AIM: To investigate the complications of intravitreal triamcinolone acetonide (IVTA) for the treatment of macular edema, and to determine the risk factors for intraocular pressure (IOP) elevation. METHODS: Charts of p...AIM: To investigate the complications of intravitreal triamcinolone acetonide (IVTA) for the treatment of macular edema, and to determine the risk factors for intraocular pressure (IOP) elevation. METHODS: Charts of patients with macular edema secondary to branch retinal vein occlusion (BRVO), diabetic retinopathy and uveitis who had received IVTA injections were reviewed to document its complications. IOP elevation was defined as a pressure of ≥24mmHg at some point during follow-up. Multivariate logistic regression analysis was performed to characterize baseline risk factors for this elevation. RESULTS: The study included 111 eyes of 65 female and 46 male patients with a mean follow-up of (11.6±5.1) months. Of the 111 eyes, 52 (46.8%) had macular edema secondary to BRVO, 44 (39.6%) had clinically significant diabetic macular edema (CSDME) and 15 (13.5%) had non-infectious uveitis with macular edema. IOP was recorded ≥24mmHg in 38 eyes (34.2%) during the follow-up. Higher baseline IOP (P =0.022), younger age (P =0.003), and male gender (P = 0.014) were significant risk factors for IOP elevation after IVTA injection. Eyes with prior vitrectomy were less likely to have IOP elevation (P =0.054). Two eyes (5.2% of eyes with increased IOP) underwent trabeculectomy, and 9 eyes (16.3% of the phakic eyes) necessitated cataract surgery. Other complications included branch vein occlusion (1.8%), sterile endophthalmitis (0.9%) and pseudohypopyon (0.9%). CONCLUSION: IVTA has side effects with IOP elevation and cataract formation being the two most common. A subset of patients is more prone to developing increased IOP following IVTA, namely, younger male patients with higher baseline IOP.展开更多
Phacoemulsification is the main gold standard for cataract operation in the developed world together with foldable intraocular lens(IOL) implantation by injection,allowing for stable wound construction and less postop...Phacoemulsification is the main gold standard for cataract operation in the developed world together with foldable intraocular lens(IOL) implantation by injection,allowing for stable wound construction and less postoperative astigmatism. It is a safe procedure with high success rate with the advancement in machines,improvement of IOL injection systems and further maturation of surgeons’ techniques. Despite the large number of operations performed every day, foldable IOL injection leading to an intra-stromal corneal track is a very rare complication. We report a case of this unusual finding in a 70-year-old gentleman who has undergone cataract operation in November 2011 in our hospital and will review on the complications related to foldable IOL injection.展开更多
AIM:To compare surgical results of the Ahmed and Baerveldt implant procedures in glaucoma patients at 1 y follow-up at Jakarta Eye Center(JEC)Eye Hospitals.METHODS:This cohort retrospective study was conducted on glau...AIM:To compare surgical results of the Ahmed and Baerveldt implant procedures in glaucoma patients at 1 y follow-up at Jakarta Eye Center(JEC)Eye Hospitals.METHODS:This cohort retrospective study was conducted on glaucoma patients aged≥18 y who had undergone Ahmed and Baerveldt implant surgery.Intraocular pressure(IOP),visual acuity,glaucoma medication,success rate,early and late postoperative complications,and the number of resurgeries were analyzed.RESULTS:A total of 351 eyes in the Ahmed group and 94 eyes in the Baerveldt group were included in this study.At 1 y follow-up,the mean IOP was found to be significantly lower in the Baerveldt group(13±4.47 mm Hg)compared to the Ahmed group(15.02±5.73 mm Hg;P=0.025).Glaucoma medication was required in both the Ahmed and Baerveldt groups(58.92%vs 71.67%).Comparable success rate was found in both groups.The Ahmed group revealed a complete and qualified success of 86.82%,and failure of 13.17%.Similarly,the Baerveldt group showed complete and qualified success in 87.75%and failure in 12.25%cases.In the Ahmed group,11.97%early complications,26.06%late complications and 9.97%resurgeries were observed.In comparison,in the Baerveldt group,23.40%early complications,30.95%late complications and 11.70%resurgeries were observed.CONCLUSION:Both groups of glaucoma implants show significant IOP reduction,however,the Baerveldt implant group demonstrates greater IOP reduction with more failure rates and complications than the Ahmed implant group.展开更多
