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Contact lenses are required for the visual improvement in patients with keratoconus. Various contact lens options, such as rigid gas permeable (RGP) lenses, soft and soft toric lenses, piggy back contact lenses (PBCL), hybrid lenses and scleral lenses are availble. This article discusses about selection of a lens depending on the type of keratoconus and the fitting philosophies of various contact lenses including the starting trial lens. A Medline search was carried out for articles in the English language with the keywords keratoconus and various contact lenses such as Rose k lens, RGP lens, hybrid lens, scleral lens and PBCL.
ABSTRACT
OBJETIVO: Valorar los resultados visuales de los pacientes operados con la técnica de piggy back o implantes múltiples de lentes intraoculares. MÉTODOS: Se realizó un estudio descriptivo retrospectivo de corte transversal en el que se tomaron 32 ojos de 30 pacientes del universo operado de catarata, con la técnica antes descrita, en el Instituto Cubano de Oftalmología Ramón Pando Ferrer, en el período comprendido entre enero de 2000 hasta diciembre de 2006. Fueron evaluadas algunas variables demográficas, como edad y sexo, así como agudeza visual y refracción preoperatorio y posoperatoria con cristales y sin ellos. Reportamos las complicaciones transquirúrgicas y posquirúrgicas asociadas a las diferentes técnicas quirúrgicas empleadas para la extracción del cristalino. RESULTADOS: La edad promedio obtenida fue mayor de 50 años, y predominó el sexo femenino. Parte de los pacientes tuvieron una agudeza visual corregida superior a 20/40. La complicación más frecuente fue la opacidad de la cápsula posterior y solo en la tercera parte de los pacientes se obtuvo una buena corrección refractiva. CONCLUSIONES: La técnica de piggy back permitió la recuperación de cuatro líneas en la cartilla de Snellen en la agudeza visual corregida, mientras que en la agudeza visual sin corrección solo aumentó en dos líneas. Se encontró igual número de pacientes hipocorregidos y bien corregidos
OBJECTIVE: To asses the visual results of patients operated on by piggy back technique or multiple implantation of intraocular lenses METHODS: A retrospective cross-sectional descriptive study was conducted in 32 eyes from 30 patients operated on from cataract, using the above-mentioned technique, at Ramon Pando Ferrer Cuban Institute of Ophthalmology in the period January 2000 through December 2006. Some demographic variables as age and sex as well as visual acuity and preoperative and postoperative refraction with/without lenses were evaluated. Trans-surgical and post-surgical complications associated with the various surgical techniques for the crystalline extraction were reported. RESULTS: Average age was 50 years, being the females predominant. One part of the patients had corrected visual acuity over 20/40. The most frequent complication was posterior capsule opacity and only one third of patients showed good refractive correction. CONCLUSIONS: Piggy back technique allowed recovering four lines in corrected visual acuity in Snellen´s chart whereas uncorrected visual acuity increased two lines only. The number of hypocorrected and well-corrected patients was the same
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Humans , Male , Female , Middle Aged , Cataract Extraction/methods , Hyperopia/surgery , Phakic Intraocular Lenses , Cross-Sectional Studies , Epidemiology, Descriptive , Retrospective StudiesABSTRACT
During the recipient hepatectomy in liver transplantation, preservation of the retrohepatic segment of the inferior vena cava has several advantages: it decreases warm ischemia time by eliminating the infrahepatic caval anastomosis, eliminates the need for venovenous bypass and eases retransplantation. Removal of the liver of the dog without sacrificing the inferior vena cava has been considered impossible because of the intrahepatic course of the vena cava at the sites of entry of the hepatic veins. The following report reviews the history of the piggyback method, and discuss about the feasibility of the total removal of the liver without injury to the vena cava in the dog.
No transplante de fígado, a preservação do segmento retro-hepático da veia cava durante a hepatectomia do receptor apresenta uma série de vantagens: diminuição do tempo de isquemia quente por eliminar a anastomose da veia cava infra-hepática, redução da necessidade da utilização de derivações veno-venosas e simplificação da cirurgia do re-transplante hepático. Em cães, os lobos hepáticos lateral direito e caudado são caprichosamente atravessados pela veia cava inferior, dificultando a completa "esqueletização" do vaso. No presente trabalho, os autores revisam a singular história do método do "piggy-back" experimental e clínico, e discutem a técnica da cirurgia em cães.
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PURPOSE: To attain adequate intraocular lens power during cataract surgery in patients with high myopia or hyperopia, the implantation of two intraocular lenses by the piggy-back method are being widely attempted. Therefore, we report the clinical results of implantation of two intraocular lenses by the piggy-back method. MATERIALS AND METHODS: We illustrate a case of a 62-year old high myopic patient with cataract who received lens insertion of -5.0 diopter and -4.0 diopter piggy-back style in the capsular bag. Also, we illustrate a case of a 7-year old female with congenital cataract who received lens insertion in the capsular bag of +18.0 diopter and +17.0 diopter in the right eye and +17.0 diopter and +16.0 diopter in the left eye. RESULTS: Postoperative findings at 2 months showed well positioning of both lenses without noticeable complications.
Subject(s)
Child , Female , Humans , Middle Aged , Cataract , Hyperopia , Lenses, Intraocular , MyopiaABSTRACT
Objective To investigate the impact of cavoplasty on the piggy back liver transplantation and on the prevention of hepatic outflow block. Methods Three patients received modified piggy back liver transplantation with venacavoplasty under single veno venous bypass. Results All the recipients had stability of dynamic circulation, short anhepatic phase and decreased hemorrhage during operation. Postoperatively all the patients recovered quickly with good liver function without any complications. Conclusions Venacavoplasty may overcome outflow block in piggy back liver transplantation and the technique can shorten anhepatic phase and decrease complications.