266 research outputs found
The nubile savage
No full text'In Tahiti time stands still', proclaims a recent Qantas airlines advertising campaign. While time has certainly not stood still in Tahiti, in some ways the stereotype of island women has. Qantas' full page ad is dominated by a lithesome Polynesian woman. Viewed from behind, she stands looking out to sea, thick black hair falling to her waist. She wears a luxuriant garland of flowers around her head, and a bright yellow and green print pareu around her waist. She is apparently bare-breasted.
Most people will be familiar with the idea of the 'noble savage'. It denotes the close association of indigenous people with the nobility of nature which often shaded the reports of early European explorers. I would suggest that another stereotype, closely linked to, but in some ways even more pervasive, is that of the 'nubile savage'. If the noble savage idea persists in a muted form, the nubile savage assumes an even stronger place in the Western. imagination
Long-term complications of bilateral posterior chamber phakic intraocular lens implantation.
No full textA 34-year-old woman had posterior chamber phakic intraocular lens (PCP IOL) implantation to correct high myopia in both eyes. Five years postoperatively, the patient presented with a decrease in visual acuity from central anterior subcapsular cataract formation in both eyes and IOL dislocation in the left eye. In vivo confocal microscopy of the cornea showed markedly decreased endothelial cell density in both eyes and the presence of bright endothelial microdeposits possibly related to pigmentary dispersion. Gonioscopy showed angle pigmentary deposits with no intraocular pressure increase. The patient was successfully treated by removing the PCP IOLs and performing phacoemulsification with in-the-bag IOL implantation in both eyes. This led to a recovery of visual acuity. This case report presents the rare occurrence and surgical management of cataract formation, IOL dislocation, and severe endothelial cell loss as a late complication of PCP IOL implantatio
In vivo confocal microscopy in primary congenital glaucoma with megalocornea.
No full textTo report the microscopic findings of congenital glaucoma-related megalocornea using in vivo confocal microscopy.
PATIENTS AND METHODS: Two consecutive adult patients presenting the typical features of glaucomatous megalocornea underwent a complete ophthalmologic examination. The first patient presented with progressive glaucoma with bilateral megalocornea. The second patient's left eye was affected by megalocornea without actual evidence of glaucoma, whereas the right eye was healthy. Both patients were examined using a new-generation scanning slit corneal confocal microscope.
RESULTS: In both patients, confocal microscopy revealed a mild reduction of keratocyte density in the mid and rear stroma, a particular abnormal "clew-shaped" morphology of stromal nerves, and the presence of discontinuous hyperreflective structures overhanging the endothelial layer at the level of the Descemet membrane. The endothelium showed severe polymegethism, pleomorphism, and a markedly decreased cell density, and focal cellular lesions were noted.
CONCLUSION: Confocal microscopy is a diagnostic tool used to evaluate microscopic aspects of Haab striae and endothelial morphologic changes in glaucomatous megalocornea. Unsuspected alterations, such as nerves abnormalities and focal endothelial tractions by scar tissue, were observed
Prospective randomized comparison of wavefront-guided and conventional photorefractive keratectomy for myopia with the meditec MEL 70 laser.
No full textPURPOSE: To study refractive results and aberrometric changes in myopic patients treated with wavefront-guided photorefractive keratectomy (PRK) in comparison with standard PRK.
METHODS: Sixty eyes of 60 patients with myopic astigmatism were randomly divided into two groups. Group 1 included 30 eyes (mean spherical equivalent refraction -4.39 +/- 1.31 D; range -2.50 to -6.50 D) treated with wavefront-guided PRK using the WASCA workstation and the Asclepion Meditec flying spot MEL 70 excimer laser. Group 2 had 30 eyes (mean spherical equivalent refraction -4.33 +/- 1.22 D; range -2.50 to -6.50 D) that underwent conventional PRK using the same laser, and served as the control group. Wavefront analysis of high order aberrations was performed before and 6 months after surgery.
RESULTS: Postoperatively, wavefront error increased in both groups (5.0-mm wavefront aperture diameter). Six months after surgery, the eyes that received the WASCA ablation had a smaller increase in root-mean-square (RMS; 70% of increment) compared to the conventional PRK group (139% of increment) (P<.001). In the standard PRK group, all aberrations notably increased; in the wavefront-guided PRK group there was a smaller increase of trefoil and spherical aberrations (P<.001) and a decrease of coma aberrations (P<.001). The smaller increase of wavefront error in the wavefront-guided PRK group compared to the standard PRK group was more evident when preoperative RMS values were higher than 0.4 microm (P<.01). The visual parameters (spherical equivalent refraction, uncorrected and best spectacle-corrected visual acuity) did not show significant differences between the two groups.
CONCLUSION: Wavefront-guided PRK induced a smaller increase of postoperative wavefront-error compared to conventional PRK, particularly in patients with higher preoperative higher order aberrations
Femtosecond Laser-Assisted Stromal Lenticule Addition Keratoplasty for the Treatment of Advanced Keratoconus: A Preliminary Study
No full textPURPOSE: To investigate the in vivo effect of a novel femtosecond laser-assisted procedure termed stromal lenticule addition keratoplasty for advanced keratoconus.
