ABSTRACT
This case report of 2 patients describes peripheral Von Hippel-Lindau disease associated with a series of aflibercept injections.
Subject(s)
Hemangioblastoma , Retinal Neoplasms , von Hippel-Lindau Disease , Humans , Hemangioblastoma/diagnosis , Hemangioblastoma/drug therapy , von Hippel-Lindau Disease/complications , von Hippel-Lindau Disease/diagnosis , Receptors, Vascular Endothelial Growth Factor/therapeutic use , Retinal Neoplasms/diagnosis , Retinal Neoplasms/drug therapyABSTRACT
The surgeons have modified the flanged intrascleral intraocular lens (IOL) fixation technique initially described by Yamane et al. to avoid manipulation of the IOL within the anterior chamber. Their technique involves securing the IOL haptics into receiving needles within the posterior segment. Advantages of this technique include repositioning and securing a dislocated three-piece IOL to the sclera without removing the lens or creating a large corneal incision.
Subject(s)
Lens Implantation, Intraocular/methods , Lens Subluxation/surgery , Multifocal Intraocular Lenses , Sclera/surgery , Aged , Humans , Lens Subluxation/physiopathology , Male , Ophthalmologists , Reoperation , Visual Acuity/physiology , Vitrectomy , Vitreoretinal SurgeryABSTRACT
INTRODUCTION: Many ocular diseases require intravitreal injections of pharmacological agents. Optimizing patients' experiences during injections is important to ensure compliance and maintenance of quality of life. The objective of this study was to identify strategies to help alleviate discomfort during intravitreal injections. METHODS: A cross-sectional study surveying 128 patients during clinic visits between 2014 and 2015 in two outpatient Retina Clinics (one academic and one private). Patients receiving an intravitreal injection(s) for any retinal disorder were given a questionnaire with 10-yes/no responses for various potential strategies. Responses were stratified by sex, age (<30 years, 30-60 years, and >60 years) and total number of prior injections (0-9 injections, 10-20 injections and >20 injections). RESULTS: A total of 128 patients were surveyed: 59 males, 41 females and 28 with no sex specified. Our results identified four favorable strategies as those receiving more than 50% "yes" votes. These included the presence of technician/staff during the procedure, the use of a neck pillow, a verbal warning before the injection and performing injections in both eyes on the same day. Other specific strategies were identified for females, younger patients and those with greatest experience. These included: females preferred having their hand held during injections (P = 0.001) and using a stress ball (P = 0.000) when compared to males. Stratifying by age, patients 30-60 years old preferred having their hand held (P = 0.008) and background music (P = 0.007). Stratifying by prior injections, patients with >20 prior injections preferred having their hand held (P = 0.001), using a stress ball (P = 0.021) and, if necessary, having bilateral injections performed the same day to improve comfort (P = 0.037). CONCLUSIONS: Having an extra staff member present during the injection, having a neck pillow, having a verbal warning prior to injection and having both eyes injected on the same day were indicated as favorable strategies by over half of those surveyed. Further, specific strategies were identified for females, younger patients (30-60 years old) and those with greatest experience (>20 injections).