Wangmackay0422

Purpose Mandibular ramus bilateral sagittal split osteotomy (BSSO) has been the most commonly used technique in orthognathic surgery for mandibular advancement. However, a common complication of BSSO has been the occurrence of visible and palpable osseous defects at the inferior border of the mandible. The aim of the present study was to determine whether bone grafting of the osseous defect at surgery would reduce the defect at 1 year postoperatively compared with no bone grafting. Materials and methods The present retrospective cohort study evaluated patients who had undergone mandibular ramus BSSO for 10 mm or more of advancement. The primary predictor variable was BSSO surgery with bone grafting of the defect (graft group [GG]) versus no bone graft (no graft group [NGG]). The size of the mandibular ramus inferior border defect was the outcome variable considered within the framework of a 1-year postoperative cone beam computed tomography (CBCT) analysis. Gender, age, and the amount of advancement were also considered in the multilevel regression analyses. Results From January 2012 to November 2016, 84 patients (168 osteotomies) had undergone BSSO surgery with 10 mm or more of mandibular advancement at the Facesurgery Center (Parma, Italy). Their mean age was 27.4 years (range, 17 to 44 years). Of the 84 patients, 40 had undergone BSSO with bilateral bone grafts (GG). The monocortical block of the iliac crest bone was used as the bone homograft. The final residual defect was measured at 1 year postoperatively on CBCT scans. The GG and NGG had presented with a mean final defect of 0.7 mm (range, 0 to 4.5 mm) and 3.0 mm (range, 0 to 5.5 mm), respectively. Complete absence of the defect was achieved in 72% of the osteotomies in the GG and 9% of the osteotomies in the NGG. Conclusions The use of an iliac crest bone allograft block in the gap between 2 segments during mandibular advancement of 10 mm or more substantially reduced the size and incidence of inferior border defects.Purpose To describe an optical coherence tomography (OCT) sign preceding macular hole (MH) formation after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD). Design Retrospective observational case series. Methods Patients who underwent PPV for RRD at Osaka Rosai Hospital between January 2014 and December 2017 were analyzed. First, the medical records of the patients who had secondary MH after RRD repair were examined, and their sequential changes of the OCT images until MH formation were evaluated. Second, the OCT findings and the medical records of all patients who underwent PPV for RRD were evaluated based on the findings of the secondary MH cases. Results Ten eyes of 10 patients that had secondary MH after PPV for RRD were enrolled. Before MH formation, all eyes had parafoveal ERM and a characteristic OCT sign that was termed a foveal crack sign (FCS) a hyperreflective vertical line in the foveola with a deformation of the fovea. FCS was found 255 ± 217 days after PPV for RRD, and MH developed 232 ± 171 days after FCS appearance. Furthermore, among 518 eyes that underwent PPV for RRD, FCS with parafoveal ERM was found in three eyes without succeeding MH after RRD repair. FCS of these three eyes were found 363 ± 4 days after PPV for RRD. Conclusions In all cases with secondary MH after PPV for RRD, FCS with parafoveal ERM was found before MH formation. PTX inhibitor This sign may predict secondary MH formation caused by ERM traction.Purpose To provide data on VA outcomes and prognostic factors of micro-incision 23-gauge vitrectomy (MIVS) for retained lens fragments after complicated cataract surgery. Design Retrospective, interventional case series from 2012 to 2017. Methods Pre-cataract surgery and intra-operative (vitrectomy) parameters, post-vitrectomy complications, and best-corrected visual acuities (BCVA), were identified. Vitrectomy was performed as early as corneal clarity permitted. Univariate and multivariate logistic regression were used to characterize factors associated with achieving VA better than 20/40, or worse than 20/200 at 6 months. Results This study included 291 consecutive eyes (291 patients). LogMAR BCVA improved from 0.73 ± 0.70 before cataract surgery to 0.46 ± 0.63 (p less then 0.001) after vitrectomy. The pre-vitrectomy VA was 1.43 ± 0.79. At 6 months, 183 (62.9%) and 45 patients (15.5%) achieved BCVAs better than 20/40, and worse than 20/200, respectively. Most frequent complications were de novo ocular hypertension (29 eyes, 10%) and transient cystoid macular edema (CME) (25 eyes, 8.6%). Post-vitrectomy retinal detachment occurred in 9 eyes (3.1%). Final VA of 20/40 or better was independently associated only with better pre-cataract surgery VA, age less then 75 years, absence of pre-existing diabetic (DME) or post-vitrectomy persistent CME (p less then 0.05). Only poorer pre-cataract surgery VA, delaying vitrectomy to later than 2 weeks, and final aphakic status, were independently predictive of 20/200 or worse VA (p less then 0.05). Conclusion Contemporary VA outcomes of 23-gauge vitrectomy for retained lens fragments are comparable with that of prior predominantly non-MIVS cohorts, but fall short of benchmarks for uncomplicated cataract surgery. IOL type or timing of placement do not impact final VA.Purpose To compare short-term changes in the refractive prediction error (PE) after phacoemulsification among eyes receiving different types of single-piece acrylic intraocular lenses (IOLs). Design Randomized clinical trial. Methods One-hundred ninety-five eyes of 195 patients scheduled for implantation of a single-piece acrylic IOL were randomly assigned to receive 1 of 3 IOLs 1) Alcon SN60WF, 2) HOYA XY-1, or 3) AMO ZCB00V. Manifest spherical equivalent value (MRSE), PE, and changes in PE were examined at 1 day, and 1 and 2 months postoperatively, and compared among groups. Results The mean MRSE and PE significantly changed toward myopia between 1 day and 2 months postoperatively in all groups (P less then .0001). The MRSE and PE did not differ significantly among groups at 1 day and 1 month postoperatively, and were significantly smaller in the SN60WF group than in the XY-1 and ZCB00V groups at 2 months (P≤.0006). The PE change between 1 day and 2 months postoperatively was significantly smaller in the SN60WF group than in the other groups (P=.