ABSTRACT
Objetivos Evaluar la eficacia y posibles complicaciones de la trabeculostomía láser excímer (excimer laser trabeculostomy, ELT) una técnica de cirugía de glaucoma mínimamente invasiva (minimally invasive glaucoma surgery, MIGS) emergente de tipo láser, realizada en combinación con la cirugía de la catarata durante la práctica clínica habitual. Pacientes y métodos Estudio intervencionista, retrospectivo, en un único centro. Se recopilaron los datos clínicos preoperatorios y postoperatorios de pacientes con catarata y glaucoma de ángulo abierto (GAA) que fueron sometidos a cirugía combinada de ELT y facoemulsificación, en el día preoperatorio, a una semana, y uno, dos, tres, seis, nueve y 12 meses después de la cirugía. La variable principal del estudio fue la presión intraocular (PIO). El éxito cualificado y completo se definió como una PIO menor de 21 mmHg con una reducción del 20% o más de la PIO preoperatoria, con o sin tratamiento médico adyuvante, respectivamente. Resultados Se incluyeron 34 ojos de 29 pacientes; 29 ojos completaron el seguimiento a un año. La PIO preoperatoria media bajo medicación hipotensora fue de 20,9 ± 2,6 mmHg (± desviación estándar, DE) y disminuyó significativamente al año (16,3 ± 1,9; p < 0,0001). El número medio de medicamentos reductores de la PIO disminuyó de 1,7 ± 0,7 a 0,3 ± 0,8 (p < 0,0001) en el seguimiento de 12 meses. Al año, el 81% de los ojos estaban libres de medicación. Se obtuvo un éxito cualificado y completo en el 62% y el 58% de los ojos, respectivamente. Dos ojos presentaron hipema postoperatorio, tres ojos sufrieron un aumento transitorio de PIO y un paciente requirió de cirugía filtrante en los tres meses sucesivos (AU)
Purpose To evaluate the efficacy and complication profile of excimer laser trabeculostomy (ELT), an emerging laser-based trabecular minimally invasive glaucoma surgery (MIGS), combined with cataract surgery in routine clinical practice. Patients and methods Single-site, retrospective, interventional study. Preoperative and postoperative clinical data of patients with cataract and open-angle glaucoma (OAG) who underwent combined phacoemulsification and ELT were collected and analyzed at preoperative day, one week postoperatively, and after one, two, three, six, nine and 12 months. Main outcome measure was intraocular pressure (IOP). Qualified and complete success were defined as an IOP less than 21 mmHg and an IOP reduction ≥ 20% from preoperative medicated IOP with or without adjuvant medical treatment, respectively. Results Thirty-four eyes of 29 patients were included; 29 eyes completed 1-year follow-up. The mean preoperative IOP under medications was 20.9 ± 2.6 mmHg (± standard deviation, SD) and decreased significantly at one year (16.3 ± 1.9; p < 0.0001). The mean number of IOP-lowering medications decreased from 1.7 ± 0.7 to 0.3 ± 0.8 (p < 0.0001) at the 12-month follow-up. At one year, 81% of eyes were medication free. Qualified and complete success was obtained in 62% and 58% of eyes, respectively. Two eyes had postoperative hyphema, three eyes had transient IOP spikes and one patient underwent a subsequent filtering surgery at three months. Conclusion Combining ELT with phacoemulsification in eyes with cataract and mild to moderate OAG significantly reduced IOP and medication use without meaningful complications after one-year follow-up in a real world clinical practice setting (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Glaucoma/surgery , Glaucoma, Open-Angle/surgery , Phacoemulsification , Trabeculectomy , Follow-Up Studies , Treatment Outcome , Lasers, Excimer , Retrospective StudiesABSTRACT
PURPOSE: To evaluate the efficacy and complication profile of excimer laser trabeculostomy (ELT), an emerging laser-based trabecular minimally invasive glaucoma surgery (MIGS), combined with cataract surgery in routine clinical practice. PATIENTS AND METHODS: Single-site, retrospective, interventional study. Preoperative and postoperative clinical data of patients with cataract and open-angle glaucoma (OAG) who underwent combined phacoemulsification and ELT were collected and analyzed at preoperative day, one week postoperatively, and after one, two, three, six, nine and 12 months. Main outcome measure was intraocular pressure (IOP). Qualified and complete success were defined as an IOP less than 21mmHg and an IOP reduction ≥20% from preoperative medicated IOP with or without adjuvant medical treatment, respectively. RESULTS: Thirty-four eyes of 29 patients were included; 29 eyes completed 1-year follow-up. The mean preoperative IOP under medications was 20.9±2.6mmHg (±standard deviation, SD) and decreased significantly at one year (16.3±1.9; p<0.0001). The mean number of IOP-lowering medications decreased from 1.7±0.7 to 0.3±0.8 (p<0.0001) at the 12-month follow-up. At one year, 81% of eyes were medication free. Qualified and complete success was obtained in 62% and 58% of eyes, respectively. Two eyes had postoperative hyphema, three eyes had transient IOP spikes and one patient underwent a subsequent filtering surgery at three months. CONCLUSION: Combining ELT with phacoemulsification in eyes with cataract and mild to moderate OAG significantly reduced IOP and medication use without meaningful complications after one-year follow-up in a real world clinical practice setting.
