摘要:

Purpose.To describe a 30-year-old man with bilateral but asymmetric anterior keratoconus and unilateral cornea guttata in the eye with more advanced keratoconus.Method.Case report.Results.The patient's keratoconus was diagnosed three or four years earlier. The keratoconus was confirmed by slit-lamp examination, keratometry, and computer-assisted topographic analysis. Cornea guttata were confirmed by clinical examination and specular microscopy.Conclusion.This is a rare case of unilateral cornea guttata associated with asymmetric keratoconus, showing severe guttate change only in the eye with more advanced keratoconus.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To develop a technique that achieves satisfactory visual rehabilitation in keratoglobus, without the problems of re-epithelialization failure and with minimal risk of graft rejection.Methods.A patient with bilateral keratoglobus and visual acuities of light perception in the right eye and 6/60 in the left underwent a tectonic lamellar keratoplasty to the right eye. The cornea was first trephined to the depth of the anterior stroma within the limbus. A lamellar dissection technique then was used to tunnel into sclera under the limbus to preserve stem cells. The host corneal epithelium was completely débrided, and a donor corneoscleral button, denuded of its endothelium, was laid on top. A paracentesis was made, and aqueous was aspirated until the anterior chamber had collapsed enough to take up a more physiologic shape. The donor corneoscleral graft was sutured into the prefashioned scleral bed with long, interrupted sutures. Once in situ, the donor graft was débrided of epithelium, and the host limbus was sutured on to it, covering its scleral component. Six months later, a penetrating keratoplasty was performed. The same procedure was performed on the left eye 2 years later.Results.The right eye maintained a best-corrected visual acuity of 6/60 for 16 months after the penetrating graft until the graft decompensated, leaving a final acuity of counting fingers. The left eye maintained a best-corrected visual acuity of 6/18.Conclusion.Tectonic lamellar keratoplasty to preserve the host limbus, followed by secondary penetrating keratoplasty, is a realistic alternative to other procedures for the surgical management of keratoglobus.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.We present a case of peripheral corneal ulceration in a patient with hepatitis C, which rapidly and dramatically responded to intravenous steroid treatment.Methods.Clinical examination and photographs were obtained to document initial presentation and therapeutic response of Mooren's-type ulcers to steroids.Results.Bilateral peripheral corneal ulceration with documented progression responded to intravenous administration of steroids within 5 days.Conclusion.Previous reports of Mooren's-type ulcers in patients with chronic hepatitis C have shown a response to interferon alfa-2b, but not to oral corticosteroid therapy. Given the medical contraindications to interferon use in selected patients and the cost, we suggest a trial of high-dose systemic steroids as a possible therapy.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To describe a post-LASIK patient with decreased vision and a chalazion of the upper eyelid.Methods.A 46-year-old man was referred with decreased vision of 1 month's duration. He underwent bilateral uncomplicated LASIK for myopic astigmatism 1.5 years and bilateral enhancements 1 year previously. He had 20/20 uncorrected vision in both eyes after those procedures. He developed a chalazion of his right central upper eyelid 1 month prior with simultaneous blurring of vision. On our examination, his uncorrected visual acuity was 20/60 in the right eye. Complete eye examination including refraction, computerized corneal topography, and pachymetry were done.Results.With a manifest refraction of +1.25 +0.50×80, the visual acuity in the right eye improved to 20/20. Computerized corneal topography revealed circular central corneal flattening in both eyes, much greater in the right eye than the left eye. The location of the chalazion with the right eye closed corresponded to the area of central corneal flattening. The central power from the corneal topography was 39.4 D OD and 40.8 D OS. He was diagnosed as having acquired hyperopia associated with chalazion-induced central corneal flattening of the right eye. Chalazion-induced hyperopic change on topography disappeared, and his uncorrected vision improved to 20/20 in the left eye as the chalazion resolved completely.Conclusion.In post-LASIK patients with decreased vision and topography changes late after surgery, periocular masses should be considered in the differential diagnosis. Decreased corneal thickness and rigidity after LASIK might be a predisposing factor to external compression-induced curvature changes.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To present a 90-year-old patient with spontaneous expulsive suprachoroidal hemorrhage (SESCH). This unique case suggests a mechanism of SESCH, which is still under debate.Methods.The patient, who had corneal inflammatory disease and diabetes mellitus, atherosclerosis, and glaucoma, presented with active ocular bleeding and expulsion of intraocular tissues. Almost the entire cornea was absent, except for several small and irregular areas in its periphery. Histopathologic evaluation of the eviscerated contents was performed.Results.Clinicopathologic evaluation revealed acute inflammation of the corneal remains as well as intraocular inflammation. Inflammatory necrosis of choroidal vessels was evident.Conclusion.The findings point to the assumption that choroidal bleeding, secondary to vascular inflammatory necrosis, was the initial event in this case of spontaneous expulsive suprachoroidal hemorrhage. Presumedly, the intraocular pressure level was very high owing to continuous bleeding, which could result in a very large, rather than localized, tearing of the peripherally inflamed cornea.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To report on the feasibility of combined deep lamellar keratoplasty and vitreoretinal surgery in one patient with corneal opacity associated with retinal detachment.Methods.A 35-year-old man presented with a major hematocornea and retinal detachment after experiencing a right ocular trauma with corneoscleral wound 1 month earlier. We elected to perform deep lamellar keratoplasty to perform vitreoretinal surgery through the bared Descemet's membrane within the same surgical procedure.Results.Deep lamellar keratoplasty offered perfect visibility of the anterior and posterior segments of the eye through the bared Descemet's membrane during the 4-hour operation. Descemet's membrane was resilient enough to maintain remarkable tightness of the anterior chamber throughout vitreoretinal surgery procedures (vitrectomy, peeling of epiretinal membranes, encircling scleral buckling). Unfortunately, despite our efforts and extended operative time, the retina could not be restored to its position because of the high baseline level of ocular impairment.Conclusion.The combined procedure (deep lamellar keratoplasty and pars plana vitrectomy) appeared to be a good and feasible alternative to the temporary keratoprosthesis usually applied in that situation.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To describe a case of fungal keratitis caused by a rare coelomycete pathogen,Colletotrichum gloeosporioides.Methods.An 82-year-old man with myelodysplastic syndrome developed fungal keratitis 6 months after cataract surgery in the left eye. Because the findings of the anterior chamber deteriorated after the initiation of natamycin, additional treatment with topical and systemic fluconazole was initiated.Results.The isolates of corneal scraping grewC. gloeosporioides. After antifungal treatment of 2 months, the corneal lesion resolved with no recurrence of infection over a 5-year follow-up period.Conclusions.A combination treatment of natamycin and fluconazole was effective in the treatment ofC. gloeosporioides.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID