Blog

FCI Ophthalmics Introduces a line of Vitreoretinal Devices and Instruments

Posted on January 23, 2013 by FCI

FCI Ophthalmics, a worldwide leader in oculoplastic, cataract, and dry eye products introduces a line of devices and instruments designed to provide retina surgeons with high performance products for vitreoretinal procedures.

Angled Extended Illum Probe 300x49 FCI Ophthalmics Introduces a line of Vitreoretinal Devices and Instruments

The products begin with a wide selection of disposable laser probes, fiber optic probes and laser illumination sources that can connect to any manufacturers’ vitreoretinal power supply.

A range of instruments and hand-pieces made from lightweight and durable titanium in several gauges are also available including; Retilock® a one-step self-retaining trocar system for easy access to the posterior segment.

Other products in the vitreoretinal launch include:

  • Single use and reusable Backflush handles and reservoirs for passive and active aspiration
  • Disposable PFCL and Subretinal Cannulas

A9 300x93 FCI Ophthalmics Introduces a line of Vitreoretinal Devices and Instruments

FCI has performed extensive research and development to provide surgeons with outstanding products that enhance the efficiency and effectiveness of vitreoretinal procedures. Since its inception in 1984, FCI has worked in close collaboration with leading ophthalmic surgeons worldwide to develop and test products that contribute to the quality of patients’ lives and products that respond to surgeons’ needs with advanced materials.

For more information on the New Vitreoretinal products please contact FCI Ophthalmics by calling 1-800-932-4202, by email at info@fci-ophthalmics.com or by FAX at 1-781-826-9062.

Posted in Company News, Retina | Tagged , , , , | Leave a comment

FCI Ophthalmics receives 510(k) clearance for the MASTERKA® A Pushed Self-Retaining Nasolacrimal Duct Intubation Stent

Posted on October 11, 2012 by FCI

FCI Ophthalmics introduces the first ever “pushed” monocanalicular nasolacrimal intubation stent called the MASTERKA.  Designed by oculoplastic surgeon Bruno Fayet, M.D., Paris, France, the MASTERKA offers a safer and faster intubation of tear ducts as it does not require the frequently difficult step of recovery inside the nasal cavity.

 

The MASTERKA is indicated for congenital nasolacrimal duct obstructions that are resistant to probing.  Unlike the traditional “pulled” technique in which the stent is advanced through the nasolacrimal system and retrieved through the nose by pulling on the guide probe or thread, the MASTERKA has no metallic probe or suture attached to it and, therefore, it is not pulled out of the nose.  Instead, the MASTERKA is pushed into the nasolacrimal duct and anchored in place at the punctum by a plug-like fixation head similar to FCI’s signature Monoka stents.

 

A pushed intubation is more similar to a simple probing than a pulled intubation and can safely permit the use of a face mask with less risk of airway compromise, thus resulting in significantly reduced time for the intubation procedure.

 

masterka FCI Ophthalmics receives 510(k) clearance for the MASTERKA® A Pushed Self Retaining Nasolacrimal Duct Intubation Stent The MASTERKA device consists of a silicone tube molded to a fixation head and pre-mounted on an introducer to facilitate insertion.  The introducer is easily and completely removed once the intubation of the lacrimal passages has been completed.  The MASTERKA comes in three different lengths (30, 35 or 40 mm) and must be selected according to each patient’s needs.  Special sizing devices are sold separately.

 

The insertion of the MASTERKA device using the push technique is performed in the same manner as a nasolacrimal duct probing and the insertion of the traditional stents into the nasolacrimal duct system. A major difference is that the introducer for the MASTERKA is retrieved by withdrawing it upwards and back out through the canaliculus and punctum, thus avoiding the sometimes traumatic nasal recovery step of pulled intubations.  After insertion, the seating of the MASTERKA anchoring fixation head is performed in exactly the same manner as all of the other devices in FCI’s Monoka family of intubation devices.

 

Drs. James and William Katowitz, The Children’s Hospital of Philadelphia, have both collaborated with Dr. Bruno Fayet and compared results using the MASTERKA vs the Self-Threading Monoka.  Look for William Katowitz’ article titled Pushed Monocanalicular intubation: an alternative stenting system for management of congenital nasolacrimal obstructions due out in print in this month’s issue of JAAPOS.

