INTRODUCTION: Late capsular bag distension syndrome (CBS) is a rare complication of the ^lcataract surgery. AIM: The aim is to present 9 cases with delayed presentation and describe their successful management with surgical approach. METHOD: A two-year retrospective review of 9 cases was undertaken. Anterior segment optical coherence tomography (AS-OCT) was used to confirm this diagnosis. Aspiration of the milky fluid with 26 gauge needle followed by capsular bag lavage was performed and aspirated fluid was examined. RESULTS: Patients showed signs of late CBS 6,56 ± 1,94 years after uncomplicated phacoemulsification with intraocular lens (IOL) implantation into the capsular bag. All 9 patients presented with a turbid fluid collection within the distended capsular bag. AS-OCT showed a hyper-reflective material in the space between the IOL and distended posterior capsule. CONCLUSION: Awareness of the manifestations of CBS and choice of the correct imaging modality may lead to regular diagnosis and successful treatment. Management with aspiration of the milky fluid and lavage of the capsular bag is technically safe and effective procedure. It has the advantage of microbial testing of the fluid. AS-OCT is useful tool to differentiate this condition clearly from IOL opacification and posterior capsule opacification.
- MeSH
- fakoemulzifikace * MeSH
- implantace nitrooční čočky * MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci oční čočky diagnóza etiologie chirurgie MeSH
- optická koherentní tomografie * MeSH
- pooperační komplikace * MeSH
- pouzdro oční čočky * chirurgie diagnostické zobrazování MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- syndrom MeSH
- zraková ostrost fyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: The purpose of this study was to describe 5 cases (10 eyes) that, following purely cosmetic femtosecond laser-assisted keratopigmentation (KTP), showed evolution toward corneal ectasia during a variable postoperative period. METHODS: In a case series, 5 patients after bilateral purely cosmetic KTP showed progressive changes in topographic, refractive, and even in visual performance values manifesting from 6 months to 4 years following the procedure. A femtosecond laser-assisted cosmetic intrastromal KTP technique was performed in all patients using micronized mineral pigments. Two patients underwent a retouch using superficial automated KTP to optimize cosmetic outcome. RESULTS: All patients preoperatively demonstrated normal corneal topography with no intraocular pathology and unimpaired visual acuity. One of the cases developed corneal ectasia after magnetic resonance imaging, another confirmed intensive eye rubbing due to allergic conjunctivitis, and 1 patient underwent previous myopic laser in situ keratomileusis procedure. The rest did not show any preoperative clinical evidence potentially related to the development of the keratectasia. One case rather demonstrated modification of keratometry (K) values than a clear corneal ectasia. Three cases were treated with epi-off corneal cross-linking. CONCLUSIONS: Corneal ectasia is a potential complication after cosmetic KTP and should be included in the preoperative informed consent. A comprehensive preoperative screening is necessary to exclude suspicious cases, and patients should be instructed to avoid eye rubbing and other maneuvers that could affect the potential development of this complication.
- MeSH
- dilatace patologická etiologie MeSH
- dospělí MeSH
- keratokonus * etiologie MeSH
- kosmetické techniky * škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- nemoci rohovky * etiologie diagnóza MeSH
- refrakce oka fyziologie MeSH
- rohovková topografie MeSH
- stroma rohovky chirurgie MeSH
- tetování * škodlivé účinky MeSH
- zraková ostrost fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
