shima eghtedari - Academia.edu (original) (raw)
Papers by shima eghtedari
Medical Research Archives
Purpose: To introduce a novel technique using PANIS method (Plasma assisted noninvasive surgery) ... more Purpose: To introduce a novel technique using PANIS method (Plasma assisted noninvasive surgery) in pterygium removal surgery with conjunctival rotation flap. Methods: Two patients (1 male, 1 Female) with grade 3 and 4 of pterygium, based on SLIT2 grading system, underwent surgery with local anesthesia, removing pterygium tissue from cornea and also all related subtenon. Then surgeon used residual conjunctiva to cover bare sclera using rotational method. Fusion of the border of conjunctival flaps from nasal to superior occurred by plasma spots. UCVA, BCVA, OSDI and patient satisfaction were evaluated before, 1 month, 6 months and 1 year after the surgery, as well as 1 day and 1 week post-operation examinations included slit-lamp and external check-up that has been done by the surgeon. Results: Patients with primary pterygium, underwent surgery with PANIS method. Last follow-up session in 1 year, showed significant improvement in astigmatism and 1 line in BCVA. There were no complica...
Background Large conjunctival cysts are common benign lesions that can cause various visual and c... more Background Large conjunctival cysts are common benign lesions that can cause various visual and cosmetic problems. In this case report, we aim to report the successful removal of a large conjunctival cyst using the Plasma Assisted Non-Invasive Surgery (PANIS) method. Methods A 50-year-old female was diagnosed with a large conjunctival cyst. After topical anesthesia, with the use of PLEXR PLUS device, Plasma spots applied on the top of the cyst in order to sublimate and drain the cyst. visual parameters including refraction error, uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), intraocular pressure (IOP), and ocular surface disease index (OSDI) were measured before, six months, and one year after the procedure. Results Complete removal of the cyst occurred and no recurrence, any possible side effects or complications were seen in slit-lamp photos after six month and one year follow-up. Conclusion The PANIS method is a minimally invasive, office-based, and cost-...
medical research archives, 2023
Purpose: To introduce a novel technique using PANIS method (Plasma assisted noninvasive surgery) ... more Purpose: To introduce a novel technique using PANIS method (Plasma assisted noninvasive surgery) in pterygium removal surgery with conjunctival rotation flap.
Methods: Two patients (1 male, 1 Female) with grade 3 and 4 of pterygium, based on SLIT2 grading system, underwent surgery with local anesthesia, removing pterygium tissue from cornea and also all related subtenon. Then surgeon used residual conjunctiva to cover bare sclera using rotational method. Fusion of the border of conjunctival flaps from nasal to superior occurred by plasma spots. UCVA, BCVA, OSDI and patient satisfaction were evaluated before, 1 month, 6 months and 1 year after the surgery, as well as 1 day and 1 week post-operation examinations included slit-lamp and external check-up that has been done by the surgeon.
Results: Patients with primary pterygium, underwent surgery with PANIS method. Last follow-up session in 1 year, showed significant improvement in astigmatism and 1 line in BCVA. There were no complications and side effects during and after the surgery and also other reported complication included diplopia in lateral gaze, granuloma and scarring was not observed and no recurrence have been seen in the follow-up period and patients were satisfied. Additionally 1 day and 1 week slit-lamp examination showed plasma spots caused good attachment of conjunctival tissue with ocular surface.
Conclusion: After treating 2 patients with PANIS method, it seems that plasma spots can be a good substitute for suture or glue in pterygium surgery with conjunctival rotational flap, because it's easy and fast way for fusing the conjunctival flap without any complication or side effect.
Iranian Journal of Medical Sciences, 2023
Background: Conjunctival nevi (CN) are common benign ocular tumors. Given their low risk of malig... more Background: Conjunctival nevi (CN) are common benign ocular tumors. Given their low risk of malignancy, surgical removal of nevi is primarily requested by patients. Herein, we introduce Atmospheric Low-temperature Plasma (ALTP) as a novel noninvasive method for the removal of CN. Methods: A clinical case series was conducted from 2020 to 2021 at the Vision Health Ophthalmic Center in Tehran, Iran. CN in one of the eyes of seven patients was treated. In all patients, the benignity of CN was confirmed by ocular oncologists. The white handpiece of the Plexr device, which generates plasma with the lowest output, was used to apply plasma spots on the nevi. In addition, the Ocular Surface Disease Index (OSDI) questionnaire was completed by all patients before and six months after the treatment. Results: In all patients, the nevi outside the limbus area completely disappeared. The mean size of pre-and postoperative nevi was 3.89×11.7 and 0.54×1.69 mm, respectively. Results of the OSDI questionnaire showed significantly lower scores after the surgery in all patients. Conclusion: The ALTP method is a simple, cost-effective, and office-based surgery to remove CN safely and effectively.
