scholarly journals Comparison of Different Procedures in a Combination of ab Interno Microhook Trabeculotomy and Cataract Surgery

2021 ◽  
Author(s):  
Yusaku Miura ◽  
Ken Fukuda
Keyword(s):  
Cataract Surgery ◽  
Clinical Outcomes ◽  
Case Series ◽  
Patient Characteristics ◽  
University Hospital ◽  
Retrospective Case ◽  
Before And After ◽  
The Mean ◽  
Group 2 ◽  
Ab Interno

Abstract Purpose. To compare the clinical outcomes of ab interno microhook trabeculotomy (µLOT) before and after cataract surgery for the combination of µLOT and cataract surgery. Methods. This retrospective case series included 24 eyes that underwent µLOT combined with cataract surgery at Kochi University Hospital. Groups 1 and 2 included eyes that underwent µLOT before and after cataract surgery (12 eyes each), respectively. The patient characteristics and clinical outcomes were also analyzed.Results. The mean preoperative intraocular pressure (IOP) in Groups 1 and 2 (25.3 ± 11.0 mmHg and 22.4 ± 10.5 mmHg) were reduced significantly to 14.5 ± 3.6 mmHg and 12.3 ± 3.0 mmHg, respectively, at 5–7 months postoperatively. The mean preoperative number of antiglaucoma medications in Groups 1 and 2 (4.3 ± 1.4 and 3.7 ± 1.5) had also decreased significantly to 2.7 ± 0.9 and 1.7 ± 1.6 at 5–7 months postoperatively. Postoperative hyphema with niveau formation was observed in five eyes in Group 2 (41.7%) but not in Group 1. Conclusion. For the combination of µLOT and cataract surgery, performing µLOT before cataract surgery may be less likely to result in postoperative hyphema with niveau.

scholarly journals Efficacy of threading lasso fixation in repairing partial articular supraspinatus tendon avulsion lesions: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sun-Yu Chen ◽  
Zhan-Hao Xiao ◽  
Jian-Kun Wang
Keyword(s):  
Los Angeles ◽  
Clinical Outcomes ◽  
Case Series ◽  
Visual Analog Scale Score ◽  
Supraspinatus Tendon ◽  
Fixation Technique ◽  
Retrospective Case ◽  
The Mean ◽  
Tendon Avulsion

Abstract Background The partial articular supraspinatus tendon avulsion (PASTA) lesion repair remains a topic of debate. We have performed in situ repair of PASTA lesions using a potentially viable threading lasso fixation technique. This retrospective case series aimed to evaluate the clinical outcomes of PASTA lesion repair using threading lasso fixation. To the best of our knowledge, this is the first study to review this technique and its outcomes in terms of pain and upper extremity function. Methods Twenty-five patients with PASTA lesions who were treated with threading lasso fixation were reviewed. All patients were followed up for at least 1 year. Preoperative and follow-up data were retrospectively collected and reviewed. Clinical outcomes were assessed to evaluate the efficacy of the surgery. Results There were no postoperative complications. The average follow-up period was 25.7 (22–27) months. At the last follow-up, all patients underwent follow-up magnetic resonance imaging; only two cases showed a partially healed tendon and no case converted to full-thickness tear. Furthermore, shoulder pain decreased and mobility was recovered, with statistically significant differences in all scoring measures. Specifically, the mean visual analog scale score decreased from 5.4 ± 1.2 before surgery to 1.1 ± 0.8 at the last follow-up (t = 14.908, P < 0.01), and the mean American Shoulder and Elbow Surgeons Shoulder Assessment Form score improved significantly from 51.6 ± 6.4 to 89.3 ± 5.2 (t = 22.859, P < 0.01). Additionally, the mean University of California Los Angeles score improved from 17.8 ± 3.5 preoperatively to 32.3 ± 1.4 (t = 19.233, P < 0.01). Conclusions Arthroscopic repair using threading lasso fixation is a novel transtendinous technique for patients with partial articular supraspinatus tendon avulsion. Tendon integrity is preserved with this method, which may result in improved function. Overall, threading lasso fixation technique is an effective treatment.

Radiographic and Clinical Outcomes of the Salto Talaris Total Ankle Arthroplasty

2020 ◽  
Vol 41 (12) ◽  
pp. 1519-1528
Author(s):  
Jonathan Day ◽  
Jaeyoung Kim ◽  
Martin J. O’Malley ◽  
Constantine A. Demetracopoulos ◽  
Jonathan Garfinkel ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Case Series ◽  
Total Ankle Arthroplasty ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Patient Reported ◽  
The Mean ◽  
Component Revision

Background: The Salto Talaris is a fixed-bearing implant first approved in the US in 2006. While early surgical outcomes have been promising, mid- to long-term survivorship data are limited. The aim of this study was to present the survivorship and causes of failure of the Salto Talaris implant, with functional and radiographic outcomes. Methods: Eighty-seven prospectively followed patients who underwent total ankle arthroplasty with the Salto Talaris between 2007 and 2015 at our institution were retrospectively identified. Of these, 82 patients (85 ankles) had a minimum follow-up of 5 (mean, 7.1; range, 5-12) years. The mean age was 63.5 (range, 42-82) years and the mean body mass index was 28.1 (range, 17.9-41.2) kg/m2. Survivorship was determined by incidence of revision, defined as removal/exchange of a metal component. Preoperative, immediate, and minimum 5-year postoperative AP and lateral weightbearing radiographs were reviewed; tibiotalar alignment (TTA) and the medial distal tibial angle (MDTA) were measured to assess coronal talar and tibial alignment, respectively. The sagittal tibial angle (STA) was measured; the talar inclination angle (TIA) was measured to evaluate for radiographic subsidence of the implant, defined as a change in TIA of 5 degrees or more from the immediately to the latest postoperative lateral radiograph. The locations of periprosthetic cysts were documented. Preoperative and minimum 5-year postoperative Foot and Ankle Outcome Score (FAOS) subscales were compared. Results: Survivorship was 97.6% with 2 revisions. One patient underwent tibial and talar component revision for varus malalignment of the ankle; another underwent talar component revision for aseptic loosening and subsidence. The rate of other reoperations was 21.2% ( n = 18), with the main reoperation being exostectomy with debridement for ankle impingement ( n = 12). At final follow-up, the average TTA improved 4.4 (± 3.8) degrees, the average MDTA improved 3.4 (± 2.6) degrees, and the average STA improved 5.3 (± 4.5) degrees. Periprosthetic cysts were observed in 18 patients, and there was no radiographic subsidence. All FAOS subscales demonstrated significant improvement at final follow-up. Conclusions: We found the Salto Talaris implant to be durable, consistent with previous studies of shorter follow-up lengths. We observed significant improvement in radiographic alignment as well as patient-reported clinical outcomes at a minimum 5-year follow-up. Level of Evidence: Level IV, retrospective case series.

Endoscopic Cartilage Myringoplasty with Inside Out Elevation of a Tympanomeatal Flap for Repairing Anterior Tympanic Membrane Perforations

2020 ◽  
Vol 129 (8) ◽  
pp. 795-800 ◽  
Author(s):  
Zhengcai Lou
Keyword(s):  
Tympanic Membrane ◽  
Case Series ◽  
Operation Time ◽  
Tympanic Membrane Perforation ◽  
University Hospital ◽  
Retrospective Case ◽  
Graft Take ◽  
The Mean ◽  
Inside Out ◽  
Anterior Perforation

Objective: We evaluated the graft take rate and hearing gain of endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap for repairing an anterior tympanic membrane perforation. Study design: A retrospective case series Setting: Tertiary university hospital Materials and Methods: The study population consisted of patients with an anterior perforation undergoing endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap. The primary outcome was the graft take rate at 6 months. The secondary outcomes were the air–bone gap (ABG) gain at 3 months and complications. Results: A total of 51 patients with a unilateral anterior marginal perforation were included in this study. The mean operation time was 62.2 ± 8.3 minutes. The graft success rate was 92.2% (47/51) at 6 months. The mean preoperative ABG was 28.07 ± 5.13 dB, while the mean postoperative ABG was 12.24 ± 4.89 dB ( P < .05). No patients reported sensorineural hearing loss, altered taste, facial nerve palsy, vertigo, or tinnitus. Two patients with a middle perforation developed postoperative purulent otorrhea that resulted in residual perforations. The cartilage graft was extruded into the anterior annulus in two patients with large perforations that resulted in graft lateralization in one patient and residual perforation in the other. Conclusions: Endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap is a useful procedure with a low reperforation rate for repairing anterior perforation.

scholarly journals Role of diacerein in osteoarthritis.

