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Abdullah OO, Oksuz H. A simplified sclerocorneal tunnel approach in performing pediatric cataract surgery. Oman J Ophthalmol 2024; 17:91-95. [PMID: 38524322 PMCID: PMC10957051 DOI: 10.4103/ojo.ojo_321_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/01/2023] [Accepted: 01/02/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND/AIMS Performing pediatric lensectomy, anterior vitrectomy with intraocular lens implantation in one session, using a long sclerocorneal tunnel and covering the incision site with 8/0 Vicryl sutures. MATERIALS AND METHODS This study includes 52 eyes of 30 patients with pediatric cataracts. At the temporal side, the conjunctival peritomy was performed, followed by two long sclerocorneal side ports and the main incision for intraocular lens (IOLs) implantation. At the end of the operation, the side port and the conjunctiva incisions were sutured with 8/0 Vicryl sutures. The IOLs were implanted in children older than 24 months, not in smaller ones. The operations and intraoperative complications were recorded. After the operation, the patients were examined on the 1st postoperative day, then six times for the first 6 months. During follow-ups, the impact of the suture on the anterior segment complications and astigmatism was evaluated. RESULTS The age of the patients ranged between 2 months and 8 years. The average operation time was 28 ± 6 min. Due to the suture-related complication, neither re-suturing nor stitch removal was carried out; therefore, general anesthesia was not repeated. The average astigmatism value of the children in the postoperative 1st week was 1.5 ± 1.2 D (0.5-4.0). The mean astigmatism value was 0.8 ± 0.5 D (0.5-1.5) in the 3rd postoperative month. CONCLUSION The long corneoscleral tunnel method has been found safe in pediatric cataract surgery.
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Affiliation(s)
- Omer Othman Abdullah
- The Private Ibinsina Modern Eye and Retina Center, Retina Department, Erbil, Iraq
| | - Huseyin Oksuz
- The Private Adana Dunya Goz Hospital, Retina Ddepartment, Adana, Turkey
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Abihaidar N, Thuret G, Gain P, Garcin T. Treatment of Mechanical Corneal Wounds Emergencies during the COVID-19 Pandemic: Absorbable 10-0 Vicryl (Polyglactin 910) Sutures as a Suitable Strategy. J Pers Med 2022; 12:jpm12060866. [PMID: 35743651 PMCID: PMC9225171 DOI: 10.3390/jpm12060866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/16/2022] [Accepted: 05/23/2022] [Indexed: 02/01/2023] Open
Abstract
Background—The COVID-19 pandemic has changed our standard practices: operating rooms were only available for functional emergencies and outpatient visits were drastically reduced in favor of telemedicine. Aim: To report the personalized “one-shot” surgery using absorbable 10-0 Vicryl (V10-0) or polyglactin 910 monofilament in mechanical corneal injuries from February 2020 to December 2021. Methods—Prospective case series with at least 12-months’ follow-up, in a French university hospital. Among the overall population of open or closed-globe emergencies (n = 40), non-penetrating corneal lamellar lacerations (long axis > 2 mm) in zone 1 (OTC group) were treated with V10-0 suture(s) (n = 10), replacing traditional non-absorbable 10-0 nylon suture(s) or medical options in first line. The outpatient visits were performed on day (D)10, month (M)2, M6 then every six months. One interim visit by phone teleconsultation was scheduled between D10 and M2, and other(s) as needed. The main outcome was best-corrected visual acuity (BCVA) at M6. Secondary outcomes included mainly corneal astigmatism (CA) at M6 complications. Results—Among the ten corneal wounds, there were three children (30%), eight domestic accidents (80%), three eyes with metallic foreign bodies (30%), four open-globe injuries (40%), and nine eyes that received high-speed projectiles or sharp objects (90%). The complete V10-0 suture(s) absorption occurred in all eyes between D10 and M2. At M6, mean far and near BCVA decreased from 0.680 ± 0.753 and 0.490 ± 0.338 preoperatively to 0.050 ± 0.071 and 0.220 ± 0.063 logMAR (p = 0.019 and p = 0.025 respectively), mean CA decreased from 4.82 ± 3.86 preoperatively to 1.15 ± 0.66 diopters (p = 0.008). BCVA and CA were unchanged thereafter. No serious adverse event nor repeated surgery occurred. The mean number of teleconsultations was 1.20 ± 0.63 without an additional nonscheduled outpatient visit. Conclusions—The absorbable V10-0 sutures might be a safe and effective alternative for eligible corneal wounds, while reducing the number of outpatient visits, especially for children (no suture removal). The COVID-19 pandemic highlighted that they are ideally suited to logistical challenges.