Iranian Journal of Medical Sciences , 2023
Background: Conjunctival nevi (CN) are common benign ocular tumors. Given their low risk of malig... more Background: Conjunctival nevi (CN) are common benign ocular tumors. Given their low risk of malignancy, surgical removal of nevi is primarily requested by patients. Herein, we introduce Atmospheric Low-temperature Plasma (ALTP) as a novel noninvasive method for the removal of CN. Methods: A clinical case series was conducted from 2020 to 2021 at the Vision Health Ophthalmic Center in Tehran, Iran. CN in one of the eyes of seven patients was treated. In all patients, the benignity of CN was confirmed by ocular oncologists. The white handpiece of the Plexr device, which generates plasma with the lowest output, was used to apply plasma spots on the nevi. In addition, the Ocular Surface Disease Index (OSDI) questionnaire was completed by all patients before and six months after the treatment. Results: In all patients, the nevi outside the limbus area completely disappeared. The mean size of pre-and postoperative nevi was 3.89×11.7 and 0.54×1.69 mm, respectively. Results of the OSDI questionnaire showed significantly lower scores after the surgery in all patients. Conclusion: The ALTP method is a simple, cost-effective, and office-based surgery to remove CN safely and effectively.
Journal of Clinical Images and Medical Case Reports
Purpose: The present study aimed to evaluate the outcomes of a new technique for pterygium surger... more Purpose: The present study aimed to evaluate the outcomes of a new technique for pterygium surgery using a plasma-based method. Methods: A clinical case series study was carried out in 6 patients. Six eyes with grade 2 or 3 of primary pterygium were operated. The pterygium head was detached from the corneal surface. Then, the free conjunctival edges were attached near the limbus using the plasma spots [generated by Plexr device (GMV, Rocca Priora, RM, Italy)]. Refractive Error (RE), Visual Acuity (VA), Intraocular Pressure (IOP), Contrast Sensitivity (CS), Corneal Fluorescein Staining (CFS), Tear Meniscus Height (TMH), High Order Aberrations (HOA), and Ocular Surface Disorder Index (OSDI) were measured before the operation, one week after the operation, as well asone, three, and six months post-surgery. Slit-lamp images were taken before surgery and six months after that. Results: No intraoperative and postoperative complications were observed. Mild degrees of pain, tearing, foreign...
Background: Conjunctival nevi are benign ocular lesions with a low risk of malignant transformati... more Background: Conjunctival nevi are benign ocular lesions with a low risk of malignant transformation to melanoma. Due to cosmetic reasons patients usually consider surgical removal options. In this case report, we are presenting a new approach using plasma-assisted noninvasive surgery (PANIS) with amniotic membrane transplantation (AMT) to sublimate the nevus border and fuse the AMT with the remaining conjunctiva. Case presentation: A 33-year-old man with a history of large conjunctival nevus in his left eye, that its benignity was proved by an expert ophthalmologist through years of examination, has visited our center in September 2020. Plasma spots were used to sublimate the nevus border and fuse AMT with the conjunctiva. The patient was discharged fully satisfied without any complications and no recurrences were seen in a year of follow-up. Visual parameters were not significantly changed while the Ocular Surface Disease Index (OSDI) was reduced dramatically. Conclusion: Conjunctival nevi removal using the PANIS method with AMT is a safe, minimally invasive, and inexpensive therapeutic option. Plasma spots are suitable for AMT adhesion to the remaining conjunctiva after the nevus removal.
Background: The current study aims to evaluate the plasma-assisted noninvasive surgery (PANIS) as... more Background: The current study aims to evaluate the plasma-assisted noninvasive surgery (PANIS) as a novel technique for punctal occlusion to attain a long-term stricture of the punctum. Methods: This study involved 10 eyes from 10 female patients with grade 3 and 4 severity of dry eye disease (DED) based on the Delphi Panel scheme of dry eye. The punctal occlusion was conducted using the fusion mechanism of plasma spots using the white handpiece of plexr device. One single surgeon implemented the procedure three times at 2 weeks intervals. This office-based technique was assessed with acuity parameters, dry eye tests, and patient satisfaction evaluated by OSDI questionnaire before, and one month and six months after the procedure. Results: A remarkable improvement was observed in tear meniscus height (TMH) and tear break-up time (TBUT) in quite all patients. The visual parameters and intraocular pressure (IOP) had not considerably changed but CFS decreased due to more tear stability in the 6 months. The OSDI questionnaire scores of all patients had obviously reduced after the procedure. After all sessions, patients reached a quite long-term stricture in their puncta, whereas no complication or side-effects were reported after a 6-month follow-up. Conclusions: Findings of this clinical case serial study led to a novel therapy method for DED that results in the punctum stricture for months, using the PANIS method as an effective, safe, office-based, easy, and inexpensive approach where recalcitrance to the medical therapy occurs. Trial registration: This study registered in Semnan University of medical science, Semnan, Iran identified by IR.SEMUMS. REC.1398.319.
