AIM:To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma,and discuss the multiple treating methods of operation combined with primary...AIM:To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma,and discuss the multiple treating methods of operation combined with primary intraocular lens(IOL)implantation.METHODS:Non-comparativeretrospectiveobservational case series.Participants:30 cases(30 eyes)of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi’an No.4Hospital from 2007 to 2011.According to the different situations of lens subluxation/dislocation,various surgical procedures were performed such as crystalline lens phacoemulsification,crystalline lens phacoemulsification combined anterior vitrectomy,intracapsular cataract extraction combined anterior vitrectomy,lensectomy combined anterior vitrectomy though peripheral transparent cornea incision,pars plana lensectomy combined pars plana vitrectomy,and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy.And whether to implement trabeculectomy depended on the different situations of secondary glaucoma.The posterior chamber intraocular lenses(PC-IOLs)were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present.Main outcome measures:visual acuity,intraocular pressure,the situation of intraocular lens and complications after the operations.RESULTS:The follow-up time was 11-36mo(21.4±7.13).Postoperative visual acuity of all eyes were improved;28 cases maintained IOP below 21 mm Hg;2cases had slightly IOL subluxation,4 cases had slightlytilted lens optical area;1 case had postoperative choroidal detachment;4 cases had postoperative corneal edema more than 1wk,but eventually recovered transparent;2 cases had mild postoperative vitreous hemorrhage,and absorbed 4wk later.There was no postoperative retinal detachment,IOL dislocation,and endophthalmitis.CONCLUSION:To take early treatment of traumatic lens subluxation/dislocation in patients with secondary glaucoma by individual surgical plan based on the different eye conditions would be safe and effective,which can effectively control the intraocular pressure and restore some vision.展开更多
AIM:To investigate the safety and efficacy of phacoemulsification with capsular-tension-ring implantation and posterior chamber intraocular lens implantation combined with ophthalmic endoscope-controlled goniosynechia...AIM:To investigate the safety and efficacy of phacoemulsification with capsular-tension-ring implantation and posterior chamber intraocular lens implantation combined with ophthalmic endoscope-controlled goniosynechialysis(Phaco-CTR-IOL-OE-GSL)for treating secondary angle-closure glaucoma induced by traumatic lens subluxation.METHODS:A retrospective and descriptive study was performed on patients with lens subluxation,angle closure,goniosynechia,and evaluated intraocular pressure(IOP)that cannot be controlled with medication,who underwent Phaco-CTR-IOL-OE-GSL.The postoperative best-corrected visual acuity(BCVA),IOP,range of goniosynechia and complications were retrospectively observed.RESULTS:Nine patients with secondary angle-closure glaucoma induced by traumatic lens subluxation were included.The follow-up period was 51.1±8.6 mo.The preoperative range of zonule rupture was 158.2°±33.0°,and the range of goniosynechia was 220.0°±92.5°.The baseline BCVA was 0.9±1.0 logMAR,IOP was 30.7±17.3 mm Hg and number of anti-glaucoma medication was 3.2±1.1.Mild intraoperative hyphaemia with 8 eyes(88.8%)in the anterior chamber,and was absorbed two days postoperatively.One eye(11.1%)had postoperative ciliary body detachment and was recovered after five days of topical drug treatment.BCVA was 0.2±0.2 logMAR at 3 mo postoperatively.The average IOP at the last follow-up was 16.7±2.0 mm Hg,and no anti-glaucoma medications were used.The average range of recurrent goniosynechia was 54.9°±33°at the final postoperative gonioscopic examination.CONCLUSION:Phaco-CTR-IOL-OE-GSL is safe and effective in the treatment of secondary angle-closure glaucoma induced by traumatic lens subluxation.The use of an endoscope provides a more direct and clear examination for GSL,and 360°dissection is easily achieved.展开更多
