ABSTRACT
To evaluate the outcomes of transconjunctival dacryocystorhinostomy [TRC-DCR] surgery in patients with epiphora due to primary acquired nasolacrimal duct obstruction [PANDO] at second year follow-up. In this retrospective, interventional study, 33 eyes of 29 patients, with epiphora due to PANDO, are included. Lower eyelid conjunctiva is incised at vestibulum inferomedially to access the lacrimal sac and nasal mucosa. Bone is perforated with burr and rongeurs and saccal and nasal flaps are anastomosed. Conjunctival wound edges are apposed and left unsutured. Intraoperative difficulties, surgical time and complications are noted. Average follow-up time was 2 years. Anatomical success was defined as patent lacrimal passages upon irrigation and functional success was defined as relief of epiphora. In nineteen [57.6%] eyes the surgeries were completed with the anterior and the posterior flaps sutured. In eight eyes [24.2%] only anterior flaps could be sutured. In 6 eyes [18.2%], the surgical procedure was converted to external dacryocystorhinostomy since the nasal mucosa could not be exposed adequately via transconjunctival route. The mean surgical time was 65.1 min. One patient had a millimeter long lower eyelid margin laceration in one eye [3.7%] intraoperatively due to traction for visualization of the operative site. Epiphora resolved in 25 of 27 eyes [92.5%] in whom TRC-DCR could be completed. Epiphora and failure to irrigation were noted in two eyes [7.4%] at the postoperative 4th and 8th months, respectively and required reoperation. No complications occurred, except granuloma formation at the conjunctival incision site in three eyes [11.1%].Epiphora resolved in all the six eyes of patients who underwent an external DCR [100%].Transconjunctival dacryocystorhinostomy is a scarless dacryocystorhinostomy technique which is performed without endoscope and/or laser assistance, with 92.5% success rate comparable to external DCR at the second year follow-up without major complications
ABSTRACT
We performed various ophthalmic investigations in order to confirm the diagnosis and document the various features of posterior microphthalmos in a 21-year-old male. Ophthalmic examination revealed low vision with high hyperopia, papillomacular folds, midperipheral pigmentary changes and crowded optic discs. The optic discs were small and crowded with increased nerve fiber layer thickness. Fundus fluorescein angiography showed reduced diameter of a capillary free zone. Anterior segment [AS] optical coherence tomography demonstrated near normal anterior chamber depths, but markedly diminished anterior chamber angles. In spite of the increased corneal thickness and steep corneas, lens thickness and endothelial cell counts were normal. Sclerochoroidal thickening and foreshortening of the globes were detected with B-scan ultrasonography. Electroretinographic findings and visual field tests were similar to those in pigmentary retinopathy. Posterior microphthalmos is a complex eye disorder, which affects predominantly the posterior segment but also involves the AS of the eye.
Subject(s)
Humans , Male , Tomography, Optical Coherence , Anterior Eye Segment , Fluorescein Angiography , Fundus Oculi , Optical ImagingABSTRACT
The aim of this study is to report clinical course of choroidal neovascularization secondary to angioid streaks [AS] in two patients who underwent intravitreal bevacizumab therapy. Fundus examination, fluorescein angiography [FA] and optical coherence tomography [OCT] revealed the diagnosis of subfoveal classic choroidal neovascularization [CNV] in the right eye in patient 1 and in the left eye in patient 2. After three consecutive bevacizumab injections, visual acuity improved from 20/40 to 20/25 in patient 1 and from 20/80 to 20/50 in patient 2. After 3 months of therapy, additional bevacizumab injection was administered when the lesion showed recurrence. After a follow-up time of 24-months, patient 1 received 14 intravitreal bevacizumab injections; patient 2 received only 4 injections. Visual acuities remained stable at 20/32 and 20/50 in patient 1 and patient 2, respectively. Though, the patients of CNV secondary to AS showed similar clinical appearance at the beginning, this report provides the data for different responses to intravitreal bevacizumab therapy. While fewer injections were required to control the disease in one patient, the other patient needed much more injections for stabilization of the CNV. Further studies are required to understand the cause of varied treatment responses in those patients
