Irrigation-aspiration System Research Articles

Комбинированная операция на переднем и заднем отрезках глаза с дооперационным разрывом задней капсулы

Nowadays intravitreal drug administration occupies one of the leading places in the structure of the treatment of eye diseases. the technique for performing this manipulation is simple and universal. however, there may be complications during it. among them are transient ophthalmohypertension, uveitis, endophthalmitis, as well as damage to the lens and retina. a clinical case of surgical treatment of patient d., aged 81, with damage to the posterior lens capsule and fast cataract development was analyzed. Тhe operation was performed on the device EVa (dorc). retrobulbar anesthesia with ropivacaine (ropivacaine Kabi) FrESEnIUS KaBI norgE, aS (norway) 5.0 ml. paracentesis was performed at 2 and 10 o’clock, tunnel 2.2 mm, introduction of viscoelastic discoVisc (alcon). Сapsulorhexis 4 mm was performed using capsular tweezers. the swollen lens masses were washed with an irrigation-aspiration system. 25g ports were installed 3 mm from the limbus in the lower outer, upper outer, upper inner segments of the eyeball. Тotal vitrectomy was performed in the usual mode (vitreotome cuts 10 thousand per minute and irrigation 70 mm hg). the dislocated lens was also removed using a vitreotome with a frequency of 4,000 cuts per minute. Implantation of the intraocular lens rayone hydrofobic aspheric +22.0 diopters (rayner Intraocular lenses limited, United Kingdom) on the anterior capsulorhexis. Fixation of the Iol was not required because the diameter of the anterior rexis of 4 mm (which is smaller than the diameter of the Iol optics of 6 mm) made it possible to hold the lens. Interrupted 7/0 vicryl sutures were put on the sclera. Тhe approach to surgical treatment chosen by us, based on the patient’s history, examination, tactics of performing surgical intervention, showed its timeliness and effectiveness. Keywords: intravitreal injections, complications, damage of the lens capsule, lens luxation

Long term results of lower limb posttraumatic acute bone defects treated with masquelet technique

IntroductionSeveral alternatives are now available when treating posttraumatic acute bone defects. Masquelet's technique represents a safe procedure to treat lower limb open fractures associated with significant bone defects and allows surgeons to try to reduce complications incidence. Material and MethodsRetrospective study based on patients´ record files and images (2015-2017). Twelve patients suffering acute bone defect, treated using Masquelet technique, were evaluated. A total of ten patients were finally included after exclusion criteria were applied. ResultsAverage time from injury to first stage surgery was 11 days. Free flaps were required in three cases (two latissimus dorsi and one anterolateral thigh flap). Time to second stage surgery was 115 days on average. As bone graft, reaming irrigation-aspiration system was associated to this technique. Consolidation was achieved in all patients but one after an average time of 8.4 months. There was only one case of limb shortening of 20 mm. There was no case of nonunion or infection, and patients could perform daily basic activities independently. VAS mean score was one point one year after final surgery. ConclusionsMasquelet's technique achieves encouraging results when treating lower limb acute bone defects. Using this technique, surgeons could decrease infection incidence in open fractures with severe bone loss. On the other hand, it is a two-stage surgery process, which makes the process longer.

Treatment of recurrent traumatic sternomediastinitis after cardiac surgery

To assess the possibilities of omentoplasty for prevention of complications after redo sternum osteosynthesis for traumatic rupture. The study included 53 patients with recurrent sternal diastasis. Greater omentum was additionally implanted in 19 (35.8%) cases to improve healing and reduce the risk of infectious complications. In 34 patients, redo osteosynthesis was carried out using a metal wire and deployment of irrigation-aspiration system. In 19 patients, omentoplasty was additionally used to close the wound. Omentoplasty was characterized by less duration of lavage (7.4±1.5 vs. 4.2±3.3 days, p<0.0001) and no cases of arrosive bleeding (p=0.04). Omentoplasty reduces duration of treatment and risk of arrosive bleeding.

Spontaneous Anterior Lens Capsule Rupture Of a Patient with Alport Syndrome - A Case Report

BACKGROUND: Alport syndrome is a progressive genetic disease which is characterised by glomerulonephritis, sensorineural deafness and ocular abnormalities.We aimed to present a clinical case of a patient with Alport syndrome with spontaneous anterior lens capsule rupture.CASE REPORT: A 16-year-old male with histologically proven Alport syndrome was hospitalised in the Department of Ophthalmology, University Hospital „Prof. Stoyan Kirkovich“, Stara Zagora with low vision, pain, redness, high IOP and rupture of the anterior lenticular capsule of the right eye. Phacoaspiration was successfully performed (Millenium, Bausch&amp; Lomb, Rochester, New York, USA) with the bimanual irrigation-aspiration system (Geuder AG, Heidelberg, Germany) with excellent visual results.CONCLUSION: As the syndrome is quite rare and can lead to diagnostic difficulties for the ophthalmologist complications such as spontaneous or traumatic rupture of the capsule are not uncommon. In such cases, phacoaspiration is an efficient method for clear lens extraction after ruptures of the anterior lenticular capsule of young patients with Alport syndrome.

Minimally invasive evacuation of parenchymal and ventricular hemorrhage using the Apollo system with simultaneous neuronavigation, neuroendoscopy and active monitoring with cone beam CT

IntroductionThe Apollo system is a low profile irrigation–aspiration system which can be used for the evacuation of intracranial hemorrhage. We demonstrate the feasibility of using Apollo to evacuate intracranial hemorrhage...

Minimally invasive cone beam CT-guided evacuation of parenchymal and ventricular hemorrhage using the Apollo system: proof of concept in a cadaver model

IntroductionThe Apollo system (Penumbra Inc, Alameda, California, USA) is a low profile irrigation–aspiration system designed for the evacuation of intracranial hemorrhage.ObjectiveTo demonstrate the feasibility of using Apollo in combination with...

O-017 Minimally Invasive Angiographic CT Guided Evacuation of Parenchymal and Ventricular Haemorrhage Using the Apollo System: Proof of Concept in a Cadaver Model

IntroductionApollo (Penumbra Inc, Alameda, CA) is a low profile irrigation-aspiration system designed for the evacuation of intracranial haemorrhage. We demonstrate the feasibility of using Apollo through a minimally invasive approach...

A Novel Capsulorhexis Technique in White Cataract Surgery

Purpose: To investigate the efficacy and safety of novel capsulorhexis technique in white cataract surgery using the irrigation-aspiration system of a phaco device. Materials and Methods: 53 eyes of 50 patients were included in the study. Patients were randomly divided into two groups. To 27 eyes of 27 patients in Group 1, continuous curvilinear capsulorhexis (CCC) was made using an irrigation-aspiration system by a phaco machine. To 26 eyes of 23 patients in Group 2, CCC was made using an ocular visco-elastic device (OVD) and utrata forceps. Surgical results were compared between two groups. Results: No difference in outcome endothelial cell count or central corneal thickness was noted between the two groups. CCC-2 has been completed totally in Group 1 but only 22 eyes in the other group. Conclusions: Capsulorhexis with described technique is safe in white cataracts. This technique may be an alternative in capsulorhexis to the other method, which is made using OVD and forceps.

The application of bimanual irrigation-asiration system in treatment of adolescence traumatic cataract

Objective To observe the clinical results of bimanual irrigation-aspiration(I/A) system in treatment of adolescence traumatic cataract. Methods Eleven adolescence patients( 11 eyes ) were performed traumatic cataract surgery by using bimanual I/A system,including corneal penetrating injuries in 5 eyes,sclera injury in 1 eye,and corneoscleral wounds in 5 eyes. All surgeries were performed 8 - 15 days after primary wound closure surgeries. Postoperatively, we investigated the effects and results of bimanual I/A system used for removing the cortex of lens. Results All cases had undergone successfully surgeries and IOL implantation. Postoperative best corrected visual acuity (BCVA) after 1 month were 0.1 to 1.0, no serious postoperative complication was observed. Conclusions The bimanual I/A system is simple,safe and efficinet technique in treatment of adolescence traumatic cataract,which minimize the risk of intra- and post-operative complications,and lead to favorable visual outcomes. Key words: Traumatic cataract; Irrigation-aspiration system, bimanual; Adolescence; Eye injury

Complex space-filling procedures for intrathoracic infections — personal experience with 76 consecutive cases☆

The objective of our article is to analyse the results of complex space-filling procedures for chronic intrathoracic suppurations. We performed a retrospective analysis of 76 consecutive patients operated in our unit between 1 January 2003 and 31 December 2008, who presented pleural and/or pulmonary suppurations not amenable to decortication or resection; 36 patients (47%) had tuberculosis (TB) lesions (28 with positive cultures at the moment of surgery, seven with multi-drug-resistant (MDR) infections), 13 patients (17%) had postoperative empyema, 18 patients (24%) presented with frank intrapleural rupture of a pulmonary cavity and 26 patients (34%) presented with bronchial fistula. In these patients, we performed a combination of thoracoplasty (5.3+/-1.3 resected ribs) and intrathoracic transposition of extrathoracic muscles - 148 flaps (60 serratus anterior, 55 latissimus dorsi, 27 pectoralis and 6 subscapularis) with an average of 1.9 flaps per patient; in all patients, we used a closed-circuit irrigation-aspiration system and primary closure of the wound. The overall mortality was 5% (four patients) and four other patients (5%) presented recurrence of infection requiring a modified open-window thoracostomy; other local complications included minor skin necrosis solved through excision (three cases) and external thoracic fistula closed through local lavages (two cases). Postoperative hospitalisation ranged between 4 and 180 days, with an average of 40+/-5 days; all patients were discharged with healed wounds. Statistical analysis performed with the Fischer's exact test suggested that the flap or combination of flaps used to obliterate the space did not influence the rate of recurrence or the incidence of other major postoperative complications (p>0.05). Mild impairment of shoulder function was encountered in five patients. A comparative evaluation of the pre- and postoperative VC and forced expiratory volume of 1s (FEV1) showed no statistically significant difference (Wilcoxon signed-rank test -p>0.05). Patients with complex intrathoracic suppurations not amenable to decortication or lung resection require complex space-filling procedures to achieve complete obliteration of the infected space. The association between thoracoplasty and intrathoracic muscle transposition is a safe and simple solution allowing a quick recovery with good functional and aesthetic postoperative outcome.

Reaming irrigation aspiration system – Early experience

Reaming irrigation aspiration system – Early experience

Closed chamber globe stabilization and needle capsulorhexis using irrigation hand piece of bimanual irrigation and aspiration system

BackgroundThe prerequisites for a good capsulorhexis include a deep, well maintained anterior chamber, globe stabilization and globe manipulation. This helps to achieve a capsulorhexis of optimal size, shape and obtain the best possible position for a red glow under retroillumination. We report the use of irrigation handpiece of bimanual irrigation aspiration system to stabilize the globe, maintain a deep anterior chamber and manipulate the globe to a position of optimal red reflex during needle capsulorhexis in phacoemulsification.MethodsTwo side ports are made with 20 G MVR 'V' lance knife (Alcon, USA). The irrigation handpiece with irrigation on is introduced into the anterior chamber through one side port and the 26-G cystitome (made from 26-G needle) is introduced through the other. The capsolurhexis is completed with the needle.ResultsNeedle capsulorhexis with this technique was used in 30 cases of uncomplicated immature senile cataracts. 10 cases were done under peribulbar anaesthesia and 20 under topical anaesthesia. A complete capsulorhexis was achieved in all cases.ConclusionThe irrigating handpiece maintains deep anterior chamber, stabilizes the globe, facilitates pupillary dilatation, and helps in maintaining the eye in the position with optimal red reflex during needle capsulorhexis. This technique is a safe and effective way to perform needle capsulorhexis.

Phacoémulsification

In industrialized countries, phacoemulsification is the gold standard for lens extracapsular extraction. The basic principle is the vibration of a probe at an ultrasound frequency, combined with an irrigation-aspiration system. The advantages of a short incision are the rapid healing and the decreased astigmatism that both have largely contributed in the development of the ambulatory management. Flexible or injectable implants are implemented through such incisions. Phacoemulsification is a safe treatment for cataract, with specific complications related to the method. The various functions of the phacoemulsificator and the successive surgical steps are presented and illustrated.

A Technique For Removal of Filariasis of the Anterior Chamber

We describe a useful technique for removing filaria from the anterior chamber. In the case described, an immature female filaria approximately 15 mm in length was removed from the anterior chamber of a 32-year-old man in western Oregon and identified as a species of Dipetalonema. Features of four cases of filarial infection in the anterior chamber from the same geographic area are described. In three out of four cases, the worms were removed alive without difficulty by means of simple irrigation aspiration system.

Comparison of Low- and High-Volume Irrigation-Aspiration Systems for Extracapsular Cataract Extraction

A low-volume irrigation-aspiration system with a 1-mm tip (0.3-mm aspiration port) has been developed for extracapsular cataract extraction. This autoclavable system uses approximately 36% less irrigating fluid during the irrigation and aspiration of cortical material when compared to currently available models. The time required for cortical aspiration is also shortened by 33%. After three years of clinical experience with the low-volume system at the Miami Veterans Administration Medical Center, where almost all extracapsular cataract surgery is now performed with the new system, there have been no adverse effects and subsequent capsulotomy has rarely been necessary.

Comparison of the Effects of Viscoat and Healon on Postoperative Intraocular Pressure

We compared the effects of Viscoat and Healon on postoperative increases in intraocular pressure in patients undergoing uncomplicated extracapsular cataract extraction with posterior chamber intraocular lens implantation in a prospective, randomized, single-masked study. Eleven eyes received Viscoat and 13 received Healon. The Viscoat or Healon was aspirated from the anterior chamber with the irrigation-aspiration tip of an automated irrigation-aspiration system at the end of the procedure. No prophylactic intraoperative or postoperative ocular hypotensive agents were used. Intraocular pressure was measured at three, six, 12, and 24 hours postoperatively. Compared with preoperative intraocular pressure, postoperative intraocular pressure was significantly increased in both the Viscoat group and the Healon group. Some postoperative intraocular pressures were as high as 50 to 60 mm Hg, despite removal of the viscoelastic substance at the end of surgery. There was no significant difference in the postoperative intraocular pressures of the Viscoat group and the Healon group.

The "Rotterdam" irrigation--aspiration system for extracapsular cataract operation.

A new easy-to-use instrument for irrigation and aspiration of cataractous lenses is described, combining advantages of a number of already existing instruments.

Needle capsulorhexis in intumescent white cataract using slow injecting viscoelastic device through an anterior chamber maintainer

DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5282Nepal J Ophthalmol 2011; 3(2): 214-215