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Affiliation(s)
- Nicolas Abihaidar
- Ophthalmology Department, University Hospital, 42000 Saint-Etienne, France; (N.A.); (G.T.); (P.G.)
| | - Gilles Thuret
- Ophthalmology Department, University Hospital, 42000 Saint-Etienne, France; (N.A.); (G.T.); (P.G.)
- Institut Universitaire de France, Boulevard Saint-Michel, 75005 Paris, France
- Corneal Graft Biology, Engineering and Imaging Laboratory, BiiGC, EA2521, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, 42000 Saint-Etienne, France
| | - Philippe Gain
- Ophthalmology Department, University Hospital, 42000 Saint-Etienne, France; (N.A.); (G.T.); (P.G.)
- Corneal Graft Biology, Engineering and Imaging Laboratory, BiiGC, EA2521, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, 42000 Saint-Etienne, France
| | - Thibaud Garcin
- Ophthalmology Department, University Hospital, 42000 Saint-Etienne, France; (N.A.); (G.T.); (P.G.)
- Corneal Graft Biology, Engineering and Imaging Laboratory, BiiGC, EA2521, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, 42000 Saint-Etienne, France
- Correspondence: ; Tel.: +33-(0)4-77-12-77-93; Fax: +33-(0)4-77-12-09-95
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Park D, Yong IS, Cho KJ, Cheng J, Jung Y, Kim SH, Lee SH. Thae use of microfluic spinning fiber as an ophthalmology suture showing the good anastomotic strength control. Sci Rep 2017; 7:16264. [PMID: 29176617 PMCID: PMC5701120 DOI: 10.1038/s41598-017-16462-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/13/2017] [Indexed: 11/09/2022] Open
Abstract
Adjusting the mechanical strength of a biomaterial to suit its intended application is very important for realizing beneficial outcomes. Microfluidic spinning fiber have been attracting attention recently due to their various advantages, but their mechanical strength has unfortunately not been a subject of concentrated research, and this lack of research has severely limited their applications. In the current work, we showed the mechanical properties of microfibers can be tuned easily and provided a mathematical explanation for how the microfluidic spinning method intrinsically controls the mechanical properties of a microfluidic spinning fiber. But we were also able to adjust the mechanical properties of such fibers in various other ways, including by using biomolecules to coat the fiber or mixing the biomolecules with the primary component of the fiber and by using a customized twisting machine to change the number of single microfiber strands forming the fiber. We used the bundle fiber as an ophthalmology suture that resulted in a porcine eye with a smoother post-operative surface than did a nylon suture. The results showed the possibility that the proposed method can solve current problems of the microfibers in practical applications, and can thus extend the range of applications of these microfibers.
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Affiliation(s)
- DoYeun Park
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - In Sung Yong
- Department of Bio and Brain Engineering, KAIST, Daejeon, 34141, Republic of Korea
| | - Kyong Jin Cho
- Department of Ophthalmology, College of Medicine, Dankook University, 119 Danaeo-ro, Dongnam-gu, Cheonan-si, Chungcheongnam-do, 31116, Republic of Korea
| | - Jie Cheng
- MOE Key Laboratory of Spectrochemical Analysis & Instrumentation, Collaborative Innovation Center of Chemistry for Energy Materials, Key Laboratory for Chemical Biology of Fujian Province, State Key Laboratory of Physical Chemistry of Solid Surfaces, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen, 361005, China
| | - Youngmee Jung
- Biomaterials Research Center, Korea Institute of Science and Technology, 5, Hwarang-ro 14-gil, Seongbuk-gu, Seoul, 02792, Republic of Korea
| | - Soo Hyun Kim
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
- Biomaterials Research Center, Korea Institute of Science and Technology, 5, Hwarang-ro 14-gil, Seongbuk-gu, Seoul, 02792, Republic of Korea.