American Journal of Clinical and Experimental Medicine, 2021
Background: In recent years plasma medicine, played an important role in treating several ocular ... more Background: In recent years plasma medicine, played an important role in treating several ocular surface disorders. This study will introduce atmospheric low-temperature plasma (ALTP) for removing the pinguecula. Methods: In the clinical case series, five eyes of five patients (2 patients OD, 3 patients OS) with pinguecula were included. The pinguecula removed and completely healed, using the white handpiece of the plasma generator device (Plexr, GMV s.r.l Grottaferrata, Italy). Refraction parameters, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (BDVA), intraocular pressure (IOP), corneal fluorescein staining (CFS), contrast sensitivity (CS) and dry eye tests including, tear meniscus height (TMH) and tear breakup time (TBUT) were measured before, one month and six months after treatment for all patients. Results: The median size of the pinguecula was 3.5 mm (ranged from 2.5 to 4.5 mm). In all patients, the pinguecula was completely sublimated and after six months of follow-up, no evidence of recurrence was observed. In addition, the patient follow-up did not reveal any considerable complications during or 6 months after the surgery. Conclusion: Overall, the current study showed that, plasma assisted noninvasive surgery (PANIS method) is a simple, office-based, minimally invasive, effective approach to treat pinguecula with no considerable complications but it is noteworthy that, study with higher sample size like clinical trial is needed.
SCIREA Journal of Clinical Medicine, 2021
Background: Several studies have reported plasma-assisted noninvasive surgery (PANIS method) as a... more Background: Several studies have reported plasma-assisted noninvasive surgery (PANIS method) as a simple, inexpensive, office-based, minimally invasive, effective technique for treating some ocular surface diseases. This study aims to explore the efficacy of this method for occluding tear drainage system, temporary, in order to treat dry eye disease. Methods: Study was undertaken in six patients with moderate to severe dry eye (Schirmer's test < 10 mm and TBUT 10 sec). The inferior puncta were fused using white handpiece of the plasma generator device (Plexr, GMV s.r.l Grottaferrata, Italy) under topical anesthesia and they remained occlude for 2-5 days. The efficacy of the PANIS method was assessed with comprising Refraction, visual acuity, intraocular pressure (IOP), corneal fluorescein staining score (CFS), contrast sensitivity (CS), Schirmer test values, dry eye tests, and ocular surface disease index (OSDI) questionnaire which were collected before, 1week, 1month and 6 months after the procedure and during the first week after this treatment, the slit-lamp examination was performed every day.
Expert Review of Ophthalmology
ABSTRACT Background: Conjunctivochalasis (CCh) is a common bilateral conjunctival condition defin... more ABSTRACT Background: Conjunctivochalasis (CCh) is a common bilateral conjunctival condition defined by loose, redundant conjunctival folds, typically in the inferior bulbar conjunctiva. In recent years, various surgical procedures have been proposed to treat the conjunctivochalasis that each has its own limitations. The aim of this study was the evaluation of a quick surgical treatment of CCh using plasma, as a noninvasive procedure, and its effectiveness. Research design and methods: In this study, six patients with grade 3 and 4 CCh were evaluated as non-randomized and non-blinded trial case series. The surgery was performed using plasma spots produced by the white handpiece of the Plexr device at a distance of 4 mm from the inferior limbus. The number and rows of plasma spots were varied depending on the grade of CCh. Results: After surgery, patients were followed-up for 6 months. In all patients, the grade 3 and 4 CCh were decreased to grade 1 and 2, respectively, after one month all treated eyes were normal and no interface complications were observed. Conclusions: Based on the results, it seems that Plasma Assisted Noninvasive Surgery (PANIS) method can be used as a quick and easy method for the treatment of CCh.
Background and Objective: Plasma is one of the newest therapies recently used. This study aimed t... more Background and Objective: Plasma is one of the newest therapies recently used. This study aimed to evaluate a quick treatment modality of conjunctival concretions using plasma as a noninvasive procedure. Methods: Six eyes of six patients with conjunctival concretions were evaluated. The procedure was performed using plasma spots generated by the white handpiece of the Plexr device. The eyelid was everted and concretions sublimated by plasma spots from the upper and lower eyelids. Refractive Errors, visual acuity (BCVA and UCVA), Ocular Surface Disease Index (OSDI), and Intraocular pressure (IOP) were measured before and after six months of the procedure. Results: The results of 6 months follow-up show that this effective method had no recurrence or side effects. Treatment was effective in all of the patients. No complication and recurrence was observed. The OSDI score was improved to the normal range. This method had no effects on Refractive Errors, Visual Acuity, and IOP. Conclusion: Based on the results, it seems that the PANIS method can be used as a practical, quick, and straightforward approach for the treatment of conjunctival concretions.
BMC Ophthalmology
Background Atmospheric Low-Temperature Plasma (ALTP) can be used as an effective tool in conjunct... more Background Atmospheric Low-Temperature Plasma (ALTP) can be used as an effective tool in conjunctival cyst ablation, but little is known about how conjunctival ALTP-exposure affects the concentration of inflammatory mediators and also the duration of inflammatory responses. Methods We used 8 female adult Lewis rats that were followed up in 4 groups. The right eye of each rat was selected for the test, whereas the left eye was considered as a control. The ALTP was generated and used to target 3 spots of the conjunctiva. The digital camera examinations were performed to follow-up the clinical outcomes after ALTP exposure. Tear and serum samples were isolated—at 2 days, 1 week, 1 month, and 6 months after treatment—from each rat and the concentration of candidate pro-inflammatory (i.e. IL-1α, IL-2, IL-6, IFN-γ, and TNF-α) and anti-inflammatory cytokines (i.e. IL-4 and IL-10) were measured using flow cytometry. Results The external and digital camera examinations showed no ocular surfac...
