DOCSLIB.ORG

Changes in Blood Flow on Optic Nerve Head After Vitrectomy for Rhegmatogenous Retinal Detachment

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Changes in Blood Flow on Optic Nerve Head After Vitrectomy for Rhegmatogenous Retinal Detachment Retina Changes in Blood Flow on Optic Nerve Head After Vitrectomy for Rhegmatogenous Retinal Detachment Takeshi Iwase, Misato Kobayashi, Kentaro Yamamoto, Kosei Yanagida, Eimei Ra, and Hiroko Terasaki Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan Correspondence: Takeshi Iwase, De- PURPOSE. To determine the preoperative characteristics and the changes in retinal blood flow partment of Ophthalmology, Nagoya following vitrectomy in eyes with a rhegmatogenous retinal detachment (RRD). University Graduate School of Medi- cine, 65 Tsurumai-cho, Showa-ku, METHODS. Twenty-five–gauge vitrectomy without scleral bucking was performed on 31 eyes of Nagoya 466-8560, Japan; 31 patients with macula-on RRD. The retinal blood flow on the optic nerve head (ONH) was [email protected]. assessed by laser speckle flowgraphy (LSFG), and the mean blur rate (MBR) and pulse Submitted: August 21, 2016 waveform parameters before and at 10 days, 1, 2, 3, and 6 months after the surgery were Accepted: October 10, 2016 examined. Eyes treated by scleral buckling, and eyes with an epiretinal membrane and cataract that underwent surgery were used as controls. Citation: Iwase T, Kobayashi M, Ya- mamoto K, Yanagida K, Ra E, Terasaki RESULTS. The mean preoperative MBR-vessel on the ONH was significantly lower in eyes with H. Changes in blood flow on optic RRD than in the fellow unaffected eyes (P < 0.001), but it was not significantly different from nerve head after vitrectomy for rheg- the operated eye and the fellow eye in the control group. A significant increase in the mean matogenous retinal detachment. In- MBR-vessel on the ONH was observed following vitrectomy in eyes affected by RRD (P < vest Ophthalmol Vis Sci. 0.001), whereas no significant difference was observed in the fellow eye, the scleral 2016;57:6223–6233. DOI:10.1167/ buckling–treated eyes, and the control eyes. Of the eight pulse waveform parameters, only iovs.16-20577 the flow acceleration index was significantly lower in eyes with a RRD than in the fellow eyes preoperatively, but then it significantly increased with time following vitrectomy. The changes in the MBR-vessel were not correlated with that of other parameters (e.g., the ocular perfusion pressure). CONCLUSIONS. These results indicate that the retinal blood flow is reduced in eyes affected by RRD preoperatively, and can recover following successful RRD repair by vitrectomy. Keywords: retinal blood flow, rhegmatogenous retinal detachment, vitrectomy, laser speckle flowgraphy rhegmatogenous retinal detachment (RRD) is a separation incision instruments and wide-angle viewing systems.13 Be- A of the sensory retina from the RPE caused by tears in the cause PPV without concomitant scleral buckling does not entail retina and can lead to a permanent loss of vision if untreated.1 a compressional step, it is possible to evaluate the natural Rhegmatogenous retinal detachment is usually treated by either course of ocular blood flow before and after successful RRD scleral buckling alone or by pars plana vitrectomy (PPV) with repair. However, there have been only a few studies examining or without scleral buckling. The results of a randomized the effects of PPV on the ocular blood flow in eyes with RRD. controlled trial indicated that both of these surgical procedures Kimura et al.14 reported that the ocular microcirculation is led to successful reattachment in phakic, pseudophakic, and normal 6 months after PPV for RRD. It has been reported that a 2 aphakic patients with similar final reattachment rates. gas tamponade might have subclinical adverse effects on the Although scleral buckling is a well-established surgical circulation in the region of the neuroretinal disk rim.14 treatment for RRD, it has been reported that the procedure A variety of techniques have been developed for measuring can cause problems in the ocular circulation.3–10 Diddie and the retinal blood flow including fluorescein angiography,15 Ernest7 used the microsphere technique and found that the radioactive microspheres,16 hydrogen clearance,17 laser Dopp- encircling buckling method significantly decreased the retinal ler technique,4,5 color Doppler ultrasonography,18 and the and choroidal circulation in rabbit eyes. There have also been 9 several studies reporting that scleral buckling can reduce the pulsatile technique. Time intensiveness and problems with retinal5,6,8 and choroidal blood flow.9–11 Compressional mech- reproducibility have hampered the widespread use of many of anisms have been cited as the cause of the reduced choroidal these measurement techniques. More recently, a Doppler 19 blood flow following scleral buckling.7,12 Thus, the reduced optical coherence tomographic (OCT) technique, OCT ocular blood flow has been attributed to a direct obstruction of angiography,20 and optical microangiography (OMAG)21,22 have the choroidal venous drainage by the scleral buckling, and the been developed and used to measure the blood flow on the time course of the ocular blood flow following scleral buckling optic nerve head (ONH) and retina using high-resolution depth- is always affected by the procedures. resolved imaging with high reproducibility. However, these The safety and effectiveness of PPV has improved by the techniques still have inherent limitations for clinical use improvements in the surgical instruments including micro because of the time intensiveness of the procedures. iovs.arvojournals.org j ISSN: 1552-5783 6223 This work is licensed under a Creative Commons Attribution 4.0 International License. Downloaded from iovs.arvojournals.org on 09/27/2021 Changes in Blood Flow After Retinal Detachment IOVS j November 2016 j Vol. 57 j No. 14 j 6224 Laser speckle flowgraphy (LSFG) is a noninvasive, real-time All patients underwent a comprehensive ophthalmic method that has been used to measure the relative blood flow examination as standard examination in our hospital including on the ONH. The measurement duration is only 4 seconds and the measurements of the IOP and axial length, slit-lamp can be performed without the intravenous injection of any biomicroscopy, fundus photography with the Optomap camera contrast agents.23–25 A recent update of the software embed- (Optos plc., Dunfermline, Scotland), spectral-domain OCT (SD- ded in the most recent LSFG device (LSFG Analyzer, v. 3.1.62; OCT; Spectralis OCT, Heidelberg Engineering, Heidelberg, Softcare Co., Ltd., Fukutsu, Japan) enables the recording of Germany), and LSFG before, and 10 days, and 4, 8, 12, and images synchronized with each cardiac cycle, and can then 24 weeks after the surgery. determine the various blood flow parameters at each All patients were asked to abstain from alcoholic and heartbeat. Laser speckle flowgraphy can detect the speckle caffeinated beverages on the morning of the day of the contrast pattern produced by the interference of the illumi- examination because the intake of alcohol and caffeine can nating laser light that is scattered by the movement of influence the IOP28,29 and blood pressure.30,31 Thirty minutes erythrocytes in the blood vessels. This enables the device to before the LSFG examinations, 0.4% tropicamide/phenyleph- calculate the relative blood flow in the vessels of the ONH and rine (Mydrin P; Santen Pharmaceutical Co., Ltd., Osaka, Japan) retina, which is expressed as the mean blur rate (MBR).23–25 was used to dilate the pupil. The subjects rested for 10 to 15 The ‘‘vessel extraction’’ function of the software then identifies minutes in a quiet, dark room before the examination, and all the vessel and tissue areas on the ONH so that the MBR of each examinations were performed in the sitting position. The area can be assessed separately. The vessel area can be used to refractive error (spherical equivalent) was measured with an evaluate the blood flow in the retinal vessels excluding the autorefractometer (KR8900; Topcon, Tokyo, Japan), and the choroidal blood vessels.26 Aizawa et al.27 reported that the axial lengths were measured by partial optical coherence coefficient of variation (COV) for determining the MBR was 3.4 interferometry (IOLMaster; Carl Zeiss Meditec, La Jolla, CA, for the ONH. Therefore, LSFG is considered to be suitable for USA). The IOP was measured with a handheld tonometer measuring the blood flow rates on the ONH. (Icare; Tiolat Oy, Helsinki, Finland). The systolic and diastolic However, there have been only a few reports describing the blood pressures (SBP and DBP) were measured at the left ocular blood flow in eyes affected by RRD before surgery and brachial artery at the height of the heart in a sitting position that following PPV. It is not easy to estimate the preoperative with an automatic sphygmomanometer (CH-483C; Citizen, retinal blood flow in eyes affected by RRD because the retinal Tokyo, Japan). The mean arterial blood pressure (MAP), and vessels are tortuous and ascend vertically to the surface to the mean ocular perfusion pressure (MOPP) were calculated as RPE in the areas where the retina is detached. follows: MAP ¼ DBP þ 1/3 (SBP À DBP), MOPP ¼ 2/3MAP À 32 Thus, the aim of this study was to evaluate the blood flow IOP. on the ONH in the PPV-treated eyes with RRD by comparing The size of the retinal tear and the extent of the retinal the values with that of the fellow eyes and the scleral buckling– detachment were calculated as the ratio of retinal tear or treated eyes. Laser speckle flowgraphy was used to determine extent of detachment area to the area of the entire fundus the changes in the ONH blood flow before and after surgery. photograph taken with the Optomap camera. Laser Speckle Flowgraphy (LSFG) ETHODS M The LSFG-NAVI (Softcare Co., Ltd.) instrument was used to Ethics Statement determine the ONH blood flow. The principles of LSFG have been described in detail.33–36 Briefly, this instrument consists This was a retrospective, cross-sectional, single-center study, of a fundus camera equipped with an 830-nm diode laser as the and the procedures used were approved by the Ethics light source and a standard charge-coupled device sensor (750 Committee of the Nagoya University Hospital (Nagoya, Japan).
Load more

Recommended publications
  • Early Postoperative Rotational Stability and Its Related Factors of a Single-Piece Acrylic Toric Intraocular Lens
    Eye (2020) 34:474–479 https://doi.org/10.1038/s41433-019-0521-0 ARTICLE Early Postoperative Rotational stability and its related factors of a single-piece acrylic toric intraocular lens 1,2 3 4 5 1 1 1 Shuyi Li ● Xi Li ● Suhong He ● Qianyin Zheng ● Xiang Chen ● Xingdi Wu ● Wen Xu Received: 30 November 2018 / Accepted: 18 June 2019 / Published online: 12 July 2019 © The Author(s) 2019. This article is published with open access Abstract Purpose In the present study, we aimed to evaluate the early postoperative rotational stability of TECNIS toric intraocular lens (IOL) and analyse its correlation with preoperative and intraoperative parameters. Methods A total of 102 eyes from 87 cataract patients who underwent implantation of TECNIS toric IOL during July 2016 to November 2017 were enrolled in this retrospective study. Preoperative parameters including corneal astigmatism, axial length (AL), lens thickness (LT), anterior chamber depth (ACD) and sulcus-to-sulcus (STS), were determined. The area of capsulorhexis was measured with Rhinoceros 5.0 software. The follow-up examinations including the residual astigmatism (RAS) and postoperative toric IOL axis, were performed at 1 month and 3 months after surgery. − − 1234567890();,: 1234567890();,: Results RAS was 0.84 ± 0.88 D at 1 month and 0.81 ± 0.89 D at 3 months after surgery. The rotation of toric IOL at 3 months was 4.83 ± 3.65°. The Pearson’s r of ACD, horizontal and vertical STS, and toric IOL target axis was 0.011, 0.039, 0.045 and 0.082. The toric IOL rotation was positively correlated with the area of capsulorhexis (r = 0.522, P = 0.0003), LT (r = 0.288, P = 0.003) and AL (r = 0.259, P = 0.009).
