Göz Sağlığı ve Hastalıkları Uzmanı
Konyagöz Hastanesi Acil Servis Ünitesi; alanında uzmanlaşmış doktorları, acil servis alanında deneyimli hemşire ve sağlık personellerinden oluşan dinamik bir…
Konyagöz Hastanesi Acil Servis Ünitesi; alanında uzmanlaşmış doktorları, acil servis alanında deneyimli hemşire ve sağlık personellerinden oluşan dinamik bir…
IRIDODIALYSIS REPAIR WITH INTRASCLERAL FIXATION OF FLATTENED FLANGED POLYPROPYLENE SUTURE
Yazarlar: Fikret Ucar
Yayın tarihi: 2022/3/2
Dergi: RETINA
Yayıncı: LWW
Açıklama
Purpose:
To present the flattened flanged polypropylene suture technique developed to obtain round and stable pupils in patients with iridodialysis.
Methods:
After performing a fornix-based conjunctival peritomy, a flange was created at the tip of a 6.0 polypropylene suture by cautery. In the quadrant of iridodialysis, an ultrathin 30-gauge needle was inserted into the sclera at a distance of 2 mm from the limbus and advanced 1.5 mm intrasclerally, parallel to the limbus. The needle was directed radially into the eye and easily passed through the edge of the peripheral iris. The polypropylene suture was pushed into the lumen of the needle with the help of forceps. After the needle was externalized, the tip of the suture was flanged by cautery and the flange was immediately flattened using a needle holder.
Results:
Six eyes of 6 patients with iridodialysis were enrolled in this study. Postoperatively, the irises remained well …
CAN BLEEDING IN TRABECULECTOMY BE DECREASED? EFFECTIVENESS OF BRIMONIDINE PRE-TREATMENT
Purpose: To evaluate the efficacy of preoperative topical brimonidine use to maintain visibility during trabeculectomy and control intraoperative bleeding and postoperative subconjunctival hemorrhage.
Methods: The first group comprised 35 eyes of 34 patients administered brimonidine tartrate 0.15% (Brimogut, Bilim Ilac, Turkey) eye drops 6 and 3 min before surgery, and 33 eyes of 31 patients who received no medication for vasoconstriction formed the second group. Preoperative and postoperative photographs and operation video images were taken and vision analysis software used. Black-and-white images were obtained to identify the blood vessel and surface hemorrhage areas. The surface area of the hemorrhage was calculated by counting the black pixels with Image J software.
Results: There was no significant difference between two groups in terms of baseline (preoperative) eye redness (p > 0.05). In the first group, the eye redness values were 344.7 ± 19.5 pixels preoperatively and 244.1 ± 23.3 pixels at the beginning of the surgery, respectively (p < 0.001). However, no significant change was observed in the second group in eye redness (348.2 ± 17.5 pixels preoperatively and 360.7 ± 26.8 pixels at the beginning of the surgery, p > 0.05). Cautery was used for an average of 11.91 ± 1.96 s in the first group and 25.57 ± 4.66 s in the second to control intraoperative bleeding (P < 0.001).
Conclusion: Preoperative topical brimonidine use in trabeculectomy surgery significantly decreased intraoperative bleeding and postoperative subconjunctival hemorrhage and facilitated bleeding control.
Keywords: Trabeculectomy; brimonidine tartrate; glaucoma; hemostasis; intraoperative bleeding.
INFLUENCE OF INCISION SIZE ON DRY EYE SYMPTOMS IN THE SMALL INCISION LENTICULE EXTRACTION PROCEDURE
Yazarlar: Servet Cetinkaya, Mehmet Gulmez, Emine Mestan, Fikret Ucar, Nermin Ali
Yayın tarihi: 2019/1/1
Dergi: Cornea
Cilt: 38
Sayı: 1
Sayfalar: 18-23
Yayıncı: LWW
Açıklama
Purpose:
To evaluate the influence of incision size on dry eye symptoms in the small incision lenticule extraction (SMILE) procedure.
Methods:
Ninety-four eyes of 47 patients with myopia and/or myopic astigmatism who had undergone the SMILE procedure were enrolled in this study. The patients were divided into 3 groups according to the incision size (2, 3, and 4 mm) applied during the SMILE procedure.
Results:
There were no significant differences among the groups in respect to age and sex (P values 0.251 and 0.974, respectively) and in respect to preoperative, postoperative first day, first week, first month, third month, and sixth month values of the Ocular Surface Disease Index score, tear break-up time, ST1, and staining grades.
Conclusions:
There was no difference in dry eye symptoms with 2-, 3-, and 4-mm incisions. In the learning period of SMILE surgery, larger incision sites can be used to make the …
CAN TORIC IOL ROTATION BE MINIMIZED? TORIC IOL-CAPSULAR TENSION RING SUTURING TECHNIQUE AND ITS CLINICAL OUTCOMES
Purpose: In this study, we aimed to evaluate the outcomes of the toric intraocular lens (IOL) and capsular tension ring (CTR) suturing technique in patients with cataract and astigmatism.
Methods: Group 1 comprised 37 eyes of 36 patients to whom the CTR-toric IOL complex was co-implanted after the CTR was sutured to the toric IOL haptic. Group 2 comprised 35 eyes of 33 patients in whom the toric IOL and CTR were implanted without suturing. Both groups were compared in terms of preoperative and postoperative astigmatism, best-corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), and IOL rotation.