ABSTRACT
The clinical and imaging findings and therapeutic outcomes of intravitreal bevacizumab injection in a patient with macular telangiectasia type 2 are described. The patient first presented with the non-proliferative stage of the disease for 4 months, then the disease transformed to the proliferative stage. In the proliferative period, the patient was treated with intravitreal bevacizumab injections as-clinically warranted. Over a follow up period lasting 26 months, the patient received 6 intravitreal bevacizumab injections, the visual acuity improved from 20/100 to 20/40, the central retinal thickness decreased from 318 microns to 198 microns. This case implies that the patients with non-proliferative macular telangiectasia type 2 should be followed carefully for proliferative transformation, and intravitreal bevacizumab treatment seems to be effective for proliferative macular telangiectasia type 2
Subject(s)
Humans , Female , Telangiectasis/drug therapy , Retinal Diseases/therapy , Antibodies, Monoclonal, Humanized/administration & dosage , Antibodies, Monoclonal, Humanized , Intravitreal InjectionsABSTRACT
To evaluate the 2-year outcomes of phacoemulsification combined with primary posterior curvilinear capsulorhexis [PPCC] in adults. In this retrospective case series, 93 eyes of 91 patients with bilateral age-related cataract who underwent phacoemulsification combined with PPCC were evaluated. The study included cases due to postoperative residual posterior capsule opacification despite careful polishing. Data were evaluated on preoperative and postoperative best corrected visual acuity [CDVA] [Snellen acuity], slit-lamp biomicroscopy and intraocular pressure [IOP] measurement. Perioperative and postoperative complications were also recorded. The mean follow-up was 24.9 +/- 13.5 months [range, 12-53 months]. At the last visit, 87.1% of the eyes had CDVA>/=20/40 and 58% had>/=20/25. Posterior capsular opacification [PCO] occurred in 2 [2.2%] of patients. No serious complications such as retinal detachment and endophthalmitis were observed during follow-up. Cataract surgery combined with PPCC is a safe procedure with a low rate of complications over the long term. This procedure reduced the necessity of Nd:YAG laser capsulotomy in adults with postoperative residual posterior capsule opacification despite careful polishing
ABSTRACT
A 16-year-old woman presented with Marfan syndrome and bilateral ectopia lentis. The surgical treatment including removal of the crystalline lens and implantation of an iris-supported intraocular lens in both eyes at a week interval. Postoperatively, the biomicroscopic examination showed total pupil closure bilaterally. After the topical tropicamide treatment, the pupil returned to normal shape
ABSTRACT
Combined cataract surgery and transconjunctival sutureless vitrectomy are a good option in patients with cataract and vitreoretinal diseases. To evaluate the effectiveness, outcomes, and complications of combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery. A retrospective case series was conducted at the Beyoglu Eye Education and Research Hospital. In this study, 28 eyes of 28 patients underwent combined 23-gauge transconjunctival sutureless vitrectomy and phacoemulsification and IOL implantation for cataract and various posterior segment diseases. The outcome measures included, visual acuity, intraocular pressure changes, and anatomical success were evaluated. The mean follow-up was 4.8 months [range, 3-15 months]. Mean overall preoperative visual acuity was 20/333, and final acuity was 20/95 [P < 0.001]. Mean intraocular pressure [IOP] on the preoperative and first postoperative day was 15.6 +/- 7.5 and 13.8 +/- 3.3 mmHg, respectively [P > 0.05]. Three eyes [10.7%] had postoperative hypotony [<6 mmHg]that all recovered spontaneously within the first postoperative week. Three eyes [10.7%] required laser treatment for iatrogenic retinal tears. Anatomical success was obtained in all cases. No serious complications such as endophthalmitis were observed during the follow-up period. Combined transconjunctival sutureless vitrectomy and phacoemulsification was effective and safe in patients with significant lens opacities and vitreoretinal pathology. Although the anatomic and visual outcomes were satisfactory, the outcomes depended mainly on underlying vitreoretinal pathology