1,721,016 research outputs found

    Main complications of photorefractive keratectomy and their management

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    Photorefractive keratectomy (PRK) was the first surface ablation procedure introduced for the treatment of refractive errors and has been proven to be effective and safe. In some cases, however, the patient may not be totally satisfied with the final result and retreatment may be necessary. We performed a literature review to describe the main conditions that may arise following PRK that may require retreatment and new promising techniques to allow customized and effective treatments for patients. There is currently no gold standard for retreatment of residual refractive error after PRK. The surgeon must take into account the patient’s history and type of problem when choosing the most appropriate technique. LASIK and PRK are the main options. Haze can be treated with good results with phototherapeutic keratectomy and mytomicin C. High order aberrations and decentration may be addressed with topographically-guided excimer photoablation or with wavefront-guided PRK

    Diagnostic and management strategies of aspergillus endophthalmitis: current insights

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    Fungal endophthalmitis is subsequent to endogenous or exogenous infection and represents an important complication of ocular surgery which may lead to significant visual loss and blindness. The prognosis is poor because of delayed diagnosis and limited availability of effective antifungal drugs with good ocular penetration. Furthermore, the critical issue in diagnosing fungal infection of the eye is microbiological identification of the etiologic agent in clinical samples. Aspergillus is among the most frequent isolated organisms in fungal endophthalmitis. Early diagnosis is essential to prevent severe complications and blindness. Treatments include local, systemic and surgical therapeutic strategies. The purpose of the present review is the analysis of the current procedures adopted to promptly diagnose and treat Aspergillus endophthalmitis

    Efficacia di una terapia senza bendaggio con gel a base di trealosio ialuronato sodico carbomero, nella riparazione del danno corneale epiteliale di tipo meccanico vs terapia a base di pomata antibiotica oftalmica con bendaggio