Purpose: Medical plasma application has been used in different fields recently. In this study, we... more Purpose: Medical plasma application has been used in different fields recently. In this study, we assess the outcome of using plasma-assisted noninvasive surgery (PANIS) with amniotic membrane transplantation (AMT) in pterygium surgical treatment. Methods: This clinical case series was conducted in 4 patients with primary grades 1, 2, and 3 pterygium (Table 1). After exclusion and inclusion criteria considerations, patients underwent different examinations. Various measurements were obtained such as uncorrected visual acuity (UCVA), refractive error (RE), the best-corrected visual acuity (BCVA), and ocular surface disease index (OSDI). The surgical procedure was pterygium removal from the cornea and then AMT attached to the conjunctival borders with plasma spots using a white handpiece of Plexr device (Plexr, GMV s.r.l Grottaferrata, Italy) instead (Table 2). After postoperative follow-ups within the first week of the surgery and in 1 month and 6 months later the results were obtained. Results: All patients have been fully recovered after the surgery without any complications. In all 4 cases, UCVA, BCVA, and RE parameters have improved during 6 months after the surgical procedure. Every patients' OSDI decreased after the surgery. Recurrence has not been seen in any cases during 6 months follow-up. Conclusion: Pterygium removal surgery using the PANIS technique with AMT is safe, effective, fast, and cost-benefit.
Background: In recent years plasma medicine, played an important role in treating several ocular ... more Background: In recent years plasma medicine, played an important role in treating several ocular surface disorders. This study will introduce atmospheric low-temperature plasma (ALTP) for removing the pinguecula. Methods: In the clinical case series, five eyes of five patients (2 patients OD, 3 patients OS) with pinguecula were included. The pinguecula removed and completely healed, using the white handpiece of the plasma generator device (Plexr, GMV s.r.l Grottaferrata, Italy). Refraction parameters, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (BDVA), intraocular pressure (IOP), corneal fluorescein staining (CFS), contrast sensitivity (CS) and dry eye tests including, tear meniscus height (TMH) and tear breakup time (TBUT) were measured before, one month and six months after treatment for all patients. Results: The median size of the pinguecula was 3.5 mm (ranged from 2.5 to 4.5 mm). In all patients, the pinguecula was completely sublimated and after six months of follow-up, no evidence of recurrence was observed. In addition, the patient follow-up did not reveal any considerable complications during or 6 months after the surgery. Conclusion: Overall, the current study showed that, plasma assisted noninvasive surgery (PANIS method) is a simple, office-based, minimally invasive, effective approach to treat pinguecula with no considerable complications but it is noteworthy that, study with higher sample size like clinical trial is needed.
Background: Several studies have reported plasma-assisted noninvasive surgery (PANIS method) as a... more Background: Several studies have reported plasma-assisted noninvasive surgery (PANIS method) as a simple, inexpensive, office-based, minimally invasive, effective technique for treating some ocular surface diseases. This study aims to explore the efficacy of this method for occluding tear drainage system, temporary, in order to treat dry eye disease. Methods: Study was undertaken in six patients with moderate to severe dry eye (Schirmer's test < 10 mm and TBUT 10 sec). The inferior puncta were fused using white handpiece of the plasma generator device (Plexr, GMV s.r.l Grottaferrata, Italy) under topical anesthesia and they remained occlude for 2-5 days. The efficacy of the PANIS method was assessed with comprising Refraction, visual acuity, intraocular pressure (IOP), corneal fluorescein staining score (CFS), contrast sensitivity (CS), Schirmer test values, dry eye tests, and ocular surface disease index (OSDI) questionnaire which were collected before, 1week, 1month and 6 months after the procedure and during the first week after this treatment, the slit-lamp examination was performed every day.
BMC Ophthalmology
Background Plasma medicine is an innovative research field focused on the application of atmosphe... more Background Plasma medicine is an innovative research field focused on the application of atmospheric-pressure low-temperature plasmas (ALTP) for therapeutic purposes. Considering the potentials of plasma in ophthalmology, in this study, we evaluated the safety of plasma on the conjunctival tissue in animal models for 6 months. Methods Twelve adult male New Zealand albino rabbits were divided into four groups. The right eye of each rabbit was chosen for the test and the left eye was considered as the control. Experiments were performed using the Plexr device (GMV, Rocca Priora, RM, Italy). Four plasma spots were applied on the superior part of the conjunctiva (from 10 to 2 o’clock positions) using the continuous mode and a low power level (white handpiece) of the Plexr. For evaluation of the plasma safety, the histopathological changes were assessed 1 week (A), 1 month (B), 3 months (C), and 6 months (D) after the intervention. Results According to the histopathological findings, a m...
