Ocular Surgery (ocular + surgery)

Distribution by Scientific Domains

Selected Abstracts

Effect of topical steroids on corneal epithelial healing after vitreoretinal surgery

Fatma Yülek
Abstract. Purpose:,Topical steroid use is usually avoided in cases of corneal epithelial defect. We evaluated the effect of topical steroid treatment on corneal epithelial healing after epithelial debridement in vitreoretinal surgery. Methods:,Our study population included 85 eyes undergoing vitreoretinal surgeries in our clinic. We prospectively compared the duration of corneal epithelial wound healing in 43 eyes in which topical dexamethasone was used with that in 42 eyes in which topical dexamethasone was not used in the early postoperative period after epithelial debridement. Factors that may retard corneal epithelial healing, including pre- and intraoperative topical solutions, median operative time, the presence of diabetes mellitus, prior ocular surgeries, pseudophakia, aphakia and the presence of intraocular gas or silicone oil in aphakic patients, were not significantly different between the two groups. Results:,The mean corneal epithelial defect closure time was 59.7 ± 2.6 hours (mean ± SEM) in the group receiving topical steroid treatment, and 61.9 ± 2.6 hours in the group that did not receive steroids. Conclusion:,Topical dexamethasone administered five times/day did not significantly retard corneal epithelial healing in subjects undergoing vitreoretinal surgery with postoperative topical steroid treatment, compared with subjects who did not receive steroid treatment. [source]

Effect of alkalinization and/or hyaluronidase adjuvancy on a local anesthetic mixture for sub-Tenon's ophthalmic block

M. M. Moharib
Background and objectives: pH adjustment and/or addition of hyaluronidase to local anesthetic drugs decrease the time to onset and prolong the duration of regional anesthetic techniques for ocular surgery. The objective of this study was to investigate whether these factors are effective also in sub-Tenon's block. Methods: Sixty patients were randomly assigned to four groups in a double blind, prospective fashion, and received 5.125 ml mixtures as follows: 2.5 ml lignocaine 2%, 2.5 ml bupivacaine 0.5% and 0.125 ml isotonic saline (group LB); 2.5 ml lignocaine 2%, 2.5 ml bupivacaine 0.5%, 15 IU hyaluronidase/ml and 0.125 ml isotonic saline (group LBH); 2.5 ml lignocaine 2%, 2.5 ml bupivacaine 0.5% and 0.125 ml sodium bicarbonate 8.4% (group LBpH); and 2.5 ml lignocaine 2%, 2.5 ml bupivacaine 0.5%, 15 IU hyaluronidase/ml and 0.125 ml sodium bicarbonate 8.4% (group LBHpH). This measurement was based on one quadrant sub-Tenon's block. Akinesia was assessed every 30 s. Results: No statistically significant differences were found between the groups regarding mean times to onset and to complete akinesia. Group LBH displayed a significantly lower frequency of patients experiencing pain and a lower need for rescue medication during surgery than the other groups. Conclusion: pH adjustment and/or addition of hyaluronidase to a mixture of lignocaine and bupivacaine did not shorten the time to onset of akinesia following sub-Tenon's technique. However, the addition of hyaluronidase was associated with a lower fraction of patients experiencing pain during surgery. [source]

The first two Japanese cases of severe type I congenital plasminogen deficiency with ligneous conjunctivitis: Successful treatment with direct thrombin inhibitor and fresh plasma,,

Takashi Suzuki
A 71-year-old woman and her elder sister developed ligneous conjunctivitis after ocular surgery. Laboratory tests demonstrated that the proband and her sister had 6.6% and 8.1% of plasminogen activity, and 1.2 and 1.4 mg/dl of antigen, respectively. Thus, they were diagnosed as having severe type I plasminogen deficiency, for the first time, in Japan. DNA sequencing and PCR-RFLP analyses revealed that these two cases are homozygotes of a novel A-to-G mutation at the obligatory splicing acceptor site in intron-C. Both cases were satisfactorily treated with a direct thrombin inhibitor, topical Argatroban, and topical plasma obtained from their healthy family members. Am. J. Hematol. 2009. © 2009 Wiley-Liss, Inc. [source]

