ISSN:0277-3740    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

&NA;Sixty‐three eyes of 49 patients with keratoconus were studied by means of computer‐assisted corneal topographic analysis. Two patients with keratoconus in one eye had no topographic evidence of keratoconus in the opposite eye. Keratoconic topographic alterations were classified into two groups. The majority of the patients (72%) had peripheral cones, with steepening extending to the limbus. In this group, the steepening was commonly restricted to one or two quadrants. In some cases, however, the changes involved nearly the entire corneal surface. The remaining group (about one quarter of the keratoconus patients) had steepening that was restricted to the central cornea. In either group, the topographic alterations in the two eyes of any single patient were characterized by a high degree of nonsuperimposable mirrorimage symmetry (enantiomorphism). In the majority of patients, however, there was a large and statistically significant disparity between the two eyes in the power at the apex of the cone and the total cylinder [mean differences 8.2 ± 6.0 D (p < 0.0001) and 4.3 ± 2.7 D (p < 0.0001), respectively].

ISSN:0277-3740    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

&NA;In 107 HLA‐A‐ and HLA‐B‐matched corneal transplantations performed in high‐risk patients, the 3‐year graft survival was 60.5%. The criteria used for the definition of high risk were vascularization of the recipient cornea and/or one or more previous failed grafts; they were also the indications for HLA typing and matching. Donor/recipient compatibility was defined by the presence of only 0 or 1 HLA‐A or HLA‐B mismatches. When nonimmunological factors leading to graft failure were excluded, the 3‐year survival was 76.3%. During that follow‐up period, a total of 33 grafts failed; in 13 cases, the cause was allograft rejection. When only first transplants were considered, a 3‐year graft survival of 81.0% was observed. Retrospective DR typing was possible in 33 cases. Because only three graft rejections occurred in that group, we were unable to assess the importance of DR compatibility on the survival of corneal allografts.

ISSN:0277-3740    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

&NA;Penetrating keratoplasty (PKP) in conjunction with postoperative corticosteroids may reactivate latent herpes simplex virus type 1 (HSV‐1) to cause persistent postoperative epithelial defects. The clinical diagnosis of HSV keratitis after penetrating keratoplasty is difficult because the postoperative appearance may be nondendritic and, therefore, not characteristic of HSV‐1 infection. Presently, the most reliable method to diagnose HSV‐1 under these conditions is to culture eyes for the presence of HSV‐1. To determine the coincidence of positive HSV‐1 ocular cultures with HSV‐1 epithelial defects, 15 rabbits (20 eyes) latently infected with HSV‐1 underwent autograft PKP with postoperative corticosteroids. Daily ocular cultures and slit‐lamp examinations were performed on postoperative days 1‐8 and 10. Viral shedding occurred in 15 of 19 (79.0%) of the eyes postoperatively. Superficial punctate keratopathy (SPK) was observed in 19 of 19 (100%) of the eyes and coincided with positive HSV‐1 cultures 24% of the time. Dendritic lesions were observed in three of 19 (15.8%) of the eyes; the dendrites coincided with positive HSV‐1 cultures 60% of the time. Finally, epithelial ulcers were seen in eleven of 19 (57.9%) of the eyes, thus coinciding with HSV‐1 positive cultures 29% of the time. The greatest coincidence of positive HSV‐1 cultures with nondendritic epithelial lesions occurred on postoperative day number 4. The results suggest that an epithelial lesion following PKP and postoperative corticosteroids could represent HSV infection, even if a single HSV ocular culture is negative.

ISSN:0277-3740    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

&NA;Moraxellacorneal ulcers are uncommon but may be complicated by marked inflammation and corneal perforation. In a series of eight cases treated over a period of 6 years, despite appropriate antibiotic therapy, descemetoceles and/or perforations developed in four cases, resulting in loss of the eye in two cases. In our series, the final visual acuity was count fingers or less in most patients (six of eight; 75%). Ulcers not only occurred in patients with systemic diseases, including alcoholism and malnutrition, but also in patients with various pre‐existing ocular surface diseases. It is important to be aware of the potential ofMoraxellaulcers to result in loss of vision and the eye.

