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1.
Arch Soc Esp Oftalmol ; 95(6): 300-310, 2020 Jun.
Artículo en Inglés, Español | MEDLINE | ID: mdl-32409243

RESUMEN

OBJECTIVE: Minimize exposure to the SARS-CoV-2, reduce the chances of cross-transmission between patients and healthcare personnel, and prevent the development of postoperative complications from the management of patients with eye diseases during the 2019 coronavirus disease pandemic (COVID-19). METHODS: COVID-19 literature review and consensus establishment between different Spanish ophthalmology societies in order to provide guidelines and recommendations of maximum resources primarily conditioned by the state of alert, confinement and social distancing that occurs in Spain since March 16, 2020. RESULTS: The recommendations will promote the adoption of action and protection measures for eye care in outpatient clinics, surgical areas and hospitalization, for unconfirmed (asymptomatic and symptomatic) and confirmed COVID-19 patients. Measures must be adapted to the circumstances and availability of personal protective equipment in each of the centers and Autonomous Communities, which will be updated according to the pandemic phases and the measures adopted by the Spanish Government. CONCLUSIONS: During the COVID-19 pandemic, attention to the potential health risks to the population caused by coronavirus should prevail over the possible progression of the common eye diseases. Ophthalmologists and other eye care professionals must assume a possible progression of these diseases due to the impossibility of adequate patient follow-up.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Oftalmopatías/diagnóstico , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Complicaciones Posoperatorias/prevención & control , Antimaláricos/uso terapéutico , Enfermedades Asintomáticas , Seguridad de la Sangre , Cloroquina/uso terapéutico , Lentes de Contacto , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Progresión de la Enfermedad , Oftalmopatías/terapia , Humanos , Hidroxicloroquina/uso terapéutico , Procedimientos Quirúrgicos Oftalmológicos/efectos adversos , Procedimientos Quirúrgicos Oftalmológicos/métodos , Oftalmología , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/prevención & control , Factores de Riesgo , Sociedades Médicas , España , Evaluación de Síntomas/métodos , Privación de Tratamiento
2.
Orbit ; 39(4): 316-318, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32295460

RESUMEN

At present, all parts of the world are hit hard by COVID-19. The first confirmed case of COVID-19 in the territory of Hong Kong was announced on January 23, 2020. Since then, oculoplastic surgeons in Hong Kong have been taking every measure to protect all healthcare workers and patients from contracting the disease. This paper aims to share the experiences of and measures taken by local oculoplastic surgeons in combating COVID-19. Three main aspects are discussed, namely clinical, administrative, and training and educational. We hope our experiences would provide reference to fellow oculoplastic colleagues in other parts of the world in fighting this COVID-19 pandemic.


Asunto(s)
Blefaroplastia/métodos , Infecciones por Coronavirus/epidemiología , Procedimientos Quirúrgicos Oftalmológicos/métodos , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Rinoplastia/métodos , Blefaroplastia/tendencias , Femenino , Hong Kong , Humanos , Masculino , Rinoplastia/tendencias , Medición de Riesgo , Cirugía Plástica/tendencias
3.
Medicine (Baltimore) ; 99(12): e19038, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32195929

RESUMEN

Conventional levator aponeurosis plication is a widely accepted technique for correction of mild to moderate ptosis. However, this method is associated with a high recurrence rate. The objective of this study was to investigate the clinical efficacy of levator aponeurosis posterior layer plication technique for correction of mild to moderate ptosis.A convenience sampling approach was used to recruit 450 patients with mild to moderate blepharoptosis at the Guangzhou Eye-Nose-Face Aesthetic Plastic Surgery Hospital between August, 2015 and December, 2017. All participants were treated with levator aponeurosis posterior layer plication technique. The primary outcome was the postoperative change in marginal reflex distance 1 (MRD1). The paired t test was used to determine the clinical efficacy. Outcomes were assessed at 1 week, 1 month, 3 months, and 6 months after surgery.The mean preoperative MRD1 was 1.7 ±â€Š0.5 mm, and the mean postoperative MRD1 at 6-month follow-up was 3.7 ±â€Š0.4 mm (P < .0001). According to the postoperative survey, 427 (94.9%) patients were satisfied with surgical outcomes.This modified levator aponeurosis plication technique is a simple and effective procedure for correction of mild to moderate blepharoptosis. It results in good MRD1 and high patient satisfaction.


