1,720,979 research outputs found
Gas tamponade and cyclocryotherapy of a chronic cyclodialysis cleft.
No full textAims: To describe a minimally invasive technique to treat a chronic large cyclodialysis cleft that had failed to respond to medical therapy. Methods: A 51-year-old man with a history of blunt trauma developed a unilateral chronic ocular hypotony. He was treated with topical atropine 1% for 3 months. 12 months later, the patient was referred to our glaucoma service for evaluation and treatment of persistent hypotony. Ultrasound biomicroscopy (UBM) displayed a cyclodialysis cleft extending from the 6 to 12 o'clock positions. B-scan echography revealed a peripheral choroidal effusion. A single bubble of 20% sulfur hexafluoride was injected into the vitreous cavity and transconjunctival cyclocryotherapy was performed. Results: After gas absorption, intraocular pressure increased to 12 mm Hg and became steady during the follow-up. B-scan echography showed the disappearance of choroidal effusion, and UBM displayed a complete closure of the cyclodialysis cleft from the 6 to 8:30 o'clock positions and from the 9:30 to 12 o'clock positions. A small cleft extending from the 8:30 to the 9:30 positions remained after the treatment, but the distance between the scleral spur and the ciliary boby decreased, and the cleft was limited at the back due to the scar formation. Conclusion: Gas tamponade with cyclocryotherapy represents a minimally invasive technique that is worth considering for patients with cyclodialysis clefts associated with a shallow anterior chamber and that had failed to respond to medical therapy. This technique should be useful in cases of cyclodialysis clefts that are not amenable to treatment with more conservative efforts
Comparison between morphology and morphometry of ciliary processes and ophthalmic parameters
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Influence of the COVID-19 Pandemic on Admissions for Retinal Detachment in a Tertiary Eye Emergency Department
Full text linkPurpose: To compare the incidence and clinical characteristics of retinal detachments (RDs) diagnosed in a tertiary eye emergency department (EED) during the COVID-19 pandemic and in the corresponding period of the previous 4 years. Methods: EED consultations performed from February 21, 2020 (first national case of COVID-19 infection) to May 3, 2020 (end of lockdown imposed by national Government) and for the same date range of 2016-2019 (pre-COVID-19 period), and with a confirmed diagnosis of RD were collected and reviewed. The following demographical and clinical features have been analyzed: age, gender, etiology of RD, macular involvement, best corrected visual acuity (BCVA), and duration of experienced symptoms. Results: Eighty-two subjects (20.5±1.0 eyes/year) were diagnosed with RD in the pre-COVID-19 period, compared to 12 patients in the COVID-19 period (-41.5%). During the pandemic, patients complained symptoms for a median of 8.5 days (IQR, 1.7-15 days) before the EED consultation, while in the pre-COVID-19 period, they declared they had been symptomatic for 2 days (IQR, 1-4 days) (p=0.037); macula-off RD raised from 56% to 75% and no one reported trauma as a triggering event. Conclusion: During the COVID-19 pandemic, the rate of RD diagnosed in our EED decreased significantly and patients waited longer before asking for an ophthalmologic examination. These findings are probably due to the fear of contracting the COVID-19 infection attending hospital environments. Even if emergency departments are often misused by people suffering non-urgent conditions, patients complaining of sudden visual loss, visual field defects, or phosphenes should always and promptly attend an EED visit to prevent a worse prognosis
Simultaneous bilateral acute angle-closure glaucoma in a patient with subarachnoid hemorrhage
No full textPURPOSE: To present an unusual case of simultaneous bilateral acute angle-closure (AAC) glaucoma in a patient with subarachnoid hemorrhage due to an aneurysm involving the right middle cerebral artery. METHODS: A 60-year-old woman with a clinically inexplicable bilateral nonreacting mydriasis after brain surgery underwent an ophthalmologic consultancy. The bilateral mydriasis was diagnosed as an unusual clinical presentation of simultaneous bilateral AAC glaucoma. One week after the AAC was bilaterally resolved, the patient underwent echographic examination because of the outbreak of a unilateral relapsed ocular hypertensive attack that required an ultrasound biomicroscopy (UBM) to be accurately diagnosed and treated. RESULTS: The bilateral AAC regressed completely after pharmacologic therapy. UBM evaluation of the eye with recurrence of the angle-closure glaucoma attack was necessary to confirm the diagnosis of unilateral relapsed angle-closure glaucoma due to an unresolved pupillary block. A viscoelastic-aided opening of the angle and peripheral surgical iridectomy were performed. UBM and tonometry were performed intraoperatively to confirm the success of the surgical treatment. CONCLUSIONS: The UBM allowed us to identify the pupillary block as the main mechanism involved in the pathogenesis of this unusual case of simultaneous bilateral AAC glaucoma. Despite the fact that drug-induced supraciliary uveal effusion and mydriasis due to surgical anesthesia have been frequently reported to contribute to this complication, we presumed that simultaneous intravenous administration of sedative drugs and adrenergic agonists, in a patient with individual biometric predisposing factors to the angle-closure, created the anatomic conditions which induced the pupillary block with obliteration of the trabeculum. © 2008 Lippincott Williams & Wilkins, Inc
Comparison of visual outcomes following cataract surgery with implantation of Lentis Mplus multifocal intraocular lens and Crystalens HD accomodating intraocular lens
No full textComparison of dynamic contour tonometry and Goldmann applanation tonometry in deep lamellar and penetrating keratoplasties
No full textPURPOSE: To compare the measurements of intraocular pressure (IOP) with dynamic contour tonometry (DCT) and Goldmann applanation tonometry (GAT) in eyes with corneal graft and to evaluate the influence of corneal thickness (CCT), corneal curvature (CC), and astigmatism on these methods. DESIGN: Prospective, observational cross-sectional study. METHODS: Eighteen eyes of 18 patients after penetrating keratoplasty (PKP) and 14 eyes of 14 patients after deep lamellar keratoplasty (DLKP) underwent IOP evaluation with DCT and GAT, and measurements of CCT, CC, and astigmatism. Bland-Altman plots were used to evaluate the agreement between tonometers. Multivariate regression analysis was used to evaluate the influence of ocular structural factors and running suture on IOP measurements obtained with both tonometers. RESULTS: IOP values obtained by DCT and GAT were strongly correlated in all eyes (r = .91; P < .001). DCT values measured 2.5 +/- 1.7 mm Hg higher than GAT readings (P < .001). A reduction of the mean IOP difference between DCT and GAT with an increase in IOP values (P < .001) was found. Regression analysis showed no effect of CCT, CC, astigmatism, and running suture on both DCT and GAT readings, either in DLKP or in PKP eyes. CONCLUSIONS: We found a good overall correlation between both tonometers but the agreement between instruments differs in high or low IOP ranges. The wide and varying 95% limits of agreement between DCT and GAT indicates that DCT provides IOP measurements on deep lamellar and penetrating keratoplasties which can be used in the clinical practice
Simultaneous bilateral retinal detachment following coronary artery bypass graft: case report
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