Ophthalmologic

Senile ptosis is a disease often seen in ophthalmology. If not treated timely, this condition can result in unwanted consequences both cosmetic and functional terms. This paper addressed to clinical features of senile ptosis and the efficiency of surgical correcting procedures. Subjects: Target groups of the study consist of over sixty years old patients suffering senile ptosis who were treated at the National Institute of Ophthalmology between 2002 - 2005. Method: the author had investigated senile ptosis clinical features and its correction surgery with three ways: excision of excessive skin, frontalis suspension operation, aponeurotic resection and resection of Muller's muscles (by Tyers A. G.). Results and conclusion: References drawn from the study on senile ptosis clinical features are as follows: Senile ptosis is often seen in patients aged between 60 and 65, the highest rate of ptosis (56.25%) at the over 70-years-old group, 100% of such patients have excessive skin; These surgeries are highly efficient for correction of senile ptosis. Our series of 55 eyes, 70,59, per cent (36 eyes) achieved a good results, 25.49 per cent (13 eyes) achieved an average results and 3.92 percent (2 eyes) achieved a poor results with an average follow up of 12 months. Though preliminary results are very encouraging, further study is still needed to optimized the treatment.
Eye Diseases, Ophthalmologic Surgical Procedures, Blepharoptosis, Therapeutics

OPHTHALMOLOGY ; OPHTHALMOLOGIC SURGICAL PROCEDURES/HISTORY ; PHILIPPINES

Ophthalmologic Surgical Procedures ; Ophthalmology ; COVID-19

Human ; BLEPHAROPLASTY ; OPHTHALMOLOGIC SURGICAL PROCEDURE ; RECONSTRUCTIVE SURGICAL PROCEDURE ; PLASTIC SURGERY

Objectives: Refractive changes have been studied after muscle surgery in literature but most results are inconsistent. It has been postulated that changes in corneal tension after muscle surgery may cause a change in corneal curvature resulting in the change in refraction postoperatively. This study investigated changes in corneal topography and clinical refraction after horizontal rectus muscle surgery. Methods: Twenty-one eyes of 13 patients underwent horizontal rectus muscle surgery via limbal approach. Manifest refraction, cycloplegic refraction, and corneal topography were measured preoperatively, and postoperatively at day 1 and weeks 1, 2, 4 and 8. The proportion of subjects with at least 0.5 D change from preoperative measurements and the proportion of subjects that needed new prescription postoperative were also computed. Analysis of the results were done using the Friedman test to identify significant differences among measurements at different time periods with post-hoc analysis utilized to identify specific time periods with significant changes from preoperative measurements. Results: Mean corneal keratometry, horizontal, vertical, and oblique astigmatism, obtained topographically showed no significant difference from preoperative measurements. The statistically significant difference in corneal astigmatism in the recession group at day 1, week 4 and week 8 postoperatively was not confirmed when converted to power vectors in both vertical/horizontal (J0) and oblique (J45) astigmatism. Clinical refraction showed a transient myopic shift in spherical equivalent, statistically significant only on postoperative day 1 in the recession group. There was no statistically significant difference in clinical astigmatism. There was ≥ 0.5 D change in spherical equivalent in 60% in both study groups by the end of follow-up. The shift in J0 was more than 10% in the recession group. More than fifty percent (52.4%) needed new prescription for glasses. Conclusion No statistically significant change in corneal topography and clinical refraction following horizontal rectus muscle surgery were found. Patients should still be refracted at least 2 weeks postoperatively to check if there is a need for change in prescription glasses to improve alignment and/or improve vision.
Astigmatism ; Oculomotor Muscles ; Ophthalmologic Surgical Procedures ; Vision Tests ; Strabismus

BACKGROUND: A transcaruncular approach is typically used for reconstructions of medial wall fractures. However, others reported that a transconjunctival approach was conducive for securing an adequate surgical field of view. In this study, we aimed to examine the extent of repair of medial wall fracture via a transconjunctival approach. METHODS: We retrospectively reviewed the medical records of 50 patients diagnosed as having medial wall fracture via preoperative computed tomography and who underwent surgery between March 2011 and February 2014. The fracture location was defined by dividing each of the anterior-posterior and superior-inferior distances into three compartments. RESULTS: A transcaruncular approach was used in 7 patients, while the transconjunctival approach was performed in the remaining 43 patients. The transconjunctival approach enabled a relatively broad range of repair that partially included the front and back of the medial wall, and was successful in 86% of the entire study population. CONCLUSION: It is known that more than 50% of total cases of the medial wall fracture occur mainly in the middle-middle portion, a majority of which can be reconstructed via a transconjunctival approach. We used a transconjunctival approach in identifying the location of the fracture on image scans except for cases including the fracture of the superior portion in patients with medial wall fracture. If it is possible to identify the location of the fracture, a transconjunctival approach would be an useful method for the reconstruction in that it causes no damages to the lacrimal system and is useful in confirming the overall status of the floor.
Humans ; Medical Records ; Methods ; Ophthalmologic Surgical Procedures ; Orbital Fractures ; Orbital Implants ; Reconstructive Surgical Procedures ; Retrospective Studies

We report a case of possible venous air embolism (VAE) during trans pars plana vitrectomy with air-fluid exchange of the vitreous cavity. Shortly after initiation of air-fluid exchange, decreases in end-tidal CO2, oxygen saturation, and blood pressure were observed. The patient rapidly progressed to cardiac arrest unresponsive to cardiopulmonary resuscitation, and recovered after the application of percutaneous cardiopulmonary support. Prompt termination of air infusion is needed when VAE is suspected during air-fluid exchange, and extracorporeal life support should be considered in fatal cases. Although the incidence is rare the possibility of VAE during ophthalmic surgery clearly exists, and therefore awareness and vigilant monitoring seem critical.
Blood Pressure ; Cardiopulmonary Resuscitation ; Embolism, Air* ; Heart Arrest* ; Humans ; Incidence ; Ophthalmologic Surgical Procedures ; Oxygen ; Vitrectomy

PURPOSE: To present a case of ocular sparoganosis presenting as itching sensation. METHODS: A 60-year-old woman presented for removal of an itchy subconjunctival mass in her left eye. Her ocular findings were normal, except for a subconjunctival mass (1.5 x 1.5 mm). RESULTS: A parasite excised from the subconjunctival mass was identified as a sparganum, by microscopic examination after hematoxylin-eosin staining. The mummified parasite was identified as the plerocercoid phase of the sparganum, by microscopy. CONCLUSIONS: Although rare, parasitic disease should be suspected in a palpable subconjunctival mass unresponsive to the medical treatment.
Sparganosis/*complications/pathology/surgery ; Pruritus/*etiology ; Ophthalmologic Surgical Procedures ; Middle Aged ; Korea ; Humans ; Female ; Eye/*parasitology

BACKGROUNDSo far, most of the surgical techniques for congenital blepharophimosis syndrome are two-stage procedures. In this study, we investigated a modified one-stage procedure to reduce the suffering of patients.

METHODSFrom 2003 to 2005, we adopted an one-stage technique combining blepharoptosis correction with medial canthoplasty in 16 patients with congenital blepharophimosis syndrome (10 male, 6 female; aged from 6 to 21). All the patients had bilateral severe blepharoptosis, epicanthus inversus, and flat dorsum nasi. The movement of the upper lid was 0 to 3 mm, vertical length of the eye fissure 2 to 4 mm, horizontal length 13 to 22 mm, and the distance between the eyes was 35 to 39 mm. The patients were followed up for one half to 2 years after the operation.

RESULTSIn all the patients, after the operation, the horizontal length of the eyelid > 25 mm, the vertical length > 6 mm. and the distance between the eyes < 35 mm. The appearance of their double eyelids was satisfying.

CONCLUSIONThe modified one-stage technique combining blepharoptosis correction with medial canthoplasty can achieve favorable outcomes for patients with congenital blepharophimosis syndrome.

Adolescent ; Adult ; Blepharophimosis ; pathology ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Male ; Ophthalmologic Surgical Procedures ; methods