1,720,994 research outputs found
Concomitant effect of topical ubiquinone Q10 and vitamin E to prevent keratocyte apoptosis after excimer laser photoablation in rabbits
No full textPURPOSE:
To investigate in vivo whether ubiquinone Q10 together with vitamin E protects rabbit corneas from keratocyte apoptosis after excimer laser irradiation.
METHODS:
Photorefractive keratectomy (PRK) was performed in both eyes of three New Zealand white rabbits. During 3 days before surgery, each right eye received four-times-daily instillation of an eye-drop solution containing ubiquinone Q10 0.20% and vitamin E 0.04%; each left eye was treated with a solution that did not contain ubiquinone or vitamin E. The central cornea was analyzed after surgery using the in situ end labelling (ISEL) technique of nicked DNA to detect DNA fragmentation. To determine the number of ISEL positive nuclei, an average of 70 random microscopic fields (five for each de-epithelialized tissue section) of 138,000 mu2 were examined in the right and left cornea samples at 250X by two different observers.
RESULTS:
Light microscopic examination of the sections from corneas treated before PRK showed that cells committed to apoptosis by PRK were about 50% compared to those of untreated controls.
CONCLUSION:
Treatment of rabbit eyes before PRK with ubiquinone Q10 lowered the number of apoptotic events
Broad Beam vs. Flying Spot Excimer Laser: Refractive and Videokeratographic Outcomes of two Different Ablation Profiles after Photorefractive Keratectomy
No full textPURPOSE:
To assess the refractive outcomes and videokeratographic patterns in photorefractive keratectomy (PRK) of two last-generation excimer lasers: broad beam and flying spot lasers.
METHODS:
Forty eyes were treated for a mean myopic correction of -5.59+/-2.17 D with a Ladarvision excimer laser (Autonomous Technology Corp). We compared the refractive outcomes and the videokeratographic patterns with those of 40 eyes treated with the Summit Apex Plus laser (Summit Technology Inc) for a mean myopic correction of -5.60+/-2.24 D.
RESULTS:
During the 6-month follow-up, we found no significant difference in uncorrected and spectacle-corrected visual acuity, haze grade, regularity index, or decentration. The eyes treated by Ladarvision showed a lower refractive error at 1 month (P = .04), a lower incidence of central islands at 1 (P = .003) and 3 months (P = .04), a wider mean effective ablation area at 1 (P = .0004), 3 (P = .0000009), and 6 months (P = .0000000004), a less steep ablation edge at 1 (P = .0026), 3 (P = .015), and 6 months (P = .011).
CONCLUSIONS:
The small beam excimer laser provides better videokeratographic outcomes, which lead to quicker refractive stability and better visual performance
Mechanical vs. alcohol epithelial removal during photorefractive keratectomy.
No full textPURPOSE:
To assess whether a chemical debridement method for excimer laser photorefractive keratectomy may lead to better refractive and visual results than the standard method which involves the use of a blunt blade to scrape off the epithelium.
METHODS:
Ninety-three eyes with a mean attempted correction of -5.72 +/- 2.47 D were debrided using a surgical microsponge after epithelial melting by 20% ethanol solution applied for 20 seconds, and treated by PRK. Results were compared to those from 97 eyes with a mean attempted correction of -6.05 +/- 2.46 D, deepithelialized using a Desmarres blade.
RESULTS:
Debridement time was faster in the eyes where alcohol was used (P = .04). During a 6-month follow-up, we found no significant differences in refractive error, uncorrected, and spectacle-corrected visual acuity. However, haze rates at were lower (1 month, P = .04), and corneal regularity index was better (3 months, P = .01) in the eyes deepithelialized using alcohol.
CONCLUSIONS:
Epithelial debridement using a 20% alcohol solution was faster to perform, and provided sharper edges and a smoother Bowman's layer surface than mechanical debridement. This may explain the better results in terms of haze and corneal regularity
Combined pars plana vitrectomy and phacoemulsification to restore visual acuity in patients with chronic uveitis.
No full textAbstract
PURPOSE:
To report the outcomes of combined phacoemulsification and pars plana vitrectomy (PPV) to restore visual acuity in patients with cataract and posterior segment involvement secondary to chronic uveitis.
SETTING:
Ocular Immunology and Uveitis Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
METHODS:
This study comprised 34 patients (20 women, 14 men; 36 eyes) with posterior segment involvement secondary to chronic uveitis who had combined phacoemulsification and PPV from 1998 to 2002. The main outcome measures were visual acuity, intraocular pressure, and cystoid macular edema.
RESULTS:
The mean patient age was 45 years +/- 16.09 (SD). The mean duration of uveitis before surgery was 56 +/- 44.17 months. In 24 eyes (66.7%), an intraocular lens (IOL) was implanted during surgery; 12 eyes (33.3%) were left aphakic. Five eyes (13.8%) received an intraocular steroid injection intraoperatively. Visual acuity improved in 26 eyes (72.2%), deteriorated in 5 (13.9%), and was unchanged in 5 (13.9%). The main reason for decreased visual acuity was refractory macular edema. During the follow-up, 2 IOLs were explanted secondary to lens intolerance. One IOL was repositioned because of iris capture by the haptics, and 1 dislocated inferiorly, causing monocular diplopia. The mean follow-up was 23.4 +/- 16.7 months.
