1,720,992 research outputs found
Cheratotomie curve con arcitomo di Hanna associate a PRK nella correzione degli astigmatismi miopici
No full textManual deep lamellar keratoplasty: alternative methods and air-guided technique.
No full textPurpose. To describe the techniques proposed for performing deep lamellar keratoplasty
(DLK) and to evaluate the efficacy of a new, modified technique.
Methods. Fourteen eyes in 11 patients with keratoconus of moderate degree were
included. All patients underwent a DLK with manual dissection from a limbal side port
after an air bubble injection in the anterior chamber. All patients had complete
ophthalmologic examination 6 months after the suture removal, evaluating best corrected
visual acuity, corneal thickness, endothelial cell count, and topographic astigmatism.
Results. One case (7.1%) was converted to penetrating keratoplasty because of microperforation.
In the 13 successful cases, 10 eyes (71.4%) achieved 20/30 or better 6 months
after suture removal. Mean postoperative pachymetry was 628.39 (SD 57.34). Specular
microscopy 6 months after suture removal revealed average endothelial cell count of 2261
(SD 287/mm2).
Conclusions. Comparing this modified DLK technique with other methods proposed by
several authors, air-guided DLK seems to be safe and effective and, after a short learning
curve, can be performed with a low risk of conversion to penetrating keratoplasty
Stage 4 diffuse lamellar keratitis after laser in situ keratomileusis Clinical, topographical, and pachymetry resolution 5 years later.
No full textIn March 1999, a 35-year-old woman had uneventful laser in situ keratomileusis in both eyes on the same day. Five days postoperatively, slitlamp biomicroscopy of the left eye showed an appearance similar to haze after photorefractive keratectomy, with greater density at the center and striae convergent toward the infiltrate (stage 4 diffuse lamellar keratitis [DLK]). The patient received treatment with dexamethasone 0.2% eyedrops every 2 hours. After 2 weeks, visual acuity was better and improvement was evident on topography, pachymetry, and slitlamp photography. The improvements were more marked at 6 months and 1 year. There was a progressive increment in corneal thickness and consequent improvement in corneal transparency, curvature, and regularity. This case, in which continuous morphologic adaptation of the cornea occurred, indicates that observation, rather than intervention, is a valid therapeutic option for stage 4 DLK
Tumore neuroectodermico primitivo dell’orbita successivo a radioterapia ed escissione di una neoplasia gliale cerebrale
No full textPermaVision intracorneal lens for the correction of hyperopia.
No full textPURPOSE: To evaluate the safety, predictability, and efficacy of sutureless synthetic keratophakia (SSK) with PermaVision intracorneal lens (Anamed) implantation.
SETTING: Ophthalmic Hospital, Rome, Italy.
METHODS: This retrospective study analyzed the refractive outcomes in 10 eyes of 6 patients who had SSK with PermaVision lens implantation for spherical hyperopia (cylinder less than 1.0 diopter [D]). Preoperatively, the mean spherical equivalent (SE) refraction was +4.33 D +/- 1.52 (SD) (range +3.00 to +6.37 D). All procedures were performed using the Hansatome microkeratome (Bausch & Lomb) with a superior hinge except in 1 eye in which the flap was cut using the Amadeus microkeratome (Allergan) with a nasal hinge.
RESULTS: Six months after PermaVision lens insertion, the mean SE refraction was +0.03 +/- 0.36 D (range -0.50 to +0.38 D), the mean uncorrected visual acuity was 0.85 +/- 0.13 (range 0.63 to 1.00), and the mean best corrected visual acuity was 0.99 +/- 0.19 (range 0.63 to 1.25). No eye lost lines of visual acuity. In 1 eye, the lens was acutely decentered and had to be explanted.
CONCLUSIONS: Sutureless synthetic keratophakia with the PermaVision intracorneal lens is a new technique for the correction of hyperopia. It is easy to perform as well as reversible, and the learning curve of the experienced laser in situ keratomileusis surgeon is short. The technique was safe and effective for spherical hyperopia, but longer follow-up and additional cases are needed to draw conclusions about the efficacy of the technique
Ultrasound biomicroscophy in the diagnosis and management of ciliary body traumatic avulsion
No full textLong-term results of combined 1-way phacoemulsification, intraocular lens implantation, and trabeculectomy.
No full textPURPOSE: To analyze the results of 1-way phacoemulsification and posterior chamber intraocular lens (IOL) implantation combined with trabeculectomy.
