This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search.The definition can be related to a number of special phenotypes.In the more challenging cases of complex microphthal...This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search.The definition can be related to a number of special phenotypes.In the more challenging cases of complex microphthalmos,relative anterior microphthalmos,and nanophthalmos,the surgeon can approach these cases more safely if they have a deep understanding of the anatomical variations and ideal formulae for intraocular lens computation and knows how to avoid intra-and post-operative complications.In this article,we review the criteria by which we recognize and describe pre-,intra-,and post-operative considerations,as well as discuss the ideal intraocular lenses for microphthalmos,given the intricate varieties of small eye phenotypes.展开更多
Keratoconus is a progressive, non-inflammatory disease of the cornea, which is characterized by marked cornealsteepening and thinningrll. It induces myopia and irregular astigmatism leading frequently to severe visual...Keratoconus is a progressive, non-inflammatory disease of the cornea, which is characterized by marked cornealsteepening and thinningrll. It induces myopia and irregular astigmatism leading frequently to severe visual impairmentu. Although several aetiological factors have been implicated in its pathophysiology, the exact mechanisms underlying keratoconus are not fully elucidated yet. Corneal crosslinking is the treatment of choice in order to inhibit the progression of keratoconus, whereas advanced cases require penetrating or lamellar keratolalasty for visual restoration.展开更多
AIM: To analyze the features of the filtering blebs following implantation of the Ex-PRESS glaucoma device(model P-50) with the aid of the Visante anterior segment optical coherence tomography(AS-OCT)METHODS: Five pat...AIM: To analyze the features of the filtering blebs following implantation of the Ex-PRESS glaucoma device(model P-50) with the aid of the Visante anterior segment optical coherence tomography(AS-OCT)METHODS: Five patients with open angle glaucomas were included in the study. They all underwent implantation of the Ex-PRESS device under a scleral flap. The surgical procedure was augmented with the use of mitomycin C subconjunctivally. The filtering blebs were analyzed with the Visante AS-OCT with the scans taken along the axis of the implantation of the glaucoma device.RESULTS: All filtering blebs were graded as diffuse functioning. The morphological characteristics of the blebs were similar to those of the trabeculectomy.However the use of the Ex-PRESS implant tend to form a characteristic episcleral lake at the site of the plate of the implant. CONCLUSION: The use of the Ex-PRESS implant produces filtering blebs similar to those of the trabeculectomy with the formation of a characteristic episcleral lake at the site of the plate of the implant.展开更多
AIM： To determine the impact of biometric characteristics on the biomechanical properties of the human cornea using the ocular response analyzer （ORA） and standard comprehensive ophthalmic examinations before and a...AIM： To determine the impact of biometric characteristics on the biomechanical properties of the human cornea using the ocular response analyzer （ORA） and standard comprehensive ophthalmic examinations before and after standard phacoemulsificaUon. METHODS： This study comprised 54 eyes with cataract with significant lens opacification in stages I or II that underwent phacoemulsification （2.8 mm incision）. Corneal hysteresis （CH）, corneal resistance factor （CRF）, Goldmann-correlated intraocular pressure （IOPg）, and corneal-compensated intraocular pressure （IOPcc） were measured by ORA preoperatively and at lmo postoperatively. Biometric characteristics were derived from corneal topography [TMS-5, anterior equivalent （EQTMS） and cylindric （CYLTMS） power], corneal tomography [Casia, anterior and posterior equivalent （EQaCASC, EQpCASIA） and cylindric （CYLaCASIA, CYLpCASIA） power], keratometry [IOLMaster, anterior equivalent （EQIOL） and cylindric （CYL,oL） power] and autorefractor [anterior equivalent （EQAR）]. Results from ORA were analyzed and correlated with those from all other examinations taken at the same time point. RESULTS： Preoperatively, CH correlated with EQpCASIA and CYLpCASIA only （P=0.001, P=0.002）. Postoperatively, IOPg and IOPcc correlated with all equivalent powers （EQTMS, EQIOL, EQAR, EQaCASIA, and EQpCASIA）（P=0.001, P=0.007, P=0.001, P= 0.015, P=0.03 for IOPg and P〈0.001, ,0=0.003, P〈0.001, P= 0.009, P=0.014 for IOPcc）. CH correlated postoperatively with EQaCASIA and EQpCASIA only （P=0.021, P=0.022）. CONCLUSION： Biometric characteristics may significantly affect biomechanical properties of the cornea in terms of CH, IOPcc and IOPg before, but even more after cataract surgery.展开更多