Asunto(s)
Blefaroptosis/cirugía , Procedimientos Quirúrgicos Oftalmológicos/métodos , Adolescente , Adulto , Aponeurosis/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Adulto Joven
4.
BMC Ophthalmol ; 20(1): 9, 2020 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-31906894

RESUMEN

BACKGROUND: To determine whether a sense of deviation remains in adults with successful motor alignment who fulfil diplopia criteria after surgery and to examine the factors associated with this judgement. METHODS: This was a retrospective study. Adult patients defined as having a successful outcome based on more than 1 year of post-operative follow-up visits were included in the study. The sense of deviation was determined at the last visit. Pre- and post-operative deviation and characteristics including age, gender, education level, occupation, diagnosis, size of deviation, extraocular movement (EOM), binocular function, and health-related quality of life (HRQOL) were recorded. RESULTS: In total, 22 (24%) of the 91 adults with successful surgical outcomes reported a sense of deviation. No significant differences were noted between subjects with and without a sense of deviation regarding patient demographics, pre- and post-operative deviation, changes in deviation, sensory fusion or EOM. Subjects with a sense of deviation had an increased prevalence of and larger post-operative vertical deviation, poorer stereo function, and lower HRQOL scores than those with no sense of deviation. The presence of post-operative vertical deviation was associated with a sense of deviation. CONCLUSIONS: Approximately one-fourth (24%) of adults defined as having successful surgical outcomes who still had a sense of deviation exhibited worse stereo function, higher vertical deviation size and lower HRQOL scores. The presence of 3 to 5 prism dioptres(pd) of vertical deviation would be the main factor associated with a sense of deviation post-operatively.


Asunto(s)
Diplopía/fisiopatología , Procedimientos Quirúrgicos Oftalmológicos , Estrabismo/cirugía , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Músculos Oculomotores/cirugía , Procedimientos Quirúrgicos Oftalmológicos/métodos , Calidad de Vida , Estudios Retrospectivos , Estrabismo/fisiopatología , Visión Binocular
5.
Am J Ophthalmol ; 210: 3-7, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31730837

RESUMEN

PURPOSE: To evaluate long-term outcomes of surgical treatment for abnormal head positioning (AHP) associated with infantile nystagmus syndrome (INS). DESIGN: Retrospective observational case series. METHODS: Review of 150 patients who underwent surgery for AHP associated with nystagmus. Outcomes included head positioning, duction limitations, and strabismus, and were evaluated several times postoperatively. Successful collapse of AHP was defined as being ≤10°. RESULTS: Thirty-one patients had surgery for AHP in the pitch (chin up/down) position, whereas 119 had surgery for a horizontal AHP. In addition, 54 underwent 50%-60% augmentation, 19 underwent 40% augmentation, 5 underwent less than 40% augmentation. Thirty-eight had surgical dose modified to correct strabismus, and 3 underwent surgery different from standard Kestenbaum procedures. Collapse of AHP: At the 1-3-week follow-up (n = 131), 125 patients (95%) had collapse of AHP. The percentage trended down at the 2-5-month (91%, n = 106) and 2-year follow-ups (83%, n = 57). However, at 5 and 10 years, it was 93% (n = 42) and 93% (n = 14), respectively, due to reoperation in a small minority. Over- and undercorrection: At 1-3 weeks, 5% of patients were overcorrected whereas 0% were undercorrected. Over- and undercorrection rates peaked at 2 years postoperatively. Ten years out, there were no overcorrections and 7% undercorrections. Four percent of patients required reoperation for overcorrection (mean 2.7 years) and 5% did for undercorrection (mean 3.9 years). CONCLUSION: Surgery for the head positioning associated with INS produces excellent outcomes throughout 10 years postoperatively. Overcorrection presents early and resolves either over time or with additional surgery. Undercorrection develops later and can persist despite reoperation.


