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Deep sclerectomy with bevacizumab and mitomycin C: a comparative study.

PURPOSE: To assess the comparative efficacy and safety of primary deep sclerectomy (DS) augmented with subconjunctival Bevacizumab and intraoperative Mitomycin C (MMC). METHODS: Retrospective, comparative case-control series of consecutive primary DS between January 2008 and December 2010. Seventy-five eyes of 73 patients were included, with 32 eyes in the MMC and 43 in the Bevacizumab group. MMC (0.2 mg/mL for 2 min) was applied subconjunctivally before scleral flap dissection. Bevacizumab (2.5 mg in 0.1 mL) was injected subconjunctivally at the end of surgery. Complete success was intraocul…

Sutureless scleral fixation of intraocular lenses: outcomes of two approaches. The 2014 Yasuo Tano Memorial Lecture.

PURPOSE: We sought to assess the clinical outcomes and complications of two approaches to scleral fixation of intraocular lenses (IOLs): transconjunctival fixation through trocar cannulas and fixation using scleral tunnels created with a microvitreoretinal (MVR) blade. METHODS: This retrospective chart review was comprised of 23 eyes that received scleral fixation of a three-piece IOL with concurrent pars plana vitrectomy between June 2012 and June 2014. Scleral fixation was performed either by transconjunctival fixation through trocar cannulas (cannula fixation) or by the creation of scleral…

Partial lamellar sclerouvectomy of ciliary body tumors in a Korean population.

PURPOSE: To describe the clinical characteristics of ciliary body tumors, surgical outcomes, and factors associated with poor visual outcome and metastasis. DESIGN: Retrospective case series. METHODS: Medical records of 27 patients with ciliary body tumors who underwent partial lamellar sclerouvectomy in a single-center setting (Seoul, South Korea) were reviewed. Surgical outcomes were reviewed, and clinical characteristics were analyzed with respect to visual prognosis and globe retention rate. RESULTS: Tumors were diagnosed histopathologically as benign in 8 (30%) cases and as melanoma in

Topical plus subconjunctival anaesthesia: foldable intraocular lens implantation in eyes without capsule support through a self-sealing incision.

PURPOSE: To evaluate the clinical outcomes of topical plus subconjunctival anaesthesia for secondary implantation of foldable intraocular lens (IOL) (Ophtec PC 425Y) in eyes without capsule support through a self-sealing incision. METHODS: We reviewed the medical records of 22 patients (22 eyes) who received topical plus subconjunctival anaesthesia for scleral fixation of a foldable IOL through small incision. The scleral incision technique was used for IOL scleral fixation. Twelve eyes had traumatic cataract, seven had postphacoemulsification complications and three were aphakic. We studied …

Expanding MIRAgel scleral buckle simulating an orbital tumor in four cases.

PURPOSE: To describe four patients with an enlarging orbital mass from a swollen MIRAgel scleral buckle that simulated an orbital neoplasm. METHODS: In a retrospective, single-center case series at the Ocular Oncology Service at Wills Eye Hospital of Thomas Jefferson University, 4 eyes of 4 patients were referred for evaluation and treatment of a suspected orbital tumor. RESULTS: The initial presenting features were orbital mass (case 1), strabismus (case 2), and conjunctival mass with orbital extension (cases 3 and 4). Each patient vaguely recalled previous uncomplicated retinal detachment …

Ocular and systemic findings in relapsing polychondritis.

The ocular and systemic findings in 112 Mayo Clinic patients with relapsing polychondritis were reviewed. The incidence of males and females was equal, with median age at diagnosis of 51 years and the median follow-up of 6 years. Most patients had several organ systems involved at the time of the diagnosis. Twenty-one patients had ocular symptoms at the onset, and 57 developed ocular symptoms during their course. Major ocular complications included proptosis, lid edema, episcleritis/scleritis, corneal infiltrates/thinning, iridocyclitis, retinopathy, and optic neuritis. The major system involv

Effect of Resveratrol on MMP-2 Expression in Scleral Fibroblasts: An In Vitro Study.

PURPOSE: To investigate the effects of resveratrol (Res) on human fetal scleral fibroblasts (HFSFs) and its potential mechanism. METHODS: HFSFs were randomly divided into the Res-treated group and the control group. Following, HFSFs were treated with or without a concentration of 10 μM Res for 48 h. To detect the expression of related genes, reverse transcription quantitative PCR (RT-qPCR) and western blotting were used. The apoptosis rate of different groups was determined using flow cytometry. RESULTS: The mRNA expression of matrix metalloproteinase 2 (MMP-2), Collagen, Type I, Alpha 1 (CO…

Decreased Choroidal Blood Perfusion Induces Myopia in Guinea Pigs.

PURPOSE: The development of myopia in guinea pigs can be inhibited by attenuating scleral hypoxia by increasing choroidal blood perfusion (ChBP). In this study, we reduced ChBP through surgical and pharmacological methods to determine the effect on myopia development. We also determined whether ChBP was reduced by quinpirole, a drug that enhances form-deprivation myopia (FDM). METHODS: ChBP was reduced in the right eyes of guinea pigs via transection of the temporal ciliary arteries or daily injections of phenylephrine into the inferior peribulbar space for one week during normal ocular growt…

Anterior Segment Optical Coherence Tomography Angiography Imaging of Conjunctiva and Intrasclera in Treated Primary Open-Angle Glaucoma.