    [Show full text]
  • Nd:Y AG LASER CLEARANCE of the ANTERIOR SURFACE of POSTERIOR CHAMBER INTRAOCULAR LENSES
    Nd:Y AG LASER CLEARANCE OF THE ANTERIOR SURFACE OF POSTERIOR CHAMBER INTRAOCULAR LENSES S. J. TALKS Northampton SUMMARY CASE REPORTS Purpose: To demonstrate the use of Nd:YAG laser in Case 1. Post-operative Haemorrhage clearing the anterior surface of posterior chamber A 73-year-old Caucasian insulin-dependent diabetic intraocular lenses. man, on aspirin, who had previously had a right Method: Six cases are presented with the following trabeculectomy, had a right extracapsular cataract conditions: haemorrhage, inflammatory deposits, a extraction (ECCE) + pcIOL. At surgery a broad fibrinous papillary membrane, capsulorhexis shrinkage. iridectomy was performed through the original Nd:YAG laser was successful in managing Results: peripheral iridectomy to enable adequate pupil each of these cases. dilation. This was sutured with 10.0 Prolene. No Conclusion: With careful use Nd:YAG laser clearance haemorrhage was noted during surgery but the next of the anterior surface of a posterior chamber day a large blood clot covered the pupil. This did not intraocular lens can be carried out successfully without clear with the use of prednisolone acetate 1 % damaging the lens. (Predforte) and mydriatics. The patient did not wish further surgery. Following cataract surgery the anterior surface of After 3 months the visual acuity was still hand posterior chamber intraocular lenses (pcIOL) can movements and so Nd:YAG laser was used. The sometimes become obscured.1 This may be due to laser was applied to the organised clot at the edge of haemorrhage, inflammatory deposits, the formation the pupil (171 pulses, at 2-3 mJ, Q switched). Most of of a fibrinous pupillary membrane, or the shrinkage the clot cleared leaving a fibrinous membrane.
    [Show full text]
  • Little Capsulorhexis Tear-Out Rescue
    J CATARACT REFRACT SURG - VOL 32, SEPTEMBER 2006 Little capsulorhexis tear-out rescue Brian C. Little, FRCOphth, Jennifer H. Smith, MD, Mark Packer, MD Backward traction on the capsule flap forms the basis of a predictable technique for rescuing the capsulorhexis from a radial tear-out. J Cataract Refract Surg 2006; 32:1420–1422 Q 2006 ASCRS and ESCRS The continuous curvilinear capsulorhexis (CCC) has pro- and in the direction of the projected circular path of the fin- vided important advantages for lens removal and intraocu- ished capsulorhexis. In the event of a tear-out, the path of lar lens (IOL) implantation by prompting the development the progressing tear veers peripherally toward the lens of endocapsular phacofragmentation techniques and the equator. To ‘‘rescue’’ the capsulorhexis, the tear must be re- use of advanced IOL technology. Ophthalmologists have directed centrally and back to the desired circumferential benefited from the work of Fercho, who developed contin- path. The first step in rescuing the tear with the Little tech- uous tear capsulotomy (C. Fercho, MD, ‘‘Continuous Cir- nique is to fill the chamber completely with an OVD. The cular Tear Anterior Capsulotomy,’’ presented at the Welsh force applied to the capsule flap is then reversed in direc- Cataract Congress, Houston, Texas, USA, September tion but maintained in the plane of the anterior capsule. 1986), and Gimbel and Neuhann, who popularized the If necessary, a second corneal paracentesis incision is CCC.1–3 made at the position that allows the optimum angle of ap- In constructing the capsulorhexis, it is essential to con- proach for applying traction.
    [Show full text]
  • History of Posterior Continuous Curvilinear Capsulorhexis and Optic
    HISTORY OF POSTERIOR CONTINUOUS CURVILINEAR BY HOWARD V. GIMBEL, MD, MPH, FRCSC CAPSULORHEXIS AND OPTIC CAPTURE This useful technique is not just for pediatric surgery. econdary cataracts after pedi- I first used this technique in 1987 children in a publication coauthored atric cataract surgery have long to remove a dense posterior capsular with DeBroff in 1994.4 been recognized as an expected plaque and in 1988 to convert a PC In my early experience, the PCCC complication when the posterior tear to a PCCC.2 was done after the IOL was in the bag capsule is left intact. Planned Optic capture in the anterior con- so that, in the event of an unsuccess- Santerior vitrectomy after posterior tinuous curvilinear capsulorhexis was ful PCCC, the IOL would already be capsulectomy or capsulotomy is now described by Neuhann and Neuhann safely in the bag. To keep the vitreous performed routinely with cataract and in a film, “The Rhexis-Fixated Lens,” from coming through the PCCC as it IOL surgery in children. This is because, in 1991.3 With the experience I was being fashioned, a highly cohesive even with the posterior capsule open gained using that technique in adult OVD was placed through the first and the IOL in the bag, lens epithelial cataract surgery, it seemed obvious small tear in the PC. Then more OVD cell migration can proceed through that, after performing a PCCC, the was added as the tear was completed the posterior continuous curvilinear same capture technique could be with forceps. Optic capture was then capsulorhexis (PCCC), behind the IOL, used with the haptics left in the bag performed slowly, one edge at a time, and across the visual axis, making it and the optic captured by the PCCC.
    [Show full text]
  • Tips and Techniques for Cataract Surgery in Glaucoma Patients
    Tips and Techniques for Cataract Surgery in Glaucoma Patients Joey Yen-Cheng Hsia, MD Assistant Professor of Ophthalmology Glaucoma Service University of California, San Francisco No Financial Disclosures Introduction • Visually significant cataract often co-exist with glaucoma in the elderly population. • Glaucoma incisional surgery can lead to accelerated cataract formation. • Glaucoma patients are at risk for perioperative complications • Set realistic expectation preoperatively Preoperative Evaluation – Is the cataract or glaucoma causing the decreased vision? – PAP or PAM – Set realistic expectation – Is the IOP at target? – Role of combined surgery? – No. of medications – Anticoagulation – ⍺-1 blocker – Prior incisional surgeries Examination – angle grading, trab ostium - Prior incisional surgery - endothelial dysfunction – shallowing – dilation, prior LPI, iridectomy – PXE, phacodynesis – cupping, pallor, retinal pathology Postoperative IOP Spike • Note the of glaucoma – Foveal involving scotoma – At risk for progression with IOP spike : – Advanced glaucoma, IFIS, No. of gtts, long AXL, PXE • IOP spike occurs after surgery – Same day check up for high risk patients History of Trabeculectomy – Modify incisions accordingly – Avoid suction / fixation ring – High function bleb may lead to chemosis / chamber instability – Age<50, Preop IOP > 10, iris manipulation, postop IOP spike, and short interval time between trabeculectomy and cataract – Longer steroid +/- anti- metabolite Grover-Fellman spatula; Epislon History of Tube Shunt –
    [Show full text]
  • Collecting Empirical Physician Time Data
    H EA LTH POLI CY CEN TER RESEARCH REPORT Collecting Empirical Physician Time Dat a Piloting an Approach for Validating Work Relative Value Units St ephen Zuckerman, PhD Kat ie Merrell, BA Robert Berenson, MD Susan Mitchell, RHIA URBAN INSTITUTE ACTUARIAL RESEARCH URBAN INSTITUTE RTI INTERNATIONAL CORPORATION (FORM ERLY SOCIAL & SCIENTIFIC SYSTEM S, I N C.) Divvy Upadhyay, MD, MPH Rebecca Lewis, MPH URBAN INSTITUTE RTI INTERNATIONAL December 2016 ABOUT THE URBAN INSTITUTE The nonprofit Urban Institute is dedicat ed to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Copyright © December 2016. Urban Institute. Permission is granted for reproduction of this file, with attribution to the Urban Institute. Cover image by Tim M eko. Contents Acknowledgments v Execut ive Summary vi Background 1 Collecting Empirical Service Time Dat a 3 Analytic Approach and Methods 6 Preparing t he Empirical Time Data for Analysis 6 Empirical Measure of Intraservice Physician Time 6 Clinical Expert Review Met hods 10 Physician Int erviews 13 Result s 15 Empirical Time Analysis 15 Empirical Time Estimates for Selected Services 15 Implications for Physician Work Values 21 Clinical Expert Review Results 29 Representativeness of Vignettes 29 Accuracy of Service Descriptions 30 Intraservice Time Estimates 34 Limitat ions: Challenges of Empirical Time Data Collection 36 Summary 38 Recommendations for Further Data Collection 39 Appendix A.