ISSN:0277-3740    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

&NA;An aminoglycoside‐resistant strain ofPseudomonas aeruginosawas injected intrastromally into the corneas of rabbits, and keratitis was allowed to develop over a 22‐h period. Rabbits were treated with either 0.75% ciprofloxacin, 1% norfloxacin, or 1.36% tobramycin administered topically every 15 min for 1 h and then every 30 min for the following 3 h. All therapy ceased 26 h postinoculation. Rabbits were killed 1 h after the treatment, and the number of bacteria per cornea were quantified in terms of bacterial colony‐forming units. Aqueous humor specimens were obtained from rabbits receiving norfloxacin and ciprofloxacin, and bioassays were performed to determine drug concentration. Ciprofloxacin caused a 5 log reduction in the number of bacterial colony‐forming units, as compared with untreated controls (p < 0.0001); it also produced a significantly greater reduction in bacterial colony‐forming units than either norfloxacin or fortified tobramycin drops (p < 0.0001). Norfloxacin produced a 2 log reduction in bacterial colony‐forming units, as compared with untreated controls (p < 0.0001). The mean aqueous concentration of norfloxacin (7.5 μg/ml) was substantially less than that achieved by ciprofloxacin (30.5 μg/ml). We conclude that ciprofloxacin may be a useful broad spectrum, topical chemotherapeutic agent in the therapy of aminoglycoside‐resistantP. aeruginosakeratitis.

ISSN:0277-3740    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

&NA;Corneal endothelial decompensation is a frequent complication when silicone oil is used as a tamponade following vitrectomy for treatment of proliferative vitreoretinopathy in an aphakic eye. We evaluated the clinical, histopathological, and ultrastructural features of silicone oil‐induced keratopathy in 10 patients who developed corneal complications requiring penetrating keratoplasty. Clinically, some cases showed corneal edema, corneal hypesthesia, endothelial opacification, band keratopathy, and peripheral corneal vascularization. Histopathologically, retrocorneal membranes were present, and different degrees of stromal hypercellularity, superficial stromal calcification, and vascularization were noted. The ultrastructural features of endothelial cell loss and retrocorneal membrane formation are consistent with changes previously reported in rabbits and cats receiving intracameral silicone oil injections.

ISSN:0277-3740    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

&NA;The problem of astigmatism, occurring both congenitally and in conjunction with cataract and refractive surgery, is a common and significant one. A review of patients in this study shows 18% > 2 diopters and 6% > 3 diopters of astigmatism measured by keratometry. Many methods for correcting this astigmatism have developed, including long peripheral incisions, both straight and curved, the many varieties of the Ruiz procedure, and short paired relaxing incisions. I have reviewed my results for short paired incisions following cataract surgery, congenital astigmatism, and radial keratotomy at 6 months following surgery. The average change in astigmatism was 2.69 ± 0.78 (manifest)/2.35 ± 1.09 (keratometry) for the 5‐mm optic zone following cataract surgery. Paired relaxing incisions following radial keratotomy showed a change in astigmatism of 0.92 ± 0.19 (manifest)/1.29 ± 1.29 (keratometry) diopters for the 6‐mm optic zone and 2.12 ± 0.34 (manifest)/2.25 ± 0.49 (keratometry) diopters for the 5.5‐mm optic zone. No significant complications and no large overcorrections were encountered.

ISSN:0277-3740    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

&NA;Endothelial permeability (Pac) to carboxyfluorescein and Na+/K+ATPase pump site density were determined in human corneas following storage for 4 or 7 days at 4°C in either modified McCarey‐Kaufman (mMK) or K‐Sol media. Following 4 days of storage, Pac values for mMK‐and K‐Sol‐preserved corneas were not significantly different from those of their prestorage mates. After 7 days of storage, however, corneas stored in K‐Sol media showed a significant increase in Pac compared to their prestorage mates, whereas the mMK‐stored corneas showed no change in Pac. Na+/K+ATPase pump site density determined using [3H]ouabain was similar to a control group in the K‐Sol‐stored tissue but higher in the mMK‐stored tissue following 7 days of storage. These studies suggest that mMK medium maintains endothelial barrier function and Na+/K+ATPase pump site density at least as well as K‐Sol medium through 7 days of corneal storage.

ISSN:0277-3740    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

&NA;The microbiologic evaluations of 332 consecutive patients with the primary diagnosis of chronic blepharitis were reviewed and compared to those of 160 control patients. The most commonly isolated organisms from lids with blepharitis wereStaphylococcus epidermidis(95.8%),Propronibacterium acnes(92.8%),Corynebacteriumsp. (76.8%),Acinetobactersp. (11.4%), andStaphylococcus aureus(10.5%). Compared to controls,S. epidermidis(p < 0.01),P. acnes(p < 0.02), andCorynebacteriumsp. (p < 0.001) were present significantly more often.S. aureusand the isolation of more than one microbial species were not more common in blepharitis patients. Quantitatively, heavy growth, by total and individual species, was significantly more common in blepharitis patients (total, p < 0.001;S. epidermidis,p < 0.001,P. acnes,p < 0.001). These data demonstrate that patients with blepharitis are more likely to have normal skin bacteria on their lids and in greater quantities than nonblepharitis patients.

ISSN:0277-3740    

出版商:OVID    

年代:1991

数据来源: OVID