1.Result of implantation of scleral-fixated posterior chamber intraocular lenses
Enkhzul D ; Enkhtuul S ; Burenjargal P ; Tuvshintugs B ; Bat-Erdebe B ; Byamvadorj D
Innovation 2021;14(1-Ophthalmology):36-41
Purpose:
The aim of this study was to determine the surgical and visual outcomes of scleral
fixated intraocular lens implantation in eyes with as subluxated and dislocated crystalline lens or
traumatic aphakic eyes.
Methods:
A retrospective and short-term prospective cohort study was carried out in 45 eyes
of 43 individuals who underwent SFIOL implantation surgery in First Central Hospital of Mongolia
between January 2017 and January 2020 and had a minimum follow-up of 3 months. Pre-operative
and post-operative best corrected visual acuity, postoperative outcomes and complications
were summarized. Patients after the implantation of a scleral fixated PCIOL were evaluated for
the disease etiology, pre- and post-operative best corrected visual acuity, and occurrence of
postoperative complications.
Results:
The analysis included 45 eyes from 43 patients. Thirty-two (74.4%) patients were men and
eleven (24.6%) were women . The mean age at implantation was 57.2 ± 20.0. Indications for the
IOL implantation included ocular trauma (48.9%), pseudoexfoliation syndrome (22.2%) and Marfan
syndrome (15.6%). Disease etiology and age group were compared and results were Marfan
syndrome is mostly diagnosed in 20-29 years of age, ocular trauma is usually diagnosed in 30-69
years of age and pseudoexfoliation syndrome is occurred in 70 and above of age. Post-operative
visual acuity was improved in all cases from which 35 of patients (77.77%) visual outcome was 6/12
and above.
The mean preoperative best corrected visual acuity (BCVA) was 0.083 ± 0.088, which improved to
0.569 ± 0.221 (p<0.001) third month postoperatively and these were statistically significant.
The most frequent complication was induced astigmatism, which occurred in 6 eyes which
successfully corrected with glasses. Suture erosion occurred in three eyes which successfully
relocate it. The most serious complications such as vitreous hemorrhage, retinal detachment,
suprachoroidal hemorrhage, endophthalmitis and suture degradation or breakage was not seen.
Conclusion
Ab externo SFIOL implantation is a reasonable technique for the management of
eyes with aphakia or absence of capsular support, with relatively high visual outcomes and few
serious complications.
The most frequent cause of aphakia and absence of capsular support was ocular trauma thus,
pseudoexfoliation and Marfan syndrome were the most common in elderly and in young age,
respectively.
2.OUTCOME OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Tuvshintugs B ; Gantsooj N ; Undarmaa T ; Bolortungalag P ; Sainbileg D ; Enkhtuul S ; Enkhzul D ; Burenjargal P
Innovation 2018;12(3):12-16
BACKGROUND: There are two general types of age-related macular degeneration: dry and wet. During wet or neovascular age-related macular degeneration new abnormal vessels grow and leak in the macula. As anti-vascular endothelial growth factor (anti-VEGF) was invented, it revolutionized the treatment of nAMD by inhibiting the progress of this disease. The incidence of AMD increases as life expectancy grows and there is a growing need to study this disease. We aimed to evaluate the outcome of anti-VEGF therapy for the treatment of nAMD and the incidence of ocular serious adverse events (SAE) after injections.. METHODS: In our retrospective, single-center study, medical records of patients receiving a single dose of anti-VEGF treatment (Bevacizumab) for nAMD between 17th of April, 2016 and October, 2017 were evaluated. Outcome measures were the change in the baseline visual acuity (VA) score at post-injective month one, incidence of ocular SAE and patients’ baseline characteristics affecting VA. Patients, whose treatment were started before April 2016 and had anti-VEGF treatment for the diseases other than nAMD, were excluded.. RESULTS: 15 eyes in 15 patients between 52 and 85 years of age received single dose of anti-VEGF (Bevacizumab/Avastin) injection. The mean baseline VA improved from pre-injective average of 0.21 to post-injective 1-month average of 0.37 by Snellen. Furthermore, there was no vision loss or other severe adverse effects, such as endophthalmitis, vitreous hemorrhage, retinal detachment, traumatic cataract after 4 weeks. CONCLUSION: Anti-vascular endothelial growth factor therapy has promising short-term outcomes on treating neovascular age-related macular degeneration.
3.RECURRENCE RATE WITH USE OF INTRAOPERATIVE MITOMYCIN C AND CONJUNCTIVAL AUTOGRAFT FOLLOWING PTERYGIUM EXCISION
Gantsooj N ; Undarmaa T ; Tuvshintugs B ; Tumur G ; Bolortungalag P ; Sainbileg D ; Enkhzul D ; Tumurbaatar B ; Burenjargal P ; Enkh-Oyun Ts
Innovation 2018;12(3):28-30
BACKGROUND: Pterygium is a fibrovascular wing shaped encroachment of conjunctiva
onto the cornea. Although the pathogenesis remains obscure, the ultraviolet radiations
(UVR), especially UVR-A and UVR-B (290-400 nm), are considered the most dangerous in
developing pterygium among other environmental factors (hot, dry, windy, dusty and
smoky environments and hereditary factors. The main histopathological change in primary
pterygium is elastotic degeneration of conjunctival collagen. Patient complaints include
foreign body feeling and visual loss due to corneal astigmatism or growth over the pupil and
cosmetic problems. Anti-inflammatory drugs and lubricants have an important role minimizing
the patient’s discomfort, but they do not cure the disease. After surgical removal there are
still many recurrences regardless of the method used. Autologous conjunctival grafting seems
to be the best method, given both the low recurrence rate and high safety. As described first
by Kenyon et al. in 1985, a conjunctival autograft reported a recurrence rate of 5.3% with
infrequent and relatively minor complications. The primary disadvantage of this technique
is the prolonged operative time required when compared to the bare sclera technique.
These disadvantages are outweighed by the lack of sight-threatening complications and the
relatively low recurrence rate, which made this procedure gain popularity in many centers.
The application of intraoperative 0.02% mitomycin C for the 5 minutes is efficient in reducing
the recurrence rate to a minimum.
METHODS: This retrospective case series, single center study was conducted on 239
patients, who underwent pterygium excision from Jan 2017 to Dec 2017 at the Department
of Ophthalmology of the First Central Hospital. All patients had a detailed ophthalmic
examination before the surgical intervention. Data were collected through a prepared
questionnaire. Postoperative follow-up examination sheets were evaluated. Data
for recurrence rate of pterygium excision were collected and analyzed by using SPSS version 17..
RESULTS: Among the 239 patients, who underwent an operation, 37.2% (n=89) were male and
62.8% (n=150) were female. Participants’ age ranged from 29 -70 years with mean age of 49.5
years old.
There is no statistical significance between the stages of the disease and its post-operative
outcome in the patients, who underwent pterygium excision surgery in 2017. Postoperative
pterygium recurrence was in 9 patients (3.8%); 5 (55.5%) out of all 9 patients with recurred
pterygium had underwent pterygium excision without conjunctival autograft.
MMC was not used intraoperatively for all 9 (3.8%) patients with recurrence post pterygium
excision.
CONCLUSION: The relationship between pterygium stage and its post-operative recurrence
was not statistically significant (P=0.683).
The recurrence rate after pterygium excision with conjunctival autograft was low (P≤0.001)
which showed significant statistically.
There was no recurrence after pterygium excision with MMC (P≤0.001).
The results of studies from Canada, Hong-Kong, India, Philippines and Iran were similar to our
outcome.