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1.
Bo Li Sapna Sharan 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(1):45-48
Objective
To describe the presentation, clinical evaluation, work-up, surgical management, and surgical outcomes in children older than 8 years with spontaneous, comitant, acquired nonaccommodative esotropia (ANAET).Design
Retrospective chart review.Participants
Children who underwent bilateral medial rectus recession surgery for ANAET with initial esotropia onset later than 8 years of age.Methods
The medical records of children older than 8 years presenting with ANAET from 2009 to 2015 were retrospectively reviewed. The clinical presentation, work-up, surgical intervention, preoperative and postoperative deviations, and surgical outcomes were recorded.Results
A total of 7 healthy patients were identified. The average age of onset was 11.9 years. All patients presented with symptoms of diplopia with large-angle esotropia. Most patients had no preceding illness and presented with minimal refractive error. All 7 patients had unremarkable neurological and general pediatric evaluations without findings of acute intracranial pathology on neuroimaging. Bilateral medial recession surgery was performed for all 7 patients with resolution of diplopia and excellent stereopsis postoperatively.Conclusions
Diplopia is the most common presenting symptom among older children presenting with ANAET. Bilateral medial recession surgery achieved excellent postoperative results with resolution of diplopia and excellent stereopsis. 相似文献2.
Kelsey A. Roelofs Chris J. Rudnisky 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):533-537
Objective
To evaluate the refractive outcomes after anterior capsular tear (ACT).Design
Retrospective case–control study.Participants
After ethics approval, the surgical operative records of 4301 consecutive patients undergoing cataract surgery by a single surgeon were reviewed for cases of ACT.Methods
All ACTs were managed using a balancing incision of the capsulorrhexis margin 180 degrees away from the tear. If the patient’s other eye had undergone cataract surgery by the same surgeon, it was included as a control.Results
Fifty-one eyes of 51 patients were complicated by ACT (incidence = 1.2%). The mean age of patients in the study was 64.2 ± 12.1 years. Of the 51 patients with ACT, 34 underwent contralateral surgery. These eyes were used as the control group. There was no significant difference in preoperative visual acuity (p = 0.683) or proportion of eyes that received in-the-bag intraocular lens placement (p = 0.347) between groups (ACT = 92.2%; control = 97.1%). In 3 ACT eyes, the tear extended into the posterior capsule (5.9%), and although this did not occur in control eyes, this difference was not statistically significant (p = 0.150). There was no difference in best-corrected final logMAR visual acuity between groups (p = 0.424) or postoperative spherical equivalent between ACT (?0.23 ± 1.2D) and control (?0.15 ± 0.62D) eyes (p = 0.985).Conclusions
Cataract extraction complicated by ACT can result in equivalent visual and refractive outcomes as in uncomplicated surgery. The technique used in this study prevented extension of ACT to the posterior capsule in 94.1% of cases. 相似文献3.
Andrei-Alexandru Szigiato Simrenjeet Sandhu Gokulan Ratnarajan Michael W. Dorey Iqbal Ike K. Ahmed 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(3):246-251
Objective
To evaluate and compare the surgeon’s learning experience with an ab-interno gelatin microstent (XEN-45, Allergan) to other glaucoma surgeries.Design
Cross-sectional survey study.Methods
All surgeons in Canada who used the gelatin microstent were identified and given an anonymous online survey (FluidSurveys, Survey Monkey) designed to evaluate key factors associated with the device, including prior surgical experience, patient selection criteria, analysis of each surgical step, and postoperative care. The survey was validated using input from 3 experienced glaucoma surgeons.Results
Surgeons were in early to mid-career (11.8 ± 7.2 operating years) and experienced with filtration surgery (94.1% very comfortable). Surgeons would more commonly operate on patients who had moderate to advanced disease (88.2% and 76.5% of surgeons felt appropriate to operate, respectively); had a diagnosis of primary open angle glaucoma or pseudoexfoliative glaucoma (70.6%); were on 2, 3, or 4 glaucoma medications (70.6%, 75.5%, 70.6%, respectively); and had previously undergone microinvasive glaucoma surgery (83.3%). Creation of the scleral tunnel into the subconjunctival space was rated the most difficult step of the surgery. Most surgeons (52.9%) required 6–10 cases to be comfortable with the procedure and felt it was easier to gain proficiency with ab-interno microstent implantation than traditional filtration surgery (94.1% agree or strongly agree).Conclusion
The group of glaucoma surgeons surveyed felt it was easier to gain proficiency with gelatin microstent implantation than with traditional filtration surgery. 相似文献4.
