ISSN:1040-8738    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1040-8738    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Herpes simplex virus (HSV) is a leading cause of chronic infectious ocular disease in the United States. The morbidity from recurrent herpetic episodes is high, and the resultant corneal scarring may require penetrating keratoplasty for visual rehabilitation. Effective treatments for acute episodes of HSV have been verified by early Herpetic Eye Disease Study (HEDS) trials. The recent HEDS trial on the efficacy of oral acyclovir as prophylaxis against recurrent stromal keratitis represents the first report of a treatment likely to reduce long-term scarring from herpetic disease. This article reviews all the HEDS trials and the implications of their findings for the management of patients with ocular HSV.

ISSN:1040-8738    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

In the past 2 years, significant advances have been made in the genetics of corneal dystrophies. Genetic heterogeneity (one disease condition caused by single mutations in any one of multiple genes) and phenotypic diversity (many disease conditions caused by mutations in a single gene) are common emerging themes. Genetic heterogeneity in Meesmann corneal dystrophy was established with the identification of two causative genes, keratins 3 and 12, that encode cytoskeletal proteins. Conversely, mutations in a single gene, keratoepithelin, were found to cause several distinct corneal dystrophies affecting the Bowman layer and the stroma. We present a novel preliminary classification of corneal dystrophies based on molecular etiology. This classification may be useful in understanding the pathogenesis of corneal dystrophies and in developing new strategies to treat these dystrophies.

ISSN:1040-8738    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

A seven-stage approach to the management of the paretic eyelid complex has been described. These stages include supportive care, planning and execution of general facial reanimation, lower eyelid and canthal resuspension or support, passive upper eyelid animation, dynamic lid animation, and soft tissue repositioning. A final stage, the epilogue, is described for the treatment of the synkinesis and hypertonicity that often develop. Recent developments in these areas are discussed. Floppy eyelid syndrome, first described by Culbertson and Ostler, is a syndrome of chronic papillary conjunctivitis in overweight patients with easily everted eyelids. The syndrome has now been associated with a variety of other conditions and findings. Surgical management with horizontal shortening of the floppy eyelids remains the mainstay of therapy.

ISSN:1040-8738    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The development of excimer laser technology, coupled with advances in lamellar corneal surgery, has heralded a new era in the treatment of refractive errors. This paper discusses the current status of hyperopic laser-assisted in situ keratomileusis. This surgical modality is at a relatively early stage of investigation but appears to offer promise for the surgical correction of hyperopia. This paper considers the evolution of the technique, analyzes the current literature, and discusses the current indications, limitations, and possible future developments.

ISSN:1040-8738    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

New surgical techniques in lamellar keratoplasty, including phototherapeutic keratectomy, automated lamellar keratectomy, plano-epikeratoplasty, deep anterior lamellar keratoplasty, combined amniotic membrane and limbal transplantation, large-diameter corneoscleral lamellar keratoplasty, and posterior lamellar keratoplasty, have recently become available. These procedures broaden the array of treatments for corneal disorders and may be used as alternatives to penetrating keratoplasty.

ISSN:1040-8738    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The advent of corneal refractive surgery has, inevitably, resulted in the occasional need for contact lens fitting after surgery. For each new, developing procedure, new contact lens fitting challenges arise. The literature on contact lens use after radial keratotomy is rich and well known, but reports on the use of contact lenses after photorefractive keratectomy or laser-assisted in situ keratomileusis are few and far between. This review summarizes the prevailing clinical opinions on the contact lenses and contact lens fitting methods that are most effective after refractive surgery that results in high refractive error, irregular astigmatism, or anisometropia.

ISSN:1040-8738    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Laser periocular surgery has achieved an increased popularity, especially since recent technical developments in the carbon dioxide and erbium:yttrium-aluminum-garnet lasers. Despite the relative safety of these procedures in experienced hands, postoperative complications affecting the periocular region, and the eye itself, may follow laser surgery. Common complications include persistent erythema, hyper-and hypopigmentation, and hypertrophic scarring. Skin infection (viral, bacterial, or fungal) may also jeopardize the postoperative period after periocular laser treatment. Severe burns, transitory or permanent, lower lid ectropion, and even corneal injuries or ocular perforation are among the most severe hazards. A thorough preoperative evaluation, appropriate training, and a cautious and conservative approach are reinforced to minimize such problems.

ISSN:1040-8738    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Neurotrophic keratopathy is a degenerative corneal disease caused by an impairment of corneal sensitivity. Lack of the sensory nerve's trophic effect is responsible for the impairment in corneal healing and for the changes on the ocular surface that lead to corneal epithelial deficit, ulcer, and perforation. The etiology and recent advances in understanding of the pathogenetic mechanisms of neurotrophic keratopathy are reviewed here. An accurate history and a clinical examination that covers the function of cranial nerves often identify the cause of the disease. Clinical features and guidelines for the differential diagnosis and treatment are presented. Specific medical and surgical treatments, selected on the basis of clinical staging of the disease, can often halt disease progression. Future developments in medical treatment, including the use of neuropeptide and growth factors, are discussed. The identification of corneal anesthesia associated with an epithelial defect allows appropriate treatment and prevention of progression to stromal lysis and perforation.

ISSN:1040-8738    

出版商:OVID    

年代:1999

数据来源: OVID