Posted in Company News, Lacrimal Stents | Tagged , , | Leave a comment

NEW! Kitaro Cataract Surgery Training Kits for Complex Cases

Posted on August 9, 2012 by FCI

From the creators of the revolutionary Kitaro Dry and Wet Lab cataract surgery training system comes an exciting new set of Complex Case Lab kits for advanced surgeons to practice complex surgical procedures.

 

The Kitaro system offers surgeons the ability to repeatedly practice procedures and techniques using synthetic but realistic materials without complicated preparation and expensive consumable goods such as those needed for porcine wet labs.

 

kitcc1 300x199 NEW! Kitaro Cataract Surgery Training Kits for Complex Cases

Kitaro Complex Case Lab 1

The Kitaro Complex Case Lab 1 allows a surgeon to practice such cases as small pupil management, weak or ruptured zonules, and intraocular lens transcleral fixation.  The surgeon may also elect practice phakic IOL insertion with an optional add-on part.  The kit includes specialized realistic artificial cornea parts for each procedure, which attach to the sclera part.  The sclera part sits on top of an oculomotor device that provides a realistic feel for the eye movements during surgery.  The kit also includes a number of mock instruments, a set of mock iris retractors and a capsular tension ring.  Special artificial nuclei for practicing weak zonule management are also included in each kit.

 

The Kitaro Complex Case Lab 2 allows a surgeon to practice conventional extracapsular extraction (ECCE) and posterior capsule rupture management (PCRM).  This kit offers the same oculomotor device, but set on a redesigned base and mask specific to the procedures. The kit includes specialized artificial corneas, scleras, sclerocorneal sheets and nuclei for each procedure, as well as a number of reusable mock instruments.

 

cc 1 300x169 NEW! Kitaro Cataract Surgery Training Kits for Complex Cases

Kitaro Complex Case Lab 1 - Carrying Case

Each kit comes assembled in a handy carrying case with instructional booklets and DVDs.  Any additional or replacement items may be ordered as needed.

The new Kitaro Complex Case Labs are now available in the United States from FCI Ophthalmics.

 

 

 

Posted in Cataracts, Company News, KITARO Kits | Tagged , , , | Leave a comment

Treatments for Severe Dry Eye

Posted on July 26, 2012 by FCI

For people suffering from ongoing dry eyes that are resistant to over-the-counter artificial tears or drops, there are treatments available. Most require a doctor’s evaluation and prescription, however, as the underlying causes differ widely.

What it is and what causes it

Severe dry eye, known as keratoconjunctivitis sicca, is defined as persistent dryness that can’t be corrected by over-the-counter drops or home remedies. It is painful and has the potential to cause permanent eye damage if not treated. Tears protect the surface of the eye from bacteria and particles with a film, keeping it moist and cool. They also work to flush any foreign objects out of the eye. When left untreated, dry eyes can develop tiny abrasions on the cornea. These can lead to corneal erosion, scarring, thinning, and, in rare cases, even perforation.

Severe dryness may be caused by one of the following:

  • Medication for an unrelated condition
  • An eyelid infection
  • An autoimmune disorder
  • Eyelids that don’t close completely

How to treat it

Treatment depends on the cause and may be as simple as changing or adding a medication or as complex as surgery. A doctor will be able to determine the underlying cause and suggest the appropriate action.

Medication

  • Often a prescription that has a drying side effect can be changed to another with the same overall effect but less drying.
  • If the dry eye is caused by an eyelid infection, the infection prevents glands in the eyelids from secreting lubricating oil. Antibiotics are usually prescribed to clear up this kind of infection.
  • Corneal inflammation, often the result of an autoimmune disorder, can be treated with corticosteroids or immune suppressants.

Artificial Tear Inserts

If over-the-counter artificial tears don’t work, a doctor may prescribe inserts to place between the lower lid and the eye once a day. The inserts are tiny, clear grains of hydroxypropyl cellulose that dissolve slowly to recreate the lubricating effect of tears.

Closing Tear Ducts

snug plug Treatments for Severe Dry EyeSometimes the problem of dry eyes can be solved by partially or completely sealing the tear ducts to prevent tears from escaping into the nasal passages. A doctor may consider this method if medications and drops prove ineffective. It can be done in one of two ways:

  • Silicone plugs - These can be removed or left in place. They seal in natural tears and any drops used to lubricate the eye.
  • Thermal cautery - This is a permanent method of sealing the tear ducts using a heated wire that shrivels the ducts and creates scar tissue to block the hole. Local anesthetic is applied before the procedure, which is performed in a doctor’s office.