Jingwen Ding Xuan Ma Yue Xin Dongmei Li 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):458-461
Objective
Lower eyelid retraction is a common and challenging complication of the anophthalmic socket. The underlying pathophysiology includes contraction of the posterior lamellae of the eyelid, shortening of the inferior fornix, and lateral canthal tendon laxity. This study aimed to evaluate the surgical efficacy of hard palate mucosa as a posterior spacer graft in the lower eyelid retraction repair in the anophthalmic socket.Methods
The surgical technique involved hard palate grafting combined with recession of inferior retractors and lateral tarsal strip suspension to lengthen the posterior lamellar and strengthen the support of the lower eyelid. The records of anophthalmic patients with lower eyelid retraction who underwent this technique from January 2009 through August 2014 were reviewed. Postoperative outcomes were determined by lower eyelid elevation, presence of lagophthalmos, complications, prosthesis fitting, and patient satisfaction.Results
A total of 12 patients (12 eyelids) were included. The mean age at surgery was 36 years (range, 29–52 years) and the mean follow-up period was 53 months (range, 20–71 months). The lower eyelids of the operated eyes significantly elevated by 2.9 ± 0.8 mm, and mild residual lagophthalmos was observed in 3 patients. All patients were satisfied with the surgical outcomes. Minor complications occurred in 3 cases, including mild recurrent retraction, granuloma, and mucous discharge. There were no complications detected at the donor site.Conclusion
Hard palate grafting combined with recession of lower eyelid retractors achieves long-term stable outcomes in lower eyelid retraction repair in the anophthalmic socket. 相似文献5.
Nicolas Cadet Isabelle Hardy Diana Dudek Krystyna Miszkiewicz Patrick Boulos Quyhn Nguyen Jamie Wong 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(1):29-33
Objective
To evaluate the effectiveness of a topical silicone gel on scars in patients who had undergone bilateral direct brow lift surgery.Design
A randomized double-blind clinical trial with a placebo applied to one scar and topical silicone gel (Dermatix Ultra; Valeant Pharmaceuticals, Laval, Que.) used on the other scar for 2 months.Participants
Twelve patients (for a total of 24 surgical scars evaluated) were included in the study.Methods
This study was performed in 2 academic hospitals of the University of Montreal in Montreal, Que. (Maisonneuve-Rosemont Hospital and Notre-Dame Hospital). Inclusion criteria were all bilateral direct brow lift surgeries performed in our hospitals. Exclusion criteria included revision surgery, silicone or latex allergy, and wound infection. Each patient received 2 tubes (1 with silicone gel and 1 with placebo) and applied 1 tube to their right brow scar and the other tube to their left brow scar, following the preassigned instructions. The patient and surgeon were blinded to the nature of the substance that was applied to each scar. At each visit, pictures of both scars were taken, and a questionnaire titled “The Patient and Observer Scar Assessment Scale” was filled out by the patient and the surgeon. A grade ranging from 0 to 10 was given on the multiple criteria in the questionnaire, and the sum of these grades was subsequently used for the data analysis. A lower sum was interpreted as improved scarring. At the end of the study, an independent evaluator graded both scars based on pictures. Follow-up visits were held on day 7, week 6, month 3, and month 6 after surgery. A comparison of the experimental and placebo group was performed with nonparametric tests of Wilcoxon signed rank.Results
A total of 24 scars of 12 patients were analyzed (based on 4 follow-up visits). General improvement of scars was reported by the patient, the surgeon, and based on pictures. No statistically significant difference was found between the group treated with silicone gel and the group treated with placebo. All tests had a p value ≥0.08.Conclusions
We did not find a statistically significant difference between scars treated with silicone gel and scars treated with the placebo after direct brow lift surgery. 相似文献6.
