We might be in the age of vitrectomy, but we believe that scleral buckling is the treatment of choice for certain retinal detachments
But which patients are the best candidates for a primary scleral buckle and how should surgery be approached?
We overview when primary buckling should be considered and provide guidance on which techniques will help success, as well as when to avoid a primary buckle
Welcome to scleral buckling 101 for the senior ophthalmology resident and the junior retina fellow!
Mahmoud A Khaimi
Dean McGee Eye Institute, Oklahoma City, OK, USA
Background: While loteprednol etabonate (LE) suspension 0.5% is approved for the treatment of postoperative ocular inflammation, there have been no reported studies of its use in glaucoma patients undergoing canaloplasty.
Methods: This was a retrospective medical chart review conducted at a single US center. Data were collected on patients with glaucoma who underwent canaloplasty with or without cataract surgery, and were prescribed LE suspension 0.5% postoperatively. Outcomes evaluated included postsurgical inflammation (anterior chamber [AC] cells and flare), intraocular pressure (IOP), number of IOP-lowering medications, and postsurgical complications.
Results: Data were collected on 204 patients (262 eyes) with a mean (SD) age of 71.6 (11.3) years. The most frequent LE dosing regimens at day 1, week 1, and month 1 postsurgery were QID (92.3%; 241/261), TID (52.6%; 133/253), and QD (65.5%; 78/119), respectively. Inflammation (AC flare and cells), mostly mild, was noted in 33.2% (86/259) of eyes on postoperative day 1 and 8.6% (21/244) of eyes at month 1. Mean IOP and mean number of IOP-lowering medications were significantly reduced from baseline (P<0.001) at all time points postoperatively. Complete (no IOP-lowering medication) or qualified (use of ≤2 IOP-lowering medications) surgical success was achieved in 78.8% and 90.6% of eyes, respectively, at month 6 and 63.4% and 92.7% of eyes at month 36. The most frequently observed postoperative complication was hyphema in 48.7% (126/259) eyes at day 1, which decreased to 0.4% (1/244) of eyes by month 1. IOP ≥30 mmHg was noted in 13 (5.3%) eyes at postoperative week 1 and rarely thereafter, and no patient discontinued therapy because of an IOP increase.
Conclusion: These real-world data suggest that canaloplasty with or without cataract surgery managed postoperatively with LE suspension 0.5% is effective and safe in the glaucoma patient.
AcrivaUD Trinova is manufactured with Seamless Vision Technology (SVT) that is invented by VSY Biotechnology. The SVT is a unique patent pending technique to produce an IOL optical surface which does not exhibit any sharp edges. It provides best optical performance in trifocal IOL design. The lens shape is derived from sinusoidal functions and results in smoothly varying surface profiles. Therefore ideal continuous vision is achieved as opposed to common traditional overlapping diffraction pattern trifocal IOLs with sharp edges. This concept also helps to reduce halos and scattered light.
At a Glance
Cambodia has a small population of 15 million, but there are only 32 ophthalmologists – and only 23 who are surgically trained
The incidence of blindness is high and on the increase, despite 90 percent of all cases being preventable
The Khmer Sight Foundation (KSF) was initiated to bring eyecare to Cambodians who need it most
Here, we share the story of the first mission, and look to the future of KSF – and preserving the sight of the Cambodian population.
Кто говорит, что ротация это плохо?
2018 starts with welcoming a new WGA President: Keith Martin, Professor and Head of Ophthalmology, University of Cambridge, UK. The new President Elect is Fabian Lerner, Professor of Ophthalmology, University Favaloro School of Medical Sciences in Buenos Aires, Argentina.
At the Executive Office we welcome Shan Lin, Professor of Clinical Ophthalmology at the University of California, San Francisco, US as Executive Vice President and Kaweh Mansouri, Consultant at the Glaucoma Center, Montchoisi Clinic, Lausanne, Switzerland as Associate Executive Vice President.
New members of the WGA Board of Governors per 2018 are Arthur Sit (Rochester, Minnesota United States), Ingeborg Stalmans (Leuven, Belgium), Fotis Topouzis (Thessaloniki, Greece) and Lingam Vijaya (Chennai, India).
When patients receive a new diagnosis of glaucoma, they suddenly face the numerous, complex trade-offs in risks and benefits posed by the three main options for therapy—medications, laser surgery, and incisional surgery. For a majority of patients, starting a topical glaucoma medication is the most intuitive first step of treatment. The practice of instilling eye drops may be familiar if they wear contact lenses or have administered topical ophthalmic solutions for dry eye disease or allergic conjunctivitis. Moreover, for many of them, daily medication use is already a part of their routine.
Clinical Minute distills a peer-reviewed study into what is relevant for practicing clinicians/surgeons in approximately one minute.
In the debut episode of this series, Neda Shamie, MD, outlines a recent paper by Iqbal Ike K. Ahmed, MD, FRCSC, on the Xen implant (Allergan). The paper offers surgical pearls and patient management protocols to ensure successful outcomes with this microinvasive glaucoma surgical device.
What is the advantage to you of publishing in Pharmacogenomics and Personalized Medicine?
It is an open access journal which means that your paper is available to anyone in the world to download for free directly from the Dove website.
Although Pharmacogenomics and Personalized Medicine receives many papers, unlike most traditional journals, your paper will not be rejected due to lack of space. We are an electronic journal and there are no limits on the number or size of the papers we can publish.
The time from submission to a decision being made on a paper can, in many journals, take some months and this is very frustrating for authors. Pharmacogenomics and Personalized Medicine has a quicker turnaround time than this. Generally peer review is complete within 4-7 weeks and the editor’s decision within 2-14 days of this. It is therefore very rare to have to wait more than 9 weeks for a final decision.
Many authors have found that our peer reviewer’s comments substantially add to their final papers.
Question What is the association of systemic medication with intraocular pressure in a multiethnic Asian population?
Findings In a post hoc analysis of a population-based study of 8063 participants from 3 ethnic groups (Chinese, Malays, and Indians), lower intraocular pressure was more likely associated with participants using systemic β-blockers, whereas higher intraocular pressure was more likely associated with participants using angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, statins, or sulfonylureas.
Meaning The effect of commonly dispensed systemic medication on intraocular pressure may have implications for glaucoma risk in individuals taking these medications for coexisting comorbidities.
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