Medical Research Archives
Purpose: To introduce a novel technique using PANIS method (Plasma assisted noninvasive surgery) ... more Purpose: To introduce a novel technique using PANIS method (Plasma assisted noninvasive surgery) in pterygium removal surgery with conjunctival rotation flap. Methods: Two patients (1 male, 1 Female) with grade 3 and 4 of pterygium, based on SLIT2 grading system, underwent surgery with local anesthesia, removing pterygium tissue from cornea and also all related subtenon. Then surgeon used residual conjunctiva to cover bare sclera using rotational method. Fusion of the border of conjunctival flaps from nasal to superior occurred by plasma spots. UCVA, BCVA, OSDI and patient satisfaction were evaluated before, 1 month, 6 months and 1 year after the surgery, as well as 1 day and 1 week post-operation examinations included slit-lamp and external check-up that has been done by the surgeon. Results: Patients with primary pterygium, underwent surgery with PANIS method. Last follow-up session in 1 year, showed significant improvement in astigmatism and 1 line in BCVA. There were no complica...
Background Large conjunctival cysts are common benign lesions that can cause various visual and c... more Background Large conjunctival cysts are common benign lesions that can cause various visual and cosmetic problems. In this case report, we aim to report the successful removal of a large conjunctival cyst using the Plasma Assisted Non-Invasive Surgery (PANIS) method. Methods A 50-year-old female was diagnosed with a large conjunctival cyst. After topical anesthesia, with the use of PLEXR PLUS device, Plasma spots applied on the top of the cyst in order to sublimate and drain the cyst. visual parameters including refraction error, uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), intraocular pressure (IOP), and ocular surface disease index (OSDI) were measured before, six months, and one year after the procedure. Results Complete removal of the cyst occurred and no recurrence, any possible side effects or complications were seen in slit-lamp photos after six month and one year follow-up. Conclusion The PANIS method is a minimally invasive, office-based, and cost-...
medical research archives, 2023
Purpose: To introduce a novel technique using PANIS method (Plasma assisted noninvasive surgery) ... more Purpose: To introduce a novel technique using PANIS method (Plasma assisted noninvasive surgery) in pterygium removal surgery with conjunctival rotation flap.
Methods: Two patients (1 male, 1 Female) with grade 3 and 4 of pterygium, based on SLIT2 grading system, underwent surgery with local anesthesia, removing pterygium tissue from cornea and also all related subtenon. Then surgeon used residual conjunctiva to cover bare sclera using rotational method. Fusion of the border of conjunctival flaps from nasal to superior occurred by plasma spots. UCVA, BCVA, OSDI and patient satisfaction were evaluated before, 1 month, 6 months and 1 year after the surgery, as well as 1 day and 1 week post-operation examinations included slit-lamp and external check-up that has been done by the surgeon.
Results: Patients with primary pterygium, underwent surgery with PANIS method. Last follow-up session in 1 year, showed significant improvement in astigmatism and 1 line in BCVA. There were no complications and side effects during and after the surgery and also other reported complication included diplopia in lateral gaze, granuloma and scarring was not observed and no recurrence have been seen in the follow-up period and patients were satisfied. Additionally 1 day and 1 week slit-lamp examination showed plasma spots caused good attachment of conjunctival tissue with ocular surface.
Conclusion: After treating 2 patients with PANIS method, it seems that plasma spots can be a good substitute for suture or glue in pterygium surgery with conjunctival rotational flap, because it's easy and fast way for fusing the conjunctival flap without any complication or side effect.
Iranian Journal of Medical Sciences, 2023
Background: Conjunctival nevi (CN) are common benign ocular tumors. Given their low risk of malig... more Background: Conjunctival nevi (CN) are common benign ocular tumors. Given their low risk of malignancy, surgical removal of nevi is primarily requested by patients. Herein, we introduce Atmospheric Low-temperature Plasma (ALTP) as a novel noninvasive method for the removal of CN. Methods: A clinical case series was conducted from 2020 to 2021 at the Vision Health Ophthalmic Center in Tehran, Iran. CN in one of the eyes of seven patients was treated. In all patients, the benignity of CN was confirmed by ocular oncologists. The white handpiece of the Plexr device, which generates plasma with the lowest output, was used to apply plasma spots on the nevi. In addition, the Ocular Surface Disease Index (OSDI) questionnaire was completed by all patients before and six months after the treatment. Results: In all patients, the nevi outside the limbus area completely disappeared. The mean size of pre-and postoperative nevi was 3.89×11.7 and 0.54×1.69 mm, respectively. Results of the OSDI questionnaire showed significantly lower scores after the surgery in all patients. Conclusion: The ALTP method is a simple, cost-effective, and office-based surgery to remove CN safely and effectively.