2021 ◽  
Vol 28 (11) ◽  
pp. 1552-1556
Author(s):  
Samara Siddique ◽  
Yasir Imran ◽  
Asma Rizwan ◽  
Sahira Aaraj
Keyword(s):  
Visual Analogue Scale ◽  
Study Design ◽  
Analogue Scale ◽  
Case Series ◽  
Retrospective Case ◽  
Before And After ◽  
Alternative Drug ◽  
Grade Ii ◽  
The Mean

Objectives: To evaluate the role of Diacerein among patients with OA. Study Design: Retrospective Case Series. Setting: Mayo Hospital, Lahore. Period: April 2020 to September 2020. Material & Methods: The study was conducted among forty patients with OA (grade II to IV according to ACR criteria) at Department of Rheumatology (EMW), Mayo Hospital, Lahore. Baseline WOMAC (Western Ontario and McMaster Universities Arthritis Index) and VAS (Visual Analogue Scale) was noted. Diacerine, 100mg in bd (twice a day) dose was given for 6 months. After 6 months, WOMAC and VAS were noted and %age improvement was calculated. Results: The mean WOMAC at presentation was 48.78+6.42 and after treatment was 36.20+20 (p<0.05). The mean VAS before and after treatment was 5.88+1.20 and 3.58+3.22, respectively (p<0.05). A 20% improvement was seen among 40% patients. The efficacy of the drug was labeled as yes in 40% patients. One (2.5%) patients suffered from diarrhea, and one (2.5%) patient had raised LFTs after treatment. Conclusion: Diacerine significantly improves the mean WOMAC and VAS score after 6 months of therapy. The efficacy is also high. So, it can be considered as an alternative drug among symptomatic patients with OA in whom the symptoms do not improve after conventional analgesics.

scholarly journals Ab Interno vs. Ab Externo Microcatheter-Assisted Circumferential Trabeculotomy in Treating Patients With Primary Open-Angle Glaucoma

2021 ◽  
Vol 8 ◽  
Author(s):  
Weijia Zhang ◽  
Yiwei Wang ◽  
Chen Xin ◽  
Yang Sun ◽  
Kai Cao ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Open Angle ◽  
Success Rates ◽  
Criterion A ◽  
The Mean ◽  
Group 2 ◽  
Ab Interno ◽  
Group 1

Background: Circumferential trabeculotomy have evolved from ab externo to ab interno approach. Both procedures may lower IOP, but it is unclear which maybe a superior approach.Purpose: To compare the outcomes of ab interno and ab externo circumferential trabeculotomy in patients with primary open-angle glaucoma.Design: Retrospective, comparative case series.Participants: Primary open angle glaucoma patients undergoing ab interno (40 patients in Group 1) or ab externo (54 patients in Group 2) circumferential trabeculotomy, with about one half of them having prior incisional glaucoma surgery.Methods: Outcomes including intraocular pressure (IOP), glaucoma medications and surgical complications were analyzed.Main Outcome Measures: IOP, medications and surgical success defined as an IOP of ≤ 21 mmHg and a reduction of IOP ≥20% from baseline (criterion A) or IOP ≤ 18 mmHg and a reduction of IOP 20% from baseline (criterion B) with (qualified success) or without (complete success) medications.Results: At 1 year, IOP decreased by 37.1% (26.0–14.8 mmHg) in Group 1 and 39.5% (28.5–15.1 mmHg) in Group 2. Medications decreased from 3.5 in Group 1 and 3.6 in Group 2 pre-operatively to 0.6 ± 1.0 and 0.3 ± 0.6 post-operatively, respectively. Success rates did not differ significantly between groups based on criterion A (complete and qualified success: 68.7 and 81.9% in Group 1, and 75.3 and 90.4% in Group 2, respectively) or criterion B (complete and qualified success: 58.2 and 79.3%in Group 1, and 69.5 and 88.4% in Group 2, respectively). For eyes with prior filtration surgeries, the mean percent reduction of IOP (41.7 ± 32.7% in Group 1, 39.7 ± 27.8% in Group 2, P = 0.724) and the mean medication reduction (2.9 ± 1.6 in Group 1, 3.4 ± 1.0 in Group 2, P = 0.454) were not significantly different.Conclusions: Ab interno circumferential trabeculotomy achieved comparable outcomes to ab externo trabeculotomy and may be an effective surgical option for patients with primary open-angle glaucoma.