2127: Ghrelin concentration in the aqueous humour and plasma in open angle glaucoma patients

Purpose Ghrelin is a peptide hormone that exerts metabolic and smooth muscle-relaxant effects in ocular tissues. The aim of this study was to compare aqueous humor and plasma levels of ghrelin in patients with open angle glaucoma (OAG) and controls. Methods Twenty four OAG, including 7 pseudoexfoliation (PXG) and 17 primary open-angle glaucoma (POAG) patients, and 30 controls were included. All participants were patients scheduled for cataract or glaucoma surgery. Patients with other concomitant ocular disease, previous ocular surgery or diabetes were excluded. Blood samples were collected before cataract surgery. Aqueous humor was aspirated from the anterior chamber through a paracentesis with a 27 G needle under sterile conditions. Ghrelin levels in both samples were measured quantitatively with commercially available Radioimmunoassay (RIA) kits. Results Mean±SD age was 71.0±9.3 and 69.6±6.6 years in the OAG and control groups, respectively (p=0.6). Plasma levels of ghrelin were 495.6±157.7 pg/ml in the OAG and 482.2±125.4 pg/ml in the control group, respectively (Mann-Whitney test, p=0.9). Aqueous humor levels of ghrelin were 85.5±15.4 pg/ml and 123.4 ±25.5 pg/ml in the OAG and control groups, respectively (Mann-Whitney test, p<0.01). The ratio of plasma/aqueous concentration in ghrelin was higher in the OAG versus the control group (5.82± 1.94 versus 4.00±1.04, Mann-Whitney test, p<0.01). There was no difference neither in plasma nor in aqueous humor levels of ghrelin between POAG and PXG patients (p>0.5). Conclusion Aqueous humor levels of ghrelin were significantly lower in OAG patients. This difference may manifest a role of ghrelin in the disease process or a consequence of antiglaucoma treatment. [source]

3236: Corneal grafting assisted by wavelength-optimised ultrashort pulser lasers

Purpose We realized an innovative device for ocular surgery by ultrafast pulse laser optimised for corneal grafting. Methods We constructed a demonstrator device that reproduces surgical conditions of corneal transplant. It is thus possible to realize with the help of an easy handling automatised interface all the kinds of already existing corneal transplants. Also, in order to maximize the spatial quality of the beam, a wavefront correction system using a deformable mirror module has been added. The Demonstrator contains an erbium fiber laser emitting at 1,6 microns. This laser delivers a beam of a few Joule with pulse duration of 700 femtoseconds and a repetition rate of 100-200 KHz. It includes deformable mirrors permitting horizontal displacements and a wavefront sensor. It also contains the administration system of the laser beam. Results The experiments carried out with a surgical tunable source confirmed the initial assumptions: the penetration depth is limited to wavelengths close to 1 microns. When increasing the wavelength, the drop of the scattering compensates the absorption and therefore the penetration depth is slowly varying when increasing the wavelength. The laser does not penetrate near the maximum of the water absorption band located at 1,45 microns. However, the use of a wavelength of 1,6 micros enables an important increasing of penetration depth (factor 3) while conserving the same energy of current technologies. Conclusion The use of a laser source with a wavelength corresponding to the window of transparency of the cornea (1,65 microns) permits to increase both the penetration depth of an ultrafast laser source and the cut quality. [source]

