1,721,018 research outputs found
In vivo confocal microscopy in a patient with conjunctival lymphoma
No full textA case of primary conjunctival mucosa-associated lymphoid tissue lymphoma studied by in vivo corneal confocal microscopy (IVCM) is described for the first time. Examination of the lower mediobulbar and forniceal conjunctiva of the left eye of a 37-year-old female patient showed a typical salmon-pink patch. IVCM examination of the conjunctival lesion showed irregular, polygonal, conjunctival bulbar epithelial cells with blurred edges and without visible nucleus. Many small, roundish, hyper-reflective cells were also seen. These cells were arranged diffusely or in nests in cyst-like hypo-reflective spaces. A few highly reflective cells were also visible among deep stromal collagen fibres. The IVCM picture recalled the histological profile of low-grade mucosa-associated lymphoid tissue lymphoma, characterized by sheets of neoplastic cells around reactive follicles. IVCM enabled non-invasive evaluation of the eye surface at high magnification and with good contrast, and could be useful for early differential diagnosis of conjunctival lesions. © 2007 The Author Journal compilation © 2007 Royal Australian and New Zealand College of Ophthalmologists
Indagine clinico-statistica sui portatori di lenti a contatto nell’ambulatorio della Clinica Oculistica di Siena
No full textReview of corneal transplant role of Eye Banks and introduction of the artificial cornea AlphaCor in Italy : Trapianti di cornea; ruolo dell’Eye Banking e introduzione della cornea artificiale AlphaCorTM in Italia
No full textLa situazione dei trapianti corneali in Italia è stata monitorata dalla Società Italiana Trapianti di Cornea (SITRAC), nata allo scopo fondamentale di aggiornare i suoi iscritti sulle novità e sulle linee guida nel campo della chirurgia corneale con l'ulteriore compito di fornire dati statistici sulla chirurgia del trapianto di cornea in Italia.
Dai dati in nostro possesso risulta un incremento annuale del numero di trapianti di cornea; dal 1999 al 2001 sono stati eseguiti oltre 12 000 trapianti di cornea con lembi provenienti da banche italiane con un incremento rispetto al triennio precedente di circa il 50% legato all'intensificarsi della preziosissima attività svolta dal servizio nazionale di Eye Banking e alla diffusione che questa chirurgia ha avuto attraverso il lavoro della SITRAC. Il trend in aumento è confermato dai dati relativi al triennio 2001-2003, sia per quanto riguarda il numero di cornee espiantate e sottoposte a valutazione analitica, che sottolinea un congruo aumento delle donazioni in Italia, sia per quanto attiene la percentuale di idoneità, che si è dimostrata stabile con un relativo incremento del rapporto del numero di cornee analizzate e assegnate.
I risultati dimostrano una buona autonomia del servizio di Eye Banking in Italia, come risulta dalla percentuale sempre più ridotta dei centri di chirurgia oftalmica che si rivolgono a banche estere per la richiesta dei lembi corneali destinati al trapianto. Tuttavia si registrano ancora difficoltà legate alla significativa percentuale di cornee ritenute non idonee.
In questa review si riporta la situazione generale dei trapianti corneali in Italia verificata dal Dipartimento di Scienze Oftalmologiche e Neurochirurgiche dell'Università di Siena su incarico dalla SITRAC.
Non sempre il trapianto di cornea rappresenta la soluzione in tutti i casi di opacità corneale. Nel mondo vi sono oltre 10 milioni di individui affetti da cecità corneale bilaterale che non si possono sottoporre a trapianto corneale standard da donatore per ripetuti insuccessi, insuccessi previsti, controindicazioni alle terapie aggiuntive per la sopravvivenza dell'innesto e assenza di servizi di Eye Banking.
Nel 2002 presso la Struttura Complessa di Oftal-mologia dell'Università di Siena è stata introdotta per la prima volta in Italia la cornea artificiale australiana AlphaCorTM completamente sintetica, costituita da polyhema hydrogel. AlphaCor, a nostro avviso, apre nuovi orizzonti ed entusiasmanti prospettive nella chirurgia corneale e, in casi selezionati, abbattendo ulteriormente i costi, potrebbe rappresentare una grande speranza di recupero visivo per milioni di individui.The situation with regard to corneal transplant in Italy is monitored by the Italian Corneal Transplant Society (Società Italiana Trapianti di Cornea, SITRAC), formed with the aim of keeping members up to date on advances and guidelines in the field of corneal surgery and of providing statistical data on corneal transplant in Italy. SITRAC data shows an annual increase in the number of transplants. In the period 1999-2001, more than 12 000 corneal transplants were done with material from Italian eye banks, an increase of about 50% with respect to the previous triennium. This increase is related to intensification of the activity of the national eye banking service and the informative role of SITRAC regarding corneal surgery. The increasing trend in the number of corneas explanted and analysed and the percentage of corneas judged suitable for transplant are confirmed by the 2001-2003 figures, underlining an increase in donors in Italy. The results show good autonomy of the eye banking service in Italy with a diminishing percentage of ophthalmic surgery Centers seeking corneas from foreign banks. However, a significant percentage of corneas continue to be judged unsuitable. Here we report the general situation of corneal transplant in Italy as determined by the Department of Ophthalmology and Neurosurgery of Siena University, under commission to SITRAC. Corneal transplant is not always the solution for corneal opacity. There are more than 10 million patients in the world with bilateral corneal blindness who cannot undergo standard donor corneal transplant due to repeated or predicted failure, contraindications for antirejection therapy or lack of a national eye banking service. In 2002, the Australian artificial cornea AlphaCorTM was introduced into Italy by the Ophthalmology Unit of Siena University. The cornea is made entirely of poly-hema hydrogel. In our experience, AlphaCorTM opens new horizons and exciting new prospects in corneal surgery, further reducing costs. With appropriate selection of cases, it could restore sight in millions of individuals
Multiple sclerosis and eye: Geometric complexity of the optic nerve head microvascularity-a pilot study
No full textMultiple Sclerosis (MS) is a progressive neurodegenerative disease of the central nervous system characterized by focal demyelinating lesions in the white matter of the brain or spinal cord. When MS affects the nerves in a person’s eyes, it can cause Optic Neuritis (ON). We have investigated the microvascular pattern of the nerve head performing the evaluation of its fractal dimension (geometric complexity). Mean geometric complexity of the optic nerve head microvascularity in the affected eye in patients with multiple sclerosis resulted higher than in control normal subjects (p<0.01), and, moreover, the unaffected eye in patients with multiple sclerosis showed a geometric complexity that was not significantly different from the one of the affected eye and higher than in control normal subjects (p<0.01). These data, if confirmed in a higher number of patients, could show a characteristic microvascular pattern of the optic nerve head in subjects affected by multiple sclerosis, giving us a possible tool to identify earlier subjects that can develop multiple sclerosis
Parasurgical therapy for keratoconus by riboflavin-ultraviolet type A rays induced cross-linking of corneal collagen: preliminary refractive results in an Italian study
No full textPurpose: To assess the effectiveness of riboflavin-ultraviolet type A rays induced cross-linking of corneal collagen in reducing progression of keratoconus and in improving visual acuity in patients with progressive keratoconus. Setting: Department of Ophthalmology, Siena University, Siena, Italy. Methods: This was a second-phase prospective nonrandomized open study. Starting in September 2004, 10 eyes of 10 patients (mean age 31.4 years) with bilateral keratoconus were treated by combined riboflavin-ultraviolet type A rays (UVA) collagen cross-linking. Radiant energy was 3 mW/cm2 or 5.4 joule/cm2 for a 30-minute exposure at 1 cm from the corneal apex. A complete ophthalmologic examination (uncorrected visual acuity [UCVA], sphere spectacles corrected visual acuity (SSCVA), best spectacle-corrected visual acuity [BSCVA]) was performed. Patients had corneal computerized topographic examination, linear scan optical tomography, endothelial cell count, ultrasound pachometry, intraocular pressure (IOP) evaluation, and HRT II system confocal microscopy at 1, 2, 3, and 6 months. After treatment, eyes were medicated and dressed with a soft contact lens. Results: Comparative preoperative and postoperative results showed increases of 3.6 lines for UCVA (P = .0000112), 1.85 lines for SSCVA (P = .00065), and 1.66 lines for BSCVA (P = .00071). Topographic analysis showed a mean K reduction of 2.1 ± 0.13 diopters (D) in the central 3.0 mm. Statistical analysis of IOP and endothelial cell count did not show significant differences. Topo-aberrometric analysis findings of corneal symmetry showed a trend toward increasing corneal symmetry with a major reduction in asymmetry between vertical hemimeridians. Conclusions: Refractive results showed a reduction of about 2.5 D in the mean spherical equivalent, topographically confirmed by the reduction in mean K. Results of surface aberrometric analysis showed improvement in morphologic symmetry with a significant reduction in comatic aberrations. © 2006 ASCRS and ESCRS
Lamellar Keratoplasty
No full textLamellar corneal surgery was conceived in the first years of the 20th century. Despite the intuition of decreasing the possibility of allograft rejection, this technique was given up on account of bad visual results, if compared with penetrating keratoplasty, due to inadequate techniques and instruments. In the eighties, the development of refractive surgery techniques, causes a new attention in this kind of surgery and the ideation of deep lamellar keratoplasty (DLK). In the last few years a new lamellar technique, Deep Lamellar Endothelial Kerato-plasty, was developed in order to correct endothelial diseases such as bullous keratopathy. In this article we will describe some of the most important anterior and posterior lamellar techniques
Air-guided manual deep lamellar keratoplasty
No full textPURPOSE. To evaluate the efficacy of a new modified technique of deep lamellar keratoplasty (DLK). METHODS. Nine eyes of eight patients with keratoconus of moderate degree were included. All patients underwent DLK with manual dissection from a limbal side port after an air bubble injection in the anterior chamber. The patients underwent a 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 (11.1%) was converted to penetrating keratoplasty because of microperforation. In the eight successful cases, 7 eyes (77.8%) achieved 20/30 or better visual acuity 6 months after suture removal. Mean postoperative pachymetry was 604.76 μm (SD 46.76). Specular microscopy 6 months after suture removal revealed average endothelial cell count of 2273/mm 2 (SD 229). CONCLUSIONS. This modified DLK technique is a safe and effective procedure and could facilitate, after a short learning curve, this kind of surgery with a low risk of conversion to penetrating keratoplasty
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