Iranian Journal of Medical Sciences , 2023
Background: Conjunctival nevi (CN) are common benign ocular tumors. Given their low risk of malig... more Background: Conjunctival nevi (CN) are common benign ocular tumors. Given their low risk of malignancy, surgical removal of nevi is primarily requested by patients. Herein, we introduce Atmospheric Low-temperature Plasma (ALTP) as a novel noninvasive method for the removal of CN. Methods: A clinical case series was conducted from 2020 to 2021 at the Vision Health Ophthalmic Center in Tehran, Iran. CN in one of the eyes of seven patients was treated. In all patients, the benignity of CN was confirmed by ocular oncologists. The white handpiece of the Plexr device, which generates plasma with the lowest output, was used to apply plasma spots on the nevi. In addition, the Ocular Surface Disease Index (OSDI) questionnaire was completed by all patients before and six months after the treatment. Results: In all patients, the nevi outside the limbus area completely disappeared. The mean size of pre-and postoperative nevi was 3.89×11.7 and 0.54×1.69 mm, respectively. Results of the OSDI questionnaire showed significantly lower scores after the surgery in all patients. Conclusion: The ALTP method is a simple, cost-effective, and office-based surgery to remove CN safely and effectively.
Journal of Clinical Images and Medical Case Reports
Purpose: The present study aimed to evaluate the outcomes of a new technique for pterygium surger... more Purpose: The present study aimed to evaluate the outcomes of a new technique for pterygium surgery using a plasma-based method. Methods: A clinical case series study was carried out in 6 patients. Six eyes with grade 2 or 3 of primary pterygium were operated. The pterygium head was detached from the corneal surface. Then, the free conjunctival edges were attached near the limbus using the plasma spots [generated by Plexr device (GMV, Rocca Priora, RM, Italy)]. Refractive Error (RE), Visual Acuity (VA), Intraocular Pressure (IOP), Contrast Sensitivity (CS), Corneal Fluorescein Staining (CFS), Tear Meniscus Height (TMH), High Order Aberrations (HOA), and Ocular Surface Disorder Index (OSDI) were measured before the operation, one week after the operation, as well asone, three, and six months post-surgery. Slit-lamp images were taken before surgery and six months after that. Results: No intraoperative and postoperative complications were observed. Mild degrees of pain, tearing, foreign...
Background: Conjunctival nevi are benign ocular lesions with a low risk of malignant transformati... more Background: Conjunctival nevi are benign ocular lesions with a low risk of malignant transformation to melanoma. Due to cosmetic reasons patients usually consider surgical removal options. In this case report, we are presenting a new approach using plasma-assisted noninvasive surgery (PANIS) with amniotic membrane transplantation (AMT) to sublimate the nevus border and fuse the AMT with the remaining conjunctiva. Case presentation: A 33-year-old man with a history of large conjunctival nevus in his left eye, that its benignity was proved by an expert ophthalmologist through years of examination, has visited our center in September 2020. Plasma spots were used to sublimate the nevus border and fuse AMT with the conjunctiva. The patient was discharged fully satisfied without any complications and no recurrences were seen in a year of follow-up. Visual parameters were not significantly changed while the Ocular Surface Disease Index (OSDI) was reduced dramatically. Conclusion: Conjunctival nevi removal using the PANIS method with AMT is a safe, minimally invasive, and inexpensive therapeutic option. Plasma spots are suitable for AMT adhesion to the remaining conjunctiva after the nevus removal.
Background: The current study aims to evaluate the plasma-assisted noninvasive surgery (PANIS) as... more Background: The current study aims to evaluate the plasma-assisted noninvasive surgery (PANIS) as a novel technique for punctal occlusion to attain a long-term stricture of the punctum. Methods: This study involved 10 eyes from 10 female patients with grade 3 and 4 severity of dry eye disease (DED) based on the Delphi Panel scheme of dry eye. The punctal occlusion was conducted using the fusion mechanism of plasma spots using the white handpiece of plexr device. One single surgeon implemented the procedure three times at 2 weeks intervals. This office-based technique was assessed with acuity parameters, dry eye tests, and patient satisfaction evaluated by OSDI questionnaire before, and one month and six months after the procedure. Results: A remarkable improvement was observed in tear meniscus height (TMH) and tear break-up time (TBUT) in quite all patients. The visual parameters and intraocular pressure (IOP) had not considerably changed but CFS decreased due to more tear stability in the 6 months. The OSDI questionnaire scores of all patients had obviously reduced after the procedure. After all sessions, patients reached a quite long-term stricture in their puncta, whereas no complication or side-effects were reported after a 6-month follow-up. Conclusions: Findings of this clinical case serial study led to a novel therapy method for DED that results in the punctum stricture for months, using the PANIS method as an effective, safe, office-based, easy, and inexpensive approach where recalcitrance to the medical therapy occurs. Trial registration: This study registered in Semnan University of medical science, Semnan, Iran identified by IR.SEMUMS. REC.1398.319.