Background:The aim of this study is to review the outcomes of canaloplasty versus canaloplasty combined with phacoemulsification in a retrospective cohort study and to evaluate the efficacy of these methods in terms o...Background:The aim of this study is to review the outcomes of canaloplasty versus canaloplasty combined with phacoemulsification in a retrospective cohort study and to evaluate the efficacy of these methods in terms of intraocular pressure(IOP)lowering effect,postoperative complications and additional glaucoma surgery or reintroduction of medical therapy over a 12-month follow-up.Methods:In a retrospective cohort study,602 eyes with primary open angle glaucoma(POAG)were treated with canaloplasty or canaloplasty combined with phacoemulsification.The results were evaluated separately in two main groups;group A canaloplasty(262 eyes)and group B canaloplasty combined with phaco(322 eyes).Each group was then subdivided into three additional groups according to the severity of glaucoma.The criteria for successful treatment were evaluated between three IOP ranges;IOP≤16 mmHg,18 mmHg and 21 mmHg.Complete success was considered the percentage of eyes reaching target IOP with no medication and partial success with medication.Groups A and B subgroups were compared using the Kaplan Meier test.Mean IOP,reduction of antiglaucoma agents and additional IOP lowering methods were also evaluated.The follow-up time was 12 months.Statistical significance was set at p<0.05.Results:An incomplete intraoperative cannulation of Schlemm’s canal resulting in conversion to other glaucoma surgery occurred in 18 eyes(2.99%).In both of the main groups,postoperative hyphema,descemet membrane detachment and transient IOP rise were the most common postoperative complications.The mean IOP in group A and subgroups at 12 months was 13.26±4.5 mmHg,15.19±3.97 mmHg and 18.09±3.75 mmHg.Respectively in group B mean IOP was 14.51±4.69 mmHg,14.40±4.11 mmHg and 14.25±2.76 mmHg.Complete success was achieved in group A in 69.19,74.51 and 74.31%of eyes.In group B complete success was achieved in 81.60,77.33 and 83.33%of eyes respectively.Kaplan Meier between groups A and B was statistically significant for IOP≤16 mmHg and IOP≤21 mmHg(p=0.0041 and p=0.0312),but not for IOP≤18 mmHg(p=0.6935).Partial success for IOP≤16 mmHg was 95.23 and 92.26%,for IOP≤18 mmHg was 91.66 and 90.47%and for IOP≤21 mmHg,90.00 and 93.10%,in groups A and B respectively.Twenty-three eyes received additional surgery(3.93%),10 trabeculectomies and 2 cyclophotocoagulation in group A,and 9 trabeculectomies and 2 cyclophotocoagulation in group B.Conclusion:Canaloplasty and canaloplasty combined with phacoemulsification significantly lower the IOP and have a lower postoperative complication rate.Additional glaucoma surgery or medication following both procedures is necessary if target IOP is unsatisfactory.In this study,canaloplasty combined with phacoemulsification demonstrated superior success rate compared to canaloplasty alone.展开更多
Purpose:To report preliminary 6-month results on the use of the Preserflo Microshunt implant with and without Ologen in 50 pseudophakic eyes with moderate to advanced primary open-angle glaucoma(POAG).Methods:Fifty ps...Purpose:To report preliminary 6-month results on the use of the Preserflo Microshunt implant with and without Ologen in 50 pseudophakic eyes with moderate to advanced primary open-angle glaucoma(POAG).Methods:Fifty pseudophakic eyes underwent ab externo Preserflo Microshunt implantation.Data was gathered retrospectively and two groups were then created,group A with application of MMC 0.2 mg/ml and group B with MMC 0.2 mg/ml and Ologen collagen matrix(OCM)implantation.Absolute success was regarded as the percentage of eyes achieving:a)5≤intraocular pressure(IOP)≤13 mmHg,b)5≤IOP≤16 mmHg,and c)5≤IOP≤21 mmHg without additional medication or surgery and qualified success was regarded as the percentage of eyes achieving a)IOP≤13 mmHg,b)IOP≤16 mmHg,and c)IOP≤21 mmHg with or without medication.Evaluation was performed using a log-rank Kaplan-Meier test.A scatterplot analysis presented the treatment effect data of all eyes with a minimum of 20%IOP reduction per case.Failure was defined as requiring additional surgery,IOP greater than 21 mmHg with or without medication and failure to reach 20%IOP reduction.Results:Mean postoperative IOP was significantly lower in both groups.IOP decreased by 49.06%in group A and by 53.01%in group B at 6 months(P<0.88),respectively.Medication use was lower in both groups(Wilcoxon test,P<0.001).The absolute and qualified success rates were not statistically significant between the groups(all P>0.05).Cumulative IOP results per case were not statistically different in group A compared with group B.One revision surgery in group A(4%failure rate)and three in group B(12%failure rate)were performed.Conclusions:Both groups showed equal results in terms of cumulative and mean IOP reduction,medication reduction as well as in absolute and qualified success rates.No significant difference was found in any parameters tested between Preserflo Microshunt with MMC 0.2 mg/ml and with or without OCM implantation at 6 months.Long-term follow-up is required to further evaluate this data.展开更多
文摘This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search.The definition can be related to a number of special phenotypes.In the more challenging cases of complex microphthalmos,relative anterior microphthalmos,and nanophthalmos,the surgeon can approach these cases more safely if they have a deep understanding of the anatomical variations and ideal formulae for intraocular lens computation and knows how to avoid intra-and post-operative complications.In this article,we review the criteria by which we recognize and describe pre-,intra-,and post-operative considerations,as well as discuss the ideal intraocular lenses for microphthalmos,given the intricate varieties of small eye phenotypes.
文摘Keratoconus is a progressive, non-inflammatory disease of the cornea, which is characterized by marked cornealsteepening and thinningrll. It induces myopia and irregular astigmatism leading frequently to severe visual impairmentu. Although several aetiological factors have been implicated in its pathophysiology, the exact mechanisms underlying keratoconus are not fully elucidated yet. Corneal crosslinking is the treatment of choice in order to inhibit the progression of keratoconus, whereas advanced cases require penetrating or lamellar keratolalasty for visual restoration.
文摘AIM: To analyze the features of the filtering blebs following implantation of the Ex-PRESS glaucoma device(model P-50) with the aid of the Visante anterior segment optical coherence tomography(AS-OCT)METHODS: Five patients with open angle glaucomas were included in the study. They all underwent implantation of the Ex-PRESS device under a scleral flap. The surgical procedure was augmented with the use of mitomycin C subconjunctivally. The filtering blebs were analyzed with the Visante AS-OCT with the scans taken along the axis of the implantation of the glaucoma device.RESULTS: All filtering blebs were graded as diffuse functioning. The morphological characteristics of the blebs were similar to those of the trabeculectomy.However the use of the Ex-PRESS implant tend to form a characteristic episcleral lake at the site of the plate of the implant. CONCLUSION: The use of the Ex-PRESS implant produces filtering blebs similar to those of the trabeculectomy with the formation of a characteristic episcleral lake at the site of the plate of the implant.
文摘AIM： To determine the impact of biometric characteristics on the biomechanical properties of the human cornea using the ocular response analyzer （ORA） and standard comprehensive ophthalmic examinations before and after standard phacoemulsificaUon. METHODS： This study comprised 54 eyes with cataract with significant lens opacification in stages I or II that underwent phacoemulsification （2.8 mm incision）. Corneal hysteresis （CH）, corneal resistance factor （CRF）, Goldmann-correlated intraocular pressure （IOPg）, and corneal-compensated intraocular pressure （IOPcc） were measured by ORA preoperatively and at lmo postoperatively. Biometric characteristics were derived from corneal topography [TMS-5, anterior equivalent （EQTMS） and cylindric （CYLTMS） power], corneal tomography [Casia, anterior and posterior equivalent （EQaCASC, EQpCASIA） and cylindric （CYLaCASIA, CYLpCASIA） power], keratometry [IOLMaster, anterior equivalent （EQIOL） and cylindric （CYL,oL） power] and autorefractor [anterior equivalent （EQAR）]. Results from ORA were analyzed and correlated with those from all other examinations taken at the same time point. RESULTS： Preoperatively, CH correlated with EQpCASIA and CYLpCASIA only （P=0.001, P=0.002）. Postoperatively, IOPg and IOPcc correlated with all equivalent powers （EQTMS, EQIOL, EQAR, EQaCASIA, and EQpCASIA）（P=0.001, P=0.007, P=0.001, P= 0.015, P=0.03 for IOPg and P〈0.001, ,0=0.003, P〈0.001, P= 0.009, P=0.014 for IOPcc）. CH correlated postoperatively with EQaCASIA and EQpCASIA only （P=0.021, P=0.022）. CONCLUSION： Biometric characteristics may significantly affect biomechanical properties of the cornea in terms of CH, IOPcc and IOPg before, but even more after cataract surgery.
文摘Background:The aim of this study is to review the outcomes of canaloplasty versus canaloplasty combined with phacoemulsification in a retrospective cohort study and to evaluate the efficacy of these methods in terms of intraocular pressure(IOP)lowering effect,postoperative complications and additional glaucoma surgery or reintroduction of medical therapy over a 12-month follow-up.Methods:In a retrospective cohort study,602 eyes with primary open angle glaucoma(POAG)were treated with canaloplasty or canaloplasty combined with phacoemulsification.The results were evaluated separately in two main groups;group A canaloplasty(262 eyes)and group B canaloplasty combined with phaco(322 eyes).Each group was then subdivided into three additional groups according to the severity of glaucoma.The criteria for successful treatment were evaluated between three IOP ranges;IOP≤16 mmHg,18 mmHg and 21 mmHg.Complete success was considered the percentage of eyes reaching target IOP with no medication and partial success with medication.Groups A and B subgroups were compared using the Kaplan Meier test.Mean IOP,reduction of antiglaucoma agents and additional IOP lowering methods were also evaluated.The follow-up time was 12 months.Statistical significance was set at p<0.05.Results:An incomplete intraoperative cannulation of Schlemm’s canal resulting in conversion to other glaucoma surgery occurred in 18 eyes(2.99%).In both of the main groups,postoperative hyphema,descemet membrane detachment and transient IOP rise were the most common postoperative complications.The mean IOP in group A and subgroups at 12 months was 13.26±4.5 mmHg,15.19±3.97 mmHg and 18.09±3.75 mmHg.Respectively in group B mean IOP was 14.51±4.69 mmHg,14.40±4.11 mmHg and 14.25±2.76 mmHg.Complete success was achieved in group A in 69.19,74.51 and 74.31%of eyes.In group B complete success was achieved in 81.60,77.33 and 83.33%of eyes respectively.Kaplan Meier between groups A and B was statistically significant for IOP≤16 mmHg and IOP≤21 mmHg(p=0.0041 and p=0.0312),but not for IOP≤18 mmHg(p=0.6935).Partial success for IOP≤16 mmHg was 95.23 and 92.26%,for IOP≤18 mmHg was 91.66 and 90.47%and for IOP≤21 mmHg,90.00 and 93.10%,in groups A and B respectively.Twenty-three eyes received additional surgery(3.93%),10 trabeculectomies and 2 cyclophotocoagulation in group A,and 9 trabeculectomies and 2 cyclophotocoagulation in group B.Conclusion:Canaloplasty and canaloplasty combined with phacoemulsification significantly lower the IOP and have a lower postoperative complication rate.Additional glaucoma surgery or medication following both procedures is necessary if target IOP is unsatisfactory.In this study,canaloplasty combined with phacoemulsification demonstrated superior success rate compared to canaloplasty alone.
文摘Purpose:To report preliminary 6-month results on the use of the Preserflo Microshunt implant with and without Ologen in 50 pseudophakic eyes with moderate to advanced primary open-angle glaucoma(POAG).Methods:Fifty pseudophakic eyes underwent ab externo Preserflo Microshunt implantation.Data was gathered retrospectively and two groups were then created,group A with application of MMC 0.2 mg/ml and group B with MMC 0.2 mg/ml and Ologen collagen matrix(OCM)implantation.Absolute success was regarded as the percentage of eyes achieving:a)5≤intraocular pressure(IOP)≤13 mmHg,b)5≤IOP≤16 mmHg,and c)5≤IOP≤21 mmHg without additional medication or surgery and qualified success was regarded as the percentage of eyes achieving a)IOP≤13 mmHg,b)IOP≤16 mmHg,and c)IOP≤21 mmHg with or without medication.Evaluation was performed using a log-rank Kaplan-Meier test.A scatterplot analysis presented the treatment effect data of all eyes with a minimum of 20%IOP reduction per case.Failure was defined as requiring additional surgery,IOP greater than 21 mmHg with or without medication and failure to reach 20%IOP reduction.Results:Mean postoperative IOP was significantly lower in both groups.IOP decreased by 49.06%in group A and by 53.01%in group B at 6 months(P<0.88),respectively.Medication use was lower in both groups(Wilcoxon test,P<0.001).The absolute and qualified success rates were not statistically significant between the groups(all P>0.05).Cumulative IOP results per case were not statistically different in group A compared with group B.One revision surgery in group A(4%failure rate)and three in group B(12%failure rate)were performed.Conclusions:Both groups showed equal results in terms of cumulative and mean IOP reduction,medication reduction as well as in absolute and qualified success rates.No significant difference was found in any parameters tested between Preserflo Microshunt with MMC 0.2 mg/ml and with or without OCM implantation at 6 months.Long-term follow-up is required to further evaluate this data.