Contact Lenses

Called bandage lenses or corneal shields, these lenses cover the eye and trap natural moisture close to the surface while protecting the eye from irritants. As with other methods, these corrections require a prescription because they are not the best solution for everybody and must be determined by a trained professional.

Surgery

In cases where the eyes are dry because the lids don’t meet either from an anatomical anomaly or cosmetic procedure, the best option may be surgery to reshape the lids. This can involve cutting and stretching the eyelid skin or inserting small weights into the lid to hold it down when closed. In severe cases, the lids are partially sewn together. Known as tarsorrhaphy, this is usually a temporary method pending some more permanent procedure.

Weights

A simpler method than plastic surgery, and one that doctors often suggest before surgery to see how well they work, is external eyelid weights.  These are small metal strips colored to roughly match skin color that come with adhesive tape. The weights pull down the upper lid to meet the lower, repairing whatever damage drove them apart. They may be worn all day or only at night, when a great deal of natural moisture and eye repair is lost if the eyes don’t close.blinkeze Treatments for Severe Dry Eye

What often seems like a fairly straightforward and minor condition is actually quite complex in its causes and methods of treatment. A visit to your ophthalmologist can provide you with additional information to help you determine the best course of action in treating dry eyes and restoring them to their safe and natural state of lubrication.

Posted in Dry Eyes | Tagged , , , | Leave a comment

Early Signs of Retinal Detachment

Posted on May 23, 2012 by FCI

What is Retinal Detachment?

The retina is the thin, light-sensitive membrane lining the inside of your eye that is responsible for transmitting images through the optic nerve to the brain. Retinal detachment occurs when the retina separates from the tissue and blood vessels located in the back of the eye. Often brought on by a retinal tear, retinal detachment may lead to permanent vision loss or complete blindness if left untreated.

Causes of Retinal Detachment

Retinal detachment is the result of vitreous liquid (the fluid inside the eye) leaking through a small hole or tear in the retina. When this occurs, the retina slowly peels away from the adjacent tissue, damaging the blood supply to the retina and preventing it from working properly. Those more likely at risk for retinal detachment are adults age 40 and older, anyone who has had a previous detachment or eye surgery, those with a family history of retinal detachment, those with diabetes or myopia (severe nearsightedness), or anyone who has sustained a serious eye injury. Yearly visits to an eye specialist can help determine risk factors.

Early Signs of Retinal Detachment

While there is no pain associated with a retinal detachment, there are warning signs that, if recognized and treated early enough, may save vision. There are several very clear symptoms that almost always appear before a retinal detachment occurs. The symptoms can appear slowly or suddenly, depending on the progression of the retinal separation. The gradual increase in symptoms often is a sign that the retina is still attached but a tear may be present causing the retina to slowly separate from its underlying tissue. A sudden onset of symptoms may mean that the retina has immediately detached. In either case, an ophthalmologist should be consulted immediately.

The most common symptoms of retinal detachment include:

  • Flashes of light – The appearance of fleeting bright flashes, most often in the peripheral vision, is one of the first warning signs of a retinal tear or detachment. These flashes may occur with quick movements of the head or eyes and are most easily seen while looking at dark surfaces.  These flashes are the result of the vitreous in the eye either tugging at the retina or shrinking and bumping against the retina. While flashes in vision may also be the result of a less critical posterior vitreous detachment (PVD), an eye care specialist should be consulted to rule out a tear or detachment if they occur.
  • Floaters – Another symptom of retinal detachment is a showering effect of “floaters.” Floaters often show up as spots, flecks, or strings that float across the field of vision. Floaters themselves are not uncommon, but a dramatic increase in the number or size of floaters may be a sign that a tear or detachment has occurred. These floaters are the result of solidifications of small amounts of vitreous gel. If a massive shower of dark floaters appears abruptly, there is a good chance that a tear or complete detachment has occurred, causing blood or pigment to enter into the vitreous. This is a very serious condition and warrants immediate attention.
  • The “Curtain Effect” – This effect appears as graying or darkening of the field of vision, and can also indicate that a retinal detachment has occurred. This darkening is often described as a gray curtain across the central part of the visual field and is accompanied by a shadow in the vision periphery. This graying occurs when the retina completely detaches from the underlying tissue and no longer functions properly, if at all.