Milad Modabber Andrei F. Dan Razek G. Coussa Michael Flanders 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(6):621-626
Objective
To characterize the ocular response to retrobulbar anaesthesia and to evaluate the efficacy of retrobulbar anaesthesia for adjustable strabismus surgery in adults.Design
Prospective observational study.Participants
Adult patients undergoing adjustable strabismus surgery under retrobulbar anaesthesia.Methods
Surgical success was defined by ocular alignment within 10 prism diopters (PD) of orthotropia for horizontal rectus surgery and within 5 PD for vertical rectus surgery. After retrobulbar injection of Xylocaine with epinephrine, the onset time and the degree of visual impairment, ocular akinesia, and analgesia were evaluated. Postoperative parameters included the restoration of vision, onset of pain, resolution of ptosis, normalization of pupil, resolution of extraocular motility deficits, and the timing of postoperative adjustment. Perioperative complications were also documented.Results
A total of 33 patients were initially included in this study. Two patients experienced complications (perioperative retrobulbar hemorrhage, postoperative suprachoroidal hemorrhage) and were excluded from data analysis. Of the remaining 31 patients (mean age, 50.2 ± 14.8 years), surgical outcome was satisfactory in 30/31 (96.8%) patients at the first postoperative visit and in 15/19 (78.9%) cases at last follow-up (mean, 6.1 ± 1.6 months). Excellent intraoperative ocular akinesia and analgesia was achieved with retrobulbar anaesthesia. After retrobulbar injection, visual impairment was the first to resolve to preoperative levels within (mean ± SD) 3.7 ± 1.9 hours postinjection, followed by onset of pain at 4.1 ± 1.0 hours, resolution of ptosis at 4.3 ± 1.9 hours, and normalization of pupil reactivity at 6.1 ± 1.0 hours. The resolution of anaesthesia upon extraocular motility occurred within 5.7 ± 1.0 hours postinjection (range, 4.5–8.0 hours), allowing for subsequent same-day postoperative adjustment.Conclusions
Retrobulbar anaesthesia in the context of adult, adjustable strabismus surgery is a relatively safe and effective technique. It provides excellent intraoperative analgesia and akinesia. Retrobulbar anaesthesia enables for same-day suture adjustments to be reliably performed. 相似文献7.
Michelle M. Porter Andrew W. Cull 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):538-541
Objective
Cataract surgery can have many benefits for older adults, including enabling continued ability to drive. However, it is not known how objectively measured driving patterns change after cataract surgery. The purpose of this study was to examine how participants drove before and after cataract surgery.Design
Longitudinal study.Participants
Individuals from the Winnipeg site of Candrive (a longitudinal study of older drivers in Canada).Methods
An in-vehicle device monitored all trips taken in 1-second intervals, allowing for the analysis of distances driven, number of trips, time of trips, speeding, excessive braking/accelerating, and types of roadways.Results
Over the 4 years of data collection, there were 16 cases of participants having cataract surgery, whereby there was also suitable driving data for analyses. Participants drove 28% further after surgery (p = 0.022). They also drove further from home and more on primary roads (p < 0.05) and had fewer episodes of hard braking per distance travelled (p < 0.001). No other variables significantly changed.Conclusions
This study suggests that older drivers changed some of their driving patterns after cataract surgery. Future studies could explore the effects of increased driving exposure, in conjunction with potentially safer driving behaviors, on overall driving safety after cataract surgery. 相似文献8.
