BackgroundReport of three patients with pseudophakic angle-closure from a Soemmering ring. Three mechanisms of the Soemmering ring induced pseudophakic angle-closure in three patients were demonstrated by meticulous anterior segment examination and ultrasound biomicroscopic (UBM) analysis.Case presentationIn the first case, the Soemmering-capsule-IOL complex caused relative pupillary block similar to a phakic eye and was successfully treated with laser iridotomy alone. In the second case, an enlarged Soemmering ring provided posterior iris support in apposition to the anterior chamber angle. We performed a laser capsulotomy through the iridotomised hole. The last, a protruding Soemmering content causing absolute pupillary block became resolved after laser iridotomy and total Soemmering ring content removal.ConclusionAngle-closure in pseudophakic eyes is uncommon. Several causes have been reported in the literatures including Soemmering ring. This is the first report on three different mechanisms of Soemmering ring related angle-closure in pseudophakic eyes. Ultrasound biomicroscopic analysis plays a crucial role as a diagnostic tool.
To study the affect of anatomical variance of lacrimal sac fossa on dacryocystorhinostomies (DCR) performed by the traditional external (EX-DCR) approach or an endoscopic (EN-DCR) endonasal approach. A total of 292 consecutive cases with primary nasolacrimal obstruction underwent DCR surgery. Orbital computed tomography scan was used to measure lacrimal sac fossa and other related structures and Lac-Q questionnaire was used to compare surgery result. Maxillary portion of lacrimal sac fossa is thicker in failed surgery group than successful surgery group (P<0.05). Lateral nasal structures (uncinate process, operculum of the middle turbinate, agger nasi) are dominantly adjusting to lacrimal sac fossa in failed surgery group (P<0.05). Patients who underwent EX-DCR has a 6.0-point and EN-DCR group 11.0-point improvement (P<0.016) in Lac-Q questionnaire. Patients who have a thick frontal process of the maxilla and uncinate process, operculum of the middle turbinate, ethmoid cells adjusting to lacrimal fossa are prone to have recurrence of nasolacrimal duct obstruction after DCR surgery. The EN-DCR and the EX-DCR approach have an equivalent surgical success rate but improvement in quality of life by using the Lac-Q questionnaire is greater in the endoscopic group when compared with the external.
Purpose. To compare the outcomes of transcanalicular diode laser-assisted dacryocystorhinostomy (TCL-DCR), nonendoscopic endonasal dacryocystorhinostomy (NEN-DCR), and external dacryocystorhinostomy (EXT-DCR) as first-line treatments for functional epiphora. Methods. This multicenter, retrospective, case-control study included 135 eyes of 135 patients with functional epiphora (86 females and 49 males). Functional epiphora was diagnosed based on a patent lacrimal system with a delay in the fluorescein dye disappearance test (FDDT) or dacryoscintigraphy (DSG) and no ocular surface or eyelid abnormalities. The patients were treated with TCL-DCR (2008–2011) or Ext-DCR (2005–2008, 2011–2017) at Beyoglu Eye Research Hospital (Istanbul, Turkey) and NEN-DCR at Carrot Eye Surgery Clinic affiliated with the McMaster University (Hamilton, ON, Canada) (2010–2016). Success was defined as the absence of epiphora and the normalization of an earlier delayed FDDT after surgery. Results. The TCL-DCR, NEN-DCR, and EXT-DCR groups consisted of 38, 47, and 50 eyes with 25.9, 44.2, and 45.9 months of follow-up. The success rate for TCL-DCR was 65.8%, 70.2% for NEN-DCR, and 84.0% for EXT-DCR. During the follow-up period, 13.2% of TCL-DCR cases and 6.4% of NEN-DCR cases developed an anatomic obstruction of the lacrimal system. Conclusion. The EXT-DCR group had a higher success rate in the management of functional epiphora than the NEN-DCR and TCL-DCR groups and was significantly safer in terms of an iatrogenic anatomic block of the lacrimal system.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.