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Postoperative Visual Acuity (postoperative + visual_acuity)

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Medical Sciences	100%

Selected Abstracts

Endoscopic Endonasal Management of Pseudotumor Cerebri: Is it Effective?

THE LARYNGOSCOPE, Issue 7 2007
Ashok K. Gupta MD
Abstract Purpose: To study the efficacy and safety of endoscopic endonasal optic nerve fenestration for the management of idiopathic intracranial hypertension (IIH). Design: A prospective study at a tertiary care center. Patients and Methods: All patients with a final diagnosis of IIH from July 2001 to March 2005 were included and subjected to detailed neuro-ophthalmologic examination and endoscopic endonasal optic nerve fenestration. Postoperative visual acuity and the perimetry was compared with the preoperative status, and the results were analyzed using the ,2 test. Results: Of the 18 patients included in the study, 17 had improvement in vision postoperatively. Fifteen patients had visual deterioration in the other eye as well, and of these, 12 had improvement, obviating the need for surgery on the other side. Complications were minimal and in the form of synechiae in two of the cases. Discussion: A number of procedures have been described for the management of this entity, and each is associated with a significant morbidity; therefore, there was a need for a minimally invasive procedure. The procedure adopted in the series is minimally invasive and is associated with a 94.5% success rate and minimal morbidity. Conclusions: Endoscopic endonasal optic nerve fenestration is a safe, minimally invasive, and extremely effective procedure for the management of IIH. [source]

Anatomical and functional outcome in brilliant blue G assisted chromovitrectomy

ACTA OPHTHALMOLOGICA, Issue 5 2010
Paul B. Henrich
Abstract. Purpose:, To evaluate the potential of brilliant blue G (BBG) for intraoperative staining of the inner limiting membrane (ILM) with respect to staining properties and surgical outcome. Methods:, In a retrospective, non-comparative clinical case series, we analysed 17 consecutive chromovitrectomy interventions for surgery of macular holes, ERMs, vitreoretinal traction syndromes and cystoid macular oedema. Following complete posterior vitreous detachment, BBG was injected into the vitreous cavity at a concentration of 0.25 mg/ml, followed by immediate washout. Main outcome measures were staining properties, visual acuity, central visual field testing and optical coherence tomography (OCT) measurements over a mean follow-up period of 3 months. Results:, ILM staining was somewhat less intensive for BBG than for average indocyanine green (ICG) chromovitrectomy. However, the ILM was removed successfully without additional ICG in 15/17 patients. Postoperative visual acuity was improved in 16/17 patients and remained unchanged in one patient. Central retinal OCT thickness showed a postoperative reduction, with values ranging from +7 to ,295 ,m (median ,89 ,m). Neither visual field defects nor any other adverse events were recorded. Conclusion:, BBG permits sufficient staining for safe ILM removal. In this short-term study, good anatomical and functional results were achieved and no adverse events were observed. [source]

Vitrectomy without postoperative posturing for idiopathic macular holes

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 5 2007
Adrian Rubinstein MRCSEd
Abstract Purpose:, To determine the success of vitrectomy with ILM peeling and C3F8 tamponade for macular holes without the need for postoperative face-down posturing. Methods:, Twenty-four eyes of 24 consecutive patients undergoing pars plana vitrectomy with indocyanine green-assisted ILM peeling and C3F8 tamponade without prone posturing were included in the study. All patients had follow up on 1 day, 2 weeks and 3 months postoperatively. Biomicroscopy and optical coherence tomography were used to assess macular hole closure at 3 months postoperatively. Snellen visual acuity was compared pre- and postoperatively. Results:, Of the 24 eyes recruited, two (8%) had stage II, 17 (71%) had stage III and five (21%) had stage IV macular holes. Nineteen (79%) eyes were phakic and five (21%) eyes were pseudophakic at the time of surgery. The macular holes had been present for an average of 7.5 months (range 3,18 months). At 3-month follow up, 22/24 (91.6%) holes were closed. Both of the two holes that failed to close were stage IV macular holes. Preoperative visual acuity ranged from 6/18 to 6/60 (mean 6/36). Postoperative visual acuity ranged from 6/9 to 6/60 (mean 6/18). Eighteen eyes had improvement of visual acuity of at least one line on the Snellen chart, six eyes had no improvement. No eyes had worse vision postoperatively. Conclusion:, Macular hole surgery without face-down posturing provides anatomical and functional results comparable to those with prone posturing. Combined phacovitrectomy is not essential to avoid prone posturing. [source]