Parveen Sen Vinay Kumar S. Pramod Bhende Pukhraj Rishi Ekta Rishi Chetan Rao Dhanashree Ratra Pradeep Susvar Sreelakshmi Kummamuri Sufiyan Shaikh Lingam Gopal 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(1):49-55
Objective
To study the outcome and complications of sutured scleral fixated intraocular lenses (SSFIOL) in children.Design
Retrospective study.Subjects
A total of 279 eyes of 230 children who underwent SSFIOL at ≤18 years of age in a tertiary eye care centre in India.Methods
Treatment-naive children having traumatic cataract or subluxated lens underwent a single-sitting lensectomy and pars plana vitrectomy (PPV), along with SSFIOL insertion. Children with aphakia underwent PPV with SSFIOL, and vitrectomized eyes underwent only SSFIOL implantation. Fixation of SSFIOL was done by the 4-point ab externo fixation technique using 10-0 prolene suture.Main outcome measures
Preoperative and postoperative visual acuity, as well as intraoperative and postoperative complications.Results
The mean age at which SSFIOL was performed was 10.8 ± 4.22 years. The most common indication of SSFIOL in our study was traumatic subluxation of lens (47.63%; n = 133 patients), followed by congenital subluxation in 38.7% (n = 108). Best-corrected visual acuity was maintained or improved from the preoperative visual acuity in 93.19% of eyes. The complications included choroidal detachment in 2.86% (n = 8), dispersed vitreous hemorrhage in 2.86% (n = 8), endophthalmitis in 0.72% (n = 2), raised intraocular pressure in 12.54% (n = 35), diplopia in 0.72% (n = 2), retinal detachment in 5.73% (n = 16), and dislocation of the SSFIOL in 4.6% (n = 13). The mean follow-up after SSFIOL implantation was 39.68 months.Conclusions
SSFIOLs are effective in correcting aphakia in children; long-term follow-up of these children is, however, necessary. 相似文献9.
Jacob A. Evans Thomas J.E. Clark Kai Wang Erin M. Shriver 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):462-465
Objective
To introduce “iris show,” the amount of visible iris tissue between the superior pupil border and the upper eyelid margin, to evaluate the effect of iris show on perceived upper eyelid height, and to discuss potential nonsurgical treatment options for mild blepharoptosis.Methods
Participants completed a survey containing 4 subject photographs. These photographs depicted images of varying iris colouration (blue, green, light brown, and dark brown) with identical upper eyelid marginal reflex distance (MRD1) values, but asymmetric pupil size/amount of visible iris show. Study participants were asked to select the eyelid that appeared “droopier,” or choose “same height.” Statistical analyses used 1-tailed and 2-tailed t tests.Results
390 participants completed the survey. In photographs of blue and green irides, both eyelids had equal MRD1s, but the eyelid with less iris show was perceived as more ptotic (p = 0.002 and 0.03, respectively). In patients with dark brown irides, eyelid heights were perceived as identical despite differences in iris show (p = 0.002).Conclusions
Decreased iris show corresponds to perceived lowering of the upper eyelid in light-coloured irides (e.g., blue and green), but may be less impactful in brown and/or dark brown irides where the iris tissue is less distinguishable from the pupil. Topical instillation of apraclonidine may represent a nonsurgical option for treatment of mild blepharoptosis in patients with light irides as it both elevates the upper eyelid margin and induces miosis, resulting in an increase in iris show and corresponding enhanced perception of upper eyelid elevation. 相似文献10.
Samuel M. Philbrick Darrell E. Baskin 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(3):222-228
Objective
To determine whether stereoscopic footage of cataract surgery could be captured with smartphones and to develop a procedure for editing and viewing the footage. The authors sought to measure whether subjectively convincing stereo footage could be captured with smartphones, whether it would be possible to sync this footage for stereoscopic viewing, and whether these tasks could easily be performed at lower cost than commercially available options.Design
Brief research report.Participants
The entities studied were phones and programs.Methods
Surgeries were recorded at Fort Belvoir Community Hospital. Two smartphones were attached to the eyepieces of a surgical microscope’s assistant scope. Surgical footage was recorded. Videos from the left and right eyepieces were edited and combined into videos that facilitated stereoscopic viewing.Results
Stereo footage was captured with 2 smartphones and edited to enable 3D viewing with both anaglyph glasses and head-mounted displays. Viewing experience was superior when using head-mounted displays compared to using anaglyph glasses.Conclusions
Stereoscopic footage of operations performed under the surgical microscope may be captured and viewed using inexpensive equipment and simple procedures requiring minimal prior expertise. The techniques described in this paper may enable more training programs to capture and distribute 3D footage of their operations, enhancing the educational value of ophthalmic surgical videos. 相似文献11.
Laura B. Amsden Neal H. Shorstein Helene Fevrier Liyan Liu James Carolan Lisa J. Herrinton 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(4):337-341
Objective
We surveyed cataract surgeons to gain insight into their perceptions of and attitudes about immediate sequential bilateral cataract surgery (ISBCS).Design
Cross-sectional.Participants
All active cataract surgeons in Kaiser Permanente Northern California in 2016.Methods
Online survey that asked cataract surgeons why they did or did not perform ISBCS, their interest in offering ISBCS, concerns about the procedure, and desired supports.Results
Of the 165 active cataract surgeons, 107 (65%) participated in the survey, of whom 92 (86%) responded that they currently practiced ISBCS and 15 (14%) reported that they did not. For ISBCS surgeons, patient convenience (95%) and patient request (91%) were the top reasons for performing the procedure. For surgeons who do not perform ISBCS, the most commonly cited concerns were not having the postoperative refractive outcome from the first eye to guide intraocular lens selection in the second eye (80%) and risk of bilateral vision loss (73%). Among those who do not perform ISBCS, 9 (60%) identified the need for evidence-based patient selection criteria to support a decision to adopt the procedure. In addition, many surgeons in both groups wanted streamlined patient education materials and established protocols.Conclusion
Patient centeredness is a key construct of contemporary health care delivery, and in an era of low complication risk, many patients request ISBCS; the number of these surgeries has increased. In our capitated health care system, the great majority of surgeons perform ISBCS for the convenience of their patients. Providing surgeons with guidelines and tools to support ISBCS likely would increase adoption. 相似文献12.
Tarek Ibrahim Phillip Goernert Guillermo Rocha 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(1):56-59
Objective
To determine the time needed to perform a femtosecond laser–assisted cataract surgery (FLACS) and its effect on the efficiency of cataract surgery flow in a Canadian public health centre.Design
Retrospective chart review.Participants
Patients who had cataract surgery performed in the first 3 months of femtosecond laser (FSL) technology use were compared with patients who had conventional phacoemulsification in the 3 months before FSL installation at Brandon Regional Health Centre (Brandon, Man.).Methods
The primary outcome measure was the time needed to complete FLACS versus the time needed to complete conventional phacoemulsification. Secondary outcome measures were the time the patient spent in the operating room (time in and time out) and the number of cataract surgeries done per surgical day before and after FSL was implemented systemwide.Results
There were 235 FSL cases and 199 conventional cases. Operating room time, total surgery time, and manual time were significantly longer in patients who underwent FLACS compared with patients who underwent conventional phacoemulsification (p < 0.001). Manual times and FSL suction times on the first day of implementing FLACS surgery were significantly longer than those on day 23 (p < 0.03), which suggests a learning curve effect. The number of cases per surgical day dropped by 28.6% in the first operative day and by 7.1% in the second and third operative days of FSL use, then reverted to pre-FSL levels.Conclusion
The addition of FLACS results in longer time per case than traditional cataract surgery. Although statistically significant, the results may not be indicative of practical differences. 相似文献13.
Helen Chung Emi Sanders Jamie Bhamra 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(3):278-283
Objective
To investigate public perception that ophthalmologists are hesitant to undergo refractive surgery by determining the personal opinions of ophthalmologists on different surgical options.Design
Prospective cross-sectional survey.Participants
Members of the American Society of Cataract and Refractive Surgery electronic mailing list.Methods
An online survey administered from July to August 2014.Results
There were 396 (5.7%) respondents: 204 (51.5%) would undergo laser refractive surgery (LRS) and 192 (48.5%) would not. Of the 228 (57.6%) with refractive error, 121 (53.1%) would have LRS, with 83 (36.4%) already having had the procedure done. Top reasons against LRS include existing contraindications, worry about intolerable side effects, and worry about complications. 179 (45.3%) would undergo lenticular refractive surgery (lenRS), with 22 (12.3%) having already had this done. Among those who said yes, most preferred a monofocal intraocular lens (IOL; 59 [33.0%]), whereas those who said no thought Toric IOLs to be superior (82 [38.0%]). 184 (46.6%) would undergo femtosecond laser–assisted cataract surgery (FLACS); the main reason against FLACS was concern regarding efficacy, followed by safety. Pearson χ2 analysis found that younger age and higher number of LRS procedures performed were associated with increased willingness to undergo LRS. Furthermore, willingness to undergo LRS was positively correlated with willingness to undergo lenRS.Conclusions
Ophthalmologists indeed are willing to undergo corrective refractive procedures. There is an approximately 50–50 divide on whether or not they would undergo LRS. Slightly less than half of ophthalmologists would personally undergo lenticular surgery, which includes cataract refractive surgery and FLACS. 相似文献14.
Suresh Sagili Jerome Ha 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2019,54(1):98-101
Objective
To describe a modification of trans-conjunctival, lower eyelid retractor advancement to correct tarsal ectropion.Design
A retrospective case review.Participants
Consecutive patients with lower eyelid tarsal ectropion.Methods
Cases of lower eyelid tarsal ectropion, surgically corrected by advancement of inferior retractor to the lower border of tarsus via a transconjunctival approach, were identified. Lateral tarsal strip was also performed simultaneously in all cases.Results
Twenty patients (25 eyelids) were included in this study. There were 19 primary lower eyelid tarsal ectropion and 6 recurrent tarsal ectropion. Complete resolution of tarsal ectropion was achieved in all patients postoperatively. Mean follow-up was 8.4 months (range 1–36 months). There were no cases of overcorrection, recurrent ectropion, suture abscess, wound dehiscence, or inferior fornix shortening after surgery.Conclusions
Visualization of the lower eyelid retractor (white-line) and advancement to the inferior border of tarsus through a transconjunctival approach is effective in correcting both primary and recurrent cases of tarsal ectropion. This can be performed through a small conjunctival incision in the middle third of the lower eyelid, without the need for any excision of tissue or suture loop tie on the skin surface. 相似文献15.
Brandon J. Baartman Richard Gans Jeffrey Goshe 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(2):131-134
Objective
Prevention of cystoid macular edema (CME) is important to achieve good surgical outcomes after cataract surgery. Although many options for management exist, control of postoperative inflammation with topical steroids is one of the most commonly employed. We evaluated the difference in incidence of pseudophakic CME in patients treated with prednisolone or dexamethasone topical steroids.Methods
The study was a retrospective chart review of patients who had undergone phacoemulsification at the Cole Eye Institute of the Cleveland Clinic. Reviewable patient charts had to indicate the topical steroid used and whether or not an additional medication (e.g., nonsteroidal anti-inflammatory drugs [NSAIDs]) was used after surgery. Excluded were patients who underwent combination procedures (e.g., trabeculectomy), perioperative anti–vascular endothelial growth factor or intraocular steroid, eyes with epiretinal membrane or prior retinal vein occlusion, those who developed postoperative endophthalmitis, patients with less than 3 months of follow-up, and patients who received topical NSAIDs. Pseudophakic CME was defined as new or worsening macular edema on optical coherence tomography within the first 3 months after cataract extraction.Results
In total, 1135 patient charts were included in the analysis; 721 patients were treated with prednisolone acetate, and 414 were treated with dexamethasone. Patient characteristics were similar between the 2 treatment groups. No significant difference was found in the rate of postoperative CME for patients receiving prednisolone or dexamethasone (4.0% vs 4.1%, p = 0.94).Conclusions
There was no significant difference in the rate of pseudophakic CME when either prednisolone acetate or dexamethasone sodium phosphate was used after cataract surgery. 相似文献16.