American Journal of Clinical and Experimental Medicine, 2021
Background: In recent years plasma medicine, played an important role in treating several ocular ... more Background: In recent years plasma medicine, played an important role in treating several ocular surface disorders. This study will introduce atmospheric low-temperature plasma (ALTP) for removing the pinguecula. Methods: In the clinical case series, five eyes of five patients (2 patients OD, 3 patients OS) with pinguecula were included. The pinguecula removed and completely healed, using the white handpiece of the plasma generator device (Plexr, GMV s.r.l Grottaferrata, Italy). Refraction parameters, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (BDVA), intraocular pressure (IOP), corneal fluorescein staining (CFS), contrast sensitivity (CS) and dry eye tests including, tear meniscus height (TMH) and tear breakup time (TBUT) were measured before, one month and six months after treatment for all patients. Results: The median size of the pinguecula was 3.5 mm (ranged from 2.5 to 4.5 mm). In all patients, the pinguecula was completely sublimated and after six months of follow-up, no evidence of recurrence was observed. In addition, the patient follow-up did not reveal any considerable complications during or 6 months after the surgery. Conclusion: Overall, the current study showed that, plasma assisted noninvasive surgery (PANIS method) is a simple, office-based, minimally invasive, effective approach to treat pinguecula with no considerable complications but it is noteworthy that, study with higher sample size like clinical trial is needed.
SCIREA Journal of Clinical Medicine, 2021
Background: Several studies have reported plasma-assisted noninvasive surgery (PANIS method) as a... more Background: Several studies have reported plasma-assisted noninvasive surgery (PANIS method) as a simple, inexpensive, office-based, minimally invasive, effective technique for treating some ocular surface diseases. This study aims to explore the efficacy of this method for occluding tear drainage system, temporary, in order to treat dry eye disease. Methods: Study was undertaken in six patients with moderate to severe dry eye (Schirmer's test < 10 mm and TBUT 10 sec). The inferior puncta were fused using white handpiece of the plasma generator device (Plexr, GMV s.r.l Grottaferrata, Italy) under topical anesthesia and they remained occlude for 2-5 days. The efficacy of the PANIS method was assessed with comprising Refraction, visual acuity, intraocular pressure (IOP), corneal fluorescein staining score (CFS), contrast sensitivity (CS), Schirmer test values, dry eye tests, and ocular surface disease index (OSDI) questionnaire which were collected before, 1week, 1month and 6 months after the procedure and during the first week after this treatment, the slit-lamp examination was performed every day.
Expert Review of Ophthalmology
ABSTRACT Background: Conjunctivochalasis (CCh) is a common bilateral conjunctival condition defin... more ABSTRACT Background: Conjunctivochalasis (CCh) is a common bilateral conjunctival condition defined by loose, redundant conjunctival folds, typically in the inferior bulbar conjunctiva. In recent years, various surgical procedures have been proposed to treat the conjunctivochalasis that each has its own limitations. The aim of this study was the evaluation of a quick surgical treatment of CCh using plasma, as a noninvasive procedure, and its effectiveness. Research design and methods: In this study, six patients with grade 3 and 4 CCh were evaluated as non-randomized and non-blinded trial case series. The surgery was performed using plasma spots produced by the white handpiece of the Plexr device at a distance of 4 mm from the inferior limbus. The number and rows of plasma spots were varied depending on the grade of CCh. Results: After surgery, patients were followed-up for 6 months. In all patients, the grade 3 and 4 CCh were decreased to grade 1 and 2, respectively, after one month all treated eyes were normal and no interface complications were observed. Conclusions: Based on the results, it seems that Plasma Assisted Noninvasive Surgery (PANIS) method can be used as a quick and easy method for the treatment of CCh.
Background and Objective: Plasma is one of the newest therapies recently used. This study aimed t... more Background and Objective: Plasma is one of the newest therapies recently used. This study aimed to evaluate a quick treatment modality of conjunctival concretions using plasma as a noninvasive procedure. Methods: Six eyes of six patients with conjunctival concretions were evaluated. The procedure was performed using plasma spots generated by the white handpiece of the Plexr device. The eyelid was everted and concretions sublimated by plasma spots from the upper and lower eyelids. Refractive Errors, visual acuity (BCVA and UCVA), Ocular Surface Disease Index (OSDI), and Intraocular pressure (IOP) were measured before and after six months of the procedure. Results: The results of 6 months follow-up show that this effective method had no recurrence or side effects. Treatment was effective in all of the patients. No complication and recurrence was observed. The OSDI score was improved to the normal range. This method had no effects on Refractive Errors, Visual Acuity, and IOP. Conclusion: Based on the results, it seems that the PANIS method can be used as a practical, quick, and straightforward approach for the treatment of conjunctival concretions.
BMC Ophthalmology
Background Atmospheric Low-Temperature Plasma (ALTP) can be used as an effective tool in conjunct... more Background Atmospheric Low-Temperature Plasma (ALTP) can be used as an effective tool in conjunctival cyst ablation, but little is known about how conjunctival ALTP-exposure affects the concentration of inflammatory mediators and also the duration of inflammatory responses. Methods We used 8 female adult Lewis rats that were followed up in 4 groups. The right eye of each rat was selected for the test, whereas the left eye was considered as a control. The ALTP was generated and used to target 3 spots of the conjunctiva. The digital camera examinations were performed to follow-up the clinical outcomes after ALTP exposure. Tear and serum samples were isolated—at 2 days, 1 week, 1 month, and 6 months after treatment—from each rat and the concentration of candidate pro-inflammatory (i.e. IL-1α, IL-2, IL-6, IFN-γ, and TNF-α) and anti-inflammatory cytokines (i.e. IL-4 and IL-10) were measured using flow cytometry. Results The external and digital camera examinations showed no ocular surfac...