Having these symptoms does not necessarily mean that a retinal detachment is about to occur, but these signs should not be ignored. The sooner the doctor can diagnose these symptoms, the greater the odds are of preventing further damage and regaining lost vision.

Treatment Options

retina 300x225 Early Signs of Retinal DetachmentIf an ophthalmologist finds a hole, tear, or complete detachment of the retina it is very likely that surgery will be performed to correct the issue. There are several surgical options, depending on the severity of the damage to the eye. For small tears or holes, the ophthalmologist may suggest photocoagulation (laser surgery) or cryopexy (retinal freezing) to repair the damage. Both procedures are done on an outpatient basis. For complete detachments, the ophthalmologist may suggest different surgical options including:

  • Scleral buckling, in which a silicone or plastic band is placed around the eye to indent the wall of the eye. This indent relieves the pulling of the retina and allows it to reattach to the underlying tissue.
  • Pneumatic retinopexy, in which a small air or gas bubble is injected into the vitreous, allowing it to push up against the retina and seal any tear that is causing the vitreous gel to leak behind the retina. In many cases, photocoagulation or cryopexy is also used to help seal the tear.
  • Vitrectomy, in which the vitreous gel of the eye is removed and replaced with a saline or liquid silicone solution to push the retina back up against the underlying tissues and reattach it. This surgical treatment is often combined with scleral buckling.

Retinal detachment surgery is not a guarantee that vision will be fully restored, but the sooner a retina is repaired, the better the chances of a successful recovery. While there is no way to predict or prevent a retinal detachment, knowing the risks and warning signs may prevent serious, permanent vision damage.

Posted in Diseases of the Eye, Eye Surgery, Retina | Leave a comment

The Role of the Orbital Tissue Expander in Anophthalmia and Microphthalmia Treatments

Posted on May 4, 2012 by FCI

The orbital tissue expander (OTE) is an award-winning enhancement in treating congenital conditions such as anophthalmia and microphthalmia, or acquired anophthalmia from tumors or trauma. Dr. David Tse’s design consists of a flexible balloon fixed in place by a titanium plate to help mitigate the problem of permanent facial disfigurement from improper growth of the eye orbit during development. Here we’ll discuss how the OTE design plays a critical role in the treatment of these conditions.

  • Anophthalmia results from one or both eyes not forming during early fetal life. Anophthalmia may be primary (complete absence of the eyeball), secondary (tiny eyes or a small amount of eye tissue) or degenerative (the eye began to develop but the development was not complete and blood supply is damaged).
  • Microphthalmia is defined as an eye globe that is below the average size by 1-2 standard deviations. Microphthalmia may be simple (intact eye with shortened globe length) or complex (malformation of various parts of the eye).

Causes of anophthalmia and microphthalmia can be linked to genetic mutations, abnormal chromosomes, and environmental factors. These conditions are rare, occurring in only 1 of 10,000 live births. They account for 3-11% of child blindness. There is currently no treatment for severe anophthalmia or microphthalmia to restore vision or rebuild the eye globe. Tissue expanders and prosthetics are used to allow for growth of facial bones and to maintain a uniform appearance. Early intervention of these conditions is essential to proper anatomical development.

Conformers are placed during infancy and exchanged frequently as the child grows. A prosthesis fashioned to look like a normal eye usually replaces these conformers between the ages of one and two. Orbital implants are placed to allow for normal bone growth and to support the prosthesis. Types of orbital implants used today include the orbital tissue expander, bioceramic orbital implants, mesh-wrapped bioceramic orbital implants, silicone orbital implants, and acrylic orbital implants.

Benefits of the Orbital Tissue Expander

The orbital tissue expander’s titanium fixation plate is anchored to the lateral orbital wall. The flexible balloon implant is then expanded as the child’s eye orbit grows to help ote The Role of the Orbital Tissue Expander in Anophthalmia and Microphthalmia Treatmentsmaintain normal orbital bone growth and a symmetrical facial appearance.

The orbital tissue expander has proven to be a great improvement to previous models as it is flexible in nature and includes many benefits, including:

  • Enables the ocular orbit to grow as if it were surrounding a healthy eye. This prevents facial disfigurement over time, which can occur if natural pressure on the ocular orbit is absent during development.
  • Has the ability to be implanted using standard oculoplastic techniques.
  • Easily inflates and deflates to omit the need for multiple surgeries as the child grows.
  • Extrusion by the body is prevented by a fixed bone plate.
  • Requires minimal follow-up, surgical adjustment, and intervention.