Visual outcomes following vitrectomy and peeling of epiretinal membrane

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 4 2005
James G Wong MMed
Abstract Background:, Visual outcomes of patients following vitrectomy and peeling of visually significant epiretinal membranes were assessed to determine the influence of specific perioperative factors and surgical complications on final visual acuity and functional vision. Methods:, In an unmatched, consecutive surgical series, vitrectomy and membrane peeling were performed on 125 eyes of 123 patients with visually significant macular epiretinal membranes. Patients were followed for 6,36 months. Visual outcome measures included postoperative logMAR visual acuity, change in visual acuity and functional vision tasks evaluated by questionnaire. Perioperative factors including duration of symptoms, preoperative visual acuity, aetiology, membrane type and leakage on fundal fluorescein angiogram were correlated with final visual outcomes. Results:, Visual acuity improved by a mean of 0.31 Â± 0.21 units (three lines of vision). In 104 cases (83%), visual acuity improved in patients by two lines or more, with 20 cases (16%) having unchanged acuity and one case (1%) having worse acuity. Ninety-three per cent of interviewed cases reported improvement in functional vision, especially reduction of distortion. Cataract was observed in 52 cases (52% of phakic eyes) postoperatively compared with 19 cases (19%) preoperatively. Postoperative visual acuity correlated with preoperative visual acuity. Patients with worse preoperative vision recorded greater visual improvement following surgery. No other perioperative factors were found to have a prognostic value in this study. Conclusion:, Epiretinal membrane peeling improves vision in the majority of patients with significant symptoms, even if preoperative visual acuity is not substantially reduced. Surgery improves functional vision including metamorphopsia not measurable by visual acuity, and thus assessment of functional vision should be included in surgical case planning. [source]

The macular hole: report of an Australian surgical series and meta-analysis of the literature

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 4 2000
H K Kang MB BS
ABSTRACT Purpose: To report an Australian series of macular hole surgery by pars plana vitrectomy and fluid-gas exchange, and to identify factors influencing the outcome of the surgery through meta-analysis of the literature. Methods: Fifty-six consecutive cases of macular hole were treated by pars plana vitrectomy, fluid-gas exchange and face-down positioning for at least 7 days, and prospectively followed for 3,12 months. Thirty-six reports of macular hole surgery were reviewed. A meta-analysis on the pre- and postoperative parameters was performed on 389 cases, in which case-specific data-points were available. Results: In the current series, anatomical closure was achieved in all (100%) of 16 stage 2, and in 35 (87.5%) of 40 stage 3 or 4 macular holes. At least 2 logMAR lines of improvement in visual acuity were seen in 10 (62.5%) stage 2 and 20 (50.0%) stage 3 or 4 holes. Postoperative visual acuity was 6/12 or better in 10 (62.5%) stage 2 and 17 (42.5%) stage 3 or 4 holes. In both the current series and the meta-analysis, favourable surgical outcomes were associated with stage 2 macular holes, better preoperative visual acuity, and shorter preoperative duration. Adjuvant use was associated with a higher rate of anatomical closure but there was no clear benefit in terms of postoperative visual acuity. Conclusion: Our experience and the results of the meta-analysis suggest that macular hole surgery should be offered as early as possible once full-thickness neuroretinal defect occurs. [source]

Vitreoretinal surgery in Behçet's disease with severe ocular complications

ACTA OPHTHALMOLOGICA, Issue 2 2001
Yusuf Özertürk
ABSTRACT. Purpose: To investigate effects of vitreoretinal surgery in Behçet's disease. Materials and Method: Vitreoretinal surgery was applied to 26 eyes of 21 patients with Behçet's disease. Preoperative and postoperative visual acuities, number and duration of attacks, anterior and posterior segment pathologies were evaluated. Results: The mean age of the patients was 33 years and female/male ratio was 6/15. The mean follow-up was 23 months. Visual acuity increased in 15 eyes (58%), did not change in 11 eyes (42%). In the postoperative period, there was a significant decrease in mean number of uveitis attacks compared to the preoperative period (p=0.001), as well as a significant decrease in the mean duration of uveitis attacks (p=0.001). In the postoperative follow-up, intravitreal haemorrhage in 2 eyes (8%), posterior subcapsular cataract in 5 eyes (19%) and corticonuclear cataract in 2 eyes (8%) were observed. Posterior capsular opacification (PCO) developed in 5 of 16 eyes (31%) having ECLE-IOL. CME continued in 3 eyes (12%). Conclusion: Vitreoretinal surgery has favourable effect on the visual and anatomic prognosis in Behçet's patients with severe ocular complications. [source]

2166: Clinical applications of corneal Scheimpflug densitometry in DSAEK and cornea guttata patients

ACTA OPHTHALMOLOGICA, Issue 2010
M WEYNS
Purpose The aim of this project is to study clinical applications of corneal Scheimpflug densitometry. In the first part of the study a correlation between corneal Scheimpflug densitometry and endothelial cell count in cornea guttata will be studied. The second part will investigate a possible correlation between the smoothness of the corneal graft and postoperative visual acuity in DSAEK patients. Methods Cross-sections of corneal Scheimpflug images will be analyzed by means of custom written software. Parameters such as average densitometry profile, position and intensity of the Bowman membrane and corneal endothelium peaks, as well as the position and intensity of the interface between an acceptor cornea and the DSAEK graft (if present) will be calculated. Results The method to analyze the corneal densitometry has already been developed and tested on corneas of contact lens wearers and post refractive surgery patients. A small number of DSAEK en cornea guttata eyes have been analyzed as well, demonstrating the potential of this technique in these patients. Conclusion Corneal Scheimpflug densitometry may be complementary to endothelial cell count in monitoring the disease progression in cornea guttata patients. Corneal Scheimpflug images may also be considered a predictor for visual outcome after DSAEK if the postoperative visual acuity variations in DSAEK patients can be linked to wrinkles in the posterior surface of the graft. [source]

The Boston keratoprosthesis in autoimmune disease

ACTA OPHTHALMOLOGICA, Issue 2009
J CHODOSH
Purpose Patients with corneal blindness due to mucous membrane pemphigoid and Stevens Johnson syndrome who undergo corneal transplantation carry a poor prognosis for visual recovery. The Boston keratoprosthesis has been demonstrated to provide excellent retention rates and postoperative visual acuity in patients with corneal graft failure, however, poor visual outcomes still occur in patients with underlying autoimmune disease. Methods We reviewed the current literature to determine the results of keratoprosthesis in patients with blinding autoimmune diseases. Results Much of the published literature on keratoprosthesis fails to clearly differentiate outcomes on the basis of the underlying disorder. Based on available evidence, inflammation, retinal detachment, and glaucoma appear to be the most significant complications after keratoprosthesis in autoimmune patients, and a diagnosis of mucous membrane pemphigoid or Stevens Johnson Syndrome appears to be associated with a significantly higher complication rate than other preoperative conditions. Conclusion Patients with autoimmune diseases carry the worst prognosis for success with keratoprosthesis. Improvement in clinical outcomes might be achieved with changes in keratoprosthesis design and material, perioperative therapy, and/or surgical technique. Possible approaches to complications after Boston keratoprosthesis in patients with underlying autoimmune diseases will be discussed. [source]

Comparison of visual acuity measurements and Purkinje's vessel shadow perception for prediction of postoperative visual acuity in different ophthalmological diseases