Asunto(s)
Cabeza/fisiología , Nistagmo Patológico/cirugía , Músculos Oculomotores/cirugía , Procedimientos Quirúrgicos Oftalmológicos/métodos , Postura/fisiología , Adolescente , Adulto , Niño , Femenino , Humanos , Lactante , Estimación de Kaplan-Meier , Masculino , Nistagmo Patológico/fisiopatología , Estudios Retrospectivos , Estrabismo/cirugía
6.
Ophthalmic Res ; 63(1): 34-40, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31352453

RESUMEN

AIM: To report the outcomes of ab externo surgery using a surgical microscope, wide-angle viewing system, and chandelier endoilluminator (microscope-assisted ab externo surgery) for rhegmatogenous retinal detachment (RRD). METHODS: This was a retrospective study. Consecutive charts of patients with RRD who underwent microscope-assisted ab externo surgery were analyzed. The following demographic parameters were analyzed: age (years), gender (male/female), and eye (right/left). Clinical parameters were axial length (AL) measured in millimeters (mm), preoperative best-corrected visual acuity (BCVA) measured in logarithm of minimum angle of resolution (logMAR), intraocular pressure (IOP), and lens status (phakic/pseudophakic). The parameters of RRD were number and type of retinal breaks, location of retinal breaks, extent of retinal detachment (RD) (number of detached quadrants), and macular detachment (MD), as well as retinal breaks not detected preoperatively. Use of cryopexy, circumferential or segmental scleral buckle, drainage of subretinal fluid, injection of air or gas, and duration of surgery were recorded. The postoperative parameters analyzed were BCVA, IOP and recurrence of RD and postoperative complications. Follow-up was established at 3 months. RESULTS: A total of 213 eyes (97 right, 116 left) of 205 patients (114 males, 91 females) affected by primary RRD were included. Fifty-two eyes (24.4%) were affected by high myopia (AL >26.5 mm), and 160 patients (75.1%) were affected by RRD caused by a single retinal break and involving only one quadrant. The superior quadrant was the most frequently involved (49.3%). Forty-two eyes (19.7%) were affected by MD. In 13 eyes (11.3%), retinal breaks were not detected preoperatively. The duration of surgery was 75.5 ± 42 min. No significant BCVA changes were observed in the whole group, whereas a significant improvement of BCVA from the baseline (2.83 ± 0.87 logMAR) to each time point of follow-up was observed in the subgroup of patients affected by MD. Six eyes (2.8%) developed a recurrent RD, secondary to proliferative vitreoretinopathy (3 eyes) and secondary to a new retinal break (3 eyes). Two eyes developed a persistent vitreous hemorrhage, and one eye developed a macular hole after 1 week. PPV was performed for both. CONCLUSION: Microscope-assisted ab externo surgery is effective and safe, it reduces discomfort, it allows the surgeon to work with both hands free, and provides an adequate visualization of each step being performed.


Asunto(s)
Crioterapia/métodos , Endotaponamiento/métodos , Procedimientos Quirúrgicos Oftalmológicos/métodos , Desprendimiento de Retina/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Microscopía/métodos , Persona de Mediana Edad , Perforaciones de la Retina/cirugía , Estudios Retrospectivos , Agudeza Visual
7.
Eur J Ophthalmol ; 30(1): 132-138, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30360648

RESUMEN

PURPOSE: To determine the possible predictors of the motor outcome after corrective surgery for acquired comitant esotropia. METHODS: The study included 40 patients with acquired comitant esotropia. After evaluation of the visual, sensory, and motor status; cycloplegic refraction; fundus examination; and spectacle prescription, all patients underwent corrective strabismus surgery. A successful motor outcome was defined as 0 to 10 prism diopters of horizontal tropia. Statistical analysis of the results was done using the chi-square tests. RESULTS: At the sixth postoperative month, 90% achieved a successful motor outcome, while 2.5% had a consecutive exotropia >10 prism diopters, and 7.5% had a residual esotropia >10 prism diopters. A statistically significant relationship existed between the motor outcome and the following: preoperative results of the Worth four-dot test at 6 m (p = .011) and 0.33 m (p = .009), preoperative distant (p = .016) and near (p = .017) angles of esotropia with glasses, postoperative near angles of deviation at 1 week (p = .005), 1 month (p < .001), 6 weeks (p < .001), 3 months (p = .001), and 6 months (p < .001) following surgery, postoperative distant angles of deviation at 6 weeks (p < .001) and 3 months (p = .03) following surgery, 6 week (p = .01) and 6 month (p = .036) postoperative results of the Worth four-dot test at 0.33 m, and the 6-month postoperative sensory outcome (p = .006). CONCLUSION: Preoperative and postoperative sensory and motor functions are predictors of the 6-month postoperative motor outcome.