The greatest and most notable benefit of the OTE is that it can be easily increased in size as a child develops. Unlike the OTE, less popular solutions such as acrylic spheres that are not anchored to the lateral orbital rim to promote self-centering can cause complications over time. Without proper anchoring, these spheres can prolapse against the conjunctiva. Over time, issues such as this can lead to permanent facial disfigurement in the developing child.

Another great benefit of the OTE is that with patient cooperation, no general anesthesia is necessary. Patients can be locally anesthetized in order to inject the implant with fluid to maintain accurate pressure on the eye orbit. Tested at the University of Miami, the device is currently manufactured by Innovia LLC, and has been used with great success in patients with anophthalmia and microphthalmia.

The orbital tissue expander has found its place in patients with congenital anophthalmia and microphthalmia. Named in the 2010 Medical Design Excellence Awards competition, the OTE is a high-ranking medical product used both throughout the United States and also in the Middle East. Study results are overwhelmingly positive, and all patients included in these studies have had increased orbital sizes as a result of using this medical advancement.The orbital tissue expander has found its place in patients with congenital anophthalmia and microphthalmia. No infections, erosions, or implant-related issues have been documented.

Posted in Orbital Implants | Tagged , , | Leave a comment

Use of Vitrectomy in Treating Diabetic Retinopathy

Posted on May 1, 2012 by FCI

Diabetic retinopathy is a complication of diabetes that is caused by damage to the blood retina1 150x150 Use of Vitrectomy in Treating Diabetic Retinopathyvessels of the retina. The retina is responsible for transmitting light and images in the eye via nerve signals sent to the brain. As a complication of diabetes such as cataracts or glaucoma, this eye disease is the most common of the bunch, and can cause severe vision loss or blindness. Those with diabetes that is poorly controlled are at a higher risk of diabetic retinopathy.

Stages and Symptoms

Diabetic retinopathy most commonly develops over a period of months as high blood sugar damages the retina’s blood vessels and the disease begins to progress. There are four main stages of diabetic retinopathy:

  • Mild non-proliferative retinopathy – small swelling in the retina’s blood vessels
  • Moderate non-proliferative retinopathy – some nourishing blood vessels become blocked
  • Severe non-proliferative retinopathy – more vessels become blocked, signaling the body to grow new vessels
  • Proliferative retinopathy – signals sent by the retina trigger growth of new abnormal vessels that may leak blood into the vitreous gel of the eye and cause vision loss and blindness

Symptoms of this disease include blurred vision and slow vision loss over time, floaters, shadows, and decreased night vision.

Prevention

The damage of small blood vessels can be mitigated by keeping diabetic blood sugar levels and blood pressure managed. Diabetics who are also smokers are at a greater risk of retinal damage. A regular yearly dilated eye exam can also help identify and prevent diabetic retinopathy and help prevent vision loss and blindness. Timely treatment is a very important part of maintaining vision and helping to slow the progression of the disease by removing unhealthy blood vessels.

Treatment

Laser eye surgery and laser photocoagulation, scatter photocoagulation, pan-retinal and focal photocoagulation, and intravitreal Triamcinolone acetonide can all help slow down the progression of this disease. Retinal reattachment can also reaffix a retina to the back of the eye to restore vision.

If blood pools in the center of the eye, vitrectomies may restore sight by clearing blood and removing scar tissue. This treatment often prevents further hemorrhage by removing the abnormal vessels that caused the original bleeding. Performed under either local or general anesthesia in a hospital or ambulatory surgery center, a vitrectomy is performed by first creating a tiny incision in the eye. A small instrument is then used to remove the blood-clouded vitreous gel. This natural vitreous gel is then replaced with a saline solution to help maintain the eye’s shape. A gas bubble may be placed to help flatten the retina, press it against the back of the eye, and allow it to heal. Vitrectomies can also remove scar tissue that is tugging on the retina and pulling it out of place, helping to prevent possible retinal detachment. This procedure of removing blood and scar tissue restores the retina’s ability to collect and transmit light and images to the brain.

Aside from a sensitive eye, most vitrectomies are an outpatient procedure requiring nothing more than a temporary eye patch and medicated drops after treatment. If a gas bubble is placed in the eye, the patient may need to keep their head in a specific position until the eye heals.