SETTING: Department of Ophthalmology and Neurosurgery, University of Siena, Siena, Italy.
METHODS: This retrospective study comprised 42 eyes of 36 patients with glaucoma and cataract who had phacoemulsification with posterior chamber IOL implantation combined with trabeculectomy. The mean follow-up of 28.24 months +/- 10.99 (SD) (range 11 to 52 months) included measurement of intraocular pressure (IOP), visual acuity, visual field, endothelial cell loss, and notation of complications.
RESULTS: There was a statistically significant postoperative improvement in visual acuity (P < .001). Mean preoperative best corrected visual acuity (BCVA) was 20/200 (range 20/30 to hand movements). Mean 1 year postoperative BCVA was 20/30 (range 20/20 to 20/60). The preoperative mean IOP of 24.06 mm Hg decreased to 15.36 mm Hg at 1 year (P < .001). All 42 eyes had a postoperative IOP of less than 21.00 mm Hg. Mean central cornea endothelial cell density preoperatively was 2238 +/- 396 cells/mm2 (range 1697 to 2906 cells/mm2) and postoperatively, 2005 +/- 397 cells/mm2 (range 1302 to 2801 cells/mm2). Early postoperative complications consisted of a choroidal detachment in 2 patients (4.76%). Three and 4 days after surgery, respectively, 2 patients (4.76%) had surgery to remove viscoelastic substance under the IOL. Late complications included posterior synechias in 3 eyes (7.14%). One year after surgery, because of a significant decrease in vision, a neodymium:YAG laser posterior capsulotomy was necessary in 2 eyes, 1 with an acrylic IOL (3.70%) and 1 with a silicone lens (9.09%).
CONCLUSION: Combined phacoemulsification, posterior chamber IOL implantation, and trabeculectomy was safe and effective in patients with coexisting glaucoma and cataract
Complex retinal detachment in phakic patients: previtrectomy. Phacoemulsification Versus Combined Phacovitrectomy
Full text linkPURPOSE:: To assess the impact of phacoemulsification performed one week before pars plana vitrectomy versus combined phacovitrectomy on postoperative anterior segment status and final functional and anatomical outcomes in phakic patients affected by complex rhegmatogenous retinal detachment. METHODS:: The authors retrospectively reviewed the records of 59 phakic patients affected by complex rhegmatogenous retinal detachment. Twenty-nine patients underwent cataract surgery 7 days before vitrectomy (preemptive cataract surgery—Group 1), whereas 30 patients underwent combined phacovitrectomy (Group 2). Preoperative, intraoperative, early- and late-postoperative outcomes were measured and compared. RESULTS:: Numbers of previous retinal surgical procedures, nuclear sclerosis grade, proliferative vitreoretinopathy grade, eyes with inferior breaks, surgical time, and ratio of silicone oil/gas tamponade were all similar between the two groups. After surgery, there was less extension of posterior synechia in Group 1. There was no significant difference in fibrin, number of patients with posterior synechia, final intraocular pressure, retinal redetachment rate, final retinal status, or final best-corrected visual acuity. CONCLUSION:: Preemptive cataract surgery was associated with less extensive postoperative posterior synechia, however, its final functional and anatomical outcomes were not significantly different from those of phacovitrectomy. Both approaches were efficacious.This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially
Choroidal neovascularization after laser-assited in situ keratomileusis following penetrating keratoplasty
No full textPURPOSE:
To describe a case of choroidal neovascularization (CNV) after laser in situ keratomileusis (LASIK) following penetrating keratoplasty (PK).
METHODS:
Case report.
RESULTS:
A 30-year-old man underwent PK in both eyes for bilateral keratoconus in 1997. Two years later, best-corrected visual acuity (BCVA) was 20/40 (-6=-4.50 x 170 degrees ) in RE and 20/20 (-1.50=-0.50 x 90 degrees ) in LE. To reduce the anisometropic defect, LASIK was performed in RE. After surgery, the refractive defect in RE reduced to -1.75 x 125 degrees and BCVA improved to 20/25. Six months after LASIK the patient presented loss of vision and metamorphopsia in RE due to choroidal neovascularization. BCVA was reduced to 20/200. Photodynamic therapy was performed in RE; 1 year later BCVA was stable at 20/200.
CONCLUSION:
Vitreoretinal complications after LASIK occur rarely. The potential relationship between CNV and LASIK is discussed
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