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1.
Cureus ; 15(5): e38903, 2023 May.
Article in English | MEDLINE | ID: mdl-37303455

ABSTRACT

PURPOSE: To evaluate the incidence of optic cracks and/or fractures during foldable acrylic intraocular lens (IOL) implantation via the manual Monarch delivery system with the cartridge and to determine factors that help to avoid such complications. METHODS: Small-incision phacoemulsification surgery was performed in 702 eyes with visually significant cataract formation. A foldable acrylic soft IOL (AcrySofâ MA60BM/MA30BA, Alcon, Fort Worth, TX, USA) or a single-piece acrylic soft IOL (Acriva BBâ, VSY Biotechnology, Amsterdam, The Netherlands) was inserted in all eyes using a cartridge and viscoelastic agents (sodium hyaluronate, Healon®, Advanced Medical Optics, Santa Ana, CA, USA). RESULTS: Postoperative central, paracentral, or peripheral optic cracks or fractures were encountered in a total of six of 702 eyes (0.85%). Four of six lenses (0.57%) had optic cracks within the IOL substance, whereas two of 702 cases (0.28%) had full-thickness IOL fractures in the substance in multiple locations. Three of the four lenses with optic cracks were noted to be handled by tying forceps during the cartridge insertion, and one of them was the complication of holding forceps. Two IOLs with full-thickness optic fractures were encountered during the insertion of the IOLs in the capsular bag as a result of direct trauma to the lens optic by the plunger of the injector system overriding the lens optic during cartridge passage. None of the patients suffered from glare or other visual disturbances postoperatively, and, therefore, none of the six eyes required lens replacement. CONCLUSION: The unintentional extensive pressure effect of the forceps during the holding process of the IOL or the direct trauma to the lens optic by the plunger of injector systems may cause optic cracks or fractures. Physicians should continue to monitor the eyes postoperatively regularly and must determine the benefits and risks to be derived from lens replacement, if such patients complain of significant glare, image degradation, and visual disturbances. We recommend the use of preloaded lenses, which have their own delivery systems and cartridges, to minimize the risk of such complications.

2.
Ocul Immunol Inflamm ; 30(1): 111-114, 2022 Jan 02.
Article in English | MEDLINE | ID: mdl-32835567

ABSTRACT

PURPOSE: To report genital and ocular Bacillus Calmette-Guérin (BCG) infection as a rare complication of intravesical BCG immunotherapy. METHODS: We report a patient with bladder carcinoma who developed penile and ocular BCG infection. Medical history, clinical features, imaging findings, histopathological evaluation, and response to treatment clinched the diagnosis. RESULT: Granulomatous inflammation was noted on histopathological evaluation of lung and cutaneous lesion of the penis. The left eye with choroidal tubercle and tractional retinal detachment involving fovea underwent pars plana vitrectomy. After silicone removal, best-corrected visual acuity was 20/100 and patient received anti-TB regimen for 12 months. At 1 year follow-up, the choroidal tuberculoma was found to have completely resolved and the ocular status was stable. CONCLUSIONS: Though there are other reported cases of BCG infection secondary to intravesical BCG instillation noted in the literature, penile granuloma accompanying with choroidal tubercle is an uncommon form among these complications.


Subject(s)
Carcinoma , Urinary Bladder Neoplasms , Administration, Intravesical , BCG Vaccine/adverse effects , Carcinoma/drug therapy , Humans , Male , Urinary Bladder , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/drug therapy
3.
Turk J Ophthalmol ; 50(5): 264-270, 2020 10 30.
Article in English | MEDLINE | ID: mdl-33342192