CONCLUSIONS:
Results indicate that combined phacoemulsification and PPV is a feasible technique for the removal of cataract and pathologic vitreous in eyes with chronic uveitis. Although the exact role of vitrectomy in patients with uveitis remains to be determined, the combined surgery successfully restored useful vision in most cases
Transient therapeutic effect of vitrectomy in primary intraocular lymphoma
No full textThis photo essay shows the transient therapeutic effect of pars plana vitrectomy (PPV) in a patient affected by primary intraocular lymphoma (PIOL). PPV is crucial for the diagnosis of PIOL, but it may also play a role in the therapeutic approach
Depth-Resolved Imaging of Papillary Vitreoretinal Neovascularization: OCT-Angiography Assessment in Ocular Ischemic Syndrome
No full textPost-operative endophthalmitis caused by Acremonium falciforme with orbital and extra-orbital involvement following combined cataract and glaucoma surgery: a case report
No full textINTRODUCTION:
In this report, we describe an unusual case of post-operative Acremonium falciforme endophthalmitis with orbital and extra-orbital involvement following combined cataract and glaucoma surgery.
CASE PRESENTATION:
A 68-year-old Caucasian man with glaucoma presented with endophthalmitis characterized by pain, redness and impaired vision in the left eye fifteen days after combined cataract and filtering surgery. He subsequently underwent a pars plana vitrectomy, with vitreous sampling, silicone oil placement and intra-vitreal injection of antibiotics, but only after a second vitrectomy we identified Acremonium falciforme as the causative agent for the endophthalmitis. An antifungal systemic and topical therapy was started, but meanwhile the infection extended to orbital and peri-orbital tissues. Following these procedures, even if the eye went slowly in phthisis, we were able to limit the further extension and circumscribe the orbital and extra-orbital involvement.
CONCLUSION:
To our knowledge, this report is the first describe Acremonium falciforme endophthalmitis with orbital and extra-orbital involvement, following anterior segment combined surgery. Ophthalmologists and physicians should be aware of the extension risk of a fungal panophthalmitis, but also to potentially serious side effects related to systemic therapy
Adverse drug rections to treatments for ocular toxoplasmosis: a retrospective chart review.
No full textOBJECTIVE:
This study evaluated the incidence and types of adverse drug reactions (ADRs) associated with medications used to treat active toxoplasmic chorioretinitis.
METHODS:
This was a retrospective review of the clinical records of a consecutive series of patients with active toxoplasmic chorioretinitis, examined between March 1991 and August 1998. For inclusion in the review, patients had to have been diagnosed with active toxoplasmic chorioretinitis, been treated with a single drug or drug combination indicated for this condition, and been followed for at least 8 weeks. Patients who were lost to follow-up or who had incomplete chart data were excluded. Demographic data, pertinent aspects of the medical history, drug treatments, and ADRs associated with antitoxoplasmic treatment were recorded.
RESULTS:
Fifty-five patients met the criteria for inclusion in the review. In descending order of frequency, they received antitoxoplasmic treatment with clindamycin (n = 50), sulfadiazine (n = 40), pyrimethamine (n = 33), trimethoprim-sulfamethoxazole (n = 16), and atovaquone (n = 10), alone or in combination. Twenty-two patients (40.0%) had a total of 27 ADRs. The most frequently occurring ADRs were rash (19 [34.5%]), mostly associated with sulfadiazine (9/40 [22.5%]) and clindamycin (6/50 [12.0%]), and gastrointestinal ADRs such as diarrhea (6 [10.9%]), stomach upset (6 [10.9%]), and bleeding (1 [1.8%]), mostly associated with clindamycin (5/50 [10.0%], 3/50 [6.0%], and 1/50 [2.0%], respectively). The incidence of ADRs associated with individual antitoxoplasmic drugs was 30.0% (3/10) for atovaquone, 26.0% (13/50) for clindamycin, 22.5% (9/40) for sulfadiazine, 12.5% (2/16) for trimethoprim-sulfamethoxazole, and 12.1% (4/33) for pyrimethamine. There were 2 serious ADRs: gastrointestinal bleeding in a patient treated with clindamycin and leukopenia in a patient treated with pyrimethamine. Twenty-five ADRs were reversed on drug discontinuation; the remaining 2 were mild and did not require drug discontinuation.
CONCLUSIONS:
The overall incidence of treatment-associated ADRs was high (40.0%) in these patients with ocular toxoplasmosis. The most frequently occurring ADRs were rash and gastrointestinal complaints
Retinal astrocytic hamartoma with associated macular edema: report of spontaneous resolution of macular edema as a result of increasing hamartoma calcification
No full textThe purpose of this article is to report a case of retinal astrocytic hamartoma with an associated macular edema and the spontaneous resolution of the latter due to an increase in hamartoma calcification over a seven-year follow-up period. Clinical examination, red-free and colour fundus photographs, fluorescein angiography, and optical coherence tomography were performed during a seven-year follow-up. We conclude that retinal astrocytic hamartomas may be associated with cystoid macular edema. In some cases, the CME may resolve due to an increase in tumor calcification. Whether the progressive calcification of the retinal mass represents an overall positive prognostic factor is still unknown and further histologic studies are certainly required
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