BACKGROUND Synovial chondromatosis is a disease originating from the synovium and characterized by the presence of metaplastic cartilaginous nodules in synovial cavities.The exact prevalence of synovial chondromatosis...BACKGROUND Synovial chondromatosis is a disease originating from the synovium and characterized by the presence of metaplastic cartilaginous nodules in synovial cavities.The exact prevalence of synovial chondromatosis remains unknown,and the involvement of the shoulder joint is very rare.Synovial chondromatosis accompanied by subluxation of the humeral head without a history of trauma is rarely encountered,and to our knowledge,no published reports describe this condition.CASE SUMMARY We present two cases of synovial chondromatosis in the shoulder joint,accompanied by subluxation of the humeral head,in two arthroscopically managed adult patients.We performed arthroscopic labrum fixation and removal of the loose body from the shoulder joint.To identify primary and secondary categories,pathological analysis was arranged.Clinical and radiographic evaluations at the 1-mo follow-up were satisfactory.CONCLUSION The biomechanical function of the shoulder joint requires attention,especially following the detection of loose bodies,as observed with synovial chondroma occurring in rare sites.Arthroscopic management is successful in patients with synovial chondromatosis combined with shoulder subluxation.展开更多
AIM:To investigate the effect of Cionni-modified capsular tension ring(CTR)implantation in patients with severely traumatic subluxated cataracts.METHODS:All patients who totally had traumatic cataracts and lost zonule...AIM:To investigate the effect of Cionni-modified capsular tension ring(CTR)implantation in patients with severely traumatic subluxated cataracts.METHODS:All patients who totally had traumatic cataracts and lost zonule support and underwent cataract surgery were retrospectively analyzed.Corrected distance visual acuity(CDVA),extent of zonulysis,intraocular lens(IOL)position,intraoperative presentation,and complications were assessed.The primary outcomes included IOL centration stability and other postoperative complications.RESULTS:Twenty patients(20 eyes)were included in this study.The mean age in this study was 58.0±11.3y,and the average follow-up time was 17.3±12.8mo.Capsule bags were saved by Cionni-modified CTR.Nine eyes(45%)underwent simultaneously anterior vitrectomy due to the presence of vitreous in the anterior chamber.The preoperative mean CDVA was 0.83±0.24 log MAR,and the postoperative average CDVA was 0.23±0.30 log MAR(P<0.05).The horizontal and vertical IOL decentration after surgery was 0.27±0.12 mm and 0.41±0.19 mm,respectively;the vertical and horizontal IOL tilt after surgery was 5.5°±2.5°and 6.1°±2.2°,respectively.None of the eyes had obvious IOL decentration during the follow-up time.Eight eyes(40%)had posterior capsule opacification(PCO)that was severe enough to cause poor vision.Neodymium:YAG laser capsulotomy were performed on these eyes when the CTR was stabilized.CONCLUSION:With the help of Cionni-modified CTR,capsular bag preservation and better IOL concentration can be achieved without major complications in patients with severely traumatic subluxated cataracts.展开更多
Most cases of medial patella subluxation occur under iatrogenic conditions that are often associated with a prior excessive lateral retinacular release procedure. We report a case of medial subluxation following minor...Most cases of medial patella subluxation occur under iatrogenic conditions that are often associated with a prior excessive lateral retinacular release procedure. We report a case of medial subluxation following minor trauma with no history of previous lateral release. The abnormality was identified on magnetic resonance imaging and was successfully treated by direct repair of the lateral retinaculum. The recognition and treatment of medial subluxation of the patella without retinacular release can be difficult. Therefore, consideration of multiple causes through careful medical history taking, physical examination, and radiologic examination is needed for accurate diagnosis.展开更多
BACKGROUND Atlantoaxial rotatory subluxation(AARS)is an uncommon disease with a greater prevalence among children than adults,and it is mostly associated with trauma.Iatrogenic spinal injury accounts for a low percent...BACKGROUND Atlantoaxial rotatory subluxation(AARS)is an uncommon disease with a greater prevalence among children than adults,and it is mostly associated with trauma.Iatrogenic spinal injury accounts for a low percentage of injuries.However,in AARS,20%-40%of cases are associated with surgery,and 48%are caused by infection.Here,we describe our experience with a case of iatrogenic AARS after general anesthesia.CASE SUMMARY A 12-year-old girl presented with right-sided torticollis and cervical