We describe a novel surgical technique for pterygium removal taking advantage of the properties of amniotic membrane and limbal epithelial stem cells. A total of 10 eyes underwent pterygium excision ...with amniotic membrane coverage of the bare sclera and placement of pieces of limbal epithelium in a linear fashion in the affected limbal area covered by a second amniotic membrane using fibrin glue. After up to 8 months of follow-up, there were no signs of early recurrence or sight-threatening complications. The minor ipsilateral simple limbal epithelial transplantation technique for the treatment of pterygium requires less tissue than the conventional conjunctival autograft, leaving healthy conjunctiva if needed for another procedure in the future and offers the advantages of epithelial stem cells, which in the long term may reduce the rate of recurrence significantly.
The global incidence and prevalence of diabetes mellitus(DM)have reached epidemic proportions.Estimates indicate that more than 360 million people will be affected by DM by 2030.All of these ...individuals will be at risk of developing diabetic retinopathy(DR).It is extremely important to categorize,classify and stage the severity of DR in order to establish adequate therapy.With proper management more than 90%of cases of visual loss can be prevented.The purpose of the current paper is to review the classification of DR with a special emphasis on the International Clinical Disease Severity Scale for DR.This new classification is simple to use,easy to remember and based on scientific evidence.It does not require specialized examinations such as optical coherence tomography or fluorescein angiography.It is based on clinical examination and applying the Early Treatment of Diabetic Retinopathy Study 4:2:1 rule.
To compare the short-term visual and anatomic outcomes after intravitreal injections of 2 different tumor necrosis factor-α inhibitors to continued antivascular endothelial growth factor (VEGF) ...therapy in eyes with choroidal neovascularization (CNV) secondary to age-related macular degeneration that responded suboptimally to anti-VEGF agents.
Retrospective comparative case series of 26 eyes. Eyes were injected intravitreally with 1 mg infliximab, 2 mg infliximab, 2 mg adalimumab, or 1.25 mg bevacizumab. The main outcomes measured were the best-corrected visual acuity (BCVA) and the central macular thickness (CMT) at 3 months of follow-up.
The mean log minimal angle of resolution BCVA changed from 1.04±0.23 at baseline to 1.06±0.51 at 3 months (P=0.9455) in the 1-mg infliximab group; 0.94±0.48 at baseline to 0.85±0.43 in the 2-mg infliximab group (P=0.2802); 1.58±0.50 at baseline to 1.38±0.43 in the adalimumab group (P=0.1116); and 1.08±0.1 at baseline to 1.03±0.16 in the bevacizumab group (P=0.9928). The mean CMT changed from 387±54 μm at baseline to 342±108 μm (P=0.1053) in the 1-mg infliximab group; 301±42 μm at baseline to 284±73 μm (P=0.4854) in the 2-mg infliximab group; remained unchanged at 348±106 μm (P=0.308) in the adalimumab group; and 362±66 μm to 340±27 μm in the bevacizumab group (P=0.4622). Adverse events included uveitis in 37.5% (6/16) of eyes injected with infliximab.
Intravitreal infliximab and adalimumab do not appear to benefit eyes with CNV that responded suboptimally to anti-VEGF agents. Intravitreal injections of infliximab may elicit a severe intraocular inflammatory reaction.
The aim of the study is to evaluate the safety and efficacy of trans-epithelial accelerated corneal cross-linking (TE-ACXL) in children with progressive keratoconus. Retrospective, case-series of 23 ...eyes of 14 children who underwent TE-ACXL. Evaluations were performed at baseline and 1, 3, 6, 12 and 18mo postoperatively. Mean follow-up time of 23.82±3.15mo and mean age was 13.7±1.4y (range 11 to 16y). Mean preoperative uncorrected distance visual acuity changed from 0.92±0.45 logMAR (20/160) to 0.71±0.40 logMAR (20/100) (
=0.001). Mean keratometry (Km) changed from 53.87± 6.03 to 53.00±5.81 (
=0.001). Pachymetry did not have significant changes at last follow-up (
=0.30). The mean preoperative sphere was -5.58±2.48 and -4.89±4.66 D (
=0.11) at last follow-up; refractive cylinder from -5.58±2.48 to -5.02±2.23 (
=0.046). In conclusion, tomographic and refractive stability are shown in over 91% of eyes with pediatric progressive keratoconus who underwent TE-ACXL.
Keratoconus (KC) shows several distinctive features in clinical appearance, disease progression, and treatment in children compared with adults. Therefore, diagnostic, clinical care, and therapeutic ...approaches are different. However, pediatric keratoconus is often undiagnosed and thus untreated in many cases. Once diagnosis has been made, compliance with treatment recommendations is often poor. Pediatric keratoconus also tends to have more rapid progression than in adults; therefore, early detection and treatment are paramount to prevent serious vision impairment, which can affect the child's development. This review of pediatric keratoconus discusses important issues such as worldwide epidemiology, clinical features in children compared to adults, and challenges in diagnosis and treatment and focuses on the most appropriate management strategies based on the best available current evidence.
Cataract Following Pars Plana Vitrectomy: A Review Hernandez-Bogantes, Erick; Abdala-Figuerola, Alexandra; Olivo-Payne, Andrew ...
Seminars in ophthalmology,
11/2021, Letnik:
36, Številka:
8
Journal Article
Recenzirano
Introduction: The indications for pars plana vitrectomy (PPV) have increased over the years. The vitreous is no longer considered an inert ocular structure and it is well known that its removal has ...anatomical and physiological consequences. The vitreous is no longer considered an inert ocular structure. The vitreous plays a key role as an intraocular physiologic oxygen regulator. In order to maintain its transparency, the crystalline lens needs protection from an excessive oxygen exposure. PPV leads to progression of nuclear sclerosis in most eyes.
Methods: A systematic review of the literature was conducted using Embase and Medline databases. Articles studying the physiology, pathogenesis and surgical treatment of cataract after PPV were included in this review.
Results: The pathogenesis of cataract formation after PPV remains unclear. Predisposing factors include advanced patient age, preexisting nuclear sclerosis, light toxicity, intraoperative oxidation of lens proteins, use of silicone oil or intravitreal gas, mechanical trauma and the duration of exposure to an irrigating solution.
Conclusion: Cataract surgery in vitrectomized eyes presents with more technical difficulties, is more challenging and often has a higher risk of intraoperative and postoperative complications than in non vitrectomized eyes. There is no standardized technique or management in these cases; therefore, it requires more precautions during surgery.
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