Asunto(s)
Esotropía/cirugía , Movimientos Oculares/fisiología , Músculos Oculomotores/cirugía , Procedimientos Quirúrgicos Oftalmológicos/métodos , Agudeza Visual , Adolescente , Niño , Preescolar , Esotropía/fisiopatología , Femenino , Humanos , Lactante , Masculino , Músculos Oculomotores/fisiopatología , Periodo Posoperatorio , Estudios Prospectivos , Resultado del Tratamiento
8.
N Z Vet J ; 68(2): 112-118, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31738860

RESUMEN

Aims: To evaluate the outcome of surgical management of entropion of the upper and lower eyelids in Shar Pei dogs which had previously undergone temporary palpebral tacking, using the Stades forced granulation procedure of the upper eyelid only.Methods: Medical records were retrospectively searched to identify Shar Pei dogs referred for bilateral entropion of both the lower and upper eyelids, and that were treated with the forced granulation procedure of the upper eyelid only. Dogs were included if they had previously undergone unsuccessful temporary palpebral tacking and had at least three follow-up examinations in the 30 days following surgery.Results: Twenty-seven Shar Pei dogs with a median age of 7.9 (min 4, max 24) months were included in the study. Before surgery, all dogs showed signs of severe ocular discomfort with bilateral keratitis and visual deficit due to blepharospasm, enophthalmos and protrusion of the third eyelid. In 13/54 eyes, keratitis was associated with a corneal ulcer. When re-examined 4 weeks after surgery, correction of the upper eyelid entropion and associated trichiasis resolved ocular signs in 50/54 eyes. Mild bilateral lower entropion remained in two dogs postoperatively, which underwent revision surgery with the Hotz-Celsus technique. There were no cases of long-term recurrence of entropion or ocular irritation in the 38 eyes (19 dogs) which were re-examined 1 year after surgery.Conclusion and clinical relevance: The forced granulation procedure performed on the upper eyelid only was effective for correction of entropion in the Shar Pei dogs included in this study. In our experience, it is preferable to operate on the upper eyelid alone, rather than attempting to correct upper and lower entropion during the same surgical operation. The dog can then be reassessed a few weeks later to determine whether the lower entropion is anatomical or secondary to the severe blepharospasm resulting from the painful ocular irritation.


Asunto(s)
Enfermedades de los Perros/cirugía , Entropión/veterinaria , Párpados/cirugía , Procedimientos Quirúrgicos Oftalmológicos/veterinaria , Animales , Perros , Entropión/cirugía , Párpados/patología , Femenino , Masculino , Procedimientos Quirúrgicos Oftalmológicos/métodos , Estudios Retrospectivos
9.
Strabismus ; 28(1): 25-28, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31775558

RESUMEN

Purpose: To evaluate the efficacy of single or combined superior oblique tendon (SO) advancement for selected cases of unilateral superior oblique palsy (SOP).Methods: The medical records of 14 patients who underwent single or combined superior oblique tendon advancement in one institution from May 2017 to October 2018 were reviewed. All subjects with a diagnosis of unilateral SOP who underwent single or combined SO tendon advancement surgery were included. The goal of the surgery was to correct the hypertropia and head tilt. The single or combined SO tendon advancement surgery was selected based on the amount of hypertropia or head tilt and the Knapp classification of the SOP. The information recorded included pre- and postoperative deviation angle and ocular motility findings. The degree of upshoot in adduction was graded pre- and postoperatively.Results: Fourteen patients between the age of 3 and 52 years with unilateral superior oblique palsy were selected to undergo SO tendon advancement. Single SO tendon advancement was carried out in eight acquired Knapp class II or residual SOP patients. SO tendon advancement combined with contralateral inferior rectus recession was carried out in two acquired Knapp class II patients. SO tendon advancement combined with ipsilateral inferior oblique myectomy was carried out in four congenital Knapp class III patients. The changes in pre- and postoperative hypertropia at primary gaze in single SO tendon advancement patients were from 6.25 ± 2.12 prism diopters to 0.86 ± 1.46 prism diopters. The changes in degree of upshoot in adduction were from +1.86 to +0.21. Conclusions: SO tendon advancement worked well as single or combined muscle procedure to treat unilateral superior oblique palsy.