motion limit.The patient had undergone thyroidectomy 2 mo ago.Computed tomography revealed AARS with bilateral locked facets.Following the failure of repeated external reduction under general anesthesia,the patient underwent an open surgical reduction.The patient gained atlantoaxial alignment without any complications.Follow-up radiographs showed a normal appearance without instability.The cervical spine of children is more predisposed to injury due to anatomical and biomechanical differences.AARS secondary to infection and surgery is known as Grisel’s syndrome,which involves non-traumatic AARS.Several cases of AARS after surgery and other procedures with no evidence of inflammation have been reported.Our experience shows that surgery requiring hyperextension of the neck after general anesthesia should also be included as a risk factor.CONCLUSION Surgeons and anesthesiologists should be careful not to excessively extend the neck during pediatric surgery.Moreover,clinicians caring for pediatric patients with recent head and neck procedures must be aware of common AARS presentations.展开更多
AIM:To evaluate the visual and refractive outcomes in cases after sutured scleral fixation of existing subluxated or dislocated acrylic one-piece intraocular lenses(IOLs).METHODS:This study retrospectively enrolled a ...AIM:To evaluate the visual and refractive outcomes in cases after sutured scleral fixation of existing subluxated or dislocated acrylic one-piece intraocular lenses(IOLs).METHODS:This study retrospectively enrolled a consecutive series of patients who underwent a surgery of sutured existing subluxated or dislocated IOLs from October 2018 to June 2020.All patients underwent comprehensive preoperative and postoperative ophthalmologic examination,and data were collected including age,sex,surgical indications,best-corrected visual acuity,refractive error,intraocular pressure.Presence of intraoperative and postoperative surgical complications was documented.RESULTS:A total of 20 consecutive cases were enrolled for analysis with mean final follow-up period 9.8±5.3mo.Visual acuity improved from a mean of 0.35(0.46±0.32 logMAR)preoperatively to 0.61(0.21±0.18 logMAR)at the 3-month follow-up(P=0.002).The mean amount of preoperative keratometric astigmatism and total postoperative refractive astigmatism was-1.24±0.80 diopters(D)and-1.42±0.97 D,respectively.There was no statistically significant difference between preoperative and postoperative astigmatism(P=0.156).The mean IOL-induced astigmatism was-0.23±0.53 D.The mean spherical equivalent at the 3-month follow-up was-0.1±0.94 D.No major complications were noted during the follow-up period.CONCLUSION:Surgical techniques using sutured scleral fixation of existing subluxated or dislocated acrylic one-piece IOLs result in favorable visual and refractive outcomes without major complications.展开更多
AIM:To present a technique of transcapsular scleral fixation of the standard capsular tension ring(CTR)through equatorial capsulotomy and in-the-bag intraocular lens(IOL)implantation in subluxated lenses.METHODS:This ...AIM:To present a technique of transcapsular scleral fixation of the standard capsular tension ring(CTR)through equatorial capsulotomy and in-the-bag intraocular lens(IOL)implantation in subluxated lenses.METHODS:This retrospective consecutive case series included patients with subluxated lenses by more than 180 degrees who underwent lens extraction,transcapsular scleral fixation of the standard CTR through equatorial capsulotomy,in-the-bag IOL implantation and with at least 6mo follow-up.Preoperative and postoperative best corrected visual acuity(BCVA),intraocular pressure(IOP),complications,and postoperative IOL tilt and decentration were recorded.RESULTS:Nine eyes of 7 patients with a mean followup of 11.0±3.7mo were included in this study.The BCVA was significantly improved from 0.64±0.22 logMAR preoperatively to 0.21±0.19 logMAR postoperatively(P<0.001).The IOP was within the normal range postoperatively.The mean tilt of the IOL was 4.30°±2.31°(range,1.0°to 8.9°)and the mean decentration of the IOL was 0.37±0.12 mm(range,0.14 to 0.50 mm).No visually threatened intraoperative and postoperative complications were detected during the follow-up period.CONCLUSION:This is a safe and effective surgical technique for managing patients with severely subluxated lenses.It has achieved favorable outcomes with fewer surgical manipulations and less need for advanced capsular support devices.展开更多
