroidal drainage with collagen sheet implantation seems to be a safe and effective surgical technique for non-penetrating glaucoma surgery that yields the opportunity of a sufficient IOP reduction for eyes unsuitable for canaloplasty.
[Mh] Termos MeSH primário: Corioide/cirurgia
Colágeno/farmacologia
Drenagem/métodos
Implantes para Drenagem de Glaucoma
Glaucoma de Ângulo Aberto/cirurgia
Esclera/transplante
Retalhos Cirúrgicos
[Mh] Termos MeSH secundário: Idoso
Materiais Revestidos Biocompatíveis
Estudos de Viabilidade
Feminino
Seguimentos
Glaucoma de Ângulo Aberto/diagnóstico
Glaucoma de Ângulo Aberto/fisiopatologia
Seres Humanos
Masculino
Projetos Piloto
Estudos Prospectivos
Desenho de Prótese
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Coated Materials, Biocompatible); 9007-34-5 (Collagen)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.1007/s00417-017-3873-9


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[PMID]:29208834
[Au] Autor:Shekhawat N; Goyal K
[Ad] Endereço:Department of Ophthalmology, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan, India.
[Ti] Título:Sutureless glueless intrascleral fixation of posterior chamber intraocular lens: Boon for aphakic.
[So] Source:Indian J Ophthalmol;65(12):1454-1458, 2017 Dec.
[Is] ISSN:1998-3689
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To report results of intrascleral fixation of 3-piece IOL without the help of suture and glue. METHODS: Study included intrascleral fixation of haptic in 50 eyes by T-fixation technique. Preoperative and postoperative visual acuity, slit lamp and fundus examination, applanation tonometry, keratometry, biometry, optical coherence tomography, Scheimpflug imaging were done for extensive evaluation. Qualitative and quantitative data were summarized in the form of proportion and mean and standard deviation, respectively. The significance of difference was measured by Chi-square test or unpaired t-test or ANOVA whichever is appropriate. P < 0.05 was considered as statistically significant. RESULTS: There was one case in which haptic broke during handshake maneuver and another IOL was required. Postoperative complications included corneal edema (4%), increased intraocular pressure (6%), cystoid macular edema (2%), decentration (4%), and dislocation (2%), which were all managed to the level of good visual recovery. There was no significant change in corneal astigmatism. There was significant change found in best-corrected visual acuity and uncorrected visual acuity after surgery. CONCLUSION: This modified technique seems to be a good alternative in IOL implantation in eyes with deficient capsules in view of the decrease in the learning time and surgical time and risk for complications.
[Mh] Termos MeSH primário: Afacia Pós-Catarata/cirurgia
Implante de Lente Intraocular/métodos
Segmento Posterior do Olho/cirurgia
Esclera/cirurgia
Procedimentos Cirúrgicos sem Sutura/métodos
Acuidade Visual
[Mh] Termos MeSH secundário: Adesivos
Afacia Pós-Catarata/fisiopatologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Desenho de Prótese
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Adhesives)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180103
[Lr] Data última revisão:
180103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.4103/ijo.IJO_620_17


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[PMID]:29208833
[Au] Autor:Kelkar AS; Fogla R; Kelkar J; Kothari AA; Mehta H; Amoaku W
[Ad] Endereço:Department of Ophthalmology, National Institute of Ophthalmology, Pune, Maharashtra, India.
[Ti] Título:Sutureless 27-gauge needle-assisted transconjunctival intrascleral intraocular lens fixation: Initial experience.
[So] Source:Indian J Ophthalmol;65(12):1450-1453, 2017 Dec.
[Is] ISSN:1998-3689
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The purpose of the study was to report our initial experience with the transconjunctival Intrascleral Intraocular Lens (SFIOL) fixation with modified Yamane's double-needle technique and flanged haptics. METHODS: This was a prospective interventional study that enrolled 31 consecutive patients undergoing SFIOL with the modified Yamane's technique. All patients underwent comprehensive evaluation including uncorrected and best-corrected vision, intraocular pressure, ultrasound biomicroscopy, endothelial cell density, and macular thickness using optical coherence tomography (OCT). We excluded patients with visually significant coexistent pathology such as corneal scars, macular pathology, and glaucoma. RESULTS: The mean age of subjects was 57 ± 16.9 years and 23 were men (74%). Surgery was performed for aphakia following complicated cataract surgery in 10 eyes (32%), with lensectomy for subluxated/dislocated cataract in 6 eyes (19%), and with IOL explantation for subluxated/dislocated IOL in 15 eyes (48%). There were no intraoperative complications. Uncorrected visual acuity improved from median of 1.48 logarithm of minimum angle of resolution (logMAR) units (interquartile range [IQR] = 1.3-2 logMAR) at baseline to 0.3 logMAR (IQR = 0.2-0.4 logMAR) at 6 weeks (P < 0.001) which was maintained at 6 months. There were no significant changes in endothelial cell density (P = 0.34) and OCT-based macular thickness (P = 0.31) at 6 months. Two eyes had slight IOL decentration. CONCLUSION: Our initial experience suggests that the Yamane's technique for SFIOL is a simple procedure with a short-learning curve and is independent of scleral flaps, tunnels, sutures, and fibrin glue. Using widely available 27-gauge needle instead of 30-gauge thin wall needle as originally described by Yamane makes it possible for the use of various three-piece IOLs available globally. Further studies are required for widespread acceptance of this technique.
[Mh] Termos MeSH primário: Afacia/cirurgia
Túnica Conjuntiva/cirurgia
Lentes Intraoculares
Agulhas
Esclera/cirurgia
Procedimentos Cirúrgicos sem Sutura/instrumentação
Acuidade Visual
[Mh] Termos MeSH secundário: Afacia/fisiopatologia
Desenho de Equipamento
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180103
[Lr] Data última revisão:
180103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.4103/ijo.IJO_659_17



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