PURPOSE: To investigate conjunctival and intrascleral vasculature in glaucoma eyes using anterior segment (AS)-optical coherence tomography angiography (OCTA) and assess the factors contributing to the vessel density in AS-OCTA images. DESIGN: Prospective, cross-sectional study. METHODS: Thirty-four patients with primary open-angle glaucoma and 20 healthy subjects were included. A swept-source OCT system was used to obtain the AS-OCTA images of the corneoscleral limbus at the nasal and temporal quadrants. Vessel densities were measured in the superficial (from the conjunctival epithelium to …

Long-term effect of corneoscleral contact lenses on refractory ocular surface diseases.

PURPOSE: To report the therapeutic effect of corneoscleral contact lenses (CLs) with a diameter of 14.0 mm on the refractory ocular surface diseases. METHODS: Medical records of 13 eyes (of nine patients) attempted for fitting with corneoscleral CLs for the management of the severe refractory ocular surface diseases were retrospectively reviewed including Stevens-Johnson syndrome (SJS; eight eyes) and chronic ocular graft-versus-host disease (GVHD; five eyes). Lenses were fitted to improve refractory punctate epithelial erosions (PEE, ten eyes) and persistent epithelial defect (PED, three eye…

Outcomes of intraocular lens scleral fixation with the friction knot technique.

PURPOSE: To examine the clinical outcomes of intraocular lens (IOL) scleral fixation with the friction knot technique. METHODS: Retrospective case series of 152 eyes of 152 patients with inadequate capsular bag support operated with the friction knot IOL scleral fixation technique by a single surgeon. The fixated IOLs were one-piece or three-piece models all with open loop haptics. Main outcome measures were change in corrected distance visual acuity (CDVA) and postoperative complications. RESULTS: The mean follow-up time was 11.7 months (median 4.9, range 0.7-64.8). The mean logarithm of th…

Pro-fibrotic pathway activation in trabecular meshwork and lamina cribrosa is the main driving force of glaucoma.

While primary open-angle glaucoma (POAG) is a leading cause of blindness worldwide, it still does not have a clear mechanism that can explain all clinical cases of the disease. Elevated IOP is associated with increased accumulation of extracellular matrix (ECM) proteins in the trabecular meshwork (TM) that prevents normal outflow of aqueous humor (AH) and has damaging effects on the fine mesh-like lamina cribrosa (LC) through which the optic nerve fibers pass. Applying a pathway analysis algorithm, we discovered that an elevated level of TGFβ observed in glaucoma-affected tissues could lead to

Rates of glaucomatous visual field change before and after transscleral cyclophotocoagulation: a retrospective case series.

BACKGROUND: The primary goal of glaucoma treatment is to lower and control intraocular pressure (IOP) and thereby prevent functional deterioration. For glaucomas that are refractory to medical and incisional surgical therapies, transscleral diode cyclophotocoagulation (TCP) is a well-established procedure to effectively decrease IOP. This study investigated rates of visual field (VF) change in patients with glaucoma before and after TCP. METHODS: This retrospective case series investigated rates of VF changes in glaucoma patients before and after they underwent TCP. At least four VF examinati…

Uveal melanoma treated with iodine-125 episcleral plaque: an analysis of dose on disease control and visual outcomes.

PURPOSE: To investigate, in the treatment of uveal melanomas, how tumor control, radiation toxicity, and visual outcomes are affected by the radiation dose at the tumor apex. METHODS AND MATERIALS: A retrospective review was performed to evaluate patients treated for uveal melanoma with (125)I plaques between 1988 and 2010. Radiation dose is reported as dose to tumor apex and dose to 5 mm. Primary endpoints included time to local failure, distant failure, and death. Secondary endpoints included eye preservation, visual acuity, and radiation-related complications. Univariate and multivariate a

From post-war reconstruction to the twenty-first century - ophthalmic pathology in Freiburg 1945-2015. Part 2: review of 43,169 histological diagnoses from 39,256 specimens collected over 71 years at a large German tertiary eye care centre.

BACKGROUND: Ophthalmic pathology is essential for diagnosing ocular diseases, correlating clinical and histopathological findings, and advancing research. The Eye Center at the University of Freiburg, Germany, has archived histopathological specimens since 1945, offering a unique resource to analyse long-term diagnostic trends. This study examines 43,169 diagnoses from 39,256 specimens over 71 years (1945–2015), providing insights into the evolution of ophthalmic pathology at a major tertiary care centre. METHODS: We performed a retrospective analysis of all archived ophthalmic pathology repor

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… Sclera Among all the registered 38 scleral samples, the most frequent diagnosis was normal sclera (32%), which was removed during trabeculectomy, followed by scleritis (27%). … Despite this, normal sclera was the most frequent diagnosis in the intervals 1975–1984 (50%, n = 2) and 1995–2004 (60%, n = 6). …

[Study on the correlation between color Doppler flow imaging and histopathology of choroidal melanoma].

Objective: To explore the correlation between the characteristics of color Doppler flow imaging (CDFI) and histopathological manifestations … by CDFI and the internal blood flow characteristics of the tumor, tumor size, clinical stage, extra-scleral extension grade of the tumor, and cell type were analyzed. The consistency between CDFI and histopathological results was compared using the Adler semi-quantitative method. Paired Wilcoxon signed-rank test and Hodges-Lehman method were used for sta …

Probable intrafamilial transmission of coxsackievirus b3 with vertical transmission, severe early-onset neonatal hepatitis, and prolonged viral RNA shedding.

Here we report a familial cluster of 3 cases of coxsackievirus B3 infection: a recent history of illness in a woman's 3-year-old son with a … g/mL]), suggestive of disseminated intravascular coagulopathy. Clinical examination revealed yellow sclera, hepatomegaly (5 cm), and splenomegaly (2 cm), consistent with hepatitis. Serial chest radiographs showed bilateral pleural effusions, and an ultrasound of the abdomen demonstrated ascites. An echocardiogram showed normal cardiac structure and good …