    [Show full text]
  • Type of Article
    Original Research Article Comparison between a modified three bend cystitome and conventional two bend cystitome in performing capsulorhexis A Nayak1*, P Bharathi2, P Santosh3, A Shetty4 1,2,4Resident, Department of Ophthalmology, KIMS, Bangalore, INDIA. 3Comprehensive Fellow, Aravind Eye Hospital, 64, Sankagiri Main Road, Nethimedu, Salem. Email: [email protected] Abstract Aim: To evaluate the efficacy of a modified 3-bend cystitome compared with conventional 2-bend cystitome in performing continuous curvilinear capsulorhexis(CCC). Materials and Methods: We modified a 2-bend cystitome for CCC for Manual Small Incision Cataract Surgery and phacoemulsification surgery for improved safety and easier surgery. A 26G needle was converted into a cystitome with 3 bends. In our study, the performance of modified 3-bend cystitome was compared with a 2-bend cystitome. 162 eyes of 126 patients were included in our study. Results: In the 3- bend cystitome group, mean completion time of CCC and the viscoelastics used were less with the CCC success rate being higher. Complications like postoperative corneal edema and V-shaped tears, were also lower in 3-bend group. No posterior capsular rents or any other complication was observed in either group. Conclusion: It is safe, efficient and the 3 bend cystitome helps achieve a CCC while maintaining the anterior chamber depth (ACD) by keeping the posterior lip intact. The 3-bend cystitome allowed for adequate visualisation into the anterior chamber from a lack of wound deformation. Key Words: Capsulorhexis, Cataract, Cystitome, Phacoemulsification, SICS *Address for Correspondence: Dr. A. Nayak, Resident, Department of Ophthalmology, KIMS, Bangalore, INDIA. Email: [email protected] Received Date: 01/04/2019 Revised Date: 24/05/2019 Accepted Date: 11/07/2019 DOI: https://doi.org/10.26611/10091114 for a continuous curvilinear capsulorhexis (CCC), even Access this article online though femtosecond laser produced capsulotomies are Quick Response Code: more precise, accurate, reproducible, and stronger.
    [Show full text]
  • Efficacy of Plasma Knife Assisted Posterior Capsulotomy Versus
    Prakash S, Giridhar, Harshila Jain. Efficacy of plasma knife assisted posterior capsulotomy versus manual primary posterior capsulorhexis in preventing visual axis opacification in pediatric cataract surgery: A randomized controlled trial. IAIM, 2017; 4(9): 171-177. Original Research Article Efficacy of plasma knife assisted posterior capsulotomy versus manual primary posterior capsulorhexis in preventing visual axis opacification in pediatric cataract surgery: A randomized controlled trial Prakash S1*, Giridhar2, Harshila Jain3 1Assistant Professor, 2Professor and Head, 3Associate Professor Department of Ophthalmology, Dhanalakshmi Srinivasan Medical College and Hospital, Siruvachur, Perambalur, India *Corresponding author email: [email protected] International Archives of Integrated Medicine, Vol. 4, Issue 9, September, 2017. Copy right © 2017, IAIM, All Rights Reserved. Available online at http://iaimjournal.com/ ISSN: 2394-0026 (P) ISSN: 2394-0034 (O) Received on: 04-09-2017 Accepted on: 13-09-2017 Source of support: Nil Conflict of interest: None declared. How to cite this article: Prakash S, Giridhar, Harshila Jain. Efficacy of plasma knife assisted posterior capsulotomy versus manual primary posterior capsulorhexis in preventing visual axis opacification in pediatric cataract surgery: A randomized controlled trial. IAIM, 2017; 4(9): 171-177. Abstract Background: Posterior capsule opacification (PCO) is the commonest complication of extracapsular catraract surgery in pediatric patients with an incidence as high as 95%. But there is inadequate evidence on appropriate intervention to prevent PCO. Aim: To compare the efficacy of plasma knife assisted posterior capsulotomy versus manual primary posterior capsulorhexis in Pediatric Cataract surgery. Materials and methods: The current study was a randomized open labeled controlled study, conducted in the department of ophthalmology, All India Institute of Medical Sciences, New Delhi between July 2015 to June 2016.
