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External vs. Endonasal Endoscopic Dacryocystorhinostomy: Surgical Success and Patient Satisfaction 鼻内镜下泪囊鼻腔造瘘术:手术成功率和患者满意度
Pub Date : 2020-10-22 DOI: 10.4172/2324-8599.1000225
Suresh Rasaily, Ben Limbu, R. Saiju
Introduction: The aim of study was to compare and analyze surgical success and patient satisfaction in doing external dacryocystorhinostomy and endonasal endoscopic dacryocystorhinostomy for the management of primary acquired nasolacrimal duct obstruction at tertiary care referral hospital in Kathmandu, Nepal. Methods: Hospital based prospective, comparative, nonrandomized, interventional study. A total of 70 patients, 36 patients (36 eyes) in external DCR group and 34 patients (36 eyes) in endoscopic DCR group, diagnosed as primary nasolacrimal duct obstruction (PANDO) meeting inclusion criteria were enrolled in the study from 1st June 2015 to 30 May 2016 with additional 6 months and consecutive six months follow up were observed for all patients. Postoperative symptomatic improvement and patency of lacrimal passage on syringing were analysed in each follow up. The success was defined by both symptomatic improvement and patent lacrimal passage on syringing at 6 months after surgery. Intraoperative and postoperative complications were also evaluated. Patient satisfaction and quality of life were analysed using Glasgow Benefit Inventory Questionnaire. Statistical analysis was done using IBM SPSS 21 version software programme. The pvalue< 0.05 was considered statistically significant. Results: Total of 72 DCR surgeries (36 in each group) were performed in 70 primary NLDO patients including 2 bilateral endoscopic DCR. Mean age of presentation in external DCR was 45.17 years ± 6.05 SD (range, 21–61 years) whereas in endoscopic DCR group was 31.28 years ± 10.54 SD (range, 15-41 years). Female preponderance was seen in both groups (F: M=27: 9 in Ex-DCR group and 28:6 in En-DCR). Overall, success rate is 95.83% (n=69 out of 72). Intergroup success rate was almost similar in both groups (Ex-DCR 35/36, 97.22% and En-DCR 34/36, 94.44% and p value=1.00). The mean total score from GBI was 46.60 ± 10.61 (95% CI, 22.22-75) and 62.89 ± 18.03 (95% CI, 22.22-91.67) in Ex-DCR and En-DCR groups respectively, p value<0.001. The mean general subscale score was 44.33 ± 13.33 (95% CI, 12.50-70.83) in Ex- DCR group and 63.77 ± 19.33(95% CI, 2.50-95.83) in En- DCR group and P-value<0.001. Social support subscale was 46.76 ± 11.14 (95% CI, 0-66.67) in Ex-DCR and 49.54 ± 18.03 (95% CI, 0-83.33) in En-DCR group and p-value=0.276. Physical health subscale score was 56.48 ± 15.57(95% CI, 50-100) in Ex-DCR group and 74.54 ± 14.95 (95% CI,-66.67-100) in En-DCR p-value<0. 001. The commonest intraoperative and post-operative complication was bleeding in both groups. However, intra-operative complication rate (En- DCR, 12 (33.33%, Ex-DCR 3 (8.33%) and p-value=0.01 and postoperative complication rate (En-DCR, 11 (30.66%), Ex- DCR 19 (52.78%) p-value=0.06. Conclusion: Surgical success rate is almost comparable in both groups. Endoscopic DCR was found to have higher intraoperative complication but minimal post-operative complication compared to external DCR. Endoscopic DCR was found
