Purpose: To describe a new technique for transconjunctival intrascleral fixation of Cionni CTR using double-flanged polypropylens suture. Methods: This is a prospective interventional case series which included 7 cases with severe (more than 180 degrees) zonular dialysis. Three cases were hereditary lens subluxation (Marfan syndrome), 2 cases with traumatic subluxation and 2 cases with pseudoexfoliation syndrome. Results: All cases achieved a good postoperative stable and centered IOL with good visual results. No postoperative complications were recorded apart from PCO in 3 cases and mild bleeding during needle passage in one case. Conclusion: This described technique is a simple, time sparing and minimally invasive method for achieving good bag centration. It eliminates the need of conjunctival peritomy, subconjunctival vessels cautery and scleral fashioning of a flap, pocket or a groove. The use of 6/0 polypropylene theoretically can achieve better longevity.
This technique of four-point scleral fixation of posterior chamber IOLs reduces the operation time, achieves good centration and stability of the IOL, and minimises postoperative suture-related complications.
Purpose: To describe the efficiency and visual results of a new method of transconjunctival intrascleral fixation of single-piece foldable IOL using double-flanged 6/0 prolene suture. Materials and Methods: Seventeen aphakic eyes of 17 patients without adequate capsular support were involved in this study. Lens was prepared by passing the 6/0 prolene suture in a track in the haptic of single-piece foldable IOL created by 31 g needle. The 6/0 prolene suture was retrieved through a 30 g needle transconjunctivally to outside the globe; then, IOL was implanted and a terminal bulb was created at the outer end of the prolene suture. Results: All cases were aphakic after complicated phacoemulsification. In 10 cases hydrophilic IOLs were used and in 7 cases hydrophobic IOLs were used. There is clear statistically significant difference between pre-UCVA and post-UCVA. Complications included suture slippage in 2 cases and prolene bulb exposure in one case. There was no significant difference in endothelial cell count and IOP before and after 3 months. Conclusion: Transconjunctival intrascleral fixation of foldable single-piece IOLs is a safe efficient method for correcting aphakia.
Both aflibercept and bevacizumab are comparably effective for treatment of macular edema secondary to central retinal vein occlusion without significant complications. However, the burden of frequent intravitreal injections could be significantly reduced when using aflibercept.
Background. The stress response to laryngoscopy and intubation causes an undesirable increase in heart rate, blood pressure, and intraocular pressure. This study was designed to compare the effect of two doses of gabapentin on the stress response to laryngoscopy and intubation. Patients and Methods. (ASA I and II) 60 patients, aged from 18 to 60 years undergoing elective eye surgery requiring endotracheal intubation, were randomly allocated into 3 groups, 20 patients each. 2 hours before the surgery, group I received oral placebo, and groups II and III received oral gabapentin 800 mg and 1200 mg, respectively. Heart rate (HR), mean arterial pressure (MAP), and intraocular pressure (IOP) were measured before and after induction of anesthesia, immediately after, 5 minutes, and 10 minutes after intubation. Results. Gabapentin 1200 mg prevented the increase in HR, MAP, and IOP, secondary to laryngoscopy and intubation, and kept them below the baseline till 10 minutes after intubation ( < 0.001), while with gabapentin 800 mg, the increase in HR, MAP, and IOP was nonsignificant ( > 0.05) and returned to levels below the baseline at 5 and 10 minutes after intubation. Conclusion. Preoperative gabapentin 1200 mg effectively prevented the stress response to laryngoscopy and intubation; meanwhile, gabapentin 800 mg only prevented significant stress response.
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