Background: To explore the safety and effectiveness of Sclera patch grafts in the management of scleral defects.
Methods: This is a retrospective uncontrolled study. Medical records were retrospectively reviewed for 8 eyes of 8 patients with sclera patch grafts. Two patients had necrotizing scleritis, 2 patients had scleral melting/perforation secondary to thermal burns, 4 patients had scleral staphyloma secondary to surgery. Sclera was reconstructed with allogenic sclera patch grafts, 6 in 8 patients combined autologous conjunctival pedicle flap, 1 patient combined partial medial rectus translocation, 1 patient combined autologous pedicle tenon graft, simultaneously. Treatment outcomes were evaluated using structural integrity, best corrected visual acuity (BCVA), scleritis remission, sclera rejection and melt, and ocular symptoms.
Results: Eight patients were reviewed. In all of these cases, satisfactory anatomic and functional outcomes were achieved. In the at least half a year follow-up, the BCVA of all the eight patients were no worse than that of preoperative. No eye pain, foreign body sensation and other discomforts showed in all the patients, except one woman, who showed sclera rejection and melt 1 month postoperative. In addition, one patient showed high intraocular pressure (28 mmHg), which can be controlled by a kind of medicine.
Conclusions: In this series, sclera patch grafts is an effective method for management scleral defects in the at least half a year following-up. Attention should be paid to the sclera patch rejection and melt post operatively.
Background: To report a new simplified surgical technique to manage small iris coloboma or traumatic iris defect.
Methods: A new surgical technique in which simplified pupilloplasty technique through only a clear corneal paracentesis to manage the iris coloboma or traumatic iris defect within the 120° range was designed. A retrospective revision of the medical records of patients treated with this technique between the years 2013 and 2016 was made. Six eyes of six patients with iris coloboma or traumatic iris defect treated with this new technique were included.
Results: All the operated eyes quickly recovered with central round pupil, negligible complications, inessential symptoms of photophobia and glare, and mild inflammation after a median follow-up time of 22 months (range: 6–34 months).
Conclusions: The simplified pupilloplasty technique presented here could be a good alternative for the management of small iris coloboma or traumatic iris defect.
Background: To settle the fundamentals of a numerical procedure that relates retinal ganglion-cell density and threshold sensitivity in the visual field. The sensitivity of a generated retina and visual pathways to virtual stimuli are simulated, and the conditions required to reproduce glaucoma-type defects both in the optic-nerve head (ONH) and visual fields are explored.
Methods: A definition of selected structural elements of the optic pathways is a requisite to a translation of clinical knowledge to computer programs for visual field exploration. The program is able to generate a database of normalized visual fields. The relationship between the number of extant receptive fields and threshold sensitivity is plotted for background sensitivity and corresponding automated perimetry. A solution in two planes to the 3D distribution of axons in the ONH is proposed. Visual fields with induced damage in the optic disc are comparable in pattern and quantity to glaucomatous records.
Results: The two-level simulation of the ONH facilitates the analysis of optic-cup/retinal defects. We can generate the virtual optic pathways tailored to the age and morphology of the patient’s eye, and it is possible to reproduce glaucomatous damage by “reverse engineering” engineering. The virtual cortical model renders a quantitative relationship between visual defect and neural damage.
Conclusions: A two-level computing of the retina/optic nerve facilitates the analysis of neuroretinal defects and can be incorporated to automatic perimeters to facilitate visual field analysis.
Background: To evaluate efficacy and safety of combined pars plana vitrectomy (PPV) and scleral fixated intraocular lens (SFIOL) surgery as a single procedure.
Methods: Retrospective interventional case series done at a tertiary eye care center in Northern India. Eleven patients who underwent combined PPV and SFIOL surgery were included and analyzed retrospectively.
Results: Mean age of the patients was 43.36±15.12 years (range, 22–64 years). Eight were male. Mean baseline best corrected visual acuity (BCVA) was 0.78±0.63 logMAR units while the mean post-operative BCVA at 6 months follow-up was 0.37±0.29 logMAR units, the visual gain being statistically significant (P=0.021). None of the patients had a drop in BCVA with nine patients having final BCVA better than 0.48 logMAR units. Choroidal detachment (CD) was the only notable complication, seen in three patients. Other complications included two cases of intraoperative retinal breaks, a case each of reversible corneal edema, ocular hypertension and cystoid macular edema.
Conclusions: Combined PPV and SFIOL is an efficacious procedure for managing IOL/lens dislocation and aphakia in a single surgery. There may be short-term reversible complications with no impact on final visual gain.
Abstract: Tea is the second most popular beverage worldwide after water. Green tea has the highest nutraceutical values with well-established general health benefits and wide safety margins. Natural polyphenols found in green tea, including (+)-catechin (C), (–)-epicatechin (EC), (+)-gallocatechin (GC), (–)-epigallocatechin (EGC), (–)-epicatechin-3-gallate (ECG), (–)-gallocatechin-3-gallate (GCG) and (–)-epigallocatehin-3-gallate (EGCG). They have many potent biological properties and therapeutic effects in human health and diseases. These small molecules have high bioavailability and specific therapeutic potential in eye tissues. Recently some researchers studied the metabolomic responses to the green tea. In this talk, summary of these studies will be reviewed and its potential applications in the ocular research will be discussed.
Abstract: Myopia prevalence is dramatically increasing in recent years and in cases in which the refractive error is greater than ?6.00 D this disease can lead to severe visual impairment as well as even blindness. Changes in visual input affect the balance between ocular growth and refractive power development. If a mismatch occurs during eye development, the severity of this error affects the degree of myopia. In different animal models of this disease, we found that spatial visual stimuli are essential for maintaining a stable refractive status and normal vision. This is evident because the effects of changes in temporal visual stimuli (e.g., flickering light) on this process depend on whether spatial information is present or absent in the visual environment. Furthermore, the frequency, wavelength and intensity of light are involved in controlling refraction development. However, the molecular mechanisms underlying light-induced refraction changes are still unclear. There is definitive evidence that dopamine (DA) is one of the regulators of this process. This retinal neurotransmitter released by dopaminergic amacrine cells appears to play an important role in vision-guided eye growth because its synthesis and release are positively associated with the light intensity and spatial stimuli impinging on the retina. We found that bright light enhances retinal DA synthesis, and attenuates form deprivation myopia (FDM) development via activation of the dopamine receptor 1 (D1R). A nonselective DA receptor agonist apomorphine (APO) inhibited FDM in dopamine receptor 2 (D2R) knockout mice. These individual similar effects of DA and APO in wildtype and D2R knockout mice suggest that D1R activation has a protective effect against myopia development. On the other hand, D2R activation instead appears to promote myopia development because either genetic D2R ablation or pharmacological inactivation of D2R also attenuates myopia development. Based on these results, we hypothesize that the visual environment regulates the retinal DA levels, which in turn affects the relative balance between D1R and D2R activation. When D1R is relatively hyperactivated, the ocular refractive status shifts towards hyperopia. In contrast, such an effect on D2Rpromotes the refractive status to shift in the opposite direction towards myopia.