Objective To introduce a new procedure for treatment of rotatory subluxation of the scaphoid. Methods Eighteen patients with rotatory subluxation of the scaphoid were divided into five types according to clinical mani...Objective To introduce a new procedure for treatment of rotatory subluxation of the scaphoid. Methods Eighteen patients with rotatory subluxation of the scaphoid were divided into five types according to clinical manifestation and cause: type Ⅰ (predynamic) 1 case,type Ⅱ (dynamic) 2 cases, type Ⅲ (static) 7 cases, type Ⅳ (degenerative) 3 cases, type Ⅴ( secondary) 5 cases. All cases underwent scapho-trapezio-trapezoid limited wrist arthrodesis. Results The follow-up ranged from 6 months to 3 years. The results showed that the all rotatory subluxatiopn of scaphoid in the study had been corrected with satisfactory fusion and painless wrist. The average grip strength was 90% of the normal wrist, and the average range of motion was 62% of the opposite side. Conclusion Scapho-trapezio-trapezoid limited arthrodesis is a reliable and useful procedure for treatment of chronic andChina Medical Abstracts(Surgery) static rotatory subluxation of the scaphoid. 15 refs,2 figs.展开更多
Background:To present a surgical technique using a rigid intraocular lens as endocapsular supporting device in manual small incision cataract surgery(MSICS)for treating mild-moderate subluxated cataracts.Methods:In ou...Background:To present a surgical technique using a rigid intraocular lens as endocapsular supporting device in manual small incision cataract surgery(MSICS)for treating mild-moderate subluxated cataracts.Methods:In our technique,a single-piece rigid polymethyl methacrylate(PMMA)lens was implanted in the bag following the nucleus removal,with its axis vertical to the zonular dialysis.This endocapsular-implanted IOL stretched the bag and provided sufficient stability and lens centration.This technique was performed in 19 eyes with subluxated cataracts,with zonulysis of≤120 degree and nuclear sclerosis of grade≤3.Mean follow-up time was 9.8 months.Results:All eyes had endocapsular IOL implantation during surgery.Intraoperative extension of the dialysis did not occur in any eye.The IOL was placed in the bag in all but 1 case,in which dislocation of the IOL haptic into the vitreous occurred.Though the IOL was slightly decentered in 3 cases,it kept stable.All patients were asymptomatic.Conclusions:This approach provides a simplified and practical strategy for surgically managing subluxation with mild-moderate zonular loss.展开更多
文摘AIM:To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma,and discuss the multiple treating methods of operation combined with primary intraocular lens(IOL)implantation.METHODS:Non-comparativeretrospectiveobservational case series.Participants:30 cases(30 eyes)of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi’an No.4Hospital from 2007 to 2011.According to the different situations of lens subluxation/dislocation,various surgical procedures were performed such as crystalline lens phacoemulsification,crystalline lens phacoemulsification combined anterior vitrectomy,intracapsular cataract extraction combined anterior vitrectomy,lensectomy combined anterior vitrectomy though peripheral transparent cornea incision,pars plana lensectomy combined pars plana vitrectomy,and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy.And whether to implement trabeculectomy depended on the different situations of secondary glaucoma.The posterior chamber intraocular lenses(PC-IOLs)were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present.Main outcome measures:visual acuity,intraocular pressure,the situation of intraocular lens and complications after the operations.RESULTS:The follow-up time was 11-36mo(21.4±7.13).Postoperative visual acuity of all eyes were improved;28 cases maintained IOP below 21 mm Hg;2cases had slightly IOL subluxation,4 cases had slightlytilted lens optical area;1 case had postoperative choroidal detachment;4 cases had postoperative corneal edema more than 1wk,but eventually recovered transparent;2 cases had mild postoperative vitreous hemorrhage,and absorbed 4wk later.There was no postoperative retinal detachment,IOL dislocation,and endophthalmitis.CONCLUSION:To take early treatment of traumatic lens subluxation/dislocation in patients with secondary glaucoma by individual surgical plan based on the different eye conditions would be safe and effective,which can effectively control the intraocular pressure and restore some vision.
基金Wenzhou Municipal Science and Technology Bureau(No.Y20180712)。
文摘AIM:To investigate the safety and efficacy of phacoemulsification with capsular-tension-ring implantation and posterior chamber intraocular lens implantation combined with ophthalmic endoscope-controlled goniosynechialysis(Phaco-CTR-IOL-OE-GSL)for treating secondary angle-closure glaucoma induced by traumatic lens subluxation.METHODS:A retrospective and descriptive study was performed on patients with lens subluxation,angle closure,goniosynechia,and evaluated intraocular pressure(IOP)that cannot be controlled with medication,who underwent Phaco-CTR-IOL-OE-GSL.The postoperative best-corrected visual acuity(BCVA),IOP,range of goniosynechia and complications were retrospectively observed.RESULTS:Nine patients with secondary angle-closure glaucoma induced by traumatic lens subluxation were included.The follow-up period was 51.1±8.6 mo.The preoperative range of zonule rupture was 158.2°±33.0°,and the range of goniosynechia was 220.0°±92.5°.The baseline BCVA was 0.9±1.0 logMAR,IOP was 30.7±17.3 mm Hg and number of anti-glaucoma medication was 3.2±1.1.Mild intraoperative hyphaemia with 8 eyes(88.8%)in the anterior chamber,and was absorbed two days postoperatively.One eye(11.1%)had postoperative ciliary body detachment and was recovered after five days of topical drug treatment.BCVA was 0.2±0.2 logMAR at 3 mo postoperatively.The average IOP at the last follow-up was 16.7±2.0 mm Hg,and no anti-glaucoma medications were used.The average range of recurrent goniosynechia was 54.9°±33°at the final postoperative gonioscopic examination.CONCLUSION:Phaco-CTR-IOL-OE-GSL is safe and effective in the treatment of secondary angle-closure glaucoma induced by traumatic lens subluxation.The use of an endoscope provides a more direct and clear examination for GSL,and 360°dissection is easily achieved.
基金Supported by the Natural Science Foundation of Jilin Province,No.20200201536JC.
文摘BACKGROUND Synovial chondromatosis is a disease originating from the synovium and characterized by the presence of metaplastic cartilaginous nodules in synovial cavities.The exact prevalence of synovial chondromatosis remains unknown,and the involvement of the shoulder joint is very rare.Synovial chondromatosis accompanied by subluxation of the humeral head without a history of trauma is rarely encountered,and to our knowledge,no published reports describe this condition.CASE SUMMARY We present two cases of synovial chondromatosis in the shoulder joint,accompanied by subluxation of the humeral head,in two arthroscopically managed adult patients.We performed arthroscopic labrum fixation and removal of the loose body from the shoulder joint.To identify primary and secondary categories,pathological analysis was arranged.Clinical and radiographic evaluations at the 1-mo follow-up were satisfactory.CONCLUSION The biomechanical function of the shoulder joint requires attention,especially following the detection of loose bodies,as observed with synovial chondroma occurring in rare sites.Arthroscopic management is successful in patients with synovial chondromatosis combined with shoulder subluxation.
