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.PRIMARY PHACOEMULSIFICATION WITH INTRAOCULAR LENS IMPLANTATION FOR ACUTE PRIMARY ANGLE-CLOSURE GLAUCOMA
Enkhzul D ; Enkhtuul S ; Burenjargal P ; Tuvshuntugs B ; Gantsooj N ; Bolortungalag P ; Sainbileg D
Innovation 2018;12(3):6-10
BACKGROUND. Acute primary angle-closure glaucoma (PACG) is a severe disease requiring intensive and emergency treatment. Surgical peripheral iridectomy and laser peripheral iridectomy procedures are performed to decrease papillary block and create an opening for the aqueous humor to pass through the eye. However, the intraocular pressure (IOP) cannot be consistently controlled by peripheral iridectomy. Phacoemulsification can widen the anterior chamber angle, position the ciliary processes in eyes with PAC posteriorly and inhibit the acute angle closure. This procedure can control the intraocular pressure sustainably for a long period. The higher incidence of the acute angle closure glaucoma in Mongolia compared to other countries was the rationale of this study.
MATERIAL AND METHODS. Medical records of 9 patients (9 eyes) with acute PACG, who had received phacoemulsification with intraocular lens implantation as initial management for medically uncontrolled high IOP, were analyzed in a retrospective chart review. IOP, visual acuity, anterior chamber depth (ACD) and the number of anti-glaucoma medications used were evaluated.
RESULTS. The postoperative IOP was reduced in 9 eyes (100%). The mean preoperative IOP was 37.9 ± 13.0 mmHg, which decreased postoperatively to 11.0 ± 1.9 mmHg at day 1, 11.1 ± 2.1 mmHg at week 1, 11.1±2.0 mmHg at 2 weeks, 11.8 ± 1.9 mmHg at month 1, and 11.3 ± 1.4 mmHg at 3 months, which showed statistically significance (p < 0.001). The mean visual acuity improved from preoperative average of 0.04±0.03 to postoperative average of 0.17±0.24 at day 1, 0.45±0.26 at week 1, 0.54±0.31 at week 2, 0.56±0.34 at 1 month, and 0.57±0.33 (p = 0.001) at 3-months. There was functional success at month 3.
СONCLUSION. Our outcome indicates that primary phacoemulsification with intraocular lens implantation lowered IOP and improved visual acuity significantly in patients with acute PACG. This is a safe and effective method of IOP control and can be considered a first line treatment option in managing patients with acute PACG and coexisting cataract.
3.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.
4.The treatment outcome оf the patients with infectious keratitis
Undarmaa T ; Tumurbaatar B ; Burenjargal P ; Bayarmaa E ; Sayamaa L
Innovation 2021;14(1-Ophthalmology):26-31
Background:
Infectious keratitis is a disease caused by inflammation, infection, and other
ocular damage to the outer and other deep layers of corneal epithelium. It is a major cause of
monocular blindness and visual disability worldwide regardless of age and gender. Therefore, we
aimed to determine the clinical features and risk factors of infectious keratitis among Mongolians
and to identify the causative microorganism and compared them with the treatment results.
Methods:
We collected the data of 149 patients who diagnosed as infectious keratitis at the
Ophthalmology Department of the First State Central Hospital in 2017-2020 and using a case series
model of descriptive study. Statistical analysis was calculated using Stata14 software.
Results:
The majority of patients in our study were male, with a male-to-female ratio is 2.1:1. The
cause of infectious keratitis were categorized and eye injury-induced keratitis accounted for the
highest percentage of 38.3% (n=57), with the majority being men 73.7% (n=42) (p=0.028). As for the
type of treatment, antibacterial drugs 103 (69.1%) and evisceration 27(45%) predominate.
Conclusion
Our study shows that the majority of infectious keratitis in Mongolia is due to trauma
in male patients. Forty-five percent of all surgeries involve evisceration surgery, which reduces the
client's quality of life.
5.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.
6.Outcomes of COVID-19 Immunization Among Healthcare Workers
Dashpagam O ; Davaalkham D ; Burenjargal B ; Tselkhaasuren B ; Baigal V ; Shatar Sh ; Khorolsuren L ; Tsogtsaikhan S
Mongolian Journal of Health Sciences 2025;87(3):191-198
Background:
The first case of COVID-19 was reported in our country on November
11, 2020. As of 2023, a total of 869,385 cases and 2,128 deaths have been
recorded nationwide. The World Health Organization (WHO) has recommended
that countries use 15 vaccines from 11 manufacturers listed for emergency use.
The WHO has advised low-income member states to prioritize vaccinating healthcare
workers and other high-risk populations vulnerable to severe illness and
death from COVID-19. The main goal of the coronavirus vaccination program is to
prevent infection, complications, and death among priority target groups, such as
healthcare workers and other populations at high risk of severe illness. The effectiveness
of the vaccination is measured by its ability to reduce the risk of illness,
hospitalization, and death from COVID-19-related complications among vaccinated
individuals. While extensive research is being conducted globally to develop,
evaluate, and assess the effectiveness and outcomes of COVID-19 vaccines,
there has been limited research focused on these outcomes within our country.
