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Purpose@#The aim of this study was to determine the surgical and visual outcomes of scleral fixated intraocular lens implantation in eyes with as subluxated and dislocated crystalline lens or traumatic aphakic eyes.@*Methods@#A retrospective and short-term prospective cohort study was carried out in 45 eyes of 43 individuals who underwent SFIOL implantation surgery in First Central Hospital of Mongolia between January 2017 and January 2020 and had a minimum follow-up of 3 months. Pre-operative and post-operative best corrected visual acuity, postoperative outcomes and complications were summarized. Patients after the implantation of a scleral fixated PCIOL were evaluated for the disease etiology, pre- and post-operative best corrected visual acuity, and occurrence of postoperative complications.@*Results@#The analysis included 45 eyes from 43 patients. Thirty-two (74.4%) patients were men and eleven (24.6%) were women . The mean age at implantation was 57.2 ± 20.0. Indications for the IOL implantation included ocular trauma (48.9%), pseudoexfoliation syndrome (22.2%) and Marfan syndrome (15.6%). Disease etiology and age group were compared and results were Marfan syndrome is mostly diagnosed in 20-29 years of age, ocular trauma is usually diagnosed in 30-69 years of age and pseudoexfoliation syndrome is occurred in 70 and above of age. Post-operative visual acuity was improved in all cases from which 35 of patients (77.77%) visual outcome was 6/12 and above. </br> The mean preoperative best corrected visual acuity (BCVA) was 0.083 ± 0.088, which improved to 0.569 ± 0.221 (p<0.001) third month postoperatively and these were statistically significant.</br> The most frequent complication was induced astigmatism, which occurred in 6 eyes which successfully corrected with glasses. Suture erosion occurred in three eyes which successfully relocate it. The most serious complications such as vitreous hemorrhage, retinal detachment, suprachoroidal hemorrhage, endophthalmitis and suture degradation or breakage was not seen.@*Conclusion@#Ab externo SFIOL implantation is a reasonable technique for the management of eyes with aphakia or absence of capsular support, with relatively high visual outcomes and few serious complications.</br> The most frequent cause of aphakia and absence of capsular support was ocular trauma thus, pseudoexfoliation and Marfan syndrome were the most common in elderly and in young age, respectively.
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Background@#Infectious keratitis is a disease caused by inflammation, infection, and other ocular damage to the outer and other deep layers of corneal epithelium. It is a major cause of monocular blindness and visual disability worldwide regardless of age and gender. Therefore, we aimed to determine the clinical features and risk factors of infectious keratitis among Mongolians and to identify the causative microorganism and compared them with the treatment results.@*Methods@#We collected the data of 149 patients who diagnosed as infectious keratitis at the Ophthalmology Department of the First State Central Hospital in 2017-2020 and using a case series model of descriptive study. Statistical analysis was calculated using Stata14 software.@*Results@#The majority of patients in our study were male, with a male-to-female ratio is 2.1:1. The cause of infectious keratitis were categorized and eye injury-induced keratitis accounted for the highest percentage of 38.3% (n=57), with the majority being men 73.7% (n=42) (p=0.028). As for the type of treatment, antibacterial drugs 103 (69.1%) and evisceration 27(45%) predominate.@*Conclusion@#Our study shows that the majority of infectious keratitis in Mongolia is due to trauma in male patients. Forty-five percent of all surgeries involve evisceration surgery, which reduces the client's quality of life.
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@#Эвэрлэгийн цагаа, эвэрлэгийн бусад эмгэгийн үед төгс эмчилгээний арга нь эвэрлэг шилжүүлэн суулгах юм. Deep Anterior lamellar keratoplasty (DALK) мэс засал нь гэмтсэн эвэрлэгийн стромын давхарга болон эпителийг бүхэлд нь аван эрүүл эндотели болон десцемет давхаргыг нь үлдээн хийдэг хагалгаа юм. DALK мэс заслын үед Мухамед Анварын том бөмбөлгөн (“Big Bubble” technique) техникийг дэлхий дахинд өргөн ашигладаг ба үүнийг өөрөөр десцеметийн давхаргыг ил гаргах техник (Descemet’s baring technique) гэж нэрлэдэг. Энэ техникийн үед агаарыг эвэрлэгийн стромлуу шахаж өгдөг ба тухайн шахсан агаар нь стромыг десцеметийн давхаргаас салган гэмтсэн эдүүдийг эрүүл эдээс тусгаарлана. Сүүлийн хэдэн жил том бөмбөлгөн техникээр Deep Anterior lamellar keratoplasty (DALK) хагалгааг олон удаа хийх явцад Дуа-гийн давхаргыг олж нээсэн. Энэхүү судалгаанд Дуа-гийн давхаргын онцлог шинж чанар, анатомийн байрлал, түүний нотолгоо болон эмнэл зүйн ач холбогдол хэрэглээг судалсан.
