Day 1 :
Keynote Forum
Jiping Cai
Nanjing Medical University, China
Keynote: Traumatic chiasmal syndrome following traumatic brain injury
Time : 11:15 - 11:45
Biography:
Jiping Cai has more than 25 years working experience in ophthalmology. His clinical and research interests are vitreo-retinal diseases such as retinal detachment, diabetic retinopathy, retinal vascular diseases orbital diseases such as thyroid-associated orbitopathy and orbital tumor.
Abstract:
Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality that leads to structural and functional damage in several parts of the brain such as cranial nerves, optic nerve tract or other circuitry involved in vision and occipital lobe, depending on its location and severity. As a result, the function associated with vision processing and perceptions are significantly affected and cause blurred vision, double vision, decreased peripheral vision and blindness. Here two cases complaining of monocular vision loss (actually temporal hemianopia) due to traumatic chiasmal syndrome after frontal head injury were reported, and were compared the findings with individual case reports published in the literature. Reported cases of traumatic chiasmal syndrome appear to share some common features, such as injury to the frontal bone and fracture of the anterior skull base. The degree of bitemporal hemianopia and visual loss acuity has a variable presentation, and was not necessarily related to the severity of the craniocerebral trauma.
Chiasmal injury may occur even in the absence bony chip impingement. Isolated bitemporal hemianopia is rare and clinical improvement usually may not occur. Mechanisms of damage to the optic chiasm after trauma include direct tearing, contusion haemorrhage and contusion necrosis, and secondary mechanisms such as cell death, inflammation, edema, neurogenesis impairment and axonal damage associated with TBI. Beside visual field test, MRI evaluation of optic pathways seems to the strong objective evidence to demonstrate the impairment of the integrity of visual systems following TBI. Therefore, traumatic chiasmal syndrome should be considered as a differential diagnosis by both neurosurgeons and ophthalmologists in patients presenting with visual impairment, especially bitemporal hemianopia after head injury causing frontal and anterior skull base fracture.
- Ophthalmology | Ocular Oncology | Pediatric Ophthalmology | Neuro-Ophthalmology | Diabetic Retinopathy | Strabismus
Location: Vancouver, Canada
Session Introduction
Puneet Sharma
Ophthalmologists, India
Title: Effect of ND: YAG laser posterior capsulotomy on intraocular pressure, refraction, anterior chamber depth, and macular thickness
Biography:
Puneet Sharma is an ophthalmologist currently working in India. He has an impressive track record, having published numerous research papers and displaying a keen interest in various fields, including Retina and Retinal Detachment, Cornea Disorders and Treatments, Dry Eye & Low Vision, and Ophthalmology Surgery.
Abstract:
Purpose: To see the effect of Nd: YAG laser capsulotomy on intraocular pressure (IOP), refraction, best-corrected visual acuity (BCVA), anterior chamber depth (ACD), and macular thickness.
Methodology: The authors conducted a prospective, descriptive study on pseudophakic eyes with posterior capsule opacification who underwent Nd: YAG laser capsulotomy. BCVA, IOP, spherical equivalent (SE), macular thickness and ACD were noted preoperatively at 1 hr postoperatively and at 1-month follow-up. Patients were divided into two groups based on energy used (Group I ≤50 mJ, Group II >50 mJ). None of the patients received prophylactic anti-glaucoma medications either before or after the procedure.
Results: There were 96 eyes of 83 patients. Mean total energy levels were 26.64±12.92 mJ in Group I and 81.96±32.10 mJ in Group II. BCVA at 1 hr and 1 month postoperatively improved significantly in both the groups compared to preoperative BCVA (P<0.001). There was no significant change in SE compared to preoperative values in both the groups. The ACD continued to increase significantly in both the groups at both 1 hr and 1-month follow-up. In Group I, IOP increased at 1 hr postoperatively (P=0.023) and declined to preoperative levels at 1 month. In Group II, IOP increased at 1 hr postoperatively (P<0.001) and did not return to preoperative levels at 1-month follow-up (P=0.003). Likewise, macular thickness increased at 1 hr in both groups (P<0.001). In Group I, macular thickness decreased significantly to preoperative level at 1 month whereas in Group II, it remained significantly high at 1-month follow-up (P=0.006). There was no case with serious rise in IOP or cystoid macular edema.
Conclusions: Statistically significant increment in IOP and macular thickness occurs after Nd: YAG laser capsulotomy which however may not necessitate the use of any medications.
Lin Chen
Hospital of Chongqing Medical University, China
Title: The incidence and risk factors for dry eye after pediatric strabismus surgery
Biography:
Lin Chen, a pioneering ophthalmologist, has played a pivotal role in revolutionizing eye care at the esteemed Hospital of Chongqing Medical University in China. Dr. Chen's dedication to improving vision and treating ocular ailments has earned her widespread recognition.
Abstract:
Aim: To investigate the incidence and risk factors for dry eye after pediatric strabismus surgery.
Methods: Children aged 5 to 12 who underwent strabismus surgery were included in this single-center, prospective, cohort study. The ocular surface assessments were conducted 1 day before and 1 week, 4 weeks and 8 weeks after surgery. The main outcome measures are the incidence of dry eye after strabismus surgery and associated risk factors.
Results: A total of 84 eyes (48 children) that underwent strabismus surgery were included in the study. The mean age at surgery was 7.21 years. The incidence of dry eye was 47.62% at 1 week, 10.71% at 4 weeks, 0% at 8 weeks after surgery. The preoperative tear breakup time (BUT) were lower in the dry eye group than that in the non-dry eye group (P<=0.01). The univariate analysis showed that preoperative BUT was significantly associated with the incidence of dry eye after pediatric strabismus surgery (odds ratio [OR]: 0.647, confidence interval [IC]: 0.503~0.833, P<=0.01).
Conclusions: Dry eye commonly occurs after pediatric strabismus surgery. Tear film instability is more common than deficient aqueous tear production in patients with dry eye after surgery. Children with a low preoperative BUT are more likely to develop dry eye after strabismus surgery.
Sangkyung Choi
VHS Medical Center, South Korea
Title: Analysis of refractive changes after cataract surgery according to the haptic shape of intraocular lenses
Biography:
Sangkyung Choi is an ophthalmologist based in Seoul, South Korea. After graduating from Seoul National University, she finished her ophthalmology training at Korean Veterans Hospital. Dr. Choi was a research fellow at Wilmer Eye Institute in the Ocular Microbiology department. She also completed her clinical and research fellowship at Seoul National University Hospital, studying artificial cornea. She performs various surgeries including cataract operations, glaucoma surgeries, keratoplasty as well as refractive surgeries. She has performed over 35,000 ocular surgeries over the course of her career. She spends the remaining time on research and teaching.
Abstract:
Purpose: To analyze and compare refractive error changes according to different haptic intraocular lenses, after cataract surgery.
Methods: We retrospectively reviewed the medical records of 508 eyes of 254 subjects who underwent cataract surgeries in both eyes, with one eye using the MBI® SAL302AC(C loop haptic IOL), and the other using the Zeiss® CT ASPHINA509M (plate haptic IOL). By using Barrett Universal II formula, prediction errors were calculated at 1 week, 2 weeks, 1 month, 2 months and 6 months after the surgery.
Results: In the C loop group, prediction error was -0.26 ± 0.42 D at postoperative 1 week, -0.17 ± 0.45 D at postoperative 2 weeks. Hyperopic shift which reduced myopia progressed until postoperative 2 weeks (p<0.001), and then there was no significant shift after postoperative 2 weeks. In the plate group, prediction error was -0.37 ± 0.45 D at postoperative 1 week, -0.25 ± 0.44 D at postoperative 2 weeks, -0.11 ± 0.44 D at postoperative 1 month, -0.04 ± 0.44 D at postoperative 2 months. Hyperopic shift progressed at postoperative 2 weeks (p<0.001), 1 month (p<0.001), 2 months (p=0.02), and then there was no significant shift after postoperative 2 months. There were no significant differences between the two groups in the mean and median absolute error at postoperative 2 months.
|
MBI®SAL302AC |
Zeiss®CT Asphina509M |
|
|
|
|
|
|
Overall Diameter |
13.0 mm |
11.0 mm |
|
Optic diameter |
6.0 mm |
6.0 mm |
|
Haptic design |
C loop |
Plate |
|
Haptic angle |
0 degree |
0 degree |
|
Material |
hydrophobic Acrylic |
hydrophilic acrylic(25%) with hydrophobic surface |
|
Optic type |
Biconvex, Aspheric |
Aspheric |
Table: Refractive error with Barrett Universal II formula
Conclusions: In both the C loop and plate groups, refraction was myopic at postoperative 1 week, and then the C loop group progressed hyperopic shift until postoperative 2 weeks, and the plate group progressed hyperopic shift until postoperative 2 months. At postoperative 2 months, prediction error of the plate group shows more hyperopic tendency than the C loop group, but there was no significant difference between the two groups in accuracy based on the absolute.