Medium-term results of implantable miniaturized telescopes in eyes with age-related macular degeneration

Symposium on Cataract, IOL and Refractive Surgery -- MAY, 2000 -- BOSTON, MASSACHUSETTSWOS: 000172079600016PubMed ID: 11709247Purpose: To evaluate the efficacy of an implantable miniaturized telescope, the IMT, in patients with age-related macular degeneration (ARMD). Setting. Ege University Faculty of Medicine, Ophthalmology Department, izmir, Turkey. Methods:Among 15 patients meeting the inclusion criteria for IMT implantation, 3 were willing to participate in this prospective clinical trial and had cataract extraction with IMT implantation. The effect of the IMT on visual outcome and daily activities was assessed over 18 months, Results. All patients had some improvement in distance and near vision. However, this did not lead to significant improvements in the ability to perform daily activities. One patient had 2 attacks of mild iritis that were controlled with topical medications. In another patient, bubbles that were noted inside the IMT soon after implantation were still present at 1 year. In this patient, the IMT was replaced with a conventional poly(methyl methacrylate) intraocular lens. Conclusions. Implantation of an IMT may positively affect the visual outcome and daily activities in some ARMD patients. However, proper patient selection and fully informed patient consent and understanding are mandatory. (C) 2001 ASCRS and ESCRS.IO

Transient subretinal hemorrhage after photodynamic therapy of subfoveal choroidal osteoma

Purpose: To report a case of choroidal osteoma that developed subretinal hemorrhage after photodynamic therapy (PDT). Methods: Interventional case report. Results: An 8-year-old boy was brought to our attention because of mild visual loss in his left eye. The visual acuity was 20/25. A subfoveal yellow-orange-colored lesion, measuring 5.0 mm 3 4.5 mm in base diameter was detected in the left eye. B-mode ultrasonography showed an acoustically solid 2.0-mm-thick mass with orbital shadowing. Orbital computed tomography confirmed the presence of calcium, and choroidal osteoma was diagnosed. As there was a decrease in the best-corrected visual acuity (20/30) and the lesion showed growth (6.0 mm 3 6.0 mm), PDT was performed at 6 months follow-up. The day after PDT, the visual acuity was counting fingers at 1 m and a subretinal hemorrhage over the lesion was detected. Two weeks after PDT, subfoveal hemorrhage dissappeared with some retinal pigment epithelial hyperplasia and visual acuity increased back to 20/30. Conclusion: Although PDT can induce decalcification in choroidal osteomas, it should not be performed in subfoveal osteomas unless there is evidence to treat the lesion such as the presence of choroidal neovascularization

Non-penetrating deep sclerectomy and collagen implant surgery in glaucoma patients with advanced field loss

PubMed ID: 11456247Purpose: The aim of the study was to determine the medium term intraocular pressure (IOP) lowering effects and the potential complications of non-penetrating deep sclerectomy and collagen implant (DSCI) surgery in glaucoma patients. Patients and methods: 54 eyes of 52 patients with medically uncontrolled open angle glaucoma with advanced field loss underwent DSCI under topical anaesthesia. Follow-up period was 24 months. Results: The mean preoperative IOP was 24.7 ± 6.2 mmHg and decreased to 15.1 ± 4.0 mmHg at 24 months (p = 0.0068). During the follow-up period, 36 of 54 eyes (66%) received no topical antiglaucomatous medications. In 18 eyes, monotherapy with topical beta blockers (Betaxolol HCl) was added to the regimen. At last visit, only two patients (3.8%) had IOP greater than 18 mmHg. We did not detect any additional optic disc changes, visual field or visual acuity defects postoperatively. Detailed slit-lamp examination revealed no anterior segment complications regarding the probable complications of trabeculectomy. None of the patients developed surgery related cataract. As a complication, we diagnosed one case of self-limited, shallow choroidal detachment. Conclusion: DSCI appears to provide considerable medium term IOP decrease with few postoperative complications without deteriorating visual acuity. Owing to our medium term results, we believe that DSCI could be a valuable alternative to trabeculectomy especially in cases of advanced medically uncontrolled open angle glaucoma

Recession of inferior rectus muscle with adjustable loop suture using topical anesthesia in dysthyroid ophthalmopathy