ACTA OPHTHALMOLOGICA, Issue 2 2007
Stephan Schulze
Abstract. Purpose:, Prediction of postoperative visual acuity (VA) is extremely important to the patient and highly relevant to the surgeon. However, objective evaluation of the macula is frequently impossible in cases such as mature cataract, cataract in high myopia or vitreous haemorrhage. This study compares different preoperative examination techniques used to predict postoperative VA. Methods:, We retrospectively evaluated the charts of all patients who underwent any of the following procedures at our hospital in 2004: phacoemulsification for mature cataract or cataract in high myopia; vitrectomy for diabetic vitreous haemorrhage; macular pucker, and macular hole. The following methods were evaluated: preoperative distance and reading VA; laser interferential VA; Purkinje's vessel shadow perception, and postoperative distance VA. Results:, Complete documentation was available for 136 patients (29 mature cataracts, 25 immature cataracts in high myopia, 42 vitreous haemorrhages, 19 macular puckers, 21 macular holes). In cases of preoperative mature cataract, a positive Purkinje's vessel shadow perception predicted a postoperative VA , 20/50 (odds ratio 11.2). In cases of high myopia, interferential VA correlated best with visual outcome (p < 0.05). In macular surgery laser interferential VA predicted postoperative VA to be better and preoperative reading VA predicted it to be worse than it actually turned out after surgery. Laser interferential VA and last known VA prior to vitreous haemorrhage (mean of 20 months previously) correlated best with postoperative VA (p < 0.05) in cases of vitreous haemorrhage. Purkinje's vessel shadow perception , if positive , predicted a postoperative VA , 20/300 in these cases (odds ratio 15.0). Conclusions:, Postoperative VA after vitrectomy for macular pucker or macular hole and in cases of cataract in high myopia is best predicted by laser interferential VA. Postoperative VA after vitrectomy for diabetic vitreous haemorrhage is best predicted by prehaemorrhage VA or laser interferential VA, especially when prehaemorrhage VA is unknown. Positive Purkinje's vessel shadow perception is an excellent method of predicting postoperative VA , 20/300 in cases of vitreous haemorrhage and VA = 20/50 in mature cataract. [source]

Topical versus peribulbar anaesthesia for cataract surgery

ACTA OPHTHALMOLOGICA, Issue 6 2003
Gangolf Sauder
Abstract. Background:,To assess and compare the efficacy and safety of topical versus peribulbar anaesthesia in patients undergoing routine cataract surgery. Methods:,The unicentre, prospective, randomized, clinical interventional trial included 140 consecutive patients undergoing routine cataract surgery performed by one of two surgeons. The patients were randomly distributed to either peribulbar anaesthesia or topical anaesthesia. To assess intraoperative pain, each patient was asked immediately after surgery to quantitate his/her pain using a 10-point pain rating scale. Results:,The study groups did not differ significantly in pain score (p = 0.54), duration of surgery (p = 0.52), anaesthesia-related intraoperative difficulties (p = 0.17), postoperative visual acuity (p = 0.94), overall intraoperative surgical complication rate, blood pressure rise (p = 0.16) or blood oxygen saturation (p = 0.74) Conclusions:,Patient comfort and surgery-related complications did not differ between topical anaesthesia and peribulbar anaesthesia. As there are no significant differences between the two techniques in terms of subjective pain experienced by patients, intraoperative complications and postoperative visual outcome, and in view of the minimally invasive character of topical anaesthesia compared to peribulbar anaesthesia, the present study suggests the use of topical anaesthesia for routine cataract surgery. [source]

Densiron intraocular tamponade: a case series

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 3 2008
Beng Liam Lim MBBS(Hons) MPH
Abstract Purpose:, To report on the use of Densiron (heavy silicone oil), a new endotamponade agent with proposed benefits in complex retinal detachments involving inferior proliferative vitreoretinopathy. Method:, Retrospective case note review. Results:, Ten cases (10 eyes) in which Densiron was used in eyes which had failed initial retinal detachment surgery. The overall success rate of long-term total reattachment was 70%. Mean preoperative visual acuity was logMAR 2.03 (SD 0.406), which improved to a mean postoperative visual acuity of logMAR 1.00 (SD 0.571) (P = 0.001). Conclusion:, Densiron was well tolerated with few side-effects and appears to be a useful agent in patients with inferior proliferative vitreoretinopathy. [source]