Purpose: Medical plasma application has been used in different fields recently. In this study, we... more Purpose: Medical plasma application has been used in different fields recently. In this study, we assess the outcome of using plasma-assisted noninvasive surgery (PANIS) with amniotic membrane transplantation (AMT) in pterygium surgical treatment. Methods: This clinical case series was conducted in 4 patients with primary grades 1, 2, and 3 pterygium (Table 1). After exclusion and inclusion criteria considerations, patients underwent different examinations. Various measurements were obtained such as uncorrected visual acuity (UCVA), refractive error (RE), the best-corrected visual acuity (BCVA), and ocular surface disease index (OSDI). The surgical procedure was pterygium removal from the cornea and then AMT attached to the conjunctival borders with plasma spots using a white handpiece of Plexr device (Plexr, GMV s.r.l Grottaferrata, Italy) instead (Table 2). After postoperative follow-ups within the first week of the surgery and in 1 month and 6 months later the results were obtained. Results: All patients have been fully recovered after the surgery without any complications. In all 4 cases, UCVA, BCVA, and RE parameters have improved during 6 months after the surgical procedure. Every patients' OSDI decreased after the surgery. Recurrence has not been seen in any cases during 6 months follow-up. Conclusion: Pterygium removal surgery using the PANIS technique with AMT is safe, effective, fast, and cost-benefit.
Background: In recent years plasma medicine, played an important role in treating several ocular ... more Background: In recent years plasma medicine, played an important role in treating several ocular surface disorders. This study will introduce atmospheric low-temperature plasma (ALTP) for removing the pinguecula. Methods: In the clinical case series, five eyes of five patients (2 patients OD, 3 patients OS) with pinguecula were included. The pinguecula removed and completely healed, using the white handpiece of the plasma generator device (Plexr, GMV s.r.l Grottaferrata, Italy). Refraction parameters, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (BDVA), intraocular pressure (IOP), corneal fluorescein staining (CFS), contrast sensitivity (CS) and dry eye tests including, tear meniscus height (TMH) and tear breakup time (TBUT) were measured before, one month and six months after treatment for all patients. Results: The median size of the pinguecula was 3.5 mm (ranged from 2.5 to 4.5 mm). In all patients, the pinguecula was completely sublimated and after six months of follow-up, no evidence of recurrence was observed. In addition, the patient follow-up did not reveal any considerable complications during or 6 months after the surgery. Conclusion: Overall, the current study showed that, plasma assisted noninvasive surgery (PANIS method) is a simple, office-based, minimally invasive, effective approach to treat pinguecula with no considerable complications but it is noteworthy that, study with higher sample size like clinical trial is needed.
Background: Several studies have reported plasma-assisted noninvasive surgery (PANIS method) as a... more Background: Several studies have reported plasma-assisted noninvasive surgery (PANIS method) as a simple, inexpensive, office-based, minimally invasive, effective technique for treating some ocular surface diseases. This study aims to explore the efficacy of this method for occluding tear drainage system, temporary, in order to treat dry eye disease. Methods: Study was undertaken in six patients with moderate to severe dry eye (Schirmer's test < 10 mm and TBUT 10 sec). The inferior puncta were fused using white handpiece of the plasma generator device (Plexr, GMV s.r.l Grottaferrata, Italy) under topical anesthesia and they remained occlude for 2-5 days. The efficacy of the PANIS method was assessed with comprising Refraction, visual acuity, intraocular pressure (IOP), corneal fluorescein staining score (CFS), contrast sensitivity (CS), Schirmer test values, dry eye tests, and ocular surface disease index (OSDI) questionnaire which were collected before, 1week, 1month and 6 months after the procedure and during the first week after this treatment, the slit-lamp examination was performed every day.
BMC Ophthalmology
Background Plasma medicine is an innovative research field focused on the application of atmosphe... more Background Plasma medicine is an innovative research field focused on the application of atmospheric-pressure low-temperature plasmas (ALTP) for therapeutic purposes. Considering the potentials of plasma in ophthalmology, in this study, we evaluated the safety of plasma on the conjunctival tissue in animal models for 6 months. Methods Twelve adult male New Zealand albino rabbits were divided into four groups. The right eye of each rabbit was chosen for the test and the left eye was considered as the control. Experiments were performed using the Plexr device (GMV, Rocca Priora, RM, Italy). Four plasma spots were applied on the superior part of the conjunctiva (from 10 to 2 o’clock positions) using the continuous mode and a low power level (white handpiece) of the Plexr. For evaluation of the plasma safety, the histopathological changes were assessed 1 week (A), 1 month (B), 3 months (C), and 6 months (D) after the intervention. Results According to the histopathological findings, a m...