Asunto(s)
Músculos Oculomotores/cirugía , Estrabismo/cirugía , Tendones/cirugía , Enfermedades del Nervio Troclear/cirugía , Adolescente , Adulto , Niño , Preescolar , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Oftalmológicos/métodos , Periodo Posoperatorio , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
10.
Strabismus ; 28(1): 29-33, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31847669

RESUMEN

Purpose: Monocular transposition of the inferior oblique muscle belly (IOMBT) effectively weakened mild to moderate inferior oblique overaction and corrected small primary position hypertropia. Now we aim to evaluate the efficacy of inferior oblique muscle belly transposition (IOMBT) in treating V pattern strabismus with upshoot in adduction.Methods: This is a retrospective review of 13 patients with V pattern who underwent IOMBT procedure from January 2017 to December 2018. The inclusion criteria were: the amount of V pattern from 15 to 25 pd; the degree of upshoot in adduction from +1 to +3; no or trace vertical deviation in primary gaze position. Bilateral IOMBT was performed to reduce the V pattern. Horizontal rectus muscle surgery was performed at the same stage to correct the horizontal deviation. The angle of deviation in upgaze and downgaze was measured pre- and postoperatively. The degree of elevation in adduction was graded. The amount of V pattern was the difference in horizontal angle between up- and downgaze. The change in the amount of V pattern was assessed postoperatively.Results: All 13 patients had complete resolution of the V pattern. The amount of V pattern changed from 18.92 ± 4.310 prism diopters to 3.462 ± 1.854 prism diopters postoperatively. The mean grade of upshoot in adduction changed from 1.92 to 0.12 postoperatively. No depression in adduction or consecutive A pattern were found after surgery.Conclusions: IOMBT can successfully eliminate the V pattern in patients with mild V pattern esotropia or exotropia with mild to moderate upshoot in adduction. This procedure appears to be a useful addition to our inferior oblique surgical armamentarium.


Asunto(s)
Músculos Oculomotores/trasplante , Procedimientos Quirúrgicos Oftalmológicos/métodos , Estrabismo/cirugía , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino , Periodo Posoperatorio , Estudios Retrospectivos , Estrabismo/fisiopatología , Resultado del Tratamiento , Visión Binocular/fisiología
12.
Asia Pac J Ophthalmol (Phila) ; 8(6): 476-480, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31789650

RESUMEN

BACKGROUND: Pterygium causes a significant ocular disturbance which usually requires surgical removal; however, recurrence of pterygium after surgery frustrates both patients and surgeons. This survey aimed to determine the current surgical approaches in primary and recurrent pterygium, and the ideal surgical techniques among Thai ophthalmologists. METHODS: Questionnaires were sent to 1150 ophthalmologists who are members of Royal College of Ophthalmologists of Thailand (RCOPT). A survey was conducted between 21 September and December 21, 2016. RESULTS: 438 of 515 responded questionnaires were valid. The highest number of the respondents applied the bare sclera technique (BST) (37.4%) and conjunctival autograft transplantation (CAGT, 44.9%) in primary pterygium and recurrent pterygium, respectively. The recurrence was the most reported late postoperative complication. An ideal technique for primary pterygium surgery was CAGT (42.4%), whereas amniotic membrane transplant (AMT) with adjuvant therapy (27.4%) was most selected for recurrent pterygium. Around half of the respondents currently applied the ideal techniques in their practice. The inaccessible and unaffordable amniotic membranes or fibrin glues (58%) concerning about complications (26%), inexperience in surgical procedures (25%), large number of patients in the surgery waiting list, prolonged surgical time, and need for conjunctiva preservation in glaucoma patients were reported as the obstacles to the ideal techniques. CONCLUSIONS: BST and CAGT were the most selected surgical techniques for primary and recurrent pterygium, respectively. Better provision and distribution of amniotic membranes and fibrin glue along with training courses would promote the ideal surgical techniques.


Asunto(s)
Conjuntiva/anomalías , Procedimientos Quirúrgicos Oftalmológicos/métodos , Pterigion/cirugía , Amnios/trasplante , Conjuntiva/cirugía , Conjuntiva/trasplante , Adhesivo de Tejido de Fibrina/uso terapéutico , Humanos , Recurrencia , Tailandia , Trasplante Autólogo
13.
Medicine (Baltimore) ; 98(51): e18077, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31860958