AIM:To evaluate the safety and efficacy of Densiron 68 heavy silicone oil (HSO) tamponade for complicated retinal detachment(RD)in Chinese eyes.METHODS:Twenty-one eyes of 21 patients with complicated RD were included ...AIM:To evaluate the safety and efficacy of Densiron 68 heavy silicone oil (HSO) tamponade for complicated retinal detachment(RD)in Chinese eyes.METHODS:Twenty-one eyes of 21 patients with complicated RD were included in this retrospective study.All patients underwent pars plana vitrectomy with an internal tamponade using Densiron 68 HSO.Anatomical and functional results and complications were evaluated,including retinal status,visual acuity(VA),intraocular pressure(IOP),intraocular inflammation,lens opacity,and HSO emulsification.RESULTS:Allthepatients were followed up for 3mo to1y(5.8±1.16mo).Retinal reattachment was achieved in 19of 21 patients(90.5%).VA improved in 18 of 21 patients(85.7%),from 1.93 logMAR(±0.48)to 1.52 logMAR(±0.45)(P=0.001).Postoperative complications included early dispersion of HSO in 7 eyes(38.8%),cataract in 10 of 18phakic eyes(55.5%),moderate postoperative inflammation reaction in 10 eyes(47.6%),and elevated IOP in 5 eyes(23.8%),all of which were controlled by medication or by surgery.CONCLUSION:Highanatomical and functional success rates can be achieved with primary vitrectomy for complicated RD by using Densiron 68 HSO;however,it should not be ignored that Densiron 68 HSO can cause some complications in the eye.展开更多
AIM: To compare the effectiveness of brimonidine/timolol fixed combination(BTFC) and dorzolamide/timolol fixed combination(DTFC) in the management of short-term intraocular pressure(IOP) increase after phacoemulsifica...AIM: To compare the effectiveness of brimonidine/timolol fixed combination(BTFC) and dorzolamide/timolol fixed combination(DTFC) in the management of short-term intraocular pressure(IOP) increase after phacoemulsification surgery.·METHODS: Eighty eyes of 80 patients undergoing phacoemulsification and intraocular lens(IOL)implantation were randomly assigned into three groups.Group 1 consisted of 28 eyes and represented the control group. Group 2 consisted of 25 eyes undergoing phacoemulsification surgery and BTFC was instilled at the end of surgery. Group 3 consisted of 27 eyes undergoing phacoemulsification surgery and DTFC was instilled at the end of surgery. IOP was measured preoperatively and 6, 24 h and 1wk postoperatively.·RESULTS: There was no statistically significant difference in preoperative baseline IOP among the three groups(P =0.84). However, IOP was significantly lower in groups 2 and 3 compared to the control group(P <0.05 for all comparisons) at all postoperative visits. There was no significant difference between groups 2 and 3 at any visit. Eight eyes(28.6%) in the control group, two(8%) in Group 2 and one(3.7%) in Group 3 had IOP >25 mm Hg at 6h after surgery(P =0.008). However, IOP decreased and was >25 mm Hg in only one eye in each group at24 h after surgery.·CONCLUSION: BTFC and DTFC have similar effects in reducing increases in IOP after phacoemulsificationsurgery and can both be recommended for preventing IOP spikes after such surgery.展开更多
We present 14 patients with secondary gluacoma following the implantation of a posterior chamber intraocular lens (lOLs). All patients were u-nilateral gluacoma , which developed within 1 month following the IOL impla...We present 14 patients with secondary gluacoma following the implantation of a posterior chamber intraocular lens (lOLs). All patients were u-nilateral gluacoma , which developed within 1 month following the IOL implantation in 10 cases, and from 1 to 3 years in 4 cases. The angle of anterior chamber was open in 8 patients, and close in 6 ones. Seven patients required treatment of antiglaucomatous medicine; 4 patients underwent laser indecto-my and 3 patients required antiglaucoma surgery. The results s...展开更多
AIM: To investigate the outcomes of off label singlepiece acrylic intraocular lenses(SPA-IOL) ciliary sulcus placement compared to three-piece IOL(3P-IOL). METHODS: The charts of eight consecutive eyes of patients who...AIM: To investigate the outcomes of off label singlepiece acrylic intraocular lenses(SPA-IOL) ciliary sulcus placement compared to three-piece IOL(3P-IOL). METHODS: The charts of eight consecutive eyes of patients who received sulcus-placed SPA-IOLs between 2006 and 2009 were reviewed. None of the patients underwent IOL exchange. Charts of six age-matched patients who received sulcus placed 3P-IOLs were reviewed as a control group. RESULTS: Mean follow up was 16 mo for SPA-IOL and 23 mo for 3P-IOL. Five of 8 patients in the SPA-IOL group required chronic use of IOP lowering medications at final follow up. Of these, one patient needed glaucoma implant surgery for uncontrolled IOP. One patient in the 3P-IOL group used chronic aqueous suppression pre- and postoperatively. Four of eight eyes with SPAIOL were treated with chronic topical steroids and or non-steroidal anti-inflammatory drugs for cystoid macu-la edema, chronic uveitis, pigment dispersion syndrome or a combination of the above, compared to none in the control group. Mean best-corrected visual acuity was 20/35 in the SPA-IOL group and 20/47 in the 3PIOL group.CONCLUSION: Sulcus placed SPA-IOLs are associated with increased ocular morbidity. In select cases good visual acuity may be achieved. Due to postoperative rotation of sulcus placed toric SPA-IOLs stable astigmatism correction cannot be achieved. Alternative intraocular lenses should be considered when in-the-bag placement of SPA-IOL is not possible.展开更多
文摘AIM: To investigate the complications of intravitreal triamcinolone acetonide (IVTA) for the treatment of macular edema, and to determine the risk factors for intraocular pressure (IOP) elevation. METHODS: Charts of patients with macular edema secondary to branch retinal vein occlusion (BRVO), diabetic retinopathy and uveitis who had received IVTA injections were reviewed to document its complications. IOP elevation was defined as a pressure of ≥24mmHg at some point during follow-up. Multivariate logistic regression analysis was performed to characterize baseline risk factors for this elevation. RESULTS: The study included 111 eyes of 65 female and 46 male patients with a mean follow-up of (11.6±5.1) months. Of the 111 eyes, 52 (46.8%) had macular edema secondary to BRVO, 44 (39.6%) had clinically significant diabetic macular edema (CSDME) and 15 (13.5%) had non-infectious uveitis with macular edema. IOP was recorded ≥24mmHg in 38 eyes (34.2%) during the follow-up. Higher baseline IOP (P =0.022), younger age (P =0.003), and male gender (P = 0.014) were significant risk factors for IOP elevation after IVTA injection. Eyes with prior vitrectomy were less likely to have IOP elevation (P =0.054). Two eyes (5.2% of eyes with increased IOP) underwent trabeculectomy, and 9 eyes (16.3% of the phakic eyes) necessitated cataract surgery. Other complications included branch vein occlusion (1.8%), sterile endophthalmitis (0.9%) and pseudohypopyon (0.9%). CONCLUSION: IVTA has side effects with IOP elevation and cataract formation being the two most common. A subset of patients is more prone to developing increased IOP following IVTA, namely, younger male patients with higher baseline IOP.
文摘Phacoemulsification is the main gold standard for cataract operation in the developed world together with foldable intraocular lens(IOL) implantation by injection,allowing for stable wound construction and less postoperative astigmatism. It is a safe procedure with high success rate with the advancement in machines,improvement of IOL injection systems and further maturation of surgeons’ techniques. Despite the large number of operations performed every day, foldable IOL injection leading to an intra-stromal corneal track is a very rare complication. We report a case of this unusual finding in a 70-year-old gentleman who has undergone cataract operation in November 2011 in our hospital and will review on the complications related to foldable IOL injection.
文摘AIM:To compare surgical results of the Ahmed and Baerveldt implant procedures in glaucoma patients at 1 y follow-up at Jakarta Eye Center(JEC)Eye Hospitals.METHODS:This cohort retrospective study was conducted on glaucoma patients aged≥18 y who had undergone Ahmed and Baerveldt implant surgery.Intraocular pressure(IOP),visual acuity,glaucoma medication,success rate,early and late postoperative complications,and the number of resurgeries were analyzed.RESULTS:A total of 351 eyes in the Ahmed group and 94 eyes in the Baerveldt group were included in this study.At 1 y follow-up,the mean IOP was found to be significantly lower in the Baerveldt group(13±4.47 mm Hg)compared to the Ahmed group(15.02±5.73 mm Hg;P=0.025).Glaucoma medication was required in both the Ahmed and Baerveldt groups(58.92%vs 71.67%).Comparable success rate was found in both groups.The Ahmed group revealed a complete and qualified success of 86.82%,and failure of 13.17%.Similarly,the Baerveldt group showed complete and qualified success in 87.75%and failure in 12.25%cases.In the Ahmed group,11.97%early complications,26.06%late complications and 9.97%resurgeries were observed.In comparison,in the Baerveldt group,23.40%early complications,30.95%late complications and 11.70%resurgeries were observed.CONCLUSION:Both groups of glaucoma implants show significant IOP reduction,however,the Baerveldt implant group demonstrates greater IOP reduction with more failure rates and complications than the Ahmed implant group.
文摘AIM:To evaluate the safety and efficacy of Densiron 68 heavy silicone oil (HSO) tamponade for complicated retinal detachment(RD)in Chinese eyes.METHODS:Twenty-one eyes of 21 patients with complicated RD were included in this retrospective study.All patients underwent pars plana vitrectomy with an internal tamponade using Densiron 68 HSO.Anatomical and functional results and complications were evaluated,including retinal status,visual acuity(VA),intraocular pressure(IOP),intraocular inflammation,lens opacity,and HSO emulsification.RESULTS:Allthepatients were followed up for 3mo to1y(5.8±1.16mo).Retinal reattachment was achieved in 19of 21 patients(90.5%).VA improved in 18 of 21 patients(85.7%),from 1.93 logMAR(±0.48)to 1.52 logMAR(±0.45)(P=0.001).Postoperative complications included early dispersion of HSO in 7 eyes(38.8%),cataract in 10 of 18phakic eyes(55.5%),moderate postoperative inflammation reaction in 10 eyes(47.6%),and elevated IOP in 5 eyes(23.8%),all of which were controlled by medication or by surgery.CONCLUSION:Highanatomical and functional success rates can be achieved with primary vitrectomy for complicated RD by using Densiron 68 HSO;however,it should not be ignored that Densiron 68 HSO can cause some complications in the eye.
文摘AIM: To compare the effectiveness of brimonidine/timolol fixed combination(BTFC) and dorzolamide/timolol fixed combination(DTFC) in the management of short-term intraocular pressure(IOP) increase after phacoemulsification surgery.·METHODS: Eighty eyes of 80 patients undergoing phacoemulsification and intraocular lens(IOL)implantation were randomly assigned into three groups.Group 1 consisted of 28 eyes and represented the control group. Group 2 consisted of 25 eyes undergoing phacoemulsification surgery and BTFC was instilled at the end of surgery. Group 3 consisted of 27 eyes undergoing phacoemulsification surgery and DTFC was instilled at the end of surgery. IOP was measured preoperatively and 6, 24 h and 1wk postoperatively.·RESULTS: There was no statistically significant difference in preoperative baseline IOP among the three groups(P =0.84). However, IOP was significantly lower in groups 2 and 3 compared to the control group(P <0.05 for all comparisons) at all postoperative visits. There was no significant difference between groups 2 and 3 at any visit. Eight eyes(28.6%) in the control group, two(8%) in Group 2 and one(3.7%) in Group 3 had IOP >25 mm Hg at 6h after surgery(P =0.008). However, IOP decreased and was >25 mm Hg in only one eye in each group at24 h after surgery.·CONCLUSION: BTFC and DTFC have similar effects in reducing increases in IOP after phacoemulsificationsurgery and can both be recommended for preventing IOP spikes after such surgery.
文摘We present 14 patients with secondary gluacoma following the implantation of a posterior chamber intraocular lens (lOLs). All patients were u-nilateral gluacoma , which developed within 1 month following the IOL implantation in 10 cases, and from 1 to 3 years in 4 cases. The angle of anterior chamber was open in 8 patients, and close in 6 ones. Seven patients required treatment of antiglaucomatous medicine; 4 patients underwent laser indecto-my and 3 patients required antiglaucoma surgery. The results s...
基金Supported by NIH Center Core,No.P30EY014801Research to Prevent Blindness Unrestricted Grant,Department of Defense,No.DOD-Grant#W81XWH-09-1-0675
文摘AIM: To investigate the outcomes of off label singlepiece acrylic intraocular lenses(SPA-IOL) ciliary sulcus placement compared to three-piece IOL(3P-IOL). METHODS: The charts of eight consecutive eyes of patients who received sulcus-placed SPA-IOLs between 2006 and 2009 were reviewed. None of the patients underwent IOL exchange. Charts of six age-matched patients who received sulcus placed 3P-IOLs were reviewed as a control group. RESULTS: Mean follow up was 16 mo for SPA-IOL and 23 mo for 3P-IOL. Five of 8 patients in the SPA-IOL group required chronic use of IOP lowering medications at final follow up. Of these, one patient needed glaucoma implant surgery for uncontrolled IOP. One patient in the 3P-IOL group used chronic aqueous suppression pre- and postoperatively. Four of eight eyes with SPAIOL were treated with chronic topical steroids and or non-steroidal anti-inflammatory drugs for cystoid macu-la edema, chronic uveitis, pigment dispersion syndrome or a combination of the above, compared to none in the control group. Mean best-corrected visual acuity was 20/35 in the SPA-IOL group and 20/47 in the 3PIOL group.CONCLUSION: Sulcus placed SPA-IOLs are associated with increased ocular morbidity. In select cases good visual acuity may be achieved. Due to postoperative rotation of sulcus placed toric SPA-IOLs stable astigmatism correction cannot be achieved. Alternative intraocular lenses should be considered when in-the-bag placement of SPA-IOL is not possible.