基金Supported by the National Natural Science Foundation of China(No.82070968)China Postdoctoral Science Foundation(No.2022M712386)+4 种基金Tianjin Health Research Project(No.TJWJ2022MS040,No.ZC20166)Nankai University Eye Institute(No.NKYKK202203,No.NKYKK202206)Tianjin Eye Hospital Research Project(No.YKYB1902)Natural Science Foundation of Tianjin(No.20JCQNJC01860)Tianjin Key Medical Discipine(Specialty)Construction Project(No.TJYXZDXK-016A)。
文摘AIM:To investigate the effect of Cionni-modified capsular tension ring(CTR)implantation in patients with severely traumatic subluxated cataracts.METHODS:All patients who totally had traumatic cataracts and lost zonule support and underwent cataract surgery were retrospectively analyzed.Corrected distance visual acuity(CDVA),extent of zonulysis,intraocular lens(IOL)position,intraoperative presentation,and complications were assessed.The primary outcomes included IOL centration stability and other postoperative complications.RESULTS:Twenty patients(20 eyes)were included in this study.The mean age in this study was 58.0±11.3y,and the average follow-up time was 17.3±12.8mo.Capsule bags were saved by Cionni-modified CTR.Nine eyes(45%)underwent simultaneously anterior vitrectomy due to the presence of vitreous in the anterior chamber.The preoperative mean CDVA was 0.83±0.24 log MAR,and the postoperative average CDVA was 0.23±0.30 log MAR(P<0.05).The horizontal and vertical IOL decentration after surgery was 0.27±0.12 mm and 0.41±0.19 mm,respectively;the vertical and horizontal IOL tilt after surgery was 5.5°±2.5°and 6.1°±2.2°,respectively.None of the eyes had obvious IOL decentration during the follow-up time.Eight eyes(40%)had posterior capsule opacification(PCO)that was severe enough to cause poor vision.Neodymium:YAG laser capsulotomy were performed on these eyes when the CTR was stabilized.CONCLUSION:With the help of Cionni-modified CTR,capsular bag preservation and better IOL concentration can be achieved without major complications in patients with severely traumatic subluxated cataracts.
文摘Most cases of medial patella subluxation occur under iatrogenic conditions that are often associated with a prior excessive lateral retinacular release procedure. We report a case of medial subluxation following minor trauma with no history of previous lateral release. The abnormality was identified on magnetic resonance imaging and was successfully treated by direct repair of the lateral retinaculum. The recognition and treatment of medial subluxation of the patella without retinacular release can be difficult. Therefore, consideration of multiple causes through careful medical history taking, physical examination, and radiologic examination is needed for accurate diagnosis.
基金Supported by The Chonnam National University Hospital Biomedical Research Institute,No.BCRI22023。
文摘BACKGROUND Atlantoaxial rotatory subluxation(AARS)is an uncommon disease with a greater prevalence among children than adults,and it is mostly associated with trauma.Iatrogenic spinal injury accounts for a low percentage of injuries.However,in AARS,20%-40%of cases are associated with surgery,and 48%are caused by infection.Here,we describe our experience with a case of iatrogenic AARS after general anesthesia.CASE SUMMARY A 12-year-old girl presented with right-sided torticollis and cervical motion limit.The patient had undergone thyroidectomy 2 mo ago.Computed tomography revealed AARS with bilateral locked facets.Following the failure of repeated external reduction under general anesthesia,the patient underwent an open surgical reduction.The patient gained atlantoaxial alignment without any complications.Follow-up radiographs showed a normal appearance without instability.The cervical spine of children is more predisposed to injury due to anatomical and biomechanical differences.AARS secondary to infection and surgery is known as Grisel’s syndrome,which involves non-traumatic AARS.Several cases of AARS after surgery and other procedures with no evidence of inflammation have been reported.Our experience shows that surgery requiring hyperextension of the neck after general anesthesia should also be included as a risk factor.CONCLUSION Surgeons and anesthesiologists should be careful not to excessively extend the neck during pediatric surgery.Moreover,clinicians caring for pediatric patients with recent head and neck procedures must be aware of common AARS presentations.
文摘AIM:To evaluate the visual and refractive outcomes in cases after sutured scleral fixation of existing subluxated or dislocated acrylic one-piece intraocular lenses(IOLs).METHODS:This study retrospectively enrolled a consecutive series of patients who underwent a surgery of sutured existing subluxated or dislocated IOLs from October 2018 to June 2020.All patients underwent comprehensive preoperative and postoperative ophthalmologic examination,and data were collected including age,sex,surgical indications,best-corrected visual acuity,refractive error,intraocular pressure.Presence of intraoperative and postoperative surgical complications was documented.RESULTS:A total of 20 consecutive cases were enrolled for analysis with mean final follow-up period 9.8±5.3mo.Visual acuity improved from a mean of 0.35(0.46±0.32 logMAR)preoperatively to 0.61(0.21±0.18 logMAR)at the 3-month follow-up(P=0.002).The mean amount of preoperative keratometric astigmatism and total postoperative refractive astigmatism was-1.24±0.80 diopters(D)and-1.42±0.97 D,respectively.There was no statistically significant difference between preoperative and postoperative astigmatism(P=0.156).The mean IOL-induced astigmatism was-0.23±0.53 D.The mean spherical equivalent at the 3-month follow-up was-0.1±0.94 D.No major complications were noted during the follow-up period.CONCLUSION:Surgical techniques using sutured scleral fixation of existing subluxated or dislocated acrylic one-piece IOLs result in favorable visual and refractive outcomes without major complications.