| | - Sang-Hoon Lee
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
- School of Biomedical Engineering, College of Health Science, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
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Kwon KA, Shipley RJ, Edirisinghe M, Ezra DG, Rose GE, Rayment AW, Best SM, Cameron RE. Microstructure and mechanical properties of synthetic brow-suspension materials. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 35:220-30. [DOI: 10.1016/j.msec.2013.10.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 10/02/2013] [Accepted: 10/29/2013] [Indexed: 11/17/2022]
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Abstract
PURPOSE Traumatic globe rupture following penetrating keratoplasty is a life-long postoperative concern. We look at a series of penetrating keratoplasties in one institution and determine the rates of traumatic rupture and the outcomes following rupture. The reasons for persisting wound weakness are reviewed, and recommendations for eye protection based on wound strength are given. METHODS A case-control study compared the postsurgical rupture rates for all cases of penetrating keratoplasty to those cases of globe rupture after extracapsular cataract surgery and phacoemulsification. A literature review of corneal wound healing was completed. RESULTS Over 10 years 139 penetrating keratoplasties were performed. The incidence of traumatic rupture following keratoplasty was 5.8%. Fifty percent of those with ruptured globes had a visual outcome of hand movement vision or worse. Of the traumatic ruptures, 37.5% occurred in the first postoperative month. The indication for initial keratoplasty did not influence the rupture rate. In comparison, the general rate of penetrating eye injuries in the population was 2.2/100,000 per annum. The rupture rate for extracapsular cataract surgery was 1/221 (0.45%) and 0/6450 for phacoemulsification. Both of these rates were significantly less than after penetrating keratoplasty (P=0.005, P<0.0001). DISCUSSION Penetrating keratoplasty cases have a higher rate of globe rupture than other ocular procedures. There are 5 important time periods of wound integrity after penetrating keratoplasty. The highest risk period is the month following surgery, when wound strength is derived almost entirely from sutures. The 18 months following surgery are moderately high risk. The month following removal of sutures is a second high-risk period. In the 6 months following this, the wound has a similar strength to the first postoperative year. Following penetrating keratoplasty the cornea never regains its preoperative strength and remains at risk for traumatic rupture for the remainder of the patient's life.
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Affiliation(s)
- Mark J Elder
- Ophthalmology Department, Christchurch Hospital, Christchurch, New Zealand.
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Abstract
Over the past quarter century, advances in our understanding of corneal anatomy, physiology, and wound healing have all played an integral role in the management of corneal trauma. As the etiologies of corneal trauma have changed, so has our understanding of the impact of injury on corneal function as it relates to visual rehabilitation. Numerous new classes of antibiotics, antiinflammatory agents, and tissue adhesives have emerged. Occlusive therapy has advanced from simple pressure patching bandage soft contact lenses and collagen shields. Surgical instrumentation, operating microscopes, viscoelastic substances, and suture materials have all improved the outcomes of corneal trauma repair. Improved understanding of the refractive properties of the cornea through topography and alternative suture techniques has helped us restore the natural corneal curvature and visual outcomes. Consequently, in the last quarter of this century our therapeutic approaches to cornea trauma, both medical and surgical, have improved.
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Affiliation(s)
- M S Macsai
- Division of Ophthalmology, Evanston Northwestern Healthcare, Northwestern University Medical School, Illinois, USA
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Clark D, Fleming W, Bosanquet R, Down E. Load bearing and deformation characteristics of monofilament nylon 66 and their implications for ophthalmic surgery. Phys Med Biol 1996; 41:1233-42. [PMID: 8822788 DOI: 10.1088/0031-9155/41/7/012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The load bearing and deformation characteristics of monofilament nylon 66 have been examined. This material has been shown to have increased strength and altered deformation properties compared to bulk nylon. These features are beneficial in its role as a corneal suture. However, the load bearing performance of monofilament nylon 66 has been shown to be influenced by the manner in which it is stressed, making the task of producing identical stitches difficult. Moreover, a period of rapid relaxation has been shown to occur immediately after installation which makes the time taken to install the suture a critical factor in its subsequent performance. These factors, which are essentially beyond the control of the ophthalmic surgeon, must surely play a significant role in the inconsistent post operative results seen.
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Affiliation(s)
- D Clark
- Regional Medical Physics Department, Newcastle General Hospital, Newcastle upon Tyne, UK
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