简介:本研究的目的是比较和分析尼泊尔加德满都三级转诊医院采用外部泪囊鼻腔造瘘术和鼻内窥镜泪囊鼻腔造瘘术治疗原发性获得性鼻泪管阻塞的手术成功率和患者满意度。方法:以医院为基础的前瞻性、比较、非随机、介入性研究。本研究于2015年6月1日至2016年5月30日招募符合纳入标准的原发性鼻泪管梗阻(PANDO)患者共70例,其中外用DCR组36例(36眼),内窥镜DCR组34例(36眼),并对所有患者进行6个月及连续6个月的随访。每次随访均分析术后症状改善情况及泪道通畅情况。术后6个月症状改善和泪道通畅是成功的标志。术中及术后并发症也进行了评估。采用格拉斯哥福利量表对患者满意度和生活质量进行分析。采用IBM SPSS 21版软件进行统计分析。p值< 0.05认为有统计学意义。结果:70例原发性NLDO患者共行DCR手术72例(每组36例),其中双侧内镜下DCR 2例。外部DCR组的平均发病年龄为45.17岁±6.05 SD(范围21-61岁),而内窥镜DCR组的平均发病年龄为31.28岁±10.54 SD(范围15-41岁)。两组均有女性优势(Ex-DCR组F: M= 27:9, En-DCR组28:6)。总体成功率为95.83% (n=69 / 72)。两组间成功率基本一致(Ex-DCR 35/36, 97.22%; En-DCR 34/36, 94.44%, p值=1.00)。Ex-DCR组和En-DCR组GBI平均总分分别为46.60±10.61 (95% CI, 22.22 ~ 75)和62.89±18.03 (95% CI, 22.22 ~ 91.67), p值<0.001。Ex- DCR组一般亚量表平均得分为44.33±13.33 (95% CI, 12.50 ~ 70.83), En- DCR组平均得分为63.77±19.33(95% CI, 2.50 ~ 95.83), p值<0.001。前dcr组社会支持分量表为46.76±11.14 (95% CI, 0-66.67),后dcr组为49.54±18.03 (95% CI, 0-83.33), p值=0.276。Ex-DCR组身体健康亚量表评分为56.48±15.57(95% CI, 50-100), En-DCR组p值<0为74.54±14.95 (95% CI,-66.67-100)。001. 两组最常见的术中及术后并发症均为出血。但术中并发症发生率(En-DCR 12例(33.33%),Ex-DCR 3例(8.33%),p值=0.01;术后并发症发生率(En-DCR 11例(30.66%),Ex-DCR 19例(52.78%),p值=0.06。结论:两组手术成功率基本相当。与外部DCR相比,内镜下DCR术中并发症更高,术后并发症最少。与外部DCR相比,内镜下DCR患者满意度更高。
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引用次数: 2
A Short Note on Glaucoma 青光眼简记
Pub Date : 2020-09-30 DOI: 10.37532/IOPJ.2020.9(4).244
Akhila Sabbineni
Glaucoma is an eye disorder that can damage the optic nerve. The optic nerve supplies visual information to your brain from the eyes. Glaucoma is usually, results of abnormally high pressure inside your eye. Over time, the increased pressure can erode optic nerve tissue, which may lead to vision loss or blindness. If it’s treated early, you may be able to prevent additional vision loss.
青光眼是一种会损害视神经的眼部疾病。视神经从眼睛向大脑提供视觉信息。青光眼通常是由于眼睛内部异常高压引起的。随着时间的推移,压力的增加会侵蚀视神经组织,这可能导致视力下降或失明。如果及早治疗,你可能能够防止额外的视力损失。
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引用次数: 0
Quantitative Measurement of Vascular Density and Flow Using Optical Coherence Tomography Angiography in Patients with Vasculitis; Can OCTA detect the vasculitis? 光学相干断层成像血管造影定量测量血管炎患者血管密度和血流OCTA能检测血管炎吗?
Pub Date : 2020-09-30 DOI: 10.37532/IOPJ.2020.9(4).247
Ramak Roohipoor, Mirataollah Salabati, M. Zarei, Nazanin Ebrahimiadib, M. Rajabi, H. R. Esfahani, Bahman Inanloo, Fatemeh Bazv
Methods: Patients with uveitis and vasculitis in at least one eye were included and compared with 50 eyes from healthy individuals. The OCTA was done for each patient and control subject. The images were analysed at three capillary plexuses layers (superficial and deep retinal capillary layers and choriocapillaris layer). contact lens was placed on the corneal surface. Corneal edema decreased gradually in one month post-operatively. Results: Fifty-five eyes from 28 patients were enrolled in the study. Studied eyes were categorized into 4 groups: 1-eyes with posterior vasculitis (38 eyes), 2-eyes with peripheral vasculitis without posterior vasculitis (7 eyes), 3-fellow uninvolved eyes of patients with unilateral vasculitis (10 eyes), and 4-eyes of healthy controls (50 eyes). The whole vascular density and parafoveal vascular density in both superficial and deep retinal capillary plexuses were reduced significantly from group 4 to group1. A decreasing trend in macular blood flow was also observed from group 4 followed by group 3, group 2 and group 1 in all three capillary layers including superficial retinal capillary plexus, deep retinal capillary plexus and choriocapillaris. By choosing the threshold of 26.2, the formula (-0.447×F1ch+75.82×VDdp) was the best model to differentiate the vasculitis group from the control group with an area under the curve (AUC) of 0.979, the sensitivity of 98% and specificity of 92.3%. (F1ch: flow in the central 1mm-radius-circle of the choriocapillaris, and VDdp: vascular density of parafoveal in the deep capillary network). Conclusion: In patients with vasculitis, especially in the cases with posterior pole involvement, OCTA showed reduced vascular density and flow in all three capillary layers. OCTA might be a helpful tool to give us additional information about the macular microvasculature changes under inflammatory conditions.