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@#BACKGROUND: Pterygium is a fibrovascular wing shaped encroachment of conjunctiva onto the cornea. Although the pathogenesis remains obscure, the ultraviolet radiations (UVR), especially UVR-A and UVR-B (290-400 nm), are considered the most dangerous in developing pterygium among other environmental factors (hot, dry, windy, dusty and smoky environments and hereditary factors. The main histopathological change in primary pterygium is elastotic degeneration of conjunctival collagen. Patient complaints include foreign body feeling and visual loss due to corneal astigmatism or growth over the pupil and cosmetic problems. Anti-inflammatory drugs and lubricants have an important role minimizing the patient’s discomfort, but they do not cure the disease. After surgical removal there are still many recurrences regardless of the method used. Autologous conjunctival grafting seems to be the best method, given both the low recurrence rate and high safety. As described first by Kenyon et al. in 1985, a conjunctival autograft reported a recurrence rate of 5.3% with infrequent and relatively minor complications. The primary disadvantage of this technique is the prolonged operative time required when compared to the bare sclera technique. These disadvantages are outweighed by the lack of sight-threatening complications and the relatively low recurrence rate, which made this procedure gain popularity in many centers. The application of intraoperative 0.02% mitomycin C for the 5 minutes is efficient in reducing the recurrence rate to a minimum. METHODS: This retrospective case series, single center study was conducted on 239 patients, who underwent pterygium excision from Jan 2017 to Dec 2017 at the Department of Ophthalmology of the First Central Hospital. All patients had a detailed ophthalmic examination before the surgical intervention. Data were collected through a prepared questionnaire. Postoperative follow-up examination sheets were evaluated. Data for recurrence rate of pterygium excision were collected and analyzed by using SPSS version 17.. RESULTS: Among the 239 patients, who underwent an operation, 37.2% (n=89) were male and 62.8% (n=150) were female. Participants’ age ranged from 29 -70 years with mean age of 49.5 years old. There is no statistical significance between the stages of the disease and its post-operative outcome in the patients, who underwent pterygium excision surgery in 2017. Postoperative pterygium recurrence was in 9 patients (3.8%); 5 (55.5%) out of all 9 patients with recurred pterygium had underwent pterygium excision without conjunctival autograft. MMC was not used intraoperatively for all 9 (3.8%) patients with recurrence post pterygium excision. CONCLUSION: The relationship between pterygium stage and its post-operative recurrence was not statistically significant (P=0.683). The recurrence rate after pterygium excision with conjunctival autograft was low (P≤0.001) which showed significant statistically. There was no recurrence after pterygium excision with MMC (P≤0.001). The results of studies from Canada, Hong-Kong, India, Philippines and Iran were similar to our outcome.
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@#BACKGROUND: There are two general types of age-related macular degeneration: dry and wet. During wet or neovascular age-related macular degeneration new abnormal vessels grow and leak in the macula. As anti-vascular endothelial growth factor (anti-VEGF) was invented, it revolutionized the treatment of nAMD by inhibiting the progress of this disease. The incidence of AMD increases as life expectancy grows and there is a growing need to study this disease. We aimed to evaluate the outcome of anti-VEGF therapy for the treatment of nAMD and the incidence of ocular serious adverse events (SAE) after injections.. METHODS: In our retrospective, single-center study, medical records of patients receiving a single dose of anti-VEGF treatment (Bevacizumab) for nAMD between 17th of April, 2016 and October, 2017 were evaluated. Outcome measures were the change in the baseline visual acuity (VA) score at post-injective month one, incidence of ocular SAE and patients’ baseline characteristics affecting VA. Patients, whose treatment were started before April 2016 and had anti-VEGF treatment for the diseases other than nAMD, were excluded.. RESULTS: 15 eyes in 15 patients between 52 and 85 years of age received single dose of anti-VEGF (Bevacizumab/Avastin) injection. The mean baseline VA improved from pre-injective average of 0.21 to post-injective 1-month average of 0.37 by Snellen. Furthermore, there was no vision loss or other severe adverse effects, such as endophthalmitis, vitreous hemorrhage, retinal detachment, traumatic cataract after 4 weeks. CONCLUSION: Anti-vascular endothelial growth factor therapy has promising short-term outcomes on treating neovascular age-related macular degeneration.
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@#BACKGROUND. Acute primary angle-closure glaucoma (PACG) is a severe disease requiring intensive and emergency treatment. Surgical peripheral iridectomy and laser peripheral iridectomy procedures are performed to decrease papillary block and create an opening for the aqueous humor to pass through the eye. However, the intraocular pressure (IOP) cannot be consistently controlled by peripheral iridectomy. Phacoemulsification can widen the anterior chamber angle, position the ciliary processes in eyes with PAC posteriorly and inhibit the acute angle closure. This procedure can control the intraocular pressure sustainably for a long period. The higher incidence of the acute angle closure glaucoma in Mongolia compared to other countries was the rationale of this study. MATERIAL AND METHODS. Medical records of 9 patients (9 eyes) with acute PACG, who had received phacoemulsification with intraocular lens implantation as initial management for medically uncontrolled high IOP, were analyzed in a retrospective chart review. IOP, visual acuity, anterior chamber depth (ACD) and the number of anti-glaucoma medications used were evaluated. RESULTS. The postoperative IOP was reduced in 9 eyes (100%). The mean preoperative IOP was 37.9 ± 13.0 mmHg, which decreased postoperatively to 11.0 ± 1.9 mmHg at day 1, 11.1 ± 2.1 mmHg at week 1, 11.1±2.0 mmHg at 2 weeks, 11.8 ± 1.9 mmHg at month 1, and 11.3 ± 1.4 mmHg at 3 months, which showed statistically significance (p < 0.001). The mean visual acuity improved from preoperative average of 0.04±0.03 to postoperative average of 0.17±0.24 at day 1, 0.45±0.26 at week 1, 0.54±0.31 at week 2, 0.56±0.34 at 1 month, and 0.57±0.33 (p = 0.001) at 3-months. There was functional success at month 3. СONCLUSION. Our outcome indicates that primary phacoemulsification with intraocular lens implantation lowered IOP and improved visual acuity significantly in patients with acute PACG. This is a safe and effective method of IOP control and can be considered a first line treatment option in managing patients with acute PACG and coexisting cataract.