RESUMEN
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
RESUMEN
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
RESUMEN
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