方法:纳入至少一只眼睛有葡萄膜炎和血管炎的患者,并与50只健康人的眼睛进行比较。对每位患者和对照组进行OCTA检查。对三个毛细血管丛层(视网膜浅、深毛细血管层和绒毛膜毛细血管层)的图像进行分析。隐形眼镜放置在角膜表面。术后1个月角膜水肿逐渐减轻。结果:来自28名患者的55只眼睛被纳入研究。被研究的眼睛分为4组:1只眼有后侧血管炎(38只),2只眼有外周血管炎但无后侧血管炎(7只),3只眼有单侧血管炎(10只),4只眼健康对照(50只)。4组与1组相比,视网膜浅、深毛细血管丛的全血管密度和凹旁血管密度均显著降低。视网膜浅毛细血管丛、视网膜深毛细血管丛、绒毛膜毛细血管等3个毛细血管层的黄斑血流从4组开始依次减少,3组、2组和1组依次减少。选择阈值为26.2,公式(-0.447×F1ch+75.82×VDdp)为区分血管炎组与对照组的最佳模型,曲线下面积(AUC)为0.979,敏感性为98%,特异性为92.3%。(F1ch:脉络膜毛细血管中央1mm半径圈内的血流,VDdp:深层毛细血管网中央凹旁血管密度)。结论:血管炎患者,特别是后极受累的患者,OCTA显示所有三层毛细血管密度和血流减少。OCTA可能是一种有用的工具,可以为我们提供炎症条件下黄斑微血管变化的额外信息。
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引用次数: 0
Iridocorneal Endothelial Syndrome Management is tough but Never Impossible. A Case Series Study 虹膜内皮综合征的治疗是困难的,但从来都不是不可能的。案例系列研究
Pub Date : 2020-09-29 DOI: 10.37532/IOPJ.2020.9(4).245
S. Noman
Purpose: To document and describe clinical manifestations and management approaches to patients diagnosed with Iridocorneal Endothelial (ICE) syndrome presenting at the Glaucoma Department, Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh. Design: A hospital-based prospective observational case series review. Participants: 25 patients who were diagnosed as ICE syndrome from November 2007 to October 2009. Method: Patient particulars, history with main causes of hospital presentations were recorded. Ophthalmic examination details including tonometry, slit lamp examination, gonioscopy, indirect ophthalmoscopy, visual fluid examination and management given were documented. Similar relevant details were recorded for three follow up periods on all patients extending over a total period of 12 months. Main outcome measure: Significant observations, pattern or associations within the cohort. Results: 25 patients were included in the study. There were 15 female and 10 male patients. All 25 cases were unilateral. The mean age of the patients was 41 ± 15.27 years. Among them 15(60%) had pre-treatment visual acuity between 6/9 – 6/18 and 10(40%) had 6/24 – 6/60). Improved visual acuity was observed one year after starting treatment. 21 patients (84%) presented with eccentric pupil (corectopia), 9 patients (36%) with peripheral anterior synechiae, 6 patients (32%) with iris atrophy, 6 patients (24%) with mild corneal oedema, 3 patients (12%) with ectropion uveae, 2 patients (8%) with polyconic and 11 patients (44%) presented with pigmentary changes over iris (like diffuse iris naevus). Mean IOP at presentation was 24.08 ±14.3 mmHg and that of last follow-up was 17.38 ± 7.57 mmHg. IOP was controlled with 2 – 3 topical anti glaucoma medications in 8 patients (32%); with only observation in 5 patients (20%) and with surgical intervention in 12 patients (48%). Conclusion: Although ICE syndrome is a refractory glaucoma, control of Intraocular Pressure (IOP) and preservation of visual acuity were seen in 52% of cases which had conservative management with topical medications and observation. Patients not responding to medical management needed surgery for the control of intraocular pressure.
目的:记录和描述孟加拉国吉大港眼科医院和培训中心青光眼科诊断为虹膜角膜内皮(ICE)综合征患者的临床表现和治疗方法。设计:以医院为基础的前瞻性观察病例系列综述。研究对象:2007年11月至2009年10月诊断为ICE综合征的25例患者。方法:记录患者资料、病史及主要住院原因。记录眼科检查细节,包括眼压计、裂隙灯检查、角膜镜检查、间接眼镜检查、视液检查和治疗。对所有患者进行为期12个月的三次随访,记录了类似的相关细节。主要结果测量:在队列中有意义的观察、模式或关联。结果:25例患者纳入研究。女性15例,男性10例。25例均为单侧。患者平均年龄41±15.27岁。其中15例(60%)术前视力在6/9 ~ 6/18之间,10例(40%)术前视力在6/24 ~ 6/60之间。开始治疗一年后,视力有所改善。21例(84%)患者表现为瞳孔偏心(纠正斜视),9例(36%)患者表现为周围前粘连,6例(32%)患者表现为虹膜萎缩,6例(24%)患者表现为轻度角膜水肿,3例(12%)患者表现为葡萄膜外翻,2例(8%)患者表现为多圆锥,11例(44%)患者表现为虹膜色素改变(如弥漫性虹膜痣)。患者首发时平均眼压为24.08±14.3 mmHg,末次随访时平均眼压为17.38±7.57 mmHg。8例患者(32%)使用2 - 3种外用抗青光眼药物控制IOP;仅观察5例(20%),手术干预12例(48%)。结论:虽然ICE综合征是一种难治性青光眼,但在局部用药和观察保守治疗的情况下,52%的患者眼压得到了控制,视力得到了保持。治疗无效的患者需要手术控制眼压。
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引用次数: 0
Short Note on Ophthalmology 关于眼科的简短说明
Pub Date : 2020-09-29 DOI: 10.37532/IOPJ.2020.9(4).243
Akhila Sabbineni
Ophthalmology is that the study of medical conditions regarding the eye. Ophthalmologists are doctors specialized in the medical and surgical operation of the eye. A general observe doctor could refer somebody to associate oculist if they show symptoms of cataracts, eye infections, cranial nerve issues, or different eye conditions. In this article, we glance at what ophthalmologists do, as well as the categories of conditions that they treat, the procedures they perform, and once someone would possibly see this specialist. Share on Pinter Esan oculist could treat cataracts, eye infections, and cranial nerve issues. An oculist may be a medical doctor World Health Organization makes a specialty of identification and treating eye related conditions.
眼科学是关于眼睛的医学状况的研究。眼科医生是专门从事眼科医学和外科手术的医生。如果患者出现白内障、眼部感染、脑神经问题或其他眼部疾病的症状,一般观察医生会将患者转介给眼科助理医生。在这篇文章中,我们大致了解一下眼科医生的工作,以及他们治疗的疾病类别,他们进行的手术,以及一旦有人可能会去看这位专家。Esan眼科医生可以治疗白内障、眼部感染和脑神经问题。眼科医生可能是一名医生。世界卫生组织专门从事识别和治疗与眼睛有关的疾病。
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引用次数: 0
Recalcitrant Tattoo-Associated Uveitis 顽固性纹身相关葡萄膜炎
Pub Date : 2020-09-05 DOI: 10.36266/jop/102r
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引用次数: 0
Surgery of an Idiopathic Macular Hole in the Eyes Accompanied by Dry, Age Related Macular Degeneration Own Results 伴有干性、年龄相关性黄斑变性的眼部特发性黄斑孔的手术治疗
Pub Date : 2020-08-04 DOI: 10.37532/IOPJ.2020.9(2).236
Adam Cywiński
The paper presents own results of surgical treatment of a full thickness macular hole in eyes, where age-related macular degenerative changes of the “dry” type were also found. The use of conventional surgical technique has resulted in a favourable anatomical and functional effect. An idiopathic, full thickness macular hole accompanied by dry changes of age-related macular degeneration should be treated in the same way as a typical macular hole without macular degeneration.