基金Supported by Wenzhou Basic Research Foundation(No.2024Y1244).
文摘AIM:To present a technique of transcapsular scleral fixation of the standard capsular tension ring(CTR)through equatorial capsulotomy and in-the-bag intraocular lens(IOL)implantation in subluxated lenses.METHODS:This retrospective consecutive case series included patients with subluxated lenses by more than 180 degrees who underwent lens extraction,transcapsular scleral fixation of the standard CTR through equatorial capsulotomy,in-the-bag IOL implantation and with at least 6mo follow-up.Preoperative and postoperative best corrected visual acuity(BCVA),intraocular pressure(IOP),complications,and postoperative IOL tilt and decentration were recorded.RESULTS:Nine eyes of 7 patients with a mean followup of 11.0±3.7mo were included in this study.The BCVA was significantly improved from 0.64±0.22 logMAR preoperatively to 0.21±0.19 logMAR postoperatively(P<0.001).The IOP was within the normal range postoperatively.The mean tilt of the IOL was 4.30°±2.31°(range,1.0°to 8.9°)and the mean decentration of the IOL was 0.37±0.12 mm(range,0.14 to 0.50 mm).No visually threatened intraoperative and postoperative complications were detected during the follow-up period.CONCLUSION:This is a safe and effective surgical technique for managing patients with severely subluxated lenses.It has achieved favorable outcomes with fewer surgical manipulations and less need for advanced capsular support devices.
文摘Objective To introduce a new procedure for treatment of rotatory subluxation of the scaphoid. Methods Eighteen patients with rotatory subluxation of the scaphoid were divided into five types according to clinical manifestation and cause: type Ⅰ (predynamic) 1 case,type Ⅱ (dynamic) 2 cases, type Ⅲ (static) 7 cases, type Ⅳ (degenerative) 3 cases, type Ⅴ( secondary) 5 cases. All cases underwent scapho-trapezio-trapezoid limited wrist arthrodesis. Results The follow-up ranged from 6 months to 3 years. The results showed that the all rotatory subluxatiopn of scaphoid in the study had been corrected with satisfactory fusion and painless wrist. The average grip strength was 90% of the normal wrist, and the average range of motion was 62% of the opposite side. Conclusion Scapho-trapezio-trapezoid limited arthrodesis is a reliable and useful procedure for treatment of chronic andChina Medical Abstracts(Surgery) static rotatory subluxation of the scaphoid. 15 refs,2 figs.
基金The study was approved by IRB of The First People’s Hospital of Yunnan Province(No.2016031).
文摘Background:To present a surgical technique using a rigid intraocular lens as endocapsular supporting device in manual small incision cataract surgery(MSICS)for treating mild-moderate subluxated cataracts.Methods:In our technique,a single-piece rigid polymethyl methacrylate(PMMA)lens was implanted in the bag following the nucleus removal,with its axis vertical to the zonular dialysis.This endocapsular-implanted IOL stretched the bag and provided sufficient stability and lens centration.This technique was performed in 19 eyes with subluxated cataracts,with zonulysis of≤120 degree and nuclear sclerosis of grade≤3.Mean follow-up time was 9.8 months.Results:All eyes had endocapsular IOL implantation during surgery.Intraoperative extension of the dialysis did not occur in any eye.The IOL was placed in the bag in all but 1 case,in which dislocation of the IOL haptic into the vitreous occurred.Though the IOL was slightly decentered in 3 cases,it kept stable.All patients were asymptomatic.Conclusions:This approach provides a simplified and practical strategy for surgically managing subluxation with mild-moderate zonular loss.