RESUMEN

RATIONALE: Angelman syndrome (AS) is an uncommon genetic disease characterized as serious retarded mental development and ocular abnormality. PATIENT CONCERNS: This report aims to present the ophthalmological features, and identify the diagnosis and outcomes of strabismus surgery in AS patients. DIAGNOSIS: Three children with exotropia were diagnosed with AS based on their typical clinical features. INTERVENTIONS: All patients underwent multiplex ligation-dependent probe amplification (MLPA) analysis and accepted lateral rectus recession surgery with the assistance of intravenous combined inhalation anesthesia. OUTCOMES: The maternal heritage deletion of chromosome 15q11.2-q13 was verified in all patients by MLPA. All patients with strabismus could not cooperate during the vision test, and had astigmatism. The strabismus type of AS patients was horizontal exotropia, and no vertical strabismus was found. One of these patients was combined with high myopia. The hypopigmentation on the hair and iris was ubiquitous. However, retina pigmentation was normal. After different degrees of lateral rectus recession, the exotropia was significantly relieved, and the surgical effects were stable postoperatively. LESSONS: Horizontal exotropia is the major strabismus type. Severe intellectual disability, hyperactivity, and speech impairment are the common characteristics of AS children. Its examination and operation design remains challenging. Thus, repeated examinations and intelligence rehabilitation are essential.


Asunto(s)
Síndrome de Angelman/diagnóstico , Exotropía/diagnóstico , Exotropía/cirugía , Movimientos Oculares/fisiología , Músculos Oculomotores/cirugía , Procedimientos Quirúrgicos Oftalmológicos/métodos , Síndrome de Angelman/complicaciones , Niño , Preescolar , China , Exotropía/complicaciones , Femenino , Humanos , Masculino , Músculos Oculomotores/fisiopatología , Pronóstico , Enfermedades Raras , Recuperación de la Función , Estrabismo/complicaciones , Estrabismo/diagnóstico , Estrabismo/cirugía , Resultado del Tratamiento , Pruebas de Visión
14.
J Refract Surg ; 35(11): 740-747, 2019 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-31710377

RESUMEN

PURPOSE: To review the intraoperative and postoperative complications after intracorneal ring segment implantation and to report the explantation rate among the available scientific literature. METHODS: Three different databases (PubMed, Web of Science, and Scopus) were assessed from January 1995 to June 2019. The keywords used were: ring, rings, ICRS (intracorneal ring segments), segment, segments or Intacs, complication, explantation, explanted, retired, and removal. RESULTS: The selection process of this systematic review study is described in a flow diagram. A total of 39 studies published between 1995 and 2019 were included. Sixteen studies were case reports, 21 were case series studies, and 2 were chart analysis works. This study enrolled 1,946 participants, and 2,590 eyes were included. The postoperative complications described in most studies included migration, ring extrusion, corneal thinning, corneal melting, and some type of infective keratitis. These complications together with glare, halos, fluctuating vision, neovascularization, foreign body sensation, or pain represented most of the causes. The percentage rate of explantation ranged from 0.5% up to 83.3%. If we analyze those articles with a high number of implantations (2,124 eyes), an explantation rate between 0% and 1.4% was obtained. CONCLUSIONS: The complication rate and explantation ratio in segments of the intracorneal ring segments analyzed in the available scientific literature are minimal. Therefore, patient selection, surgery planning, and postoperative follow-up are critical to the success of surgery. [J Refract Surg. 2019;35(11):740-747.].


Asunto(s)
Sustancia Propia/cirugía , Remoción de Dispositivos/métodos , Miopía/cirugía , Procedimientos Quirúrgicos Oftalmológicos/métodos , Complicaciones Posoperatorias/cirugía , Prótesis e Implantes/efectos adversos , Sustancia Propia/patología , Topografía de la Córnea , Humanos , Complicaciones Posoperatorias/diagnóstico
15.
Rom J Ophthalmol ; 63(3): 273-276, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31687631

RESUMEN

Purpose. To report a case of benign fibrous histiocytoma of the conjunctiva involving the cornea, an uncommon ocular surface tumor. Methods. A 57-year-old patient came in our service complaining of a progressively enlarging conjunctival mass temporally to the limbus and invading the adjacent cornea of the left eye. Results. The approach consisted in surgical excision followed by cryotherapy on the edges and on the base of the excision site and amniotic membrane patch reconstruction of the ocular surface defect. Pathologic examination and immunohistochemistry were performed in order to establish the diagnosis. No recurrences appeared in 8 months of follow up. Conclusions. Fibrous histiocytoma might be easily misdiagnosed as it is exceedingly rare. Complete resection with careful inspection of edges is advised. Cryotherapy at the base and borders of the resection site is recommended as both benign and malignant tumors can show recurrence. Amniotic membrane should always be regarded as an efficient option in reconstruction of broad surface defects after tumor resection. Abbreviations: FH = fibrous histiocytoma, CIN = corneal intraepithelial neoplasia, SSCA = squamous cell carcinoma, AM = amniotic membrane, MMC = topical mitomycin-C, 5-FU = 5-fluorouracil, BCVA = best corrected visual acuity.