Subject(s)
Glaucoma, Open-Angle , Glaucoma , Phacoemulsification , Trabeculectomy , Follow-Up Studies , Glaucoma/surgery , Glaucoma, Open-Angle/surgery , Humans , Lasers, Excimer , Retrospective Studies , Treatment OutcomeABSTRACT
PURPOSE: To evaluate the efficacy and complication profile of excimer laser trabeculostomy (ELT), an emerging laser-based trabecular minimally invasive glaucoma surgery (MIGS), combined with cataract surgery in routine clinical practice. PATIENTS AND METHODS: Single-site, retrospective, interventional study. Preoperative and postoperative clinical data of patients with cataract and open-angle glaucoma (OAG) who underwent combined phacoemulsification and ELT were collected and analyzed at preoperative day, one week postoperatively, and after one, two, three, six, nine and 12 months. Main outcome measure was intraocular pressure (IOP). Qualified and complete success were defined as an IOP less than 21 mmHg and an IOP reduction ≥ 20% from preoperative medicated IOP with or without adjuvant medical treatment, respectively. RESULTS: Thirty-four eyes of 29 patients were included; 29 eyes completed 1-year follow-up. The mean preoperative IOP under medications was 20.9 ± 2.6 mmHg (± standard deviation, SD) and decreased significantly at one year (16.3 ± 1.9; p < 0.0001). The mean number of IOP-lowering medications decreased from 1.7 ± 0.7 to 0.3 ± 0.8 (p < 0.0001) at the 12-month follow-up. At one year, 81% of eyes were medication free. Qualified and complete success was obtained in 62% and 58% of eyes, respectively. Two eyes had postoperative hyphema, three eyes had transient IOP spikes and one patient underwent a subsequent filtering surgery at three months. CONCLUSION: Combining ELT with phacoemulsification in eyes with cataract and mild to moderate OAG significantly reduced IOP and medication use without meaningful complications after one-year follow-up in a real world clinical practice setting.
ABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Strabismus/diagnosis , Amblyopia/diagnosis , Vision Screening , Child Health , Primary Health CareABSTRACT
CASE REPORT: A 43-year-old woman referred for a hyperemic node in the inferior conjunctival fornix. No improvement was observed after 10 days of antibiotic and anti-inflammatory topical treatment, so biopsy-extirpation was performed. Histopathological and immunohistochemical findings suggested the diagnosis of Langerhans cell histiocytosis (LCH). No findings of extraocular manifestations were shown after an intensive clinical and analytical investigation. DISCUSSION: LCH is a disease with different organ manifestations whose diagnosis depends on histological findings. We present a patient with isolated conjunctival affectation, which to our knowledge is the third case published in the literature.