Complications

Along with common surgical risks such as infection, vitrectomies can rarely cause retinal detachment, high intraocular pressure, bleeding in the eye, and cataracts. Despite these minimal risks, over 80 percent of patients experience significant improvements after surgery. Complications are uncommon, and eye surgeries are carefully conducted by highly trained ophthalmologists.

Outlook

Approximately 65,000 diabetics per year develop this eye disease. Vitrectomies for diabetic retinopathy are effective in removing scar tissue, blood, and abnormal vessels. But this treatment to staunch bleeding vessels is not a cure. Vitrectomies are reserved for patients whose complications have already developed, and additional surgeries may be required to remove scar tissue or repair additional retina detachments. Although results vary and depend on many factors, results of vitrectomy surgery are usually seen within a week.

Diabetic retinopathy is a progressive, dangerous, and potentially debilitating eye disease common to diabetics with uncontrolled blood sugar. Vitrectomies are a successful means by which to resolve this issue with minimal risk and maximum results. Although these patients often require multiple surgeries over their lifetimes, vitrectomies can effectively restore vision and prevent progressive blindness.

Posted in Retina | Tagged , , | Leave a comment

Benefits of Bioceramic Orbital Implants in Enucleation and Evisceration Procedures

Posted on April 18, 2012 by FCI

Orbital implants are medical prosthetics used to replace the eye following enucleation or evisceration procedures. These implants aid in replacing the lost eye in the orbit and allow for realistic movement of an ocular prosthesis. After orbital implantation, an ocular prosthesis, or artificial eye, is then fit over the implant to mimic the appearance of a natural eye.

mesh orbital 150x150 Benefits of Bioceramic Orbital Implants in Enucleation and Evisceration Procedures

Orbital implants in history have most commonly been constructed with hydroxyapatite as their main material. Original eye implant models even recruited substances such as cork, glass, and various metals. Although hydroxyapatite is well-tolerated by the body and recognized as a similar substance, the later introduction of bioceramic material has accelerated this advancement to a new level. The bioceramic orbital implant of today uses a ceramic biomaterial made of aluminum oxide (Al2O3). This material is well-known in the medical industry and has found use for more than 30 years in the orthopedic and dental fields for many types of prosthetics. Bioceramic implants became FDA-approved in April of 2000.

The body has shown to respond better to this aluminum oxide material and is therefore more biocompatible than its hydroxyapatite counterpart. Tissue grows more readily on this recent advancement, and has thus helped it to become the new standard in orbital implant material.

Noted Benefits of the Bioceramic Implant

There are three basic types of bioceramic implants: mesh wrapped, spherical, and egg-shaped. These three forms of bioceramic orbital implants have an improved vascularization structure, allowing for quick fibrovasculariation. This bioceramic material is a biocompatible, bioinert, nontoxic, and nonallergenic substance. These implants are well-known by surgeons as a stable and easily handled implant for use in enucleation and evisceration procedures. Beneficial features of these implants include:

  • Porous, strong and non-brittle composition
  • Rapid fibrovascularization
  • No risk of disease-transmission
  • Lightweight and easy to insert during surgery
  • Easy to suture to extra ocular muscles
  • Effortlessly hand-drilled without crumbling
  • Non-dissolving
  • Does not release soluble components
  • Does not cause excessive tissue inflammation
  • Improved motility of the artificial eye

Another great benefit of this material comes in that after implanted, a protein coating is formed over the implant that camouflages the implant and prevents rejection. On the mesh-wrapped form of these implants, the vinyl mesh wrapping allows the intraocular muscles to be sutured directly to the implant, which creates a more natural movement. The porous composition of the implant allows for the previously mentioned fibrovascular ingrowth, which also helps to prevent migration of the implant over time.

Study Results

One study performed to assess the effectiveness and benefits of bioceramic orbital implants showed marked benefits in the reviewed patient surgeries. One such study mapped 107 patients who received bioceramic orbital implants over a 3-year period (Jordan, D., Gillberg, S, Mawn, L. 3,2003. The Bioceramic Orbital Implant: Experience with 107 Implants Ophthalmic Plastic & Reconstructive Surgery: 19 (2):128-135). This study analyzed many of the aspects of these patients and their procedures, including, but not limited to: patient age, surgery type, implant type, complications, and treatment.