本文介绍了自己的结果手术治疗全层黄斑孔的眼睛,其中年龄相关的黄斑退行性变化的“干”型也被发现。常规手术技术的应用已取得良好的解剖和功能效果。特发性全厚度黄斑孔伴干性变化的老年性黄斑变性应与典型的黄斑孔无黄斑变性的治疗方法相同。
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引用次数: 0
Short Note on Crossed Eyes 关于斗眼的简短笔记
Pub Date : 2020-08-03 DOI: 10.37532/IOPJ.2020.9(3).240
Akhila Sabbineni
Crossed eyes, also called strabismus, it is a condition in which your eyes do not line up. If you have crossed eyes, your eyes look in different directions. And each eye will focus on a two different object. The condition is usually common in children, but it can also occur later in life. In older people, children and adults, crossed e yes can be caused by a variety of underlying medical conditions, like cerebral palsy or stroke. Crossed eyes can usually be treated with corrective lenses, surgery, or a combination of both. If you have strabismus, your eyes might point inward or outward o r focus on different directions. You might also have impaired vision, double vision, decreased depth perception, eyestrain, or headache.
斜视,也被称为斜视,是一种你的眼睛没有对齐的情况。如果你有斜视,你的眼睛会朝不同的方向看。每只眼睛都会聚焦在两个不同的物体上。这种情况通常在儿童中很常见,但也可能在以后的生活中发生。在老年人、儿童和成年人中,交叉e yes可能是由各种潜在的疾病引起的,如脑瘫或中风。交叉眼通常可以通过矫正镜片、手术或两者结合进行治疗。如果你有斜视,你的眼睛可能向内或向外,或者聚焦在不同的方向。你也可能有视力受损、复视、深度知觉下降、眼睛疲劳或头痛。
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引用次数: 0
Editorial Note on Tear-Deficient Dry Eye 关于泪水缺失型干眼症的社论注释
Pub Date : 2020-08-03 DOI: 10.37532/IOPJ.2020.9(3).242
Akhila Sabbineni
The tears in eyes make do much more than your sorrow when you cry. These glands produce a constant supply of liquid. Your eyes should always be moist. Whenever you blink, the action drags tear along the surface of your eye. This keeps it wet, clean, and healthy. If your glands do not produce enough tears, you can get a condition called aqueous tear-deficient dry eye. It causes pain in eye, redness, and vision loss problems.
当你哭的时候,眼里的泪水比你的悲伤更重要。这些腺体产生源源不断的液体。你的眼睛应该一直湿润。每当你眨眼的时候,这个动作就会把眼泪拖到你的眼睛表面。这使它保持湿润、清洁和健康。如果你的腺体没有产生足够的眼泪,你可能会患上一种名为水性眼泪缺乏型干眼症的疾病。它会导致眼睛疼痛、发红和视力下降。
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引用次数: 0
Short Note on Cataract 白内障简介
Pub Date : 2020-08-03 DOI: 10.37532/IOPJ.2020.9(3).239
Akhila Sabbineni
Cataract is a cloudy area which forms in the lens of the eyes. Cataract usually begins when protein in the eye forms clumps and prevents the lens from sending clear images to retina. Retina usually works by converting the light that comes from lens into signals. It sends the signals to optic nerve and sends to brain and slowly interfere with vision and develops Cataract. Slowly in both eyes. But it will not affect both eyes at a time. Generally, Cataract are most common in older people. a medical condition in which the lens of the eye are not able to see, resulting in blurred vision. "she had cataracts in both eyes". Most cataracts develop in older people or injury changes the tissue that makes up your eye's lens. Some inherited genetic disorders cause other health problems which can increase the risk of cataracts. Cataracts can also be caused by other eye conditions, past eye surgery or medical conditions such as diabetes. Cataract leads to blindness when untreated.
白内障是在眼睛的晶状体中形成的浑浊区域。白内障通常是在眼睛中的蛋白质形成团块并阻止晶状体向视网膜发送清晰图像时开始的。视网膜通常通过将来自晶状体的光转换成信号来工作。它将信号发送到视神经,再发送到大脑,慢慢地干扰视力,发展为白内障。两只眼睛慢慢地看。但它不会同时影响两只眼睛。一般来说,白内障在老年人中最常见。视力模糊一种医学状况,眼睛的晶状体不能看东西,导致视力模糊“她双眼都有白内障”。大多数白内障发生在老年人身上,或者损伤改变了构成晶状体的组织。一些遗传性遗传病会引起其他健康问题,从而增加患白内障的风险。白内障也可能由其他眼部疾病、过去的眼部手术或糖尿病等疾病引起。如果不治疗,白内障会导致失明。
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引用次数: 0
期刊
International Journal of Ophthalmic Pathology
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