Subject(s)
Conjunctival Diseases/pathology , Histiocytosis, Langerhans-Cell/pathology , Adult , Antigens, CD1/analysis , Biomarkers , Conjunctival Diseases/diagnosis , Conjunctival Diseases/surgery , Female , Histiocytosis, Langerhans-Cell/diagnosis , Histiocytosis, Langerhans-Cell/surgery , Humans , Hyperemia/etiology , S100 Proteins/analysisABSTRACT
Caso clínico: Mujer de 43 años que consulta por unnódulo hiperémico en fondo de saco conjuntivalinferior. Tras diez días de tratamiento antibiótico yantiinflamatorio tópico no se observa mejoría, porlo que se realiza una biopsia-extirpación. El resultadoanatomopatológico e inmunohistoquímico esinformado como histiocitosis de células de Langerhans(HCL), procediéndose a realizar un estudiosistémico con diferentes pruebas complementarias,sin hallar afectación a otro nivel.Discusión: La histiocitosis de células de Langerhanses una enfermedad de afectación muy variada,cuyo diagnóstico se establece mediante hallazgoshistológicos. Presentamos un caso de implicaciónexclusivamente conjuntival, habiéndose publicadosólo tres casos previamente en la literatura médica consultada(AU)
Case report: A 43-year-old woman referred for ahyperemic node in the inferior conjunctival fornix.No improvement was observed after 10 days ofantibiotic and anti-inflammatory topical treatment,so biopsy-extirpation was performed. Histopathologicaland immunohistochemical findings suggestedthe diagnosis of Langerhans cell histiocytosis(LCH). No findings of extraocular manifestationswere shown after an intensive clinical and analyticalinvestigation.Discussion: LCH is a disease with different organmanifestations whose diagnosis depends on histologicalfindings. We present a patient with isolatedconjunctival affectation, which to our knowledge isthe third case published in the literature(AU)
Subject(s)
Humans , Female , Adult , Histiocytosis, Langerhans-Cell/complications , Histiocytosis, Langerhans-Cell/diagnosis , Biopsy , Immunohistochemistry/methods , /methods , Histiocytosis, Langerhans-Cell/physiopathology , Eye Diseases/complications , Eye Diseases/diagnosis , Diagnosis, DifferentialABSTRACT
CASE REPORT: Miller Fisher Syndrome (MFS) is the most frequent variant of the Guillain-Barré Syndrome. It is characterised by the classic triad of ophthalmoplegia, ataxia and areflexia. We present a case of a patient who developed these clinical findings 5 days after flu vaccination. DISCUSSION: Miller Fisher Syndrome is an unusual condition seen in ophthalmologic clinical practice. Although respiratory and digestive infections have been reported as antecedent infectious agents in MFS, it has not previously been described in relation to the flu vaccine.
Subject(s)
Influenza Vaccines/adverse effects , Miller Fisher Syndrome/etiology , Ophthalmoplegia/etiology , Antibody Specificity , Autoantibodies/blood , Autoantibodies/immunology , Autoantigens/immunology , Diplopia/etiology , Facial Paralysis/etiology , Gait Disorders, Neurologic/etiology , Gangliosides/immunology , Humans , Immunoglobulins, Intravenous/therapeutic use , Male , Middle Aged , Miller Fisher Syndrome/diagnosis , Miller Fisher Syndrome/immunology , Miller Fisher Syndrome/therapy , Nausea/etiology , Respiration Disorders/etiologyABSTRACT
Caso clínico: El síndrome de Miller Fisher (SMF) es la variante más frecuente del síndrome de Guillain Barré. Se caracteriza por la tríada clásica de oftalmoplejía, ataxia y arreflexia. Se expone el caso de un paciente que presenta esta clínica a los 5 días de recibir la vacuna antigripal. Discusión: El síndrome de Miller Fisher se encuentra con poca frecuencia en la práctica clínica. Están descritos cuadros asociados a infecciones respiratorias y digestivas, pero no ha sido descrito secundario a la vacuna de la gripe
Case report: Miller Fisher Syndrome (MFS) is the most frequent variant of the Guillain-Barré Syndrome. It is characterised by the classic triad of ophthalmoplegia, ataxia and areflexia. We present a case of a patient who developed these clinical findings 5days after flu vaccination. Discussion: Miller Fisher Syndrome is an unusual condition seen in ophthalmologic clinical practice. Although respiratory and digestive infections have been reported as antecedent infectious agents in MFS, it has not previously been described in relation to the flu vaccine