IMPORTANCE: Biosimilars may be lower-cost alternatives to originator biologic products, potentially offering expanded access or reduced economic burden, but have not been evaluated with aflibercept in diabetic macular edema (DME). OBJECTIVE: To compare efficacy and safety of MYL-1701P, an aflibercept biosimilar, with reference aflibercept (Eylea [Regeneron]) in DME. DESIGN, SETTING, AND PARTICIPANTS: This was a double-masked, randomized clinical trial that included participants at 77 centers across the US, Europe, Japan, and India. Included in the analysis were individuals 18 years and older with type 1 or type 2 diabetes with central DME and best-corrected visual acuity (BCVA) letter score of 73 to 38 in the study eye using an Early Treatment Diabetic Retinopathy Study (ETDRS) chart. Study data were analyzed from October to December 2021. INTERVENTIONS: Formulations of MYL-1701P (0.5-mg vial) or reference aflibercept every 4 weeks for 5 consecutive intravitreal injections, followed by every 8 weeks through week 52. MAIN OUTCOMES AND MEASURES: The primary outcome was the adjusted difference in least squares mean (SE) change from baseline BCVA letter score at week 8 with an equivalence margin of -3 to +3 letters. Secondary outcomes included change in central subfield thickness (CST), BCVA, number of injections over 52 weeks, incidence of adverse events (AEs), and antidrug antibodies (ADAs). RESULTS: A total of 355 participants (mean [SD] age, 62.2 [9.2] years; 216 male [60.8%]) were randomized to MYL-1701P (179 participants [50.4%]) and aflibercept (176 participants [49.6%]). At week 8, mean (SE) change in BCVA was 6.60 (0.55) letters vs 6.56 (0.55) letters in the MYL-1701P vs aflibercept groups. The adjusted mean difference of 0.04 letters (90% CI, -1.16 to 1.24 letters) met the primary outcome. At week 8, mean (SE) change in CST was -112 (7) μm vs -124 (7) μm in the MYL-1701P vs aflibercept groups (adjusted mean difference, 12 μm; 90% CI, -3 to 26 μm). The incidence of treatment-emergent AEs in the MYL-1701P and aflibercept arms were ocular (30.9% [55 of 178] vs 29.5% [52 of 176]), serious ocular (0.6% [1 of 178] vs 1.1% [2 of 176]), nonocular (65.2% [116 of 178] vs 65.3% [115 of 176]), and serious nonocular (16.9% [30 of 178] vs 11.9% [21 of 176]). The mean (SD) total number of injections was 8.4 (2.1) vs 8.7 (1.8) in the MYL-1701P vs aflibercept groups. The incidence of treatment-induced or treatment-boosted ADAs was 2.8% (5 of 177) vs 5.7% (10 of 176) in the MYL-1701P vs aflibercept arms. CONCLUSIONS AND RELEVANCE: MYL-1701P demonstrated clinical equivalence in regard to efficacy, with comparable safety and immunogenicity, to reference aflibercept. These findings support use of MLY-1701P as an alternative to reference aflibercept. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03610646.
- MeSH
- biosimilární léčivé přípravky * terapeutické užití škodlivé účinky MeSH
- diabetická retinopatie * farmakoterapie diagnóza patofyziologie MeSH
- dvojitá slepá metoda MeSH
- inhibitory angiogeneze * aplikace a dávkování terapeutické užití škodlivé účinky MeSH
- injekce intravitreální * MeSH
- lidé středního věku MeSH
- lidé MeSH
- makulární edém * farmakoterapie patofyziologie diagnóza MeSH
- optická koherentní tomografie MeSH
- receptory vaskulárního endoteliálního růstového faktoru * aplikace a dávkování MeSH
- rekombinantní fúzní proteiny * terapeutické užití aplikace a dávkování MeSH
- senioři MeSH
- vaskulární endoteliální růstový faktor A antagonisté a inhibitory MeSH
- výsledek terapie MeSH
- zraková ostrost * fyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
PURPOSE: The aim of this neurophysiological study was to retrospectively analyze visual evoked potentials (VEPs) acquired during an examination for diagnosing optic nerve involvement in patients with Lyme neuroborreliosis (LNB). Attention was focused on LNB patients with peripheral facial palsy (PFP) and optic nerve involvement. METHODS: A total of 241 Czech patients were classified as having probable/definite LNB (193/48); of these, 57 were younger than 40 years, with a median age of 26.3 years, and 184 were older than 40 years, with a median age of 58.8 years. All patients underwent pattern-reversal (PVEP) and motion-onset (MVEP) VEP examinations. RESULTS: Abnormal VEP results were observed in 150/241 patients and were noted more often in patients over 40 years (p = 0.008). Muscle/joint problems and paresthesia were observed to be significantly more common in patients older than 40 years (p = 0.002, p = 0.030), in contrast to headache and decreased visual acuity, which were seen more often in patients younger than 40 years (p = 0.001, p = 0.033). Peripheral facial palsy was diagnosed in 26/241 LNB patients. Among patients with PFP, VEP peak times above the laboratory limit was observed in 22 (84.6%) individuals. Monitoring of patients with PFP and pathological VEP showed that the adjustment of visual system function occurred in half of the patients in one to more years, in contrast to faster recovery from peripheral facial palsy within months in most patients. CONCLUSION: In LNB patients, VEP helps to increase sensitivity of an early diagnostic process.