Asunto(s)
Conjuntiva/patología , Enfermedades de la Conjuntiva/diagnóstico , Crioterapia/métodos , Histiocitoma Fibroso Benigno/diagnóstico , Procedimientos Quirúrgicos Oftalmológicos/métodos , Enfermedades de la Conjuntiva/terapia , Diagnóstico Diferencial , Histiocitoma Fibroso Benigno/terapia , Humanos , Masculino , Persona de Mediana Edad , Lámpara de Hendidura
16.
Medicine (Baltimore) ; 98(47): e18185, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31764860

RESUMEN

RATIONALE: Nd:YAG laser-induced macular holes (MHs) feature more extensive anatomical defects and worse functional outcomes than idiopathic MHs. Although new treatment options for large refractory MHs have been suggested, the current literature on Nd:YAG laser-induced MHs suggests only conventional pars plana vitrectomy combined with internal limiting membrane (ILM) peeling, which is the same treatment as for idiopathic MHs. PATIENT CONCERNS: A 40-year-old dermatologist was referred to us because of a sudden decrease in visual acuity following exposure to a floor-tile-reflected single-shot Nd:YAG laser beam while not wearing protective goggles. DIAGNOSES: An Nd:YAG laser-induced MH was diagnosed based on fundoscopy and optical coherence tomography (OCT). INTERVENTIONS: Pars plana vitrectomy using an inverted ILM flap technique and autologous platelet concentrate (APC) was performed. OUTCOMES: Postoperative spectral domain OCT and en-face OCT showed "U-shaped" closure of the MH and a decreased ellipsoid zone defect, while the best-corrected visual acuity improved from 20/500 to 20/25. LESSONS: The inverted ILM flap technique combined with APC is an effective option to achieve successful MH closure and visual improvement in patients with an Nd:YAG laser-induced MH.


Asunto(s)
Dermatología , Láseres de Estado Sólido/efectos adversos , Traumatismos Ocupacionales/etiología , Traumatismos Ocupacionales/cirugía , Perforaciones de la Retina/etiología , Perforaciones de la Retina/cirugía , Colgajos Quirúrgicos , Adulto , Humanos , Masculino , Procedimientos Quirúrgicos Oftalmológicos/métodos
17.
Medicine (Baltimore) ; 98(48): e18123, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31770242

RESUMEN

This retrospective observational study aims to report the clinical characteristics and surgical results in eyes with Posner-Schlossman syndrome (PSS), and compare these outcomes between cytomegalovirus (CMV)-positive and -negative eyes.We reviewed the medical records of 21 consecutive immunocompetent patients clinically diagnosed with PSS between the years 2010 and 2018. Aqueous humor was collected from all the affected eyes to detect if CMV was present, and polymerase chain reaction (PCR) was performed using the herpesvirus family primers.The average period between the initial PSS attack and aqueous humor sampling at our institute was 9.3 years. Out of the 21 patients, 62% were CMV-positive. Regardless of CMV status, the mean intraocular pressure (IOP), mean deviation (MD), and central corneal endothelium cell (CEC) density, at the initial examination at our institute were already significantly worse in the affected eyes than in the unaffected eyes (all P values < .05). The average visual acuity (VA) was only significantly worse in the CMV-positive group (P = .02). Out of all the patients, those that were CMV-positive had undergone more glaucoma surgeries (P = .056). Fourteen patients underwent either a trabeculectomy (TRAB) or a trabeculotomy (LOT), and their IOP significantly reduced following surgery (P < .001). In 85.7% of those that had surgery, their IOP was successfully lowered to less than 20 mm Hg.Long-lasting PSS causes a decrease in VA, MD, and the CEC density. A prompt diagnosis is required, and an appropriate treatment plan should be formulated. In those patients with PSS that develop uncontrolled glaucoma, both TRAB and LOT may be effective in controlling IOP.