scholarly journals Comparison of Different IOL Types in the Flanged IOL Fixation Technique

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Yusaku Miura ◽  
Yosuke Harada ◽  
Yoshiaki Kiuchi
Keyword(s):  
Postoperative Complications ◽  
Case Series ◽  
Operation Time ◽  
University Hospital ◽  
Fixation Technique ◽  
The Mean ◽  
Group 2 ◽  
Iol Fixation ◽  
Group 1

Purpose. To compare short-term clinical outcomes between two different intraocular lens (IOL) types in the flanged IOL fixation technique. Methods. This study was a retrospective case series and included the patients who underwent flanged IOL fixation between June 2017 and July 2018 at the Hiroshima University Hospital. Two different 3-piece IOLs (NX-70 and PN6A) were used. Recipients of NX-70 and PN6A IOLs were classed into groups 1 (15 eyes) and 2 (25 eyes), respectively. Patient characteristics, surgical results, and postoperative complications were analyzed. We excluded patients with a postoperative follow-up of <1 month. Results. The mean follow-up period was 13.3 ± 11.7 weeks. The postoperative best corrected visual acuity, in logarithm of the minimum angle of resolution (logMAR), was 0.10 ± 0.33 in group 1 and 0.26 ± 0.42 in group 2. The mean operation times for groups 1 and 2 were 11.2 ± 4.54 minutes and 7.00 ± 2.20 minutes, respectively (p=0.0024). Detachment of the IOL haptic from the optic during surgery occurred in four eyes in group 2 (16%), but did not occur in group 1. Iris capture of the optic was observed in 3 of the 13 eyes (23%) without a peripheral iridotomy in group 2. No peripheral iridotomies were performed on group-1 eyes, but iris capture did not occur in that group. Conclusions. There was a trend to fewer intraoperative and postoperative complications when using NX-70 IOLs. On the other hand, PN6A IOLs was easy to maneuver within the anterior chamber, and the operation time was shorter when using PN6A IOLs. Selection of optimal IOLs for flanged IOL fixation necessitates an understanding of their characteristics in terms of intraoperative and postoperative complications.

scholarly journals The Effectiveness of First-Generation iStent Microbypass Implantation Depends on Initial Intraocular Pressure: 24-Month Follow-Up—Prospective Clinical Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Joanna Konopińska ◽  
Milena Kozera ◽  
Paweł Kraśnicki ◽  
Zofia Mariak ◽  
Marek Rękas
Keyword(s):  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Observation Time ◽  
Open Angle ◽  
Group I ◽  
Before And After ◽  
The Mean ◽  
Group Ii