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    Introduzione: la superficie oculare è una complessa unità funzionale, il cui normale funzionamento è regolato dal sistema nervoso, particolarmente espresso a livello corneale. Diverse patologie possono portare ad una alterazione della superficie oculare e tra queste le patologie traumatiche della superficie oculare. In caso di trauma lo scopo principale della terapia della superficie oculare è di riparare il danno epiteliale. L’effetto protettivo e riparativo di una formulazione in gel a base di trealosio/ialuronato sodico/carbomero può trovare una valida applicazione nei processi di riparazione di danno epiteliale. Scopo: valutare l’efficacia riparativa nei confronti del danno epiteliale di tipo meccanico, di una formulazione in gel a base di trealosio/ialuronato sodico/carbomero, senza bendaggio oculare in confronto ad una terapia topica antibiotica con bendaggio oculare. Materiali e metodi: studio osservazionale condotto su 262 pazienti afferiti presso la clinica Oculistica di Roma nel periodo maggio 2014 – giugno 2017 per una lesione corneale e/o corneo-congiuntivale di natura da corpo estraneo o per abrasione corneale traumatica. È stata ottenuta l’approvazione del Comitato Etico ed il consenso informato dei pazienti. Il primo gruppo era costituito da 158 pazienti sottoposti a rimozione di corpo estraneo corneale e trattati per 7 giorni con le seguenti modalità: 83 pazienti con una formulazione in gel a base di trealosio/ialuronato sodico/carbomero quattro volte al giorno senza bendaggio oculare; 75 pazienti con una terapia topica antibiotica quattro volte al giorno con bendaggio oculare. Il secondo gruppo costituito da 104 pazienti con abrasione corneale e trattati con le stesse modalità descritte nel primo gruppo di pazienti (50 vs 54 rispettivamente). Risultati: dopo 4 giorni di trattamento la percentuale di guarigione dei pazienti trattati con la formulazione in gel a base di trealosio/ialuronato sodico/carbomero rispetto ai pazienti trattati con terapia topica antibiotica era significativamente superiore in entrambi i gruppi (73% vs 32%; p<0,01 Gruppo 1) (78% vs 29%; p<0,01 Gruppo 2). La differenza si è mantenuta anche dopo 7 giorni di trattamento (98% vs 91%; p<0,01 Gruppo 1) (100% vs 87% Gruppo 2; p<0,01). Una differenza statisticamente significativa dopo 4 giorni di trattamento è stata riscontrata per i parametri soggettivi come dolore (0,22 vs 0,47; p<0,01 Gruppo 1) (0.1 vs 0.5; p<0,01 Gruppo 2), bruciore (0,23 vs 0,79; p<0,01 Gruppo 1) (0.1 vs 0.8; p<0,01 Gruppo 2) e sensazione di corpo estraneo (0,51 vs 1,37; p<0,01 Gruppo 1) (0.4 vs 1.8; p<0,01 gruppo 2). Conclusioni: la terapia con una formulazione in gel a base di trealosio/ialuronato sodico/carbomero senza bendaggio sembra una valida alternativa all’applicazione di pomata oftalmica antibiotica con bendaggio.Introduction: The ocular surface is a complex functional unit whose normal functions are regulated by the nervous system, particularly expressed at the corneal level. Various diseases, and also traumatic injuries, can lead to the alteration of the ocular surface. In case of trauma, the main purpose of ocular surface therapy is to repair the epithelial damage. A gel formulation based on trehalose/sodium hyaluronate/carbomer may represent a valid strategy to help the epithelial repair processes, thanks to its protective and repairing action. Aim: To evaluate the effect of a gel formulation based on trehalose/sodium hyaluronate/carbomer without eye patching compared to topical antibiotic therapy with eye patching, in recovering epithelial damage caused by mechanical injury. Materials and methods: An observational study involving 262 patients referred to the Ophthalmology Clinic in Rome between May 2014 and June 2017 for corneal and/or cornealconjunctival lesion caused by a foreign body or by traumatic corneal abrasion. Ethical approval was obtained , and only consenting subjects were involved. The first group involved 158 patients who underwent corneal foreign body removal and were treated for 7 days as follows: 83 patients received a gel formulation based on trehalose/sodium hyaluronate/carbomer four times a day, without occlusive eye patch; 75 patients were treated with topical antibiotic therapy four times a day and occlusive eye patch. The second group included 104 patients with corneal abrasion who underwent the same treatments described for the first group of patients (50 vs 54 patients, respectively). Results: After 4 days of treatment, the recovery rate was significantly higher in both groups of patients treated with the gel formulation based on trehalose/sodium hyaluronate/carbomer, compared to patients treated with topical antibiotic therapy (73% vs 32%, p<0.01; Group 1) (78% vs 29%, p<0.01; Group 2). The difference was maintained even after 7 days of treatment (98% vs 91%, p<0.01; Group 1) (100% vs 87%, p<0.01; Group 2). A statistically significant difference was found after 4 days of treatment in subjective parameters such as pain (0.22 vs 0.47, p<0.01; Group 1) (0.1 vs 0.5, p<0.01; Group 2), burning sensation (0.23 vs 0.79, p<0.01; Group 1) (0.1 vs 0.8, p<0.01; Group 2) and foreign body sensation (0.51 vs 1.37, p<0.01; Group 1) (0.4 vs 1.8, p<0.01; Group 2). Conclusions: Treatment with a gel formulation based on trehalose/sodium hyaluronate/carbomer without occlusive patch seems a valid alternative to the application of an antibiotic ophthalmic ointment and occlusive eye patching

    MEASUREMENT OF CORNEAL THICKNESS BY ULTRASOUND AFTER PHOTOREFRACTIVE KERATECTOMY IN HIGH MYOPIA

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    BACKGROUND: Photorefractive keratectomy (PRK) has been used to treat myopia in human eyes since 1988.METHODS: We evaluated corneal ablation depth after excimer laser myopic photorefractive keratectomy with the Summit Technology Excimed UV200LA laser. Preoperative refraction was: mean 9.58 diopters (D) +/- 2.01, (range 6 to 17), We used ultrasound pachometry (1640 m/sec) in 40 eyes of 33 patients. Mean follow-up was of 49.5 weeks (range 16 to 76).RESULTS: The measurement of the corneal thickness showed a reduction of the initial thickness followed by an inconsistent increase caused by wound healing and tissue proliferation.CONCLUSION: The data showed no direct correlation between diopters of refractive correction and the change in corneal thickness

    Steroids and neuroendocrine hormones detected by the immunoperoxidase technique from malignant melanomas and nevi of the choroid and conjunctiva

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    By the peroxidase-antiperoxidase technique, the authors studied 7 malignant choroidal melanomas, 7 conjunctival nevi and 1 malignant conjunctival melanoma with the aim to detect the presence of vasoactive intestinal polypeptide (VIP), adrenocorticotropic hormone (ACTH), gastrin, estradiol and testosterone. Positive staining reaction for VIP, estradiol and testosterone was observed in both malignant melanomas of the choroid and conjunctival nevi. The case of conjunctival melanoma was positive for VIP and ACTH but not for estradiol and gastrin
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