Asunto(s)
Infecciones por Citomegalovirus/cirugía , Citomegalovirus , Infecciones Virales del Ojo/cirugía , Hipertensión Ocular/cirugía , Procedimientos Quirúrgicos Oftalmológicos/estadística & datos numéricos , Uveítis Anterior/cirugía , Infecciones por Citomegalovirus/virología , Epitelio Anterior/cirugía , Epitelio Anterior/virología , Infecciones Virales del Ojo/virología , Femenino , Glaucoma/cirugía , Glaucoma/virología , Humanos , Presión Intraocular , Masculino , Persona de Mediana Edad , Hipertensión Ocular/virología , Procedimientos Quirúrgicos Oftalmológicos/métodos , Estudios Retrospectivos , Síndrome , Trabeculectomía , Resultado del Tratamiento , Uveítis Anterior/virología
18.
Ophthalmic Surg Lasers Imaging Retina ; 50(11): e278-e287, 2019 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-31755979

RESUMEN

BACKGROUND AND OBJECTIVE: To analyze the anatomic success rate of pars plana vitrectomy (PPV), retinectomy, and silicone oil (SO) tamponade without scleral buckle (SB) for repair of recurrent rhegmatogenous retinal detachment (RRD) associated with proliferative vitreoretinopathy (PVR). PATIENTS AND METHODS: Retrospective, consecutive, single-surgeon case series of 28 eyes of 28 patients with PVR-associated RRD repaired with PPV, retinectomy, and SO tamponade without SB. RESULTS: The single-procedure anatomic success rate was 85.2% at 3 months and 82.1% at 12 months. Final reattachment rate was 100.0%. There were no preoperative factors that predicted single procedure anatomic success. Mean logarithm of the minimal angle of resolution visual acuity (VA) was improved at 3 months (1.61 to 1.51, P = .732) and at 12 months (1.61 to 1.41; P = .271). VA outcome was related to preoperative macula and lens status. CONCLUSION: The single-procedure anatomic success rate of PPV, retinectomy, and SO tamponade without SB for PVR-related recurrent RRD is comparable to prior reports of similar surgery incorporating SB. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:e278-e287.].


Asunto(s)
Procedimientos Quirúrgicos Oftalmológicos/métodos , Desprendimiento de Retina/cirugía , Vitreorretinopatía Proliferativa/complicaciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Endotaponamiento/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Curvatura de la Esclerótica/métodos , Aceites de Silicona/administración & dosificación , Agudeza Visual , Vitrectomía/métodos , Vitreorretinopatía Proliferativa/cirugía , Adulto Joven
19.
Ophthalmic Plast Reconstr Surg ; 35(6): e136-e138, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31567913

RESUMEN

The development of orbit-eroding mucocele associated with inverted papilloma has been rarely reported., Here, the authors present a case and surgical management of a patient with orbit-eroding mucocele associated with inverted papilloma who declined craniotomy. A combined approach utilizing frontal endoscopic sinus surgery and external sub-brow anterior orbitotomy was used to explore, drain, and excise the mucocele and inverted papilloma. Gelatin sponges soaked in gentamicin were used to cover the exposed dura and to protect the orbital content from the frontal sinus cavity.A fronto-ethmoidal sinus inverted papilloma associated with recurrent orbit-eroding mucocele was excised by combined transnasal endoscopic and external sub-brow anterior orbitotomy approach using stereotactic navigation.


Asunto(s)
Senos Etmoidales/patología , Mucocele/cirugía , Procedimientos Quirúrgicos Oftalmológicos/métodos , Enfermedades Orbitales/cirugía , Papiloma Invertido/cirugía , Neoplasias de los Senos Paranasales/cirugía , Anciano , Humanos , Masculino , Papiloma Invertido/complicaciones , Neoplasias de los Senos Paranasales/complicaciones , Resultado del Tratamiento
20.
J Binocul Vis Ocul Motil ; 69(4): 153-156, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31584357

RESUMEN

Acquired strabismus fixus is a rare form of severe esotropia described most frequently in patients with high axial myopia and infrequently associated with other conditions. Refractive errors, cataracts, and ocular motility disorders are common in patients with trisomy 21. We report two unusual cases of patients with trisomy 21 who developed severe acquired restrictive strabismus fixus. Both patients were successfully treated with medial rectus recession followed by lateral rectus and superior rectus myopexy combined with additional medial rectus weakening, including free tenotomy in one case.


Asunto(s)
Síndrome de Down/complicaciones , Movimientos Oculares/fisiología , Músculos Oculomotores/fisiopatología , Estrabismo/etiología , Progresión de la Enfermedad , Femenino , Humanos , Persona de Mediana Edad , Músculos Oculomotores/cirugía , Procedimientos Quirúrgicos Oftalmológicos/métodos , Índice de Severidad de la Enfermedad , Estrabismo/fisiopatología , Estrabismo/cirugía
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