This gap highlights the need for and serves as the basis of the present study.
Аim:
To assess the risk of infection, hospitalization, and associated risk factors among
healthcare workers vaccinated against COVID-19, and to examine the factors that
influence these risks.
Materials and Methods:
A This follow-up study was conducted over an 80-week
period—at weeks 12, 24, and 48—from February 23, 2021, to December 31, 2022.
The study involved healthcare workers from Ulaanbaatar city and the aimags of
Bayankhongor, Orkhon, Bulgan, Dundgovi, Darkhan-Uul, and Dornod. The study
was conducted over a period of 1.5 years (80 weeks) following the administration
of the first two doses of the COVID-19 vaccine. Data were collected from participants
at three time points: before vaccination, after the second dose, and after
each booster dose. A structured questionnaire comprising 7 sections and 49 questions
was used for data collection, and the results were analyzed using SPSS version
26.0.
Results:
Of the total respondents, 574 (60%) worked in direct contact
with infected individuals in the 'red zone,' while 370 (40%) worked in the 'yellow
zone.' Additionally, 250 participants (27.1%) were healthcare workers from Ulaanbaatar
city, and 674 (72.9%) were from rural areas. In our observational study, the
risk of new infections among healthcare workers increased over time, rising from
38.4% at week 24 to 59.6% by week 80. Hospitalizations also increased during the
follow-up period: 24 cases (2.6%) were recorded at week 12, 160 (17.3%) at week
24, 202 (21.9%) at week 48, and 204 (22.1%) by week 80. Among frontline workers
in rural areas, those in Bayankhongor and Orkhon aimags exhibited a lower
risk of infection compared to their counterparts in other aimags.
Conclusion
In
our follow up study, an increase in the duration since primary immunization was
associated with a higher risk of new infection among workers, rising from 38.4%
at 24 weeks to 59.6% at 80 weeks post-vaccination. Administration of additional
(booster) immunizations was associated with a reduced risk of subsequent infection.
COVID-19 vaccination was associated with a reduced risk of complications
necessitating hospitalization. Employment in rural settings and designated red
zones was identified as a risk factor for incident infections, hospitalizations, and
reinfections.
7. Impact of Individual Temperament on the Immune Response After COVID-19 Vaccination
Burenjargal B ; Dashpagam O ; Shatar Sh ; Khongorzul T ; Ariunzaya B ; Zolmunkh N ; Gansukh Ch ; Ulziisaikhan B ; Chimidtseren S ; Baasanjargal B ; Enkh-Amar B ; Nomin-Erdene Ts ; Davaalkham D ; Tsogtsaikhan S ; Batbaatar G
Mongolian Journal of Health Sciences 2025;88(4):47-51
Background:
The first confirmed case of COVID-19 in Mongolia was reported on November 11, 2020. In response, the
government imposed a nationwide lockdown, which significantly impacted the population’s mental health. Heightened
levels of stress, anxiety, loneliness, and depression during the pandemic altered individuals’ psychological stability and
behavior. Personality traits—defined as relatively stable patterns of emotion, cognition, and behavior—play a key role in
stress responses and emotional regulation under pressure. Emerging evidence suggests that these psychological factors
may influence the immune system’s responsiveness, including vaccine-induced antibody production.
Aim:
To evaluate the association between post-vaccination antibody responses and personality types following two doses
of COVID-19 vaccines.
Materials and Methods:
A total of 738 participants who received two doses of COVID-19 vaccines (AstraZeneca
ChAdOx1, n=29; Pfizer-BioNTech, n=119; Sinopharm BBIBP, n=590) and had no prior SARS-CoV-2 infection were
enrolled. Serum samples were collected 21–28 days after the second dose, and SARS-CoV-2 RBD (S) IgG antibodies
were measured using ELISA (Proteintech Inc., USA). Personality types were assessed using a 56-item temperament
questionnaire developed by A. Belov, categorizing individuals into classical temperament types (choleric, phlegmatic,
sanguine, melancholic). Logistic regression and ROC analysis were used to examine associations between personality
types and antibody response.
Results:
The presence of an antibody response was significantly higher among individuals with a melancholic tempera
ment, and significantly lower among those with a phlegmatic temperament. Furthermore, antibody titers were higher in
participants with melancholic and sanguine temperaments and lower in those with a phlegmatic type.
Conclusions
1. During the early period following the second dose of COVID-19 vaccination, the antibody response was higher
in individuals with a pure melancholic temperament, while it was lower in those with a phlegmatic temperament.
2. After the second dose of the Sinopharm BBIBP COVID-19 vaccine, antibody titers were higher in individuals with
pure melancholic and sanguine temperaments, and lower in those with a phlegmatic temperament.