Background. Evaluation of efficacy of the iStent trabecular bypass implant in reducing intraocular pressure (IOP) depending on the value pretreatment IOP and number of medications used before surgery in patients with primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PXG) and coexisting cataract. Methods. A prospective, uncontrolled, interventional case series. 72 patients, on a mean age of 72.42 ± 9.17, were divided into two groups depending on baseline IOP: group I < 26 mmHg and group II ≥ 26 mmHg. All subjects underwent ab interno implantation of a single iStent together with cataract surgery. Best-corrected visual acuity (BCVA), IOP, number of antiglaucoma medications, visual field, and number and type of complications were examined before and after surgery. Postoperative patients were followed up at 1, 7, and 30 days and 3, 6, 12, and 24 months. All the patients were washed out preoperatively as well as postoperatively. Results. The mean observation time was 20 months. The mean preoperative IOP was 21.03 ± 1.44 mmHg in group I and reduced to mean 15.60 ± 2.12 mmHg after operation. In group II, mean IOP reduced from 26.00 ± 0.00 to 18.56 ± 1.81 (p=0.003). Mean glaucoma medications decreased from 1.35 ± 0.65 to 0.29 ± 0.52 in group I (p<0.001) and from 2.89 ± 1.18 to 1.33 ± 1.50 in group II (p<0.001). At 24 months, medication reduction was significantly greater in group I than group II (p=0.026). Conclusions. Combined cataract surgery with implantation of iStent seems to be an effective procedure in patients with mild-to-moderate open-angle glaucoma and cataract. In patients with baseline IOP < 26 mmHg, surgery reduced IOP and medication use significantly declined to 2 years, with greater reductions achieved versus patients with baseline IOP ≥ 26 mmHg. This trial is registered with NCT03807869.

scholarly journals The Clinical Outcomes of Keratoplasty in Irreversible Corneal Decompensation Secondary to Axenfeld-Rieger Syndrome

2021 ◽  
Author(s):  
Ting Yu ◽  
Jing Hong ◽  
Ge-ge Xiao ◽  
Rong-mei Peng
Keyword(s):  
Endothelial Cell ◽  
Clinical Outcomes ◽  
Case Series ◽  
Postoperative Management ◽  
Retrospective Case ◽  
Rieger Syndrome ◽  
Significant Difference ◽  
Corneal Decompensation ◽  
The Mean ◽  
Glaucoma Treatment

Abstract Porpose To evaluate the clinical outcomes of penetrating keratoplasty (PK) and Descemet’s stripping automated endothelial keratoplasty (DSAEK) in eyes with irreversible corneal decompensation secondary to Axenfeld-Rieger syndrome (ARS).Methods In this retrospective case series, a total of 4 eyes undergoing PK and 7 eyes undergoing DSAEK, including 1 eye requiring 1 repeat DEASK, between 2014 and 2021 were enrolled. Postoperative complications, graft survival, glaucoma treatment before and after keratoplasty, visual outcomes, and endothelial cell density were recorded.Results The mean follow-up duration was 33.4 ± 16.8 months. Before keratoplasty, the mean BCVA was 2.0 ± 0.4 LogMAR, and the mean IOP was 21.6 ± 8.1 mmHg. 63.6% of eyes (7/11) received glaucoma treatment, including 5 eyes with glaucoma surgeries. After keratoplasty, 27.3% of eyes (3/11) exhibited secondary graft failure. The mean BCVA reached a maximum of 0.7 ± 0.5 LogMAR at 8.9 ± 7.5 months, with no significant difference between the PK and DSAEK groups (P1=1.00, P2=0.12). Four eyes with previous glaucoma surgeries exhibited markedly high IOP. 72.7% of eyes (8/11) required additional glaucoma treatments. The mean endothelial cell loss (ECL) rates at 1, 6, 12 and 24 months were 43%, 49%, 63% and 54%, respectively, with no significant difference between the PK and DSAEK groups (P1=0.64, P2=1.00, P3=0.57, and P4=0.44).Conclusion Both PK and DSAEK can successfully treat corneal decompensation secondary to ARS, resulting in similar outcomes with regard to IOP control, BCVA and ECL. IOP control is essential for postoperative management, especially for eyes with previous glaucoma surgeries.