Results showed implant-related problems in only 11% of these patients, with no patients suffering from infection. Additionally, in a paper published after this study, researcher Dr. Jordan stated that these implants were also quieter than other implants. The conclusions of this study revealed that the bioceramic implant is a preferred alternative to hydroxyapatite implant. It is structurally strong, easily manufactured, and cheaper than other manufactured implants on the market. The noted complications are similar to conventional implants, but have been found to be less common.

Bioceramic orbital implants have provided ophthalmologists with easy and effective means by which to perform successful enucleation and evisceration procedures. Proven to be more biocompatible than hydroxyapatite, bioceramic orbital implants are easily inserted, non-sticky, and promote quick fibrovascularization after implantation. The improved connectivity and easy suturing to surrounding muscles helps aid in the motility of the implant while also helping to prevent implant migration.  This latest generation of orbital implant is easy to manufacture, strong, and easily drillable. Its immediate protein coating after implantation relieves the concern of rejection, and the implant overall is very well tolerated by the body. It has become today’s implant of choice by ophthalmologists for use in enucleation and evisceration surgical procedures.

Posted in Eye Surgery, Orbital Implants | Tagged , , , , | Leave a comment

Symptoms and Treatment of Lagophthalmos

Posted on April 13, 2012 by FCI

Lagophthalmos is a condition in which the eyelids do not close to cover the eye completely. The term lagophthalmos actually comes from the Greek word for hare (lagoos) and derives from a myth that hares sleep with their eyes open. A normal, healthy eye is covered by a film of tears that protects the surface and washes away dust and particles. Dry eyes that result from lagophthalmos are not only uncomfortable, but are also subject to injury or infection from foreign objects landing in and abrading the eye surface. Left untreated, lagophthalmos can lead to permanent loss of vision.

Doctors consider lagophthalmos to be a symptom more than a disease, as it usually has an attributable cause. A few of the most common causes of lagophthalmos are:

  • facial paralysis (such as Bell’s palsy)
  • stroke
  • infection
  • trauma
  • skin conditions such as ichthyosis
  • surgical procedures

Surgical procedures that can cause lagophthalmos include a common plastic surgery procedure called a blepharoplasty, in which the upper eyelid is cut and tightened to reduce signs of aging. This surgery can result in a misalignment with the lower eyelid. Comatose patients can also suffer from lagophthalmos due to a decrease in use and tone of the orbicularis (a facial muscle). Lagophthalmos may also be a sign of thyroid disease or a tumor such as an acoustic neuroma, which is why doctors recommend early diagnosis to identify the source of the problem and eliminate any serious causes.

A variant of this condition is nocturnal lagophthalmos, in which sufferers do not completely close their eyes while sleeping. This is difficult to discover, as many people don’t know they have it unless someone tells them they are sleeping with their eyes open. Patients sometimes report poor sleep patterns or waking with dry or painful eyes. Doctors can identify nocturnal lagophthalmos by asking a patient to close his or her eyes as though sleeping or just to blink normally. Even an opening of a few millimeters can cause dryness.

Treatment

blinkeze 150x135 Symptoms and Treatment of LagophthalmosThere are two basic types of treatment for lagophthalmos: supportive care and surgery. As a first effort to relieve the condition and in cases where surgery is not feasible, artificial tears can be applied several times a day to keep the cornea moist. Sufferers of nocturnal lagophthalmos can use an ointment at night or tape their eyelids closed with surgical tape, but problems reported with these methods include blurry vision upon waking with the ointment and skin irritation from the tape. Flexible goggles, similar to a sleep mask, can prevent the tear film from evaporating during sleep. A newer method recommended for short- or long-term therapy is external weights taped to the eyelid to help restore normal blink function. These reduce a patient’s dependence on ointments and drops and can be a good way to test the effectiveness of internal weights before going forward with implantation surgery.

If surgery is possible but will not occur immediately, a procedure called a tarsorrhaphy is thin profile Symptoms and Treatment of Lagophthalmosoften recommended. The lids are sewed partially shut to protect the cornea. This is reversible and usually causes no complications. A more permanent method is to insert gold or platinum weights into the upper eyelid to pull the eyelid down into position. Often a follow-up surgery is required to tighten and raise the lower lid to make sure the lids meet properly, and sometimes one lid will drop lower than the other one. Occasionally, the weight causes a corneal astigmatism, which leads to vision problems.