METHODS:
Ten patients with stage III and IV stable keratoconus were included. Negative meniscus-shaped stromal lenticules were produced from corneoscleral eye bank buttons with a refractive lenticule extraction procedure with a 500-kHz VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany). Recipient corneas underwent a modified femtosecond laser flap-cut procedure to produce an intrastromal pocket and lenticules were implanted. Patients were followed up for 6 months after surgery with determination of uncorrected (UDVA) and corrected (CDVA) distance visual acuity, subjective refraction and topographic corneal curvature changes, anterior segment optical coherence tomography (AS-OCT), and in vivo confocal microscopy.
RESULTS:
Comparison of preoperative and 6-month postoperative UDVA and CDVA showed statistically significant improvements (P = .024 and .007, respectively) from 1.58 ± 0.36 to 1.22 ± 0.37 and from 1.07 ± 0.17 to 0.70 ± 0.23 logMAR. Eight of 10 eyes showed an improvement in UDVA (P < .001) that ranged between one and three lines, whereas all but one eye presented improved CDVA. Corneal topography documented a decrease between preoperative and 6-month postoperative anterior mean curvature (AVG-K at 3 mm) and anterior Q values (P = .005). AS-OCT showed a significant increase in thickness of the central and mid-peripheral cornea produced by the lenticule implantation (P = .005).
CONCLUSIONS:
The stromal lenticule addition keratoplasty procedure was clinically efficient in improving the corneal shape and vision in patients with keratoconus. Negative meniscus-shaped lenticule addition induced a flattening of the cone while increasing corneal thickness
Management of scleral rupture during retinal detachment surgery: a case report.
No full textPURPOSE: Rupture of the sclera occurring during retinal detachment surgery is generally associated with unfavourable anatomic and visual outcomes. Re-operation after a failed scleral buckle procedure and pre-existing scleral thinning are considered the main risk factors for scleral rupture.
CASE REPORT: We describe the management and the favourable outcome of a case of scleral rupture in a 71-year-old woman during re-operation for retinal detachment.
CONCLUSIONS: We managed this case of scleral rupture in accordance with current indications concerning the anatomical recovery, by scleral suture and patch graft, restoring IOP by gas tamponade. The positive outcome was partly related to the prompt closure of the retinal hole which led to reattachment, and partly to favourable events such as the moderate intensity of vitreous hemorrhage and the lack of any more serious intraoperative and postoperative complications
Pathological changes of anatomical structure and markers of limbal stem cell niche due to inflammation
No full textPurpose: It’s known that severe inflammatory processes may cause limbal stem cell (SC) deficiency decreasing the number of SC niches and changing the microanatomy of these structures.Methods: The aim of this study was to evaluate the expression of different SC markers in normal human limbus and to study how an inflammatory conditions can modulate these antigens. To understand the pathological changes in limbal crypts structure due to severe inflammation, a case of corneal melting and perforation in advanced herpes simplex (HSV) disease, two cases of endophthalmitis and a case of fungal infection were analyzed.Samples were examined by immunohistochemistry or immunofluorescence for p63, vimentin, laminin5, integrin (Int) α6, int β1, int β4, ABCG2, desmoglein 3, connexin43, N-cadherin and cytokeratin (K) 12 positivity. We evaluated the anatomical structure of limbal crypts in each case and the positivity for SC marker used to identify SC.Results: In normal limbus, the investigated SC markers were positive. In the HSV we didn’t observe presence of crypts, whereas in both cases of endophthalmitis crypts were still present but they had an atypical structure: the basal cells in the crypts were “stretched” and endowed by inflammatory cells. In the pathological cases, we observed positivity for K12 while, among SC markers, p63, ABCG2 and connexin43 were still present; the others antigens were variably expressed.Conclusion: Different pathologies involving the limbus may result in marked chenges of expression of SC markers within the crypts
Structural modifications and tissue response after standard epi-off and iontophoretic corneal crosslinking with different irradiation procedures
No full textPURPOSE: The aim of this study is to investigate modifications in human cadaver corneas after different crosslinking procedures, including standard epi-off treatment, iontophoresis imbibition, and different exposure to ultraviolet A (UVA) sources (30 minutes at 3 mW and 9 minutes at 10 mW).
METHODS:
A total of 12 human cadaver corneas was examined and divided as follows: 3 served as control (group 1), 3 were treated with a standard epi-off procedure (group 2), 6 underwent iontophoresis imbibition for 5 minutes, and then 3 were irradiated for 30 minutes with 3 mW UVA (group 3), and 3 for 9 minutes at 10 mW UVA (group 4). Deformation amplitude index was measured before and after the corneas underwent treatment. After treatment, corneas were prepared for hematoxylin-eosin and immunohistochemistry evaluation. The expression of TUNEL, matrix metalloproteinase-1 (MMP-1), collagen type I, and CD34 was investigate in all samples.
RESULTS:
The deformation amplitude index decreased in all groups, in particular in group 4, indicating an improvement of corneal biomechanical properties. Immunohistochemical staining showed a significant stromal alteration in group 2, mild damage in group 3, and no modifications in corneal morphology in group 4. The TUNEL (P < 0.001) and MMP-1 (P = 0.002) positivity was more evident in group 4. Collagen type I positivity significantly increased in groups 3 (P = 0.002) and 4 (P = 0.002). The CD34 expression was more evident in groups 2 (P = 0.003) and 3 (P = 0.003).
CONCLUSIONS:
Iontophoresis imbibition followed by UVA irradiation for 9 minutes at 10 mW determined less tissue damage and better stromal remodeling
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