Retrograde Drilling for Osteochondral Lesions of the Talus in Skeletally Immature Children

2020 ◽  
Vol 41 (7) ◽  
pp. 827-833
Author(s):  
So Minokawa ◽  
Ichiro Yoshimura ◽  
Kazuki Kanazawa ◽  
Tomonobu Hagio ◽  
Masaya Nagatomo ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Case Series ◽  
Osteochondral Lesions ◽  
Skeletally Immature ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Retrograde Drilling ◽  
Ct Findings ◽  
The Mean

Background: Osteochondral lesions of the talus (OLTs) involve damage to the cartilage and subchondral bone and are infrequent in children. Clinicians usually attempt nonsurgical treatment of OLTs first, and subsequently progress to surgical treatments, including retrograde drilling (RD), if the initial outcomes are insufficient. Good clinical outcomes of RD have been reported. However, the clinical outcomes of RD in skeletally immature children remain unclear, and the associated preoperative and postoperative computed tomography (CT) findings have not been reported. The purpose of this study was to evaluate the clinical outcomes and CT findings and clarify the efficacy of RD for OLTs. Methods: From January 2015 to April 2018, RD was performed on 8 ankles in 6 skeletally immature children. The patients comprised 4 boys and 2 girls with a mean age at surgery of 11.1 years. The mean follow-up was 22.8 months. The clinical outcomes were evaluated according to the Japanese Society for Surgery of the Foot (JSSF) scale. Preoperative and final follow-up CT findings were used to determine the degree of healing. Results: The mean JSSF scale in all ankles improved from 79.4 (range, 69-90) points preoperatively to 98.4 (range, 87-100) points at final follow-up ( P < .05). In the preoperative CT findings, 3 ankles had no bone fragmentation, 4 had partial bone fragmentation, and 1 had whole fragmentation. In the final follow-up CT findings, 4 ankles demonstrated good healing, 3 were fair, and 1 was poor. Conclusion: The present findings suggest that RD is an effective surgical treatment for OLTs in skeletally immature children. Level of Evidence: Level IV, retrospective case series.

Clinical characteristics and treatment of secondary glaucoma, glaucoma suspects and ocular hypertension after congenital cataract surgery

2021 ◽  
pp. 112067212199135
Author(s):  
Katharina Eibenberger ◽  
Barbara Kiss ◽  
Ursula Schmidt-Erfurth ◽  
Eva Stifter
Keyword(s):  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Ocular Hypertension ◽  
Congenital Cataract ◽  
Case Series ◽  
Secondary Glaucoma ◽  
Visual Axis ◽  
Retrospective Case ◽  
Pediatric Cataract ◽  
Congenital Cataract Surgery

Objective: To evaluate changes in intraocular pressure after congenital cataract surgery in a real-world setting. Methods: This retrospective case series included all children aged 0–2 years undergoing lens extraction due to congenital cataract. Development of an elevated intraocular pressure was divided into three groups: secG, suspG and OHT. Further, risk factors for IOP changes, the therapeutic approach and functional outcome were assessed during follow-up. Results: One hundred and sixty-one eyes of 110 patients aged 0–2 years were included, whereof 29 eyes of 17 children developed secondary glaucoma (secG; 11 eyes/8 patients), glaucoma suspect (suspG; three eyes/three patients) or ocular hypertension (OHT; 15 eyes/10 patients). No difference in surgrical procedure ( p = 0.62) was found, but age at cataract surgery differed significantly ( p = 0.048), with the secG group (1.74 ± 1.01 months) being the youngest (suspG: 3.93 ± 1.80 months; OHT group: 5.91 ± 5.36 months). Secondary surgical intervention was significantly higher in the secG (4.64 ± 3.41) followed by the suspG (2.00 ± 2.65) and OHT groups (0.40 ± 0.74; p < 0.001). Postoperative complications including nystagmus ( p = 0.81), strabismus ( p = 0.98) and amblyopia ( p = 0.73) showed no difference, in contrast to visual axis obscuration which was more common in the secG group ( p = 0.036). Conclusion: Initial lensectomy and anterior vitrectomy procedure together with or without IOL implantation seems to have no influence for the development of IOP changes after pediatric cataract surgery. However, children who developed secondary glaucoma had cataract surgery significantly earlier, within the first 2–3 months of life. Glaucoma surgery was required to achieve final IOP control in most eyes. The development of secondary glaucoma was also associated with a significant increase in surgical re-treatments.

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