Doctors advise people who suffer from mild lagophthalmos to discuss their condition carefully with a corneal and external disease specialist before undergoing blepharoplasty, BOTOX injection, or LASIK corrective surgery. These procedures can, but will not always, exacerbate the problem. The specialist can evaluate the dysfunctional tear film and make recommendations on how to proceed safely.

Lagophthalmos is itself not a serious condition, but it can lead to acute and permanent damage if not effectively treated. Furthermore, it is often a symptom of a more pernicious disease that may not manifest in other ways until it’s too late for treatment. Symptoms include dry, irritated eyes and the physical inability to close the eyelids and often follow facial paralysis, trauma, or plastic surgery. Therapy for lagophthalmos, whether external or surgical, is fairly simple and with no lasting side effects.

Posted in Lagopthalmos | Tagged , | Leave a comment

What to Expect After Your Retinal Detachment Surgery

Posted on February 10, 2012 by FCI

The retina is the light-sensing membrane that captures and transmits images to the brain. Most retinal detachments experienced by individuals are originally caused by a small tear or hole in this sensitive retina wall. Often due to thinning of the retina or shrinking of the vitreous gel within the eye over time, retinal detachments cause vision loss that may become permanent if not treated quickly and effectively.  Often affecting those individuals who are middle-aged or older, retinal tears and detachments are most common in nearsighted individuals and those with a genetic predisposition.

Prompt treatment of a retinal detachment is vital to the prevention of permanent vision loss. Scleral buckling, pneumatic retinopexy and vitrectomies are the most common treatments of retinal detachment. These treatments help press the retina against the wall of the eye and hold the tissues in place so that they can heal. Surgical retinal reattachment surgery is conducted through a quick one-and-a-half to two-hour surgery.

Complications

Although every surgery comes with its risk of complications, most retinal detachments come with infrequent and treatable complications, which include: bleeding under the retina, cataracts, recurrence, or infection.

Going Home after Surgery

Retinal detachment surgery is normally followed by a short recovery at the hospital before returning home. Patients can often return to normal activity one to two weeks after surgery. Traveling should be avoided for some time, and increases in altitude should be avoided until cleared by the surgeon.

Pain and Eye Protection

After a retinal detachment surgery is performed the eye may be inflamed, sore, and swollen for some time. Although very little pain is expected after surgery, pain medications are often sent home with the patient to aid in post-surgical pain control. Eye drops and an eye patch may be necessary aftercare to keep the eye moist, sanitized, and protected. A shield may also be used to avoid accidental pressure on the eye during sleep. Follow-up visits will be scheduled for the day after surgery and again for regular checkups over the next two to three months depending on patient progress. Some discharge is expected during the healing process, but the eye should be monitored for unusual drainage.

Care will need to be taken when showering not to get soap in the eye. Some procedures require a gas bubble to be placed in the eye during surgery to help keep the retina pressed up against the inner wall of the eye. Patients may be asked to position their head facing down to aid in the effect of this pressure bubble. This positioning may be necessary for one to two weeks after surgery.

Activity

The first week after surgery should be reserved for rest and slow movement. Excessive close concentration or TV watching should be avoided to prevent eye strain and further discomfort. Some patients may experience sensitivity to light after surgery. Activity can often be resumed after a month, but heavy lifting over 20 pounds and strenuous activities should be avoided while the eye heals.

Driving should also be avoided until vision improves and stabilizes. Initial depth perception and field of view is compromised after surgery and care should be taken before patients get back behind the wheel. Sedentary jobs may be returned to between ten and fourteen days after surgery, but more active jobs should be cleared by the surgeon before resumed.

Outlook

Surgical treatment for retinal detachment is successful in over 90 percent of cases. If the retinal reattachment is a success, the patient will have some degree of vision restored. Depending on the condition of the retina, a varying degree of reading and traveling vision may be restored, and oftentimes patients can expect a full recovery of their vision.

A period of healing is necessary after surgery before patients will begin to see an improvement in their vision. This improvement should be expected to begin two weeks after surgery, and within six weeks postoperative vision improvement should be complete. The retina may continue to heal for a year or more, and it may take months for vision to stabilize after surgery.

Retinal detachment procedures are highly successful, come with few complications, and are imminent when a detachment occurs to help restore vision before blindness becomes permanent. Recovery is quick and requires a short period of rest and care while the retina heals and vision improves.

Posted in Eye Surgery | Tagged , , , | Leave a comment