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Omoto T, Agata C, Akiyama R, Kitamoto K, Toyono T, Yoshida J, Yamagami S, Usui T, Miyai T. Iridotrabecular and Iridocorneal Contact Changes after Cataract Surgery and Endothelial Keratoplasty in Bilateral Iridoschisis. Case Rep Ophthalmol 2021; 12:198-203. [PMID: 33976682 PMCID: PMC8077475 DOI: 10.1159/000513793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/14/2020] [Indexed: 12/03/2022] Open
Abstract
We report a case of bilateral iridoschisis with corneal oedema and a quantitative evaluation of the changes in iridotrabecular and iridocorneal contact before and after cataract surgery and after Descemet stripping automated endothelial keratoplasty (DSAEK). A 76-year-old woman with iridoschisis and cataracts, previously managed with laser iridotomy, experienced progressive vision loss. The preoperative iridotrabecular contact (ITC) index measured by anterior segment optical coherence tomography was 23.6% in the right eye and 24.4% in the left eye. Preoperative corneal oedema in the right eye was more severe than that in the left eye. Cataract surgery, followed by DSAEK, was performed in the right eye and subsequently in the left eye. Her visual acuity improved postoperatively, and the corneal oedema of both eyes was treated successfully. Moreover, the ITC index improved in both eyes, to 4.7 and 6.9% after cataract surgery and to 0 and 0% after DSAEK in the right and left eyes, respectively. Staged cataract surgery and DSAEK were effective for endothelial decompensation caused by iridoschisis. Additionally, we confirm that iridotrabecular and iridocorneal contacts improved after both surgical procedures not only after cataract surgery but also after DSAEK. This case report showed the clinical usefulness of the ITC index in the detection of changes after different surgical procedures.
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Affiliation(s)
- Takashi Omoto
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Chisato Agata
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Tokyo Teishin Hospital, Tokyo, Japan
| | - Reina Akiyama
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.,JR Tokyo General Hospital, Tokyo, Japan
| | - Kohdai Kitamoto
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Tetsuya Toyono
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Junko Yoshida
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Department of Ophthalmology, International University of Health and Welfare, Chiba, Japan
| | - Satoru Yamagami
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Department of Visual Sciences, Nihon University School of Medicine, Tokyo, Japan
| | - Tomohiko Usui
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Department of Ophthalmology, International University of Health and Welfare, Chiba, Japan
| | - Takashi Miyai
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
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Jeon GS, Han J. Effectiveness of Scleral Buckling with a Wide-Field Surgical Microscope and Chandelier Illumination in Retinal Detachment Repair. Ophthalmologica 2019; 242:31-37. [DOI: 10.1159/000496165] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 12/10/2018] [Indexed: 11/19/2022]
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Nagpal MP, Mahuvakar SA, Chaudhary PP, Mehrotra NS, Jain AK. Chandelier-assisted retroillumination for phacoemulsification in phacovitrectomy. Indian J Ophthalmol 2018; 66:1094-1097. [PMID: 30038149 PMCID: PMC6080457 DOI: 10.4103/ijo.ijo_85_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose: To describe chandelier-assisted retroillumination for phacoemulsification in patients with poor fundal glow due to posterior segment pathology during combined phacovitrectomy procedure. Methods: This was a prospective observational study. Thirty eyes underwent combined phacoemulsification and 25G sutureless pars plana vitrectomy. Sclerotomy port for chandelier tip was made in the inferotemporal or superonasal quadrant based on the incision site for phacoemulsification. Later, it was replaced with infusion cannula or endoilluminator. Cases included had posterior segment pathologies such as vitreous hemorrhage and vitritis. Results: Red reflex was markedly enhanced during phacoemulsification for all cases. In all eyes, a continuous curvilinear capsulorhexis was achieved without the use of dye. The posterior capsule remained intact in all cases. The visual acuity in all patients improved, and the median best-corrected visual acuity was 20/60 (range: 4/60–20/30) at 6 months. There were no intraoperative or postoperative complications. Conclusion: Cases with poor red reflex pose a challenge for anterior segment surgeons, and chandelier-assisted retroillumination proves to be a safe and effective tool in combined phacovitrectomy surgeries. Moreover, no additional cannula port is required for this chandelier insertion.
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Affiliation(s)
- Manish P Nagpal
- Department of Retina, Retina Foundation and Eye Research Clinic, Asopalav Eye Hospital, Ahmedabad, Gujarat, India
| | - Sheetal A Mahuvakar
- Department of Retina, Retina Foundation and Eye Research Clinic, Asopalav Eye Hospital, Ahmedabad, Gujarat, India
| | - Pranita Prakash Chaudhary
- Department of Retina, Retina Foundation and Eye Research Clinic, Asopalav Eye Hospital, Ahmedabad, Gujarat, India
| | - Navneet S Mehrotra
- Department of Retina, Retina Foundation and Eye Research Clinic, Asopalav Eye Hospital, Ahmedabad, Gujarat, India
| | - Ashish K Jain
- Department of Retina, Retina Foundation and Eye Research Clinic, Asopalav Eye Hospital, Ahmedabad, Gujarat, India
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