ABSTRACT

Objectives: To investigate the agreement between optical coherence tomography (OCT) and OCT-based angiography (OCT-A) in estimating retinal nerve fiber layer thickness (RNFLT) and evaluate the associations between peripapillary vessel density (VD) and RNFLT measurements obtained with both devices. Materials and Methods: The AngioVue (Optovue Inc., Fremont, CA, USA) and Spectralis (Heidelberg Engineering, Heidelberg, Germany) images of 325 patients were screened retrospectively. RNFLT values were recorded using both devices. The intraclass correlation coefficient (ICC) and Bland-Altman plots were obtained to investigate the agreement between the devices. Age- and intraocular pressure-corrected associations between VD and RNFLT measured by the two devices were analyzed using linear regression models. Results: ICC revealed excellent agreement for global, superior, inferior, and temporal RNFLT and good agreement for the nasal quadrant (ICC=0.895, 0.936, 0.923, 0.887, and 0.614, respectively). The Bland-Altman plots showed poor agreement for all measurements with a large span of limits of agreement and significant proportional bias (p<0.05). VD was found to be strongly associated with the RNFLT measurements of both devices (p<0.001). Conclusion: The disagreement between the devices should be considered in clinical practice, and the data should not be used interchangeably. The association of the peripapillary VD with RNFLT using both devices indicated that RNFLT assessed by the AngioVue could be used in glaucoma management along with VD.


Subject(s)
Fluorescein Angiography/methods , Glaucoma/diagnosis , Nerve Fibers/pathology , Retinal Ganglion Cells/pathology , Tomography, Optical Coherence/methods , Female , Fundus Oculi , Humans , Male , Middle Aged , ROC Curve , Retrospective Studies
4.
Orbit ; 37(4): 262-265, 2018 Aug.
Article in English | MEDLINE | ID: mdl-29300516

ABSTRACT

PURPOSE: To describe clinical, imaging findings, and management of dacryops cases. METHODS: A retrospective chart review was performed to identify the patients diagnosed with dacryops over a 5-year period. The clinical features based on clinical findings, computerized tomography and ultrasonography, and observation and surgical excision results were noted when available. RESULTS: We included 14 eyes of 14 patients. Seven (50%) were men with a median age of 48 years. The most common symptom was non-painful upper eyelid mass. All patients had the visible protruding cyst while eversion of the upper eyelid. Imaging studies, including orbital computerized tomography and ultrasonography were performed in six cases. Histological assessment of the excised cyst was done in two cases. Surgical excision was performed in five (36%) cases and observation was elected for nine (64%) cases. The median follow-up was 30 months. There was no recurrence of cysts in patients underwent surgery and the symptoms were not deteriorated in patients elected observation. CONCLUSION: Dacryops is a rare clinical entity that can be diagnosed easily with or without imaging methods. Surgical excision of the cyst could be curative and observation is also a safe method in selected cases.


Subject(s)
Cysts/diagnosis , Cysts/surgery , Lacrimal Apparatus Diseases/diagnosis , Lacrimal Apparatus Diseases/surgery , Adult , Aged , Diagnostic Techniques, Ophthalmological , Female , Humans , Male , Middle Aged , Ophthalmologic Surgical Procedures , Retrospective Studies , Tomography, X-Ray Computed , Ultrasonography , Young Adult
5.
Arq Bras Oftalmol ; 79(3): 195-6, 2016.
Article in English | MEDLINE | ID: mdl-27463634

ABSTRACT

Keratoacanthomas rarely occur in the conjunctiva. We report a case of a 24-year-old man with a rapidly growing conjunctival mass. The tumor was excised with a safety margin to exclude squamous cell carcinoma and was histopathologically diagnosed as a keratoacanthoma. There has been no recurrence over 2 years of follow-up. To the best of our knowledge, he is the youngest patient to be diagnosed with conjunctival keratoacanthoma who had no known risk factors such as skin disorders, trauma, surgery, or infection. In similar cases, we recommend complete early surgical excision and careful follow-up to exclude malignancy.


Subject(s)
Conjunctival Diseases/pathology , Keratoacanthoma/pathology , Carcinoma, Squamous Cell/pathology , Conjunctival Diseases/surgery , Diagnosis, Differential , Humans , Keratoacanthoma/surgery , Male , Young Adult
6.
Arq. bras. oftalmol ; 79(3): 195-196, graf
Article in English | LILACS | ID: lil-787338

ABSTRACT

ABSTRACT Keratoacanthomas rarely occur in the conjunctiva. We report a case of a 24-year-old man with a rapidly growing conjunctival mass. The tumor was excised with a safety margin to exclude squamous cell carcinoma and was histopathologically diagnosed as a keratoacanthoma. There has been no recurrence over 2 years of follow-up. To the best of our knowledge, he is the youngest patient to be diagnosed with conjunctival keratoacanthoma who had no known risk factors such as skin disorders, trauma, surgery, or infection. In similar cases, we recommend complete early surgical excision and careful follow-up to exclude malignancy.


RESUMO Ceratoacantoma raramente ocorre na conjuntiva. Nós relatamos o caso de um homem de 24 anos de idade, com uma massa conjuntival de rápido crescimento. O tumor foi retirado com uma margem de segurança para excluir carcinoma de células escamosas. Ele foi diagnosticado histopatologicamente como sendo ceratoacantoma. Não houve recidiva em dois anos de seguimento. Ele é o paciente mais jovem com ceratoacantoma conjuntival que não tinham fatores de risco conhecidos como doenças de pele a ser descrito. Em casos semelhantes, recomendamos excisão cirúrgica precoce completo e um acompanhamento cuidadoso para excluir malignidade.


Subject(s)
Humans , Male , Young Adult , Conjunctival Diseases/pathology , Keratoacanthoma/pathology , Carcinoma, Squamous Cell/pathology , Conjunctival Diseases/surgery , Diagnosis, Differential , Keratoacanthoma/surgery
7.
J Craniofac Surg ; 27(2): e200-2, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26872282

ABSTRACT

Benign masses arising from facial bones have been reported several times in the literature. Hemangiomas are one of the uncommon benign tumors. In this study, the authors aimed to present a rare patient of zygomatic intraosseos hemangioma and their management. A 40-year-old woman with a mass in her left lateral cantus admitted to our clinic. Preoperative computed tomography and magnetic resonance imaging revealed an osseos mass in her left zygoma. The authors conclude that it should be kept in mind that although they are very rare benign tumors, intraosseos hemangiomas can cause facial masses. Meticulous radiologic examination can give important clues for differential diagnosis before the surgery.


Subject(s)
Hemangioma/surgery , Zygoma/surgery , Adult , Biopsy, Large-Core Needle , Diagnosis, Differential , Female , Hemangioma/diagnostic imaging , Hemangioma/pathology , Humans , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Zygoma/diagnostic imaging , Zygoma/pathology
9.
Saudi Med J ; 36(10): 1205-9, 2015 Oct.
Article in English | MEDLINE | ID: mdl-26446332

ABSTRACT

OBJECTIVES: To analyze the indications and types of eye removals at a military tertiary care hospital in Turkey. METHODS: The medical records (age, gender, affected eye, type of surgical procedure, indications of surgery) of 123 patients who underwent evisceration and enucleation in the course of a 15-year period (January 2000 to December 2014) at Gulhane Military Medical Academy, Ankara, Turkey were reviewed retrospectively. RESULTS: The mean age was 35.61±18.52 (range 3-80 years). The number of male in the patient group was 92 (74.8%) and female was 31 (25.2%). Patients who underwent evisceration were 95 (77.2%), whereas 28 (22.8%) of them underwent enucleation. The mean age of the eviscerated patients was 30.63±13.08, whereas the mean age of the enucleated patients was 52.50±23.92 (p less than 0.001). The leading indications for eye amputations were trauma (n=62, 50.4%), malignancy (n=20, 16.3%), painful blind eye and absolute glaucoma (n=20, 16.3%), endophthalmitis (n=12, 9.7%), and phthisis bulbi, and cosmetic reasons (n=9, 7.3%). CONCLUSION: Trauma was the most common etiology for evisceration, and malignancy was the most common etiology for enucleation. Using protective eyewear and early detection of intraocular malignancy and glaucoma through routine ophthalmic examinations are essential for providing non-invasive treatment modalities instead of eye removal.


Subject(s)
Eye Diseases/surgery , Eye Enucleation/statistics & numerical data , Eye Evisceration/statistics & numerical data , Eye Injuries/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Eye Diseases/epidemiology , Eye Injuries/epidemiology , Female , Hospitals, Military/statistics & numerical data , Humans , Male , Middle Aged , Retrospective Studies , Tertiary Care Centers/statistics & numerical data , Turkey/epidemiology , Young Adult
11.
Eur J Ophthalmol ; 25(1): 65-7, 2015.
Article in English | MEDLINE | ID: mdl-24832039

ABSTRACT

PURPOSE: Primary or secondary infiltration of the lacrimal drainage system by a lymphoid neoplasm is rare in children. Primary immunodeficiencies are characterized by occurrence of unusual malignancies at unexpected locations in the pediatric age group. METHODS: Case report. RESULTS: A 12-year-old boy with a history of Bruton agammaglobulinemia and non-Hodgkin lymphoma (NHL) that primarily originated in the perianal region was referred to our oculoplastics department for persistent epiphora. Computed tomography scan and nasal endoscopy revealed relapse of NHL in the inferior portion of the nasolacrimal duct. Complete remission was achieved with chemotherapy. CONCLUSIONS: Epiphora could be the initial manifestation of a relapse or a recurrence of an underlying malignancy in the pediatric population with predisposing immunodeficiency.


Subject(s)
Agammaglobulinemia/complications , Eye Neoplasms/diagnosis , Genetic Diseases, X-Linked/complications , Lacrimal Apparatus Diseases/diagnosis , Lymphoma, Non-Hodgkin/diagnosis , Nasolacrimal Duct/pathology , Neoplasm Recurrence, Local/diagnosis , Child , Endoscopy/methods , Humans , Male , Nasolacrimal Duct/diagnostic imaging , Physical Examination , Tomography, X-Ray Computed
12.
Case Rep Ophthalmol Med ; 2014: 823953, 2014.
Article in English | MEDLINE | ID: mdl-25054072

ABSTRACT

Choroidal osteoma is a rare benign intraocular tumor composed of calcification throughout the choroid. Various treatment modalities are available according to location of the tumor and the cause of the visual distortion. We report herein a 30-year-old male who was referred to our hospital with acute blurred vision as a result of the subretinal hemorrhage from choroidal osteoma. We ruled out the presence of CNV and observation was preferred and we prevented unnecessary treatment attempts as spontaneous recovery is the easiest and safest way.

13.
Orbit ; 33(4): 295-7, 2014 Aug.
Article in English | MEDLINE | ID: mdl-24830982

ABSTRACT

A subepidermal calcified nodule is an uncommon variant of calcinosis cutis and only a limited number of cases have been reported about the eyelid nodules in the literature. A 20-year-old male was referred to our department with symmetrical nodules on both upper eyelids enlarging over 3 years. Both nodules were removed by excisional biopsy. After the histopathologic evaluation, the diagnosis was subepidermal calcified nodule. He had a complete recovery with no recurrence and acceptable aesthetic appearance. As a rare entity, subepidermal calcified nodule should be thought in differential diagnosis of eyelid nodular lesions and symmetrical appearance may be seen.


Subject(s)
Calcinosis/pathology , Eyelid Diseases/pathology , Calcinosis/surgery , Eyelid Diseases/surgery , Humans , Male , Young Adult
14.
Clin Exp Ophthalmol ; 42(2): 126-31, 2014 Mar.
Article in English | MEDLINE | ID: mdl-23844550

ABSTRACT

BACKGROUND: To investigate the frequency of prostaglandin-associated periorbitopathy among bimatoprost, latanoprost and travoprost users. DESIGN: Retrospective observational case series. PARTICIPANTS: The study group included 105 patients who were using one of the drugs in one eye for more than 1 month, and the other eye was used as a control. MAIN OUTCOME MEASURES: The frequency of prostaglandin-associated periorbitopathy. METHODS: Special care was taken to detect five prostaglandin-associated periorbitopathy findings. Hertel exophthalmometry measurements and colour pictures of the periocular area were taken. RESULTS: Statistically significant differences were found among the groups regarding the presence of all prostaglandin-associated periorbitopathy findings (P < 0.05). Periorbital fat loss was the most frequent and was observed in nearly all prostaglandin-associated periorbitopathy patients except those who were relatively young. The overall frequency of prostaglandin-associated periorbito pathy was 93.3% in the bimatoprost group, 41.4% in the latanoprost group and 70% in the travoprost group. The frequency of deepening of the upper lid sulcus was 80% in the bimatoprost group, 15.7% in the latanoprost group and 45% in the travoprost group. The frequency of milder changes (the presence of either only periorbital fat loss or dermatochalasis involution or the presence of both) was higher in the latanoprost group (62%) than in the travoprost (35.7%) and bimatoprost (7.1%) groups. CONCLUSIONS: Prostaglandin-associated periorbitopathy is as common as other adverse effects when careful examinations are performed and is more frequent and more severe in bimatoprost users. The loss of the periorbital fat pad is the first sign to occur during the evolution of prostaglandin-associated periorbitopathy, especially in older patients.


Subject(s)
Antihypertensive Agents/adverse effects , Eyelid Diseases/chemically induced , Orbital Diseases/chemically induced , Prostaglandins F, Synthetic/adverse effects , Adolescent , Adult , Aged , Amides/adverse effects , Bimatoprost , Cloprostenol/adverse effects , Cloprostenol/analogs & derivatives , Eyelid Diseases/diagnosis , Female , Glaucoma/drug therapy , Humans , Intraocular Pressure/drug effects , Latanoprost , Male , Middle Aged , Ocular Hypertension/drug therapy , Ophthalmic Solutions , Orbital Diseases/diagnosis , Retrospective Studies , Travoprost , Young Adult
16.
Indian J Ophthalmol ; 59(6): 461-4, 2011.
Article in English | MEDLINE | ID: mdl-22011490

ABSTRACT

PURPOSE: To report the management outcomes of diplopia in patients with blowout fracture. MATERIALS AND METHODS: Data for 39 patients with diplopia due to orbital blowout fracture were analyzed retrospectively. The inferior wall alone was involved in 22 (56.4%) patients, medial wall alone was involved in 14 (35.8%) patients, and the medial and inferior walls were involved in three (7.6%) patients. Each fracture was reconstructed with a Medpore® implant. Strabismus surgery or prism correction was performed in required patients for the management of persistent diplopia. Mean postoperative follow up was 6.5 months. RESULTS: Twenty-three (58.9%) patients with diplopia underwent surgical repair of blowout fracture. Diplopia was eliminated in 17 (73.9%) patients following orbital wall surgery. Of the 23 patients, three (7.6%) patients required prism glasses and another three (7.6%) patients required strabismus surgery for persistent diplopia. In four (10.2%) patients, strabismus surgery was performed without fracture repair. Twelve patients (30.7%) with negative forced duction test results were followed up without surgery. CONCLUSIONS: In our study, diplopia resolved in 30.7% of patients without surgery and 69.2% of patients with diplopia required surgical intervention. Primary gaze diplopia was eliminated in 73.9% of patients through orbital wall repair. The most frequently employed secondary surgery was adjustable inferior rectus recession and <17.8% of patients required additional strabismus surgery.


Subject(s)
Diplopia/etiology , Diplopia/surgery , Ophthalmologic Surgical Procedures/methods , Orbital Fractures/complications , Orbital Fractures/surgery , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , Young Adult
17.
Kulak Burun Bogaz Ihtis Derg ; 20(5): 232-6, 2010.
Article in Turkish | MEDLINE | ID: mdl-20815800

ABSTRACT

OBJECTIVES: This study aimed to describe ophthalmic complications of paranasal sinus mucoceles and principles of treatment. PATIENTS AND METHODS: The medical records of 25 paranasal sinus mucoceles patients (18 males, 7 females; mean age 35 years; range 20 to 62 years) that had been treated in two different ear, nose and throat clinics between the years January 2004 and June 2009 were evaluated retrospectively. Out of 22 patients of who had developed internal mucoceles in anterior paranasal sinuses, diplopia was observed in five, proptosis in four and partial loss of sight in one. Out of three patients with posterior paranasal sinus mucoceles, two developed diplopia and one developed proptosis, with loss of sight in all three. Eight patients were treated using osteoplastic flap technique and the remaining 17 were treated using endoscopic sinus surgery. RESULTS: In only one patient was loss of sight permanent whereas, in all the other patients eye complications resolved. CONCLUSION: In mucoceles that involve the posterior ethmoid and sphenoid sinuses loss of sight can be observed often because of their adjacency to the optic nerves, and loss can be permanent in advanced disease. It is possible to obtain good results in most patients treated in time with endoscopic sinus surgery and osteoplastic flep techniques.


Subject(s)
Mucocele/complications , Paranasal Sinus Diseases/complications , Vision Disorders/etiology , Adult , Diplopia/etiology , Diplopia/surgery , Endoscopy , Exophthalmos/etiology , Exophthalmos/surgery , Female , Humans , Male , Middle Aged , Mucocele/surgery , Paranasal Sinus Diseases/surgery , Surgical Flaps , Treatment Outcome , Vision Disorders/epidemiology , Vision Disorders/surgery , Young Adult
18.
Ophthalmic Genet ; 30(3): 146-51, 2009 Sep.
Article in English | MEDLINE | ID: mdl-19941420

ABSTRACT

A considerable volume of literature has been published on the association of lacrimal outflow dysgenesis with developmental anomalies or systemic syndromes. We report three affected individuals in a consanguineous family those are associated with bilateral ptosis, upper ocular movement limitation, and absence of the lacrimal punctum. T our knowledge, this is the first article reporting the association of bilateral ptosis, facial dysmorphism, upper ocular movement limitation, and absence of the lacrimal punctum in a hereditary form. As a sole example, these findings may be accepted as a new syndrome with autosomal recessive pattern because of consanguinity.


Subject(s)
Blepharoptosis/genetics , Craniofacial Abnormalities/genetics , Eyelids/abnormalities , Lacrimal Apparatus/abnormalities , Ocular Motility Disorders/genetics , Adult , Consanguinity , Female , Humans , Male , Pedigree , Syndrome , Young Adult
19.
J Trauma ; 65(6): 1284-6, 2008 Dec.
Article in English | MEDLINE | ID: mdl-19077614

ABSTRACT

BACKGROUND: To assess prognostic value of the Ocular Trauma Score (OTS) in childhood open-globe injuries. METHODS: This retrospective, interventional case series included 61 children with open-globe injuries. Certain numerical values rendered to the OTS variables (visual acuity, rupture, endophthalmitis, perforating injury, retinal detachment, afferent pupillary defect) at presentation were summated and converted into OTS categories; the likelihood of the final visual acuities in the OTS categories were calculated, and compared with those in the OTS Study. RESULTS: Age ranged from 3 years to 14 years (mean, 8.0 years). Forty-two boys and 19 girls were included. Follow-up ranged from 6 months to 56 months (mean, 18 months). The likelihood of the final visual acuities (no light perception, light perception/hand motion, 1/200-19/200, 20/200-20/50, and > or = 20/40) in the OTS categories (1 through 5) in this group were similar to those in the OTS Study group. CONCLUSIONS: OTS calculated at initial examination may provide prognostic information in children with open-globe injuries.


Subject(s)
Eye Injuries, Penetrating/classification , Trauma Severity Indices , Adolescent , Blast Injuries/classification , Blast Injuries/surgery , Blindness/etiology , Child , Child, Preschool , Endophthalmitis/classification , Endophthalmitis/surgery , Eye Injuries, Penetrating/surgery , Female , Follow-Up Studies , Humans , Male , Postoperative Complications/etiology , Prognosis , Pupil Disorders/classification , Pupil Disorders/surgery , Retinal Detachment/classification , Retinal Detachment/surgery , Rupture , Terrorism , Visual Acuity
20.
Retin Cases Brief Rep ; 2(3): 256-8, 2008.
Article in English | MEDLINE | ID: mdl-25390104

ABSTRACT

PURPOSE: To describe presumed malignant transformation of a single retinocytoma into retinoblastoma in a child with multifocal retinocytomas. METHODS: A 7-year-old boy presented with a white fundus lesion in the left eye. Ophthalmic evaluation showed one retinocytoma (spontaneously regressed retinoblastoma/arrested retinoblastoma) in each eye and one active endophytic retinoblastoma in the left eye. The left eye was enucleated. RESULTS: Histopathologic examination disclosed a small predominantly endophytic retinoblastoma with extensive vitreous seeding in association with a basal focus of well differentiated tumor with photoreceptor differentiation, suggestive of retinocytoma. The findings were consistent with malignant transformation of retinocytoma into retinoblastoma. CONCLUSION: Patients presumed to have retinocytoma at clinical evaluation should have lifelong follow-up for the remote possibility of malignant transformation.

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