    [Show full text]
  • Existing Posterior Capsular Defect (PPCD)
    Images in… BMJ Case Rep: first published as 10.1136/bcr-2021-243330 on 10 May 2021. Downloaded from Modified technique of managing congenital cataract with pre- existing posterior capsular defect (PPCD) Sudarshan Khokhar,1 Mousumi Banerjee ,1,2 Sanketh Singh Rathod,2 Sushil Kumar2 1Ophthalmology, All India DESCRIPTION Institute of Medical Sciences, Congenital cataract with pre- existing posterior New Delhi, Delhi, India 2 capsule defect (PPCD) is a rare condition with an RPC, All India Institute of incidence ranging from 2% to 6.7%.1 2 The most Medical Sciences, New Delhi, common hypothesis of PPCD is the presence of Delhi, India pre-existing posterior lenticonus and its subsequent Correspondence to thinning which leads to microleaks and rapid matu- Dr Mousumi Banerjee; ration of the cataract leading to further thinning banerjeemou12@ gmail. com and formation of posterior capsular defect.2 Surgical management in paediatric cataract with Accepted 22 April 2021 PPCD remains a challenge due to the increased risk of lens matter drop in the vitreous cavity. We present a modified approach of managing such challenging situations with preoperative ultrasound Figure 2 Clinical picture of type 2 posterior capsule biomicroscopy (UBM) and ‘dry lens aspiration tech- defect (PCD) in a 8- month- old chid with significant loss nique’ through limbal route . of lens volume (A) better appreciated after lens aspiration Three types of PPCD have been described in with circular, regular margins of type 2 PCD (B) clinical literature based on the morphology of the poste- picture of type 1 PCD in a 9- month- old child with nuclear rior capsular defect.
    [Show full text]
  • The Following Acronyms and Terms Have Been Compiled Through Input from the ARVO Membership and Are Presented Here for Your Reference
    # A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Search The following acronyms and terms have been compiled through input from the ARVO membership and are presented here for your reference. The acronyms may have additional meanings based on the context in which they are used. ARVO encourages the use of full terms when appropriate. Abbreviations and acronyms should be used on a limited basis and always defined with the first mention. ARVO is making this document available under the Creative Commons Attribution-NonCommercial license (CC BY-NC). You are free to copy and distribute the content with attribution for non-commercial purposes. Send any comments or questions to us via our online feedback form. Acronym Term Acronym Term 1D4 the last 8 amino acids of rhodopsin Add adduction, turn in, addition epitope (antigen sequence for 1d4 ADP adenosine diphosphate antibody) 2AFC two-alternative-forced-choice adRP autosomal dominant retinitis pigmentosa 5-FU 5-fluorouracil AFM atomic force microscopy AACG acute angle closure glaucoma Ag antigen AAV adenoassociated virus AGFX air gas fluid exchange Abd abduction (aka turn out) AGI Audacious Goals Initiative National ABK aphakic bullous keratopathy Eye Institute AC, A/C adenylate cyclase AGM anti-glaucoma medication AC Allen cards AGV Ahmed-glaucoma valve AC amacrine cell AH aqueous humor AC anterior chamber AHD aqueous humor dynamics AC/A accommodative AIDS acquired immune deficiency convergence/accommodation ratio syndrome ACA anterior chamber angle AIOL, accommodating intraocular lens aIOL
    [Show full text]
  • Clinical Outcomes of Primary Posterior Continuous Curvilinear Capsulorhexis in Postvitrectomy Cataract Eyes