- MeSH
- dítě MeSH
- dospělí MeSH
- faciální paralýza patofyziologie diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymská neuroborelióza * patofyziologie diagnóza komplikace MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nemoci zrakového nervu * patofyziologie diagnóza MeSH
- nervus opticus patofyziologie MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- zraková ostrost fyziologie MeSH
- zrakové evokované potenciály * fyziologie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PRCIS: Deep sclerectomy (DS) with fibrin adhesive can constitute a safe alternative to the classic procedure using sutures, providing nonallergenic, nontoxic, and secure adhesion with no sign of aqueous humor outflow obstruction postoperatively. OBJECTIVE: To evaluate short and medium-term postoperative results of DS with a fibrin sealant. PATIENTS AND METHODS: This prospective, noncomparative, interventional case series involves 12 eyes of 12 patients with uncontrolled open angle glaucoma who underwent DS with Esnoper (Clip or V2000) implant between February 2021 and March 2022. A novel method of wound closure (sclera, Tenon fascia, and conjunctiva) employing fibrin glue was used instead of classic sutures. Surgical outcomes assessed include: intraocular pressure and glaucoma therapy reduction, best-corrected visual acuity changes, and number of complications registered peri and postoperatively. All measurements were performed preoperatively, as well as at 1 day, at 1 and 2 weeks, and at 1, 2, 3, 6, 9, and 12 months after surgery. RESULTS: The mean intraocular pressure decreased from 24.0 ± 9.1 mm Hg to 13.8 ± 6.3 mm Hg at 1 year postoperatively ( P < 0.001). Kaplan-Meier survival analysis revealed complete and qualified success rates of 83.3% and 91.7%. The mean glaucoma therapy decreased from 3.2 ± 1.1 to 0.8 ± 1.3 drugs 12 months after surgery ( P < 0.001). Nd:YAG goniopunture was performed in 2 eyes at 1 and 12 months postoperatively. No significant best-corrected visual acuity changes were registered. Perioperatively, we noted a trabeculo-descemet microperforation in 1 eye, transient hypotony in 5 eyes, and mild hyphema in 2 eyes. CONCLUSIONS: Fibrin adhesive provided an effective closure in sutureless DS in the patients included in our study. This modification of classical DS may simplify the surgical technique, ensure secure wound adaptation, optimize healing, and lower the risk of inflammation and fibrosis postoperatively.
- MeSH
- bezstehová chirurgie * metody MeSH
- drenážní implantáty glaukomové MeSH
- fibrinová tkáňová adheziva * terapeutické užití MeSH
- glaukom s otevřeným úhlem * chirurgie patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- nitrooční tlak * fyziologie MeSH
- prospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- skléra * chirurgie MeSH
- sklerostomie * metody MeSH
- tkáňová adheziva * terapeutické užití MeSH
- tonometrie oční MeSH
- výsledek terapie MeSH
- zraková ostrost * fyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Aims: We present two rare cases of non-surgical-related massive spontaneous suprachoroidal hemorrhage. Case report: The first case was a 73-year-old male with uncontrolled hypertension, who presented with left vision loss, only able to perceive light, with very high intraocular pressure (IOP) and blood pressure (BP), 68 mmHg and 196/106 mmHg, respectively. Ocular examination showed a limited fundus view, and the B-scan revealed near kissing suprachoroidal hemorrhage. The second case was a 59-year-old male, post valve replacement surgery on life-long warfarin, who presented with hand movement vision and IOP of 47 mmHg. The B-scan showed massive submacular and suprachoroidal hemorrhage with therapeutic range International Normalized Ratio (INR). Conclusion: Suprachoroidal hemorrhage is one of the rare complications that can be seen in any ocular surgery. However, spontaneous suprachoroidal hemorrhage is a rarer disease. Most of the reported cases are associated with underlying medical conditions. Thus prevention is crucial. This involves ophthalmologists, physicians and general practitioners in managing this group of patients with associated risk factors, for better recognition of this devastating ocular complication in which early detection may reduce ocular morbidity.