27th Annual Meeting of the European-Strabismological-Association -- JUN 06-09, 2001 -- FLORENCE, ITALYWOS: 000181916200053We aimed to evaluate the surgical results of inferior rectus (IR) recession with adjustable loop suture under topical anesthesia for vertical deviations secondary to thyroid ophthalmopathy. Five patients were enrolled in the study. All patients had a vertical deviation greater than 15 PD and severe limitation of upgaze. Post- surgical follow up was at least 12 months. Mean pre- operative vertical deviation decreased from 24 PD to 2.4 PD at 1 year postoperatively. Two patients were orthotropic and 3 patients had residual hypotropia ranged from 2 PD to 6 PD. Upgaze limitation relieved significantly in the post-operative period. As we obtained satisfactory results without any significant complications in our patients, we advocate that recession of the IR with adjustable loop suture under topical anesthesia is safe and effective in patients with thyroid ophthalmopathy.European Strabismol Asso

Axial length changes accompanying successful nonpenetrating glaucoma filtration surgery

WOS: 000182241800004PubMed ID: 12660483We aimed to evaluate the effect of nonpenetrating glaucoma filtration surgery on axial length (AL). Thirty patients (30 eyes) who underwent successful nonpenetrating glaucoma filtration surgery were prospectively analyzed. AL was measured preoperatively and postoperatively at 1 and 12 months. Associations between change in AL and age, gender, diagnosis, preoperative and postoperative visual acuity, refraction and intraocular pressure (IOP) were analyzed. AL decreased in 22 of 30 eyes postoperatively. The mean change in AL measurement was -0.15 +/- 0.27 mm (range -1.37 to +0.12 mm) at 1 month. Regression analysis showed that young age, a high preoperative IOP and a greater change in IOP were associated with a greater decrease in AL (p 0.2), but was significantly greater than the mean AL 1 month postoperatively (p = 0.001). There was no statistically significant difference between the IOP levels obtained postoperatively at 1 and 12 months (p >0.1). Nonpenetrating glaucoma surgery can result in a small decrease in AL which can reverse during the follow-up period. Copyright (C) 2003 S. Karger AG, Basel

Comparison of outcomes of viscocanalostomy and phacoviscocanalostomy

WOS: 000187426100006PubMed ID: 14740800Background: Many adults who undergo glaucoma filtering surgery also need surgical treatment of coexisting cataract. Recent reports of the use of new alternative non-penetrating techniques in combination with phacoemulsification have given encouraging results. The purpose of this study was to compare the safety and efficacy of viscocanalostomy and phacoviscocanalostomy in the management of medically uncontrolled open-angle glaucoma. Methods: Twenty patients who underwent phacoviscocanalostomy in one eye each were enrolled in the study. Twenty matching patients who underwent viscocanalostomy in one eye each at our institution were selected as the control group. Postoperative reductions in intraocular pressure (IOP) and number of antiglaucoma medications were compared between the groups. Visual acuity and complications were secondary outcomes. Results: Significant reductions of IOP and of use of antiglaucoma medication occurred in both groups (p 0.05). The mean IOP reduction was 34% in the eyes that underwent viscocanalostomy alone and 38% in the eyes that underwent phacoviscocanalostomy. The success rates of the two procedures were also comparable (p > 0.05). In the combined-surgery group the best-corrected visual acuity improved by 2 or more lines in 18 eyes (90%). Intraoperative complications did not occur in either group. Interpretation: Combining phacoemulsification with viscocanalostomy did not have a negative effect on the IOP control achieved by viscocanalostomy alone and did not increase the complication rate. Phacoviscocanallostomy was safe and effective in the surgical management of eyes with both glaucoma and cataract

Oculometric features of hyperopia in children with accommodative refractive esotropia

WOS: 000183192900013PubMed ID: 12780405Purpose: To determine the nature of hyperopia in children with accommodative refractive esotropia (ARE) by evaluating the relationships between corneal radius (CR), axial length (AL), age and equivalent spherical refraction (SEQ). Methods: A total of 112 children with ARE were included in the study. The children underwent an overall ophthalmic examination including cycloplegic refraction, keratometry and ultrasonic AL measurement. Results: Statistical analysis revealed a strong relationship between AL and SEQ (p < 0.001). A significant correlation was also found between AL and CR (p < 0.001). The relationship between AL and age was weak but statistically significant (p = 0.02). Multiple regression analysis, using SEQ as the dependent variable and CR, AL and age as independent variables, revealed that AL accounts for 43.5% of the variance, and the combination of CR and AL accounts for 60.9% of the variance. Conclusion: Hyperopia is predominantly axial in nature in children with ARE. However, other refractive components are also involved in producing hyperopic refractive errors