    Hindawi Journal of Ophthalmology Volume 2020, Article ID 6287274, 7 pages https://doi.org/10.1155/2020/6287274 Research Article Clinical Outcomes of Primary Posterior Continuous Curvilinear Capsulorhexis in Postvitrectomy Cataract Eyes Mengting Yu ,1 Duan Yan,1,2 Wenjie Wu ,1,2 Yingbin Wang,1 and Xinna Wu1 1Ophthalmology Department, Provincial Clinical Medical College of Fujian Medical University, Fuzhou 350001, China 2Ophthalmology Department, Fujian Provincial Hospital, Fuzhou 350001, China Correspondence should be addressed to Wenjie Wu; [email protected] Received 6 April 2020; Revised 11 June 2020; Accepted 14 July 2020; Published 31 July 2020 Academic Editor: Dirk Sandner Copyright © 2020 Mengting Yu et al. .is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. To evaluate the safety and outcomes of primary posterior continuous curvilinear capsulorhexis (PPCCC) combined with phacoemulsification in postvitrectomy eyes. Design. Retrospective case series. Methods. Twenty-one postvitrectomy eyes of 21 patients with cataract between April 2017 and December 2019 were enrolled. PPCCC through the cornea incision was performed before in-the-bag intraocular lens implantation. All patients were followed up for at least 3 months postoperatively. .e outcome measures were corrected distance visual acuity (CDVA), intraocular pressure (IOP), corneal endothelium cell counts (CECC), central macular thickness (CMT), the occurrence of intraoperative or postoperative complications, and the incidence of posterior capsular opacification (PCO). Results. .e mean age was 56.14 ± 9.76 years (ranging from 31 to 68). .e mean Snellen CDVA was 20/400 preoperatively and improved to 20/67 postoperatively (P < 0:001).
    [Show full text]
  • Why Use Ultrashort Pulses in Ophthalmology and Which Factors Affect Cut Quality
    medicina Review Why Use Ultrashort Pulses in Ophthalmology and Which Factors Affect Cut Quality Bojan Pajic 1,2,3,4,5,* , Brigitte Pajic-Eggspuehler 1, Christian Rathjen 6, Mirko Resan 5 and Zeljka Cvejic 2 1 Eye Clinic ORASIS, Swiss Eye Research Foundation, 5734 Reinach AG, Switzerland; [email protected] 2 Department of Physics, Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovica 4, 21000 Novi Sad, Serbia; [email protected] 3 Division of Ophthalmology, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland 4 Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland 5 Faculty of Medicine of the Military Medical Academy, University of Defense, 11000 Belgrade, Serbia; [email protected] 6 Ziemer Ophthalmic Systems, 2562 Port, Switzerland; [email protected] * Correspondence: [email protected]; Tel.: +41-62-765-6080 Abstract: The power density of femtosecond lasers and exposure time to the tissue are crucial for a successful procedure in terms of safety and precision. The reduction of the pulse duration allows reducing the quantity of the energy to be delivered to the tissue for disruption with strongly diminished mechanical and thermal collateral damage. The cutting effect of ultra-short pulses is very precise, minimally traumatic, safe, and predictable. Future developments will lead to further energy reductions to achieve optical breakdowns. However, the pulse length cannot be shortened arbitrarily because below 100 fs nonlinear effects can change the process in an unfavorable way. Compared to manual-conventional cataract surgery, femtosecond laser-assisted cataract surgery (FLACS) shows Citation: Pajic, B.; Pajic-Eggspuehler, B.; Rathjen, C.; Resan, M.; Cvejic, Z.
    [Show full text]