- Klíčová slova
- spontánní subarachnoidální krvácení,
- MeSH
- acetazolamid aplikace a dávkování terapeutické užití MeSH
- antihypertenziva aplikace a dávkování terapeutické užití MeSH
- choroidální krvácení * diagnóza farmakoterapie MeSH
- glycerol aplikace a dávkování terapeutické užití MeSH
- latanoprost aplikace a dávkování terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- nitrooční tlak účinky léků MeSH
- senioři MeSH
- výsledek terapie MeSH
- zraková ostrost fyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- angiografie klasifikace metody MeSH
- diagnostické techniky oftalmologické * klasifikace MeSH
- fluorescence MeSH
- indokyanová zeleň terapeutické užití MeSH
- lidé MeSH
- makulární degenerace * diagnóza etiologie MeSH
- neovaskularizace choroidey diagnostické zobrazování MeSH
- optická koherentní tomografie dějiny metody MeSH
- optické zobrazování MeSH
- retina diagnostické zobrazování patologie MeSH
- umělá inteligence MeSH
- zraková ostrost fyziologie MeSH
- zraková percepce MeSH
- zrakové testy dějiny klasifikace metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- Klíčová slova
- zraková neuroplasticita,
- MeSH
- amblyopie * etiologie patologie terapie MeSH
- lidé MeSH
- neuroplasticita * fyziologie MeSH
- zraková ostrost fyziologie MeSH
- zraková percepce * fyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
PURPOSE: To evaluate the long-term results of combining cataract surgery, intraocular lens (IOL) implantation, and Descemet membrane endothelial keratoplasty with peripheral stromal support (DMEK-S). METHODS: The outcomes of 107 eyes of 37 patients who had undergone a combination of cataract surgery, IOL implantation, and DMEK-S between October 2007 and February 2015 were retrospectively evaluated. The average follow-up duration was 18.2 ± 18.3 months (range, 6-84 months). Changes in uncorrected and corrected distance visual acuity, spherical equivalent, and corneal endothelial cell density were analyzed. Intraoperative and postoperative complications were also recorded. RESULTS: The mean logMAR uncorrected distance visual acuity improved from 0.92 ± 0.60 preoperatively to 0.33 ± 0.33, 0.28 ± 0.25, 0.24 ± 0.20, and 0.27 ± 0.27 at 6, 12, 24, and 36 months postoperatively (P < 0.001), respectively. The mean logMAR corrected distance visual acuity improved from 0.62 ± 0.65 preoperatively to 0.17 ± 0.29, 0.13 ± 0.21, 0.07 ± 0.16, and 0.11 ± 0.23 at 6, 12, 24, and 36 months postoperatively (P < 0.001), respectively. The mean endothelial cell density decreases were 50.7% ± 21.1%, 50.8% ± 19.8%, 60.7% ± 16.6%, 62.2% ± 11.8%, and 61.8% ± 20.0% at 6, 12, 24, 36, and 48 months after surgery, respectively. Similar trends, although with slightly better visual outcomes, were found in the subgroup of patients without other eye diseases. The mean final deviation from intended spherical equivalent was 0.77 ± 1.19 D, representing a hyperopic shift. CONCLUSIONS: A combined procedure of cataract surgery, IOL implantation, and DMEK-S is an effective method of treatment in patients with combined corneal disease and cataract, maintaining visual rehabilitation in the long term. Future developments should be performed to minimize the incidence of complications.
- MeSH
- fakoemulzifikace * MeSH
- implantace nitrooční čočky MeSH
- katarakta komplikace MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- nemoci rohovky komplikace MeSH
- počet buněk MeSH
- poruchy zraku rehabilitace MeSH
- retrospektivní studie MeSH
- rohovkový endotel patologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stroma rohovky chirurgie MeSH
- úbytek endoteliálních buněk rohovky patofyziologie MeSH
- výsledek terapie MeSH
- zadní lamelární keratoplastika * MeSH
- zraková ostrost fyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Nearby flanking bars degrade letter identification and resolution, a phenomenon known as contour interaction. However, many previous studies found that the relationship between foveal letter identification and flanker separation is non-monotonic, with an upturn in performance at very small target-to-flanker separations. Here, we replicate this observation and show that a similar upturn occurs also for targets presented at 5 deg in the inferior field, if the target-to-flanker separation is sufficiently small. The presence and magnitude of the observed performance upturn depends on the flanking-bar width, being more evident for narrower compared to wider flanking bars. We interpret our results to indicate that neural interactions between nearby contours reduce performance when the target and flanking bars form discrete neural images. At sufficiently small separations, the images of the target and flanking bars can not be distinguished and performance is governed by the contrast of the target in the blended neural image.
- MeSH
- analýza rozptylu MeSH
- citlivost na kontrast fyziologie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- nahuštění v prostoru MeSH
- senioři MeSH
- světelná stimulace MeSH
- vnímání tvaru fyziologie MeSH
- zraková ostrost fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH