New technology for examining the anterior segment by ultrasonic biomicroscopy
ABSTRACT To compare the comfort levels and measurement accuracy of the open-shell technique and a bag/balloon technology (ClearScan, ESI) in anterior segment ultrasound biomicroscopy.
Department of Ophthalmology and Visual Science, Robert Cizik Eye Clinic, University of Texas Medical School at Houston, Houston, Texas, USA.
In this prospective investigation, 20 subjects stated their preference and rated comfort (0 best to 5 worst) for the open-shell technique versus the bag/balloon technology. Three anterior chamber depth and sulcus-to-sulcus measurements were obtained, and the mean for each structure was taken as datum for each subject. Order presentation between the 2 methods was randomized. Pairwise t tests and linear regression analysis were used to determine statistical differences.
One hundred percent of the cohort preferred the bag/balloon technology to the traditional open-shell technique. The mean comfort score was 0.40 +/- 0.53 (SD) and 2.95 +/- 0.90, respectively (P<.0001). Anterior chamber depth measurements did not differ clinically (0.056 mm) nor did sulcus-to-sulcus determinations (0.039 mm).
Biometry, patient comfort, and ease of use were better with the ClearScan bag/balloon technology than with the traditional open-shell technique.
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ABSTRACT: To quantitatively evaluate the anterior segment using anterior segment optical coherence tomography (AS-OCT) following Boston keratoprosthesis type 1. A retrospective study consisted of AS-OCT imaging at a single time point postoperatively in 52 eyes. Main outcomes measures include anatomical and functional anterior chamber depth (ACD), angle (ACA) and peripheral and proximal synechiae. The mean time point of imaging was 19.3 months postoperatively. Average anatomical and functional ACD was 2.0 and 0.21 mm respectively, and mean ACA ranged from 2.5° to 6.14° in representative meridians. An average of 8.7 clock hours of angle closure was observed in the 25 eyes in which all meridians were imaged. The majority of eyes showed peripheral (86.5%) and proximal (67.3%) synechiae. AS-OCT is a useful tool for quantitative evaluation of anterior segment and angle after keratoprosthesis, which is otherwise poorly visible. The majority of eyes showed shallow ACD, extensive angle closure and synechiae formation.PLoS ONE 09/2013; 8(8):e70673. DOI:10.1371/journal.pone.0070673 · 3.53 Impact Factor
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ABSTRACT: Objective: To describe the surgical technique and outcomes of implantation of a glaucoma drainage device (GDD) at the time of Boston type I keratoprosthesis (KPro) procedure. Methods: Consecutive cases of combined GDD and KPro surgery performed between January 2005 and January 2011 with at least 6 months of follow-up were reviewed. Outcome measures included visual acuity, number of glaucoma medications, and complications. Results: Twenty-nine eyes (29 patients) underwent combined GDD and KPro surgery. 82.8% of KPro were retained at a mean follow-up of 34.4 +/- 17.7 months. Major complications included corneal necrosis (3 eyes, 10.3%), retinal detachment (3 eyes, 10.3%), endophthalmitis (1 eye, 3.4%), sterile vitritis (1 eye, 3.4%), and loss of light perception (2 eyes, 6.9%). Final corrected distance visual acuity improved in 17 (58.6%), remained unchanged in 7 (24.1%), and worsened in 5 eyes (17.2%). Mean numbers of glaucoma medications required postoperatively from 3 to 36 months were lower than the preoperative number, but the differences were not statistically significant. The tube of the GDD was able to be inserted into the anterior chamber or the ciliary sulcus in 27 eyes (91.3%). In 14 eyes with anterior segment ocular coherence tomographic evaluation, blockage of the ostium of the tube was noted in 2 eyes (14.3%). Conclusions: Combined GDD and KPro surgery provides the opportunity of additional IOP management and restoring vision in the same setting, saving the patient from additional glaucoma surgery, and is not associated with an increased KPro retention failure rate or other secondary complications.Journal of Glaucoma 10/2014; 23(8):501-507. DOI:10.1097/IJG.0b013e31829d9c00 · 2.43 Impact Factor
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ABSTRACT: Purpose. To investigate age- and position-related changes of anterior chamber angle anatomy in normal, healthy eyes. Patients and Methods. Thirty subjects were separated into a younger and older cohort. The superior and inferior anterior chamber angles of the eyes were measured in supine and sitting positions by ultrasound biomicroscopy (UBM) with bag/balloon technology. Statistical analysis was used to evaluate positional and age-related changes in angle morphology. Results. In the younger cohort, no location or positional differences in angle anatomy were observed. In the older cohort, the inferior quadrant was significantly narrower than the superior quadrant (P = 0.0186) in the supine position. This cohort also demonstrated an interaction effect between position and location. In the older cohort, the angle was deeper inferiorly while the subject was sitting but was deeper superiorly while the subject was supine. Conclusion. Comparison of positional variations in anterior chamber angle anatomy as measured by UBM has recently become possible. This study found that age-related positional changes in the anterior chamber angle anatomy exist in normal healthy eyes.04/2013; 2013:706201. DOI:10.1155/2013/706201