Rida Shahzad M.A. Rehman Siddiqui Sidra Zafar Farzana Kausar Masroor H. Shahzad 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(1):60-64
Objective
The aim of this study was to assess changes in subfoveal choroidal thickness (SFCT), measured using swept-source optical coherence tomography (SS-OCT), after routine phacoemulsification cataract surgery.Design
This is a prospective, interventional, controlled study that took place at Shahzad Eye Hospital, Karachi, Pakistan, between February 2015 and January 2016.Participants
One hundred and one patients who were undergoing routine cataract surgery were recruited. One eye per patient was included. The unoperated fellow eyes acted as controls.Methods
Swept-source optical coherence tomography scans were performed preoperatively, 1 week postoperatively, and 1 month postoperatively. Two independent graders evaluated the scans to measure the SFCT. The SFCT was measured and recorded for OCT scans from each visit. The general linear model repeated analysis technique was used to assess data from the 3 different time intervals, and paired t tests were used to assess a statistically significant difference between mean preoperative and postoperative SFCT. Probability values of less than 0.05 were considered to be statistically significant.Results
The mean preoperative SFCT in the study eye was 272.9 ± 96.2; SFCT was 278.9 ± 101.4 (p = 0.051) and 281.5 ± 105.2 (p = 0.01) at week 1 and month 1, respectively. In the control eyes, the mean measurement of preoperative SFCT was 274.2 ± 98.5; measurements were 273.8 ± 100.7 (p = 0.875) and 277.9 ± 103.1 (p = 0.063) at week 1 and month 1, respectively.Conclusions
There was a gradual increase in SFCT at 1 month after cataract removal in the study eyes. The effect was more pronounced in younger individuals and nondiabetic individuals. 相似文献17.
Oded Ohana Igor Kaiserman Yuval Domniz Eyal Cohen Oz Franco Tzahi Sela Gur Munzer David Varssano 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):523-528
Objective
To report the outcomes and complications of combined photorefractive keratectomy (PRK) and collagen crosslinking (CXL).Design
A retrospective cohort study of consecutive patients undergoing combined PRK-CXL between 2011 and 2013 at Care Laser, Inc, Tel Aviv, Israel.Participants
Ninety-eight eyes of 56 patients were included. Only patients without keratoconus were included.Methods
Data were collected from the patients’ files and imaging devices. Main outcome measures were corrected and uncorrected distance visual acuity (CDVA/UDVA); spherical equivalent (SE); refractive, keratometric, and pachymetric stability; and the occurrence of postoperative complications.Results
Mean age was 27.69 ± 6.6 years. UDVA improved from 1.38 ± 0.60 to 0.15 ± 0.24 logMAR (p < 0.001). SE improved from ?4.45 ± 2.87 diopter (D) to +0.20 ± 0.90 D (p < 0.001), and 69% of the patients were within ±0.50 D from emmetropia. Four eyes had significant corneal haze; of them 3 eyes lost more than 2 Snellen lines. No cases of corneal ectasia were recorded.Conclusions
In our cohort PRK-CXL achieved significantly improved UDVA and SE compared to baseline. Corneal haze was a significant complication. Refractive results were less accurate than published for patients undergoing PRK procedures. Although no cases of corneal ectasia were seen, given the rarity of such complication, the added benefit of CXL remains to be proven. 相似文献18.
Verena R. Juncal Mostafa Hanout Filiberto Altomare David R. Chow Louis R. Giavedoni Rajeev H. Muni David T. Wong Alan R. Berger 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(4):408-414
Objective
To report the anatomical and visual outcomes of patients with thick submacular hemorrhage (SMH) treated with pars plana vitrectomy (PPV), subretinal tissue plasminogen activator (t-PA), and pneumatic displacement.Design
Single-centre, retrospective case series.Participants
A total of 99 eyes of 99 consecutive patients with thick SMH secondary to any underlying etiology treated with PPV with subretinal t-PA and pneumatic displacement by 6 vitreoretinal surgeons at St. Michael’s Hospital, Toronto, between July 2004 and August 2016.Methods
All medical records and colour fundus photographs were reviewed for data collection. Blood displacement was evaluated at follow-up visits and classified as complete, partial, or none. Main outcome measures included blood displacement at final follow-up, postoperative Snellen best-corrected visual acuities (BCVA), and complication and recurrence rates.Results
Patients had a mean age of 77.7 ± 12.3 years and were followed up for an average of 18.4 ± 22.3 months. Wet age-related macular degeneration was the most common etiology associated with thick SMH (80.8%). Complete blood displacement was observed by final follow-up in 85.9% of the cases, partial displacement in 12.1%, and none in 2.0%. Mean logMAR BCVA improved from 2.03 ± 0.81 (Snellen 20/2143) at baseline to 1.80 ± 1.00 (Snellen 20/1262; p = 0.009) at final follow-up, and baseline BCVA was a significant predictor of final BCVA (p < 0.001). Early postoperative complications included vitreous hemorrhage in 13 eyes and rhegmatogenous retinal detachment in 8. Recurrent SMH was observed in 12 cases.Conclusions
Vitrectomy with subretinal t-PA and pneumatic displacement seems to be an effective treatment for SMH in terms of blood displacement and visual outcomes. 相似文献19.
Matthew D. Benson Khaliq Kurji Calvin Tseng Bo Bao Dean Mah 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(6):568-573
Objective
To study indications for penetrating keratoplasty (PK) at a single site. The trends in the causative organisms for infectious keratitis requiring surgery were also evaluated.Design
Retrospective observational study.Participants
A total of 1181 eyes of 935 patients undergoing PK between January 2000 and December 2015 in Northern Alberta, Canada.Methods
Indications for PK were evaluated over the 16-year study period, and the trends in these indications were compared over 5-year intervals. The microbiology of infectious keratitis cases requiring surgery was similarly evaluated.Results
The most common indications for PK from 2000 to 2015 were keratoconus (23%), re-graft (22%), and corneal scar (12%). There was a decline in the percent of total surgeries done for Fuchs’ dystrophy (p = 1.1 × 10?3) and pseudophakic bullous keratopathy (p = 5.6 × 10?5), whereas a corresponding increase in keratoconus (p = 3.2 × 10?5), trauma (p = 2.1 × 10?3), and infectious keratitis cases (p = 0.010) was observed. The most common causes for infectious keratitis cases were viral (45%), bacterial (18%), parasitic (11%), and fungal (9%). There was a significant increase in the percent of infectious keratitis cases due to a viral etiology from 2005 to 2010 (p = 6.4 × 10?3).Conclusions
The indications for PK are comparable with other centres in North America. Nearly half of all infectious keratitis cases requiring surgery are viral. The increase in viral cases requiring surgery may reflect improved diagnostics or recurrent cases. 相似文献20.
Reinhard Angermann Claus Zehetner Patrick Sidoroff Inga Waltl Gerhard Kieselbach Martina Kralinger 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(6):632-636