Anton Banko, the Slovenian inventor behind the success of Charles Kelman

Behind the success story of phacoemulsification that started with Charles Kelman, there was an ingenious engineer that helped him to create the first clinically useful apparatus. Anton Banko was born in a Slovenian family in Istria, very close to actual venue of EVER meeting. He studied engineering and electrics in Ljubljana and later moved to United Sates where he worked in the field of ultrasound instruments for dental use Cavitron company as the director of research and development. Charles Kelman turned to him with a request to construct an ultrasound device for cataract removal and their first joint US patent No. 3589363 was filed on 25th July 1967. A year later, Anton Banko established his own company in New York, named Surgical Design, and the company produced a series of very reliable and successful phaco machines that are still used worldwide. Anton Banko continued to develop many other patents used in ocular surgery including instrument for vitrectomy that he patented in 1969 after which a combined Mackool/Heslin Ocusystem machine was designed. Sadly , he died of incurable disease soon after the success of his company which since then is led by his son William. Anton Banko's wish to donate one of the machines to the University Eye Hospital in Ljubljana was conweyed by his family. Due to his legacy, surgeons from Slovenia started to use phacoemulsification as early as in 1989 after training in the wetlab of Surgical Design company. Anton Banko remains one of the giants of instrumentation in ocular surgery with Slovenian origins. [source]

ATD perimetry in glaucoma and ocular hypertensive patients.

A preliminar study
Purpose: The new ATD perimetry assesses contrast sentivity thresholds for the three afferent sensory pathways of the visual system. Our aim is to compare contrast sensitivity to stimuli with different spatio-temporal frequencies in glaucomatous (G) and ocular hypertensive (OHT) subjects. Methods: Twenty three G and OHT subjects were selected from the ophthalmic clinic, all subjects signed an informed consent. Inclusion criteria were diagnosis of G or OHT, normal Farnsworth-Munsell color test, ametropia less than 6 D, visual acuity over 20/30, absence of previous ocular surgery and experience in perimetry. Twenty locations and the fovea were evaluated in a 60º x 40º fovea-centered field. Eight gabor stimuli were used: 0.5cpd-12Hz, 0.5cpd-24Hz, 4cpd-2Hz and 4cpd 12Hz, modulated along the achromatic (A) direction, 0.5cpd-12Hz and 4cpd-2Hz along the red/green (T) and blue/yellow (D) directions. Statistical analysis included ANOVA and Schéffé tests. Results: Mean thresholds for G and OHT were respectively, 0.4872 ± 0.5323 and 0.1077 ± 0.1922, for A 0.5cpd-12Hz; 0.7296 ± 0.5925 and 0.2280 ± 0.2246 for stimulus A 0.5cpd-24Hz; 1.4444 ± 0.5244 and 1,2671 ± 0.6138 for A 4cpd-2Hz; and 0.7751 ± 0.1937 and 0.6851 ± 0.2379 for D 0.5cpd-12Hz. Significant statistical differences (p<0.05) were found between G and OHT groups only with these stimuli. Conclusions: These preliminary results show that certain stimuli may differentiate between G and OHT subjects. A larger population sample, including glaucoma suspects, is currently under study. [source]

LASIK after retinal detachment surgery

Mohsen Farvardin
Abstract. Purpose:,To compare, in the same individuals, the safety and efficacy of laser in situ keratomileusis (LASIK) in eyes with and without previous retinal detachment surgery. Methods:,In a prospective clinical trial, seven myopic patients who had previously undergone scleral buckling surgery in one eye underwent conventional LASIK surgery in both eyes. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction, Orbscan topography and pachymetry were recorded before and 1, 3, 6 and 12 months after surgery. The eyes were divided into two groups: group 1 consisted of eyes that had undergone previous surgery for retinal detachment, and group 2 consisted of the fellow eyes of the same patients, which had not undergone any previous ocular surgery. Student's t -test for match-paired data was used to evaluate the significance of differences. Results:,LASIK was performed successfully in all patients. The UCVA improved in all eyes in both groups. The mean change in the spherical equivalent between 1 and 12 months after LASIK surgery was 1.7 ± 1.1 and 0.6 ± 0.5 diopter in groups 1 and 2, respectively (p = 0.019). Conclusion:,LASIK may be considered for treatment of myopia in eyes that have had previous surgery for retinal detachment. However, the risk of regression may be higher in such eyes than in eyes with no previous scleral buckling surgery. [source]