Results: The mean rotation degree was 0.54° ± 2.29° in group 1 and 4.28° ± 8.84° in group 2 (p = .01). While there was no significant difference between the postoperative residual astigmatism and the estimated residual astigmatism in group 1, the postoperative residual astigmatism was statistically higher than the estimated residual astigmatism in group 2 (p = .47 and 0.000, respectively). The mean postoperative UCVA was 0.02 ± 0.04 (logMAR) in group 1 and 0.08 ± 0.13 (logMAR) in group 2 (p = .01).
Conclusion: The toric IOL and CTR suturing technique provides excellent rotational stability and astigmatism correction.
Keywords: Astigmatism; Capsular tension ring; Cataract; Toric IOL; Toric IOL-CTR suturing technique.
THE RESULTS OF PREOPERATIVE USE OF TOPICAL BRIMONIDINE IN STRABISMUS SURGERY
Purpose: In this study, we wanted to retrospectively evaluate the effect of the use of topical brimonidine on intraoperative bleeding and surgical hemostasis before strabismus surgery. Methods: Brimonidine tartrate 0.15% (Brimogut, Bilim Ilac, Turkey) eye drops were applied 6 and 3 min before surgery to 44 eyes of 22 patients in group 1 for vasoconstriction. Drops were not applied to 46 eyes of 23 patients in group 2. Preoperative and postoperative photographs and video images were taken. Black-and-white images were used to define the surface areas of the blood vessels. The surface area was calculated by counting the black pixels with ImageJ software. Results: In group 1, redness of eye was observed, on average, at preoperative 339.25 ± 11.52 pixels and intraoperative 247.93 ± 10.63 pixels (P < 0.001). But there was no change in group 2 (preoperative 338.87 ± 8.45 pixels to intraoperative 339.71 ± 9.52 pixels, P > 0.05). The incidence of intraoperative bleeding evaluated by the number of eyes on which cautery was used shows that it was significantly less in group 1 than in group 2 (P < 0.001). Conclusions: The use of topical brimonidine before strabismus surgery facilitates clear monitoring of anatomical structures during surgery by effectively controlling hemorrhage. In the postoperative period, it significantly reduces subconjunctival hemorrhage.
Keywords: brimonidine tartrate; hemostasis; hyperemia; strabismus.
THE RESULTS OF PREOPERATIVE TOPICAL BRIMONIDINE USAGE IN PTERYGIUM SURGERY
Purpose: To evaluate the reduction of conjunctival and episcleral hyperemia and bleeding in pterygium surgery following the use of topical brimonidine preoperatively. Methods: In this study, 45 patients who had undergone pterygium surgery under topical anesthesia were enrolled. Brominidine tartrate 0.15% eye drops were applied topically to 25 eyes of 25 patients at the sixth and third minutes preoperatively, and no drops were applied to 20 eyes of 20 patients for vasoconstriction. Preoperative and postoperative photographs and video images were taken. Results: Vasoconstriction effects of topical brimonidine tartrate on surface vessels were observed. The surface area of blood vessels was reduced 60% within 5 min; this effect was observed with the help of Photoshop and ImageJ programs and it lasted for ∼20 min. The surgery lasts for 7 min, on average, so the conjunctival whitening formed by brimonidine tartrate provides a safe and comfortable operative area throughout the surgery. Conclusion: We recommend applying brimonidine tartrate before pterygium surgery due to its conjunctival whitening effect to provide a safe and comfortable operative area throughout the surgery.
Keywords: brimonidine tartrate; hyperemia; pterygium; vasoconstriction.
INTRAOCULAR LENS IMPLANTATION WITH FLATTENED FLANGED INTRASCLERAL FIXATION TECHNIQUE IN PEDIATRIC APHAKIA
Purpose: To evaluate the clinical outcomes of flattened flanged intrascleral fixation of the intraocular lens (IOL) in cases of pediatric aphakia without adequate capsular support.
Methods: The medical records of children who underwent flattened flanged intrascleral IOL implantation for aphakia with insufficient capsular support, subluxated cataract, ectopia lentis, and dislocated IOL were reviewed retrospectively. Best-corrected visual acuity, astigmatism, corneal endothelial cell loss, IOL tilt, and intra- and postoperative complications were evaluated.
Results: A total of 21 eyes of 16 patients were included. Mean patient age at time of surgery was 7.1 ± 3.8 years (range, 2-15). Mean follow-up time after surgery was 2.0 years. The mean pre- and postoperative best-corrected visual acuities were 1.03 ± 0.49 logMAR and 0.33 ±0.44 logMAR, respectively (P < 0.001). The mean preoperative astigmatism was 2.2 ± 0.9 D; and the mean postoperative astigmatism, 1.8 ± 0.8 D. The mean IOL tilt was 3.2° ± 3.1° (range, 0°-10°). The mean endothelial loss was 4.8%. Postoperatively, one of the haptics was partially visible in the scleral tunnel in one eye of a patient with Marfan syndrome.
Conclusions: In our study cohort, the flattened flanged IOL fixation technique provided good IOL fixation, with firm haptic fixation, without use of sutures or glue.
