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Sample records for corneal surgery preliminary

  1. Refractive corneal surgery - discharge

    Science.gov (United States)

    Nearsightedness surgery - discharge; Refractive surgery - discharge; LASIK - discharge; PRK - discharge ... You had refractive corneal surgery to help improve your vision. This surgery uses a laser to reshape your cornea. It corrects mild-to-moderate nearsightedness, ...

  2. Corneal Topographical Changes Flollowing Strabismus Surgery

    Institute of Scientific and Technical Information of China (English)

    MaiGH; WangZ

    1999-01-01

    Purpose:To study corneal topographical changes after strabismus surgery.Methods:Computer-aided corneal topography was used in 43 strabismus patients(45 eyes)one or two days prior to and six or seven ays after strabismus surgery.The spherical and cylindrical equivalents were calculated based on the simulated keratometry.Results:After the surgery,only the changes at 3mm in the inferior quadrant were statistically significant.The changes at 3mm in the rest quadrants and the changes at 7mm were no significant.Significant changes in spherical equivalent were found post-operatively.neither the horizontal nor the verical meridional equivalent showed significant changes after surgery.Conclusions:The results of corneal topographical changes following strabismus surgery in our preliminary study indicated the little effect of strabismus surgery on corneal curvature and corneal astigmatism.

  3. Corneal Topographic Changes After Eyelid Ptosis Surgery.

    Science.gov (United States)

    Savino, Gustavo; Battendieri, Remo; Riso, Monica; Traina, Salvatore; Poscia, Andrea; DʼAmico, Giovanni; Caporossi, Aldo

    2016-04-01

    To evaluate the corneal topography and the topographic changes after ptosis surgery on patients affected by congenital and acquired blepharoptosis. Twenty eyes of 17 patients affected by acquired and congenital ptosis underwent surgical correction through anterior levator complex tightening. Computerized tomography (Syrius Sistem; CSO) was used to analyze any change in corneal astigmatism (CYL), simulated keratometry, anterior corneal symmetry index front, apical keratometry front, and central corneal thickness. Visual acuity, margin reflex distance, and levator function were also measured. After surgical ptosis repair, corneal topography demonstrated a reduction in average keratometry of 0.15 ± 0.47 diopters (D) and in corneal astigmatism of 0.26 ± 1.12 D. Significant differences were found in apical keratometry front (-1.84 ± 1.76 D) and in best-corrected visual acuity (-0.18 ± 0.06 logMAR) in the postoperative examinations. Central corneal thickness did not show significant differences between preoperative and postoperative examinations. Postoperative topographic maps showed a reduction of symmetry index front (0.10 ± 0.64 D). Eyelid ptosis modifies anterior corneal surface inducing refractive errors and modifying corneal astigmatism in patients, thus affecting the quality of vision. The surgical correction of blepharoptosis induces anterior corneal surface modification, restoring corneal symmetry and regular corneal astigmatism. Postoperative corneal topography showed normal corneal contours.

  4. Equine corneal surgery and transplantation.

    Science.gov (United States)

    Denis, Heidi M

    2004-08-01

    Corneal disease is common in equine ophthalmology and requires vigilant monitoring and appropriate therapy to optimize the outcome. Many equine corneal diseases, particularly those that progress rapidly, may benefit from surgical intervention. These include descemetoceles, deep corneal lacerations and ulcers, corneal perforation/iris prolapse, ulcerative keratitis, corneal stromal abscesses, and corneoscleral neoplasia. Indications for corneal transplantation include optical, tectonic, therapeutic, and cosmetic purposes. Corneal transplantation is most often implemented in equine patients for tectonic and therapeutic reasons when a cornea is compromised by corneal stromal abscess, iris prolapse, or neoplasia. This article provides an outline of when to consider surgical intervention for corneal disease, the procedures available and expected outcomes, and how appropriate early surgical intervention can dramatically improve the end result.

  5. Corneal topographic changes following retinal surgery

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    Pandey RM

    2004-08-01

    Full Text Available Abstract Background To study the effect of retinal/ vitreoretinal surgeries on corneal elevations. Methods Patients who underwent retinal/ vitreoretinal surgeries were divided into 3 groups. Scleral buckling was performed in 11 eyes (Group 1. In 8 (25% eyes, vitreoretinal surgery was performed along with scleral buckling (Group 2. In 12 eyes, pars plana vitrectomy was performed for vitreous hemorrhage (Group 3. An encircling element was used in all the eyes. The parameters evaluated were best-corrected visual acuity (BCVA, change in axial length, and corneal topographic changes on Orbscan topography system II, preoperative and at 12 weeks following surgery. Results There was a statistically significant increase in anterior corneal elevation in all the three groups after surgery (p = 0.003, p = 0.008 & p = 0.003 respectively. The increase in posterior corneal elevation was highly significant in all the three groups after surgery (p = 0.0000, p = 0.0001 & p = 0.0001 respectively. The increase in the posterior corneal elevation was more than the increase in the anterior elevation and was significant statistically in all the three groups (group I: p = 0.02; group II: p = 0.01; group III: p = 0.008. Conclusions Retinal/ vitreoretinal surgeries cause a significant increase in the corneal elevations and have a greater effect on the posterior corneal surface.

  6. Past and present of corneal refractive surgery

    DEFF Research Database (Denmark)

    Vestergaard, Anders Højslet

    Surgical correction of refractive errors is becoming increasingly popular. In the 1990s, the excimer laser revolutionized the field of corneal refractive surgery with PRK and LASIK, and lately refractive lenticule extraction (ReLEx) of intracorneal tissue, using only a femtosecond laser, has become...

  7. Prevalence of corneal astigmatism before cataract surgery.

    Science.gov (United States)

    Mohammadi, Mehran; Naderan, Mohammad; Pahlevani, Rozhin; Jahanrad, Ali

    2016-12-01

    The purpose of this study was to describe and analyze the prevalence and pattern of corneal astigmatism in cataract surgery candidates. In a prospective cross-sectional study, preoperative demographics, and keratometric and refractive values of cataract surgery candidates were collected from January 2013 to December 2014. Axial length (AL) and flat and steep keratometry measurements were optically measured by a partial coherence interferometry device (IOLMaster). This study consisted of 2156 eyes of 1317 patients with a mean age of 64.92 ± 11.48 (SD) (30-88 years). The mean of AL was 23.33 ± 1.37 mm, and the mean of corneal astigmatism was 1.12 ± 1.10 diopter (D) (range 0.0-7.00), in all patients. Furthermore, the mean of flat and steep keratometry were 43.70 ± 1.70 and 44.83 ± 1.79 D, respectively. Corneal astigmatism was 1.50 D or less in 1590 eyes (73.7 %), more than 1.50 D in 566 eyes (26.2 %), 3.00 D or more in 161 eyes (7.4 %), WTR in 796 eyes (36.9 %), ATR in 1010 eyes (46.8 %), and oblique in 350 eyes (16.2 %). ATR astigmatism axis significantly increased with the increase in age. Corneal astigmatism of most cataract surgery candidates fell between 0.50 and 1.50 D. The results of our study however is confined to our demographics might provide useful data for cataract patients, surgeons, and intraocular lens manufacturers for different purposes.

  8. Retinal evaluation and treatment after refractive corneal surgery.

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    Swinger, C A; Kraushar, M F

    1985-08-01

    Refractive corneal surgery (a collective term used to describe a variety of surgical procedures that alter the refractive status of the eye through the surgical modification of corneal curvature) shows promise for use in situations where current methods of optical correction do not meet the patient's needs. This article reviews our experiences with the retinal evaluation of patients who have undergone corneal refractive surgery and offers recommendations for the treatment of retinal pathology after such surgery.

  9. IOL Power Calculation after Corneal Refractive Surgery

    Directory of Open Access Journals (Sweden)

    Maddalena De Bernardo

    2014-01-01

    Full Text Available Purpose. To describe the different formulas that try to overcome the problem of calculating the intraocular lens (IOL power in patients that underwent corneal refractive surgery (CRS. Methods. A Pubmed literature search review of all published articles, on keyword associated with IOL power calculation and corneal refractive surgery, as well as the reference lists of retrieved articles, was performed. Results. A total of 33 peer reviewed articles dealing with methods that try to overcome the problem of calculating the IOL power in patients that underwent CRS were found. According to the information needed to try to overcome this problem, the methods were divided in two main categories: 18 methods were based on the knowledge of the patient clinical history and 15 methods that do not require such knowledge. The first group was further divided into five subgroups based on the parameters needed to make such calculation. Conclusion. In the light of our findings, to avoid postoperative nasty surprises, we suggest using only those methods that have shown good results in a large number of patients, possibly by averaging the results obtained with these methods.

  10. Femtosecond laser's application in the corneal surgery

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    Shu-Liang Wang

    2015-10-01

    Full Text Available With the rapid development over the past two decades,femtosecond(10-15slasers(FShas become a new application in ophthalmic surgery. As laser power is defined as energy delivered per unit time, decreasing the pulse duration to femtosecond level(100fsnot only increases the power delivered but also decreases the fluence threshold for laser induced optical breakdown. In ablating tissue, FS has an edge over nanosecond lasers as there is minimal collateral damage from shock waves and heat conduction during surgical ablation. Thus, application of FS has been widely spread, from flap creation for laser-assisted in situ keratomileusis(LASIKsurgery, cutting of donor and recipient corneas in keratoplasty, creation of pockets for intracorneal ring implantation. FS applied in keratoplasty is mainly used in making graft and recipient bed, and can exactly cut different tissue of keratopathy. FS can also cut partial tissue of cornea, even if it is under the moderate corneal macula and corneal edema condition.

  11. Using corneal topography design personalized cataract surgery programs

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    Jin-Ou Huang

    2014-08-01

    Full Text Available AIM:To investigate how to design personalized cataract surgery programs to achieve surgical correction of preoperative corneal astigmatism with surgical astigmatism under the guidance of corneal topography, improve postoperative visual quality and reduce the cost of treatment. METHODS: Totally 202 cases(226 eyescataract patients were divided into randomized treatment group and individualized treatment group. According to the method and location of the incision, randomized treatment group were divided into 8 groups. Surgical astigmatism after different incision were calculated with the use of preoperative and postoperative corneal astigmatism through vector analysis method. Individualized treatment groups were designed personably for surgical method with reference of every surgically induced astigmatism, the surgical method chooses the type of surgical incision based on close link between preoperative corneal astigmatism and surgically induced astigmatism, and the incision was located in the steep meridian. The postoperative corneal astigmatism of individualized treatment group was observed. RESULTS: Postoperative corneal astigmatism of individualized treatment group were lower than that of 3.0mm clear corneal tunnel incision in the randomized treatment group, there were statistically significance difference, while with 3.0mm sclera tunnel incision group there were no statistically significance difference. After 55.8% of patients with the use of individualized surgical plan could undergo the operation of extracapsular cataract extraction with relatively low cost and rigid intraocular lens implantation, the per capita cost of treatment could be reduced. CONCLUSION: Personalized cataract surgery programs are designed to achieve surgical correction of preoperative corneal astigmatism under the use of corneal topography, improve postoperative visual quality and reduce the cost of treatment.

  12. Change in corneal curvature induced by surgery

    NARCIS (Netherlands)

    G. van Rij (Gabriel)

    1987-01-01

    textabstractThe first section deals with the mechanisms by which sutures, incisions and intracorneal contact lenses produce a change in corneal curvature. To clarify the mechanisms by which incisions and sutures produce astigmatism, we made incisions and placed sutures in the corneoscleral limbus of

  13. Cataract Surgery with a Refractive Corneal Inlay in Place

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    N. R. Stojanovic

    2015-01-01

    Full Text Available Purpose. To present a case of cataract surgery performed in a patient with a refractive corneal inlay in place. Methods. A 48-year-old female patient presented to our institute with bilateral cataract. The patient had undergone refractive corneal inlay implantation three years ago in her right, nondominant eye for presbyopia correction. Biometry and intraocular lens (IOL power calculation were performed without removing the inlay. Phacoemulsification and IOL insertion were carried out in both eyes in a usual manner. Results. On day one postoperatively, the patient achieved binocular uncorrected distance visual acuity 20/20 and uncorrected near visual acuity J1. The vision remained stable during the one-year follow-up period. Conclusion. Cataract surgery was performed in a standard manner in a patient with Presbia Microlens corneal inlay in place. Visual outcomes for both near and distance vision were satisfactory.

  14. Corneal power evaluation after myopic corneal refractive surgery using artificial neural networks.

    Science.gov (United States)

    Koprowski, Robert; Lanza, Michele; Irregolare, Carlo

    2016-11-15

    Efficacy and high availability of surgery techniques for refractive defect correction increase the number of patients who undergo to this type of surgery. Regardless of that, with increasing age, more and more patients must undergo cataract surgery. Accurate evaluation of corneal power is an extremely important element affecting the precision of intraocular lens (IOL) power calculation and errors in this procedure could affect quality of life of patients and satisfaction with the service provided. The available device able to measure corneal power have been tested to be not reliable after myopic refractive surgery. Artificial neural networks with error backpropagation and one hidden layer were proposed for corneal power prediction. The article analysed the features acquired from the Pentacam HR tomograph, which was necessary to measure the corneal power. Additionally, several billion iterations of artificial neural networks were conducted for several hundred simulations of different network configurations and different features derived from the Pentacam HR. The analysis was performed on a PC with Intel(®) Xeon(®) X5680 3.33 GHz CPU in Matlab(®) Version 7.11.0.584 (R2010b) with Signal Processing Toolbox Version 7.1 (R2010b), Neural Network Toolbox 7.0 (R2010b) and Statistics Toolbox (R2010b). A total corneal power prediction error was obtained for 172 patients (113 patients forming the training set and 59 patients in the test set) with an average age of 32 ± 9.4 years, including 67% of men. The error was at an average level of 0.16 ± 0.14 diopters and its maximum value did not exceed 0.75 dioptres. The Pentacam parameters (measurement results) providing the above result are tangential anterial/posterior. The corneal net power and equivalent k-reading power. The analysis time for a single patient (a single eye) did not exceed 0.1 s, whereas the time of network training was about 3 s for 1000 iterations (the number of neurons in the hidden layer was 400).

  15. Videokeratograph (VKS for monitoring corneal curvature during surgery

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    Carvalho Luis Alberto Vieira de

    2002-01-01

    Full Text Available Purpose: We have developed an instrument for computerized surgical videokeratography. A corneal central region of approximately 7.00 mm in diameter may be analyzed, providing the surgeon with information of the power and the astigmatism. Methods: The system is based on a fiber optic Placido disc projecting cone, which is attached to the objective lens of a Zeiss compatible surgical microscope. At the beam splitter we installed a monochromatic high resolution camera. A frame grabber is installed on a PC and images are digitized at a 480x640 resolution. Image processing is used for edge detection of rings. Results: Calibrating curves based on 4 spherical surfaces were generated and approximately 3600 points are calculated for each examination. Preliminary measurements on 10 healthy corneas were compared with those of an EyeSys System 2000 Corneal Topographer. Mean deviation was 0.05 for radius of curvature, 0.24 D for the power and 5.0 degrees for the cylinder. Conclusions: This surgical VKS, with some hardware and software improvements, may be used to reduce residual astigmatisms in conventional cataract and keratoplasty. It could also be used to gather preoperative data in corneal topography assisted LASIK.

  16. Correction of low corneal astigmatism in cataract surgery

    Institute of Scientific and Technical Information of China (English)

    Pia; Leon; Marco; Rocco; Pastore; Andrea; Zanei; Ingrid; Umari; Meriem; Messai; Corrado; Negro; Daniele; Tognetto

    2015-01-01

    · AIM: To evaluate and compare aspheric toric intraocular lens(IOL) implantation and aspheric monofocal IOL implantation with limbal relaxing incisions(LRI) to manage low corneal astigmatism(1.0-2.0 D) in cataract surgery.· METHODS: A prospective randomized comparative clinical study was performed. There were randomly recruited 102 eyes(102 patients) with cataracts associated with corneal astigmatism and divided into two groups. The first group received toric IOL implantation and the second one monofocal IOL implantation with peripheral corneal relaxing incisions. Outcomes considered were: visual acuity, postoperative residual astigmatism, endothelial cell count, the need for spectacles, and patient satisfaction. To determine the postoperative toric axis, all patients who underwent the toric IOL implantation were further evaluated using an OPD Scan III(Nidek Co, Japan). Follow-up lasted 6mo.· RESULTS: The mean uncorrected distance visual acuity(UCVA) and the best corrected visual acuity(BCVA) demonstrated statistically significant improvement after surgery in both groups. At the end of the follow-up the UCVA was statistically better in the patients with toric IOL implants compared to those patients who underwent implantation of monofocal IOL plus LRI. The mean residual refractive astigmatism was of 0.4 D for the toric IOL group and 1.1 D for the LRI group(P <0.01). No difference was observed in the postoperative endothelial cell count between the two groups.· CONCLUSION: The two surgical procedures demonstrated a significant decrease in refractive astigmatism. Toric IOL implantation was more effective and predictable compared to the limbal relaxing incision.

  17. Corneal astigmatism change and wavefront aberration evaluation after cataract surgery: "Single" versus "paired opposite" clear corneal incisions

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    Hasan Razmjoo

    2014-01-01

    Full Text Available Background: Correcting the pre-existing astigmatism is an optimal goal in cataract surgery. The aim of this study is to compare the astigmatic correcting effect of a single regular 3.2 mm clear corneal incision (CCI with paired opposite CCI in cataract patients and effect of these incisions on optical aberrations using the wavefront quantitative analysis. Materials and Methods: This was a randomized controlled trial study undertaken in an ophthalmology referral center on 50 patients planned for cataract surgery who were randomized to either single 3.2 mm CCI or paired opposite CCI group. Post-operative evaluation was performed at 12 weeks and included refraction, keratometery, corneal topography and wavefront analysis. Corneal astigmatism and post-operative values were compared in two groups. Results: The mean pre-operative corneal astigmatism was 2.58 ± 1.03 D in the single incision group and 2.70 ± 0.94 D in the paired opposite incisions group. After 12 weeks of surgery, the corneal astigmatism was reached to 2.15 ± 0.82 D in single incision group and 1.63 ± 1.21 in the paired opposite incisions group. There was a statistically significant difference in two arms of treatment regarding to surgically induced astigmatism after 3 months. The mean post-operative total and higher order aberrations and values were not significantly different in two groups. Conclusion: The results of our study showed that paired opposite incisions is an effective procedure for reducing pre-existing corneal astigmatism in cataract surgery. Paired incisions did not show any beneficial effect regarding wavefront aberrations compared with conventional single incision method.

  18. Efficacy of highly hydrophilic soft contact lenses for persistent corneal epithelial defects after anterior segment surgery

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    Zhi-Wei Peng

    2015-02-01

    Full Text Available AIM:To investigate the efficacy of highly hydrophilic soft contact lenses for persistent corneal epithelial defects.METHODS:In this retrospective case analysis, 28 patients(28 eyeswith persistent corneal epithelial defects after anterior segment surgery from January 2011 to June 2013 in our hospital were reviewed. After regular treatment for at least 2wk, the persistent corneal epithelial defects were treated with highly hydrophilic soft contact lenses, until the corneal epithelial healing. Continued to wear the same lens no more than 3wk, or in need of replacement the new one. All cases were followed up for 6mo. Key indicators of corneal epithelial healling, corneal fluorescein staining and ocular symptoms improvement were observed.RESULTS: Twenty-one eyes were cured(75.00%, markedly effective in 5 eyes(17.86%, effective in 2 eyes(7.14%, no invalid cases, the total efficiency of 100.00%. Ocular symptoms of 25 cases(89.29%relieved within 2d, the rest 3 cases(10.71%relieved within 1wk. The corneal epithelial of 6 cases(21.43%repaired in 3wk, 13 cases(46.43%in 6wk, 7 cases(25.00%in 9wk, 2 cases(7.14%over 12wk. There were no signs of secondary infection. And no evidence of recurrence in 6mo. CONCLUSION: Highly hydrophilic soft contact lenses could repair persistent corneal epithelial defects after anterior segment surgery significantly, while quickly and effectively relieve a variety of ocular irritation.

  19. Central Corneal Thickness, Corneal Endothelial Characteristics and Intraocular Pressure after Pediatric Cataract Surgery

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    Naveed Nilforushan

    2008-11-01

    Full Text Available

    PURPOSE: To investigate central corneal thickness (CCT, endothelial cell characteristics and intraocular pressure (IOP in eyes with prior pediatric cataract surgery and to compare them with eyes of normal age and sex matched controls. METHODS: Specular microscopy CCT and IOP measurements were performed in 31 eyes of 17 patients with prior congenital cataract extraction and 40 eyes of 20 age and sex matched subjects. The mean of three pachymetric and specular microscopic measurements were recorded. IOP was measured using Goldmann applanation tonometry. RESULTS: Mean CCT was 632±45 µm in eyes with prior pediatric cataract surgery vs 546±33 µm in control eyes (P < 0.001, independent t test and Mann Whitney U-test. Mean IOP was 22.1±3.9 mmHg in eyes with prior pediatric cataract surgery and 14.0±1.6 mmHg in the control group (P < 0.001, independent t-test. There was no significant difference between the two groups in cell count, polymegethism and mean cell area of corneal endothelial cells. CONCLUSIONS: Although the corneas were clinically clear and there was no significant difference in endothelial characteristics in eyes with prior pediatric cataract surgery as compared to normal controls, central corneal thickness in the operated eyes was significantly greater. To differentiate actual glaucoma from artifactual IOP

  20. Progress of corneal collagen cross-linking combined with refractive surgery

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    Na Li

    2014-02-01

    Full Text Available As a photochemical reaction that can stiffen the cornea, corneal collagen cross-linking (CXL is the only promising method of preventing the progress of keratectasia, such as keratoconus and secondary ectasia following refractive surgery. The aim of CXL is to stabilize the underlying condition, with a small chance of visual improvement. Combining CXL with refractive surgery targeting both stabilization and reshaping of the corneal tissue for visual function improvement is a good treatment option. This review aims to provide a comprehensive and unbiased summary of the published research regarding combined CXL and refractive surgery, including measures and results, to help elucidate the future direction of CXL.

  1. Cataract surgery in a patient with severe chronic iritis and corneal endothelial damage.

    Science.gov (United States)

    Yasukawa, T; Suga, K; Yokoo, N; Asada, S

    1998-07-01

    We report a patient with broad anterior synechias and corneal endothelial damage. The patient had chronic iritis and cataracts secondary to chronic iritis in both eyes. Because the right eye had broad anterior synechias and severe corneal endothelial damage, extracapsular cataract extraction and intraocular lens implantation were performed through the basal iris. Good postoperative visual acuity was obtained. The cornea showed little trauma from the surgery and remained clear 36 months postoperatively.

  2. Topical 100% Serum Eye Drops for Treating Corneal Epithelial Defect after Ocular Surgery

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    Kaevalin Lekhanont

    2013-01-01

    Full Text Available The purpose of this study was to investigate the efficacy and safety of topical 100% serum eye drops for corneal epithelial defect after ocular surgery. A total of 181 patients who received topical 100% serum therapy for the treatment of corneal epithelial defect following several different types of ocular surgery were recruited into this study. Each patient already failed conventional medical therapy before being prescribed 100% serum eye drops. Slit-lamp biomicroscopic examination with fluorescein staining was performed at baseline and all follow-up visits. The main outcome measures were the rate of complete healing of the corneal epithelial defect and incidence of adverse events. One hundred and seventy-eight eyes (98.34% received autologous serum eye drops, and 3 (1.66% received allogeneic serum eye drops. The overall success rate of treating persistent postoperative epithelial defect using 100% serum eye drops was 93.92% (95% CI 0.88–0.98. The median time to complete corneal epithelialization was 4 days (95% CI 4-5. Adverse reactions were observed in 3 patients (1.66%, including sticky sensation with minimal eye discomfort and asymptomatic trace corneal subepithelial infiltration. No serious complications were reported. In conclusion, 100% serum eye drops are effective, safe, and tolerable for treating postoperative corneal epithelial defect following ocular surgeries.

  3. Corneal refractive surgery: Is intracorneal the way to go and what are the needs for technology?

    Science.gov (United States)

    Hjortdal, Jesper; Ivarsen, Anders

    2014-02-01

    Corneal refractive surgery aims to reduce or eliminate refractive errors of the eye by changing the refractive power of the cornea. For the last 20 years controlled excimer laser ablation of corneal tissue, either directly from the corneal stromal surface or from the corneal interior after creation of a superficial corneal flap has become widely used to correct myopia, hyperopia, and astigmatism. Recently, an intrastromal refractive procedure whereby a tissue lenticule is cut free in the corneal stroma by a femtosecond laser and removed through a small peripheral incision has been introduced. This procedure avoids creation of a corneal flap and the potential associated risks while avoiding the slow visual recovery of surface ablation procedures. Precise intrastromal femtosecond laser cutting of the fine lenticule requires very controlled laser energy delivery in order to avoid lenticule irregularities, which would compromise the refractive result and visual acuity. This newly introduced all-femtosecond based flap-free intracorneal refractive procedure has been documented to be a predictable, efficient, and safe procedure for correction of myopia and astigmatism. Technological developments related to further improved cutting quality, hyperopic and individualized treatments are desirable.

  4. Corneal decompensation following filtering surgery with the Ex-PRESS® mini glaucoma shunt device

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    Tojo N

    2015-03-01

    Full Text Available Naoki Tojo, Atsushi Hayashi, Akio Miyakoshi Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan Purpose: To report a case of corneal decompensation due to the Ex-PRESS® mini glaucoma shunt device (Ex-PRESS.Patient and methods: A 75-year-old man had pseudoexfoliation glaucoma in his right eye. He underwent filtration surgery with Ex-PRESS. His intraocular pressure was 7 mmHg after 9 months.Results: We observed partial decompensation of the corneal endothelium adjacent to the filtering bleb. Specular microscopy revealed a marked decrease in the endothelial cell density at the center of the cornea.Conclusion: Anterior segment optical coherence tomography is very useful for evaluating corneal edema and the position of Ex-PRESS. It is important to follow up with an examination of the corneal endothelial cells. Keywords: Ex-PRESS, bullous keratopathy, trabeculectomy, complication, cornea 

  5. Endoscopy-guided vitreoretinal surgery following penetrating corneal injury: a case report

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    Motoko Kawashima

    2010-08-01

    Full Text Available Motoko Kawashima1, Shinichi Kawashima2, Murat Dogru1,3, Makoto Inoue4, Jun Shimazaki1,51Department of Ophthalmology, Tokyo Dental College, Chiba, Japan; 2Department of Ophthalmology, International University of Health and Welfare, Tokyo, Japan; 3Department of Ocular Surface and Visual Optics, Keio University School of Medicine, Tokyo, Japan; 4Kyorin Eye Center, Tokyo, Japan; 5Department of Ophthalmology, Keio University School of Medicine, Tokyo, JapanIntroduction: Severe ocular trauma requires emergency surgery, and a fresh corneal graft may not always be available. We describe a case of perforating eye injury with corneal ­opacity, suspected endophthalmitis, and an intraocular foreign body. The patient was successfully treated with a two-step procedure comprising endoscopy-guided vitrectomy followed by corneal transplantation. This surgical technique offers a good option to vitrectomy with simultaneous keratoplasty in emergency cases where no graft is immediately available and there is the ­possibility of infection due to the presence of a foreign body.Case presentation: A 55-year-old Japanese woman was referred to our hospital with a ­perforating corneal and lens injury sustained with a muddy ferrous rod. Primary corneal sutures and lensectomy were performed immediately. Vitreoretinal surgery was required due to ­suspected endophthalmitis, vitreous hemorrhage, retinal detachment, dialysis and necrosis of the peripheral retina. Instead of conventional vitrectomy, endoscopy-guided vitreous surgery was performed with the Solid Fiber Catheter AS-611 (FiberTech, Tokyo, Japan due to the presence of corneal opacity and the unavailability of a donor cornea. The retina was successfully attached with the aid of a silicon oil tamponade. Following removal of the silicon oil at 3 months after surgery, penetrating keratoplasty and intraocular lens implantation with ciliary sulcus suture fixation were performed. At 6 months after penetrating

  6. Clinical Validation of Adjusted Corneal Power in Patients with Previous Myopic Lasik Surgery

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    Vicente J. Camps

    2015-01-01

    Full Text Available Purpose. To validate clinically a new method for estimating the corneal power (Pc using a variable keratometric index (nkadj in eyes with previous laser refractive surgery. Setting. University of Alicante and Medimar International Hospital (Oftalmar, Alicante, (Spain. Design. Retrospective case series. Methods. This retrospective study comprised 62 eyes of 62 patients that had undergone myopic LASIK surgery. An algorithm for the calculation of nkadj was used for the estimation of the adjusted keratometric corneal power (Pkadj. This value was compared with the classical keratometric corneal power (Pk, the True Net Power (TNP, and the Gaussian corneal power (PcGauss. Likewise, Pkadj was compared with other previously described methods. Results. Differences between PcGauss and Pc values obtained with all methods evaluated were statistically significant (p<0.01. Differences between Pkadj and PcGauss were in the limit of clinical significance (p<0.01, loA [−0.33,0.60] D. Differences between Pkadj and TNP were not statistically and clinically significant (p=0.319, loA [−0.50,0.44] D. Differences between Pkadj and previously described methods were statistically significant (p<0.01, except with PcHaigisL (p=0.09, loA [−0.37,0.29] D. Conclusion. The use of the adjusted keratometric index (nkadj is a valid method to estimate the central corneal power in corneas with previous myopic laser refractive surgery, providing results comparable to PcHaigisL.

  7. Factors Influencing Efficacy of Peripheral Corneal Relaxing Incisions during Cataract Surgery

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    Nino Hirnschall

    2015-01-01

    Full Text Available Purpose. To evaluate influencing factors on the residual astigmatism after performing peripheral corneal relaxing incisions (PCRIs during cataract surgery. Methods. This prospective study included patients who were scheduled for cataract surgery with PCRIs. Optical biometry (IOLMaster 500, Carl Zeiss Meditec AG, Germany was taken preoperatively, 1 week, 4 months, and 1 year postoperatively. Additionally, corneal topography (Atlas model 9000, Carl Zeiss Meditec AG, Germany, ORA (Ocular Response Analyzer, Reichert Ophthalmic Instruments, USA, and autorefraction (Autorefractometer RM 8800 Topcon were performed postoperatively. Results. Mean age of the study population n=74 was 73.5 years (±9.3; range: 53 to 90 and mean corneal astigmatism preoperatively was −1.82 D (±0.59; 1.00 to 4.50. Mean corneal astigmatism was reduced to 1.14 D (±0.67; 0.11 to 3.89 4 months postoperatively. A partial least squares regression showed that a high eccentricity of the cornea, a large deviation between keratometry and topography, and a high preoperative astigmatism resulted in a larger postoperative error concerning astigmatism. Conclusions. PCRI causes a reduction of preoperative astigmatism, though the prediction is difficult but several factors were found to be a relevant source of error.

  8. Short term effects of small incision lenticule extraction surgery on corneal endothelium

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    Dan-Yang Wang

    2016-04-01

    Full Text Available AIM: To assess the effects of small incision lenticule extraction (SMILE surgery on the corneal endothelium at 1d to 1mo postoperatively. METHODS: A retrospective, observational study was conducted on 47 patients (47 eyes who received SMILE surgery. Patients were grouped according to contact lens wear condition. The corneal endothelium was examined preoperatively and at 1d, 1wk and 1mo postoperatively. The corneal endothelium was analyzed for endothelial cell density (ECD, percentage of hexagonal cells, and coefficient of variation (CV of cell size. RESULTS: There were no significant decrease in the ECD, percentage of hexagonal cells or increase in CV at 1d, 1wk and 1mo postoperatively (P>0.05. However, there was a small increase of ECD by 2.88% in contact lens wearers (78.26±113.62 cell/mm2, P<0.05. CONCLUSION: SMILE has no significant adverse effects on the corneal ECD and morphology during 1mo follow-up time.

  9. Assessment of refractive astigmatism and simulated therapeutic refractive surgery strategies in coma-like-aberrations-dominant corneal optics

    National Research Council Canada - National Science Library

    Zhou, Wen; Stojanovic, Aleksandar; Utheim, Tor Paaske

    2016-01-01

    ...) on power and orientation of refractive astigmatism (RA) and to explore how to account for that influence in the planning of topography-guided refractive surgery in eyes with coma-like-aberrations-dominant corneal optics...

  10. Effect of Rebamipide Ophthalmic Suspension on Intraocular Light Scattering for Dry Eye After Corneal Refractive Surgery.

    Science.gov (United States)

    Igarashi, Akihito; Kamiya, Kazutaka; Kobashi, Hidenaga; Shimizu, Kimiya

    2015-08-01

    To assess the changes in intraocular scattering before and after instillation of rebamipide ophthalmic suspension in patients with dry eye after corneal refractive surgery. This study enrolled 60 eyes of 30 dry eye patients undergoing corneal refractive surgery. Patients were randomly assigned to start topical administration of rebamipide ophthalmic suspension (rebamipide group) or artificial tears (control group) 4 times daily for 4 weeks. Tear secretion, tear break-up time (TBUT), and the fluorescein score were measured before and after treatment. Intraocular light scattering was also measured as the objective scattering index (OSI) at 0.5-second intervals over 10 seconds. In the rebamipide group, the Schirmer I test, TBUT, and fluorescein score improved significantly, from 11.4 ± 9.0 mm, 2.2 ± 0.7 seconds, and 4.3 ± 1.3 to 14.9 ± 7.4 mm, 4.5 ± 1.7 seconds, and 1.9 ± 1.0, respectively (P = 0.006, P Rebamipide ophthalmic suspension was effective for improving both ocular surface parameters and optical quality in patients with dry eye undergoing corneal refractive surgery, suggesting that it may hold promise for the treatment of such patients.

  11. The effect of pterygium surgery on contrast sensitivity and corneal topographic changes

    Directory of Open Access Journals (Sweden)

    Joo Youn Oh

    2010-04-01

    Full Text Available Joo Youn Oh, Won Ryang WeeDepartment of Ophthalmology, Seoul National University Hospital, Seoul, KoreaPurpose: To investigate the effect of pterygium surgery on corneal topography and contrast sensitivity.Patient and methods: The IRB approved this prospective, nonrandomized, self-controlled study. Computerized videokeratography (Orbscan II was performed in 36 patients with primary pterygia, both before and 1 month after pterygium excision with limbal-conjunctival autografting. The topographic parameters were compared. Spatial contrast sensitivity testing was performed using VCTS 6500. Differences between preoperative and postoperative values were evaluated statistically.Results: The mean Sim K astigmatism and irregularity index, significantly decreased after pterygium surgery. The mean refractive power significantly increased after the operation. The “with-the-rule” astigmatism induced by pterygium became “against-the-rule” astigmatism after pterygium removal (P = 0.041. The contrast sensitivity of 6, 12, and 18 cycles per degree, significantly increased from 1.55 ± 0.28, 0.97 ± 0.47, and 0.29 ± 0.16 to 1.72 ± 0.18, 1.21 ± 0.44, and 0.65 ± 0.48, respectively (P = 0.007, <0.001, <0.001, respectively.Conclusions: Pterygium surgery significantly reduces corneal topographic astigmatism and improves contrast sensitivity.Keywords: corneal topography, visual acuity

  12. Related research on corneal higher-order aberrations after different ways refractive surgery

    Directory of Open Access Journals (Sweden)

    Shu-Xi He

    2015-08-01

    Full Text Available AIM:To evaluate the changes of corneal high-order aberration(including Coma, Spab, RMShafter laser in situ keratomileusis(LASIKwith femtosecond laser, sub-Bowman keratomileusis(SBKand laser epithelial keratomileusis(LASEK.METHODS: Of 82 myopic patients(164 eyes, 31 patients(62 eyeswere treated by FS-LASIK, 31 patients(62 eyeswere treated by SBK, 20 patients(40 eyeswere treated by LASEK. Sirius system was used for measuring the coma aberration, spherical aberration, and high order aberration at 1, 15d,1, 3mo after surgery.RESULTS: 1Vision: The uncorrected visual acuity of the three groups had no differences(P>0.05. 2Corneal aberrations: Three kinds of surgical procedure for patients with corneal aberration had significant impact. The C7, C8, C12 and RMSh of three groups were increased significantly(P0.05. The C7, C8, C12 and RMSh were not recovered to preoperative levels after 3mo. But the increase of patients after FS-LASIK was smaller than the other two groups, with statistical significance(P0.05.CONCLUSION: Compared with SBK and LASEK,FS-LASIK has better visual acuity in the early postoperative and corneal higher-order aberrations increase is relatively small.

  13. Corneal Laceration

    Medline Plus

    Full Text Available ... Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide ... What Is Corneal Laceration? Leer en Español: ¿Qué ...

  14. Corneal Laceration

    Medline Plus

    Full Text Available ... Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide ... What Is Corneal Laceration? Written By: Daniel Porter ...

  15. Detection of the early keratoconus based on corneal biomechanical properties in the refractive surgery candidates

    Directory of Open Access Journals (Sweden)

    Zofia Pniakowska

    2016-01-01

    Full Text Available Context: Subclinical keratoconus is contraindication to refractive surgery. The currently used methods of preoperative screening do not always allow differentiating between healthy eyes and those with subclinical keratoconus. Aim: To evaluate biomechanical parameters of the cornea, waveform score (WS, and intraocular pressure (IOP as potentially useful adjuncts to the diagnostic algorithm for precise detection of the early keratoconus stages and selection of refractive surgery candidates. Settings and Design: Department of Ophthalmology and prospective cross-sectional study. Patients and Methods: Patients enrolled in the study were diagnosed with refractive disorders. We assessed parameters of corneal biomechanics such as corneal hysteresis (CH, corneal resistance factor (CRF, Goldman-correlated IOP (IOPg, corneal compensated IOP, WS, and keratoconus match index (KMI. They were classified into one of three groups based on the predefined KMI range: Group 1 (from 0.352 to 0.757 – 45 eyes, Group 2 (from −0.08 to 0.313 – 52 eyes, and Group 0 - control group (from 0.761 to 1.642 – 80 eyes. Results: In both study groups, IOPg, CRF, and CH were decreased when compared to control (P < 0.0001. In control group, there was positive correlation between CH and KMI (P < 0.05, with no correlations in any of the two study groups. CRF correlated positively with KMI in control (P < 0.0001 and in Group 2 (P < 0.05. Conclusions: CH and CRF, together with WS and IOPg, consist a clinically useful adjunct to detect subclinical keratoconus in patients referred for refractive surgery when based on KMI staging.

  16. Preliminary results in surgery of Parkinson's disease.

    Science.gov (United States)

    Nasser, J A; Confort, C I; Ferraz, A; Bouza, A A

    1998-09-01

    The authors present the preliminary results of 20 patients selected to be operated on between January 1996 and April 1997. These patients presented one of the present indications for stereotactic posteroventral pallidotomy (PVP), such as: rigidity, akinesia/bradykinesia, gait dysfunction, drug induced dyskinesias and tremor. Every patient of this protocol was evaluated by: UPDRS score, Schwab and England scale, Hoehn and Yahr Staging Scale before and after surgery. The results in 3 months showed a remarkable improvement after PVP (P < 0.01) in all functional assessments, except for facial expression, speech and posture. The morbidity was 5%. 5 patients (25%) who were in Hoehn and Yahr 5 underwent a bilateral simultaneous PVP. In 5 patients (25%), who had tremor, during the PVP, VIM thalamotomy was added. These preliminary results, suggest that PVP is highly effective for PD symptoms.

  17. Corneal melting after cataract surgery in a patient with autoimmune disease.

    Science.gov (United States)

    García de Oteyza, G; Gómez, A; de la Paz, M

    2017-07-22

    A 78-year-old woman with rheumatoid arthritis and secondary Sjögren's syndrome presented with corneal melting three days after cataract extraction that required penetrating keratoplasty. By the fourth month, a second corneal transplant was needed due to a new descemetocele associated with her systemic disease. The underlying disease, together with the surgical history, was responsible for the complication presented. The correct anamnesis prior to cataract surgery, a refined technique, and a close post-operative follow-up can avoid such a serious complication. Immunomodulatory treatments are essential in this type of patient. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Signs and Symptoms of Dry Eye in Keratoconus Patients Before and After Intrastromal Corneal Rings Surgery.

    Science.gov (United States)

    Carracedo, Gonzalo; Recchioni, Alberto; Alejandre-Alba, Nicolás; Martin-Gil, Alba; Batres, Laura; Morote, Ignacio Jimenez-Alfaro; Pintor, Jesús

    2017-04-01

    Based on the relationship between keratoconus and dry eye, the aim of this study was to evaluate changes in signs and symptoms of dry eye in keratoconus patients before and after intrastromal corneal ring surgery. Fifteen keratoconus patients were enrolled in Fundación Jiménez-Díaz of Madrid and University Clinic of Optometry of the Universidad Complutense de Madrid (Madrid, Spain). Tear break up time (TBUT), Schirmer test without anesthesia, corneal staining, diadenosine tetraphosphate (Ap4A) concentration, and ocular surface disease index (OSDI) were evaluated. Impression cytology combined with laser confocal microscopy was performed to evaluate goblet cell density, mucin cloud height (MCH), and cell layer thickness (CLT). All measurements were performed before (pre) surgery, 1 month (post) and 6 months after surgery (post6m). We found no statistical differences in time in Schirmer test, TBUT, and corneal staining. OSDI scores were 44.96  ±  8.65, 26.30 ± 6.79, and 19.31 ± 4.28 for (pre), (post), and (post6m) surgery, respectively (p < 0.001). Impression cytology showed a decrease in cell density at (post6m) compared with presurgery (47.36 ± 35.15 cells/mm(2) and 84.88 ± 32.08 cells/mm(2), respectively, p = 0.04). At post6m, the MCH increased compared with presurgery values (13.97 ± 4.26 µm and 6.77 ± 2.51 µm, respectively, p < 0.001). There was a statistically significant increase in CLT in time. Ap4A tear concentrations were lower post6m than presurgery (1.02  ±  0.65 and 2.56   ± 1.10  µM, respectively, p < 0.001). Intrastromal corneal ring surgery induces changes improving dry eye symptoms but no changes were found in signs of dry eye after surgery in keratoconus patients except for the MCH that increases drastically. More studies are needed to clarify the reason of its improvement.

  19. Mathematical analysis of corneal remodelling after intracorneal ring surgery in keratoconus

    Science.gov (United States)

    Jarade, Elias F.; Slim, Elise; Cherfan, Carole; El Rami, Hala; Hassan, Toufic; Chelala, Elias

    2017-01-01

    AIM To represent mathematically the intersection between the ectatic corneal geometry and the plane of intracorneal ring implants (ICRS) in order to determine the corneal response to ICRS surgery in keratoconus (KC). Thereafter, to present the concept and early results of a newly derived topography-guided nomogram for ICRS surgery for the treatment of keratectasia. METHODS The corneal rings plane intersection was modelled to a conic section. Ring effect was the result of: the ring size, position (steep vs flat), location (distance from the geometric centre of the cornea), and the discrepancy between the ring's curvature and the tunnel's curvature. Femtosecond laser was used to create the tunnels and the incision sites were chosen according to the nomogram in order to place the thickest ring in the steepest portion of the cornea regardless of the astigmatism axis of refraction. RESULTS The conic section had a more prolate shape in the steep area of the cornea than in the flat area, depending on the corneal sagittal curvature. Equal ring size had more flattening effect in the steep area than in the flat area. Thick segment should be implanted under the steep portion of the cornea regardless of the cylinder axis of refraction. Single segment in the steep area was sufficient in early and moderate cases of KC. The new nomogram provided more topographic regularity with significant reduction of astigmatism and better improvement in uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) than the conventional nomogram. CONCLUSION The newly derived nomogram can produce better results than the conventional nomogram. Moreover, based on this concept, a new nomogram can be integrated into the femtosecond laser software to create topography-guided, customized, elliptical tunnels with modified focal asphericity that allows for customized focal flattening of the irregularly steepened ectatic cornea. PMID:28393023

  20. Assessment of refractive astigmatism and simulated therapeutic refractive surgery strategies in coma-like-aberrations-dominant corneal optics

    OpenAIRE

    ZHOU Wen; Stojanovic, Aleksandar; Utheim, Tor Paaske

    2016-01-01

    Background The aim of the study is to raise the awareness of the influence of coma-like higher-order aberrations (HOAs) on power and orientation of refractive astigmatism (RA) and to explore how to account for that influence in the planning of topography-guided refractive surgery in eyes with coma-like-aberrations-dominant corneal optics. Methods Eleven eyes with coma-like-aberrations-dominant corneal optics and with low lenticular astigmatism (LA) were selected for astigmatism analysis and f...

  1. Corneal toxicity secondary to inadvertent use of benzalkonium chloride preserved viscoelastic material in cataract surgery

    Science.gov (United States)

    Eleftheriadis, H; Cheong, M; Sandeman, S; Syam, P P; Brittain, P; Klintworth, G K; Lloyd, A; Liu, C

    2002-01-01

    Aims: To study the long term toxic effects of intraocular benzalkonium chloride (BAC). Methods: 19 patients exposed to intraocular BAC preserved viscoelastic during cataract surgery in February 1999 developed severe striate keratopathy immediately postoperatively. 16 patients, including two who underwent penetrating keratoplasty, were studied in the period April to June 2000. Ocular symptoms, visual acuity, biomicroscopy, intraocular pressure, dilated funduscopy, specular endothelial microscopy, and corneal pachymetry findings were recorded. The corneal and iris specimens of the two patients who underwent keratoplasty were studied by light, transmission, and scanning electron microscopy. Results: Six males and 10 females, aged 64–98 years, were studied 14–16 months postoperatively. All patients were symptomatic. 12 patients had best corrected visual acuity of 6/12 or better and four patients of between 6/18 and 6/60. Five patients had corneal epithelial oedema and 11 had Descemet's membrane folds. The central corneal thickness, 620 (SD 71) μm, in affected eyes was significantly higher (p<0.005, two tailed paired t test) than that of the contralateral eyes, 563 (SD 48) μm. The endothelial cell density was significantly lower (p<0.0001, two tailed paired t test) in affected eyes: 830 (SD 280) cells/mm2v 2017 (SD 446) cells/mm2. The mean average cell area was significantly higher in the BAC treated eyes: 1317 (SD 385) μm2v 521 (SD 132) μm2. There was no significant difference in the coefficient of variation of cell size between the two eyes (p=0.3, two tailed paired t test). Two corneal specimens displayed morphological features of bullous keratopathy and other non-specific abnormalities. Extracellular melanosomes were present in a portion of the iris of one case. Conclusion: BAC is toxic to the corneal endothelium when used intraocularly, leading to severe striate keratopathy. This cleared in most cases but left varying degrees of residual stromal thickening

  2. Surgically induced astigmatism after 3.0 mm temporal and nasal clear corneal incisions in bilateral cataract surgery

    Directory of Open Access Journals (Sweden)

    Je Hwan Yoon

    2013-01-01

    Full Text Available Aims: To compare the corneal refractive changes induced after 3.0 mm temporal and nasal corneal incisions in bilateral cataract surgery. Materials and Methods: This prospective study comprised a consecutive case series of 60 eyes from 30 patients with bilateral phacoemulsification that were implanted with a 6.0 mm foldable intraocular lens through a 3.0 mm horizontal clear corneal incision (temporal in the right eyes, nasal in the left eyes. The outcome measures were surgically induced astigmatism (SIA and uncorrected visual acuity (UCVA 1 and 3 months, post-operatively. Results: At 1 month, the mean SIA was 0.81 diopter (D for the temporal incisions and 0.92 D for nasal incisions (P = 0.139. At 3 months, the mean SIA were 0.53 D for temporal incisions and 0.62 D for nasal incisions (P = 0.309. The UCVA was similar in the 2 incision groups before surgery, and at 1 and 3 months post-operatively. Conclusion: After bilateral cataract surgery using 3.0 mm temporal and nasal horizontal corneal incisions, the induced corneal astigmatic change was similar in both incision groups. Especially in Asian eyes, both temporal and nasal incisions (3.0 mm or less would be favorable for astigmatism-neutral cataract surgery.

  3. Minimisation of the thermal load of the ablation in high-speed laser corneal refractive surgery: the 'intelligent thermal effect control' of the AMARIS platform

    Science.gov (United States)

    Brunsmann, Ulrich; Sauer, Udo; Dressler, Katharina; Triefenbach, Nico; Arba Mosquera, Samuel

    2010-03-01

    The purpose of this work was to evaluate the extent that minimisation of the thermal load of the ablation in high-speed laser corneal refractive surgery is possible. To do this, thermal load from ablations onto flat PMMA plates was recorded with an infrared thermal camera and analysed for different flying-spot sorting algorithms (from pure randomised to 36 Hz local frequency) using a 500 Hz laser system with a fluence of 500 mJ/cm2, and aspheric ablation profiles. Each ablation configuration was repeated three times. Thermal load valid for corneal ablations was modelled based upon the results from ablations onto flat PMMA plates. It was found that the thermal load of ablations onto flat PMMA plates declines steadily when the allowed local frequency decreases or when the diameter of the blocked area increases. With this laser system, a local frequency of 39 Hz dynamically controlled over a diameter of 3.865 mm seems to be optimal for avoiding corneal collagen denaturation with minimum compromise on treatment duration. Peak temperature changes of 48°C in PMMA (16°C equivalent cornea) using pure randomised flying-spot sorting algorithms were reduced to 27°C in PMMA (9°C equivalent cornea) using 36 Hz local frequency over a blocked diameter of 4.25 mm. Average temperature changes of 15°C in PMMA (5°C equivalent cornea) using pure randomised flying-spot sorting algorithms were reduced to 7°C in PMMA (2°C equivalent cornea) using 36 Hz local frequency over a blocked diameter of 4.25 mm. Hence, minimisation of the thermal load of the ablation in high-speed laser corneal refractive surgery seems feasible using 'Intelligent Thermal Effect Control'. Clinical evaluations of human eyes are needed to confirm the preliminary simulated results presented here.

  4. Clinical effects of conjunctival sac flushing using different concentration of povidoneiodine on corneal epithelium before cataract surgeries

    Directory of Open Access Journals (Sweden)

    Xue-Lian Gu

    2015-10-01

    Full Text Available AIM:To determine the most optimal concentration of the safe usage of povidone-iodine(PVP-Iin the flushing to disinfect the conjunctive sac before cataract surgeries, in order to provide a scientific basis for clinical eye surgery work.METHODS:Sixty-two patients with phacoemulsification and intraocular lens implantation in our hospital from October 2012 to October 2014 were randomly divided into 0.25g/L PVP-I group(Ⅰand 5g/L PVP-I group(Ⅱ. Sterilizing effect and the complications postoperative were analyzed.RESULTS:The sterilizing effects of the two groups after flushing conjunctiva sac using different concentrations of PVP-I were both remarkable, but the difference between the two groups was not statistically significant(P>0.05. No endophthalmitis occurred in the two groups. Observing the corneal condition after rinsing, no severe conjunctival hyperemia, corneal edema and other serious complications occurred. There was slightly punctate corneal epithelial shedding in groupⅡ, and the difference was statistically significant(PPCONCLUSION:Using 0.25g/L PVP-I in the conjunctiva sac rinsing before surgeries can inhibit the growth of bacteria in the conjunctival sac, reduce the impact on the corneal epithelium thereby reducing the incidence of postoperative complications and the positive rate of bacterial culture, increasing the comfort degree of patients, bringing a better area for the surgeries.

  5. Prevalence of Corneal Astigmatism and Anterior Segmental Biometry Characteristics Before Surgery in Chinese Congenital Cataract Patients.

    Science.gov (United States)

    Lin, Duoru; Chen, Jingjing; Liu, Zhenzhen; Wu, Xiaohang; Long, Erping; Luo, Lixia; Lin, Zhuoling; Li, Xiaoyan; Zhang, Li; Chen, Hui; Liu, Jinchao; Chen, Weirong; Lin, Haotian; Liu, Yizhi

    2016-02-25

    The prevalence and the distribution characteristics of corneal astigmatism (CA) and anterior segment biometry before surgery in Chinese congenital cataract (CC) patients are not completely understood. This study involved 400 CC patients from the Zhongshan Ophthalmic Center enrolled from February 2011 to August 2015. Data on CA, keratometry, central corneal thickness (CCT) and anterior chamber depth (ACD) were measured by the Pentacam Scheimpflug System. The mean age of patients was 54.27 months, and the ratio of boys to girls was 1.53:1. The mean CA was 2.03 diopters (D), and 39.25% of subjects had CA values ≥2 D. The most frequent (71.8%) diagnosis was with-the-rule astigmatism. Oblique astigmatism was present in 16.2% of cases, and 12% of cases had against-the-rule astigmatism. The mean keratometry measurement of cataractous eyes in bilateral patients was significantly larger than that in unilateral patients. Girls had a larger mean keratometry but a thinner CCT than did boys. The CA, CCT, and ACD of cataractous eyes were significantly larger than those of non-cataractous eyes in unilateral patients. The CA, mean keratometry, CCT, and ACD in CC patients varied with age, gender, and laterality. Fully understanding these characteristics may help inform guidelines and treatment decisions in CC patients.

  6. Sudden corneal edema due to retained lens nuclear fragment presenting 8.5 years after cataract surgery.

    Science.gov (United States)

    Pandit, Rahul T; Coburn, Amy G

    2011-06-01

    A 79-year-old woman presented with a 1-week history of sudden onset of decreased vision, pain, and redness in the right eye. Ocular history included uneventful cataract surgery in both eyes more than 8 years prior to presentation. Slitlamp examination revealed significant corneal edema and mild iritis. Gonioscopy revealed a retained lens nuclear fragment in the inferior angle. Surgical removal of the fragment improved the patient's condition. The retained nuclear fragment presumably lodged behind the iris at the time of the initial surgery and spontaneously moved forward more than 8 years later. To our knowledge, this is the longest reported delay between phacoemulsification and presentation of a retained nuclear fragment. Before this case, retained nuclear fragments had been associated with complications within a year of surgery only. We recommend gonioscopy in cases of sudden-onset corneal edema extending to the inferior limbus in patients with a history of phacoemulsification.

  7. Ocular higher-order aberrations features analysis after corneal refractive surgery

    Institute of Scientific and Technical Information of China (English)

    WANG Yan; ZHAO Kan-xing; HE Ji-chang; JIN Ying; ZUO Tong

    2007-01-01

    Background The recent studies have shown that visual performance might be affected by the ocular aberration after the corneal refractive surgery, and try to minimize it. This study was to investigate the effects of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) on the higher order of wavefront aberration and analysis of their characteristics.Method This prospective study involved 32 eyes with similar refractive powers (-5.0 D to -6.0 D preoperatively). LASIK and PRK were performed with the same parameters of 6 mm diameter optical zone and 7 mm diameter transition zone ablation. Wavefront aberrations were tested using a ray tracing technique preoperatively and 3 months postoperatively.Three measurements were obtained for each condition; the root mean squared wavefront error (RMS), values for overall wavefront aberrations and each order of the Zernike aberrations were analyzed using the Matlab software. The 2-tailed t test was used for statistical analysis.Results Overall higher order aberrations were increased from (0.55±0.26) μm preoperatively to (0.93±0.37) μm for PRK and (0.79±0.38) μm for LASIK postoperatively. This was a 1.69 fold increase in the PRK group (t=3.95, P<0.001)and a 1.43 fold increase in the LASIK group (t=2.60, P<0.05). At 3 months, the mean RMS value for higher-order (3rd to 6th) were significantly increased compared with the corresponding preoperative values (P<0.05). The fourth order aberrations, spherical like aberration, were dominant by a 2.64 fold in PRK and a 2.31 fold in LASIK. Different influences of the PRK group and LASIK group were shown in the various zernike components. The statistically significant differences were seen in C40, C4+4, C5+1, C5+3, C5+5 and C6+2 of the PRK group and C3-3, C40, C5-5, C5+5, C6-2 of the LASIK group, which represents a 7.42, 3.58, 9.21, 2.72 and 5.3 fold increases in PRK group, and 6.40, 10.80, 11.06, 3.47 and 6.09 fold increases in LASIK group, respectively. C3

  8. Assessment of corneal astigmatism following frown and straight incision forms in sutureless manual small incision cataract surgery

    Directory of Open Access Journals (Sweden)

    Amedo AO

    2016-04-01

    Full Text Available Angela Ofeibea Amedo, Kwadwo Amoah, Nana Yaa Koomson, David Ben Kumah, Eugene Appenteng Osae Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Abstract: To investigate which of two tunnel incision forms (frown versus straight in sutureless manual small incision cataract surgery creates more corneal astigmatism. Sixty eyes of 60 patients who had consented to undergo cataract surgery and to partake in this study were followed from baseline through >12-week postoperative period. Values of preoperative and postoperative corneal astigmatism for the 60 eyes, measured with a Bausch and Lomb keratometer, were extracted from the patients’ cataract surgery records. Residual astigmatism was computed as the difference between preoperative and postoperative keratometry readings. Visual acuity was assessed during the preoperative period and at each postoperative visit with a Snellen chart at 6 m. Fifty eyes of 50 patients were successfully followed-up on. Overall, the mean residual astigmatism was 0.75±0.12 diopters. The differences in mean residual astigmatism between the two different incision groups were statistically significant (t [48]=6.33, P<0.05; frown incision group recorded 1.00±0.12 diopters, whereas the straight incision group recorded 0.50±0.12 diopters. No significant difference was observed between male and female groups (t [48]=0.24, P>0.05. Residual corneal astigmatism in the frown incision group was significantly higher than in the straight incision group. Fisher’s exact test did not reveal a significant association between incision forms and visual acuity during the entire postoperative period (P>0.05. Keywords: cataract, residual corneal astigmatism, frown incision, straight incision

  9. Corneal ulcers in horses.

    Science.gov (United States)

    Williams, Lynn B; Pinard, Chantale L

    2013-01-01

    Corneal ulceration is commonly diagnosed by equine veterinarians. A complete ophthalmic examination as well as fluorescein staining, corneal cytology, and corneal bacterial (aerobic) and fungal culture and sensitivity testing are necessary for all infected corneal ulcers. Appropriate topical antibiotics, topical atropine, and systemic NSAIDs are indicated for all corneal ulcers. If keratomalacia (melting) is observed, anticollagenase/antiprotease therapy, such as autologous serum, is indicated. If fungal infection is suspected, antifungal therapy is a necessity. Subpalpebral lavage systems allow convenient, frequent, and potentially long-term therapy. Referral corneal surgeries provide additional therapeutic options when the globe's integrity is threatened or when improvement has not been detected after appropriate therapy.

  10. Scheimpflug corneal power measurements for intraocular lens power calculation in cataract surgery.

    Science.gov (United States)

    Saad, Elie; Shammas, Maya C; Shammas, H John

    2013-09-01

    To compare the keratometric (K) readings from the Pentacam-HR (High Resolution) unit with the automated K values from the IOLMaster keratometer (KIOLM), and to evaluate them in the commonly used intraocular lens (IOL) power calculation formulas for routine cataract surgery. Prospective, comparative observational study. setting: Private practice, Lynwood, California. study population: Fifty cataractous eyes scheduled for surgery between July and August 2012. observation procedure: The K readings from the Pentacam-HR unit taken at the 2-, 3-, 4-, and 5-mm zones and the 2-, 3-, 4-, and 5-mm rings, respectively, from 3 different maps: sagittal corneal front (KF), true net power (KTNP), and total refractive power (KRP) are compared with KIOLM. IOL power calculations were performed with each of the 25 sets of K readings. main outcome measures: The IOL prediction median absolute error (MedAE) obtained with each measurement. KF averaged 0.03-0.13 diopter (D) higher than KIOLM (P > .05), KTNP averaged 1.16-1.21 D lower than KIOLM (P > .001), and KRP averaged 0.23-0.72 D lower than KIOLM (P > .001), with large variations in the measurements. The MedAE obtained with the different Pentacam K readings ranged from 0.44-0.64 D vs 0.52 D obtained with KIOLM (P > .05). MedAE was lower in all categories when the pupil was 3 mm or smaller. The Pentacam KF values were the closest to KIOLM and the KF readings from the 2-mm ring yielded the best results for IOL power calculation. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Combined eye gel containing sodium hyaluronate and xanthan gum for the treatment of the corneal epithelial defect after pterygium surgery

    Directory of Open Access Journals (Sweden)

    Kocatürk T

    2015-08-01

    Full Text Available Tolga Kocatürk,1 Ataman Gençgönül,2 Faruk Balica,1 Mehmet Özbağcivan,1 Harun Çakmak1 1Department of Ophthalmology, Faculty of Medicine, Adnan Menderes University, Aydin, 2Department of Ophthalmology, Mevki Military Hospital, Ankara, Turkey Aim: The aim of this study is to compare the effectiveness of the ophthalmic gels containing hyaluronate, xanthan gum, and netilmycine with fusidic acid in terms of recovery periods of corneal epithelium in the patients who underwent pterygium surgery.Methods: Patients who underwent pterygium surgery were separated into two groups. Forty patients in group 1 were given eye gel containing sodium hyaluronate, xanthan gum, and netilmycine, and 40 patients in group 2 were given one drop of eye gel containing fusidic acid. The patients in both groups were examined at the 12th, 24th, and 48th hours in the postoperative period by using slit-lamp technique. The subjective complaints of the patients such as pain and stinging, and the recovery periods of the corneal epithelial defect were evaluated comparatively by fluorescein staining.Results: The mean ages were 26±8 years (range: 18–35 and 24±6 years (range: 18–33 in groups 1 and 2, respectively. The closure period of the corneal epithelial defect was observed as 24±8 hours (range: 16–42 and 36±12 hours (range: 18–48 in groups 1 and 2, respectively. The number of the patients suffering from subjective complaints such as pain and stinging in the first 12 hours was six and 29 in groups 1 and 2, respectively. The difference was significant both clinically and statistically (P=0.001.Conclusion: Combined eye gel containing hyaluronate, xanthan gum, and netilmycine accelerates the recovery of corneal epithelial defect and reduces the complaints of the patients, when compared to the fusidic acid gel. Combined eye gel should be considered as an option for the treatment of the corneal epithelial defect related with pterygium surgery. Keywords: iatrogenic

  12. Influence of corneal collagen crosslinking with riboflavin and ultraviolet-a irradiation on excimer laser surgery.

    NARCIS (Netherlands)

    Kampik, D.; Ralla, B.; Keller, S.; Hirschberg, M.; Friedl, P.H.A.; Geerling, G.

    2010-01-01

    PURPOSE: Riboflavin/ultraviolet A (UVA) cross-linking (CXL) of corneal collagen is a novel method of stabilizing corneal mechanical properties and preventing progression of keratectasias. This study was conducted to investigate whether CXL influences ablation rate, flap thickness, and refractive res

  13. Corneal endothelial cell changes associated with cataract surgery in patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Hugod, Mikkel; Storr-Paulsen, Allan; Norregaard, Jens Christian;

    2011-01-01

    To investigate the corneal endothelial cell density and morphology in patients with and without diabetes after phacoemulsification with intraocular lens implantation.......To investigate the corneal endothelial cell density and morphology in patients with and without diabetes after phacoemulsification with intraocular lens implantation....

  14. Influence of corneal collagen crosslinking with riboflavin and ultraviolet-a irradiation on excimer laser surgery.

    NARCIS (Netherlands)

    Kampik, D.; Ralla, B.; Keller, S.; Hirschberg, M.; Friedl, P.H.A.; Geerling, G.

    2010-01-01

    PURPOSE: Riboflavin/ultraviolet A (UVA) cross-linking (CXL) of corneal collagen is a novel method of stabilizing corneal mechanical properties and preventing progression of keratectasias. This study was conducted to investigate whether CXL influences ablation rate, flap thickness, and refractive res

  15. [One stop surgery in pediatric surgery. Preliminary report].

    Science.gov (United States)

    Sanges, G; Astuto, M; Sentina, P; Morinello, E; Di Benedetto, A

    2002-01-01

    The One-Stop Surgery (OSS) is a new method of Day Surgery, which combines preoperative evaluation and subsequent operation into one visit. This report describes the initial experience of the authors. Referring physicians were informed by fax about method and selected surgical procedures. Included form helped them to gain anamnestic data and to inform parents about preoperative fast. Form was then sent back by fax to the pediatric surgeon and anesthesiologist who determined the patient suitability and scheduled the day of the surgery. At hospital admission, if the diagnosis was confirmed and no anesthesiologic contraindications were discovered, the patient underwent the prescheduled surgical procedure and was discharged as a day case. Another form containing informations about home postoperative care and telephone numbers for emergency call was gave to the parents. From November 2000 through February 2001 43 patients, aged from 2 to 7 years, underwent one-stop surgical procedure: central venous catheter removal (n = 16), umbilical (n = 2) and inguinal (n = 10) hernia repair, prepuce dorsal slit (n = 15). Recovery of all patient was uneventful. None of them called during the period considered necessary for postoperative follow-up. Decreased costs and increased satisfaction of the patients and parents are the most important advantages of the OSS. Potential disadvantages are a not appropriate indication for the planned procedure and/or an anesthesiologic contraindication at hospital admission. It could involve a waste of human and financial resources and an useless psychologic stress for the family. Authors conclude it is not advisable the OSS use on a large scale without a sound experience in pediatric Day Surgery.

  16. The Preliminary Experimental Study of Induced Differentiation of Embryonic Stem Cells into Corneal Epithelial Cells

    Institute of Scientific and Technical Information of China (English)

    Ling Yu; Jian Ge; Zhichong Wang; Bing Huang; Keming Yu; Chongde Long; Xigu Chen

    2001-01-01

    Purpose:To study preliminarily induced differentiation of embryonic stem cells intocorneal epithelial cells in vitro.Methods: Murine embryonic stem cells were co-cultured with Rabbit limbal cornealepithelial cells in Transwell system to induce differentiation. Mophological andimmunohistochemical examination were implemented.Results: The induced cells from embryonic stem cells have an epithelial appearance.The cells formed a network and were confluent into film gradually after beingco-cultured with rabbit limbal corneal epithelial cells for 24 ~ 96 hours. The cells rangedmosaic structure and localized together with clear rim. Most of the cells showedpolygonal appearance. Transmission electron microscope showed lots of microvilli on thesurface of induced cells and tight junctions between them. These epithelial-like cellsexpressed the corneal epithelial cell specific marker cytokeratin3/cytokeratinl2.Conclusion: The potential mechanism of the differentiation of murine embryonic stemcells into corneal epithelial cells induced by limbal corneal epithelial cell-derivedinducing activity is to be further verified.

  17. Keratometry obtained by corneal mapping versus the IOLMaster in the prediction of postoperative refraction in routine cataract surgery.

    Science.gov (United States)

    Dulku, Simon; Smith, Henry B; Antcliff, Richard J

    2013-01-01

    To establish whether simulated keratometry values obtained by corneal mapping (videokeratography) would provide a superior refractive outcome to those obtained by Zeiss IOLMaster (partial coherence interferometry) in routine cataract surgery. Prospective, non-randomized, single-surgeon study set at the The Royal United Hospital, Bath, UK, District General Hospital. Thirty-three patients undergoing routine cataract surgery in the absence of significant ocular comorbidity. Conventional biometry was recorded using the Zeiss IOLMaster. Postoperative refraction was calculated using the SRK/T formula and the most appropriate power of lens implanted. Preoperative keratometry values were also obtained using Humphrey Instruments Atlas Version A6 corneal mapping. Achieved refraction was compared with predicted refraction for the two methods of keratometry after the A-constants were optimized to obtain a mean arithmetic error of zero dioptres for each device. The mean absolute prediction error was 0.39 dioptres (standard deviation 0.29) for IOLMaster and 0.48 dioptres (standard deviation 0.31) for corneal mapping (P = 0.0015). Keratometry readings between the devices were highly correlated by Spearman correlation (0.97). The Bland-Altman plot demonstrated close agreement between keratometers, with a bias of 0.0079 dioptres and 95% limits of agreement of -0.48-0.49 dioptres. The IOLMaster was superior to Humphrey Atlas A6 corneal mapping in the prediction of postoperative refraction. This difference could not have been predicted from the keratometry readings alone. When comparing biometry devices, close agreement between readings should not be considered a substitute for actual postoperative refraction data. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

  18. A corneal mold to restore normal corneal dimensions.

    Science.gov (United States)

    Swinger, C A; Kornmehl, E W; York, S; Forman, J S

    1986-01-01

    A corneal mold is described that provides an MK corneal button of normal thickness and curvature from an edematous, post-mortem button. The uniform, processed tissue can then be used for experimental refractive surgery.

  19. LASIK surgery of granular corneal dystrophy type 2 patients leads to accumulation and differential proteolytic processing of transforming growth factor beta-induced protein (TGFBIp)

    DEFF Research Database (Denmark)

    Poulsen, Ebbe Toftgaard; Nielsen, Nadia Sukusu; Jensen, Morten Mørk;

    2016-01-01

    at position 124 in mature TGFBIp leads to granular corneal dystrophy type 2 (GCD2). Homozygous GCD2 cases develop massive protein accumulation early in life whereas heterozygous GCD2 cases become affected much later and generally with a much less severe outcome. However, if heterozygous GCD2 patients undergo...... laser-assisted in situ keratomileusis (LASIK) surgery protein accumulation is accelerated and they develop massive protein accumulations a few years after surgery. Here, we present the protein profile of aggregate-containing corneal tissue from GCD2 patients with a history of LASIK surgery using LC......-MS/MS. Label-free quantification of corneal extracellular matrix proteins showed accumulation of TGFBIp. This was supported by 2DE and immunoblotting against TGFBIp that revealed the accumulation of full-length TGFBIp. In addition, a high molecular weight TGFBIp complex was more apparent in GCD2 patients after...

  20. Reasons not to select patients for corneal refractive surgery Razões para recusar candidatos à cirurgia refrativa corneana

    Directory of Open Access Journals (Sweden)

    André Luiz Parolin Ribeiro

    2002-08-01

    Full Text Available Purpose: To present how the section of Refractive Surgery of the Federal University of São Paulo assesses the candidates and the reasons to indicate for corneal refractive surgery. Methods: We examined 1626 patients. Anamnesis, complete ophthalmologic examination and corneal topography were performed in all patients. The patients spontaneously seeked evaluation at the Refractive Surgery Section by telephone without a previous screening. Reasons to refuse patients for refractive surgery were previously established by the Refractive Surgery Section. Results: Based on current technology and clinical experience, 265 patients (16.29% were refused for excimer laser corneal refractive surgery. Myopia of patients who had insufficient preoperative corneal pachymetry for the laser treatment was the main cause for refusal (51 patients. Cataract (45 patients, keratoconus (31 patients, amblyopia (21 patients, hyperopia > 5 diopters and mixed astigmatism (19 patients, presbyopia (unaware ness of the need for optical correction after the procedure; 16 patients, pupillary diameter > 5mm (9 patients, single eye (9 patients, progressive myopia (8 patients, postradial keratotomy (7 patients and low ametropia (7 patients were among the reasons for the refusal. Conclusion: Candidates for excimer laser corneal refractive surgery may present risk factors that should be known in order to avoid complications.Objetivo: O objetivo deste estudo é mostrar como o setor de Cirurgia Refrativa da Escola Paulista de Medicina da Universidade Federal de São Paulo avalia seus candidatos e quais as razões para não selecioná-los para cirurgia refrativa. Métodos: Foram examinados 1626 pacientes. Anamnese, avaliação oftalmológica completa e topografia corneana foram realizadas em todos os pacientes. Os pacientes procuraram avaliação no setor de Cirurgia Refrativa espontaneamente sem triagem prévia. Resultados: Não foram selecionados 265 pacientes (16,29% para cirurgia

  1. Preliminary development of augmented reality systems for spinal surgery

    Science.gov (United States)

    Nguyen, Nhu Q.; Ramjist, Joel M.; Jivraj, Jamil; Jakubovic, Raphael; Deorajh, Ryan; Yang, Victor X. D.

    2017-02-01

    Surgical navigation has been more actively deployed in open spinal surgeries due to the need for improved precision during procedures. This is increasingly difficult in minimally invasive surgeries due to the lack of visual cues caused by smaller exposure sites, and increases a surgeon's dependence on their knowledge of anatomical landmarks as well as the CT or MRI images. The use of augmented reality (AR) systems and registration technologies in spinal surgeries could allow for improvements to techniques by overlaying a 3D reconstruction of patient anatomy in the surgeon's field of view, creating a mixed reality visualization. The AR system will be capable of projecting the 3D reconstruction onto a field and preliminary object tracking on a phantom. Dimensional accuracy of the mixed media will also be quantified to account for distortions in tracking.

  2. Iontophoresis-Assisted Corneal Collagen Cross-Linking with Epithelial Debridement: Preliminary Results

    Science.gov (United States)

    Legrottaglie, Emanuela F.

    2016-01-01

    Purpose. To report the early outcomes of iontophoresis-assisted corneal collagen cross-linking procedure with epithelial debridement (I-SCXL). Methods. Twenty eyes of twenty patients with progressive keratoconus were included in this prospective clinical study. Best spectacle corrected visual acuity (BSCVA), sphere and cylinder refraction, corneal topography, Scheimpflug tomography, aberrometry, anterior segment optical coherence tomography (AS-OCT), and endothelial cell count were assessed at baseline and at 1, 3, and 6 months of follow-up. The parameters considered to establish keratoconus progression were always proven with differential maps as change in curvature in the cone area of at least 1 diopter obtained with an instantaneous map. Results. Functional parameters showed a significant improvement (p 0.05). Conclusion. The early results indicate that the I-SCXL may be able to reduce the treatment time and improve the riboflavin diffusion. PMID:27547758

  3. Iontophoresis-Assisted Corneal Collagen Cross-Linking with Epithelial Debridement: Preliminary Results

    Directory of Open Access Journals (Sweden)

    Paolo Vinciguerra

    2016-01-01

    Full Text Available Purpose. To report the early outcomes of iontophoresis-assisted corneal collagen cross-linking procedure with epithelial debridement (I-SCXL. Methods. Twenty eyes of twenty patients with progressive keratoconus were included in this prospective clinical study. Best spectacle corrected visual acuity (BSCVA, sphere and cylinder refraction, corneal topography, Scheimpflug tomography, aberrometry, anterior segment optical coherence tomography (AS-OCT, and endothelial cell count were assessed at baseline and at 1, 3, and 6 months of follow-up. The parameters considered to establish keratoconus progression were always proven with differential maps as change in curvature in the cone area of at least 1 diopter obtained with an instantaneous map. Results. Functional parameters showed a significant improvement (p0.05. Conclusion. The early results indicate that the I-SCXL may be able to reduce the treatment time and improve the riboflavin diffusion.

  4. Small Incision Cataract Surgery (SICS with Clear Corneal Incision and SICS with Scleral Incision – A Comparative Study

    Directory of Open Access Journals (Sweden)

    Md Shafiqul Alam

    2014-01-01

    Full Text Available Background: Age related cataract is the leading cause of blindness and visual impairment throughout the world. With the advent of microsurgical facilities simple cataract extraction surgery has been replaced by small incision cataract surgery (SICS with posterior chamber intra ocular lens implant, which can be done either with clear corneal incision or scleral incision. Objective: To compare the post operative visual outcome in these two procedures of cataract surgery. Materials and method: This comparative study was carried out in the department of Ophthalmology, Delta Medical College & Hospital, Dhaka, Bangladesh, during the period of January 2010 to December 2012. Total 60 subjects indicated for age related cataract surgery irrespective of sex with the age range of 40-80 years with predefined inclusion and exclusion criteria were enrolled in the study. Subjects were randomly and equally distributed in 2 groups; Group A for SICS with clear corneal incision and group B for SICS with scleral incision. Post operative visual out come was evaluated by determining visual acuity and astigmatism in different occasions and was compared between groups. Statistical analysis was done by SPSS for windows version12. Results: The highest age incidence (43.3% was found between 61 to 70 years of age group. Among study subjects 40 were male and 20 were female. Preoperative visual acuity and astigmatism were evenly distributed between groups. Regarding postoperative unaided visual outcome, 6/12 or better visual acuity was found in 19.98% cases in group A and 39.6% cases in group B at 1st week. At 6th week 6/6 vision was found in 36.3% in Group A and 56.1% in Group B and 46.2% in group A and 66% in group B without and with correction respectively. With refractive correction, 6/6 vision was attained in 60% subjects of group A and 86.67% of group B at 8th week. Post operative visual acuity was statistically significant in all occasions. Postoperative astigmatism of

  5. 角膜屈光手术后继发性圆锥角膜的RGP矫正疗效观察%RGP Correct Corneal Ectasia after Corneal Refractive Surgery

    Institute of Scientific and Technical Information of China (English)

    赵江浩; 吴年浪; 张惠成

    2012-01-01

    目的 评价硬性透气性角膜接触镜(rigid permeability contact lenses,RGP)矫正角膜屈光手术后圆锥角膜的疗效.方法 选择笔者医院收治的11例(21眼)角膜屈光手术后圆锥角膜患者配戴RGP,观察1年后角膜前后表明曲率,RGP和普通软性角膜接触镜的角膜地形图改变.结果 配戴RGP1年后角膜前表面最平平均曲率值和后表面曲率值没有明显变化.RGP矫正1年后角膜前表面的最陡平均曲率明显下降,角膜地形图SRI,SAI,散光减少,PVA提高.对照组佩戴普通软性角膜接触镜1年后角膜地形图无明显改善.结论 经1年的随访观察,RGP对角膜屈光手术后的圆锥角膜能明显改善患者的角膜前表面最陡平均曲率,角膜后表面和角膜前表面最平平均曲率保持稳定.是目前矫正角膜屈光手术后圆锥角膜的有效方法.%Objective To evaluate the effect of rigid permeability contact lenses (RGP) for correcting corneal ectasia after comeal refractive surgery. Methods 21 eyes from 11 patients identified as developing corneal ectasia after comeal refractive surgery were used in this study. The change of corneal curvature front surface and after the surface was observed. Also the change of corneal topography of after wearing RCP and soft contact lens after 1 year was observed. Results Front surface MIX corneal curvature value and after surface corneal curvature value did not change significantly. Front surface MAX cornea] curvature was decreased significantly after wearing RGP 1 year. SRI, SAI and stigmatism were obviously decreased, and PVA was improved after wearing RGP 1 year. At the same time corneal topography did not change significantly after wearing soft contact lens 1 year. Conclusion By 1 years of follow -up, front surface MAX corneal curvature ,stigmatism are obviously decreased after comeal refractive surgery. The patient's vision is obviously improved. Front surface MIX corneal curvature value and after surface comeal

  6. Evaluation of the effective corneal ablation in refractive surgery by two 3D topographic surface matching methods

    Science.gov (United States)

    Bueeler, M.; Donitzky, Ch.; Mrochen, M.

    2006-02-01

    The effectiveness of the corneal ablation process in refractive surgery is mostly evaluated by indirect measures of vision or optical quality such as post-operative refraction or wavefront aberrometry. Yet, the effective amount of corneal tissue removed in the treatment can only be determined by correctly overlapping a pre- and a post-operative topography measurement. However such an overlap is not trivial due to the discrepancy in the centration axes used in the measurement and the treatment, as well as due to the shift of ocular axes through the treatment or tilt between the two surfaces. We therefore present two methods for overlapping pre- and post-operative topographies for the purpose of extracting an effective corneal ablation profile. Method one uses a 3-dimensional profile matching algorithm and cross-correlation analysis on surface rings outside the optical zone of the topographies. Method two employs a surface normal matching routine to align the two surfaces along their common ablation axis. The profile matching method implies the problem that it requires measurement data outside of the optical zone which was found to be uncertain with placido-disk-based topographers. Method number two is more simple and implies the advantage of using measurement data within the optical zone. For regular profiles the extracted ablation profiles showed a very good match with the planned ones. Surprisingly, even for highly irregular profiles of topography-guided laser treatments the method delivered reasonable overlaps when being compared to the planned profiles. Analysis of the effective tissue removal yields valuable information on the quality of the ablation process.

  7. Modificaciones de la curvatura posterior corneal después de la cirugía refractiva láser Modifications in the corneal posterior curve after laser refractive surgery

    Directory of Open Access Journals (Sweden)

    Lorelei Ortega Díaz

    2011-06-01

    Full Text Available OBJETIVO: Describir las modificaciones de la curvatura posterior corneal en pacientes sometidos a cirugía refractiva láser en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" en el período de mayo a octubre de 2010. MÉTODOS: Se realizó un estudio descriptivo, longitudinal y prospectivo, con un universo de 257 pacientes (504 ojos sometidos a cirugía refractiva láser. La muestra quedó conformada por 31 pacientes (59 ojos. Se analizaron variables como edad, sexo, equivalente esférico, paquimetría preoperatoria, cantidad de ablación, estroma residual y diferencia de elevación posterior corneal, esta última obtenida del mapa de diferencia del topógrafo Galilei, con medición preoperatoria al mes y a los tres meses de la cirugía. Mediante análisis de regresión múltiple fueron valorados dichos cambios de la paquimetría, la cantidad de ablación y el estroma residual. RESULTADOS: El equivalente esférico, la paquimetría, la cantidad de ablación y el estroma residual se encontraron dentro de los parámetros de seguridad establecidos. La diferencia promedio de la elevación corneal posterior fue de 15,62 µm al mes y de 11,78 µm a los tres meses, con disminución significativa con el tiempo (p= 0,000. Se observó asociación con la paquimetría preoperatoria y el estroma residual, y se encontró una correlación inversa entre este último y la elevación corneal posterior a los tres meses. CONCLUSIONES: La cirugía refractiva láser induce un aumento precoz en la elevación corneal posterior, con disminución progresiva hacia el tercer mes. Los factores que más influyeron en estos cambios fueron el estroma residual y la paquimetría preoperatoria.OBJECTIVES: To describe the modifications in the corneal posterior curve in patients underwent laser refractive surgery in the "Ramón Pando Ferrer" Cuban Institute of Ophthalmology from May to October, 2020. METHODS: A prospective, longitudinal and descriptive study was conducted

  8. Toric Intraocular Lens vs. Peripheral Corneal Relaxing Inci-sions to Correct Astigmatism in Eyes Undergoing Cataract Surgery

    Institute of Scientific and Technical Information of China (English)

    Zhiping Liu; Xiangyin Sha; Xuanwei Liang; Zhonghao Wang; Jingbo Liu; Danping Huang

    2014-01-01

    Purpose:.To compare toric intraocular lens implantation (Toric-IOL).with peripheral corneal relaxing incisions (PCRIs) for astigmatism correction in patients undergoing cataract surgery. Methods: 54 patients (54 eyes) with more than 0.75 diopter (D).of preexisting corneal astigmatism were classified as group A (0.75-1.50D) or group B (1.75-2.50D). The patients were randomized to undergo Toric-IOL or PCRIs in the steep axis with spherical IOL implantation..LogMAR uncorrected visual acuity (LogMAR UCVA), LogMAR best corrected vi sual acuity.(LogMAR BCVA),.error of vector (|EV|), surgery induced refraction correction. (|SIRC|),.and correction rates (CR) were measured 1 month and 6 months postoperatively. Results: At 6 months postoperatively, all 54 eyes had Log-MAR BCVA≤0.2. Patients who underwent PCRIs and Toric-IOL with LogMAR BCVA≤0.1 showed no significant differ-ences in group A (P=1.00) or in group B (P=0.59). Group A showed no significant differences in LogMAR UCVA (P=0.70), |EV| (P=0.13), |SIRC| (P=0.71), and CR (P=0.56) in patients underwent PCRIs and Toric-IOL. However, group B showed significant differences in LogMAR UCVA (P Conclusion:.The efficacy and stability of Toric-IOL and PCRIs were equal in low astigmatic patients..Toric-IOL achieved an enhanced effect over PCRIs in higher astigmatic patients. PCRIs had the more refractive regression than Toric-IOL in 6 months.

  9. Corneal chromoblastomycosis.

    Science.gov (United States)

    Barton, K; Miller, D; Pflugfelder, S C

    1997-03-01

    We sought to illustrate the difficulty in managing uncommon, pigmented mold-related corneal ulceration and to highlight the role of itraconazole in treating these patients. We describe the management and clinical course of a patient with a recurring corneal infection caused by Fonsecaea pedrosoi and discuss this experience in the light of existing literature on management of cutaneous chromoblastomycosis. A corneal ulcer caused by this organism healed initially on treatment with topical and systemic antifungal medication, but infection recurred in the deep stroma 4 months after cessation of therapy. After failure to respond to a further period of medical therapy, a small therapeutic penetrating keratoplasty was performed. Culture of a fibrinous membrane from the anterior iris surface demonstrated intraocular fungal infection, and postoperatively, an episode of marked fibrinous uveitis developed, suggesting the presence of viable intraocular fungal elements. A large penetrating keratoplasty was therefore performed with excision of involved iris in combination with extracapsular cataract extraction. F. pedrosoi was again cultured from the fibrinous membrane adherent to the iris and from the anterior lens capsule. Postoperatively the patient received a 5-month course of systemic itraconazole, and no further recurrences have been encountered after a further 2 months. F. pedrosoi is the organism most commonly isolated from the chronic cutaneous mycosis, chromoblastomycosis, and is relatively resistant to medical therapy. As has been reported for cutaneous disease, surgery in combination with systemic itraconazole may provide the best chance of cure in corneal chromoblastomycosis.

  10. SURGICALLY INDUCED ASTIGMATISM AFTER 2.8 MM TEMPORAL AND NASAL CLEAR CORNEAL INCISIONS IN PHACOEMULSIFICATION CATARACT SURGERY OF SAME PATIENT

    Directory of Open Access Journals (Sweden)

    Preeti

    2015-04-01

    Full Text Available PURPOSE: To evaluate and compare the surgically induced astigmatism in phacoemulsification cataract surgery after 2.8 mm temporal and nasal clear corneal incision of same patient . MATERIAL AND METHOD : This prospective study comprised a consecutive case series of 60 eyes. Eyes from 30 patients with phacoemulsification those were implanted with a 6.00 mm foldable intraocular le ns through a 2.8 mm horizontal clear corneal incision (temporal in the right eye , nasal in the left eye. RESULTS : T he outcome measures were surgically induced astigmatism (SIA and uncorrected visual acuity (UCVA , at 1 and 3 months post - operatively. A 1 month the mean SIA was 0.81 D. for the temporal incision and 0.92 D for nasal incision (P = 0.139 at 3 months the mean SIA was 0.53 D for temporal incision and 0.62 D for nasal incision (P =0.309. The pre - operative parameters i.e. (UCVA , mean keratomet ry & keratometric cylinder between these groups were comparable. There was no statistically significant difference found between three groups pre - operatively . CONCLUSION : After cataract surgery using 2.8mm temporal and nasal horizontal corneal incision , t he induced corneal astigmatic changes was similar in both incision groups. Especially in Asian eyes , both temporal and nasal incisions (2.8 mm or less would be equally favourable for astigmatism neutral cataract surgery

  11. Changes in corneal endothelium cell characteristics after cataract surgery with and without use of viscoelastic substances during intraocular lens implantation

    Directory of Open Access Journals (Sweden)

    Schulze SD

    2015-11-01

    Full Text Available Stephan D Schulze,1 Thomas Bertelmann,1 Irena Manojlovic,2 Stefan Bodanowitz,2 Sebastian Irle,3 Walter Sekundo11Department of Ophthalmology, Philipps University of Marburg, Marburg, 2Private Practice and Ambulatory Surgical Center, Bremen, 3Freelance Statistician, Friedberg, GermanyPurpose: To evaluate whether the use of balanced salt solution (BSS or an ophthalmic viscoelastic device (OVD during hydrophilic acrylic intraocular lens (IOL implantation variously impacts corneal endothelial cell characteristics in eyes undergoing uneventful phacoemulsifications.Methods: Prospective nonrandomized observational clinical trial. Patients were assigned either to the BSS plus® or to the OVD Z-Celcoat™ group depending on the substance used during IOL implantation. Corneal endothelium cell characteristics were obtained before, 1 week, and 6 weeks after surgery. Intraoperative parameters (eg, surgery time, phacoemulsification energy were recorded.Results: Ninety-seven eyes were assigned to the BSS plus and 86 eyes to the Z-Celcoat group. Preoperative corneal endothelium cell density (ECD and endothelium cell size were 2,506±310 cells/mm2/2,433±261 cells/mm2 and 406±47 µm2/416±50 µm2 (P=0.107/P=0.09. After 1 and 6 weeks, ECD decreased and endothelium cell size increased significantly in both groups (each P<0.001 without significant differences between both groups (each P>0.05. Irrigation–aspiration suction time (30.3±16.6 versus 36.3±14.5 seconds and overall surgical time (7.2±1.2 versus 8.0±1.4 minutes were significantly longer in the OVD Z-Celcoat group (each P<0.001. No complications or serious side effects occurred.Conclusion: Implantation of a hydrophilic acrylic IOL under BSS infusion seems to be a useful and faster alternative in experienced hands without generating higher ECD loss rates.Keywords: phacoemulsification, ophthalmic viscoelastic device, endothelial cell density, IOL

  12. Late corneal scarring after retinal detachment surgery 42 months after photorefractive keratectomy.

    Science.gov (United States)

    Tosi, Gian Marco; Baiocchi, Stefano; Caporossi, Tomaso

    2004-05-01

    A 42-year-old man had uneventful bilateral nonsimultaneous photorefractive keratectomy (PRK) for severe myopia. Thirty-nine months after the procedure, the patient presented with a retinal detachment (RD) in the right eye. Cerclage, vitrectomy, endolaser, and intravitreal silicone oil tamponade were performed, and the RD was successfully repaired. Three months after vitrectomy and 42 months after PRK, the patient complained of visual impairment in the right eye and photophobia. On slitlamp examination, marked reticular scarring of the central anterior cornea was observed. The occurrence of late-onset corneal haze highlights the need for special attention to patients who have vitrectomy after PRK.

  13. Effect of 3.0mm corneal incision guided by corneal topography on corneal astigmatism in cataract surgery%角膜地形图引导下3.0mm角膜切口对白内障术后角膜散光的影响

    Institute of Scientific and Technical Information of China (English)

    陆士恒; 张忆; 吕骄

    2013-01-01

    AIM: To compare preoperative and postoperative corneal astigmatism using 3.0mm corneal incision guided by corneal topography system in phacoemulsification.METHODS: Phacoemulsification was performed on 144 cases 156 eyes with 3.0mm corneal clear incision at the steepest corneal meridian. Preoperative corneal astigmatism and the data 3 months postoperatively were observed by the corneal topography system. Statistical analysis included sample Student's t - test, one way ANOVA test, Kruskal-Wallis test and Pearson correlation test.RESULTS: According to analysis, the postoperative corneal astigmatism correlated negatively with the preoperative corneal astigmatism (r=-0. 69, P<0. 01). The corneal cylinder changed significantly in each grade after the surgery (P< 0. 05). When the preoperative corneal cylinder was between 0. 12D and 0. 25D, the postoperative corneal cylinder was higher than before. Whereas, the postoperative corneal cylinder became lower than before when the preoperative cylinder ranged from 0.37D to 1.0D.CONCLUSION: The incision located at the steepest corneal meridian under the guidance of corneal topography changes the preoperative astigmatism. For astigmatic correction, 3.0mm on - axis clear corneal incision phacoemusification is recommended with preoperative corneal astigmatism between 0.37 and 1.0D.%目的:观察角膜地形图引导下3.0mm透明角膜切口白内障超声乳化手术前后患者角膜散光的变化.方法:在角膜最大曲率子午线上做3.0mm切口行白内障超声乳化手术,对术前散光度数≤1.0D的144例156眼术前、术后3mo的资料进行回顾性分析,统计手术前后角膜地形图散光的变化.采用t检验、单因素方差分析、Pearson相关分析对数据进行统计学处理.结果:3.0mm角膜透明手术切口的术源性散光为0.77±0.53D.患者手术前后的散光对比有统计学意义(P<0.05),散光变化具有相关性(r=-0.69,P<0.01).术前角膜散光≤0.25D者术后散光增大,其

  14. 角膜伤口缝合术后迟发性角膜溃疡的临床分析%Clinical analysis of delayed corneal ulcer after corneal wound suture surgery

    Institute of Scientific and Technical Information of China (English)

    胡艳滨; 马林

    2016-01-01

    目的:分析角膜伤口缝合术后患者迟发性角膜溃疡的临床特征及发病原因。方法回顾性分析6例(6眼)角膜伤口缝合术后迟发的角膜溃疡的临床资料,分析患者角膜溃疡的发病特点和临床特征,均行角膜共聚焦显微镜检查、角膜刮片镜检及病原菌培养,并回顾分析既往外伤史、手术史、用药史及细菌真菌培养结果,探讨其迟发角膜溃疡与外伤及手术的相关性,分析角膜溃疡培养病原菌与外伤时培养病原菌是否一致。结果6例中男4例(4眼),女2例(2眼),年龄3~60岁。4例角膜溃疡围绕松动的角膜缝线,3例经历2~3次眼部手术,1例合并睑缘炎,2例曾长期反复应用糖皮质激素滴眼液;6例角膜溃疡细菌培养阳性3例、阴性3例;真菌培养阳性1例、阴性5例。外伤初诊时细菌培养阳性1例、阴性2例、病原菌情况不详3例;对比培养结果显示,除3例因外伤时病原菌不详无法比较外,其余3例感染角膜溃疡的病原菌与外伤时病原菌均不一致。结论对角膜伤口缝合术后患者,应严密随访,及时发现并处理睑缘炎症、角膜缝线松动等并发症;合理眼部用药,控制多次手术节奏,避免由于眼表微环境恶化诱发角膜感染,影响视功能。%Objective To analyse the clinical features and etiopathogenesis of delayed corneal ulcer after corneal wound suture surgery .Methods A retrospective case study .Six eyes of six patients with delayed corneal ulcer after receiving corneal wound suture surgery were recruited .The clinical features of corneal ulcer were analysed .Outcomes of corneal confocal microscopy , corneal smear microscopy as while as bacteria and fungus culture were analyzed .Past histories of trauma, surgery and medication were also evaluated .Results Four patients were male and 2 patients were female .The age ranged from 3 to 60 years old.In four patients corneal

  15. The change of corneal astigmatism after cataract surgery with different locations of clear corneal incision%非球面和球面人工晶状体植入术后视功能观察

    Institute of Scientific and Technical Information of China (English)

    吴智敏; 徐国旭

    2011-01-01

    Objective To analyze the corneal astigmatism before cataract surgery and evaluate the astigmatism changes after cataract surgery performed using clear corneal incisions with different locations. Methods This randomized prospective clinical study comprised 295 eyes of 218 patients underwent phacoemulsification and implantation of foldable intraocular lens through a corneal tunnel incision. Patients were randomly divided into three groups depending on the different locations of the incision: temporal, superotemporal and superior. Corneal topography was performed preoperatively and 1week, 1 month, and 3 months postoperatively. Surgically induced changes were calculated by vector analyses using the Holladay-Cravy-Koch method. Results Preoperatively, in 60.68% of eyes, corneal astigmatism was between 0.5 and 1.5 diopters (D) and in 11.86%, it was 1.5 D or higher. Meanwhile,about 29.49 percent of eyes had with-the-rule (WTR) astigmatism, while 51.19% had against-the-rule (ATR) astigmatism, and the others had oblique astigmatism. At three follow-up visits postoperatively,the mean magnitude of surgically-induced astigmatism (SIA) was lowest in the temporal incision group and highest- in the superior incision group. In addition, an ATR shift was found in the superior incision group. Conclusions Corneal astigmatism less than 1.5 D is present in most cataract surgery candidates. Cataract surgery using temporal clear corneal incision induces significantly less SIA in the early postoperative period. Superior incision may lead to an ATR astigmatism shift.%目的 观察非球面人工晶状体和球面人工晶状体植入术后视功能的变化.方法 收集行超声乳化联合IOL植入术的年龄相关性白内障患者85例96只眼,其中植入非球面(Alcon SN60WF)IOL48只眼,植入球面(Alcon SN60AT)IOL48只眼,所有病例术后裸眼视力均>0.1,术后6个月对色觉、对比敏感度、表观调节力等视功能检查.结果 术后6个月Alcon SN60WF和SN60AT

  16. Tendency of excimer laser corneal refractive surgeries%准分子激光角膜屈光手术的发展趋势

    Institute of Scientific and Technical Information of China (English)

    陈跃国

    2011-01-01

    In next decade, the excimer laser corneal refractive surgeries will keep the role of main stream with the continuing development and employment of femto-second laser thin flap,advanced surface ablation, wavefront and topography guided ablation, eyeball online tracking,modified monovision for compensating presbyopia. Pre-operational screening and ruling out sub-clinical keratoconus is crucial for preventing corneal ectasia and secondary keratocouns after corneal ablations.In the correction of extreme high myopia, phakic IOL implantation seems to be superior in visual quality to excimer laser corneal refractive surgeries and can keep the intact corneal biomechanical structure, suggesting that it may be a better surgical option for the treatnent of such eyes.%随着飞秒激光定制薄角膜瓣技术、改良表层切削技术、波阵面像差与角膜地形图引导技术、眼球定位及联机跟踪技术,以及老视补偿技术的不断改进和广泛应用,未来5~10年,准分子激光角膜屈光手术仍将是屈光手术的主流.术前筛选出亚临床圆锥角膜,是预防屈光手术后角膜扩张及继发性圆锥角膜的关键.为保持角膜生物力学的完整性和更好的视觉质量,可选择有晶状体眼人工晶状体植入术矫治超高度近视.

  17. Corneal Laceration

    Medline Plus

    Full Text Available ... Laceration? Corneal Laceration Diagnosis Corneal Laceration Treatment What Is Corneal Laceration? Written By: Daniel Porter Reviewed By: ... A Harrison MD Sep. 01, 2016 The cornea is the clear front window of the eye . A ...

  18. Expectativas en la cirugía de triple procedimiento versus doble procedimiento quirúrgico en afecciones corneales Expectations of triple procedure versus double procedure surgery in corneal diseases

    Directory of Open Access Journals (Sweden)

    Emilio Kuri Cienfuegos

    2007-12-01

    conducted from July 2003 to December 2005 to evaluate the results of double procedure and triple procedure surgeries in patients operated on from corneal diseases at the Ophthalmologic Service Department of “Hermanos Ameijeiras” Clinical and Surgical Hospital located in the City of Havana. The sample was made up of 45 eyes that had undergone corneal transplantation from January 1988 to June 2003 at the same hospital. The considered variables were age, sex, personal ocular antecedents, previous corneal disease, retransplantion, corneal graft viability, surgery complication during and after surgery, pre-surgical and post-surgical visual acuity, IOL estimation error and refractive error. The results were the following> prevalence of males (51 %, average age of 60,27 years, most frequent associated disease in double and triple procedure surgeries was glaucoma in 22,7 % and 26,1 % of cases respectively, the most common corneal problem was Fuchs´ epithelial-endothelial dystrophy in both procedures (72.7 % and 52.2 % respectively No transurgical complications were found in 90,9 % of double procedure-operated cases and 95,5 % of triple procedure-operated cases. Postsurgical complications were 9.1% in double procedure and 26.1 % in the triple procedure. Postoperative corneal opacity was observed in 9.1 % of cases treated with the double procedure surgery and 17.4 % with triple procedure surgery. There were more retransplanted patients in the triple procedure (17,4 %. Final refractive error had a higher number of emmetropes and lower number of hypermetropes than the triple procedure whereas in myopic patients, better visual acuity was found in the double procedure. Intraocular lens estimation error was bigger in the triple procedure.

  19. Corneal topographic analysis of small incision in cataract surgery%小切口白内障术后的早期角膜地形图分析

    Institute of Scientific and Technical Information of China (English)

    郑海华; 陈峰; 韩真真

    2001-01-01

    目的:研究白内障小切口术后角膜形态变化特点。 方法:用角膜地形图对27例(34眼)白内障小切口手术患者进行检查,分析其术前,术后1周、1月、3月的角膜地形图变化。 结果:术后1周仅产生手术源性散光0.52D,术后1月角膜散光及CIM值(角膜不规则系数)趋向稳定,裸眼视力≥0.5占26眼(76.42%),SF值(角膜形状系数)术前术后无明显变化。结论:小切口具有早期角膜形态变化小、散光稳定、视力恢复快等优点,角膜地形图可准确全面反映白内障术后角膜形态变化。%Objective:To study corneal topographic changes after cataract surgery through small incision.Methods:Corneal topography of 34 eyes in 27 patients who had undergone small incision cataract surgery was analyzed preoperatively and at 1 week, 1 month, 3 months postoperatively. Results:Surgically induced astigmatic change of 0.52D was observed at 1 week postoperatively. Corneal astigmatism and CIM remained quite stable 1 month after surgery. 26 eyes(76.42%) obtained uncorrected visual acuity to 0.5 or better. Compared with preoperative statistics, no significant change of SF was found postoperatively.Conclusion:The results suggested that the small incision produces less astigmatism postoperatively, faster postoperative recovery, less corneal topographic change early after surgery. Computerized videokeratography system is an effective way to measure precisely the change of corneal topography after cataract surgery.

  20. Evaluation of a 345 nm Femtosecond Laser for Corneal Surgery with Respect to Intraocular Radiation Hazard.

    Directory of Open Access Journals (Sweden)

    Johannes Menzel-Severing

    Full Text Available We report our findings from a preclinical safety study designed to assess potential side effects of corneal ultraviolet femtosecond laser treatment on lens and retina.Refractive lenticules (-5 dpt with a diameter of 6 mm were created in the right cornea of eight Dutch Belted rabbits. Radiant exposure was 0.5 J/cm² in two animals and 18 J/cm² in six animals. The presence of lens opacities was assessed prior to and up to six months following laser application using Scheimpflug images (Pentacam, Oculus and backscatter analysis (Opacity Lensmeter 702, Interzeag. Ganzfeld flash and flicker electroretinogram (ERG recordings were obtained from both eyes prior to and up to six weeks following laser application. At the study endpoint, retinas were examined by light microscopy.Independent of energy dose applied, no cataract formation could be observed clinically or with either of the two objective methods used. No changes in ERG recordings over time and no difference between treated and untreated eye were detected. Histologically, retinal morphology was preserved and retinal pigment epithelium as well as photoreceptor inner and outer segments appeared undamaged. Quantitative digital image analysis did not reveal cell loss in inner or outer nuclear layers.Our analysis confirms theoretical considerations suggesting that ultraviolet femtosecond laser treatment of the cornea is safe for intraocular tissues. Transmitted light including stray light induces no photochemical effects in lens or retina at energy levels much higher than required for the clinical purpose. These conclusions cannot be applied to eyes with pre-existing retinal damage, as these may be more vulnerable to light.

  1. Examination and management of corneal topography before laser in situ keratomileusis surgery%LASIK术前角膜地形图检查及处理

    Institute of Scientific and Technical Information of China (English)

    汤明霞

    2012-01-01

    Objective To explore the significance of corneal topography before laser in situ keratomileusis (LAS1K) surgery. Methods The comeal topography examination was performed to 500 patients (920 eyes) with myopia or with astigmatism. Before surgery the patients were grouped and handled according to Rabirtowitz standard. The intraoperative conditions, the number of kerato-conus, refractive regression cases and time were observed. Results Intraoperative corneal flap making accidents were not seen, keratoconus was not founded after surgery, and most refrative regressions occurred in 1 year after operation. In patients with higher K value, higher myopia and older age, refrative regression occurred easily after surgery. Conclusion Preoperative corneal topography examination before LASIK surgery is of clinical importance.%目的 探讨角膜地形图检查在准分子激光原位磨镶术(LASIK)术前的重要意义.方法 对欲行LASIK治疗的近视或伴散光的500例(920只眼)进行术前角膜地形图检查,术前根据Rabinowitz标准将患者进行分组并处理,观察各组手术病例术中情况,术后1年内发生圆锥角膜和屈光回退的例数、时间.结果 术中未出现制作角膜瓣意外,术后未发现圆锥角膜,术后回退时间多发生在1年后,K值较高、高度近视、年龄偏大的患者较易发生回退.结论 术前角膜地形图检查对LASIK 术有重要的检查意义.

  2. Small-aperture corneal inlay in patients with prior radial keratotomy surgeries

    Directory of Open Access Journals (Sweden)

    Huseynova T

    2013-09-01

    Full Text Available Tukezban Huseynova,1,* Tomomi Kanamori,1 George O Waring IV,2 Minoru Tomita1,3,* 1Shinagawa LASIK Center, Chiyoda-ku, Tokyo, Japan; 2Medical University of South Carolina, Storm Eye Institute, Charleston, SC, USA; 3Department of Ophthalmology, Wenzhou Medical College, Wenzhou, People's Republic of China *These authors contributed equally to this study Abstract: This paper describes the 3-month results of two patients who underwent KAMRA™ (AcuFocus, Inc, Irvine, CA, USA inlay implantation surgery with a history of prior radial keratotomy. The refractive error just before KAMRA inlay implantation was corrected in one patient with a laser-assisted in situ keratomileusis (LASIK procedure. The post-inlay implantation surgery results showed effective uncorrected near visual acuity outcomes with no impact on uncorrected distance visual acuity in both patients. Keywords: KAMRA™, RK, LASIK, uncorrected distance visual acuity, refractive error, uncorrected near visual acuity

  3. Professor Peter Choyce: an early pioneer of intraocular lenses and corneal/refractive surgery.

    Science.gov (United States)

    Pandey, Suresh K; Apple, David J

    2005-06-01

    Professor Peter Choyce, FRCS, DOMS, MS, was one of the pioneers of intraocular lens implant surgery. He developed an interest in artificial lens implantation following cataract surgery, a procedure that was widely criticized by the ophthalmic establishment in the UK, Europe, North America and other countries. Owing to the opposition to the intraocular lenses, Peter Choyce together with Sir Harold Ridley co-founded the International Intraocular Implant Club in 1966, which was responsible for the gradual acceptance of artificial lens implantation. Peter Choyce developed several models of intraocular lens, but did not patent the majority of them. The Choyce Mark IX, manufactured by Rayner Intraocular Lenses, became the first US Food and Drug Administration-approved intraocular lens in 1981. A review of Peter Choyce's record confirms a significant number of original innovations in the field of anterior segment surgery, including many procedures taken for granted today, but not associated with his name. These include early work on both kerato- and intraocular lens-refractive procedures, keratoprosthesis, pioneering paediatric implant procedures and others. Unfortunately his tenacious adherence to anterior chamber lens technology, while in general clinically sound, caused many to question his influence and hence he remained poorly understood even until after his death. He passed away on 8 August 2001 after a long fight with colon cancer. In this article, we provide evidence and elaborate Peter Choyce's accomplishments, which places him as one of the most innovative ophthalmologist in his surgical field in the twentieth century.

  4. Effects of Cataract Surgery on Endothelium in Transplanted Corneal Grafts: Comparison of Extracapsular Cataract Extraction and Phacoemulsification for Complicated Cataract after Penetrating Keratoplasty.

    Science.gov (United States)

    Zhou, Hong-Wei; Xie, Li-Xin

    2016-09-05

    The endothelium should be carefully evaluated when choosing a surgical technique for cataract removal. Therefore, we aimed to study the effects of different cataract surgery techniques on endothelial cell loss in transplanted corneal grafts. A total of 54 patients who received complicated cataract surgery in post-penetrating keratoplasty (PKP) eyes at the Shandong Eye Institute between February 2001 and June 2014 were included, and clinical records were reviewed. Baseline demographic details, clinical characteristics, endothelial cell density (ECD), and best-corrected visual acuity (BCVA) were recorded. Wilcoxon rank-sum test and Wilcoxon signed-rank test were used to test the equality of medians. A regression model was constructed to compare the reduced rate of ECD. Of the 54 eyes included in this study, extracapsular cataract extraction (ECCE) was performed in 34 eyes of 33 patients (ECCE group) whereas phacoemulsification was performed in 20 eyes of 20 patients (phacoemulsification group). There was no significant difference in the median age (P = 0.081) or preoperative ECD (P = 0.585) between the two groups. At 6 months after cataract surgery, ECD in ECCE group was significantly higher than that in phacoemulsification group (P = 0.043). In addition, the endothelial cell loss rate in ECCE group was significantly lower than that in phacoemulsification group at 2 months (P = 0.018), 4 months (P ECCE group (P ECCE in transplanted corneal grafts (P ECCE is more suitable than phacoemulsification in cataract surgery in complicated cataract after PKP.

  5. The effect of humidity and temperature on visual outcomes after myopic corneal laser refractive surgery

    Directory of Open Access Journals (Sweden)

    Hood CT

    2016-11-01

    Full Text Available Christopher T Hood,1 Roni M Shtein,1 Daniel Veldheer,1,2 Munira Hussain,1 Leslie M Niziol,1 David C Musch,1,3 Shahzad I Mian1 1Department of Ophthalmology and Visual Sciences, University of Michigan W.K. Kellogg Eye Center, Ann Arbor, MI, 2Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, 3Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA Objective: To determine whether procedure room environmental conditions are associated with outcomes after myopic laser in situ keratomileusis (LASIK or laser-assisted keratomileusis (LASEK. Design: Retrospective chart review. Participants: Eight hundred sixty-three eyes of 458 consecutive patients at a university-based academic practice. Methods: We reviewed the medical records of consecutive patients who underwent LASIK or LASEK over a 3-year period. Linear mixed regression models were used to investigate the association of laser room temperature and humidity with the outcomes of visual acuity and postoperative manifest spherical equivalent refraction. Repeated measures logistic regression models were used for the outcomes of diffuse lamellar keratitis (DLK and need for enhancement surgery. Results: Subjects were on an average 38.6 years old at the time of surgery (standard deviation [SD] =10.3 and the average spherical equivalent refraction of eyes was 3.8 diopters (SD =2.03. Regression models did not reveal a significant association between temperature and uncorrected distance visual acuity (UDVA or corrected distance visual acuity (CDVA, or between humidity and UDVA (P>0.05 for all. However, increased humidity was associated with a small but statistically significant improvement in CDVA after LASIK at 1 day, 1 month, 3 months, and 1 year postoperatively (P<0.05 for all. There was no significant association between temperature and humidity and the need for enhancement, the incidence of DLK, or postoperative manifest refraction. Conclusion: While increased laser

  6. Central corneal thickness changes in bevel-up versus bevel-down phacoemulsification cataract surgery: study protocol for a randomised, triple-blind, parallel group trial.

    Science.gov (United States)

    Kaup, Soujanya; Shivalli, Siddharudha; Ks, Divyalakshmi; Arunachalam, Cynthia; Varghese, Rejitha Chinnu

    2016-09-29

    Corneal endothelial damage following phacoemulsification is still one of the major concerns of modern day cataract surgery. Although many techniques have been proposed, the risks of posterior capsular rupture and corneal endothelium damage persist. In theory, damage to the corneal endothelium is minimised by delivering the lowest phaco energy only in the direction necessary to emulsify the lens nucleus. Hence, it is believed that the bevel of the needle should be turned towards the nucleus or the nuclear fragment (ie, bevel-down. However, there is a difference of opinion among ophthalmologists with reference to the phaco tip's position (bevel-up vs bevel-down) during phacoemulsification. This subject has not been extensively studied earlier. This is a prospective, triple-blinded (trial participant, outcome assessor and the data analyst), randomised controlled trial with 2 parallel groups and with an allocation ratio of 1:1. It will be conducted in a tertiary care hospital, Mangaluru, India. The objective is to compare the postoperative central corneal thickness changes between the bevel-up and bevel-down techniques of phacoemulsification. Patients aged >18 years with immature cataract undergoing phacoemulsification will be selected for the study. The important exclusion criteria are the history of previous significant ocular trauma or intraocular surgery, corneal pathology, pseudoexfoliation syndrome, intraocular inflammation, a preoperative fully dilated pupil 4. After randomisation, patients will undergo phacoemulsification surgery either by a bevel-up or bevel-down procedure. With an estimated power of 80%, the calculated sample size is 55 patients in each group. The recruitment will start from April 2016. Yenepoya University Ethics Committee, India has approved the study protocol (YUEC/148/2016 on 18 February 2016). It complies with the Declaration of Helsinki, local laws and the International Council for Harmonization-good clinical practices. CTRI/2016

  7. Preliminary results after single-port laparoscopic colonic surgery

    DEFF Research Database (Denmark)

    Mynster, Tommie; Hammer, Janne; Wille-Jørgensen, Peer

    2012-01-01

    Single incision laparoscopic surgery (SILS) may be even less invasive to patients than conventional laparoscopic surgery (CLS). The present study investigates the applicability of the procedure and we report the first year of experiences and operative quality.......Single incision laparoscopic surgery (SILS) may be even less invasive to patients than conventional laparoscopic surgery (CLS). The present study investigates the applicability of the procedure and we report the first year of experiences and operative quality....

  8. Preliminary results after single-port laparoscopic colonic surgery

    DEFF Research Database (Denmark)

    Mynster, Tommie; Hammer, Janne; Wille-Jørgensen, Peer

    2012-01-01

    Single incision laparoscopic surgery (SILS) may be even less invasive to patients than conventional laparoscopic surgery (CLS). The present study investigates the applicability of the procedure and we report the first year of experiences and operative quality.......Single incision laparoscopic surgery (SILS) may be even less invasive to patients than conventional laparoscopic surgery (CLS). The present study investigates the applicability of the procedure and we report the first year of experiences and operative quality....

  9. Modification of the Miyake-Apple technique for simultaneous anterior and posterior video imaging of wet laboratory-based corneal surgery.

    Science.gov (United States)

    Tan, Johnson C H; Meadows, Howard; Gupta, Aanchal; Yeung, Sonia N; Moloney, Gregory

    2014-03-01

    The aim of this study was to describe a modification of the Miyake-Apple posterior video analysis for the simultaneous visualization of the anterior and posterior corneal surfaces during wet laboratory-based deep anterior lamellar keratoplasty (DALK). A human donor corneoscleral button was affixed to a microscope slide and placed onto a custom-made mounting box. A big bubble DALK was performed on the cornea in the wet laboratory. An 11-diopter intraocular lens was positioned over the aperture of the back camera of an iPhone. This served to video record the posterior view of the corneoscleral button during the big bubble formation. An overhead operating microscope with an attached video camcorder recorded the anterior view during the surgery. The anterior and posterior views of the wet laboratory-based DALK surgery were simultaneously captured and edited using video editing software. The formation of the big bubble can be studied. This video recording camera system has the potential to act as a valuable research and teaching tool in corneal lamellar surgery, especially in the behavior of the big bubble formation in DALK.

  10. 激光表层角膜屈光手术的回归%The rise and return of the laser corneal surface refractive surgery

    Institute of Scientific and Technical Information of China (English)

    王勤美; 许琛琛

    2015-01-01

    激光表层角膜屈光手术因其安全性高而受到人们的青睐,由于技术的限制,曾一度陷入低谷.随着现代激光设备的改进和技术的发展,该手术逐渐成熟,重新回归临床的视线,已成为越来越多的屈光不正或伴不规则角膜眼的首选.现就激光表层角膜屈光手术术式的演变、并发症控制等方面进行简要的评述.%The laser corneal surface refractive surgery is favored by people for its higher security, but once fell into a slump because of the technical limitations.Currently, the surgery is gradually mature with the development of modern laser equipment and technology, and it has become the first choice of the correction of refractive errors without or with irregular cornea by more and more ophthalmologists.This anticle reviews the evolution and complication control of the laser corneal surface refractive surgery.

  11. To achieve better visual quality in corneal refractive surgery%追求角膜屈光手术后更完美的视觉质量

    Institute of Scientific and Technical Information of China (English)

    张丰菊

    2012-01-01

    Excimer laser cornea) refractive surgery has become the common procedure to correct refractive error. Although the modem corneal refractive surgery has achieved better unaided vision and good effect, but it is still needed to be improved and modified further. In this article, the unsatisfactory factors and resolve proposal are stated here in order to search for the best way for the perfect visual quality after corneal refractive surgery.%准分子激光角膜屈光手术已成为目前矫正屈光不正最常用的治疗方法.现代角膜屈光手术虽然已经取得了较满意的术后效果,但仍需进一步改进和发展.本文就目前存在的问题阐述原因及对策,旨在通过不断探索、提高,为患者提供更加完美的视觉质量.

  12. Estesiometria corneana pós cirurgia fotorrefrativa Esthesiometry corneal after surgery photorefractive

    Directory of Open Access Journals (Sweden)

    Alessandro Perussi Garcia

    2009-10-01

    Full Text Available OBJETIVO: Avaliar as alterações que ocorrem na sensibilidade corneanas após as cirurgias de LASIK e PRK MÉTODOS: Estudo prospectivo onde foram avaliados 60 olhos de 30 pacientes submetidos a LASIK bilateral simultaneamente e mais 30 olhos de 15 pacientes submetidos a PRK bilateral simultaneamente. De acordo com a quantidade de ablação intra-operatórias, os olhos foram divididos em dois grupos: Grupo 1 (menor que 40 µm e Grupo 2 (Maior que 40 µm. A sensibilidade corneana foi medida na região central da córnea pelo estesiometro Cochet Bonnet® no pré operatório e após 30, 90 e 180 dias da cirurgias. RESULTADOS: A sensibilidade corneana na LASIK apresentou-se diminuída durante os três primeiros meses retornando as valores pré operatórios aos 6 meses; E de acordo com a quantidade de ablação o Grupo 1 apresentou diferença estatisticamente significante em relação ao Grupo 2 durante os três primeiros meses; No entanto a PRK recuperou seus valores pré operatório aos três meses e de acordo com a quantidade de ablação o Grupo 1 apresentou diferença estatisticamente significante somente no primeiro mês de pós operatório. CONCLUSÃO: A LASIK apresentou sensibilidade menor em relação ao PRK durante os 3 primeiros meses e somente aos 6 meses os valores da sensibilidade corneana foram similares; Os resultados também sugerem que a quantidade de ablação está relacionada com a diminuição da sensibilidade corneana durante os primeiros meses em ambas as técnicas cirúrgicas, principalmente na LASIK.PURPOSE: To evaluate the alterations that occur on the cornea sensitivity after Lasik and PRK surgery. METHODS: Prospective studies have evaluated60 eyes from 30 patients subjected simultaneously to bilateral Lasik and 30 eyes from 15 patients subjected simultaneously to bilateral PRK. According to the amount of inner operatory ablation the eyes were divided into two groups: Group I ( 40µm. The cornea sensitivity was measured in

  13. Corneal Laceration

    Medline Plus

    Full Text Available ... your vision. Privacy Policy Related People with Advanced Keratoconus May Have A Future Alternative to Full Corneal ... 2016 Corneal Collagen Cross-linking Approved to Treat Keratoconus in U.S. Aug 01, 2016 Firework Blinds Teenager, ...

  14. Corneal Laceration

    Medline Plus

    Full Text Available ... lost sight from a corneal scar as a child. Now that I’m older, will a corneal transplant help me? May 15, 2015 Why Do My Eyes Burn After Inserting My Contacts? Feb 27, 2015 Dark ...

  15. Corneal refractive surgery and phakic intraocular lens for treatment of amblyopia caused by high myopia or anisometropia in children

    Institute of Scientific and Technical Information of China (English)

    Tian Chunyu; Peng Xiujun; Fan Zhengjun; Yin Zhengqin

    2014-01-01

    Objective A systematic review of literature was performed to compare various visual function parameters including the final visual acuity outcome and/or adverse events between corneal refractive surgery (CLRS) and phakic intraocular lens implantation (p-IOLi) in the treatment of refractive amblyopic children.Data sources Two reviewers independently searched the PubMed,EMBASE,and Controlled Trials Register databases for publications from 1991 to 2013.Study selection There were 25 articles,including 597 patients and 682 eyes,was included in CLRS group.Among them,21 articles reported the use of CLRS in the treatment of myopic anisometropia for 318 patients (13 photorefractive keratectomy or laser epithelial keratomileusis and eight laser in situ keratomileusis).And 11 articles had the results of CLRS in treating hyperopic anisometropic amblyopia children.Eleven articles reported the effect of p-IOLi for treating high myopia or anisometropic amblyopia,including 61 patients (75 eyes).Age,pre-and postoperation best-corrected vision acuity (BCVA),and spherical equivalent (SE) were compared in CLRS and p-IOLi groups.Results The average age of CLRS group and p-IOLi group has no statistically significant difference.The SE in CLRS group for myopic anisometropia amblyopia patients was (-10.13±2.73) diopters (D) and for hyperopic anisometropia amblyopia patients was (5.58±1.28) D.In p-IOLi group the SE was (-14.01±1.93) D.BCVA was improved significantly in both groups,and even better in p-IOLi group.Refractive errors were corrected in both groups,but there was no clinically significant difference in final SE between each group.More than one-half of the children had improved binocular fusion and stereopsis function in both groups.Conclusions Both CLRS group and p-IOLi group showed their advantage in treating refractive amblyopia in children.In comparing p-IOLi with CLRS for treatment of refractive amblyopia,no statistically significant difference in final BCVA was observed.

  16. Corneal Abrasions

    Science.gov (United States)

    ... and lead to a serious condition called a corneal ulcer . That's why it's important to see a doctor to get a corneal abrasion checked out. What Causes a Corneal ... and land on your cornea, tears help to wash the particles away. Sometimes, ...

  17. The effect of surgery on inert corneal ulcer%角膜冷溃疡手术治疗的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    赵海峰; 史伟云; 李素霞; 刘军彩

    2009-01-01

    目的 观察不同手术方法 治疗角膜冷溃疡的临床疗效.方法 回顾性分析2006年6月至2008年6月确诊为"角膜冷溃疡"的患者8例8只眼,其中4例选择结膜瓣遮盖术,4例行部分板层角膜移植术( lamellar keratoplasty,LKP),其中1例因植床穿孔改行穿透性角膜移植术( penetrating keratoplasty,PKP).术后随访4~10个月,平均6个月,观察视力、溃疡愈合及复发情况、角膜植片和植床透明度.结果行结膜瓣遮盖术者溃疡均治愈;行部分LKP术者植片透明,植床仅残留薄层瘢痕,行PKP术者植片透明,两者视力均有所提高.所有病例溃疡未见复发.结论 对于角膜冷溃疡,可根据不同病例的特点采取个体化的手术方式治疗,能获得比较满意的临床疗效.%Objective To observe the effect of various surgery on inert corneal ulcer.Methods Eight patients(8 eyes)diagnosed "inert corneal ulcer" from June 2006 to June 2008 were retrospectively analyzed,4 patients underwent conjunctival flaps,the others underwent partial lameller keratoplasty(LKP),one of which was changed for penetrating keratoplasty(PKP)because of perforation in recipient cornea during the surgery.All patients were followed up for 4 to 10 months(6 months on average)after surgery.Visual acuity,conjunctival flaps,ulcer,clearance of allografts and recipient corneas were recorded.Results The ulcers were cured by conjunctival flap;both LKP and PKP allografts were transparent and visual acuity increased,except for a thin layer of scar on every recipient cornea in LKP.Conclusions For inert corneal ulcer,we can use individual surgery according to the feature of every patient and obtain satisfactory effect.

  18. Robotic consolle for ocular surgery: a preliminary study

    Science.gov (United States)

    Rossi, Francesca; Pini, Roberto; Menabuoni, Luca; Lenzetti, Ivo; Russo, Sheila; Menciassi, Arianna; Fortuna, Damiano

    2014-02-01

    Minimally invasive surgery has recently been improved by the use of robot-assisted procedures in several medical fields. Among the ocular surgeries there are a few examples of sophisticated vitreoretinal procedures, while robotic-assisted surgery of the anterior eye segment is still under study. In this paper we propose a new approach to the robotic assisted ocular surgery: a CO2 laser system is equipped with a micromanipulator and scanner, and it is proposed to induce photothermal effects for the removal of neoformations. A sensorized tool is connected to the patient eye and to the robotic arm. This tool is equipped with force and position sensors: by the use of the spatial information from the robotic console and from the patient it is possible to control the position of the target itself and to block it in the correct position for performing surgery. The system is provided by a feedback alarm that remove the block of the patient head in any moment. The optimized robotic consolle can be used in performing scleral cuts and in the treatment of pterigium or neoformations.

  19. First steps of laparoscopic surgery in Lubumbashi: problems encountered and preliminary results.

    OpenAIRE

    Arung, Willy; Dinganga, Nathalie; Ngoie, Emmanuel; Odimba, Etienne; Detry, Olivier

    2015-01-01

    For many reasons, laparoscopic surgery has been performed worldwide. Due to logistical constraints its first steps occurred in Lubumbashi only in 2008. The aim of this presentation was to report authors' ten-month experience of laparoscopic surgery at Lubumbashi Don Bosco Missionary Hospital (LDBMH): problems encountered and preliminary results. The study was a transsectional descriptive work with a convenient sampling. It only took in account patients with abdominal surgical condition who co...

  20. First steps of laparoscopic surgery in Lubumbashi: problems encountered and preliminary results

    OpenAIRE

    Arung, Willy; Dinganga, Nathalie; Ngoie, Emmanuel; Odimba, Etienne; Detry, Olivier

    2015-01-01

    For many reasons, laparoscopic surgery has been performed worldwide. Due to logistical constraints its first steps occurred in Lubumbashi only in 2008. The aim of this presentation was to report authors’ ten-month experience of laparoscopic surgery at Lubumbashi Don Bosco Missionary Hospital (LDBMH): problems encountered and preliminary results. The study was a transsectional descriptive work with a convenient sampling. It only took in account patients with abdominal surgical condition who co...

  1. Correlations between corneal and total wavefront aberrations

    Science.gov (United States)

    Mrochen, Michael; Jankov, Mirko; Bueeler, Michael; Seiler, Theo

    2002-06-01

    Purpose: Corneal topography data expressed as corneal aberrations are frequently used to report corneal laser surgery results. However, the optical image quality at the retina depends on all optical elements of the eye such as the human lens. Thus, the aim of this study was to investigate the correlations between the corneal and total wavefront aberrations and to discuss the importance of corneal aberrations for representing corneal laser surgery results. Methods: Thirty three eyes of 22 myopic subjects were measured with a corneal topography system and a Tschernig-type wavefront analyzer after the pupils were dilated to at least 6 mm in diameter. All measurements were centered with respect to the line of sight. Corneal and total wavefront aberrations were calculated up to the 6th Zernike order in the same reference plane. Results: Statistically significant correlations (p corneal and total wavefront aberrations were found for the astigmatism (C3,C5) and all 3rd Zernike order coefficients such as coma (C7,C8). No statistically significant correlations were found for all 4th to 6th order Zernike coefficients except for the 5th order horizontal coma C18 (p equals 0.003). On average, all Zernike coefficients for the corneal aberrations were found to be larger compared to Zernike coefficients for the total wavefront aberrations. Conclusions: Corneal aberrations are only of limited use for representing the optical quality of the human eye after corneal laser surgery. This is due to the lack of correlation between corneal and total wavefront aberrations in most of the higher order aberrations. Besides this, the data present in this study yield towards an aberration balancing between corneal aberrations and the optical elements within the eye that reduces the aberration from the cornea by a certain degree. Consequently, ideal customized ablations have to take both, corneal and total wavefront aberrations, into consideration.

  2. 角膜近视屈光手术的安全性与信任度%Safety and credibility of myopic corneal refractive surgery

    Institute of Scientific and Technical Information of China (English)

    李莹

    2012-01-01

    Two decades of clinical retrospective studies have proven that myopic corneal refractive surgery is safe,effective and predictable.Ninety-eight percent of patients could obtain good refractive correction after the surgery with a long-term complication rate lower than 2%.And 96% of patients undergoing the surgery were content with postoperative outcomes,which were closely related to painlessness during the surgery,quick recovery and good uncorrected visual acuity after the surgery,advanced technology,various kinds of equipment,and an individualized operation plan.However,no more than 50% of the people were confident about the long-term safety of the surgery.Postoperative complications,refractive changes in high myopic patients,refractive regression,residual corneal turbidity and poor postoperative care should all account for this situation.Crucial factors that could enhance patient satisfaction and improve the degree of trust in myopic surgery include improvement of surgical safety,protection of the high quality of surgery,paying close attention to long-term changes in corneal and ocular status,and enhancement of the quality of care.Today in China,we should focus our problem-solving efforts on strict training of the surgical staff on standard operations,timely updates of surgical instruments and equipment,special care for the ocular changes in patients whose myopia is extremely high,and establishment of a policy to report serious surgical complications.%二十年临床回顾性研究,证明了角膜近视屈光手术安全、有效和可预测性强.98%患者手术后可达到良好的屈光矫正,长期并发症发生率低于2%.96%手术者对术后效果满意,与术后裸眼视力好、恢复快、无痛苦、技术先进、设备种类多、个性化手术设计有关;但人群中对手术远期安全性抱信任态度的不足50%.这与术后并发症存在、高度近视眼变化、屈光回退、角膜残留混浊和服务质量差有关.提

  3. Preliminary results of robotic colorectal surgery at the National Cancer Institute, Cairo University

    Directory of Open Access Journals (Sweden)

    Ashraf Saad Zaghloul

    2016-09-01

    Conclusion: To the best of our knowledge, this is the first study reporting the outcomes of robotic colorectal cancer intervention in Egyptian patients. Our preliminary results suggest that robotic-assisted surgery for colorectal cancer can be carried out safely and according to oncological principles.

  4. Pharyngeal Airway Changes after Bimaxillary Orthognathic Surgery--Preliminary Results.

    Science.gov (United States)

    Stefanović, Neda Lj; Glišić, Branislav; Nikolić, Predrag V; Juloski, Jovana; Palomo, Juan Martin

    2015-01-01

    Dentofacial deformity, a deviation from normal facial proportions and dental relationships, is corrected by jaw repositioning in all three spatial planes, which changes the position and tension of the surrounding tissues, bones and muscles. These changes may also affect the dimensions of the pharyngeal airways (PA). The aim of this study was to evaluate and compare three-dimensional PA changes in patients treated by a combination mandibular set-back/maxillary advancement versus patients that had bimaxillary advancement with genioplasty. The sample consisted of 7 patients treated by combined mandibular set-back/maxillary advancement and 7 patients treated with bimaxillary advancement surgery. Nasopharyngeal (NP) volume, oropharyngeal (OP) volume and the area of maximum constriction (AMC) in the OP were measured on CBCT scans (2 mA/120 kV/12" FOV) taken before (T1) and 3 months after surgery (T2). Paired samples t-test was used for analyzing statistical significance of changes (p ≤ 0.05). OP volume and AMC increase after bimaxillary advancement was statistically significant, while for the mandibular set-back group the increase was non-significant. NP volume was not reduced in any of the two groups. No significant differences in PA dimensions were found between groups at neither T1 nor T2 time points. Results suggest that the combination of mandibular set-back/maxillary advancement did not reduce airway dimensions, while bimaxillary advancement surgery led to a statistically significant increase in the OP dimensions.

  5. Using corneal topography design personalized cataract surgery programs%应用角膜地形图设计个性化白内障手术方案

    Institute of Scientific and Technical Information of China (English)

    黄金鸥; 陈金邦; 陈炜江; 裘义松; 魏肖红

    2014-01-01

    AIM:To investigate how to design personalized cataract surgery programs to achieve surgical correction of preoperative corneal astigmatism with surgical astigmatism under the guidance of corneal topography, improve postoperative visual quality and reduce the cost of treatment. METHODS: Totally 202 cases ( 226 eyes ) cataract patients were divided into randomized treatment group and individualized treatment group. According to the method and location of the incision, randomized treatment group were divided into 8 groups. Surgical astigmatism after different incision were calculated with the use of preoperative and postoperative corneal astigmatism through vector analysis method. Individualized treatment groups were designed personably for surgical method with reference of every surgically induced astigmatism, the surgical method chooses the type of surgical incision based on close link between preoperative corneal astigmatism and surgically induced astigmatism, and the incision was located in the steep meridian. The postoperative corneal astigmatism of individualized treatment group was observed. RESULTS: Postoperative corneal astigmatism of individualized treatment group were lower than that of 3.0mm clear corneal tunnel incision in the randomized treatment group, there were statistically significance difference, while with 3. 0mm sclera tunnel incision group there were no statistically significance difference. After 55. 8% of patients with the use of individualized surgical plan could undergo the operation of extracapsular cataract extraction with relatively low cost and rigid intraocular lens implantation, the per capita cost of treatment could be reduced. CONCLUSION: Personalized cataract surgery programs are designed to achieve surgical correction of preoperative corneal astigmatism under the use of corneal topography, improve postoperative visual quality and reduce the cost of treatment.%目的:探讨如何在角膜地形图的指导下,设计个性化

  6. Pharyngeal airway changes after bimaxillary orthognathic surgery - preliminary results

    Directory of Open Access Journals (Sweden)

    Stefanović Neda Lj.

    2015-01-01

    Full Text Available Introduction. Dentofacial deformity, a deviation from normal facial proportions and dental relationships, is corrected by jaw repositioning in all three spatial planes, which changes the position and tension of the surrounding tissues, bones and muscles. These changes may also affect the dimensions of the pharyngeal airways (PA. Objective. The aim of this study was to evaluate and compare three-dimensional PA changes in patients treated by a combination mandibular set-back/maxillary advancement versus patients that had bimaxillary advancement with genioplasty. Methods. The sample consisted of 7 patients treated by combined mandibular set-back/maxillary advancement and 7 patients treated with bimaxillary advancement surgery. Nasopharyngeal (NP volume, oropharyngeal (OP volume and the area of maximum constriction (AMC in the OP were measured on CBCT scans (2 mA/120 kV/12’’ FOV taken before (T1 and 3 months after surgery (T2. Paired samples t-test was used for analyzing statistical significance of changes (p≤0.05. Results. OP volume and AMC increase after bimaxillary advancement was statistically significant, while for the mandibular set-back group the increase was non-significant. NP volume was not reduced in any of the two groups. No significant differences in PA dimensions were found between groups at neither T1 nor T2 time points. Conclusion. Results suggest that the combination of mandibular set-back/maxillary advancement did not reduce airway dimensions, while bimaxillary advancement surgery led to a statistically significant increase in the OP dimensions.

  7. [Corneal sensibility following epikeratophakia].

    Science.gov (United States)

    Biermann, H; Grabner, G; Baumgartner, I; Reim, M

    1992-07-01

    The postoperative rate of reinnervation following corneal surgery is widely considered to be a useful indicator of the healing process. This study reports the corneal sensitivity of 14 patients following epikeratophakia for different indications (myopia, aphakia and keratoconus) after time periods ranging from 7 to 104 weeks. All transplants were clear at the time of measurement. A newly developed aesthesiometer (using a low electric current for stimulation) was employed. Nine positions on the operated eye were chosen for the measurements, five locations of the non-operated fellow eye served as controls. On the operated eye the corneal sensitivity peripheral to the trephination were significantly reduced at the 9 and 12 o'clock positions as compared to the other eye. The 3 and 6 o'clock locations showed no significant difference. On the epikeratophakia lenticule the sensitivity was significantly reduced at all points, the center showing the largest difference (p less than 0.001). No correlation with age, sex or the indication for the procedure was observed. Although there was a trend of a positive correlation between the postoperative time period and the central corneal sensitivity, the follow-up was too short to reach significant levels. The nearly complete lack of corneal sensitivity, particularly in the center of the transplant is therefore well compatible with its long-time survival, even when the lenticule has been prepared with the cryolathe and lyophilized for transportation.

  8. Corneal Laceration

    Science.gov (United States)

    ... drugs. These drugs thin the blood and may increase bleeding. After you have finished protecting the eye, see a physician immediately. Next Corneal Laceration Symptoms Related Ask an Ophthalmologist Answers I lost sight from a corneal scar as a child. Now that I’m older, ...

  9. Corneal Laceration

    Medline Plus

    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration ... Laceration Treatment What Is Corneal Laceration? Leer en Español: ¿Qué Es una Laceración de la Córnea? Written ...

  10. Corneal Laceration

    Medline Plus

    Full Text Available ... Health Find an Ophthalmologist Academy Store Eye Health A-Z Symptoms Glasses & Contacts Tips & Prevention News Ask ... Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration Sections What Is Corneal Laceration? ...

  11. Corneal Laceration

    Medline Plus

    Full Text Available ... Health Find an Ophthalmologist Academy Store Eye Health A-Z Symptoms Glasses & Contacts Tips & Prevention News Ask ... Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration Sections What Is Corneal Laceration? ...

  12. LASIK术中角膜刀与角膜瓣厚度关系的临床研究%Clinical Study of the Correlation between Microkeratome and Corneal Flap Thickness in LASIK Surgery

    Institute of Scientific and Technical Information of China (English)

    唐静晓; 王彬; 董竟

    2009-01-01

    目的:通过对角膜瓣厚度的临床观察,找出角膜刀与角膜瓣厚度的相关因素,从而确保手术的安全性.方法:对在我院行LASIK治疗的患者进行术后追踪观察3~6个月,分为90刀组和110刀组,通过统计学处理找出90刀及110刀制作角膜瓣的厚度值.结果:90刀组的角膜瓣厚度值为(116.55±12.36)μm,110刀为(138.37±12.48)μm.结论:LASIK术中角膜瓣的厚度在理论上是固定的,但在临床实践中发现角膜瓣的厚度与理论值存在较大偏差,故提醒我们设计角膜切削深度时一定要结合本单位设备情况及术者的经验找出自己的角膜瓣厚度值,从而确保手术的安全性.%Objective: By clinical observation of corneal flap thickness, find out the relevant factors of the correlation between microkeratome and corneal flap thickness, so as to ensure the safety of surgery. Method: Patients in my hospital for LASIK treatment with follow-up after 3 to 6 months, the knife is divided into 90 groups and 110 groups through statistical analysis to find out the value of the thickness of the corneal flap that 90 and 110 knife make. Results: Corneal flap thickness value of the group of 90 knife is (116.55±12.36μm), 110 knife is (138.37±12.48 μm). Conclusion: In LASIK surgery in theory the corneal flap thickness is fixed, but in clinical practice we found that the thickness of the corneal flap exist large deviations with the theoretical value, which it reminds us that the design of corneal cutting depth must combine our unit equipment situation and experience of person to find out own corneal flap thickness value, so as to ensure the safety of surgery.

  13. A Rabbit Model Study to Determine the Efficacy of a Prototype Corneal Endothelium Protector during Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Annabel C. Y. Chew

    2017-01-01

    Full Text Available Purpose. We evaluated the efficacy and safety of a mechanical device, the P-chute, in corneal endothelium preservation during phacoemulsification in a rabbit model. Methods. Twenty-four rabbits were randomly assigned into 2 groups. One eye of each rabbit underwent phacoemulsification that simulated the removal of a dense nucleus, with or without the P-chute. Serial slit-lamp examinations, anterior segment optical coherence tomography (ASOCT scans, and specular microscopy were performed. Three rabbits from each group were sacrificed on postoperative days (PODs 1, 5, 7, and 14. Histological analysis of the corneas was performed. Results. There was a trend towards lesser endothelial cell loss for the P-chute group at POD1 (4.9% versus 12.5%, p=0.53, POD5 (10.4% versus 12.2%, p=0.77, and POD7 (10.5% versus 17.2%, p=0.52. There was no significant difference in the corneal thickness (p=>0.05 between the 2 groups. The insertion of the device was challenging. The use of the P-chute only added an extra 15% to the surgical time. Conclusions. There was a trend towards better endothelium preservation with the P-chute even though the results were not statistically significant. We believe that the device could be useful in certain surgical situations. Further work is needed to improve the device insertion.

  14. [Relationship between corneal surface temperature and air flow conditions during refractive laser eye surgery using three different excimer lasers].

    Science.gov (United States)

    Szekrényesi, Csaba; Sándor, Gábor László; Gyenes, Andrea; Kiss, Huba; Filkorn, Tamás; Nagy, Zoltán

    2016-10-01

    Thermal conditions during photorefractive keratectomy might be an important issue related to the corneal wound healing and long-term outcomes. Authors tried to find out the importance of temperature conditions during the treatment. One eye of 90 patients has been included into the study. Photorefractive keratoctomy was applied with Carl Zeiss MEL 70, MEL 80 and Wavelight Allegretto excimer lasers. EBRO TLC 730 infrared thermometer was used for the measurement of surface temperature of the cornea before epithelial removal, as well as before and after the treatment. Average age of the patients was 25.5 ± 3 yr. Average myopic correction was -3.2 ± 0.8 Dpt. Statistically significant difference was found in temperature change between MEL 80 and the other two types of excimer laser devices. Different air flow conditions of the smoke removal system might have an influence on changes of the corneal temperature during treatment, but the refractive results were not influenced by this issue. Orv. Hetil., 2016, 157(43), 1717-1721.

  15. Corneal Regeneration After Photorefractive Keratectomy: A Review.

    Science.gov (United States)

    Tomás-Juan, Javier; Murueta-Goyena Larrañaga, Ane; Hanneken, Ludger

    2015-01-01

    Photorefractive keratectomy (PRK) remodels corneal stroma to compensate refractive errors. The removal of epithelium and the ablation of stroma provoke the disruption of corneal nerves and a release of several peptides from tears, epithelium, stroma and nerves. A myriad of cytokines, growth factors, and matrix metalloproteases participate in the process of corneal wound healing. Their balance will determine if reepithelization and stromal remodeling are appropriate. The final aim is to achieve corneal transparency for restoring corneal function, and a proper visual quality. Therefore, wound-healing response is critical for a successful refractive surgery. Our goal is to provide an overview into how corneal wounding develops following PRK. We will also review the influence of intraoperative application of mitomycin C, bandage contact lenses, anti-inflammatory and other drugs in preventing corneal haze and post-PRK pain. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  16. 角膜屈光手术后人工晶状体屈光度计算方法的选择%Clinical selection of IOL refractive corneal refractive surgery calculation method

    Institute of Scientific and Technical Information of China (English)

    刘毅

    2015-01-01

    目的:探讨角膜屈光手术后白内障患者进行超声乳化联合人工晶状体( intraocular lens,IOL)植入手术的临床效果,对不同IOL屈光度准确性进行比较。  方法:对我院收治的120例160眼接受白内障手术并曾行角膜屈光手术的治疗近视患者相关资料进行分析,采用病史法对可获得角膜屈光手术前的角膜曲率数据K值进行计算,采用矫正角膜曲率数值法以及角膜地形图法对患者治疗前后资料记录不完整者K值,将K值代入公式,通过比较白内障术后实际屈光状态和预期屈光状态(-0.50D),比较三种计算方法IOL屈光度准确性。  结果:白内障患者手术前平均最佳矫正视力为0.25±0.05,术后最佳矫正视力提高0.80±0.05;白内障患者手术前平均等效球镜值( spherical equivalent,SE)为-1.98±1.75,患者手术后SE为+0.85±3.38(P  结论:对具有角膜屈光手术史患者根据患者临床症状、病史等选择合适的方法,能够准确地计算患者IOL,对于资料完整者采用CHM提供角膜K值;对于资料不完整者采用AKM和CHM计算K值。%AIM: To investigate the clinical effect of phacoemulsification and intraocular lens ( IOL ) implantation for cataract patients after corneal refractive surgery, and to compare the accuracy of the different refractive IOL. METHODS:The data of 120 myopia cases (160 eyes) in our hospital, who underwent cataract surgery and corneal refractive surgery were analyzed. Corneal curvature K value before corneal refractive surgery were obtained and calculated by using history method. Corneal curvature correction numerical method and corneal topography were used to record K value of patients with incomplete data before and after treatment. The K value was substituted into the formula. By comparing the actual cataract surgery and refractive state expected refractive status (-0. 50D), the accuracy of IOL refractive obtained from three methods was compared

  17. A Large-Scale Computational Analysis of Corneal Structural Response and Ectasia Risk in Myopic Laser Refractive Surgery (An American Ophthalmological Society Thesis)

    Science.gov (United States)

    Dupps, William Joseph; Seven, Ibrahim

    2016-01-01

    Purpose: To investigate biomechanical strain as a structural susceptibility metric for corneal ectasia in a large-scale computational trial. Methods: A finite element modeling study was performed using retrospective Scheimpflug tomography data from 40 eyes of 40 patients. LASIK and PRK were simulated with varied myopic ablation profiles and flap thickness parameters across eyes from LASIK candidates, patients disqualified for LASIK, subjects with atypical topography, and keratoconus subjects in 280 simulations. Finite element analysis output was then interrogated to extract several risk and outcome variables. We tested the hypothesis that strain is greater in known at-risk eyes than in normal eyes, evaluated the ability of a candidate strain variable to differentiate eyes that were empirically disqualified as LASIK candidates, and compared the performance of common risk variables as predictors of this novel susceptibility marker across multiple virtual subjects and surgeries. Results: A candidate susceptibility metric that expressed mean strains across the anterior residual stromal bed was significantly higher in eyes with confirmed ectatic predisposition in preoperative and all postoperative cases (P≤.003). The strain metric was effective at differentiating normal and at-risk eyes (area under receiver operating characteristic curve ≥ 0.83, P≤.002), was highly correlated to thickness-based risk metrics (as high as R2 = 95%, P<.001 for the percent of stromal tissue altered (PSTA)), and predicted large portions of the variance in predicted refractive response to surgery (R2 = 57%, P<.001). Conclusions: This study represents the first large-scale 3-dimensional structural analysis of ectasia risk and provides a novel biomechanical construct for expressing structural risk in refractive surgery. Mechanical strain is an effective marker of known ectasia risk and correlates to predicted refractive error after myopic photoablative surgery.

  18. 角膜屈光手术后继发性圆锥角膜的RGP矫正疗效观察%Corneal Refractive Surgery after Secondary the Contig-oriented Correction Effect of the Treatment of Keratoconus

    Institute of Scientific and Technical Information of China (English)

    陈月兰

    2014-01-01

    目的:探讨和分析角膜屈光手术后继发性圆锥角膜的RGP矫正疗效。方法:对我院近两年来接收治疗的111例因眼角膜屈光手术后发生圆锥角膜的患者进行随机抽取,从中选取了84例患者(164眼)作为研究对象,根据研究要求,分为实验组和对照组,每组42例患者(84眼)。让实验组患者进行角膜屈光手术后佩戴硬性透气性角膜接触镜(RG P )进行矫正。而对照组患者进行角膜屈光手术后佩戴普通软性角膜接触镜进行矫正。18个月后,观察两组患者的角膜前后表面曲率和角膜地图的改变情况。结果:经过18个月的矫正,实验组患者在佩戴硬性透气性角膜接触镜(RGP)矫正后的角膜前表面的最陡平均曲率明显下降,并且患者的角膜地形图SRI、SAI、散光都明显减少,PVA提高了很多。而对照组患者在佩戴普通软性角膜接触镜矫正后的角膜地形图无明显改善。结论:在临床上,角膜屈光手术是一种非常常见的眼科手术,通常情况下,在患者手术后都需要进行RGP的矫正,通过RGP的矫正能对患者角膜屈光手术后的圆锥角膜有明显的改善,并且能保持患者角膜的前后表面最平平均曲率,是目前最有效矫正角膜屈光手术的方法。%Objective :To study and analysis of secondary keratoconus after corneal refractive surgery contig-oriented correction effect .Methods :111 cases in our hospital for almost two years to receive treatment for corneal refractive sur-gery after keratoconus patients were randomly chosen ,selected from the 84 patients (164 eyes) as the research object , according to the requirements ,divided into the experimental group and the control group ,each group of 42 patients (84 eyes) .Let the experimental group after corneal refractive surgery patients wearing hard permeability corneal con-tact lens (contig-oriented) to correct .While the control group after

  19. In vivo Confocal Microscopy Report after Lasik with Sequential Accelerated Corneal Collagen Cross-Linking Treatment.

    Science.gov (United States)

    Mazzotta, Cosimo; Balestrazzi, Angelo; Traversi, Claudio; Caragiuli, Stefano; Caporossi, Aldo

    2014-01-01

    We report the first pilot qualitative confocal microscopic analysis of a laser in situ keratomileusis (Lasik) treatment combined with sequential high-fluence accelerated corneal collagen cross-linking, denominated Lasik XTra, by means of HRT II laser scanning in vivo confocal microscopy after a 6-month follow-up. After obtaining approval from the Siena University Hospital Institutional Review Board, a 33-year-old female patient underwent a Lasik XTra procedure in her left eye. Confocal analysis demonstrated induced slight corneal microstructural changes by the interaction between UV-A, riboflavin and corneal stromal collagen, beyond the interface to a depth of 160 µm, without adverse events at the interface and endothelial levels. This application may be considered a prophylactic biomechanical treatment, stiffening the intermediate corneal stroma to prevent corneal ectasia and stabilizing the clinical results of refractive surgery. According to our preliminary experiences, this combined approach may be useful in higher-risk Lasik patients for hyperopic treatments, high myopia and lower corneal thicknesses.

  20. In vivo Confocal Microscopy Report after Lasik with Sequential Accelerated Corneal Collagen Cross-Linking Treatment

    Directory of Open Access Journals (Sweden)

    Cosimo Mazzotta

    2014-04-01

    Full Text Available We report the first pilot qualitative confocal microscopic analysis of a laser in situ keratomileusis (Lasik treatment combined with sequential high-fluence accelerated corneal collagen cross-linking, denominated Lasik XTra, by means of HRT II laser scanning in vivo confocal microscopy after a 6-month follow-up. After obtaining approval from the Siena University Hospital Institutional Review Board, a 33-year-old female patient underwent a Lasik XTra procedure in her left eye. Confocal analysis demonstrated induced slight corneal microstructural changes by the interaction between UV-A, riboflavin and corneal stromal collagen, beyond the interface to a depth of 160 µm, without adverse events at the interface and endothelial levels. This application may be considered a prophylactic biomechanical treatment, stiffening the intermediate corneal stroma to prevent corneal ectasia and stabilizing the clinical results of refractive surgery. According to our preliminary experiences, this combined approach may be useful in higher-risk Lasik patients for hyperopic treatments, high myopia and lower corneal thicknesses.

  1. Corneal Laceration

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    Full Text Available ... from Laundry Packets On the Rise Jun 30, 2017 People with Advanced Keratoconus May Have A Future Alternative to Full Corneal Transplantation Nov 29, 2016 Combating Eye Injuries from Air Guns Aug 30, ...

  2. Corneal transplant

    Science.gov (United States)

    ... lenses to achieve the best vision. Laser vision correction may be an option if you have nearsightedness, ... Editorial team. Related MedlinePlus Health Topics Corneal Disorders Refractive Errors Browse the Encyclopedia A.D.A.M., Inc. ...

  3. Corneal Laceration

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    Full Text Available ... itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe ... Dangerous for Your Eyes Sep 20, 2017 Eye Injuries from Laundry Packets On the Rise Jun 30, ...

  4. Corneal Laceration

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    Full Text Available ... itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe ... 27, 2015 Dark Spot in Vision After Blunt Trauma Dec 21, 2014 Pain a Year After Eyelid ...

  5. Corneal Laceration

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    Full Text Available ... itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe ... and preserving your vision. Privacy Policy Related Eye Injuries from Laundry Packets On the Rise Jun 30, ...

  6. Corneal Laceration

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    Full Text Available ... 2017 People with Advanced Keratoconus May Have A Future Alternative to Full Corneal Transplantation Nov 29, 2016 Combating Eye Injuries from Air Guns Aug 30, ... Public & Patients: Contact Us About ...

  7. Corneal Laceration

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    Full Text Available ... by something sharp flying into the eye. It can also be caused by something striking the eye ... If the corneal laceration is deep enough it can cause a full thickness laceration. This is when ...

  8. Corneal Laceration

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    Full Text Available ... By: Devin A Harrison MD Sep. 01, 2017 The cornea is the clear front window of the eye . A corneal laceration is a cut on the cornea. It is usually caused by something sharp ...

  9. Corneal Laceration

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    Full Text Available ... itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe ... 27, 2015 Dark Spot in Vision After Blunt Trauma Dec 21, 2014 Pain a Year After Eyelid ...

  10. Effects of Cataract Surgery on Endothelium in Transplanted Corneal Grafts: Comparison of Extracapsular Cataract Extraction and Phacoemulsification for Complicated Cataract after Penetrating Keratoplasty

    Institute of Scientific and Technical Information of China (English)

    Hong-Wei Zhou; Li-Xin Xie

    2016-01-01

    Background:The endothelium should be carefully evaluated when choosing a surgical technique for cataract removal.Therefore,we aimed to study the effects of different cataract surgery techniques on endothelial cell loss in transplanted comeal grafts.Methods:A total of 54 patients who received complicated cataract surgery in post-penetrating keratoplasty (PKP) eyes at the Shandong Eye Institute between February 2001 and June 2014 were included,and clinical records were reviewed.Baseline demographic details,clinical characteristics,endothelial cell density (ECD),and best-corrected visual acuity (BCVA) were recorded.Wilcoxon rank-sum test and Wilcoxon signed-rank test were used to test the equality of medians.A regression model was constructed to compare the reduced rate of ECD.Results:Of the 54 eyes included in this study,extracapsular cataract extraction (ECCE) was performed in 34 eyes of 33 patients (ECCE group) whereas phacoemulsification was performed in 20 eyes of 20 patients (phacoemulsification group).There was no significant difference in the median age (P =0.081) or preoperative ECD (P =0.585) between the two groups.At 6 months after cataract surgery,ECD in ECCE group was significantly higher than that in phacoemulsification group (P =0.043).In addition,the endothelial cell loss rate in ECCE group was significantly lower than that in phacoemulsification group at 2 months (P =0.018),4 months (P < 0.001),and 6 months (P < 0.001) after cataract surgery.Endothelial cell loss rate after cataract surgery increased over the 6-month study duration in both ECCE group (P < 0.00 l) and phacoemulsification group (P < 0.001),but phacoemulsification resulted in a greater reduction in ECD than that of ECCE in transplanted corneal grafts (P < 0.001).There was no significant difference in postoperative BCVA between the two groups (P =0.065).Conclusion:ECCE is more suitable than phacoemulsification in cataract surgery in complicated cataract after PKP.

  11. 角膜地形图引导下白内障手术切口构建的变异对角膜散光影响%The Effect of the Corneal Astigmatism in Changed Cataract Surgery Incision with the Corneal Topography

    Institute of Scientific and Technical Information of China (English)

    刘文慧; 施彦; 李一壮

    2010-01-01

    Objective To observe the effect of the corneal astigmatism in cataract surgery incision which selected according to corneal topography to further reduce the preoperative corneal astigmatism. Meth-ods Computer-assisted corneal topography was used to examine the 126 eyes of 123 patients preoperatively.The cases were divided into 5 groups randomly. Group A: Manual small incision cataract surgery (MSICS) Group: Superior anti-bow sclera tunnel incision was made on 22 eyes of Group A. Group B: MSICS Group: The anti-bow sclera tunnel incision was made on the steepest meridian according to the corneal topography ex-amined preoperatively on 28 eyes. Group C: Phacoemulsification Group: Superior clear corneal incision was made on 24 eyes of group C. Group D: Phacoemulsification Group: The clear corneal incision was made on the steepest meridian according to the corneal topography examined preoperatively on 26 eyes. Group E: MSICS Group: incision was made on the steepest meridian according to the corneal topography The straight sclera tun-nel examined preoperatively on 26 eyes. The corneal topography at 1 day and 7 days after surgery was ob-served and recorded except for visual acuity and so on. Results ①Visual acuity: The differences were not sta-tistically significant among these groups which Visual acuity was above 0.5 after 1 day and 7 days except the one between Group B and Group E after 7 days. ②Astigmatism axis conversion: The conversions were not sig-nificant from Group A to Group D. There were 12 cases changed in Group E. ③Corneal astigmatism: In Group A, the differences were not statistically significant among pre-operation, 1 day and 7 days. In Group B, the val-ues of corneal astigmatism in 1 day after surgery were a little more decreased than pre-existing ones, but were statistically significant 7 days later. The values of Group C and D were a little greater in 1 day after surgery and reduced 7 days later, however the values of Group C were higher. In group E

  12. Corneal Laceration

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    Full Text Available ... Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics ... Society of Refractive Surgery Museum of Vision Subspecialties Cataract/ ...

  13. Corneal endothelial cell loss in post-penetrating keratoplasty patients after cataract surgery: phacoemulsification versus planned extracapsular cataract extraction.

    Science.gov (United States)

    Acar, Banu Torun; Buttanri, Ibrahim Bulent; Sevim, Mehmet Sahin; Acar, Suphi

    2011-08-01

    To compare the changes in endothelial cell density (ECD) in post-penetrating keratoplasty (PKP) patients after cataract extraction with phacoemulsification or planned extracapsular cataract extraction (ECCE). Haydarpasa Numune Education and Research Hospital, Ophthalmology Clinic, Istanbul, Turkey. Clinical trial. Eyes with hard nuclear cataract that had previous PKP were randomly assigned to have phacoemulsification or ECCE. Noncontact specular microscopy was performed preoperatively and 1, 3, and 6 months postoperatively. Twenty-six eyes of 26 patients were enrolled (14 phacoemulsification; 12 ECCE). Six months postoperatively, the mean corneal ECD was statistically significantly lower in the phacoemulsification group (1869.50 cells/mm(2) ± 158.05 [SD]) than in the ECCE group (1996.00 ± 127.96 cells/mm(2)) (P=.024). The mean percentage of endothelial cell loss at 6 months was 20.3% and 12.7%, respectively (P.05). Extracapsular cataract extraction seemed to cause less endothelial cell damage than phacoemulsification in post-PKP patients with hard nuclear cataract. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  14. [Representation and mathematical analysis of human corneal surface].

    Science.gov (United States)

    Tălu, Stefan; Tălu, Mihai; Giovanzana, Stefano

    2011-01-01

    In the description and analysis of human corneal surface are used various mathematical models based on parametric representations, used in biomechanical studies and 3D solid modeling of the cornea. Mathematical models are important into the biomechanics of the cornea to model the corneal behavior. Corneal biomechanics also has the potential to improve outcomes in refractive surgery. The objective of this paper is to present the most representative mathematical models currently used for modeling of human corneal in optics and biomechanics fields.

  15. Corneal topographic analysis after axcimer iaser keratorefractive surgery for correction of different degree of myopia%不同近视程度及准分子激光屈光术后角膜地形图分析

    Institute of Scientific and Technical Information of China (English)

    付玲玲; 宁波; 王星瑾; 曾伶; 盛向东

    2010-01-01

    Objective To analyze the change on corneal topography before and after excimer laser keratorefractive surgery for correction of different degree of myopia, and to investigate the corneal shape changes after excimer laser keratorefractive surgery for correction of myopia. Methods 159 patients received excimer laser keratorefractive surgery in our hospital were included in the retrospective study. Parameters refrecting corneal surface, such as SRI、SAI、CLY, were analyzed in SPSS 13.0 statistics software. Results As is indicated on the Corneal Topography of Myopia of different degree: There was significant difference in CYL (P <0.05 ),and no significant difference in SRI、 SAI of each group ( P >0.05 ); As is indicated on the corneal topography before and after excimer laser keratorefractive surgery: CYL、SRI 、SAI changed with statistical significance after operation (P <0.01 ). Conclusion Among the patients of different degree of myopia, there was no significant difference in surface regularity and symmetry, and corneal astigmatism increased with an increase in the degree of refractive error .But there was significant difference in surface regularity ,symmetry and corneal astigmatism after excimer laser keratorefractive surgery. Therefore, when excimer laser keratorefractive surgery for correction of myopia is performing, more attention should be paid to the change of corneal surface, which helps reduce the occurrence of visual quality and optical questions.%目的 分析不同近视程度患者的角膜地形图及准分子激光术前、术后角膜地形图的差异,了解不同近视程度及术后角膜表面形态的改变.方法 回顾性分析2004年在我院行准分子激光屈光性手术的159例患者的角膜地形图资料,比较SRI、SAI、CLY等反映角膜表面形态的参数,采用SPSS 13.0统计软件进行统计分析.结果 不同近视程度组间角膜地形图比较示:CYL的差异有统计学意义(P<0.05),而SRI、SAI

  16. Differences between real and predicted corneal shapes after aspherical corneal ablation

    Science.gov (United States)

    Anera, Rosario G.; Villa, César; Jiménez, José R.; Gutiérrez, Ramón; Jiménez del Barco, Luis

    2005-07-01

    We study the differences between real and expected corneal shapes, using an aspherical ablation algorithm with a known equation and avoiding the limitation imposed by most studies of refractive surgery in which the ablation equations are not known. We have calculated the theoretical corneal shape predicted by this algorithm, comparing this shape with the real corneal topography. The results indicate that the deviations that appear in the corneal shape are significant for visual performance and for the correction of eye aberrations. If we include in this analysis the effect of reflection losses and nonnormal incidence on the cornea, we can reduce corneal differences, but they will remain significant. These results confirm that it is essential to minimize corneal differences to achieve effective correction in refractive surgery.

  17. Efficacy of fentanyl transdermal patch in pain control after lower third molar surgery: A preliminary study

    Science.gov (United States)

    Vasovic, Miroslav; Andric, Miroslav; Todorovic, Ljubomir; Kokovic, Vladimir

    2016-01-01

    Background Surgical removal of impacted lower third molars is a common oral surgical procedure, generally followed by moderate to severe postoperative pain. Transdermal drug delivery as a concept offers interesting possibilities for postoperative pain control. The aim of this study was to evaluate the efficacy of transdermal system with fentanyl in relieving pain following impacted lower third molar surgery. Material and Methods Seventeen patients with bilateral impacted lower third molars were included in this preliminary study. For postoperative pain control, patients randomly received a fentanyl patch plus placebo tablet after the first operation and regular (placebo) patch and an analgesic, after the second operation. Analgesia was evaluated during first 24 hours postoperatively according to patients’ reports about time of first pain appearance and additional analgesic consumption. Pain severity was rated using a 10 cm long visual analogue scale (VAS). Results Intensity of postoperative pain and postoperative analgesic consumption were significantly lower after the Fentanyl Transdermal System (FTS) was applied (p<0.05). Duration of postoperative analgesia was significantly higher with FTS when compared to control treatment (p<0.05). Conclusions Based on the results of this preliminary study, transdermal system with fentanyl significantly reduced postoperative pain after third molar surgery. Key words:Analgesia, fentanyl, transdermal administration, third molar surgery, acute pain, postoperative care. PMID:27475691

  18. Corneal Ulcer

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  19. Corneal Laceration

    Medline Plus

    Full Text Available ... Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Academy Publications EyeNet Ophthalmology ... Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Find an Ophthalmologist Advanced ...

  20. Ultra B2 - Promoção de ligações covalentes do colágeno corneal (Corneal cross-linking no tratamento de ceratocone: resultados preliminares Corneal Cross-linking for the treatment of keratoconus: preliminary results

    Directory of Open Access Journals (Sweden)

    Mirko R. Jankov II

    2008-12-01

    atingir diferença estatisticamente significante. Nenhum dos olhos perdeu linha de BSCVA, 12 mantiveram o BSCVA pré-operatório, 7 ganharam uma linha, 5 ganharam duas e 1 paciente ganhou três linhas de BSCVA. CONCLUSÕES: O tratamento com Ultra-B2 mostrou-se seguro (não apresentou perda de linha de visão corrigida e eficaz (manteve os parâmetros anatômicos e ópticos em estacionar a progressão da ectasia corneal. Houve redução, embora sem significância estatística, da curvatura corneal máxima, equivalente esférico e cilindro refrativo nos olhos com a córnea instável devida ao ceratocone.PURPOSE: To present early visual and keratometric results for corneal cross-linking with riboflavin and UV irradiation in patients with progressive keratoconus. METHODS: Twenty-five eyes of twenty patients (15 males and 5 females with a progressive keratoconus in the previous 6 months were followed. Unaided visual acuity (UVA, best spectacle corrected visual acuity (BSCVA, spherical equivalent (SEQ, manifest cylinder, and maximal corneal curvature (max K values were followed at 1, 3 and 6 months. All patients were submitted to corneal cross-linking using riboflavin (vitamin B2 as the photosensitizer and ultraviolet light (UV, wavelength 370 nm. Epithelium was removed with 20% alcohol, cornea was soaked with vitamin B2 for 15 min, and then irradiated with UV light for 30 min, after which a bandage contact lens (BCL was placed. RESULTS: UVA increased after one month (from 0.15 ± 0.15 to 0.23 ± 0.20, and went on increasing at 3 and 6 months, reaching statistical significance (p=0.025 e p=0.037, respectively. BSCVA increased from 0.41 ± 0.27 to 0.49 ± 0.29 at month six, without reaching statistical significance at any time point. Progression of keratoconus stopped in all patients, in contrast with progression in all of them in the six-month period prior to the surgery. Max K decreased by more than 2 D (from 53.02 ± 8.42 to 50.88 ± 6.05 D, SEQ less that 1 D (from -3.27 ± 4

  1. 上睑下垂矫正术后发生角膜溃疡的特殊原因及处理%The cause and treatment for corneal ulcer after ptosis surgery

    Institute of Scientific and Technical Information of China (English)

    叶琳; 彭云; 王媛; 路璐; 郭萍; 曾琨

    2014-01-01

    目的 探讨上睑下垂术后角膜溃疡发生的特殊原因及处理措施.方法 回顾性分析深圳市眼科医院2012年1月至2013年12月进行的上睑下垂矫正术89例(110眼),其中5例(6眼)发生了角膜溃疡,分析其原因及治疗效果.结果 5例(6眼)发生角膜溃疡,3例是因为术后下睑倒睫加重而引起,1例与心因性疾病有关,1例是因为脑膜瘤术后,角膜营养不良引起.进行了睑裂缝合、营养角膜、对症治疗等处理,患者角膜均恢复透明,上睑下垂手术效果满意.结论 上睑下垂患者虽然在术前、术后均采取措施避免角膜溃疡的发生因素,但还是有少数患者术后发生角膜溃疡,其原因并不常见.术前完善检查,术后出现溃疡后积极处理,是可以避免或治愈角膜溃疡的.%Objective To analyze special cause and treatment for corneal ulcer after ptosis surgery.Methods 110 eyes of 89 patients who underwent blepharoptosis correction surgery between January 2012 and December 2012 were retrospectively analyzed.Corneal ulcer occurred in 5 cases (6 eyes).The causes and treatment were analyzed.Results In 5 cases (6 eyes),corneal ulcer was caused by entropion and trichiasis in 3 eyes of 3 cases.The corneal ulcer was related to the psychological illness in 2 eyes of 1 case.The nerve nutritional corneal ulcer occurred in 1 eye of 1 case because of meningioma surgery.After the treatments,such as tarsorrhaphy,cornea nutritional therapy and symptomatic treatment,all the corneal ulcer restored transparent and the effect of surgery was satisfactory.Conclusion Before and after ptosis surgery,patients have been taken measures to prevent the occurrence of corneal ulcer,but corneal ulear still occurs.The causes are not common.So improving preoperative examinations and postoperative active treatment are very necessary.

  2. Small-aperture corneal inlay in presbyopic patients with prior phakic intraocular lens implantation surgery: 3-month results

    Directory of Open Access Journals (Sweden)

    Huseynova T

    2013-08-01

    Full Text Available Tukezban Huseynova,1 Tomomi Kanamori,1 George O Waring IV,2 Minoru Tomita1,3,4 1Shinagawa LASIK Center, Tokyo, Japan; 2Medical University of South Carolina, Charleston, SC, USA; 3Wenzhou Medical College, Wenzhou, People’s Republic of China; 4Eye Can Cataract Surgery Center, Metro Manila, Philippines Abstract: We report a series of three case reports of KAMRA inlay implantation procedures in presbyopic patients with a history of prior phakic intraocular lens implantation surgery. Three-month results showed a two to five-line improvement for uncorrected near visual acuity. The absolute uncorrected near visual acuity change for case 1 was from J4 to J2, for case 2 was from J6 to J4, and for case 3 was from J10 to J5. No significant change of uncorrected distance visual acuity was observed in all three cases. Keywords: phakic intraocular lens, IOL, KAMRA, intracorneal inlay

  3. First steps of laparoscopic surgery in Lubumbashi: problems encountered and preliminary results.

    Science.gov (United States)

    Arung, Willy; Dinganga, Nathalie; Ngoie, Emmanuel; Odimba, Etienne; Detry, Olivier

    2015-01-01

    For many reasons, laparoscopic surgery has been performed worldwide. Due to logistical constraints its first steps occurred in Lubumbashi only in 2008. The aim of this presentation was to report authors' ten-month experience of laparoscopic surgery at Lubumbashi Don Bosco Missionary Hospital (LDBMH): problems encountered and preliminary results. The study was a transsectional descriptive work with a convenient sampling. It only took in account patients with abdominal surgical condition who consented to undergo laparoscopic surgery and when logistical constraints of the procedure were found. Independent variables were patients' demographic parameters, staff, equipments and consumable. Dependent parameters included surgical abdominal diseases, intra-operative circumstances and postoperative short term mortality and morbidity. Between 1(st)April 2009 and 28(th) February 2010, 75 patients underwent laparoscopic surgery at the LDBMH making 1.5% of all abdominal surgical activities performed at this institution. The most performed procedure was appendicectomy for acute appendicitis (64%) followed by exploratory laparoscopy for various abdominal chronic pain (9.3%), adhesiolysis for repeated periods of subacute intestinal obstruction in previously laparotomised patients (9.3%), laparoscopic cholecystectomy for post acute cholecystitis on gall stone (5.3%) and partial colectomy for symptomatic redundant sigmoid colon (2.7%). There were 4% of conversion to laparotomy. Laparoscopic surgery consumed more time than laparotomy, mostly when dealing with appendicitis. However, postoperatively, patients did quite well. There was no death in this series. Nursing care was minimal with early discharge. These results are encouraging to pursue laparoscopic surgery with DRC Government and NGO's supports.

  4. Corneal Transplantation

    DEFF Research Database (Denmark)

    Hjortdal, Jesper Østergaard

    Corneal transplantation has been performed for more than 100 years. Until 15 years ago the state-of-the art type of transplantation was penetrating keratoplasty, but since the start of this millennium, newly designed surgical techniques have developed considerably. Today, the vast majority of ker...

  5. Corneal Laceration

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    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration ... After Eyelid Scratch Jul 28, 2014 Leer en Español: ¿Qué Es una Laceración de la Córnea? Find ...

  6. Corneal topography

    DEFF Research Database (Denmark)

    Andersen, J.; Koch-Jensen, P.; Østerby, Ole

    1993-01-01

    The central corneal zone is depicted on keratoscope photographs using a small target aperture and a large object distance. Information on the peripheral area is included by employing a hemispherical target with a dense circular and radial pattern. On a 16 mm (R = 8 mm) reference steel sphere...

  7. Asphericity analysis using corneal wavefront and topographic meridional fits

    Science.gov (United States)

    Arba-Mosquera, Samuel; Merayo-Lloves, Jesús; de Ortueta, Diego

    2010-03-01

    The calculation of corneal asphericity as a 3-D fit renders more accurate results when it is based on the corneal wavefront aberrations rather than on the corneal topography of the principal meridians. A more accurate prediction could be obtained for hyperopic treatments compared to myopic treatments. We evaluate a method to calculate corneal asphericity and asphericity changes after refractive surgery. Sixty eyes of 15 consecutive myopic patients and 15 consecutive hyperopic patients (n=30 each) are retrospectively evaluated. Preoperative and 3-month-postoperative topographic and corneal wavefront analyses are performed using corneal topography. Ablations are performed using a laser with an aberration-free profile. Topographic changes in asphericity and corneal aberrations are evaluated for a 6-mm corneal diameter. The induction of corneal spherical aberrations and asphericity changes correlates with the achieved defocus correction. Preoperatively as well as postoperatively, asphericity calculated from the topography meridians correlates with asphericity calculated from the corneal wavefront in myopic and hyperopic treatments. A stronger correlation between postoperative asphericity and the ideally expected/predicted asphericity is obtained based on aberration-free assumptions calculated from corneal wavefront values rather than from the meridians. In hyperopic treatments, a better correlation can be obtained compared to the correlation in myopic treatments. Corneal asphericity calculated from corneal wavefront aberrations represents a 3-D fit of the corneal surface; asphericity calculated from the main topographic meridians represents a 2-D fit of the principal corneal meridians. Postoperative corneal asphericity can be calculated from corneal wavefront aberrations with higher fidelity than from corneal topography of the principal meridians. Hyperopic treatments show a greater accuracy than myopic treatments.

  8. Outcome of corneal transplantation: can a prioritisation system predict outcome?

    OpenAIRE

    Saunders, Patrick P R; Sibley, Lyn M; Richards, John S F; Simon P. Holland; Chow, Debbie L; Courtright, Paul

    2002-01-01

    Background: In 1995 a prioritisation system for patients waiting for corneal transplantation surgery was adopted in British Columbia. In 1997 a routine outcome assessment programme was adopted. The authors sought to determine the outcomes of corneal transplant surgery in the province of British Columbia and to evaluate if they were associated with waiting list prioritisation.

  9. Corneal Laceration

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    Full Text Available ... Refractive Management/Intervention Retina/Vitreous Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  10. Corneal Laceration

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  11. Corneal Laceration

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    Full Text Available ... Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics ... Services Advocacy Foundation About Subspecialties & More Eye ...

  12. Reversible corneal toxicity of retained intracameral Perfluoro-n-octane

    Directory of Open Access Journals (Sweden)

    Saad S Alharbi

    2016-01-01

    Full Text Available A 58-year-old female presented with intracameral retained perfluoro-n-octane (PFO following previous retinal reattachment surgery. After 4 years of follow-up without related sequelae, the patient complained of a gradual decrease in vision secondary to corneal edema with whitish corneal precipitate inferiorly corresponding to the area of retained PFO. Three weeks after anterior chamber washout, corneal edema resolved and the patient obtained 20/40 visual acuity. Even though PFO considered to have a relatively good safety profile, early anterior chamber washout may prevent corneal toxicity and avoid later persistent corneal decompensation.

  13. Current status of accelerated corneal cross-linking

    Directory of Open Access Journals (Sweden)

    Michael Mrochen

    2013-01-01

    Full Text Available Corneal cross-linking with riboflavin is a technique to stabilize or reduce corneal ectasia, in diseases such as keratoconus and post-laser-assisted in situ keratomileusis (LASIK ectasia. There is an interest by patient as well as clinicians to reduce the overall treatment time. Especially, the introduction of corneal cross-linking in combination with corneal laser surgery demands a shorter treatment time to assure a sufficient patient flow. The principles and techniques of accelerated corneal cross-linking is discussed.

  14. Gaslini's tracheal team: preliminary experience after one year of paediatric airway reconstructive surgery

    Directory of Open Access Journals (Sweden)

    Torre Michele

    2011-10-01

    Full Text Available Abstract Background congenital and acquired airway anomalies represent a relatively common albeit challenging problem in a national tertiary care hospital. In the past, most of these patients were sent to foreign Centres because of the lack of local experience in reconstructive surgery of the paediatric airway. In 2009, a dedicated team was established at our Institute. Gaslini's Tracheal Team includes different professionals, namely anaesthetists, intensive care specialists, neonatologists, pulmonologists, radiologists, and ENT, paediatric, and cardiovascular surgeons. The aim of this project was to provide these multidisciplinary patients, at any time, with intensive care, radiological investigations, diagnostic and operative endoscopy, reconstructive surgery, ECMO or cardiopulmonary bypass. Aim of this study is to present the results of the first year of airway reconstructive surgery activity of the Tracheal Team. Methods between September 2009 and December 2010, 97 patients were evaluated or treated by our Gaslini Tracheal Team. Most of them were evaluated by both rigid and flexible endoscopy. In this study we included 8 patients who underwent reconstructive surgery of the airways. Four of them were referred to our centre or previously treated surgically or endoscopically without success in other Centres. Results Eight patients required 9 surgical procedures on the airway: 4 cricotracheal resections, 2 laryngotracheoplasties, 1 tracheal resection, 1 repair of laryngeal cleft and 1 foreign body removal with cardiopulmonary bypass through anterior tracheal opening. Moreover, in 1 case secondary aortopexy was performed. All patients achieved finally good results, but two of them required two surgeries and most required endoscopic manoeuvres after surgery. The most complex cases were the ones who had already been previously treated. Conclusions The treatment of paediatric airway anomalies requires a dedicated multidisciplinary approach and a

  15. Effect of basic fibroblast growth factor on corneal endothelial cell damage after cataract surgery%bFGF改善白内障手术引发角膜内皮损伤

    Institute of Scientific and Technical Information of China (English)

    孙丹宇; 包赫; 姜仕先

    2016-01-01

    目的:探究碱性成纤维细胞生长因子(bFGF)对白内障手术引发角膜内皮损伤修复的作用。方法采用超声乳化摘除30只兔子(60眼)的晶体,将其分为2组,随机分为bFGF治疗组和对照组。bFGF治疗组滴用bFGF眼用凝胶,对照组滴用相同体积的生理盐水,分别每天滴用3次。观察记录2组眼睛消肿的时间;在手术后不同时间,分别检测2组切口的愈合面积、角膜厚度、角膜内皮细胞密度,分别取各组前房水,检测各组前房水中NO、IL-1、IL-6和TNF-α的含量。结果 bFGF治疗组的眼睛消肿时间较对照组显著减少(P<0.05);bFGF治疗加速了切口愈合速率、角膜厚度和角膜内皮细胞密度的恢复及前房水内NO、IL-1、IL-6和TNF-α的减少。结论 bFGF可改善白内障手术引起的角膜内皮细胞损伤。%Objective To explore the effect of basic fibroblast growth factor (bFGF)on corneal endothelial cell damage after cataract surgery.Methods Thirty rabbits (60 eyes)whose lens extraction were done by phacoemulsification were divided into 2 groups,namely,bF-GF treatment group and control group.bFGF ophthalmic gel was used to treat the eyes 3 times daily in bFGF treatment group,and the saline of the same volume was used to treat the eyes in control group.The time of corneal edema subsidence was recorded;the healing area of inci-sion,corneal thickness,the density of corneal endothelial cells and the NO,IL-1 ,IL-6 and TNF-αcontents of the aqueous sample in anterior chamber were measured.Results The time of corneal edema subsidence of bFGF treatment group decreased significantly compared with con-trol group;bFGF treatment accelerated the healing rate of incision,the recovery of corneal thickness and the density of corneal endothelial cells and the decrease of the NO,IL-1 IL-6 and TNF-αcontents of the aqueous sample in anterior chamber.Conclusion bFGF treatment can accelerate the recovery of the corneal

  16. Kinematic analysis of motor performance in robot-assisted surgery: a preliminary study.

    Science.gov (United States)

    Nisky, Ilana; Patil, Sangram; Hsieh, Michael H; Okamura, Allison M

    2013-01-01

    The inherent dynamics of the master manipulator of a teleoperated robot-assisted surgery (RAS) system can affect the movements of a human operator, in comparison with free-space movements. To measure the effects of these dynamics on operators with differing levels of surgical expertise, a da Vinci Si system was instrumented with a custom surgeon grip fixture and magnetic pose trackers. We compared users' performance of canonical motor control movements during teleoperation with the manipulator and freehand cursor control, and found significant differences in several aspects of motion, including target acquisition error, movement speed, and acceleration. In addition, there was preliminary evidence for differences between experts and novices. These findings could impact robot design, control, and training methods for RAS.

  17. 重视白内障术后角膜上皮细胞功能障碍%Pay attention to the corneal epithelial cell dysfunction after cataract surgery

    Institute of Scientific and Technical Information of China (English)

    孙旭光; 王森

    2015-01-01

    Corneal epithelial dysfunction (CED) is the abnormality of the regeneration,conjunction,adhesion and immigration of the corneal epithelium cells without the decompensation of the corneal limbal cells.Due to the affection resulting from the systemic problems of patients and the management in the preoperative period,some of the patients at one to two weeks after cataraci surgery will present the edema and fluorescein staining of the corneal epithelium.Without correct therapy,the defect of the epithelium,or even persisting ulceration of the cornea will occur.The key points of the management for CED are the early diagnosis and reasonable therapy.We suggest paying special attention to CED in the patients with metabolism diseases,abnormality of the tear film and long-term blepharitis.%角膜上皮细胞功能障碍是指在无角膜缘细胞功能失代偿的条件下,角膜上皮细胞再生、连接、黏附及移行功能异常.由于患者自身及围手术期各种因素的影响,少数白内障患者在术后1~2周,开始出现角膜上皮水肿及角膜点状染色等,在处理不正确时,角膜上皮会发生缺损,甚至发展为迁延性溃疡.治疗的关键在于早期发现与及时正确地处理.对于有全身代谢性疾病、术前泪液异常及长期睑缘炎等情况的患者,应特别注意术后角膜上皮细胞功能障碍.

  18. Clinical Effects of Conjunctival Flap Surgery on Perforated Corneal Ulcers%结膜瓣遮盖术治疗角膜溃疡穿孔临床观察

    Institute of Scientific and Technical Information of China (English)

    郎绍文

    2012-01-01

    Objective To evaluate the therapeutic effect of conjunctival flap surgery on perforated corneal ulcers. Methods Thirteen patients(13 eyes) with perforated corneal ulcers were referred between February 2005 and August 2010. The perforation occurred in the areas of pupil in 8 patients ( 8 eyes) , in the areas of periphery in 5 patients ( 5 eyes ) . The perforations were caused by corneal ulceration in all cases. The conjunctival flap surgery was performed to cover the perforations. The healing of corneal perforation and the status of anterior chamber were observed. All patients were followed up for 3 - 12 months( mean 7. 5 months) . Results All patients were followed up for 3-12 months. All corneas ulcers were healed and normal anterior chamber depth were recovered. The visual acuity of treated eyes was improved. The vision of patients with perforations around cornea was improved to 0. 8 or higher, and of patients with perforations of center was improved to 0. 02 to 0. 40. The 0. 5 - 2. 0 mm leukomas were formed. The nebula was formed on ulcers areas of cornea. No neovascularization invading into the corneas. Conclusion The conjunctival flap surgery for the perforated corneal ulcers is helpful to the healing of corneal and the forming of anterior chamber;it can also improve the vision of patients. It is a safe, easy-operated and effective method to treat perforated corneal ulcers.%目的 探讨结膜瓣遮盖术治疗角膜溃疡穿孔的疗效.方法 选择2005年2月-2010年8月治疗角膜溃疡穿孔患者13例13眼,穿孔在角膜瞳孔区8例8眼,周边区5例5眼,穿孔原因:均为角膜溃疡所致;采用结膜瓣遮盖术治疗;观察角膜溃疡穿孔愈合情况及前房形成情况,随访3 ~12个月,平均7.5个月.结果 随访时间3~12个月,角膜溃疡愈合良好,所有病例前房均形成,治疗眼视力均有不同程度提高,其中角膜周边区穿孔视力恢复均在0.8或以上,角膜中央区穿孔视力恢复在0.02 ~0.40,

  19. Feline corneal disease.

    Science.gov (United States)

    Moore, Phillip Anthony

    2005-05-01

    The cornea is naturally transparent. Anything that interferes with the cornea's stromal architecture, contributes to blood vessel migration, increases corneal pigmentation, or predisposes to corneal edema, disrupts the corneas transparency and indicates corneal disease. The color, location, and shape and pattern of a corneal lesion can help in determining the underlying cause for the disease. Corneal disease is typically divided into congenital or acquired disorders. Congenital disorders, such as corneal dermoids are rare in cats, whereas acquired corneal disease associated with nonulcerative or ulcerative keratitis is common. Primary ocular disease, such as tear film instability, adenexal disease (medial canthal entropion, lagophthalmus, eyelid agenesis), and herpes keratitis are associated with the majority of acquired corneal disease in cats. Proliferative/eosinophilic keratitis, acute bullous keratopathy, and Florida keratopathy are common feline nonulcerative disorders. Nonprogressive ulcerative disease in cats, such as chronic corneal epithelial defects and corneal sequestration are more common than progressive corneal ulcerations.

  20. Corneal Laceration

    Medline Plus

    Full Text Available ... Intervention Retina/Vitreous Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Academy ...

  1. Corneal Laceration

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    Full Text Available ... Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Academy Publications EyeNet Ophthalmology Information for: International Ophthalmologists Media Medical Students Patients and Public Technicians and Nurses ...

  2. Corneal Laceration

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    Full Text Available ... Intervention Retina/Vitreous Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Academy ...

  3. Equine corneal stromal abscesses

    DEFF Research Database (Denmark)

    Henriksen, M. D. L.; Andersen, P. H.; Plummer, C. E.

    2013-01-01

    The last 30 years have seen many changes in the understanding of the pathogenesis and treatment of equine corneal stromal abscesses (SAs). Stromal abscesses were previously considered an eye problem related to corneal bacterial infection, equine recurrent uveitis, corneal microtrauma and corneal...

  4. Parasurgical therapy for keratoconus by riboflavin-ultraviolet type A rays induced cross-linking of corneal collagen: preliminary refractive results in an Italian study.

    Science.gov (United States)

    Caporossi, Aldo; Baiocchi, Stefano; Mazzotta, Cosimo; Traversi, Claudio; Caporossi, Tomaso

    2006-05-01

    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. Department of Ophthalmology, Siena University, Siena, Italy. 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. 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. 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.

  5. A brief history of corneal transplantation: From ancient to modern

    Directory of Open Access Journals (Sweden)

    Alexandra X Crawford

    2013-01-01

    Full Text Available This review highlights many of the fundamental concepts and events in the development of corneal transplantation - from ancient times to modern. Tales of eye, limb, and even heart transplantation appear in ancient and medieval texts; however, in the scientific sense, the original concepts of corneal surgery date back to the Greek physician Galen (130-200 AD. Although proposals to provide improved corneal clarity by surgical interventions, including keratoprostheses, were better developed by the 17 th and 18 th centuries, true scientific and surgical experimentation in this field did not begin until the 19 th century. Indeed, the success of contemporary corneal transplantation is largely the result of a culmination of pivotal ideas, experimentation, and perseverance by inspired individuals over the last 200 years. Franz Reisinger initiated experimental animal corneal transplantation in 1818, coining the term "keratoplasty". Subsequently, Wilhelmus Thorne created the term corneal transplant and 3 years later Samuel Bigger, 1837, reported successful corneal transplantation in a gazelle. The first recorded therapeutic corneal xenograft on a human was reported shortly thereafter in 1838-unsurprisingly this was unsuccessful. Further progress in corneal transplantation was significantly hindered by limited understanding of antiseptic principles, anesthesiology, surgical technique, and immunology. There ensued an extremely prolonged period of debate and experimentation upon the utility of animal compared to human tissue, and lamellar versus penetrating keratoplasty. Indeed, the first successful human corneal transplant was not performed by Eduard Zirm until 1905. Since that first successful corneal transplant, innumerable ophthalmologists have contributed to the development and refinement of corneal transplantation aided by the development of surgical microscopes, refined suture materials, the development of eye banks, and the introduction of

  6. A brief history of corneal transplantation: From ancient to modern.

    Science.gov (United States)

    Crawford, Alexandra Z; Patel, Dipika V; McGhee, Charles Nj

    2013-09-01

    This review highlights many of the fundamental concepts and events in the development of corneal transplantation - from ancient times to modern. Tales of eye, limb, and even heart transplantation appear in ancient and medieval texts; however, in the scientific sense, the original concepts of corneal surgery date back to the Greek physician Galen (130-200 AD). Although proposals to provide improved corneal clarity by surgical interventions, including keratoprostheses, were better developed by the 17(th) and 18(th) centuries, true scientific and surgical experimentation in this field did not begin until the 19(th) century. Indeed, the success of contemporary corneal transplantation is largely the result of a culmination of pivotal ideas, experimentation, and perseverance by inspired individuals over the last 200 years. Franz Reisinger initiated experimental animal corneal transplantation in 1818, coining the term "keratoplasty". Subsequently, Wilhelmus Thorne created the term corneal transplant and 3 years later Samuel Bigger, 1837, reported successful corneal transplantation in a gazelle. The first recorded therapeutic corneal xenograft on a human was reported shortly thereafter in 1838-unsurprisingly this was unsuccessful. Further progress in corneal transplantation was significantly hindered by limited understanding of antiseptic principles, anesthesiology, surgical technique, and immunology. There ensued an extremely prolonged period of debate and experimentation upon the utility of animal compared to human tissue, and lamellar versus penetrating keratoplasty. Indeed, the first successful human corneal transplant was not performed by Eduard Zirm until 1905. Since that first successful corneal transplant, innumerable ophthalmologists have contributed to the development and refinement of corneal transplantation aided by the development of surgical microscopes, refined suture materials, the development of eye banks, and the introduction of corticosteroids. Recent

  7. A brief history of corneal transplantation: From ancient to modern

    OpenAIRE

    Alexandra X Crawford; Patel, Dipika V.; Charles NJ McGhee

    2013-01-01

    This review highlights many of the fundamental concepts and events in the development of corneal transplantation - from ancient times to modern. Tales of eye, limb, and even heart transplantation appear in ancient and medieval texts; however, in the scientific sense, the original concepts of corneal surgery date back to the Greek physician Galen (130-200 AD). Although proposals to provide improved corneal clarity by surgical interventions, including keratoprostheses, were better developed by ...

  8. Clinical curative effect of conjunctival flap surgery in treatment of refractory corneal ulcer%结膜瓣遮盖术治疗难治性角膜溃疡的临床疗效

    Institute of Scientific and Technical Information of China (English)

    刘涛; 丘亮辉

    2014-01-01

    Objective To investigate the clinical effect of conjunctival flap surgery on refractory corneal ulcer.Methods A retrospective analysis was done on the 19 cases of refractory corneal ulcer who underwent conjunctival flap surgery between January 2010 and February 2013 in Meizhou people's hospital.Results The operation was successfully completed for all of the 19 patients,17 cases were cured after one time of surgery and 1 case was cured after two times of surgery,1 case was failed after several times of conjunctival flap surgery; conjunctival flap in 18 cases was thinning,became transparent gradually,the number of blood vessels reduced and fused together with cornea three months after surgery.Visual acuity of 17 cases improved in different degrees.Conclusions Conjunctival flap surgery has the advantages of simple operation,less complications,without amniotic membrane or corneal material limitations,and it can not only promote the healing of ulcer,save the eye,but also restore the vision partially,and it has a good basis for further corneal transplantation.%目的 探讨结膜瓣遮盖术治疗难治性角膜溃疡的临床疗效.方法 回顾性分析2010年1月至2013年2月期间梅州市人民医院眼科应用结膜瓣遮盖术治疗19例难治性角膜溃疡患者的病例资料.结果 19例患者均成功完成手术,角膜溃疡区均得到成功修补,17例一次手术溃疡愈合,1例二次结膜瓣遮盖术后溃疡愈合,1例多次结膜瓣遮盖术后治疗失败;术后3个月18眼结膜瓣变薄,并逐渐成为透明状,血管数量减少,与角膜融为一体.术后3个月17例视力均有不同程度改善.结论 结膜瓣遮盖术操作简单,并发症少,不受羊膜与角膜等材料的限制,对于难治性角膜溃疡不仅能够促进溃疡愈合,挽救眼球,还可部分恢复视力,为进一步的角膜移植打下良好的基础.

  9. 个性超声乳化切口并不同类型人工晶状体植入术后角膜散光和视觉质量的比较%The clinical investigation of dynamic changes of corneal astigmatism and visual quality for patients after phacoemulsification surgery through different incision and implantation of different designed intraocular lens

    Institute of Scientific and Technical Information of China (English)

    王佃科; 张杰; 王杰; 李艳; 梁山; 刘育霞

    2009-01-01

    Objective To compare the corneal astigmatism and wavefront aberration differences of patients with cataract coexisting corneal astigmatism after phacoemulsification surgery through traditional superior clear corneal incision or phacoemulsification surgery through clear corneal incision guided by corneal topography and implantation of different spherical aberration intraocular lenses (IOL). Methods In a prospective randomized sample controlled clinical trial, 90 patients (90 eyes) with age-related cataract and corneal astigmatism were randomly divided into 3 groups: (Group A) traditional superior corneal incision phacoemulsification surgery and AcrySof SN60AT IOL implantation, (Group B) corneal topography guiding incision phacoemulsification surgery and AcrySof SN60AT IOL implantation and (Group C ) corneal topography guiding incision phacoemulsification surgery and AcrySof SN60WF IOL implantation. Corneal topography tests were performed at 1 week, 1 month, 3 months and 6 months postoperatively. The Wavefront aberration was measured using a custom built Tschcming wavefront sensor--ALLEGRETTO WAVE Analyze at 90 days postoperatively. Third-, 4th-, 5th-, total and higher-order aberration (HOA) root-mean-square (RMS), spherical aberration and coma aberration were compared at virtual pupil diameters of 6 mm postoperatively. Statistical analyses were performed using the analysis of chi square test, repeated measurement data analysis of variance, one-way analysis of variance (ANOVA), and multiple comparisons Studcnts-Newman-Keuls test. Results Corneal topography tests indicated that no significant difference for corneal astigmatism was found between these three groups preoperatively( F =0. 08 ,P >0. 05). The corneal astigmatism was decomposed into J0, J45 and P with a Vector-based method, and statistically analyzed . When compared with Group B and GroupC, Group A had higher values of corneal J0 ( F = 9.54, P 0. 05 ). However groups and times had interactions ( F = 13

  10. [Low field intra-operative magnetic resonance imaging for brain tumour surgery: preliminary experience].

    Science.gov (United States)

    Roldán, Pedro; García, Sergio; González, Josep; Reyes, Luis Alberto; Torales, Jorge; Valero, Ricard; Oleaga, Laura; Enseñat, Joaquim

    Intra-operative magnetic resonance imaging (iMRI) is a recently introduced tool in the most advanced neurosurgical operating rooms worldwide. We present our preliminary experience in brain tumour surgery with low field PoleStar N30® intraoperative MRI since its introduction in 2013 in the Barcelona Clinic Hospital. A prospective non-randomised study was conducted on cases operated on using iMRI and intention of complete removal up to October 2015. A record was made of the data as regards surgical times, resection rates, histological diagnosis, hospital stay, and survival rates during follow-up. The study included 50 patients, with a mean age of 55 years (±13.7), a preoperative mean Karnofsky of 92 (being 81 post-operatively), and a mean follow-up of 10.5 months (±6.5). There were 26% re-operations due to recurrence. High-grade gliomas were reported in 56%, low-grade gliomas in 24%, and 20% "Other" tumours. Overall hospital stay was 10 days (±4.5). Depending on the histologiacl diagnosis, the "Others" group had a longer hospital stay. Overall, there were 52% complete removal, 18% of maximum removals, and 30% of partial removals. The overall survival rates during follow-up was 84%. iMRI is a safe and effective tool for brain tumour surgery. Its use allows an increase in resection rates, and minimises post-operative complications. Its implementation involves an increase in surgical time, which improves with the characteristic learning curve. More studies are needed to establish its role in the long-term survival of patients. Copyright © 2016 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. CORNEAL STROMAL THINNING: A RARE CORNEAL COMPLICATION AFTER BARE SCL ERA PTERYG I UM EXCISION TECHNIQUE

    Directory of Open Access Journals (Sweden)

    Sulaiman Abdul

    2015-06-01

    Full Text Available INTRODUCTION : Bare sclera technique without using any anti - mitotic drugs are commonly employed in rural population. Corneal dellen formation and recurrence of pterygium are more common in these cases. But the corneal complication like stromal thinning, necrosis of corne a and sclera are not common. The corneal epithelium is a highly differentiated cell type that is self - renewing. Also corneal epithelium is important for the stromal replacement in the situations like chemical, thermal burns, ocular surgery like pterygium s urgery. Interference with status of stem cell replacement and as a consequent to it, stromal thinning is occurring in the pterygium surgery. P atient 1: A 68 yr s. old male patient underwent pterygium surgery ( B aresclera excision technique. After 30 days he developed corneal thinning with the punched out partial stromal loss without perforation or descmetocele or scleral thinning. Patient 2: A 60yr s. old male patient underwent pterygium surgery 2months back, he developed same type of corneal thinning. Both P atients were treated with tear drops and improved. CONCLUSION : The stromal thinning in these two cases is may be due to chemical factors like collagenase which might have been released from the traumatised conjunctival epithelial cells causing thinning wit hout replacement of stroma by limbal stem cells.

  12. Terahertz sensing of corneal hydration.

    Science.gov (United States)

    Singh, Rahul S; Tewari, Priyamvada; Bourges, Jean Louis; Hubschman, Jean Pierre; Bennett, David B; Taylor, Zachary D; Lee, H; Brown, Elliott R; Grundfest, Warren S; Culjat, Martin O

    2010-01-01

    An indicator of ocular health is the hydrodyanmics of the cornea. Many corneal disorders deteriorate sight as they upset the normal hydrodynamics of the cornea. The mechanisms include the loss of endothelial pump function of corneal dystophies, swelling and immune response of corneal graft rejection, and inflammation and edema, which accompany trauma, burn, and irritation events. Due to high sensitivity to changes of water content in materials, a reflective terahertz (300 GHz and 3 THz) imaging system could be an ideal tool to measure the hydration level of the cornea. This paper presents the application of THz technology to visualize the hydration content across ex vivo porcine corneas. The corneas, with a thickness variation from 470 - 940 µm, were successfully imaged using a reflective pulsed THz imaging system, with a maximum SNR of 50 dB. To our knowledge, no prior studies have reported on the use of THz in measuring hydration in corneal tissues or other ocular tissues. These preliminary findings indicate that THz can be used to accurately sense hydration levels in the cornea using a pulsed, reflective THz imaging system.

  13. 角膜地形图对准分子激光屈光性手术后屈光回退的预测作用%The Prediction of regression after laser refractive surgery from corneal topography

    Institute of Scientific and Technical Information of China (English)

    陆培荣; 李龙标; 潘承思; 张济明; 张晓峰

    2001-01-01

    ObjectiveTo develop a method to predict the regression after laser refractive surgery from corneal topography.MethodsThe database of 327 eyes(176 patients)who had laser in situ keratomileusis(LASIK)or photorefractive k-eratectomy(PRK)was reviewed.There was correlation between the ratio of the clinical refractive reduction to the corneal refractive reduction(A)and the corneal refractive reduction(X):A=0.0627 X+1.153 4,r=0.602 9,P<0.001.The relationship between clinical refractive change(Y)and corneal refractive change(X)between pre- and post-operation was Y=0.062 7 X2+1.153 4 X.The relation was used to predict the regression in the follow-up.The eye was predicted to be of regression if 0.062 7 X2+1.153 4 X+0.5<the attempt refraction in any time of the follow-up.The results were compared with that of actual regression.Results309 eyes were followed up for more than 6 months,101 eyes were predicted to have regression from corneal topography,and 47 eyes of them were actual regression.There were 59 eyes of regression among 309 eyes.The predictive sensitivity was 79.66%,and the specificity was 78.40%.ConclusionIt may be clinically useful in the prediction of regression after laser refractive surgery from corneal topography.%目的建立根据角膜地形图前表面曲率变化预测准分子激光术后屈光回退的一种方法。方法根据准分子激光术后327眼手术前后角膜地形图角膜前表面曲率变化值X与临床屈光度变化值Y得出两者关系Y=0.062 7 X2+1.153 4 X,随访过程中根据X算出所矫屈光度,若预矫屈光度大于0.062 7 X2+1.153 4 X+0.5,则作为屈光回退患者,与术后实际屈光回退情况进行比较。结果随访观测309眼,实际屈光回退59眼,依本方法预测出回退的101眼中日后实际回退47眼,预测灵敏度79.66%,预测特异度78.40%。结论角膜地形图在准分子激光术后

  14. Progress in corneal wound healing.

    Science.gov (United States)

    Ljubimov, Alexander V; Saghizadeh, Mehrnoosh

    2015-11-01

    Corneal wound healing is a complex process involving cell death, migration, proliferation, differentiation, and extracellular matrix remodeling. Many similarities are observed in the healing processes of corneal epithelial, stromal and endothelial cells, as well as cell-specific differences. Corneal epithelial healing largely depends on limbal stem cells and remodeling of the basement membrane. During stromal healing, keratocytes get transformed to motile and contractile myofibroblasts largely due to activation of transforming growth factor-β (TGF-β) system. Endothelial cells heal mostly by migration and spreading, with cell proliferation playing a secondary role. In the last decade, many aspects of wound healing process in different parts of the cornea have been elucidated, and some new therapeutic approaches have emerged. The concept of limbal stem cells received rigorous experimental corroboration, with new markers uncovered and new treatment options including gene and microRNA therapy tested in experimental systems. Transplantation of limbal stem cell-enriched cultures for efficient re-epithelialization in stem cell deficiency and corneal injuries has become reality in clinical setting. Mediators and course of events during stromal healing have been detailed, and new treatment regimens including gene (decorin) and stem cell therapy for excessive healing have been designed. This is a very important advance given the popularity of various refractive surgeries entailing stromal wound healing. Successful surgical ways of replacing the diseased endothelium have been clinically tested, and new approaches to accelerate endothelial healing and suppress endothelial-mesenchymal transformation have been proposed including Rho kinase (ROCK) inhibitor eye drops and gene therapy to activate TGF-β inhibitor SMAD7. Promising new technologies with potential for corneal wound healing manipulation including microRNA, induced pluripotent stem cells to generate corneal

  15. Progress in corneal wound healing

    Science.gov (United States)

    Ljubimov, Alexander V.; Saghizadeh, Mehrnoosh

    2015-01-01

    Corneal wound healing is a complex process involving cell death, migration, proliferation, differentiation, and extracellular matrix remodeling. Many similarities are observed in the healing processes of corneal epithelial, stromal and endothelial cells, as well as cell-specific differences. Corneal epithelial healing largely depends on limbal stem cells and remodeling of the basement membrane. During stromal healing, keratocytes get transformed to motile and contractile myofibroblasts largely due to activation of transforming growth factor-β system. Endothelial cells heal mostly by migration and spreading, with cell proliferation playing a secondary role. In the last decade, many aspects of wound healing process in different parts of the cornea have been elucidated, and some new therapeutic approaches have emerged. The concept of limbal stem cells received rigorous experimental corroboration, with new markers uncovered and new treatment options including gene and microRNA therapy tested in experimental systems. Transplantation of limbal stem cell-enriched cultures for efficient re-epithelialization in stem cell deficiency and corneal injuries has become reality in clinical setting. Mediators and course of events during stromal healing have been detailed, and new treatment regimens including gene (decorin) and stem cell therapy for excessive healing have been designed. This is a very important advance given the popularity of various refractive surgeries entailing stromal wound healing. Successful surgical ways of replacing the diseased endothelium have been clinically tested, and new approaches to accelerate endothelial healing and suppress endothelial-mesenchymal transformation have been proposed including Rho kinase (ROCK) inhibitor eye drops and gene therapy to activate TGF-β inhibitor SMAD7. Promising new technologies with potential for corneal wound healing manipulation including microRNA, induced pluripotent stem cells to generate corneal epithelium, and

  16. 中国东北地区年龄相关性白内障患者角膜散光的分布情况调查%Prevalence of corneal astigmatism before cataract surgery in northeast China

    Institute of Scientific and Technical Information of China (English)

    郭作锋; 史庆成; 周衍文; 吴海娟; 李晶晶

    2016-01-01

    目的:观察和分析中国东北沈阳地区的白内障患者角膜散光的分布情况。  方法:利用回顾性研究方法观察2014年1月1日至2014年12月31日行白内障手术患者的术前角膜散光分布规律(利用IOL Master测量)。通过描述性方法分析角膜散光数据。  结果:研究包含3821名患者(平均年龄为66.36±10.38岁)4543眼。角膜散光3.0 D占8.58%。其中27.69%为顺规散光,53.84%为逆规散光。  结论:约59.46%患者的角膜散光≥1.0D。观察结果提示在白内障手术中,需要一些具有矫正散光功能的人工晶状体或特殊的手术技巧来矫正角膜散光,以保证患者术后视觉质量。%AlM: To analyze the prevalence and presentation patterns of corneal astigmatism in cataract surgery candidates of Shenyang in northeast China. METHODS:A retrospective survey was used to study the corneal astigmatism which were measured by intraocular lens( lOL) Master optical biometer before cataract surgery between Jan. 1st, 2014 and Dec. 31st, 2014. Descriptive statistics of corneal astigmatism data were analyzed. RESULTS:The keratometric data from 4 543 eyes from 3821 patients with a mean age of 66. 36±10. 38y(SD). ln 10. 50% of eyes, corneal astigmatism was between 0. 5 diopters(D) or less;in 30. 05% of eyes, it was 0. 5-1. 0 D;in 23. 60%, it was 1. 0-1. 5 D;in 13. 19%, it was 1. 5-2. 0 D;in 7. 68%, it was 2. 0-2. 5 D;in 6. 41%, it was 2. 5-3. 0 D;in 8. 58%, it was 3. 0 D or higher. With-the-rule astigmatism was found in 27. 69% of eyes, while against-the-rule was found in 53. 84% of eyes. CONCLUSlON:About 59. 46% of eyes in this study had preoperative corneal astigmatism equal to or above 1. 0 D. Findings indicated more surgical techniques or toric intraocular lenses to meet the potential demand of the cataract surgery candidates.

  17. Preliminary evaluation of a microtransesophageal probe in neonates and young infants undergoing surgery for congenital heart disease

    Directory of Open Access Journals (Sweden)

    Sreeja Pavithran

    2014-01-01

    On preliminary evaluation, the microTEE probe provided good quality images in very small infants who were not amenable for transesophageal echocardiographic evaluation so far. The probe could be used safely in small infants without complications. It appears to be a promising imaging modality in the perioperative assessment of young infants undergoing cardiac surgery, in whom intraoperative epicardial echocardiography is currently the only tool.

  18. Laser assisted robotic surgery in cornea transplantation

    Science.gov (United States)

    Rossi, Francesca; Micheletti, Filippo; Magni, Giada; Pini, Roberto; Menabuoni, Luca; Leoni, Fabio; Magnani, Bernardo

    2017-03-01

    Robotic surgery is a reality in several surgical fields, such as in gastrointestinal surgery. In ophthalmic surgery the required high spatial precision is limiting the application of robotic system, and even if several attempts have been designed in the last 10 years, only some application in retinal surgery were tested in animal models. The combination of photonics and robotics can really open new frontiers in minimally invasive surgery, improving the precision, reducing tremor, amplifying scale of motion, and automating the procedure. In this manuscript we present the preliminary results in developing a vision guided robotic platform for laser-assisted anterior eye surgery. The robotic console is composed by a robotic arm equipped with an "end effector" designed to deliver laser light to the anterior corneal surface. The main intended application is for laser welding of corneal tissue in laser assisted penetrating keratoplasty and endothelial keratoplasty. The console is equipped with an integrated vision system. The experiment originates from a clear medical demand in order to improve the efficacy of different surgical procedures: when the prototype will be optimized, other surgical areas will be included in its application, such as neurosurgery, urology and spinal surgery.

  19. SMILE术后角膜前表面非球面性与角膜高阶像差的关系%The correlation between corneal asphericity and higher order aberrations after SMILE surgery

    Institute of Scientific and Technical Information of China (English)

    苏小连; 王雁

    2014-01-01

    Objective To evaluate the characteristics of anterior corneal asphericity and higher order aberrations after SMILE surgery,and to analyze the correlation between them.Methods In this prospective study,41 subjects who underwent SMILE surgery were enrolled with right eyes selected for the study.The asphericity coefficient Q-value at diameters of 6,7,8 and 9 mm and total higher order aberrations (HOA),spherical aberrations (Z40),secondary spherical aberrations (Z60),vertical coma (Z3-1),horizontal coma (Z31),y-trefoil (Z3-3) and x-trefoil (Z33) of the cornea were measured before surgery and 3 months following the surgery.A paired-samples t test and Pearson correlation were used for analysis.Results All Q-values increased from negative to positive after SMILE surgery and the differences were statistically significant (t=-23.558,-26.661,-28.366,-28.788,P<0.01).Corneal HOA,Z40,Z60,Z3-1 and Z31 increased and the differences were statistically significant as well (t=-11.815,-11.813,-16.209,6.470,4.835,P<0.01).However,the change in Z3-3 or Z33 was not significant (t=0.278,-1.064,P>0.05).Among corneal higher order aberrations,a linear correlation was found between the Q-value and corneal HOA,Z40 and Z3-t before surgery (P<0.05).The change in corneal HOA and Z40 had a positive linear correlation with the Q-value at each diameter (HOA:r=0.554,0.480,0.416,0.352,P<0.05; Z40:r=0.671,0.577,0.495,0.395,P<0.05).The difference in Z3-1 had a positive linear correlation with the Q-values at diameters 6 and 7 mm (r=0.377,0.342,P<0.05).The difference in Z31 had a positive linear correlation with the Q-values at diameters 6,7 and 8 mm (r=0.436,0.385,0.316,P<0.05).No linear correlation was found between the changes in the Q-values at each diameter and those of Z3 3,Z33 or Z60 (P>0.05).There was not a linear correlation between the change in the Q-values and lens diameter (P>0.05).Lens diameter had a negative linear correlation with the changes in HOA and Z40 (r=-0

  20. Corneal transplant - discharge

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000243.htm Corneal transplant - discharge To use the sharing features on this page, please enable JavaScript. You had a corneal transplant. Most of the tissue of your cornea (the ...

  1. Non-genetic direct reprogramming and biomimetic platforms in a preliminary study for adipose-derived stem cells into corneal endothelia-like cells.

    Directory of Open Access Journals (Sweden)

    Ying Dai

    Full Text Available Cell fate and function can be regulated and reprogrammed by intrinsic genetic program, extrinsic factors and niche microenvironment. Direct reprogramming has shown many advantages in the field of cellular reprogramming. Here we tried the possibility to generate corneal endothelia (CE -like cells from human adipose-derived stem cells (ADSCs by the non-genetic direct reprogramming of recombinant cell-penetrating proteins Oct4/Klf4/Sox2 (PTD-OKS and small molecules (purmorphamine, RG108 and other reprogramming chemical reagents, as well as biomimetic platforms of simulate microgravity (SMG bioreactor. Co-cultured with corneal cells and decellularized corneal ECM, Reprogrammed ADSCs revealed spherical growth and positively expressing Nanog for RT-PCR analysis and CD34 for immunofluorescence staining after 7 days-treatment of both purmorphamine and PTD-OKS (P-OKS and in SMG culture. ADSCs changed to CEC polygonal morphology from spindle shape after the sequential non-genetic direct reprogramming and biomimetic platforms. At the same time, induced cells converted to weakly express CD31, AQP-1 and ZO-1. These findings demonstrated that the treatments were able to promote the stem-cell reprogramming for human ADSCs. Our study also indicates for the first time that SMG rotary cell culture system can be used as a non-genetic means to promote direct reprogramming. Our methods of reprogramming provide an alternative strategy for engineering patient-specific multipotent cells for cellular plasticity research and future autologous CEC replacement therapy that avoids complications associated with the use of human pluripotent stem cells.

  2. Comparative Analysis of High-Order Aberration After Different Corneal Refractive Surgeries%不同角膜屈光手术后高阶像差情况对比分析

    Institute of Scientific and Technical Information of China (English)

    聂新钢; 黄琰霞

    2016-01-01

    Objective To investigate the characteristic changes of high-order aberration (HOA) after different corneal refractive surgeries.Methods120 cases of patients with 236-eyes myopia and myopic astigmatism admitted into our hospital from June 2015 to December 2015, including 37 cases of 73-eyes received LASIK (A group), 40 cases of 78-eyes received FS-LASIK (B group), 43 cases of 85-eyes received FLEx (C group), compared 1 mo of cornea of HOA before and after surgeries of three groups.Results Comparing HOA of three groups before and after surgeries, there was statistical signiifcance (P<0.05), The vertical coma aberration of A and B groups, compared with that of C group, there was statistical significance (P<0.05).Conclusion HOA is increased signiifcantly after different corneal refractive surgeries, but FLEx surgery does not show obvious advantage because of the inlfuence of incision.%目的:探究不同角膜屈光手术后高阶像差(HOA)的特征性变化。方法选取我院2015年6~12月收治的120例236眼近视及近视散光患者,其中行LASIK(准分子激光原位角膜磨镶术)37例73眼(A组),行FS-LASIK(飞秒激光制瓣的LASIK)40例78眼(B组)B组,行FLEx(全飞秒激光FLEx)43例85眼(C组),对比三组手术前后1mo的角膜HOA。结果手术前后三组HOA相比,差异有统计学意义(P<0.05);A、B两组与C组相比,差异有统计意义(P<0.05)。结论不同角膜屈光手术后HOA均明显增加,而FLEx术因切口影响,未表现出明显优势。

  3. 角膜屈光手术后人工晶状体度数计算的误差及矫正%Error sources and correction of intraocular lens power calculation after corneal refractive surgery

    Institute of Scientific and Technical Information of China (English)

    徐柏升; 顾扬顺

    2013-01-01

    As the increasing popularity of corneal refractive surgery and the aging of the society population,it presents a major challenge in accurate calculation of intraocular lens (IOL) power in cataract patients with prior refractive surgery.To cope with this situation,great efforts have been made to reveal the sources of calculation error and available corrective process.Essentially,the instrument error,the keratometer index error and the IOL formula error are considered to be the main three sources,whereas other biometric measurements (e.g.axial length) contribute slightly.Numerous established algorithms aim to reduce I0L prediction error mainly through postoperative corneal power correction or direct adjustment of calculated IOL power.However,it presents a confusing of the variety of procedures and formulas for the controversy of optimal choice still going on,so it is important to make comprehensive consideration of reliable historic material,physician's experience,and patient' s expectation when faced with this issues clinically.%如何准确计算角膜屈光手术后白内障患者的人工晶状体(intraocular lens,IOL)度数是常见的临床问题.常规的IOL计算误差主要来源于仪器检测误差、屈光指数误差和公式计算误差,解决方法主要是通过矫正屈光术后角膜屈光度,或直接矫正IOL计算值来减小预测误差.各种方法的临床应用准确性仍存在一些争议,临床医生应根据自己掌握的资料、临床经验和患者的期望选择合适的计算方法.

  4. Management of corneal bee sting

    Directory of Open Access Journals (Sweden)

    Razmjoo H

    2011-12-01

    Full Text Available Hassan Razmjoo1,2, Mohammad-Ali Abtahi1,2,4, Peyman Roomizadeh1,3, Zahra Mohammadi1,2, Seyed-Hossein Abtahi1,3,41Medical School, Isfahan University of Medical Sciences (IUMS; 2Ophthalmology Ward, Feiz Hospital, IUMS; 3Isfahan Medical Students Research Center (IMSRC, IUMS; 4Isfahan Ophthalmology Research Center (IORC, Feiz Hospital, IUMS, Isfahan, IranAbstract: Corneal bee sting is an uncommon environmental eye injury that can result in various ocular complications with an etiology of penetrating, immunologic, and toxic effects of the stinger and its injected venom. In this study we present our experience in the management of a middle-aged male with a right-sided deep corneal bee sting. On arrival, the patient was complaining of severe pain, blurry vision with acuity of 160/200, and tearing, which he had experienced soon after the injury. Firstly, we administered conventional drugs for eye injuries, including topical antibiotic, corticosteroid, and cycloplegic agents. After 2 days, corneal stromal infiltration and edema developed around the site of the sting, and visual acuity decreased to 100/200. These conditions led us to remove the stinger surgically. Within 25 days of follow-up, the corneal infiltration decreased gradually, and visual acuity improved to 180/200. We suggest a two-stage management approach for cases of corneal sting. For the first stage, if the stinger is readily accessible or primary dramatic reactions, including infiltration, especially on the visual axis, exist, manual or surgical removal would be indicated. Otherwise, we recommend conventional treatments for eye injuries. Given this situation, patients should be closely monitored for detection of any worsening. If the condition does not resolve or even deteriorates, for the second stage, surgical removal of the stinger under local or generalized anesthesia is indicated.Keywords: bee sting, stinger, cornea, removal, management, surgery

  5. [Surgery treatment of vast abdominal hernias with application of unpressed syntetic mesh--preliminary communications].

    Science.gov (United States)

    Waz, Krzyszrof; Buczynowska, Mirosława; Cienciała, Antoni; Friediger, Jerzy; Topa, Jacek; Steczko-Sieczkowska, Małgorzata; Kisiel, Andrzej; Pedziwiatr, Wiesław; Gotfryd-Bugajska, Katarzyna

    2008-01-01

    This presentation present outcome of surgery treatment of vast abdominal hernias occurred in 9 patients with application of unpressed synthetic mesh: Gore-Dualmesh and SurgimeshVN. All of operated hernias was complications post previous surgery. Surgery perfomed by 5 male and 4 female patients. One of implanted mesh was removed due to faecal fistula. Patients were followed for 2 to 12 month.

  6. Rigid gas-permeable contact lens fitting after corneal refractive surgery%透气硬性角膜接触镜在角膜屈光手术后的应用

    Institute of Scientific and Technical Information of China (English)

    李军; 栗莉; 马莹; 亢晓丽

    2011-01-01

    目的 观察透气硬性角膜接触镜(Rigid Gas-permeableContactlenses,RGP)在角膜屈光手术后矫正视力、改善视觉症状的效果.方法 眼科视光门诊中做过近视性角膜屈光手术的患者7例1 1只眼,经常规检查后,予验配多种设计的RGP,记录戴镜前的裸眼视力、框架镜最佳矫正视力和戴RGP的最佳矫正视力.记录部分患者戴RGP前后的波前像差.随访过程中记录配戴情况及并发症.结果 该组患者需要三种设计的RGP镜片:圆锥角膜RGP、逆几何RGP和大直径非球面RGP.戴RGP前裸眼视力在0.03~0.4者7只眼,0.8~1.0者4只眼.戴RGP前的框架镜最佳矫正视力在0.2~0.5者5只眼,0.7~1.0者6只眼.戴RGP的最佳矫正视力在0.7~0.9者4只眼,1.0者7只眼.配戴RGP后的球差、彗差和三叶草差分别较配戴前降低88.7%、92.9%和18.9%.全部患者的视觉症状在配戴RGP后均改善.角膜上皮染色是最常见的并发症,主要是圆锥角膜的锥顶部上皮磨损染色.平均随访21.5月,全部患者能够坚持日间配戴.结论 角膜屈光手术后配戴特殊设计的RGP可以提高视力,改善视觉质量.未见严重地角膜接触镜相关的并发症.%Objective To evaluate the efficacy of specially designed rigid gas-permeable contact lenses (RGP) in visual correction and visual symptom control after corneal refractive surgery. Methods Eleven eyes of 7 cases after myopic corneal refractive surgery from optometry clinic were fitted with RGP in different designs after routine eye checks. Uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA) before RGP fitting and best contact lens corrected visual acuity (BCLCVA) after RGP fitting were recorded. Wave front aberrations of some patients before and after RGP fitting were measured. Fitting state and complications were recorded at follow-ups. Results Three kinds of lens design were applied: keratoconic design, reverse geometry design and aspheric design

  7. Corneal layer plate removal with Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis

    Directory of Open Access Journals (Sweden)

    Li-Dong Yang

    2013-08-01

    Full Text Available AIM: To investigate the clinical effect of corneal layer plate removal with Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis.METHODS: There were 168 cases suffered keratomycosis that the focus located shallow of the cornea and was not obvious to drug, who registered in our hospital from March 2005 to June 2010. In surgery we removed plate layer to cormea clear, the region was greater than focus for 0.5mm,then we injected fluconazole which is 2g/L density in corneal stroma to make the edema area greater than Removal of area for 0.5mm. At last we took pedicle conjunctival flap to cover the plant bed by continuous suture. Postoperative day use drug to drop eye and to observe that whether recurrent of the keratomycosis and how was the edema degrade, the blood supply of conjunctival graft pieces, how about the stimulating signs of the surgery eye, the vision.RESULTS: The improvement rate was 96.2% after surgery for seven days and the cure rate was 95.5% after surgery for one months. We found in 157 eyes accepted trigeminy surgery there were 6 eyes recurrence and the recurrence rate was 3.8%. The mean time of corneal stromal edema faded away was 13.4 hours. After surgery for one month there were 39 eyes(24.8%whose vision removed than preoperative, there were 91 eyes(58.0%whose vision were same as preoperative and there were 27 eyes(17.2%whose vision lower than preoperative. In these operations the loss ratio of corneal endothelium was from 0%-8%, the mean was 2.9%. The irritative symptoms postoperative were mild for 87%, moderate for 10% and severe for 3%. By this surgery the mean length of stay was 7.3 days so the mean hospitalization expenses only were 2160 RMB. Three months after surgery, 4 cases were slight corneal ectasia.CONCLUSION: This operation combined corneal layer plate removal, Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis which was in

  8. Corneal heat scar caused by photodynamic therapy performed through an implanted corneal inlay.

    Science.gov (United States)

    Mita, Mariko; Kanamori, Tomomi; Tomita, Minoru

    2013-11-01

    A 60-year-old man had a combination of laser in situ keratomileusis and Kamra corneal inlay implantation to correct presbyopia. Although the outcome was favorable postoperatively, central serous chorioretinopathy was observed in the left eye along with a decrease in the uncorrected (UDVA) and corrected (CDVA) distance visual acuities and the corrected near visual acuity (CNVA). Photodynamic therapy (PDT) was later performed in a university hospital. After PDT, the patient experienced a decline in the visual acuity and came to our clinic a month after the PDT. Degeneration and a scar were observed at the location of the inlay due to the heat and burning. Flattening of the corneal topography was also observed where the corneal scar was located, along with a significant decrease in CDVA in the left eye. Prior to any surgery in which the corneal inlay is an impediment, surgeons should take advantage of the reversibility of the Kamra inlay by explanting the inlay.

  9. Tectonic deep anterior lamellar keratoplasty in impending corneal perforation using cryopreserved cornea.

    Science.gov (United States)

    Jang, Ji Hye; Chang, Sung Dong

    2011-04-01

    We report a case of tectonic corneal transplantation for impending corneal perforation to preserve anatomic integrity using cryopreserved donor tissue. An 82-year-old woman exhibiting impending corneal perforation suffered from moderate ocular pain in the left eye for one week. After abnormal tissues around the impending perforation area were carefully peeled away using a Crescent blade and Vannas scissors, the patient received tectonic deep anterior lamellar keratoplasty using a cryopreserved cornea stored in Optisol GS® solution at -70℃ for four weeks. At six months after surgery, the cornea remained transparent and restored the normal corneal thickness. There were no complications such as corneal haze or scars, graft rejection, recurrent corneal ulcer, and postoperative rise of intraocular pressure. Cryopreserved donor lamellar tissue is an effective substitute in emergency tectonic lamellar keratoplasty, such as impending corneal perforation and severe necrotic corneal keratitis.

  10. OrbscanⅡ在准分子激光角膜屈光手术中应用的研究%Clinical application of Orbscan Ⅱ in excimer laser corneal refractive surgery

    Institute of Scientific and Technical Information of China (English)

    王巧玲; 史艳艳; 孟利娟; 王珊珊; 马文霞; 牛秋忠; 潘丽萍; 张爱武

    2011-01-01

    目的 评价OrbscanⅡ在准分子激光角膜屈光手术中的应用价值.方法 对拟行准分子激光手术的600例(1196眼),术前行Orbscan Ⅱ检查,以排除圆锥角膜、可疑圆锥角膜及中央角膜厚度过薄不适宦行LASIK手术者;术后检查200例(400眼),了解有无偏心切削、中央岛等情况.结果 术前查出圆锥角膜(5例)10眼,占0.84%;角膜偏薄56眼,占4.68%.术后查出偏心切削9眼,占2.25%,未发现中央岛.结论 OrbscanⅡ是角膜屈光手术前重要的检查手段,对手术方案的设计及术后效果的评价提供了重要依据.[1]%Objective To appraise the applied value about Orbscan Ⅱ in excimer laser corneal refractive surgery. Methods Orbscan Ⅱ was uesd in 600 cases (1196 eyes) to screen the patients who were not suitable for LASIK,including keratoconus,suspected keratoconus and the patients whose central corneal thickness were too thin. Two handred postoperative cases (400 eyes) were checked using Orbscan Ⅱ to examine the eccentric cutting,the central island and so on. Results 5 cases( 10 eyes) of keratoconus and 56 eyes with thin corneal thickness were found,each percentage were 0. 84% and 4. 68%. 9 eyes(2. 25% ) of eccentric cutting were checked,and none central island. Conclusion As an important preoperative examination , Orbscan Ⅱ measurement provides important basis for designation of the surgical treatment and postoperative evaluation of efficacy.

  11. Meta-analysis of corneal sensitivity after femtosecond LASIK and SMILE surgery%飞秒激光制瓣的LASIK与SMILE术后角膜敏感性变化的Meta分析

    Institute of Scientific and Technical Information of China (English)

    金男; 方一明; 李晓霞; 姚鹏翔; 王振亮; 蒋建伟

    2014-01-01

    literature met the inclusion criteria Meta analysis results showed that there was no difference in central corneal sensitivity between FS-LASIK and SMILE before surgery (WMD=0.28,95%CI:-0.73~ 1.29,P>0.05); however,1 week,1 month,3 months and 6 months after surgery,corneal sensitivity after SMILE was significantly higher than after FS-LASIK (WMD=-14.56,95%CI:-23.79~-5.34,P< 0.01; WMD=-15.29,95%CI:-22.46~-8.11,P<0.01; WMD=-13.12,95%CI:-18.77~-7.46,P<0.01;WMD=-3.45,95%CI:-5.72~-1.18,P<0.01).Conclusion Compared with FS-LASIK,central corneal sensitivity after SMILE has a smaller decrease and faster recovery.Corneal sensitivity after SMILE is still higher than FS-LASIK during the 6-month period after surgery.

  12. Corneal mucus plaques.

    Science.gov (United States)

    Fraunfelder, F T; Wright, P; Tripathi, R C

    1977-02-01

    Corneal mucus plaques adhered to the anterior corneal surface in 17 of 67 advanced cases of keratoconjunctivitis sicca. The plaques were translucent to opaque and varied in size and shape, from multiple isolated islands to bizarre patterns involving more than half the corneal surface. Ultrastructurally, they consisted of mucus mixed with desquamated degenerating epithelial cells and proteinaceous and lipoidal material. The condition may be symptomatic but can be controlled and prevented in most cases by topical ocular application of 10% acetylcysteine.

  13. Changes in corneal sensitivity following cross-linking for progressive early-stage keratoconus

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    Anelise de Medeiros Lago

    2014-04-01

    Full Text Available Purpose: To evaluate changes in corneal sensitivity following corneal cross-linking (CXL in patients with progressive earlier stage keratoconus. Methods: Thirty-eight eyes of 19 patients (11 women, 8 men were included in a prospective, nonrandomized clinical study. The mean patient age was 22 years (range, 18-26 years. Inclusion criteria were early stage bilateral progressive keratoconus, a transparent cornea, and a thickness of ≥440 µm in the thinnest area of the cornea. Using the Cochet-Bonnet esthesiometer, central corneal sensitivity was measured before surgery, 7 days after surgery, and once a month thereafter until recovery of baseline preoperative levels. Central corneal sensitivity >40 mm was considered normal. Results: Corneal sensitivity gradually returned to preoperative levels in all treated eyes. The mean central corneal sensitivity was 52.2, 24.0, 38.2, 42.5, 50.0, and 52.5 mm before surgery, 7 days after surgery, and at 1, 2, 3, and 4 months after surgery, respectively. Normal levels of corneal sensation, but not baseline (preoperative levels, were observed 2 months after surgery. The preoperative levels were observed 3 months after surgery. Conclusions: Our results suggest that central corneal sensitivity can be decreased for as long as 3 months after CXL for progressive earlier stage keratoconus.

  14. The Influence of Soft Contact Lens Wear and Two Weeks Cessation of Lens Wear on Corneal Curvature

    OpenAIRE

    Lloyd McKernan, Aoife; O'Dwyer, Veronica; Simo Mannion, Luisa

    2014-01-01

    Abstract Introduction Accurate corneal measurements are crucial in corneal refractive surgery (CRS) to ensure successful outcomes. Soft contact lens (SCL) wear may result in changes to corneal curvature and structure. United States Food and Drug Administration (FDA) pre-operative guidelines recommend that prior to CRS, SCL wearers cease SCL wear for “at least two weeks before examination and treatment”[1]. Corneal curvature changes induced by SCL wear may take longer than two weeks to reso...

  15. Characterization of Corneal Indentation Hysteresis.

    Science.gov (United States)

    Ko, Match W L; Dongming Wei; Leung, Christopher K S

    2015-01-01

    Corneal indentation is adapted for the design and development of a characterization method for corneal hysteresis behavior - Corneal Indentation Hysteresis (CIH). Fourteen porcine eyes were tested using the corneal indentation method. The CIH measured in enucleated porcine eyes showed indentation rate and intraocular pressure (IOP) dependences. The CIH increased with indentation rate at lower IOP ( 25 mmHg). The CIH was linear proportional to the IOP within an individual eye. The CIH was positively correlated with the IOP, corneal in-plane tensile stress and corneal tangent modulus (E). A new method based on corneal indentation for the measurement of Corneal Indentation Hysteresis in vivo is developed. To our knowledge, this is the first study to introduce the corneal indentation hysteresis and correlate the corneal indentation hysteresis and corneal tangent modulus.

  16. 2-YEAR EXPERIENCE OF CORNEAL COLLAGEN CROSSLINKING IN KERATOCONUS TREATMENT

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    D. D. Dement’ev

    2015-01-01

    Full Text Available Aim. To assess reliability, efficacy, and stability of corneal collagen crosslinking (CXL results for stage I‑II keratoconus.Patients and methods. 2‑year (2012-2014 results of CXL were analyzed. CXL was performed on 20 eyes of 15 patients (13 men and 2 women, mean age 31 years. Stage 1 keratoconus was diagnosed in 13 eyes, stage 2 keratoconus was diagnosed in 2 eyes. Primary stage 1‑2 keratoconus was diagnosed in 17 eyes, keratoconus after corneal refractive surgery (LASIK, radial keratotomy was diagnosed in 3 eyes. Preoperative and postoperative examination included uncorrected (UCVA and best-corrected (BCVA visual acuity measurement, pachymetry, corneal topography (total astigmatism measurement, and biomicroscopy. Follow-up period varied from 1 to 24 months.Results. All patients reported on vision improvement. Preoperatively, mean UCVA and BCVA were 0.4 and 0.64, respectively. Postoperatively, mean UCVA and BCVA were 0.49 and 0.66, respectively. Preoperatively and postoperatively, total astigmatism was 2.1 D and 2.0 D, respectively, while mean central corneal thickness was 454 μm and 447 μm, respectively.Conclusions. Corneal collagen crosslinking for stage 1‑2 keratoconus provides mild UCVA and BCVA improvement, decrease in total astigmatism and central corneal thickness. CXL provides stable results of treatment of primary stage 1‑2 keratoconus and keratoconus after corneal refractive surgery

  17. Genomics of corneal wound healing: a review of the literature.

    Science.gov (United States)

    Maycock, Nick J R; Marshall, John

    2014-05-01

    Corneal wound healing is a complex process: its mechanisms and the underlying genetic control are not fully understood. It involves the integrated actions of multiple growth factors, cytokines and proteases produced by epithelial cells, stromal keratocytes, inflammatory cells and lacrimal gland cells. Following an epithelial insult, multiple cytokines are released triggering a cascade of events that leads to repair the epithelial defect and remodelling of the stroma to minimize the loss of transparency and function. In this review, we examine the literature surrounding the genomics of corneal wound healing with respect to the following topics: epithelial and stromal wound healing (including inhibition); corneal neovascularisation; the role of corneal nerves in wound healing; the endothelium; the role of aquaporins and aptamers. We also examine the effect of ectasia on corneal wound healing with regard to keratoconus and following corneal surgery. A better understanding of the cellular and molecular changes that occur during repair of corneal wounds will provide the opportunity to design treatments that selectively modulate key phases of the healing process resulting in scars that more closely resemble normal corneal architecture.

  18. A PRELIMINARY STUDY FOR SIX SIGMA IMPLEMENTATION IN LASER IN SITU KERATOMILEUSIS (LASIK SURGERIES

    Directory of Open Access Journals (Sweden)

    Mehmet Tolga Taner

    2014-01-01

    Full Text Available The purpose of this study is to show how a private eye care center in Turkey developed a Six Sigma infrastructure to investigate the root causes of complications occuring during LASIK surgeries. To analyze the collected data, main tools of Six Sigma’s Define-Measure-Analyze-Improve-Control(DMAIC improvement cycle such as SIPOC table, Fishbone Diagram and, Failure, Mode and Effect Analysis were implemented. Experience of the refractive surgeons, type of microkeratome and hygiene of microkeratome were identified to be Critical-to-Quality (CTQ factors for a successful LASIK surgery. The most frequent complications of LASIK surgeries were found to be dry eye syndrome, subconjunctival haemorrhage and flap edge melt. The process sigma level was found to be 3.7135.

  19. Stereotaxic gamma knife surgery in treatment of critically located pilocytic astrocytoma: preliminary result

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    Hafez Raef FA

    2007-03-01

    Full Text Available Abstract Background Low-grade gliomas are uncommon primary brain tumors, located more often in the posterior fossa, optic pathway, and brain stem and less commonly in the cerebral hemispheres. Case presentations Two patients with diagnosed recurrent cystic pilocytic astrocytoma critically located within the brain (thalamic and brain stem were treated with gamma knife surgery. Gamma knife surgery (GKS did improve the patient's clinical condition very much which remained stable later on. Progressive reduction on the magnetic resonance imaging (MRI studies of the solid part of the tumor and almost disappearance of the cystic component was achieved within the follow-up period of 36 months in the first case with the (thalamic located lesion and 22 months in the second case with the (brain stem located lesion. Conclusion Gamma knife surgery represents an alternate tool in the treatment of recurrent and/or small postoperative residual pilocytic astrocytoma especially if they are critically located

  20. Stereotaxic gamma knife surgery in treatment of critically located pilocytic astrocytoma: preliminary result

    Science.gov (United States)

    Hafez, Raef FA

    2007-01-01

    Background Low-grade gliomas are uncommon primary brain tumors, located more often in the posterior fossa, optic pathway, and brain stem and less commonly in the cerebral hemispheres. Case presentations Two patients with diagnosed recurrent cystic pilocytic astrocytoma critically located within the brain (thalamic and brain stem) were treated with gamma knife surgery. Gamma knife surgery (GKS) did improve the patient's clinical condition very much which remained stable later on. Progressive reduction on the magnetic resonance imaging (MRI) studies of the solid part of the tumor and almost disappearance of the cystic component was achieved within the follow-up period of 36 months in the first case with the (thalamic located lesion) and 22 months in the second case with the (brain stem located lesion). Conclusion Gamma knife surgery represents an alternate tool in the treatment of recurrent and/or small postoperative residual pilocytic astrocytoma especially if they are critically located PMID:17394660

  1. A comparison between keratoconus and normal population based corneal endothelium

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    Mohamad Aghazade Amiri

    2015-07-01

    Conclusion: Keratoconus does not have any considerable effect on cell density, polymegethism and pleomorphism, in mild and moderate stages and corneal opacity risk caused by intraocular surgeries (such as: Cataract or Glaucoma surgeries and some diseases (such as diabetes and uveitis is similar in keratoconic and normal eyes.

  2. Methylene blue-related corneal edema and iris discoloration.

    Science.gov (United States)

    Timucin, Ozgur Bulent; Karadag, Mehmet Fatih; Aslanci, Mehmet Emin; Baykara, Mehmet

    2016-04-01

    We report the case of a 70-year-old female patient who developed corneal edema and iris discoloration following the inadvertent use of 1% methylene blue instead of 0.025% trypan blue to stain the anterior capsule during cataract phacoemulsification surgery. Copious irrigation was performed upon realization of incorrect dye use. Corneal edema and iris discoloration developed during the early postoperative period and persisted at 24-months follow-up. However, keratoplasty was not required. The intracameral use of 1% methylene blue has a cytotoxic effect on the corneal endothelium and iris epithelium. Copious irrigation for at least 30 min using an anterior chamber maintainer may improve outcomes.

  3. Comparison of higher-order aberrations after three different corneal refractive surgeries%三种不同角膜屈光手术后高阶像差的变化特征

    Institute of Scientific and Technical Information of China (English)

    赵静静; 王锐; 付梦军; 陈元兵

    2016-01-01

    Abstract• AIM: To assess the changes on higher -order aberrations( HOA ) after three different corneal refractive surgeries, including laser-assisted in situ keratomileusis ( LASIK ) , femtosecond LASIK ( FS -LASIK ) and femtosecond lenticule extraction ( FLEx) .•METHODS:One hundred and twenty-five patients ( 245 eyes) from June 2014 to March 2015 in refractive surgery center of our hospital were recruited. There were 38 patients ( 74 eyes ) underwent LASIK, 42 patients ( 83 eyes) underwent FS-LASIK, and 45 patients ( 88 eyes ) underwent FLEx. The higher -order aberrations were measured preoperatively, at 1mo after surgeries with iTrace.The repeated measure of ANOVA was used to analyze the changes on higher-order aberrations among the groups.•RESULTS:Compared to the preoperative corneal higher-order aberrations, vertical coma aberration, horizontal coma aberration and spherical aberration, there were significantly differences in the three groups postoperatively(P=0.002, 0.05).But it showed difference on vertical coma aberration ( F =3.943, P =0.021 ). By multiple comparisons, there were statistical significance on vertical coma aberration between FLEx group and the other two.•CONCLUSION: The postoperative corneal higher-order aberrations all in creased in three groups. Due to the large incision in FLEx, the corneal aberration is still increased after surgeries.And the FLEx does not show a certain advantage yet.%目的:对行准分子激光原位角膜磨镶术( laser in situ keratomileusis, LASIK )、飞秒激光制瓣的 LASIK (femtosecond laser LASIK,FS-LASIK)及全飞秒激光基质内透镜取出术(refracive lenticule extraction,ReLEx)包括femtosecond lenticule extraction ( FLEx )手术患者术后高阶像差进行测量,并研究其特征性变化。方法:收集2014-06/2015-03就诊于我院屈光手术中心的近视及近视散光患者共125例245眼,其中行LASIK术38例74

  4. Current status of corneal xenotransplantation.

    Science.gov (United States)

    Kim, Mee Kum; Hara, Hidetaka

    2015-11-01

    Corneal allo-transplantation is a well-established technique to treat corneal blindness. However, the limited availability of human donors demands the exploration of alternative treatments such as corneal xenotransplantation (e.g., pigs as donors) and bioengineered corneas. Since the first attempt of corneal xenotransplantation using a donor pig cornea in 1844, great advances have been made in the development of genetically-engineered pigs, effective immunosuppressive protocols and the establishment of guidelines for the conduction of clinical trials. We highlight immunological and physio-anatomical barriers of corneal xenotransplantation, recent progress of corneal xenotransplantation in non-human-primates studies, and regulatory guidelines to conduct clinical trials for corneal xenotransplantation.

  5. Corneal Viscoelastic Properties from Finite-Element Analysis of In Vivo Air-Puff Deformation

    Science.gov (United States)

    Kling, Sabine; Bekesi, Nandor; Dorronsoro, Carlos; Pascual, Daniel; Marcos, Susana

    2014-01-01

    Biomechanical properties are an excellent health marker of biological tissues, however they are challenging to be measured in-vivo. Non-invasive approaches to assess tissue biomechanics have been suggested, but there is a clear need for more accurate techniques for diagnosis, surgical guidance and treatment evaluation. Recently air-puff systems have been developed to study the dynamic tissue response, nevertheless the experimental geometrical observations lack from an analysis that addresses specifically the inherent dynamic properties. In this study a viscoelastic finite element model was built that predicts the experimental corneal deformation response to an air-puff for different conditions. A sensitivity analysis reveals significant contributions to corneal deformation of intraocular pressure and corneal thickness, besides corneal biomechanical properties. The results show the capability of dynamic imaging to reveal inherent biomechanical properties in vivo. Estimates of corneal biomechanical parameters will contribute to the basic understanding of corneal structure, shape and integrity and increase the predictability of corneal surgery. PMID:25121496

  6. The Effect of Corneal Epithelium on Corneal Curvature in Patients with Keratoconus.

    Science.gov (United States)

    Akcay, Emine Kalkan; Uysal, Betul Seher; Sarac, Ozge; Ugurlu, Nagehan; Yulek, Fatma; Cagil, Nurullah; Aslan, Nabi

    2015-01-01

    To investigate the effects of corneal epithelium on corneal curvature in patients with keratoconus. This is a prospective, nonrandomized study. Fifty-nine eyes of 47 patients diagnosed as keratoconus and for whom corneal collagen crosslinking (CXL) was recruited in this study. This study is a single-center clinical trial. Pregnancy, lactation, connective tissue disease, corneal thickness below 350 μm, severe dry eyes, or scar of corneal surgery were exclusion criteria. Before and during CXL procedure after removing the corneal epithelium, maximum values of corneal apical curvature, simulated keratometry 1 (Sim-K1), simulated keratometry 2 (Sim-K2), temporal and inferior curvature values, all of which are 1.5 mm from the corneal center, were calculated. These values before and after removal of epithelium were compared statistically. Mean age of patients was 23.30 ± 5.5 (12-38) years. Twenty-eight (59%) were male while 19 (41%) were female. Mean values measured before and after removing the corneal epithelium were: apical curvature; 59.19 ± 7.2 (47.06-82.40) diopter (D) and 61.70 ± 8.8 (49.19-92.66) D (p = 0.001), SimK1; 47.57 ± 4.3 (39.14-64.57) D and 48.23 ± 4.3 (41.89-66.70) D (p = 0.001), SimK2; 52.04 ± 5.3 (43.56-69.34) D and 53.34 ± 5.6 (43.73-70.89) D (p = 0.001), inferior curvature; 53,85 ± 5.2 (43.47-76.56) D and 55.05 ± 5.8 (44.56-81.93) D (p = 0.002), temporal curvature 49.49 ± 5.1 (41.50-71.03) D and 51.53 ± 5.4 (41.58-73.34) D (p = 0.001), respectively. In keratoconus patients during CXL treatment, after removing the corneal epithelium, more steepness is detected in the curvature of the steeper area of the cornea. When evaluating patients with keratoconus, the masking effect of corneal epithelium on values of curvature should be taken into consideration.

  7. The role of rehabilitative camouflage after cervicofacial reconstructive surgery: a preliminary study

    Directory of Open Access Journals (Sweden)

    Nicoletti G

    2014-01-01

    Full Text Available Giovanni Nicoletti,1–3 Andrea Sasso,1 Alberto Malovini,4,5 Luisa Ponchio,6 Silvia Scevola,2 Angela Faga,1–3 Aldo Pontone1 1Plastic and Reconstructive Surgery, Department of Clinical Surgical Diagnostic and Pediatric Sciences, 2Advanced Technologies for Regenerative Medicine and Inductive Surgery Research Centre, University of Pavia, Pavia, Italy; 3Plastic and Reconstructive Surgery Unit, Salvatore Maugeri Research and Care Institute, Pavia, Italy; 4Department of Computer Engineering and Systems Science, University of Pavia, Pavia, Italy; 5Laboratory of Informatics and Systems Engineering for Clinical Research, 6Oncology Unit, Salvatore Maugeri Research and Care Institute, Pavia, Italy Abstract: A randomized, prospective, controlled study was carried out at the Plastic and Reconstructive Surgery Unit of the University of Pavia, Salvatore Maugeri Research and Care Institute, Pavia, Italy, to evaluate the psychological benefits from corrective medical camouflage (CMC following surgical treatment for skin cancer of the face. Twenty-four female patients, following recovery from facial skin cancer surgery, were enrolled in the study over a period of 1 year. The study was performed using two health-related quality of life tests, the Satisfaction Profile (SAT-P test and the Body Uneasiness Test (BUT. The patients were randomized into two groups: group A, patients undergoing CMC; and group B, controls. Both the SAT-P and BUT demonstrated statistically significant better results in the treated patients versus the controls in the following functional parameters: Psychological Functionality (PsF, Physical Functionality (PhF, and Work Performance (WP for the SAT-P test and Compulsive Self-Monitoring (CSM for the BUT. The PsF demonstrated a better result 6 months post-treatment. Such a difference was particularly significant when comparing the performance at 6 months versus that at 3 months. The PhF demonstrated a better outcome at 6 months post

  8. Corneal blindness and xenotransplantation.

    Science.gov (United States)

    Lamm, Vladimir; Hara, Hidetaka; Mammen, Alex; Dhaliwal, Deepinder; Cooper, David K C

    2014-01-01

    Approximately 39 million people are blind worldwide, with an estimated 285 million visually impaired. The developing world shoulders 90% of the world's blindness, with 80% of causative diseases being preventable or treatable. Blindness has a major detrimental impact on the patient, community, and healthcare spending. Corneal diseases are significant causes of blindness, affecting at least 4 million people worldwide. The prevalence of corneal disease varies between parts of the world. Trachoma, for instance, is the second leading cause of blindness in Africa, after cataracts, but is rarely found today in developed nations. When preventive strategies have failed, corneal transplantation is the most effective treatment for advanced corneal disease. The major surgical techniques for corneal transplantation include penetrating keratoplasty (PK), anterior lamellar keratoplasty, and endothelial keratoplasty (EK). Indications for corneal transplantation vary between countries, with Fuchs' dystrophy being the leading indication in the USA and keratoconus in Australia. With the exception of the USA, where EK will soon overtake PK as the most common surgical procedure, PK is the overwhelming procedure of choice. Success using corneal grafts in developing nations, such as Nepal, demonstrates the feasibility of corneal transplantation on a global scale. The number of suitable corneas from deceased human donors that becomes available will never be sufficient, and so research into various alternatives, for example stem cells, amniotic membrane transplantation, synthetic and biosynthetic corneas, and xenotransplantation, is progressing. While each of these has potential, we suggest that xenotransplantation holds the greatest potential for a corneal replacement. With the increasing availability of genetically engineered pigs, pig corneas may alleviate the global shortage of corneas in the near future.

  9. Effect of reconstructive vascular surgery on red cell deformability--preliminary results.

    OpenAIRE

    Irwin, S. T.; Rocks, M J; McGuigan, J. A.; Patterson, C C; Morris, T. C.; O'Reilly, M J

    1983-01-01

    Using a simple filtration method, red cell deformability was measured in healthy control subjects and in patients with peripheral vascular disease. Impaired red cell deformability was demonstrated in patients with rest pain or gangrene and in patients with intermittent claudication. An improvement in red cell deformability was demonstrated after successful reconstructive vascular surgery in both patient groups. An improvement in red cell deformability was demonstrated in patients undergoing m...

  10. Comparison of propofol versus sevoflurane on thermoregulation in patients undergoing transsphenoidal pituitary surgery: A preliminary study

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    Tumul Chowdhury

    2012-01-01

    Full Text Available Purpose: General anesthesia causes inhibition of thermoregulatory mechanisms. Propofol has been reported to cause more temperature fall, but in case of deliberate mild hypothermia, both sevoflurane and propofol were comparable. Thermoregulation is found to be disturbed in cases of pituitary tumors. We aimed to investigate which of the two agents, sevoflurane or propofol, results in better preservation of thermoregulation in patients undergoing transsphenoidal excision of pituitary tumors. Methods: Twenty-six patients scheduled to undergo transsphenoidal removal of pituitary adenomas were randomly allocated to receive propofol or sevoflurane anesthesia. Baseline esophageal temperature was noted. Times for temperature to fall by 1°C or 35°C and to return to baseline were also comparable ( P>0.05. After that warmer was started at 43°C and time to rise to baseline was noted. Duration of surgery, total blood loss, and total fluid intake were also noted. If any, side effects such as delayed arousal and recovery from muscle relaxant were noted. Results: The demographics of the patients were comparable. Duration of surgery and total blood loss were comparable in the two groups. The time for temperature to fall by 1°C or 35°C and time to return to baseline was also comparable ( P>0.05. No side effects related to body temperature were noted. Conclusion: Both propofol and sevoflurane show similar effects in maintaining thermal homeostasis in patients undergoing transsphenoidal pituitary surgery.

  11. Preliminary analysis of a clinical trial for threedimensional conformal radiation therapy after conservative surgery

    Institute of Scientific and Technical Information of China (English)

    Hui Yao; Jinlan Gong; Li Li; Yun Wang; Xiaofeng Wu; Kezhu Hou

    2012-01-01

    Objective: The aim of this study was to evaluate the efficacy, complications and cosmetic results of three-dimensional conformal radiation therapy for early breast cancer after conservative surgery. Methods: Among 80 patients, 44 were treated by modified radical mastectomy followed by adjuvant radiotherapy (modified radical mastectomy, MMT), 36 were treated with breast conservative surgery with adjuvant irradiation [breast-conservation therapy (BCT)]. Tangential fields were used to deliver 6 MV X-ray beams to a total dose of 50 Gy. Another 16 Gy was added to the tumor bed with 6-9 MeV electron beams for BCT. Results: In MMT group, the local control, metastasis-free and death were 41, 41 and 1 respectively; in BCT group, the local control, metastasis-free and death were 35, 35 and 0. The difference of the above two indicators between the two groups showeed no statistical insignificance (P > 0. 05). In MMT group, 32 patients suffer radiation dermatitis above 2-level, 12 patients suffer radiation pneumonia, and 10 patients suffer edema of illness-side upper extremity; in BCT group, the above indicators were only 6, 2 and 1 respectively. Three months, six months and one year after radiation therapy, 90%, 92% and 95% patients were assessed as excellence in fine cosmetic state in BCT group. Conclusion: The effects of threedimensional conformal radiation therapy after conservative surgery are the same as that of modified radical mastectomy, while the former has better cosmetic results and lower radiation therapy induced complications.

  12. Femtosecond laser-assisted cataract surgery: A current review

    Directory of Open Access Journals (Sweden)

    Majid Moshirfar

    2011-01-01

    Full Text Available To evaluate the safety, efficacy, advantages, and limitations of femtosecond laser-assisted cataract surgery through a review of the literature. A PubMed search was conducted using topic-appropriate keywords to screen and select articles. Initial research has shown appropriate safety and efficacy of femtosecond laser-assisted cataract surgery, with improvements in anterior capsulotomy, phacofragmentation, and corneal incision. Limitations of these studies include small sample size and short-term follow-up. Cost-benefit analysis has not yet been addressed. Preliminary data for femtosecond laser-assisted cataract surgery shows appropriate safety and efficacy, and possible advantage over conventional cataract surgery. Questions to eventually be answered include comparisons of long-term postoperative complication rates-including infection and visual outcomes-and analysis of contraindications and financial feasibility.

  13. Guided implant surgery with modification of the technique involving the raising of a semicircular miniflap: a preliminary study.

    Science.gov (United States)

    Peñarrocha, María; Viña, José; Maestre, Laura; Peñarrocha, David; Balaguer, José

    2012-09-01

    An evaluation is made of pain, swelling and peri-implant attached mucosal width after implant-based rehabilitation involving guided surgery and a modification of the technique with the raising of a semicircular miniflap, in single and partial replacements. A case-control study was carried out. The study group consisted of 12 patients with the placement of 19 implants using a guided surgery and miniflap technique. The control group consisted of 12 patients with the placement of 22 implants using the conventional technique. Each patient scored postoperative swelling and pain by means of a visual analog scale (VAS). Attached vestibular mucosa width was evaluated 12 weeks after implant placement. Twelve operations were carried out in each group. Immediate aesthetics were established for all implants of the study group. One implant failed in each group. Maximum pain was recorded after 6 hours in both groups (mean VAS score 4 and 4.9 in the study and control group, respectively). Maximum swelling was recorded after 24 hours (mean VAS score 2.5) in the study group and on the second day (mean VAS score 3.4) in the control group. The mean attached vestibular mucosa width was 2.9 mm in the study group and 3.2 mm in the control group. In this preliminary study, guided implant surgery with a semicircular miniflap in single and partial replacements resulted in slightly less postoperative pain and swelling than with the conventional implant technique. The attached vestibular mucosa width was greater in the control group, though the differences were very small.

  14. Applications of computer assisted surgery and medical robotics at the ISSSTE, México: preliminary results.

    Science.gov (United States)

    Mosso, José Luis; Pohl, Mauricio; Jimenez, Juan Ramon; Valdes, Raquel; Yañez, Oscar; Medina, Veronica; Arambula, Fernando; Padilla, Miguel Angel; Marquez, Jorge; Gastelum, Alfonso; Mosso, Alejo; Frausto, Juan

    2007-01-01

    We present the first results of four projects of a second phase of a Mexican Project Computer Assisted Surgery and Medical Robotics, supported by the Mexican Science and Technology National Council (Consejo Nacional de Ciencia y Tecnología) under grant SALUD-2002-C01-8181. The projects are being developed by three universities (UNAM, UAM, ITESM) and the goal of this project is to integrate a laboratory in a Hospital of the ISSSTE to give service to surgeons or clinicians of Endoscopic surgeons, urologist, gastrointestinal endoscopist and neurosurgeons.

  15. Central corneal abscess.

    Science.gov (United States)

    van Bijsterveld, O P

    1976-05-01

    Central corneal abscess developed in the experimental animal after inoculation of biologically active staphylococcal strains in a paracentral epithelial lesion of the cornea. These abscesses did not ulcerate, developed only with high inocula, occurred more frequently in immunized rabbits. A serpiginous type of ulceration did not develop at the site of the initial epithelial lesion nor at any other place in the cornea. Histologically, the lesions consisted of densely packed polymorphonuclear leukocytes between the corneal lamellae.

  16. Effects of diabetic keratopathy on corneal optical density, central corneal thickness, and corneal endothelial cell counts.

    Science.gov (United States)

    Gao, Feng; Lin, Tao; Pan, Yingzhe

    2016-09-01

    Diabetic keratopathy is an ocular complication that occurs with diabetes. In the present study, the effect of diabetic keratopathy on corneal optical density, central corneal thickness, and corneal endothelial cell count was investigated. One hundred and eighty diabetic patients (360 eyes) were enrolled in the study during the period from March, 2012 to March, 2013. The patients were divided into three age groups: 10 years, with 60 patients per group (120 eyes). During the same period, 60 healthy cases (120 eyes) were selected and labeled as the normal control group. The Pentacam was used to measure the corneal optical density, and central corneal thickness. Specular microscopy was used to examine the corneal endothelial cell density. The coefficient of partial correlation was used to control age and correlate the analysis between the corneal optical density, corneal endothelial cell density, and central corneal thickness. The stage of the disease, the medial and intimal corneal optical density and central corneal thickness was analyzed in the diabetes group. The corneal optical density in the diabetes group increased compared with that of the normal control group. The medial and intimal corneal optical density and central corneal thickness were positively correlated with the course of the disease. However, the corneal endothelial cell density was not associated with the course of diabetes. There was a positive association between the medial and intimal corneal optical density and central corneal thickness of the diabetic patients. In conclusion, the results of the present study show that medial and intimal corneal optical density and central corneal thickness were sensitive indicators for early diabetic keratopathy.

  17. Corneal topography measurement by means of radial shearing interference: Part II - experiment results

    Science.gov (United States)

    Garncarz, Beata E.; Kowalik, Waldemar W.; Kasprzak, Henryk T.

    The method of the measurement of the corneal topography was worked out. This measurement system uses an interferometer based on radial shearing. This paper presents the preliminary results of the experiments. The results are compared with other methods.

  18. A preliminary evaluation of limb salvage surgery for osteosarcoma around knee joint.

    Directory of Open Access Journals (Sweden)

    Xing Wu

    Full Text Available OBJECTIVE: To evaluate the effectiveness and drawbacks of diversified procedures of limb salvage surgery (LSS, providing a reference of rational surgical criterion of LSS. METHODS: Fifty eight patients with stage IIB extremity osteosarcoma around knee joint area between 1992 and 2002 were studied retrospectively. Among them, 43 patients were treated by LSS followed by reconstruction. Reconstruction approaches included re-implantation of irradiation-devitalized tumor bone (n = 12, autoclaving-devitalized tumor bone (n = 8, prosthetic replacement (n = 11, allograft transplantation (n = 8 and vascularized fibula autograft implantation (n = 4. Amputations were performed in 15 patients. Patients were followed up for 6-16 years. RESULTS: There were no significant difference between LSS and amputation groups regarding disease free survival and local recurrence rates. The actuarial 5-year continuous disease free survival and local recurrence rate were 30.0% and 25.0% in patients of devitalized LSS group, whereas those were 56.5% and 8.7% in patients of non-devitalized reconstruction group. The complication rate was significantly higher in LSS group compared to amputation group (P = 0.003. CONCLUSION: LSS with non-devitalized procedures is the optimal treatment for osteosarcoma around knee joint area. Prosthesis implantation is the preferred option for bone reconstruction following LSS. Prevention and treatment of post-operative complications should be paid more attention to get good long-term outcomes of surgery.

  19. Measurement of central corneal thickness using ultrasound pachymetry and Orbscan II in normal eyes

    Directory of Open Access Journals (Sweden)

    Mohammad Mehdi Sadoughi

    2015-01-01

    Conclusion: Orbscan II has good correlation with ultrasound pachymetry for measurement of CCT in normal eyes; however Orbscan II should not be used to evaluate corneal thickness before keratorefractive surgeries, as it tends to overestimate corneal thickness and may result in undesirable, low residual stromal thickness.

  20. Application of corneal tomography before keratorefractive procedure for laser vision correction.

    Science.gov (United States)

    Luz, Allan; Lopes, Bernardo; Salomão, Marcela; Ambrósio, Renato

    2016-05-01

    Ectasia after refractive surgery represents a major concern among refractive surgeons. Corneal abnormalities and preexisting corneal ectasia are the most important risk factors. Corneal topography and central corneal thickness are the factors traditionally screening for in refractive surgery candidates. Study of the anterior surface by Placido topography allows for identification of keratoconus before biomicroscopy. However, this is insufficient for the evaluation of pre-operative refractive surgery. There are cases of ectasia after laser in situ keratomilusis (LASIK) without identifiable risk factors such that there is a need to go beyond the corneal surface. A key requirement is quantifying susceptibility to corneal biomechanical instability and progression to ectasia. Tomographic indices derived from elevation maps and pachymetry spatial variation produce a Belin Ambrosio display final D index (BAD-D index), which has shown better results compared to surface curvature indices for detecting very mild forms of ectasia. A logistic regression formula, integrating age, residual stromal bed, and BAD-D (Ectasia Susceptibility Score, ESS) resulted in a significant improvement in accuracy, leading to 100% sensitivity and 94% specificity for detecting susceptible cases. A comprehensive corneal structural analysis based on corneal segmental tomography can detect susceptible corneas, which increases safety for refractive surgery patients.

  1. 非球面人工晶状体度数计算的最优化%Preliminary evaluation of an algorithm to minimize the power error selection of an aspheric intraocular lens by optimizing the estimation of the corneal power and the effective lens position

    Institute of Scientific and Technical Information of China (English)

    DavidP Piero; VicenteJ Camps; MaraL Ramn; VernicaMateo; Roberto Soto-Negro

    2016-01-01

    目的::通过评价非球面人工晶状体( intraocular lens, IOL)屈光度的可预测性,初步开发一种计算屈光度( PIOL )的优化算法。方法:本研究纳入植入非球面 IOL ( LENTIS L-313, Oculentis GmbH)65眼,并分为2组:A组8例12眼,PIOL≥23.0D;B组35例53眼,PIOL<23.0D。术后3mo进行屈光度可预测性评价。参考角膜屈光力估计所致的可变性屈光指数计算出校正的IOL度数( PIOLadj )及屈光结果,根据年龄和解剖学因素得出校正的有效晶状体位置( adjusted effective lens position, ELPadj )。结果:术后A、B两组等效球镜度数分别为-0.75~+0.75 D、-1.38~+0.75D。 A、B两组的PIOLadj和实际晶状体屈光度(PIOLReal)之间无统计学差异(P=0.64、0.82)。 Bland-Altman分析显示A、B两组PIOLadj和PIOLReal之间的一致性区间分别为+1.11~-0.96 D和+1.14~-1.18 D。 Hoffer Q公式和Holladay I公式计算PIOLadj和PIOL之间存在临床和统计学上的显著差异(P<0.01)。结论:植入非球面IOL白内障手术的屈光可预测性可通过平行轴光学联合线性法则使角膜屈光力及晶状体位置相关误差最小化。%•AIM: To evaluate the refractive predictability achieved with an aspheric intraocular lens ( IOL ) and to develop a preliminary optimized algorithm for the calculation of its power ( PIOL ) .•METHODS:This study included 65 eyes implanted with the aspheric IOL LENTIS L-313 ( Oculentis GmbH ) that were divided into 2 groups:12 eyes (8 patients) with PIOL≥23. 0 D (group A), and 53 eyes (35 patients) with PIOL<23. 0 D ( group B ). The refractive predictability was evaluated at 3mo postoperatively. An adjusted IOL power ( PIOLadj ) was calculated considering a variable refractive index for corneal power estimation, the refractive outcome obtained, and an adjusted effective lens position ( ELPadj ) according to age and anatomical factors.•RESULTS: Postoperative spherical equivalent ranged from -0. 75 to +0. 75 D and from -1

  2. Corneal collagen crosslinking for keratoconus. A review

    Directory of Open Access Journals (Sweden)

    M. M. Bikbov

    2014-10-01

    Full Text Available Photochemical crosslinking is widely applied in ophthalmology. Its biochemical effect is due to the release of singlet oxygen that promotes anaerobic photochemical reaction. Keratoconus is one of the most common corneal ectasia affecting 1 in 250 to 250 000 persons. Currently, the rate of iatrogenic ectasia following eximer laser refractive surgery increases due to biomechanical weakening of the cornea. Morphologically and biochemically, ectasia is characterized by corneal layers thinning, contact between the stroma and epithelium resulting from Bowman’s membrane rupture, chromatin fragmentation in keratocyte nuclei, phagocytosis, abnormal staining and arrangement of collagen fibers, enzyme system disorders, and keratocyte apoptosis. In corneal ectasia, altered enzymatic processes result in the synthesis of abnormal collagen. Collagen packing is determined by the activity of various extracellular matrix enzymes which bind amines and aldehydes of collagen fiber amino acids. In the late stage, morphological changes of Descemet’s membrane (i.e., rupture and detachment develop. Abnormal hexagonal-shaped keratocytes and their apoptosis are the signs of endothelial dystrophy. The lack of analogs in domestic ophthalmology encouraged the scientists of Ufa Eye Research Institute to develop a device for corneal collagen crosslinking. The parameters of ultraviolet (i.e., wavelength, exposure time, power to achieve the desired effect were identified. The specifics of some photosensitizers in the course of the procedure were studied. UFalink, a device for UV irradiation of cornea, and photosensitizer Dextralink were developed and adopted. Due to the high risk of endothelial damage, this treatment is contraindicated in severe keratoconus (CCT less than 400 microns. Major effects of corneal collagen crosslinking are the following: Young’s modulus (modulus of elasticity increase by 328.9 % (on average, temperature tolerance increase by 5

  3. Corneal collagen crosslinking for keratoconus. A review

    Directory of Open Access Journals (Sweden)

    M. M. Bikbov

    2014-01-01

    Full Text Available Photochemical crosslinking is widely applied in ophthalmology. Its biochemical effect is due to the release of singlet oxygen that promotes anaerobic photochemical reaction. Keratoconus is one of the most common corneal ectasia affecting 1 in 250 to 250 000 persons. Currently, the rate of iatrogenic ectasia following eximer laser refractive surgery increases due to biomechanical weakening of the cornea. Morphologically and biochemically, ectasia is characterized by corneal layers thinning, contact between the stroma and epithelium resulting from Bowman’s membrane rupture, chromatin fragmentation in keratocyte nuclei, phagocytosis, abnormal staining and arrangement of collagen fibers, enzyme system disorders, and keratocyte apoptosis. In corneal ectasia, altered enzymatic processes result in the synthesis of abnormal collagen. Collagen packing is determined by the activity of various extracellular matrix enzymes which bind amines and aldehydes of collagen fiber amino acids. In the late stage, morphological changes of Descemet’s membrane (i.e., rupture and detachment develop. Abnormal hexagonal-shaped keratocytes and their apoptosis are the signs of endothelial dystrophy. The lack of analogs in domestic ophthalmology encouraged the scientists of Ufa Eye Research Institute to develop a device for corneal collagen crosslinking. The parameters of ultraviolet (i.e., wavelength, exposure time, power to achieve the desired effect were identified. The specifics of some photosensitizers in the course of the procedure were studied. UFalink, a device for UV irradiation of cornea, and photosensitizer Dextralink were developed and adopted. Due to the high risk of endothelial damage, this treatment is contraindicated in severe keratoconus (CCT less than 400 microns. Major effects of corneal collagen crosslinking are the following: Young’s modulus (modulus of elasticity increase by 328.9 % (on average, temperature tolerance increase by 5

  4. The Beneficial Effect of Hypnosis in Elective Cardiac Surgery: A Preliminary Study.

    Science.gov (United States)

    Akgul, Ahmet; Guner, Beyhan; Çırak, Musa; Çelik, Derya; Hergünsel, Oya; Bedirhan, Sevim

    2016-10-01

    Background Single-session hypnosis has never been evaluated as a premedication technique in patients undergoing coronary artery bypass grafting (CABG). The aim of the present study was to evaluate the beneficial effects of clinical hypnotherapy on perioperative anxiety, pain perception, sedation, and necessity for ventilator assistance in patients undergoing CABG. Methods Double-blind, randomized, clinical trial was performed. Forty-four patients undergoing CABG surgery were randomized into two groups. The patients in group A received preprocedural hypnosis by an anesthesiologist. Patients in group B (control) had only information on the surgical intervention by the same anesthesiologist. State-Trait-Anxiety Index-I (STAI-I) and Beck Depression Inventory (BDI) were performed preoperatively in both groups. Visual analog scale (VAS) and Ramsay sedation scale (RSS) were evaluated on 0th, 1st, 2nd, 4th, 6th, 8th, 10th, 12th, and 24th hours, postoperatively. Postoperative anxiety level, analgesic drug consumption, and duration of ventilator assistance and intensive care unit (ICU) stay were also documented. Results When anxiety and depression levels were compared, significantly lower STA-I and BDI values were detected in group A after hypnotherapy (p = 0.001, p = 0.001, respectively). Significantly less total doses of remifentanil (34.4 ± 11.4 vs. 50.0 ± 13.6 mg) and morphine (4.9 ± 3.3 vs. 13.6 ± 2.7 mg) were administered in group A in the postoperative period. Ventilator assistance duration (6.8 ± 2.0 vs. 8.9 ± 2.7 hours) was also shorter in group A when compared with that in group B (p = 0.007). Conclusion Hypnosis session prior to surgery was an effective complementary method in decreasing presurgical anxiety, and it resulted in better pain control as well as reduced ventilator assistance following CABG surgery. Georg Thieme Verlag KG Stuttgart · New York.

  5. Evaluation and Treatment of Perioperative Corneal Abrasions

    Directory of Open Access Journals (Sweden)

    Kira L. Segal

    2014-01-01

    Full Text Available Purpose. To evaluate perioperative risk factors for corneal abrasion (CA and to determine current care for perioperative CA in a tertiary care setting. Methods. Hospital-based, cross-sectional study. In Operating Room and Post-Anesthesia Care Units patients, a comparison of cases and controls was evaluated to elucidate risk factors, time to treatment, and most common treatments prescribed for corneal abrasions. Results. 86 cases of corneal abrasion and 89 controls were identified from the 78,542 surgical procedures performed over 2 years. Statistically significant risk factors were age (P=0.0037, general anesthesia (P<0.001, greater average estimated blood loss (P<0.001, eyes taped during surgery (P<0.001, prone position (P<0.001, trendelenburg position (P<0.001, and supplemental oxygen en route to and in the Post-Anesthesia Care Units (P<0.001. Average time to complaint was 129 minutes. 94% of cases had an inpatient ophthalmology consult, with an average time to consult of 164 minutes. The most common treatment was artificial tears alone (40%, followed by combination treatment of antibiotic ointment and artificial tears (35.3%. Conclusions. Trendelenburg positioning is a novel risk factor for CA. Diagnosis and treatment of perioperative corneal abrasions by an ophthalmologist typically require three hours in the tertiary care setting.

  6. Transplantation of reconstructed corneal layer composed of corneal epithelium and fibroblasts on a lyophilized amniotic membrane to severely alkali-burned cornea.

    Science.gov (United States)

    Jang, In-Keun; Ahn, Jae-Il; Shin, Jun-Seop; Kwon, Young-Sam; Ryu, Yang-Hwan; Lee, Jeong-Kyu; Park, Jung-Keug; Song, Kye-Yong; Yang, Eun-Kyung; Kim, Jae-Chan

    2006-06-01

    The purpose of this article was to evaluate the graft efficacy of reconstructed corneal layer, composed of autologous corneal epithelium and fibroblasts on a lyophilized amniotic membrane (LAM), in a severely alkali-burned corneal model. After biopsy specimens were obtained from the left eyes of 24 rabbits, the corneal epithelial cells and fibroblasts were expanded in vitro and the corneal layer was reconstructed on LAM. Thirty-six eyes of rabbits underwent alkali burn (1 N NaOH, 30 s) to create a limbal deficiency and a deeply damaged corneal stroma. Four weeks later, group 1 underwent a graft of the reconstructed corneal layer composed of autologous corneal epithelium and fibroblasts on LAM. Group 2 was transplanted with a graft of the reconstructed autologous corneal epithelium, and group 3 served as a control without surgery. Wound healing and stabilization of the ocular surfaces occurred much faster in group 1 than in groups 2 and 3. The eyes in group 3 revealed typical limbal deficiencies with conjuctivalization and persistent corneal epithelial defects. However, the corneas in group 1 developed only mild peripheral neovascularization. Immunohistochemical staining in group 1 demonstrated that p63, cytokeratin 3, E-cadherin, transforming growth factor (TGF)-beta1, and collagen IV were expressed strongly in the corneal epithelium and basement membrane. On the basis of these results, transplantation of the reconstructed corneal layer, composed of autologous corneal epithelium and fibroblasts on LAM, partially accelerated the recovery of the alkali-injured rabbit ocular surface, and might be useful therapeutically for the treatment of patients with severely damaged cornea.

  7. Design and preliminary in vivo validation of a robotic laparoscope holder for minimally invasive surgery.

    Science.gov (United States)

    Herman, Benoît; Dehez, Bruno; Duy, Khanh Tran; Raucent, Benoît; Dombre, Etienne; Krut, Sébastien

    2009-09-01

    Manual manipulation of the camera is a major source of difficulties encountered by surgeons while performing minimally invasive laparoscopic surgery. A survey of laparoscopic procedures and a review of existing active and passive holders were conducted. Based on these analyses, essential requirements were highlighted for such devices. Pursuant to this, a novel active laparoscope manipulator was designed, paying particular attention to ergonomics and ease of use. Several trials on the pelvitrainer and a first in vivo procedure were performed to validate the original design of our device. Phantom experiments demonstrated ease of use of the robot and advantages of the intuitive joystick with omnidirectional displacements and speed control. The compactness of the device and image stability were appreciated during the surgical trial. A novel robotic laparoscope holder has been developed and produced. An in vivo trial proved its value in clinical practice, enabling surgeons to work more comfortably.

  8. Preliminary testing of a compact bone-attached robot for otologic surgery

    Science.gov (United States)

    Dillon, Neal P.; Balachandran, Ramya; Motte dit Falisse, Antoine; Wanna, George B.; Labadie, Robert F.; Withrow, Thomas J.; Fitzpatrick, J. Michael; Webster, Robert J.

    2014-03-01

    Otologic surgery often involves a mastoidectomy procedure, in which part of the temporal bone is milled away in order to visualize critical structures embedded in the bone and safely access the middle and inner ear. We propose to automate this portion of the surgery using a compact, bone-attached milling robot. A high level of accuracy is required t o avoid damage to vital anatomy along the surgical path, most notably the facial nerve, making this procedure well-suited for robotic intervention. In this study, several of the design considerations are discussed and a robot design and prototype are presented. The prototype is a 4 degrees-of-freedom robot similar to a four-axis milling machine that mounts to the patient's skull. A positioning frame, containing fiducial markers and attachment points for the robot, is rigidly attached to the skull of the patient, and a CT scan is acquired. The target bone volume is manually segmented in the CT by the surgeon and automatically converted to a milling path and robot trajectory. The robot is then attached to the positioning frame and is used to drill the desired volume. The accuracy of the entire system (image processing, planning, robot) was evaluated at several critical locations within or near the target bone volume with a mean free space accuracy result of 0.50 mm or less at all points. A milling test in a phantom material was then performed to evaluate the surgical workflow. The resulting milled volume did not violate any critical structures.

  9. Resultados preliminares de um sistema de topografia de grande-ângulo usando videoceratógrafo com discos de Plácido Preliminary results of a wide-angle corneal topography system for Placido-based videokeratographers

    Directory of Open Access Journals (Sweden)

    Luis Alberto Vieira de Carvalho

    2008-04-01

    Full Text Available OBJETIVO: Desenvolver a instrumentação e o "software" para topografia de córnea de grande-ângulo usando o tradicional disco de Plácido. O objetivo é permitir o mapeamento de uma região maior da córnea para topógrafos de córnea que usem a técnica de Plácido, fazendo-se uma adaptação simples na mira. MÉTODOS: Utilizando o tradicional disco de Plácido de um topógrafo de córnea tradicional, 9 LEDs (Light Emitting Diodes foram adaptados no anteparo cônico para que o paciente voluntário pudesse fixar o olhar em diferentes direções. Para cada direção imagens de Plácido foram digitalizadas e processadas para formar, por meio de algoritmo envolvendo elementos sofisticados de computação gráfica, um mapa tridimensional completo da córnea toda. RESULTADOS: Resultados apresentados neste trabalho mostram que uma região de até 100% maior pode ser mapeada usando esta técnica, permitindo que o clínico mapeie até próximo ao limbo da córnea. São apresentados aqui os resultados para uma superfície esférica de calibração e também para uma córnea in vivo com alto grau de astigmatismo, mostrando a curvatura e elevação. CONCLUSÃO: Acredita-se que esta nova técnica pode propiciar a melhoria de alguns processos, como por exemplo: adaptação de lentes de contato, algoritmos para ablações costumizadas para hipermetropia, entre outros.PURPOSE: To develop the instrumentation and software for wide-angle corneal topography using a Placido-based videokeratographer. The objective is to allow the measurement of a greater area of the cornea using a simple adaptation to the Placido mire. METHODS: Using the traditional Placido disc of a commercial corneal topographer, 9 LEDs (Light Emitting Diodes were installed on the conic mire so that the voluntary patient could gaze in different directions. For each direction Placido images were acquired and processed to form, using a sophisticated computer graphics algorithm, a tridimensional

  10. Corneal Topography Analysis of Stromal Corneal Dystrophies

    OpenAIRE

    Kocluk, Yusuf; Yalniz-Akkaya, Zuleyha; Burcu, Ayse; Ornek, Firdevs

    2015-01-01

    Objective: The aim was to compare the corneal topography and tomography parameters of macular corneal dystrophy (MCD), granular corneal dystrophy (GCD) and lattice corneal dystrophy (LCD) patients obtained by Scheimpflug imaging system. Methods: The charts, photographs and topography images of patients were reviewed retrospectively. This study included 73 eyes of 73 patients (28 MCD, 20 GCG and 25 LCD patients). Topography images were obtained by Pentacam (Oculus Optikgerate, Wetzlar, Germany...

  11. [The relevance of Choukroun's Platelet-Rich Fibrin (PRF) during middle ear surgery: preliminary results].

    Science.gov (United States)

    Braccini, F; Tardivet, L; Dohan Ehrenfest, D M

    2009-01-01

    To evaluate the relevance of Leucocyte- and Platelet-Rich Fibrin (L-PRF, Choukroun's technique) Concentrates during tympanoplasty. 152 myringoplasties (including 2 cases with bilateral tympanic perforations) were treated by the senior surgeon in 150 patients, 63 women and 87 males aged between 25 and 55-years-old, between december 2004 and june 2008. These patients showed non marginal tympanic perforations, sized from punctiform to subtotal. For the smallest perforations, a PRF cylinder was used alone to fill the perforation without preparing a tympanomeatus flap (Champagne plug technique). For perforations largest than the third of the tympanic surface, temporal aponeurosis graft in underlay was preferred, and optimized by the lateral application of a PRF membrane (hamburger technique). 6 failures were recorded in this case series, with tympans showing residual microperforations, after a minimum follow-up of 6 months. The success rate was thus close to 96%. The mean success rate without PRF is normally 85%. All failures were recorded on large non marginal lesions. PRF will never save an inadequate surgical procedure, but it offers both mechanical and inflammatory protection to the tympanic graft and accelerates cell proliferation and matrix remodelling. Moreover, this autologous biomaterial induces no undesirable tissue reaction, is easy, quick and cheap to produce and is easily manipulated during the surgical procedure. It seems a precious help for the otologist, in order to improve tympanic healing. PRF potential applications in the middle-ear surgery seem numerous.

  12. Cardiovascular-interventional-surgery virtual training platform and its preliminary evaluation.

    Science.gov (United States)

    Zhou, Chaozheng; Xie, Le; Shen, Xianglong; Luo, Maisheng; Wu, Zhaoli; Gu, Lixu

    2014-10-13

    Cardiovascular interventional surgery (CIS) training has mainly been performed with fluoroscopic guidance on animals. However, this has potential drawbacks, including from the anatomical differences between animal models and the human body. The purpose of this research is to develop a virtual training platform for inexperienced trainees. The CIS virtual training platform is composed of a mechanical manipulation unit, a simulation platform and a user interface. A decoupled haptic device offers high-quality force feedback. An efficient physically based hybrid model was simulated. The CIS procedure was tested with three simulation studies. Translational and rotational tests were employed to preliminarily evaluate the platform. Tests showed that accuracies improved by 50% and 32.5%. Efficient collision detection and continuous collision response allowed real-time interactions. Furthermore, three simulation studies indicated that the platform had reasonable accuracy and robustness. The proposed simulation platform has the potential to be a good virtual training platform. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

  13. Tissue engineering of corneal stroma with rabbit fibroblast precursors and gelatin hydrogels.

    Science.gov (United States)

    Mimura, Tatsuya; Amano, Shiro; Yokoo, Seiichi; Uchida, Saiko; Yamagami, Satoru; Usui, Tomohiko; Kimura, Yu; Tabata, Yasuhiko

    2008-01-01

    To isolate fibroblast precursors from rabbit corneal stroma using a sphere-forming assay, to engineer corneal stroma with the precursors and gelatin, and to establish the therapeutic application of precursors in a rabbit corneal stroma. In the in vitro study, a sphere-forming assay was performed to produce precursors from rabbit corneal stroma. Corneal stroma was engineered by cultivating precursors in porous gelatin for one week. In the in vivo study, the engineered corneal stromal sheet with precursors (precursor/gelatin group) or with fibroblasts (fibroblast /gelatin group) or without cells (gelatin group) was transplanted to a pocket of rabbit corneal stroma. Gene expression and extracellular matrix production were examined immunohistochemically in each group one week and four weeks after surgery. In the in vitro study, cells in the spheres were BrdU-positive, and their progeny were keratocan-positive. The study also showed that the corneas transplanted with a porous gelatin sheet did not show any opacity four weeks after transplantation in any group. In the gelatin sheet of the precursor/gelatin group, a more intense expression of type I collagen was observed relative to the other two groups four weeks after the surgery. Our findings demonstrate that the transplantation of fibroblast precursors combined with gelatin hydrogel into the corneal stroma is a possible treatment strategy for corneal stromal regeneration.

  14. Comparison of the effects among three different corneal refractive surgeries for low and moderate myopia%三种角膜屈光手术矫正低中度近视效果的比较

    Institute of Scientific and Technical Information of China (English)

    周继红; 刘龙; 高妍; 郭秀花

    2016-01-01

    Objective To compare postoperative uncorrected visual acuity (UCVA) and residual diopters among three different corneal refractive surgeries for low and moderate myopia.Methods This is a retrospective study on non-randomized clinical trial without control group.The following three groups were involved in this trial:LASEK group,261 patients (521 eyes);microkeratome-assisted flap creation LASIK (MM-LASIK) group,1513 patients (3024 eyes) and the femtosecond laser-assisted flap creation LASIK (FS-LASIK) group,1082 patients (2164 eyes).Single factor analysis of variance was used to compare the postoperative UCVA,residual spherical equivalent (S E),root mean aquare of high aberration for pupil diameter of 3mm and 5mm (HOA RMS3 and HOA RMS5) groups.Results After the follow-up of 12 months,the difference in UCVA between MM-LASIK and LASEK group was not statistically significant (P =0.705).The UCVA in MM-LASIK and LASEK group were better than that in FS-LASIK group and the differences were statistically significant (F =17.08,P =0.00).The differences in postoperative residual S E among the three groups were statistically significant (F =4.36,P =0.01).The residual SE in MMLASIK and FS-LASIK group were lower than that in LASEK group.The descending order of HOA RMS3 was FS-LASIK group,MM-LASIK and LASEK group.There was no statistically significant difference in HOA RMS5 among three groups.Conclusion Three corneal refractive surgeries for correcting low to moderate myopia brought good results.Smaller postoperative residual SE and lower HOA RMS3 are beneficial to the recovery of postoperative UCVA.LASEK and MM-LASIK produced better visual acuity and less corneal aberrations compared to FS-LASIK.The value of HOA RMS3 in LASEK group was the smallest and the postoperative residual SE in LASEK group was the biggest.%目的 比较3种角膜屈光手术矫正低中度近视术后裸眼视力、及残留屈光度等.方法 回顾性研究,非随机临床对照设计.纳入研究的3个

  15. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with oxaliplatin for peritoneal mesothelioma: preliminary results and survival analysis.

    Science.gov (United States)

    Hubert, Julien; Thiboutot, Eva; Dubé, Pierre; Cloutier, Alexis-Simon; Drolet, Pierre; Sideris, Lucas

    2015-03-01

    Peritoneal mesothelioma is a rare disease with poor prognosis. The present study reports single center experience with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy with oxaliplatin (HIPEC-OX) over an eight-year period. Prospectively collected data of all consecutive patients with epithelial or multicystic peritoneal mesothelioma from August 2004 to October 2012 was analyzed. Patients with sarcomatoid or biphasic peritoneal mesothelioma were not included due to general poor prognosis. Treatment consisted in CRS and HIPEC-OX (460 mg/m(2)) at 43 °C during 30 min. For statistical analysis, Kaplan-Meier survival curves were plotted and compared using log-rank tests. Cox proportional-hazards regression model was used to analyze the influence of different variables on survival. Nineteen patients with peritoneal mesothelioma underwent laparotomy with CRS and HIPEC-OX with curative intent (15 epithelial, and 4 multicystic). Mean follow-up was 36.7 months. The estimated one-year and three-year overall survival rates were respectively 100% and 91%. The estimated one-year and three-year disease-free survival rates were respectively 77% and 50%. Complications were graded according to the Clavien-Dindo classification [1] and major complications occurred in 57% of cases. There was no postoperative mortality. Histological grade was not a prognostic factor of disease-free survival (p = 0.37). When comparing survival results as well as morbidity-mortality rates, the present study shows that CRS and HIPEC-OX is a valid treatment for peritoneal mesothelioma. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Scheimpflug imaged corneal changes on anterior and posterior surfaces after collagen cross-linking

    Directory of Open Access Journals (Sweden)

    Ziad Hassan

    2014-04-01

    Full Text Available AIM: To compare the anterior and posterior corneal parameters before and after collagen cross-linking therapy for keratoconus.METHODS: Collagen cross-linking was performed in 31 eyes of 31 keratoconus patients (mean age 30.6±8.9y. Prior to treatment and an average 7mo after therapy, Scheimpflug analysis was performed using Pentacam HR. In addition to corneal thickness assessments, corneal radius, elevation, and aberrometric measurements were performed both on anterior and posterior corneal surfaces. Data obtained before and after surgery were statistically analyzed.RESULTS: In terms of horizontal and vertical corneal radius, and central corneal thickness no deviations were observed an average 7mo after operation. Corneal higher order aberration showed no difference neither on anterior nor on posterior corneal surfaces. During follow-up period, no significant deviation was detected regarding elevation values obtained by measurement in mm units between the 3.0-8.0 mm-zones.CONCLUSION: Corneal stabilization could be observed in terms of anterior and posterior corneal surfaces, elevation and higher order aberration values 7mo after collagen cross-linking therapy for keratoconus.

  17. Corneal topographic changes after 20-gauge pars plana vitrectomy associated with scleral buckling for the treatment of rhegmatogenous retinal detachment

    Directory of Open Access Journals (Sweden)

    Alexandre Achille Grandinetti

    2013-04-01

    Full Text Available PURPOSE: To evaluate the changes in corneal topography after 20-gauge pars plana vitrectomy associated with scleral buckling for the repair of rhegmatogenous retinal detachment. METHODS: Twenty-five eyes of 25 patients with rhegmatogenous retinal detachment were included in this study. 20-gauge pars plana vitrectomy associated with scleral buckling was performed in all patients. The corneal topography of each was measured before surgery and one week, one month, and three months after surgery by computer-assisted videokeratoscopy. RESULTS: A statistically significant central corneal steepening (average, 0,9 D , p<0,001 was noted one week after surgery. The total corneal astigmatism had a significant increase in the first postoperative month (p=0,007. All these topographic changes persisted for the first month but returned to preoperative values three months after the surgery. CONCLUSION: Pars plana vitrectomy with scleral buckling was found to induce transient changes in corneal topography.

  18. The effect of selective incisions on corneal astigmatism after ICL surgery%选择性切口对有晶状体眼后房型人工晶状体术后散光控制的临床研究

    Institute of Scientific and Technical Information of China (English)

    蒋炎云

    2014-01-01

    Objective To evaluate the effect of the selective incisions on corneal astigmatism after ICL ( Implant-able Collamer Lens ) surgeries for high myopia .Methods This study included 195 high myopic eyes of 102 patients ran-domly assigned into 2 groups.Patients either received selective corneal incision (group A, 97 eyes) or temporal corneal in-cision (Group B, 98 eyes) in ICL surgeries.On the day before operation and at 1 week, 1 month and 3 month after surger-y, each patient was examined with corneal topography to evaluate the corneal astigmatism .Results Preoperative corneal a-stigmatism was 1.26 ±0.35 D in group A and 1.28 ±0.38 D in group B ( P >0.05).At 1 week, the astigmatism was 0.93 ±0.29 D in group A and 1.32 ±0.33 D in group B.At 1 month and 3 months, the astigmatism was 0.85 ±0.16 D and 0.80 ±0.13 in group A, and was significantly higher in group B (1.27 ±0.18 D and 1.25 ±0.20 D, respectively;P<0.01).Conclusion The selective incision could significantly reduce postoperative astigmatism after ICL surgery .%探讨选择性手术切口对有晶状体眼后房型人工晶状体( ICL)术后散光控制的作用。方法高度近视102例(195只眼),随机分成选择性切口97只眼(A组)和颞侧角膜切口组98只眼(B组),通过术前、术后1周、1、3个月分别行角膜地形图检查,观察患者术后散光的变化。结果 A组术前平均角膜散光为(1.26±0.35)D,B组术前平均角膜散光为(1.28±0.38)D,两组差异无统计学意义。术后1周、1、3个月,A组平均散光分别为(0.93±0.29)D、(0.85±0.16)D、(0.80±0.13)D,B组平均散光分别为(1.32±0.33)D、(1.27±0.18)D、(1.25±0.20)D,两组差异有统计学意义。结论选择性手术切口能在一定程度上控制ICL术后散光。

  19. Analysis of corneal esthesia in patients undergoing photorefractive keratectomy

    Directory of Open Access Journals (Sweden)

    Elmar Torres Neto

    2015-12-01

    Full Text Available ABSTRACT Purpose: To quantitatively analyze corneal esthesia in patients undergoing photorefractive keratectomy (PRK surgery. Methods: Forty-five patients selected for PRK in one eye underwent corneal esthesia using a Cochet-Bonnet esthesiometer preoperatively and 30 and 90 days postoperatively. Patients with a refractive diopter error of 4 or greater received intraoperative 0.02% mitomycin C for 20 s. Results: Twenty-four (53.3% of the 45 eyes received intraoperative 0.02% mitomycin. Decreased sensitivity was observed on postoperative day 30. By postoperative day 90, corneal esthesia had normalized but remained 14.9% lower than preoperative levels. In the mitomycin group, no recovery of corneal esthesia to normal sensitivity levels was observed. The mean esthesiometer level was 39.2 mm on postoperative day 90 (P<0.001. Conclusions: The results of the present study demonstrate recovery of corneal esthesia to normal levels at 90 days postoperatively in patients who did not receive mitomycin C. In patients administered mitomycin C, a 23.59% reduction in the corneal touch threshold was observed compared with preoperative levels indicating a failure of recovery to normal levels.

  20. Congenital Corneal Anesthesia and Neurotrophic Keratitis: Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Flavio Mantelli

    2015-01-01

    Full Text Available Neurotrophic keratitis (NK is a rare degenerative disease of the cornea caused by an impairment of corneal sensory innervation, characterized by decreased or absent corneal sensitivity resulting in epithelial keratopathy, ulceration, and perforation. The aetiopathogenesis of corneal sensory innervation impairment in children recognizes the same range of causes as adults, although they are much less frequent in the pediatric population. Some extremely rare congenital diseases could be considered in the aetiopathogenesis of NK in children. Congenital corneal anesthesia is an extremely rare condition that carries considerable diagnostic and therapeutic problems. Typically the onset is up to 3 years of age and the cornea may be affected in isolation or the sensory deficit may exist as a component of a congenital syndrome, or it may be associated with systemic somatic anomalies. Accurate diagnosis and recognition of risk factors is important for lessening long-term sequelae of this condition. Treatment should include frequent topical lubrication and bandage corneal or scleral contact lenses. Surgery may be needed in refractory cases. The purpose of this review is to summarize and update data available on congenital causes and treatment of corneal hypo/anesthesia and, in turn, on congenital NK.

  1. Comparison of corneal flap thickness using a FS200 femtosecond laser and a moria SBK microkeratome

    Directory of Open Access Journals (Sweden)

    Jing Zhang

    2014-04-01

    using the following equation:Tflap=67.77+0.076 CCT (F=5.63, P=0.021.CONCLUSION:Both the Alcon Wavelight FS200 femtosecond laser and the MORIA SBK microkeratome produced 110-μm-thick corneal flaps. The central corneal flap thickness was positively correlated with the preoperative CCT in MORIA SBK microkeratome surgery.

  2. Adipose-derived mesenchymal stem cell administration does not improve corneal graft survival outcome.

    Directory of Open Access Journals (Sweden)

    Sherezade Fuentes-Julián

    Full Text Available The effect of local and systemic injections of mesenchymal stem cells derived from adipose tissue (AD-MSC into rabbit models of corneal allograft rejection with either normal-risk or high-risk vascularized corneal beds was investigated. The models we present in this study are more similar to human corneal transplants than previously reported murine models. Our aim was to prevent transplant rejection and increase the length of graft survival. In the normal-risk transplant model, in contrast to our expectations, the injection of AD-MSC into the graft junction during surgery resulted in the induction of increased signs of inflammation such as corneal edema with increased thickness, and a higher level of infiltration of leukocytes. This process led to a lower survival of the graft compared with the sham-treated corneal transplants. In the high-risk transplant model, in which immune ocular privilege was undermined by the induction of neovascularization prior to graft surgery, we found the use of systemic rabbit AD-MSCs prior to surgery, during surgery, and at various time points after surgery resulted in a shorter survival of the graft compared with the non-treated corneal grafts. Based on our results, local or systemic treatment with AD-MSCs to prevent corneal rejection in rabbit corneal models at normal or high risk of rejection does not increase survival but rather can increase inflammation and neovascularization and break the innate ocular immune privilege. This result can be partially explained by the immunomarkers, lack of immunosuppressive ability and immunophenotypical secretion molecules characterization of AD-MSC used in this study. Parameters including the risk of rejection, the inflammatory/vascularization environment, the cell source, the time of injection, the immunosuppression, the number of cells, and the mode of delivery must be established before translating the possible benefits of the use of MSCs in corneal transplants to clinical

  3. Spontaneous corneal perforation in an eye with Peters' anomaly

    Directory of Open Access Journals (Sweden)

    Kim M

    2013-07-01

    Full Text Available Moosang Kim, Seung-Chan Lee, Seung-Jun Lee Department of Ophthalmology, School of Medicine, Kangwon National University, Chuncheon, South Korea Abstract: A premature female infant underwent her first ophthalmologic examination at the age of 4 weeks. The initial examination of the baby was requested for evaluation of a ‘white spot’ on the surface of her right eye. She had been hospitalized in the neonatal intensive care unit because of systemic abnormalities, such as a right clavicle fracture and microcephaly. Slit-lamp examination of the right eye showed a central corneal opacity, corneal thinning, and an iridocorneal adhesion. The lens and fundus of the right eye could not be observed. We observed no pathologic findings in the left eye. The baby's parents were informed of the high risk for spontaneous corneal perforation without external pressure. At 42 days of age, an ophthalmologic examination of the infant was again requested for evaluation of ‘tears’ from her right eye 3 hours previously. Examination revealed corneal perforation, iris protrusion, and a flat anterior chamber. We performed emergent conjunctival flap surgery. Three months following surgery, the patient's right eye was successfully preserved with no sign of inflammation or leakage. Keywords: conjunctival flap, corneal perforation, Peters' anomaly

  4. Resolution of persistent corneal erosion after administration of topical rebamipide.

    Science.gov (United States)

    Kashima, Tomoyuki; Akiyama, Hideo; Miura, Fumihide; Kishi, Shoji

    2012-01-01

    Rebamipide is an antiulcer agent used to treat gastric ulcer and gastritis. Biological effects of rebamipide include cytoprotection, wound healing, and anti-inflammatory properties that are known to be universal for a variety of tissues in addition to gastrointestinal mucosa. The therapeutic effects of rebamipide eye drops are due to its ability to increase corneal and conjunctival mucin-like substances and improve corneal and conjunctival injury in vivo. In this paper, we report a case of Sjögren's syndrome with complete disappearance of corneal erosion after administration of rebamipide eye drops. This was observed even though corneal erosion had not improved for 6 months after punctal occlusion surgery. The patient was a 33-year-old female, diagnosed with Sjögren's syndrome by a salivary gland biopsy. The corneal and conjunctival surfaces were filled with dense erosions, which did not improve with topical drugs. Punctal plugs were applied several times; however, the plugs were repeatedly shed. All four puncta of both eyelids were surgically occluded, and both corneal and conjunctival erosion was clearly improved. However, the erosion in the inferior cornea of both eyes had not improved for 6 months after surgery. We used the newly approved topical rebamipide for treatment of this patient. The corneal erosion gradually improved and completely disappeared 4 weeks after administration of the drug. Dry eye sensation disappeared at the same time. Both membrane-associated mucin and secreted mucin in the ocular surface are thought to be essential for maintenance of the tear film. Induction of mucin from ocular surface epithelium could be an effective treatment in cases of dry eye caused by mucin deficiency. Through its various mechanisms, rebamipide improves ocular surface conditions. To our knowledge, this is the first clinical case report using rebamipide ophthalmic solution. This drug may provide a novel approach to treat drying diseases of the eye.

  5. Customized toric intraocular lens implantation for correction of extreme corneal astigmatism due to corneal scarring

    Directory of Open Access Journals (Sweden)

    R Bassily

    2010-03-01

    Full Text Available R Bassily, J LuckOphthalmology Department, Royal United Hospital, Combe Park, Bath, UKAbstract: A 76-year-old woman presented with decreased visual function due to cataract formation. Twenty-five years prior she developed right sided corneal ulceration that left her with 10.8 diopters (D of irregular astigmatism at 71.8° (steep axis. Her uncorrected visual acuity was 6/24 and could only ever wear a balanced lens due to the high cylindrical error. Cataract surgery was planned with a custom designed toric intraocular lens (IOL with +16.0 D sphere inserted via a wound at the steep axis of corneal astigmatism. Postoperative refraction was -0.75/+1.50 × 177° with a visual acuity of 6/9 that has remained unchanged at six-week follow-up with no IOL rotation. This case demonstrates the value of high power toric IOLs for the correction of pathological corneal astigmatism.Keywords: intraocular lens, corneal ulceration, visual acuity, scarring

  6. Active Pedicle Epithelial Flap Transposition Combined with Amniotic Membrane Transplantation for Treatment of Nonhealing Corneal Ulcers

    Directory of Open Access Journals (Sweden)

    Ting Zhang

    2016-01-01

    Full Text Available Introduction. The objective was to evaluate the efficacy of active pedicle epithelial flap transposition combined with amniotic membrane transplantation (AMT in treating nonhealing corneal ulcers. Material and Methods. Eleven patients (11 eyes with nonhealing corneal ulcer who underwent the combined surgery were included. Postoperatively, ulcer healing time was detected by corneal fluorescein staining. Visual acuity, intraocular pressure, surgical complications, and recurrence were recorded. Corneal status was inspected by the laser scanning confocal microscopy and anterior segment optical coherence tomography (AS-OCT. Results. The primary diseases were herpes simplex keratitis (8 eyes, corneal graft ulcer (2 eyes, and Stevens-Johnson syndrome (1 eye. All epithelial flaps were intact following surgery, without shedding or displacement. Mean ulcer healing time was 10.8±3.1 days, with a healing rate of 91%. Vision significantly improved from 1.70 to 0.82 log MAR (P=0.001. A significant decrease in inflammatory cell infiltration and corneal stromal edema was revealed 2 months postoperatively by confocal microscopy and AS-OCT. Corneal ulcer recurred in 1 eye. None of the patients developed major complications. Conclusion. Active pedicle epithelial flap transposition combined with AMT is a simple and effective treatment for nonhealing corneal ulcers.

  7. The Place of Extensive Surgery in Locoregional Recurrence and Limited Metastatic Disease of Breast Cancer: Preliminary Results

    OpenAIRE

    Berlière, M.; Duhoux, F. P.; Taburiaux, L.; Lacroix, V.; Galant, C.; Leconte, I.; Fellah, L.; Lecouvet, F.; Bouziane, D.; Ph. Piette; Lengele, B.

    2015-01-01

    The aims of this study were first to clearly define two different entities: locoregional recurrences and limited metastatic disease and secondly to evaluate the place of extensive surgery in these two types of recurrence. Material and Methods. Twenty-four patients were followed from June 2004 until May 2014. All patients underwent surgery but for 1 patient this surgery was stopped because the tumour was unresectable. Results. The median interval between surgery for the primary tumour and the...

  8. Corneal Neurotoxicity Due to Topical Benzalkonium Chloride

    OpenAIRE

    Sarkar, Joy; Chaudhary, Shweta; Namavari, Abed; Ozturk, Okan; Chang, Jin-Hong; Yco, Lisette; Sonawane, Snehal; Khanolkar, Vishakha; Hallak, Joelle; Jain, Sandeep

    2012-01-01

    Topical application of benzalkonium chloride (BAK) to the eye causes dose-related corneal neurotoxicity. Corneal inflammation and reduction in aqueous tear production accompany neurotoxicity. Cessation of BAK treatment leads to recovery of corneal nerve density.

  9. Genetics of corneal endothelial dystrophies

    Indian Academy of Sciences (India)

    Chitra Kannabiran

    2009-12-01

    The corneal endothelium maintains the level of hydration in the cornea. Dysfunction of the endothelium results in excess accumulation of water in the corneal stroma, leading to swelling of the stroma and loss of transparency. There are four different corneal endothelial dystrophies that are hereditary, progressive, non-inflammatory disorders involving dysfunction of the corneal endothelium. Each of the endothelial dystrophies is genetically heterogeneous with different modes of transmission and/or different genes involved in each subtype. Genes responsible for disease have been identified for only a subset of corneal endothelial dystrophies. Knowledge of genes involved and their function in the corneal endothelium can aid understanding the pathogenesis of the disorder as well as reveal pathways that are important for normal functioning of the endothelium.

  10. Bilateral acute corneal calcification.

    Science.gov (United States)

    Freddo, T F; Leibowitz, H M

    1985-04-01

    A 38-year-old man with brittle, juvenile onset diabetes mellitus and bilateral severe dry eyes with recurrent corneal ulcers developed atypical band-shaped calcifications of both corneas during a 24-hour period. Serum calcium, phosphate, and carbon dioxide levels all were within normal limits. The patient was mildly uremic but was not in renal failure. When EDTA chelation failed to clear the deposits, partial keratectomies were performed in both eyes and the specimens were examined by light and electron microscopy, including energy dispersive x-ray analysis. Microscopic studies revealed an atypical calcific keratopathy which involved neither Bowman's layer nor the most superficial stromal lamellae. The deposits were confined to deeper lamellae in the anterior stroma and by electron microscopy were composed of extracellular crystalline aggregates. Energy dispersive x-ray analysis of these aggregates confirmed the presence of calcium and phosphate. Corneal dessication appeared to be a major contributing factor in the rapid formation of these deposits.

  11. Intrastromal corneal ring segments delay corneal grafting in patients with keratoconus

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    Luiz Arthur F. Beniz

    2016-02-01

    Full Text Available ABSTRACT Purpose: To assess the impact of intrastromal corneal ring segments (ICRS as a surgical alternative to corneal grafting in patients with keratoconus who were scheduled for a corneal transplant. Methods: This single-surgeon, single-center, retrospective, observational case series study included 19 eyes of 18 patients (mean age, 23.36 ± 6.22 years with a confirmed diagnosis of keratoconus. These patients were enrolled from the State of Goiás, Brazil corneal graft waiting list. Following extensive pre-operative testing, including the measurement of best-corrected visual acuity (BCVA, applanation tonometry, biomicroscopy, funduscopy, pachymetry, and corneal topography, patients were implanted with Keraring® ICRS. Patients underwent clinical examination at postoperative days 1, 7, 30, 90, and 180 and were examined again 2 years following surgery. Results: At the 2-year cut-off following ICRS implantation (mean follow-up, 28.72 ± 4.71 months, there was a statistically significant improvement in BCVA (logMAR from 0.59 ± 0.35 preoperatively to 0.35 ± 0.45 postoperatively ( p <0.01. Three of 19 eyes (15.8% still required keratoplasty. In the remaining patients (84.2%, BCVA was managed with spectacles (52.6% or contact lenses (31.6%. One patient developed infectious keratitis, requiring removal of ICR at the first postoperative visit. Conclusion: ICRS implantation may be a surgical alternative to keratoplasty in patients with keratoconus. This procedure may delay or even eliminate the need for keratoplasty in such patients.

  12. Corneal blindness: prevention, treatment and rehabilitation

    Directory of Open Access Journals (Sweden)

    Matthew J Burton

    2009-12-01

    Full Text Available Blindness from corneal disease is a major ophthalmic public health problem. There are three important elements to addressing corneal blindness: prevention, treatment, and rehabilitation.

  13. Optical coherence tomography-based topography determination of corneal grafts in eye bank cultivation

    Science.gov (United States)

    Damian, Angela; Seitz, Berthold; Langenbucher, Achim; Eppig, Timo

    2017-01-01

    Vision loss due to corneal injuries or diseases can be treated by transplantation of human corneal grafts (keratoplasty). However, quality assurance in retrieving and cultivating the tissue transplants is confined to visual and microbiological testing. To identify previous refractive surgery or morphological alterations, an automatic, noncontact, sterile screening procedure is required. Twenty-three corneal grafts have been measured in organ culture with a clinical spectral-domain optical coherence tomographer. Employing a biconic surface fit with 10 degrees of freedom, the radii of curvature and conic constants could be estimated for the anterior and posterior corneal surfaces. Thereupon, central corneal thickness, refractive values, and astigmatism have been calculated. Clinical investigations are required to elaborate specific donor-host matching in the future.

  14. Uso de mitomicina C tópico no tratamento da neoplasia intra-epitelial córneo-conjuntival e carcinoma espinocelular conjuntival: resultados preliminares Topical use of mitomycin C for the treatment of corneal-conjunctival intraepithelial neoplasia and conjunctival squamous cell carcinoma: preliminary results

    Directory of Open Access Journals (Sweden)

    Priscilla Luppi Ballalai

    2003-10-01

    2, patients with recurrent SCC, were treated with topical 0.02% MMC, qid for 21 to28 days. RESULTS: Eight patients with CIN and 1with SCC had a total regression of the lesion and all of them had negative control exfoliative cytology for neoplastic cells. One patient with CIN and 2 with SCC had partial regression of the lesions, which were excised surgically, and the pathology was negative for neoplasia. Side effects were transient and subsided after descontinuation of the treatment. There was no recurrence of the lesions on a mean follow-up of 24.9 months. CONCLUSION: The preliminary results of this study suggest that the use of the topical MMC is safe and efficient for the treatment of primary and recurrent CIN and recurrent SCC, although it did not prevent surgery in almost all cases of CEC. There were no recurrences during the follow-up. Further studies with more patients and longer follow-up are necessary to confirm this results.

  15. A new multiple noncontinuous puncture (pointage technique for corneal tattooing

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    Jin Hyoung Park

    2015-10-01

    Full Text Available AIM:To assess the safety and cosmetic efficacy of a new multiple noncontinuous transepithelial puncture technique for tattooing a decompensated cornea.METHODS:It was anon-comparative clinical case series study.The study examines 33 eyes in 33 patients with total corneal opacity due to corneal decompensation, which developed following intraocular surgery.Corneal tattooing was performed using the multiple noncontinuous transepithelial puncture technique (i.e. pointage. The safety of this new surgical strategy was assessed by occurrence of adverse events for the follow-up period. The cosmetic efficacy was determined by the patient’s cosmetic satisfaction and independent observer’s opinion about patient appearance.RESULTS:Seven women and 26 men were included in the study. The mean age was 46.4±17.5y (range:7-67. In total, 30 of 33 patients (91% reported cosmetic satisfaction within the follow-up period. Only 3 patients (9% required additional tattooing due to cosmetic unsatisfaction. Cosmetic outcomes were analyzed and classified as excellent or good in 13 (39% and 17 (52% patients, respectively. No serious adverse events developed, except delayed epithelial healing in 3 cases.CONCLUSION:The cosmetic outcomes of the multiple noncontinuous transepithelial puncture technique for corneal tattooing were good. The safety of this method is higher than conventional procedures. This new procedure also provides improved cost-effectiveness and safety over current corneal tattooing techniques.

  16. Corneal biomechanical properties after femtosecond laser assisted LASIK with the corneal visualization Scheimpflug technology and ocular response analyzer

    Directory of Open Access Journals (Sweden)

    Jing Li

    2017-02-01

    Full Text Available AIM: To investigate the changes of corneal biomechanical properties before and after femtosecond laser assisted LASIK(FS-LASIKusing Corneal Visualisation Scheimpflug Technology(Corvis STand Ocular Response Analyzer(ORA, and the correlation with other myopic parameters. METHODS:Sixty three patients(63 eyeswho had myopic femtosecond laser assisted LASIK(FS-LASIKwere enrolled in the study. The right eye of each patient was analyzed in this study. The corneal biomechanical parameters pre-operative and 1mo post-operative was measured with the Corvis ST(Oculus, Wetzlar, Germanyand ORA(Reichert, Buffalo, New York, USA. Comparison of the biomechanical property values before and after surgery was peformed using Paired t-test or Mann-Whitney U. Pearson or Spearman correlations were used to evaluate the relationship between parameters.RESULTS: The postoperative 1st A-time, Vin, 2nd A length, Vout, HC time and Radius demonstrate significant decreases comparing with preoperative values(P=0.00, P=0.00, P=0.00, P=0.00, P=0.00, P=0.00 respectively. The postoperative 2nd A-time, DA and PD significantly increases(P=0.00, P=0.00, P=0.00, however, the 1st A length had no significant difference after surgery. The CH and CRF were significantly lower after FS-LASIK(P=0.00, P=0.00. A statistically significant correlation coefficient was found between preoperative central corneal thickness(CCTwith postoperative-preoperative changes of 1st A-time, 2nd A-time, DA and Radius respectively(P=0.01, P=0.04, P=0.03, P=0.01. CONCLUSION:There were significantly changes of corneal biomechanical properties after FS-LASIK surgery. The changes of corneal biomechanical properties after FS-LASIK can be reflected by some parameters of Corvis ST and ORA. The mainly influence of corneal biomechanical alteration was possibly correlation with corneal thickness.

  17. Corneal-Based Surgical Presbyopic Therapies and Their Application in Pseudophakic Patients

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    Grace L. Paley

    2016-01-01

    Full Text Available Purpose. The purpose of this review is to provide a summary of laser refractive surgery and corneal inlay approaches to treat presbyopia in patients after cataract surgery. Summary. The presbyopic population is growing rapidly along with increasing demands for spectacle independence. This review will focus on the corneal-based surgical options to address presbyopia including various types of corneal intrastromal inlays and laser ablation techniques to generate either a multifocal cornea (“PresbyLASIK” or monovision. The natural history of presbyopia develops prior to cataracts, and these presbyopic surgeries have been largely studied in phakic patients. Nevertheless, pseudophakic patients may also undergo these presbyopia-compensating procedures for enhanced quality of life. This review examines the published reports that apply these technologies to patients after cataract surgery and discusses unique considerations for this population.

  18. OCT corneal topography within ¼ diopter in the presence of saccadic eye movements

    Science.gov (United States)

    Sayegh, Samir I.

    2013-03-01

    Refractive surgeons and cataract surgeons need accurate measurements of corneal curvature/power. Increased expectations of patients, the increasing number of patients having undergone prior surgeries and patients with corneal pathologies dictate the need for reliable curvature measurements to enhance the predictability and the quality of surgical outcomes. Eye movements can negatively influence these measurements. We present a model of eye movements based on peak saccade velocities and formulate criteria for obtaining OCT topography within ¼ of a diopter. Using these criteria we illustrate how next generation MHz systems will allow full corneal OCT topography in both healthy and pathological corneas

  19. Corneal Densitometry for Quantification of Corneal Deposits in Monoclonal Gammopathies.

    Science.gov (United States)

    Enders, Philip; Holtick, Udo; Schaub, Friederike; Tuchscherer, Armin; Hermann, Manuel M; Scheid, Christoph; Cursiefen, Claus; Bachmann, Björn O

    2017-04-01

    To assess the capability of Scheimpflug-based densitometry of the cornea to quantify light chain deposits in patients with active monoclonal gammopathies. This is a case-control study in which data from a leading tertiary university center in myeloma care were analyzed. Ten eyes of 5 patients with monoclonal gammopathy and 26 eyes of 13 healthy controls undergoing clinical evaluation and Scheimpflug-based measurements were included in the study. The main outcome measures were densitometry data of the 4 corneal layers-anterior layer (AL), central layer (CL), posterior layer, and total layer (TL)-in 4 different annuli (central annular zone 0-2 mm, intermediate annular zone 2-6 mm, peripheral annular zone 6-10 mm, and total annular zone 0-12 mm). In 8 eyes of 4 patients with IgG-based gammopathy, corneal light backscatter was highest in the AL and decreased with increasing corneal depth. The peripheral annular zone showed a higher densitometry value compared with the corneal center. Compared with healthy controls, the AL (P < 0.001), the CL (P < 0.001), and the TL (P < 0.001) had significantly higher corneal light backscatter in patients with gammopathy in the total and the peripheral annular zones. In one patient with predominantly IgA-based disease, corneal light backscatter was not elevated. Scheimpflug-based densitometry of the cornea is able to quantify opacification by immunoglobulin G light chain deposits in monoclonal gammopathies. This noninvasive technique can complement presently used in vivo confocal microscopy and corneal photography to objectivize corneal changes. Densitometry might allow monitoring of corneal immunoglobulin deposits in follow-up examinations.

  20. Resolution of persistent corneal erosion after administration of topical rebamipide

    Directory of Open Access Journals (Sweden)

    Kashima T

    2012-08-01

    Full Text Available Tomoyuki Kashima,1,2 Hideo Akiyama,1 Fumihide Miura,2 Shoji Kishi11Department of Ophthalmology, Gunma University School of Medicine, Maebashi, Japan; 2Department of Ophthalmology, Saku Central Hospital, Saku, JapanAbstract: Rebamipide is an antiulcer agent used to treat gastric ulcer and gastritis. Biological effects of rebamipide include cytoprotection, wound healing, and anti-inflammatory properties that are known to be universal for a variety of tissues in addition to gastrointestinal mucosa. The therapeutic effects of rebamipide eye drops are due to its ability to increase corneal and conjunctival mucin-like substances and improve corneal and conjunctival injury in vivo. In this paper, we report a case of Sjögren's syndrome with complete disappearance of corneal erosion after administration of rebamipide eye drops. This was observed even though corneal erosion had not improved for 6 months after punctal occlusion surgery. The patient was a 33-year-old female, diagnosed with Sjögren's syndrome by a salivary gland biopsy. The corneal and conjunctival surfaces were filled with dense erosions, which did not improve with topical drugs. Punctal plugs were applied several times; however, the plugs were repeatedly shed. All four puncta of both eyelids were surgically occluded, and both corneal and conjunctival erosion was clearly improved. However, the erosion in the inferior cornea of both eyes had not improved for 6 months after surgery. We used the newly approved topical rebamipide for treatment of this patient. The corneal erosion gradually improved and completely disappeared 4 weeks after administration of the drug. Dry eye sensation disappeared at the same time. Both membrane-associated mucin and secreted mucin in the ocular surface are thought to be essential for maintenance of the tear film. Induction of mucin from ocular surface epithelium could be an effective treatment in cases of dry eye caused by mucin deficiency. Through its various

  1. Evaluation of the preliminary effectiveness of hand massage therapy on postoperative pain of adults in the intensive care unit after cardiac surgery: a pilot randomized controlled trial.

    Science.gov (United States)

    Boitor, Mădălina; Martorella, Géraldine; Arbour, Caroline; Michaud, Cécile; Gélinas, Céline

    2015-06-01

    Although many intensive care unit patients experience significant pain, very few studies explored massage to maximize their pain relief. This study aimed to evaluate the preliminary effects of hand massage on pain after cardiac surgery in the adult intensive care unit. A pilot randomized controlled trial was used for this study. The study was conducted in a Canadian medical-surgical intensive care unit. Forty adults who were admitted to the intensive care unit after undergoing elective cardiac surgery in the previous 24 hours participated in the study. They were randomly assigned to the experimental (n = 21) or control (n = 19) group. The experimental group received a 15-minute hand massage, and the control group received a 15-minute hand-holding without massage. In both groups the intervention was followed by a 30-minute rest period. The interventions were offered on 2-3 occasions within 24 hours after surgery. Pain, muscle tension, and vital signs were assessed. Pain intensity and behavioral scores were decreased for the experimental group. Although hand massage decreased muscle tension, fluctuations in vital signs were not significant. This study supports potential benefits of hand massage for intensive care unit postoperative pain management. Although larger randomized controlled trials are necessary, this low-cost nonpharmacologic intervention can be safely administered.

  2. The corneal fibrosis response to epithelial-stromal injury.

    Science.gov (United States)

    Torricelli, Andre A M; Santhanam, Abirami; Wu, Jiahui; Singh, Vivek; Wilson, Steven E

    2016-01-01

    The corneal wound healing response, including the development of stromal opacity in some eyes, is a process that often leads to scarring that occurs after injury, surgery or infection to the cornea. Immediately after epithelial and stromal injury, a complex sequence of processes contributes to wound repair and regeneration of normal corneal structure and function. In some corneas, however, often depending on the type and extent of injury, the response may also lead to the development of mature vimentin+ α-smooth muscle actin+ desmin+ myofibroblasts. Myofibroblasts are specialized fibroblastic cells generated in the cornea from keratocyte-derived or bone marrow-derived precursor cells. The disorganized extracellular matrix components secreted by myofibroblasts, in addition to decreased expression of corneal crystallins in these cells, are central biological processes that result in corneal stromal fibrosis associated with opacity or "haze". Several factors are associated with myofibroblast generation and haze development after PRK surgery in rabbits, a reproducible model of scarring, including the amount of tissue ablated, which may relate to the extent of keratocyte apoptosis in the early response to injury, irregularity of stromal surface after surgery, and changes in corneal stromal proteoglycans, but normal regeneration of the epithelial basement membrane (EBM) appears to be a critical factor determining whether a cornea heals with relative transparency or vision-limiting stromal opacity. Structural and functional abnormalities of the regenerated EBM facilitate prolonged entry of epithelium-derived growth factors such as transforming growth factor β (TGF-β) and platelet-derived growth factor (PDGF) into the stroma that both drive development of mature myofibroblasts from precursor cells and lead to persistence of the cells in the anterior stroma. A major discovery that has contributed to our understanding of haze development is that keratocytes and corneal

  3. Effects of phacoemulsification on the intraocular pressure and corneal endothelial cells of the patients with glaucoma

    Institute of Scientific and Technical Information of China (English)

    Ye Zhao; Zhi-Feng Liu

    2016-01-01

    Objective:To explore the intraocular pressure and corneal endothelial cells integrity changes in cataract phacoemulsification after anti-glaucoma surgery.Methods:Phacoemulsification was performed in 102 patients (118 eyes) with cataract after anti-glaucoma surgery and the intraocular pressure and corneal endothelial cell integrity changes of patients were observed at Day 1 and 3, first week and first month before and after surgery, including central corneal endothelial cell density, average cell area (AVE), cell area of coefficient of variation (CV) and central corneal thickness (CCT).Results:The intraocular pressure was elevated, the central endothelial cell density was reduced, the AVE, the CV and CTT thicken were increased at Day 1 and 3, first week and first month after surgery. The difference compared with preoperative was statistically significant. The intraocular pressure and CTT almost recovered to preoperative levels in 1 month after cataract phacoemulsification and the difference was not statistically significant; while the central endothelial cell density was still decreased and AVE and CV were still increased and the difference of these indexes and the coefficient of the patients was statistically significant compared with before surgery.Conclusions:For the patients with anti-glaucoma after cataract phacoemulsification, intraocular pressure and endothelial cell integrity change was initially observed at Day 1 after surgery, whereas they can almost return to the preoperative level in a month after surgery.

  4. Use of bovine pericardium (Tutopatch®) graft for surgical repair of deep melting corneal ulcers in dogs and corneal sequestra in cats.

    Science.gov (United States)

    Dulaurent, Thomas; Azoulay, Thierry; Goulle, Frédéric; Dulaurent, Alice; Mentek, Marielle; Peiffer, Robert L; Isard, Pierre-François

    2014-03-01

    To evaluate the efficacy of bovine pericardium (BP) graft in the treatment of deep melting corneal ulcers in three dogs and corneal sequestra in three cats. Three dogs with keratomalacia affecting the deep third of the stroma and three cats with corneal sequestrum were evaluated and underwent surgery. Following keratectomy, BP material was placed into the keratectomy bed and sutured to the recipient cornea with 9/0 polyglactin suture material. Postoperative treatment with topical and systemic antibiotics, systemic nonsteroidal anti-inflammatory agents, and topical atropine was prescribed. Follow-up examinations were carried out 1, 2 weeks, 1 and 2 months after the surgery and consisted of a complete ophthalmic examination. Optical coherence tomography (OCT) was performed 1 and 2 months after the surgery in one dog and in one cat. At 1 week, corneal neovascularization was present around the BP graft in all cases. Four weeks after the BP graft, in two dogs and in all cats, the vascularization was regressing and the graft was integrated into the cornea, which was regaining transparency. Topical treatment with anti-inflammatory agents was then prescribed for 2 weeks. Two months after the surgery, 5 of 6 corneas in two dogs and three cats had healed with focal corneal scarring. The remaining dog had progression of the keratomalacia involving the deep BP graft that required additional surgery, but became blind. Bovine pericardium graft offers a promising option for surgical reconstruction of the cornea following keratectomy for the management of corneal ulcers and sequestra. © 2013 American College of Veterinary Ophthalmologists.

  5. Clinical efficacy of low level laser therapy in reducing pain and swelling after periapical surgery. A preliminary report.

    Directory of Open Access Journals (Sweden)

    Lilia Escalante-Macías

    2015-06-01

    Full Text Available ABSTRACT The objective of this study was to evaluate the efficacy of the low level laser therapy (LLLT in postoperative pain and swelling associated with periapical surgery. A double-blind, randomized, controlled clinical trial was carried out in 2 groups of 10 patients each, undergoing periapical surgery. The experimental group was treated with an intraoral application of an 810 nm-GaAsAl-laser, having an output power of 100 mW, with overlapping movements over the wound. In the control group, the same procedure was carried out, without therapeutic laser activation. Postoperative pain, swelling, and rescue medication were registered. The experimental group exhibited a decrease in pain intensity after periapical surgery compared with control group (p

  6. [Methods for sealing of corneal perforations].

    Science.gov (United States)

    Samoilă, O; Totu, Lăcrămioara; Călugăru, M

    2012-01-01

    A variety of corneal pathology can lead to corneal ulcers and perforations. A deep corneal ulcer may need surgical treatment to allow good volume restoration and reepithelisation. Corneal perforation must be sealed and when the perforation is large, the task of repairing the defect can be underwhelming. The elegant solution is the corneal transplant, but this is not always readily available, especially in undeveloped countries. We present here two cases with different solutions to seal the perforated cornea: the first one has a large peripheral defect and it is successfully sealed with scleral patch and the second one is central with small perforation and is successfully sealed with multilayered amniotic membrane. Both cases are followed for over 12 months and demonstrate good corneal restoration (both on clinical examination and corneal topography). Sclera and amniotic membrane can be used to seal corneal defects when corneal transplant is not readily available.

  7. Corneal collagen crosslinking: a systematic review.

    Science.gov (United States)

    Sorkin, Nir; Varssano, David

    2014-01-01

    Keratoconus (KCN) is an ectatic disorder with progressive corneal thinning and a clinical picture of corneal protrusion, progressive irregular astigmatism, corneal fibrosis and visual deterioration. Other ectatic corneal disorders include: post-LASIK ectasia (PLE) and pellucid marginal degeneration (PMD). Corneal crosslinking (CXL) is a procedure whereby riboflavin sensitization with ultraviolet A radiation induces stromal crosslinks. This alters corneal biomechanics, causing an increase in corneal stiffness. In recent years, CXL has been an established treatment for the arrest of KCN, PLE and PMD progression. CXL has also been shown to be effective in the treatment of corneal infections, chemical burns, bullous keratopathy and other forms of corneal edema. This is a current review of CXL - its biomechanical principles, the evolution of CXL protocols in the past, present and future, indications for treatment, treatment efficacy and safety.

  8. Patching for corneal abrasion.

    Science.gov (United States)

    Lim, Chris H L; Turner, Angus; Lim, Blanche X

    2016-07-26

    Published audits have demonstrated that corneal abrasions are a common presenting eye complaint. Eye patches are often recommended for treating corneal abrasions despite the lack of evidence for their use. This systematic review was conducted to determine the effects of the eye patch when used to treat corneal abrasions. The objective of this review was to assess the effects of patching for corneal abrasion on healing and pain relief. We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 4), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to May 2016), EMBASE (January 1980 to May 2016), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to May 2016), System for Information on Grey Literature in Europe (OpenGrey) (January 1995 to May 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 9 May 2016. We also searched the reference lists of included studies, unpublished 'grey' literature and conference proceedings and contacted pharmaceutical companies for details of unpublished trials. We included randomised and quasi-randomised controlled trials that compared patching the eye with no patching to treat simple corneal abrasions. Two authors independently assessed the risk of bias and extracted data. Investigators were contacted for further information regarding the quality of trials. The primary outcome was healing at 24, 48 and 72 hours while secondary outcomes included measures of pain, quality of life and adverse effects. We graded the certainty of the evidence using GRADE. We included 12 trials which

  9. Orthognathic surgery with or without autologous fat micrograft injection: preliminary report on aesthetic outcomes and patient satisfaction.

    Science.gov (United States)

    Raffaini, M; Pisani, C

    2015-03-01

    Orthognathic surgery leaves the intrinsic volume of the facial soft tissues untouched, sometimes resulting in unsatisfactory improvements in aesthetics. The aim of this study was to evaluate the aesthetic outcomes and patient satisfaction following bimaxillary orthognathic surgery with or without simultaneous facial lipofilling procedures. The preoperative and postoperative facial appearances of 210 patients were compared through analysis of photographs and postoperative clinical evaluation. A patient questionnaire was used to assess the perceived improvement in aesthetics. One hundred and twenty patients (mean age 20.3 years) underwent bimaxillary orthognathic surgery and simultaneous facial lipofilling procedures (group I). The remaining 90 patients (mean age 19.8 years) underwent skeletal procedures only (group II). The overall aesthetic improvement was similar in the two groups (group I 92.5%, group II 91.1%). Greater higher-level aesthetic improvement scores were recorded for group I (group I 80%, group II 55.6%). The overall patient satisfaction was 98.3% for group I and 97.8% for group II. Greater higher-level satisfaction scores were recorded for group I (group I 14.2%, group II 6.7%). The simultaneous use of the autologous fat micrograft is a promising technique that may improve the aesthetic outcomes of orthognathic surgery, leading to greater patient satisfaction.

  10. 3D mapping of cerebrospinal fluid local volume changes in patients with hydrocephalus treated by surgery: preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Hodel, Jerome [Hopital Roger Salengro, Department of Neuroradiology, Lille (France); Hopital Roger Salengro, Service de Neuroradiologie, Lille (France); Besson, Pierre; Pruvo, Jean-Pierre; Leclerc, Xavier [Hopital Roger Salengro, Department of Neuroradiology, Lille (France); Rahmouni, Alain; Grandjacques, Benedicte; Luciani, Alain [Hopital Henri Mondor, Department of Radiology, Creteil (France); Petit, Eric; Lebret, Alain [Signals Images and Intelligent Systems Laboratory, Creteil (France); Outteryck, Olivier [Hopital Roger Salengro, Department of Neurology, Lille (France); Benadjaoud, Mohamed Amine [Radiation Epidemiology Team, CESP, Centre for Research in Epidemiology and Population Health U1018, Villejuif (France); Maraval, Anne [Hopital Henri Mondor, Department of Neuroradiology, Creteil (France); Decq, Philippe [Hopital Henri Mondor, Department of Neurosurgery, Creteil (France)

    2014-01-15

    To develop automated deformation modelling for the assessment of cerebrospinal fluid (CSF) local volume changes in patients with hydrocephalus treated by surgery. Ventricular and subarachnoid CSF volume changes were mapped by calculating the Jacobian determinant of the deformation fields obtained after non-linear registration of pre- and postoperative images. A total of 31 consecutive patients, 15 with communicating hydrocephalus (CH) and 16 with non-communicating hydrocephalus (NCH), were investigated before and after surgery using a 3D SPACE (sampling perfection with application optimised contrast using different flip-angle evolution) sequence. Two readers assessed CSF volume changes using 3D colour-encoded maps. The Evans index and postoperative volume changes of the lateral ventricles and sylvian fissures were quantified and statistically compared. Before surgery, sylvian fissure and brain ventricle volume differed significantly between CH and NCH (P = 0.001 and P = 0.025, respectively). After surgery, 3D colour-encoded maps allowed for the visual recognition of the CSF volume changes in all patients. The amounts of ventricle volume loss of CH and NCH patients were not significantly different (P = 0.30), whereas readjustment of the sylvian fissure volume was conflicting in CH and NCH patients (P < 0.001). The Evans index correlated with ventricle volume in NCH patients. 3D mapping of CSF volume changes is feasible providing a quantitative follow-up of patients with hydrocephalus. (orig.)

  11. Robot-Assisted Surgery for Mandibular Angle Split Osteotomy Using Augmented Reality: Preliminary Results on Clinical Animal Experiment.

    Science.gov (United States)

    Zhou, Chaozheng; Zhu, Ming; Shi, Yunyong; Lin, Li; Chai, Gang; Zhang, Yan; Xie, Le

    2017-07-19

    Mandibular angle split osteotomy (MASO) is a procedure widely used for prominent mandibular angles. However, conventional mandibular plastic surgery is invasive and high risk. It may induce postoperative neurosensory disturbance of the inferior alveolar nerve, fractures and infection due to the complexity of the anatomical structure and the narrow surgical field of view. The success rate of MASO surgery usually depends on the clinical experience and skills of the surgeon. To evaluate the performance of inexperienced plastic surgeons conducting this surgery, a self-developed and constructed robot system based on augmented reality is used. This robot system provides for sufficient accuracy and safety within the clinical environment. To evaluate the accuracy and safety of MASO surgery, an animal study using this robot was performed in the clinical room, and the results were then evaluated. Four osteotomy planes were successfully performed on two dogs; that is, twenty tunnels (each dog drilled on bilaterally) were drilled in the dogs' mandible bones. Errors at entrance and target points were 1.04 ± 0.19 and 1.22 ± 0.24 mm, respectively. The angular error between the planned and drilled tunnels was 6.69° ± 1.05°. None of the dogs experienced severe complications. Therefore, this technique can be regarded as a useful approach for training inexperienced plastic surgeons on the various aspects of plastic surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  12. Corneal collagen cross-linking

    Directory of Open Access Journals (Sweden)

    Jankov II Mirko

    2010-01-01

    Full Text Available Corneal collagen cross-linking (CXL with riboflavin and ultraviolet-A (UVA is a new technique of corneal tissue strengthening by using riboflavin as a photosensitizer and UVA to increase the formation of intra- and interfibrillar covalent bonds by photosensitized oxidation. Keratocyte apoptosis in the anterior segment of the corneal stroma all the way down to a depth of about 300 microns has been described and a demarcation line between the treated and untreated cornea has been clearly shown. It is important to ensure that the cytotoxic threshold for the endothelium has not been exceeded by strictly respecting the minimal corneal thickness. Confocal microscopy studies show that repopulation of keratocytes is already visible 1 month after the treatment, reaching its pre-operative quantity and quality in terms of functional morphology within 6 months after the treatment. The major indication for the use of CXL is to inhibit the progression of corneal ectasias, such as keratoconus and pellucid marginal degeneration. CXL may also be effective in the treatment and prophylaxis of iatrogenic keratectasia, resulting from excessively aggressive photoablation. This treatment has also been used to treat infectious corneal ulcers with apparent favorable results. Combination with other treatments, such as intracorneal ring segment implantation, limited topography-guided photoablation and conductive keratoplasty have been used with different levels of success.

  13. Hipertensão ocular "mascarada" por edema de córnea após cirurgia da catarata Ocular hipertension confounded by corneal edema after cataract surgery

    Directory of Open Access Journals (Sweden)

    Bruno de Freitas Valbon

    2009-12-01

    intraocular pressure (IOP measurements in cases with thick and flatter corneas. This is thought to occur linearly based on mathematical and on experimental studies. However, such influence does exist, but this is more complex than the one anticipated by pachymetry and keratometry because it is related to corneal biomechanical properties. The ocular response analyzer (ORA Reichert provides the data related to the biomechanical properties of the cornea along with the IOP measurements that are calibrated for correlating to the Goldmann applanation and also compensated from corneal properties. Also corneal tomography with a pachymetric map evaluation characterizes the cornea beyond central thickness and anterior curvature. In this article, we report a case of a 77 years old female patient with low vision, photofobia and ocular pain 28 days after phacoemulsification and intraocular lens implant. In the first visit, GAT was 14mmHg, while IOPcc (ORA corneal compensated IOP was 25,6mmHg. Corneal hysteresis and resistance factor were low: 4,1 and 6,1mmHg respectively despite a central thickness of 601 micron. Corneal thickness spatial profile was attenuated with an edematous pattern that was also observed by the Scheimpflug images (Pentacam. Hypertensive uveitis was diagnosed and the patient was started on a fixed combination of timolol and brimonidine associate with prednisolone acetate. Three weeks after, the patient referred resolution of photofobia and marked improvement of vision. Clinically, edema was resolved as observed by corneal tomographyc and biomechanical findings.

  14. Application value of corneal limbus stem cells transplantation to treat pterygium

    Directory of Open Access Journals (Sweden)

    Miao-Ying Zhang

    2017-02-01

    Full Text Available AIM: To analyze the application value of corneal limbus stem cells transplantation in the treatment of pterygium. METHODS: Totally 300 patients(318 eyeswith pterygium were divided into 2 groups according to treatment methods. Patients of the control group(70 patients with 77 eyeswere given simple surgical resection, while patients of the observation group(230 patients with 241 eyeswere given corneal limbus stem cells transplantation after surgical resection. The postoperative recurrent rate, corneal epithelium incision healing time, corneal epithelium healing degree, pain score and tear film break-up time were observed. RESULTS: The corneal epithelium incision healing time of the observation group and control group were respectively 5.2±1.9d and 6.4±1.7d, and the difference had statistical significance(PPP>0.05. At 2wk after treatment, the corneal epithelium healing degree of the observation group was better, and the pain score of the observation group was lower than those of the control group, the differences between groups had statistical significance(PP>0.05. At 1 and 2wk after treatment, the tear film break-up time of the observation group was longer than that of the control group(PCONCLUSION: Corneal limbus stem cell transplantation can prevent postoperative recurrence of pterygium effectively, and its postoperative tissue repair effect is superior to simple surgery.

  15. Graft Biomechanics Following Three Corneal Transplantation Techniques

    Science.gov (United States)

    Feizi, Sepehr; Montahai, Talieh; Moein, Hamidreza

    2015-01-01

    Purpose: To compare corneal biomechanical properties following three different transplantation techniques, including Descemet stripping automated endothelial keratoplasty (DSAEK), deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) in comparison to normal eyes. Methods: This cross-sectional comparative study included 118 eyes: 17 eyes of 17 patients received DSAEK, 23 eyes of 21 patients underwent DALK using Anwar's big bubble technique, and 45 eyes of 36 patients had PK; 33 right eyes of 33 normal subjects served as the control group. Using the ocular response analyzer (ORA, Reichert Ophthalmic Instruments, Buffalo, New York, USA), corneal hysteresis (CH) and corneal resistance factor (CRF) were measured and compared among the study groups at least 3 months after all sutures were removed. Results: Mean patient age was 26.9 ± 5.0 years in the control group, 28.8 ± 4.2 in the PK group, 27.2 ± 6.5 in the DALK group, and 62.5 ± 16.8 in the DSAEK group (P < 0.001). Central corneal thickness (CCT) was 539.0 ± 24.8, 567.5 ± 38.8, 547.0 ± 42.6 and 631.1 ± 84.8 μm, respectively (P < 0.001). CH and CRF were significantly lower in the DSAEK group (7.79 ± 2.0 and 7.88 ± 1.74 mmHg, respectively) as compared to the PK (10.23 ± 2.07 and 10.13 ± 2.22 mmHg, respectively) and DALK (9.64 ± 2.07 and 9.36 ± 2.09 mmHg, respectively) groups. The two latter groups demonstrated biomechanical parameters comparable to normal subjects (9.84 ± 1.59 and 9.89 ± 1.73 mmHg, respectively). Conclusion: Graft biomechanical parameters after DSAEK are lower than those following PK and DALK. After PK and DALK in keratoconic eyes, these metrics are increased to normal values. These differences may have implications for interpreting intraocular pressure or planning graft refractive surgery after keratoplasty. PMID:26730307

  16. Optical Quality, Threshold Target Identification, and Military Target Task Performance After Advanced Keratorefractive Surgery

    Science.gov (United States)

    2011-05-01

    of Life in West Point Cadets Seeking Refractive Surgery. Anatoly Fabrikant, Dimitri Chernyak. Analysis of Wavefront and Corneal Topography Changes...since the last annual report: In the first event, a sterile corneal infiltrate/ ulcer was discovered. This adverse event was not the result of the...study, but 6 rather a recognized result of the surgery. There was no change in the risk/ benefit ratio, as corneal ulcers are recognized potential

  17. Molecular mechanism of fluoroquinolones modulation on corneal fibroblast motility.

    Science.gov (United States)

    Chen, Tsan-Chi; Tsai, Tzu-Yun; Chang, Shu-Wen

    2016-04-01

    Topical fluoroquinolones are widely used to prevent ocular infections after ophthalmic surgery. However, they have been shown to affect the corneal cell motility, whose mechanism remains indefinite. The purpose of this study was to investigate how fluoroquinolones affect corneal stromal cell motility. Human corneal fibroblasts (HCFs) were incubated in ciprofloxacin (CIP), levofloxacin (LEV), or moxifloxacin (MOX) at 0, 10, 50, and 100 μg/ml for up to 3 days. Effect of CIP, LEV, or MOX on HCF migration was monitored using migration assay. HCF viability was determined by WST-1 assay. Expression of focal adhesion kinase (FAK), paxillin (PXN), and their phosphorylated forms were analyzed by immunoblotting. Binding affinity between FAK and PXN was determined by co-immunoprecipitation. Our results revealed that CIP and MOX, but not LEV, noticeably retarded HCF migration. HCF proliferation was significantly reduced by CIP (38.2%), LEV (29.5%), and MOX (21.3%), respectively (p = 0.002). CIP and MOX suppressed the phosphorylation of PXN at tyrosines (10.2 ± 4.3%, p MOX diminished the binding affinity between FAK and PXN (8.2 ± 1.8%, p MOX, but not LEV, might delay corneal fibroblast migration via interfering with recruitment of PXN to focal adhesions and dephosphorylation of PXN at the tyrosines.

  18. Nerve regeneration by human corneal stromal keratocytes and stromal fibroblasts

    Science.gov (United States)

    Yam, Gary Hin-Fai; Williams, Geraint P.; Setiawan, Melina; Yusoff, Nur Zahirah Binte M.; Lee, Xiao-wen; Htoon, Hla Myint; Zhou, Lei; Fuest, Matthias; Mehta, Jodhbir S.

    2017-01-01

    Laser refractive surgeries reshape corneal stroma to correct refractive errors, but unavoidably affect corneal nerves. Slow nerve regeneration and atypical neurite morphology cause desensitization and neuro-epitheliopathy. Following injury, surviving corneal stromal keratocytes (CSKs) are activated to stromal fibroblasts (SFs). How these two different cell types influence nerve regeneration is elusive. Our study evaluated the neuro-regulatory effects of human SFs versus CSKs derived from the same corneal stroma using an in vitro chick dorsal root ganglion model. The neurite growth was assessed by a validated concentric circle intersection count method. Serum-free conditioned media (CM) from SFs promoted neurite growth dose-dependently, compared to that from CSKs. We detected neurotrophic and pro-inflammatory factors (interleukin-8, interleukin-15, monocyte chemoattractant protein-1, eotaxin, RANTES) in SFCM by Bio-Plex Human Cytokine assay. More than 130 proteins in SFCM and 49 in CSKCM were identified by nanoLC-MS/MS. Proteins uniquely present in SFCM had reported neuro-regulatory activities and were predicted to regulate neurogenesis, focal adhesion and wound healing. Conclusively, this was the first study showing a physiological relationship between nerve growth and the metabolically active SFs versus quiescent CSKs from the same cornea source. The dose-dependent effect on neurite growth indicated that nerve regeneration could be influenced by SF density. PMID:28349952

  19. Rapid, automated mosaicking of the human corneal subbasal nerve plexus.

    Science.gov (United States)

    Vaishnav, Yash J; Rucker, Stuart A; Saharia, Keshav; McNamara, Nancy A

    2017-03-04

    Corneal confocal microscopy (CCM) is an in vivo technique used to study corneal nerve morphology. The largest proportion of nerves innervating the cornea lie within the subbasal nerve plexus, where their morphology is altered by refractive surgery, diabetes and dry eye. The main limitations to clinical use of CCM as a diagnostic tool are the small field of view of CCM images and the lengthy time needed to quantify nerves in collected images. Here, we present a novel, rapid, fully automated technique to mosaic individual CCM images into wide-field maps of corneal nerves. We implemented an OpenCV image stitcher that accounts for corneal deformation and uses feature detection to stitch CCM images into a montage. The method takes 3-5 min to process and stitch 40-100 frames on an Amazon EC2 Micro instance. The speed, automation and ease of use conferred by this technique is the first step toward point of care evaluation of wide-field subbasal plexus (SBP) maps in a clinical setting.

  20. Continuous adductor-canal-blockade for adjuvant post-operative analgesia after major knee surgery: preliminary results

    DEFF Research Database (Denmark)

    Lund, J; Jenstrup, M T; Jæger, P;

    2011-01-01

    Because both the saphenous nerve and in part the obturator nerve are traversing the adductor canal of the thigh, we hypothesised that repeated administration of a local anaesthetic (LA) into this aponeurotic space could be a useful option for post-operative analgesia after knee replacement surgery....... A systematic search of the literature pertinent to the blockade of the saphenous and/or obturator nerves for pain relief after knee surgery was conducted. Further, pain and opioid requirements were evaluated in eight patients receiving a continuous blockade of the saphenous and obturator nerve (adductor-canal......-blockade) after total knee arthroplasty (TKA). Finally, we performed cross-sectional MR scans of the adductor canal after injection of ropivacaine 30ml in one patient. The systematic literature search revealed only one controlled study, where selective blockade of the saphenous nerve was investigated...

  1. Relation of nutritional status to physiological outcomes after cardiac surgery in elderly patients with diabetes mellitus: a preliminary study.

    Science.gov (United States)

    Izawa, Kazuhiro P; Watanabe, Satoshi

    2016-12-01

    To determine differences in physiological outcome (PO) based on the Geriatric Nutritional Risk Index (GNRI) and cut-off values for PO according to the GNRI in elderly post-cardiac surgery patients complicated by diabetes mellitus (DM). Thirty-five patients (72.9 years) were enrolled and divided by GNRI. Patient characteristics and PO of handgrip strength (HG), knee extensor muscle strength (KEMS), maximum gait speed (GS), and one-leg standing time (OLST) were compared between the groups, and cut-off values for PO were determined. These POs were significantly lower in the low-GNRI group (Nutritional status might influence PO following cardiac surgery. The cut-off values of PO reported here might be indicative of the need to improve patient nutritional status.

  2. May Renal Resistive Index Be an Early Predictive Tool of Postoperative Complications in Major Surgery? Preliminary Results

    Directory of Open Access Journals (Sweden)

    Enrico Giustiniano

    2014-01-01

    Full Text Available Background. Patients who undergo high-risk surgery represent a large amount of post-operative ICU-admissions. These patients are at high risk of experiencing postoperative complications. Renal Resistive Index was found to be related with renal dysfunction, hypertension, and posttraumatic hemorrhagic shock, probably due to vasoconstriction. We explored whether Renal Resistive Index (RRI, measured after awakening from general anesthesia, could have any relationship with postoperative complications. Methods. In our observational, stratified dual-center trial, we enrolled patients who underwent general anesthesia for high-risk major surgery. After awakening in recovery room (or during awakening period in subjects submitted to cardiac surgery we measured RRI by echo-color-Doppler method. Primary endpoint was the association of altered RRI (>0.70 and outcome during the first postoperative week. Results. 205 patients were enrolled: 60 (29.3% showed RRI > 0.70. The total rate of adverse event was 27 (18.6% in RRI ≤ 0.7 group and 19 (31.7% in RRI > 0.7 group (P=0.042. Significant correlation between RRI > 0.70 and complications resulted in pneumonia (P=0.016, septic shock (P=0.003, and acute renal failure (P=0.001 subgroups. Patients with RRI > 0.7 showed longer ICU stay (P=0.001 and lasting of mechanical ventilation (P=0.004. These results were confirmed in cardiothoracic surgery subgroup. RRI > 0.7 duplicates triplicates the risk of complications, both in general (OR 2.03 93 95% CI 1.02–4.02, P=0.044 and in cardiothoracic (OR 2.62 95% CI 1.11–6.16, P=0.027 population. Furthermore, we found RRI > 0.70 was associated with a triplicate risk of postoperative septic shock (OR 3.04, CI 95% 1.5–7.01; P=0.002.

  3. OBESITY PHENOTYPE INFLUENCES TREND IN PULMONARY FUNCTION INDICES RECOVERY FOLLOWING ABDOMINAL SURGERY: PRELIMINARY REPORT FROM A NIGERIAN POPULATION.

    Science.gov (United States)

    Akinremi, A A; Orotokun, A E; Sanya, A O

    2014-09-01

    Obesity phenotypes are known to have varying effects on pulmonary function but their effects on trends of pulmonary function indices' recovery among abdominal surgery patients is unclear. To investigate the influence of obesity phenotype on pulmonary function trend among abdominal surgery patients. An observational study involving 28 female patients aged 20-60 years who were never-smokers. Participants were classified into four groups namely: healthy BMI without abdominal obesity; healthy BMI with abdominal obesity; overweight/obese without abdominal obesity; and overweight/obese with abdominal obesity. Pulmonary function indices (FEV1, FVC and PEF) were taken day-1 pre-op; 5(th), 6(th) and 7(th) day post-surgery. Data were summarized using mean and standard deviation, while Kruskal-Wallis and Jonckheere trend test were used to test for differences and trend across the groups at p trend test showed that obesity pattern had significant effect on the trend of FEV1, FVC and PER with group I having the highest values, followed by group III and group II, while group IV had the lowest values. Obesity phenotype had significant effect on trend of pulmonary function indices among participants. Patients with abdominal obesity, irrespective of BMI, had poor pulmonary function.

  4. Corneal stromal dystrophies: a clinical pathologic study

    Directory of Open Access Journals (Sweden)

    Elvira Barbosa Abreu

    2012-12-01

    Full Text Available INTRODUCTION: Corneal dystrophy is defined as bilateral and symmetric primary corneal disease, without previous associated ocular inflammation. Corneal dystrophies are classified according to the involved corneal layer in superficial, stromal, and posterior dystrophy. Incidence of each dystrophy varies according to the geographic region studied. PURPOSE: To evaluate the prevalence of stromal corneal dystrophies among corneal buttons specimens obtained by penetrating keratoplasty (PK in an ocular pathology laboratory and to correlate the diagnosis with patient age and gender. METHODS: Corneal button cases of penetrating keratoplasty from January-1996 to May-2009 were retrieved from the archives of The Henry C. Witelson Ophthalmic Pathology Laboratory and Registry, Montreal, Canada. The cases with histopathological diagnosis of stromal corneal dystrophies were stained with special stains (Peroxid acid Schiff, Masson trichrome, Congo red analyzed under polarized light, and alcian blue for classification and correlated with epidemiological information (age at time of PK and gender from patients' file. RESULTS: 1,300 corneal buttons cases with clinical diagnose of corneal dystrophy were retrieved. Stromal corneal dystrophy was found in 40 (3.1% cases. Lattice corneal dystrophy was the most prevalent with 26 cases (65%. Nineteen were female (73.07% and the PK was performed at average age of 59.3 years old. Combined corneal dystrophy was found in 8 (20% cases, 5 (62.5% of them were female and the average age of the penetrating keratoplasty was 54.8 years old. Granular corneal dystrophy was represented by 5 (12.5% cases, and 2 (40% of them were female. Penetrating keratoplasty was performed at average age of 39.5 years old in granular corneal dystrophy cases. Macular corneal dystrophy was present in only 1 (2.5% case, in a 36 years old female. CONCLUSION: Systematic histopathological approach and evaluation, including special stains in all stromal

  5. Evaluation of Factors Limiting Corneal Donation.

    Science.gov (United States)

    Röck, Daniel; Wude, Johanna; Yoeruek, Efdal; Bartz-Schmidt, Karl Ulrich; Röck, Tobias

    2016-11-15

    BACKGROUND This study aimed to investigate factors limiting corneal donation at the University Hospital Tübingen. MATERIAL AND METHODS We retrospectively studied all hospital deaths from January 2012 to December 2015, considering each deceased patient as a potential corneal donor. During this period an ophthalmic resident managed corneal donor procurement on a full-time basis. Various factors limiting corneal donation were examined. RESULTS Among the 3412 deaths, 2937 (86.1%) displayed nonfulfillment of corneal donation. Consent for corneal donation was obtained in 475 cases (13.9%). The mean annual corneal donation rate was 13.9 donors per 100 deaths (range: 11.2-17.8). The leading causes of nonfulfillment of corneal donations were refusal to donate (49.8%, 1698 cases) and medical contraindications (23.6%, 805 cases). After next-of-kin interview of 2173 potential donors (109 potential donors were excluded because of logistical problems), willingness to participate in corneal donation was present in 475 cases (21.9%), whereas in 1698 cases (78.1%) corneal donation was refused. CONCLUSIONS Our study showed refusal to donate is the most important factor limiting corneal donation. It seems that increasing the knowledge of people about corneal donation through public education and media are necessary to address the corneal shortage.

  6. Posttraumatic growth in women after breast cancer surgerypreliminary results from a study of Polish patients

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    Aleksandra Andysz

    2015-07-01

    Full Text Available Background The aim of the study was to answer the following research questions: What percentage of women after breast cancer surgery experienced posttraumatic growth (PTG? Which aspect of PTG was experienced to the greatest extent by the participants? Do age at the day of survey, age at diagnosis, time since diagnosis, type of surgery, non-surgical methods of treatment, participation in rehabilitation or physical activity significantly differentiate participants in PTG? Participants and procedure Forty-seven women after breast cancer surgery participated in the study. Posttraumatic growth was measured with the Polish version of the Posttraumatic Growth Inventory (PTGI consisting of 4 scales: Self-Perception (SP, Relating to Others (RO, Appreciation of Life (AL and Spiritual Change (SC. The demographic, disease and treatment related variables were controlled. Results Forty-three percent of participants experienced high, 23% moderate, and 34% little or no PTG. Posttraumatic growth manifested itself mainly positive changes in relationships with others. Age at the day of the survey did not correlate significantly with scores of PTGI. Age at diagnosis correlated significantly with total PTG (ρ = –0.37, p = .012, SP (ρ = –0.33, p = .029, RO (ρ = –0.40, p = .008 and AL (ρ = –0.39, p = .010. Women aged ≤ 50 at the day of the survey had significantly higher scores of AL than women > 50 (U = 117.50, p = .042. Women who were physically active at the day of the survey had significantly higher scores in total PTG (U = 118.50, p = .008, SP (U = 7.28, p = .007 and RO (U = 108.00, p = .003. Time since diagnosis, type of treatment and participation in rehabilitation after the surgery did not differentiate respondents significantly in PTG. Conclusions Posttraumatic growth was experienced by a considerable percentage of participants. The average level of PTG was moderate. Women physically active at the time of the survey showed higher levels of PTG

  7. Corneal Biomechanical Findings in Contact Lens Induced Corneal Warpage

    Science.gov (United States)

    Letafatnejad, Mojgan; Beheshtnejad, Amir Hooshang; Ghaffary, Seyed Reza; Hassanpoor, Narges; Yaseri, Mehdi

    2016-01-01

    Purpose. To evaluate the difference in biomechanical properties between contact lens induced corneal warpage and normal and keratoconic eyes. Method. Prospective observational case control study, where 94 eyes of 47 warpage suspicious and 46 eyes of 23 keratoconic patients were included. Warpage suspected cases were followed until a definite diagnosis was made (warpage, normal, or keratoconus). Results. 44 eyes of 22 patients had contact lens related corneal warpage. 46 eyes of 23 people were diagnosed as nonwarpage normal eyes. 46 eyes of 23 known keratoconus patients were included for comparison. The mean age of the participants was 23.8 ± 3.8 years, and 66.2% of the subjects were female. The demographic and refractive data were not different between warpage and normal groups but were different in the keratoconus group. The biomechanical properties (corneal hysteresis or CH and corneal resistance factor or CRF) were different with the highest value in the warpage group followed by normal and keratoconus groups. CRF was 10.08 ± 1.75, 9.23 ± 1.22, and 7.38 ± 2.14 and CH was 10.21 ± 1.57, 9.59 ± 1.21, and 8.69 ± 2.34 in the warpage, normal, and keratoconus groups, respectively. Conclusion. Corneal biomechanics may be different in people who develop contact lens induced warpage. PMID:27688908

  8. Comparison of the Keratometric Corneal Astigmatic Power after Phacoemulsification: Clear Temporal Corneal Incision versus Superior Scleral Tunnel Incision

    Directory of Open Access Journals (Sweden)

    Yongqi He

    2009-01-01

    Full Text Available Objective. This is prospective randomized control trial to compare the mean keratometric corneal astigmatism diopter power (not surgical induced astigmatism among preop and one-month and three-month postop phacoemulcification of either a clear temporal corneal incision or a superior scleral tunnel Incision, using only keratometric astigmatic power reading to evaluate the difference between the two cataract surgery incisions. Methods. 120 patients (134 eyes underwent phacoemulcification were randomly assigned to two groups: Group A, the clear temporal corneal incision group, and Group B, the superior scleral tunnel incision group. SPSS11.5 Software was used for statistical analysis to compare the postsurgical changes of cornea astigmatism on keratometry. Results. The changes of corneal astigmatic diopter in Groups A and B after 3 month postop from keratometric reading were 1.04 + 0.76 and 0.94 + 0.27, respectively (=.84>.05, which showed no statistic significance difference. Conclusion. The incision through either temporal clear cornea or superior scleral tunnel in phacoemulcification shows no statistic difference in astigmatism change on keratometry 3-month postop.

  9. Endoscopy-assisted surgery for the management of benign breast tumors: technique, learning curve, and patient-reported outcome from preliminary 323 procedures.

    Science.gov (United States)

    Lai, Hung-Wen; Lin, Hui-Yu; Chen, Shu-Ling; Chen, Shou-Tung; Chen, Dar-Ren; Kuo, Shou-Jen

    2017-01-11

    Endoscopy-assisted breast surgery (EABS), a technique that optimizes cosmetic outcome because it is performed through small wounds hidden in inconspicuous areas, could be an alternative surgical technique for benign breast tumors. In this study, we report the preliminary results of 323 EABS procedures performed at our institution for the management of benign breast tumors. The medical records of patients who underwent EABS for benign breast lesions during the periods August 2010 to December 2015 were collected from the Changhua Christian Hospital EABS database. Data on clinicopathologic characteristics, type of surgery, hospital stay, and complications were analyzed to determine the effectiveness of the procedure for benign breast tumors. The operating time with the number of procedure performed was analyzed for learning curve evaluation. Patient satisfaction with cosmetic outcome was evaluated with a self-report questionnaire. A total of 323 EABS procedures were performed in 286 patients with benign breast lesions, including 249 (90.5%) patients with unilateral lesions. The mean age was 36 years, the mean tumor size was 2.2 cm, and the mean distance from the nipple to the tumor was 5.2 cm. Most (93.8%, 303/323) of these tumors were excised through a transareolar wound, 2.4% (8/323) through an axillary wound, and 0.3% (1/323) through the infra-mammary fold. Histopathologic analysis revealed that 63.5% (202/318) of the tumors were fibroadenoma-related lesions. The mean operative time was 81.4 min (59~89 min), which was decreased with experience increased. The overall rate of complications was 6.5%, and all were minor and wound-related. Among the 110 patients who participated in the self-report cosmetic outcome evaluation, 85.4% reported being satisfied with the cosmetic result, and almost all were satisfied with breast symmetry. Of the patients interviewed, 92.7% reported that they would choose the same procedure if they had to undergo the operation again. Our

  10. Confocal comparison of corneal reinnervation after small incision lenticule extraction (SMILE and femtosecond laser in situ keratomileusis (FS-LASIK.

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    Meiyan Li

    Full Text Available PURPOSE: To evaluate corneal reinnervation, and the corresponding corneal sensitivity and keratocyte density after small incision lenticule extraction (SMILE and femtosecond laser in situ keratomileusis (FS-LASIK. METHODS: In this prospective, non-randomized observational study, 18 patients (32 eyes received SMILE surgery, and 22 patients (42 eyes received FS-LASIK surgery to correct myopia. The corneal subbasal nerve density and microscopic morphological changes in corneal architecture were evaluated by confocal microscopy prior to surgery and at 1 week, 1 month, 3 months, and 6 months after surgery. A correlation analysis was performed between subbasal corneal nerve density and the corresponding keratocyte density and corneal sensitivity. RESULTS: The decrease in subbasal nerve density was less severe in SMILE-treated eyes than in FS-LASIK-treated eyes at 1 week (P = 0.0147, 1 month (P = 0.0243, and 3 months (P = 0.0498, but no difference was detected at the 6-month visit (P = 0.5277. The subbasal nerve density correlated positively with central corneal sensitivity in both groups (r = 0.416, P<0.0001, and r = 0.2567, P = 0.0038 for SMILE group and FS-LASIK group, respectively. The SMILE-treated eyes have a lower risk of developing peripheral empty space with epithelial cells filling in (P = 0.0005. CONCLUSIONS: The decrease in subbasal nerve fiber density was less severe in the SMILE group than the FS-LASIK group in the first 3 months following the surgeries. The subbasal nerve density was correlated with central corneal sensitivity.

  11. Reconstruction of Rabbit Corneal Layer Composed of Corneal Fibroblasts and Corneal Epithelium on the Lyophilized Amniotic Membrane

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Many researchers have employed the cryopreserved amniotic membrane(CAM) and corneal epithelial cells in the treatment of a severely damaged burned cornea, with corneal epithelial cells cultured on an amniotic membrane (AM). The lyophilized amniotic membrane (LAM) has a higher graft take and a longer shelf life; it is easier to store and safer because of gamma irradiation. Two Teflon rings(Ahn's supporter) were made for culturing the cells on the LAM, and were then used to support the LAM. To reconstruct a corneal layer composed of corneal fibroblasts and epithelium, the corneal fibroblasts were first cultivated on the stromal side of LAM for five days, followed by epithelial cells culture on the epithelial side, by using the air-liquid interface culture. The reconstructed corneal layer composed of corneal fibroblasts and corneal epithelial cells has a much healthier basal layer of corneal epithelium than the reconstructed corneal epithelium, which was got by using only corneal epithelial cells, and resembles the epithelium of normal corneas, without the horny layer. Thus, the reconstruction of the corneal layer by using a LAM is considered to be a good in vitro model, not only for its application in toxicological test kits, but also for transplantation in patients with a severely damaged cornea.

  12. Prevalence of Helicobacter pylori infection in a group of morbidly obese Saudi patients undergoing bariatric surgery: A preliminary report

    Directory of Open Access Journals (Sweden)

    Al-Akwaa Ahmad

    2010-01-01

    Full Text Available Background/Aim: Earlier reports from Saudi Arabia have shown high prevalence of Helicobacter pylori infection. However, recent studies have documented a reduction in the infection prevalence. No prior study has assessed the prevalence in morbidly obese Saudi patients. We aimed to study the prevalence of H. pylori infection in a group morbidly obese Saudi patients referred for endoscopy prior to bariatric surgery. Materials and Methods: We retrospectively reviewed the medical records of all patients who were referred for upper endoscopy prior to bariatric surgery from June 2006 to September 2008. All data were recorded including patient′s demographics, comorbid conditions, endoscopic and histological findings. Results: There were 62 patients included, 20 males and 42 females. The mean age was 34 years (range 18 - 51 with a mean BMI of 55 Kg/m 2 (range 35 -92. H. pylori were present in 53 patients (85.5% with chronic active gastritis. All patients with positive H. pylori had chronic gastritis of variable severity. Intestinal metaplasia was present in 5%. The prevalence of H. pylori infection was similar in patients with and without co-morbid conditions. Main endoscopic findings were gastritis in 67.7%, hiatus hernia in 13%, and gastric erosions in 13%. No patient had duodenal or gastric ulcer. Conclusions: There is a high prevalence of H. pylori infection in morbidly obese Saudi patients undergoing bariatric surgery being referred for upper GI endoscopy. Further prospective studies are needed to evaluate the clinical implication and benefit of eradication treatment of infection in these patients.

  13. A mindfulness-based intervention to control weight after bariatric surgery: Preliminary results from a randomized controlled pilot trial.

    Science.gov (United States)

    Chacko, Sara A; Yeh, Gloria Y; Davis, Roger B; Wee, Christina C

    2016-10-01

    This study aimed to develop and test a novel mindfulness-based intervention (MBI) designed to control weight after bariatric surgery. Randomized, controlled pilot trial. Beth Israel Deaconess Medical Center, Boston, MA, USA. Bariatric patients 1-5 years post-surgery (n=18) were randomized to receive a 10-week MBI or a standard intervention. Primary outcomes were feasibility and acceptability of the MBI. Secondary outcomes included changes in weight, eating behaviors, psychosocial outcomes, and metabolic and inflammatory biomarkers. Qualitative exit interviews were conducted post-intervention. Major themes were coded and extracted. Attendance was excellent (6 of 9 patients attended ≥7 of 10 classes). Patients reported high satisfaction and overall benefit of the MBI. The intervention was effective in reducing emotional eating at 6 months (-4.9±13.7 in mindfulness vs. 6.2±28.4 in standard, p for between-group difference=0.03) but not weight. We also observed a significant increase in HbA1C (0.34±0.38 vs. -0.06±0.31, p=0.03). Objective measures suggested trends of an increase in perceived stress and symptoms of depression, although patients reported reduced stress reactivity, improved eating behaviors, and a desire for continued mindfulness-based support in qualitative interviews. This novel mindfulness-based approach is highly acceptable to bariatric patients post-surgery and may be effective for reducing emotional eating, although it did not improve weight or glycemic control in the short term. Longer-term studies of mindfulness-based approaches may be warranted in this population. ClinicalTrials.gov identifier NCT02603601. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Intraoperative neuromonitoring of the external branch of the superior laryngeal nerve during robotic thyroid surgery: a preliminary prospective study

    Science.gov (United States)

    Kim, Su-jin; Oh, Byung-Mo; Oh, Eun Mee; Bae, Dong Sik; Choi, June Young; Myong, Jun Pyo; Youn, Yeo-Kyu

    2015-01-01

    Purpose The aim of this study was to evaluate the feasibility of monitoring external branch of the superior laryngeal nerve (EBSLN) during robotic thyroid surgery. Methods A total of 10 patients undergoing bilateral axillo-breast approach (BABA) robotic thyroid surgery were enrolled. The nerve integrity monitor (NIM Response 2.0 System) was used for EBSLN monitoring. We performed voice assessments preoperatively and at 1 and 3 months postoperatively using Voice Handicap Index-10 (VHI-10), maximal phonation time (MPT), phonation efficient index (PEI), and laryngeal electromyography (EMG). Results A total of 19 EBSLNs were at risk and 14 EBSLNs (73.7%) were identified using neuromonitoring. VHI-10 showed a change of voice over time (0.1 vs. 3.6 vs. 1.3); however, this was not statistically significant. VHI-10 scores normalized at 3 months postoperatively compared to the preoperative scores. MPT (a) (16.0 vs. 15.6 vs. 15.4), and MPT (e) (20.1 vs. 15.4 vs. 18.5) showed no significant differences preoperatively compared to the values obtained 1 and 3 months postoperatively. There was a significant change of PEI over time (4.8 vs. 1.1 vs. 4.6) (P = 0.036); however, the values normalized at 3 months postoperatively. Laryngeal EMG results showed 4 cases (21.2%) of neuropathy of EBSLNs at 1 month postoperatively, and electrodiagnostic studies revealed nearly complete recovery of the function of EBSLNs in 4 patients at 3 months postoperatively Conclusion It is suggested that neuromonitoring of EBSLNs during BABA robotic thyroid surgery is feasible and might be helpful to preserve voice quality. PMID:26576402

  15. The preliminary analysis of corneal endothelial cell of Chinese Air Force pilot%空军飞行员角膜内皮细胞的初步分析

    Institute of Scientific and Technical Information of China (English)

    刘兵; 茹海霞; 马海燕; 赵蓉; 邵德望

    2008-01-01

    目的 探讨我国空军飞行员角膜内皮细胞密度和形态特征,初步了解细胞密度和形态学的生理学参数.方法 应用角膜内皮细胞显微镜及仪器自带的角膜内皮细胞分析系统,对男性56例(112眼)现役飞行员角膜内皮细胞进行了观察,同时选取30例(60眼)与其年龄和裸眼视力具有可比性的健康男性作为对照组,两组进行分析和比较.结果 数据显示空军飞行员平均角膜内皮细胞密度为2797.0±330.3个/mm2,显著低于对照组的2917.57±318.04个/mm2(t=2.286,P=0.024).平均六角形细胞构成比,飞行员组(56.46±7.19)显著低于对照组(60.33±7.68),差异有显著性意义(t=3.253,P=0.001).飞行员组和对照组随着年龄的增加,六角形细胞构成比均逐渐减少(r=-0.395、-0.268,P=0.000、0.038).通过偏相关系数分析,在年龄因素控制条件下,飞行员飞行时间的延长伴随着细胞平均面积的增大(r=0.244,P=0.01).结论 对飞行员角膜内皮细胞形态学参数的测定和初步数据分析将有助于进一步了解高速飞行情况下眼角膜内皮的变化.%Objegtive To preliminarily study the endothelial density baseline and the morphological characteristics of the corneal endothelial cell of Chinese Air Force pilot. Metheds Density and morphology of corneal endothelial cells were observed by Topcon-2000 noncontact specular microscope and analyzed by Imagenet 2000 software(version 2.53)on 56 pilots(112 eyes)While other 30 healthy men(60 eyes)who were with the comparable age and uncorrected visual acuity were compared and analyzed as the control group. Results The data showed that the average corneal endothelial cell density was 2797.0±330.3/mm2 in pilot group which was significantly lowet than 2917.57±318.04/mm2 in control group(t=2.286,P=0.024).The mean constituent ratio of hexagonal cell was 56.46±7.19 in pilot group compared with 60.33±7.68 in control group(t=8.253,P=O.001)and it was gradually reduced with the age

  16. Corneal biomechanics: a review.

    Science.gov (United States)

    Piñero, David P; Alcón, Natividad

    2015-03-01

    Biomechanics is often defined as 'mechanics applied to biology'. Due to the variety and complexity of the behaviour of biological structures and materials, biomechanics is better defined as the development, extension and application of mechanics for a better understanding of physiology and physiopathology and consequently for a better diagnosis and treatment of disease and injury. Different methods for the characterisation of corneal biomechanics are reviewed in detail, including those that are currently commercially available (Ocular Response Analyzer and CorVis ST). The clinical applicability of the parameters provided by these devices are discussed, especially in the fields of glaucoma, detection of ectatic disorders and orthokeratology. Likewise, other methods are also reviewed, such as Brillouin microscopy or dynamic optical coherence tomography and others with potential application to clinical practice but not validated for in vivo measurements, such as ultrasonic elastography. Advantages and disadvantages of all these techniques are described. Finally, the concept of biomechanical modelling is revised as well as the requirements for developing biomechanical models, with special emphasis on finite element modelling.

  17. Soft tissue diagnosis in maxillofacial surgery: a preliminary study on three-dimensional face geometrical features-based analysis.

    Science.gov (United States)

    Calignano, Flaviana; Vezzetti, Enrico

    2010-04-01

    To obtain the best surgical results in orthognathic surgery, treatment planning and evaluation of results should be performed. In these operations it is necessary to provide the physician with powerful tools that can underline the behavior of soft tissue. For this reason, considering the improvements provided by the use of 3D scanners in medical diagnosis, we propose a methodology for analyzing facial morphology working with geometrical features. The methodology has been tested on patients with malocclusion in order to analyze the reliability and efficiency of the provided diagnostic results.

  18. Corneal Decompensation after Selective Laser Trabeculoplasty

    Directory of Open Access Journals (Sweden)

    Ahmet Ozkok

    2014-01-01

    Full Text Available A 64-year-old Caucasian man referred for decreased vision after selective laser trabeculoplasty (SLT. Slit lamp examination revealed diffuse corneal edema. Despite intensive topical treatment including steroids, corneal edema did not resolve; on the contrary, it advanced to bullous keratopathy. Corneal edema after SLT is an exceptionally rare complication and in all of the previous reports edema resolved with medical treatment. To the best of our knowledge, this is the first report presenting persistent corneal edema after SLT.

  19. Progress of research on corneal collagen cross-linking for corneal melting

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    Ke-Ren Xiao

    2016-06-01

    Full Text Available Corneal collagen cross-linking(CXLcould increase the mechanical strength, biological stability and halt ectasia progression due to covalent bond formed by photochemical reaction between ultraviolet-A and emulsion of riboflavin between collagen fibers in corneal stroma. Corneal melting is an autoimmune related noninfectious corneal ulcer. The mechanism of corneal melting, major treatment, the basic fundamental of ultraviolet-A riboflavin induced CXL and the clinical researches status and experiment in CXL were summarized in the study.

  20. Corneal relaxing incision combined with phacoemulsification and IOL implantation

    Institute of Scientific and Technical Information of China (English)

    沈晔; 童剑萍; 李毓敏

    2004-01-01

    Objective: To analyze the effectiveness and safety of corneal relaxing incisions (CRI) in correcting keratometric astigmatism during cataract surgery. Methods: A prospective study of two groups: control group and treatment group. A treatment group included 25 eyes of 25 patients who had combined clear corneal phacoemulsification, IOL implantation and CRI. A control group included 25 eyes of 25 patients who had clear corneal phacoemulsification and IOL implantation.Postoperative keratometric astigmatism was measured at 1 week, 1 month, 3 months and 6 months. Results: CRI signifi-cantly decreased keratometric astigmatism in patients with preexisting astigmatism compared with astigmatic changes in the control group. In eyes with CRI, the mean keratometric astigmatism was 0.29±0.17 D(range 0 to 0.5 D) at 1 week, 0.41±0.21 D (range 0 to 0.82 D) at 1 month, respectively reduced by 2.42 D and 2.30 D at 1 week and 1 month postoperatively (P=0.000, P=0.000), and postoperative astigmatism was stable until 6 months follow-up. The keratometric astigmatism of all patients decreased to less than 1.00 D postoperatively. Conclusions: CRI is a practical, simple, safe and effective method to reduce preexisting astigmatism during cataract surgery. A modified nomogram is proposed. The long-term effect of CRI should be investigated.

  1. Corneal surface reconstruction - a short review

    Directory of Open Access Journals (Sweden)

    Madhavan H N

    2009-01-01

    /progenitor cells, we found that single murine limbal cells exhibited clonal growth and generated stratified epithelial sheets. 12 Dogru et al determined the barrier function and cytologic features of ocular surface epithelium after autologous cultivated oral mucosal epithelial transplantation in a prospective observational study. Cultivated oral mucosal epithelial cells were observed to survive for more than 1 year after transplantation, with gradual replacement by conjunctival epithelium in some cases. Decreased barrier function of the transplanted epithelium may have prognostic implications, suggesting the presence of oral mucosal epithelium long after surgery. 13 Oral epithelial sheets cultivated in autologous serum (AS and fetal bovine serum-supplemented media were similar in morphology, and both formed basement membrane assembly proteins important for maintaining graft integrity. Complete corneal epithelialization was achieved within 2 to 5 days postoperatively. The successful use of an AS-derived oral epithelial equivalent to treat severe ocular surface disease represents an important advance in the pursuit of completely autologous xenobiotic-free bioengineered ocular equivalents for clinical transplantation. 14Since most of these studies used heterologous carrier for growth of corneal limbal cells with attendant likely complications, we developed a novel method of cultivation of human limbal cells in a synthetic material as a culture substrate and the material we chose was Mebiol Gel (Provided by Mebiol Inc., Japan through Nichi-In Bio Sciences PVT Ltd, Chennai, India.Mebiol Gel is a copolymer composed of thermo responsive polymer block [poly (Nisopropylacrylamide-co-n-butyl methacrylate (poly NIPAAm-co-BMA] and the hydrophilic polymer block [polyethylene glycol (PEG]. This polymer block is hydrophilic at temperatures below 20oC and hydrophobic at temperatures above 20°C forming cross-linking points and homogenous three dimensional (3-D network of Mebiol Gel in water

  2. Ocular dimensions, corneal thickness, and corneal curvature in quarter horses with hereditary equine regional dermal asthenia.

    Science.gov (United States)

    Badial, Peres R; Cisneros-Àlvarez, Luis Emiliano; Brandão, Cláudia Valéria S; Ranzani, José Joaquim T; Tomaz, Mayana A R V; Machado, Vania M; Borges, Alexandre S

    2015-09-01

    The aim of this study was to compare ocular dimensions, corneal curvature, and corneal thickness between horses affected with hereditary equine regional dermal asthenia (HERDA) and unaffected horses. Five HERDA-affected quarter horses and five healthy control quarter horses were used. Schirmer's tear test, tonometry, and corneal diameter measurements were performed in both eyes of all horses prior to ophthalmologic examinations. Ultrasonic pachymetry was performed to measure the central, temporal, nasal, dorsal, and ventral corneal thicknesses in all horses. B-mode ultrasound scanning was performed on both eyes of each horse to determine the dimensions of the ocular structures and to calculate the corneal curvature. Each corneal region examined in this study was thinner in the affected group compared with the healthy control group. However, significant differences in corneal thickness were only observed for the central and dorsal regions. HERDA-affected horses exhibited significant increases in corneal curvature and corneal diameter compared with unaffected animals. The ophthalmologic examinations revealed mild corneal opacity in one eye of one affected horse and in both eyes of three affected horses. No significant between-group differences were observed for Schirmer's tear test, intraocular pressure, or ocular dimensions. Hereditary equine regional dermal asthenia-affected horses exhibit decreased corneal thickness in several regions of the cornea, increased corneal curvature, increased corneal diameter, and mild corneal opacity. Additional research is required to determine whether the increased corneal curvature significantly impacts the visual accuracy of horses with HERDA. © 2014 American College of Veterinary Ophthalmologists.

  3. Acute corneal hydrops in keratoconus

    Directory of Open Access Journals (Sweden)

    Prafulla K Maharana

    2013-01-01

    Full Text Available Acute corneal hydrops is a condition characterized by stromal edema due to leakage of aqueous through a tear in descemet membrane. The patient presents with sudden onset decrease in vision, photophobia, and pain. Corneal thinning and ectasias combined with trivial trauma to the eye mostly by eye rubbing is considered as the underlying cause. With conservative approach self-resolution takes around 2 to 3 months. Surgical intervention is required in cases of non-resolution of corneal edema to avoid complications and for early visual rehabilitation. Intracameral injection of air or gas such as perflouropropane is the most common surgical procedure done. Recent investigative modality such as anterior segment optical coherence tomography is an extremely useful tool for diagnosis, surgical planning, and postoperative follow up. Resolution of hydrops may improve the contact lens tolerance and visual acuity but most cases require keratoplasty for visual rehabilitation.

  4. Posterior Corneal Surface Stability after Femtosecond Laser-Assisted Keratomileusis

    Directory of Open Access Journals (Sweden)

    Carlo Cagini

    2015-01-01

    Full Text Available The purpose of this study was to evaluate posterior corneal surface variation after femtosecond laser-assisted keratomileusis in patients with myopia and myopic astigmatism. Patients were evaluated by corneal tomography preoperatively and at 1, 6, and 12 months. We analyzed changes in the posterior corneal curvature, posterior corneal elevation, and anterior chamber depth. Moreover, we explored correlation between corneal ablation depth, residual corneal thickness, percentage of ablated corneal tissue, and preoperative corneal thickness. During follow-up, the posterior corneal surface did not have a significant forward corneal shift: no significant linear relationships emerged between the anterior displacement of the posterior corneal surface and corneal ablation depth, residual corneal thickness, or percentage of ablated corneal tissue.

  5. The Preliminary Report of Pathological Changes of Epiretinal Membranes and Internal Limiting Membrane Removed during Idiopathic Macular Hole Surgery

    Institute of Scientific and Technical Information of China (English)

    Jiaqing Li; Shibo Tang; Yan Luo; Jie Zhang; Shaofen Lin

    2002-01-01

    Purpose:To investigate the pathological changes of epiretinal membranes(ERM)and internal limiting membrane (ILM) removed during idiopathic macular hole surgery.Methods:Ten consecutive patients with a unilateral idiopathic macular hole underwent pars plana vitrectomy(PPV) with the surgical removal of the ERMs overlying the hole and ILM surrounding the hole. The pathological features of the excised tissues were examined under the microscope. Results:According to the morphological changes, four ERMs showed cellular elements which looked like glia cells, macrophages, plasma cells, lymphocytes and fibroblast cells. Two of the ILM appeared as transparent membranes without cellular elements. The other eight ILM showed cellular elements on the transparent membranes.Conclusion: Our study supports the hypothesis that the tangential traction of vitreous and proliferative cellular elements on the inner surface of ILM causes idiopathic macular holes. Removal of the posterior cortical vitreous, ILM and proliferative cellular tissue is a valid treatment for IMH.

  6. Joint-preserving surgery in rheumatoid forefoot: preliminary study with more-than-two-year follow-up.

    Science.gov (United States)

    Barouk, Louis Samuel; Barouk, Pierre

    2007-09-01

    The authors propose a joint-preserving surgery for rheumatoid forefoot deformities as an alternative to the "classic" surgical approach to the rheumatoid forefoot. The main principle is joint preservation by shortening osteotomies of all the metatarsals performed at the primary location of the rheumatoid forefoot lesions, namely the metatarsophalangeal (MTP) joints and metatarsal heads. A scarf osteotomy is normally performed on the first ray. A Weil osteotomy is performed on the lesser metatarsals. Excellent correction of the hallux valgus deformity in the rheumatoid forefoot can be achieved with a scarf osteotomy in 92% of cases without the need for MTP joint arthrodesis. Similarly, 86% of the lateral metatarsal heads can be preserved using Weil osteotomies.

  7. The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report

    Directory of Open Access Journals (Sweden)

    Kassiani Theodoraki

    2014-01-01

    Full Text Available Blood transfusion is associated with well-known risks. We investigated the difference between a restrictive versus a liberal transfusion strategy on the immune response, as expressed by the production of inflammatory mediators, in patients subjected to major abdominal surgery procedures. Fifty-eight patients undergoing major abdominal surgery were randomized preoperatively to either a restrictive transfusion protocol or a liberal transfusion protocol (with transfusion if hemoglobin dropped below 7.7 g dL−1 or 9.9 g dL−1, respectively. In a subgroup of 20 patients randomly selected from the original allocation groups, blood was sampled for measurement of IL-6, IL-10, and TNFα. Postoperative levels of IL-10 were higher in the liberal transfusion group on the first postoperative day (49.82±29.07 vs. 15.83±13.22 pg mL−1, P<0.05. Peak postoperative IL-10 levels correlated with the units of blood transfused as well as the mean duration of storage and the storage time of the oldest unit transfused (r2=0.38, P=0.032, r2=0.52, P=0.007, and r2=0.68, P<0.001, respectively. IL-10 levels were elevated in patients with a more liberal red blood cell transfusion strategy. The strength of the association between anti-inflammatory IL-10 and transfusion variables indicates that IL-10 may be an important factor in transfusion-associated immunomodulation. This trial is registered under ClinicalTrials.gov Identifier: NCT02020525.

  8. Spino-pelvic parameters after surgery can be predicted: a preliminary formula and validation of standing alignment.

    Science.gov (United States)

    Lafage, Virginie; Schwab, Frank; Vira, Shaleen; Patel, Ashish; Ungar, Benjamin; Farcy, Jean-Pierre

    2011-06-01

    Prospective and retrospective radiographic study of adult patients with spinal deformities. Construct predictive models for pelvic tilt (PT) and global sagittal balance (sagittal vertical axis [SVA]) and evaluate the effectiveness of these predictive models against a group of patients after pedicle subtraction osteotomy. Spinal balance involves a complex interaction between the pelvis and vertebral column. In the setting of adult spinal deformity, prediction of postoperative alignment can be challenging. The study included 219 adult patients treated for spinal deformity. Full-length standing films were available for all subjects. Multilinear models with a stepwise condition were used on the first group of patients (n = 179) to predict PT and global sagittal balance (measured by the SVA). Prediction models were then applied on a second group of patients (n = 40) to estimate postoperative radiographic parameters after pedicle subtraction osteotomy surgery. Differences between estimated parameters and real values were evaluated. Multilinear regression analysis applied on the first group of patients led to a predictive formula for PT (r = 0.93, standard error = 4.4°) using the following parameters: pelvic incidence, maximal lordosis, and maximal kyphosis. These parameters with the addition of the predicted PT were then used to predict the SVA (r = 0.89, standard error = 32 mm). Validation of predictive models (second group of patients) used pelvic incidence and postoperative sagittal curves. Postoperative PT was predicted with a mean error of 4.3° (SD 3.5°) and postoperative SVA was predicted with a mean error of 29 mm (SD = 23 mm). This is the first study to develop and validate pragmatic predictive models for key spino-pelvic parameters (PT and SVA) in the setting of adult spinal deformity. Using a morphologic pelvic parameter (pelvic incidence) and spinal parameters modifiable through surgery (lumbar lordosis and thoracic kyphosis), postoperative sagittal

  9. Corneal Epithelial Remodeling and Its Effect on Corneal Asphericity after Transepithelial Photorefractive Keratectomy for Myopia

    Directory of Open Access Journals (Sweden)

    Jie Hou

    2016-01-01

    Full Text Available Purpose. To evaluate the changes in epithelial thickness profile following transepithelial photorefractive keratectomy (T-PRK for myopia and to investigate the effect of epithelial remodeling on corneal asphericity. Methods. Forty-four patients (44 right eyes who underwent T-PRK were retrospectively evaluated. Epithelial thickness was measured using spectral-domain optical coherence tomography at different corneal zones (central, 2 mm; paracentral, 2–5 mm; and mid-peripheral, 5-6 mm preoperatively and at 1 week and 1, 3, and 6 months postoperatively. The correlation between the changes in corneal epithelial thickness (ΔCET and postoperative Q-value changes (ΔQ was analyzed 6 months postoperatively. Results. Epithelial thickness at 6 months showed a negative meniscus-like lenticular pattern with less central thickening, which increased progressively toward the mid-periphery (3.69±4.2, 5.19±3.8, and 6.23±3.9 μm at the center, paracenter, and mid-periphery, resp., P<0.01. A significant positive relationship was observed between epithelial thickening and ΔQ 6 months postoperatively (r=0.438, 0.580, and 0.504, resp., P<0.01. Conclusions. Significant epithelial thickening was observed after T-PRK and showed a lenticular change with more thickening mid-peripherally, resulting in increased oblateness postoperatively. Epithelial remodeling may modify the epithelial thickness profile after surface ablation refractive surgery for myopia.

  10. [Corneal manifestations in systemic diseases].

    Science.gov (United States)

    Zarranz Ventura, J; De Nova, E; Moreno-Montañés, J

    2008-01-01

    Systemic diseases affecting the cornea have a wide range of manifestations. The detailed study of all pathologies that cause corneal alteration is unapproachable, so we have centered our interest in the most prevalent or characteristic of them. In this paper we have divided these pathologies in sections to facilitate their study. Pulmonar and conective tissue (like colagen, rheumatologic and idiopathic inflamatory diseases), dermatologic, cardiovascular, hematologic, digestive and hepatopancreatic diseases with corneal alteration are described. Endocrine and metabolic diseases, malnutrition and carential states are also studied, as well as some otorhinolaryngologic and genetic diseases that affect the cornea. Finally, a brief report of ocular toxicity induced by drugs is referred.

  11. Insertion force in manual and robotic corneal suturing.

    Science.gov (United States)

    Yang, Yang; Xu, Cunliang; Deng, Shijing; Xiao, Jingjing

    2012-03-01

    Due to differences in corneal grafting microsurgery between manual and robotic suturing, new challenges have arisen in testing the insertion force and torque of corneal tissue acting on suturing needles in order to guarantee successful completion of surgical procedures. In order to measure the force during the insertion operation, from the needle entering the cornea through the entry point until the puncturing of the exit point along the circular trajectory, a force measurement system was established, including fresh porcine cornea, a corneal-suturing robot, a circular needle, a micro-forceps manipulator with a force transducer, a computer with a data acquisition board and a medical microscope. The force values in the needle coordinate frames were obtained on the basis of a sensor coordinate frame through D-H coordinate transformation, and an index is proposed here to evaluate the insertion performance. Experiments on both manual and robotic suturing were carried out for comparison. The scale and changes of the needle insertion force were obtained using two different suturing methods. The maximal tangent force in robotic suturing is a little larger than in manual suturing, and the maximal resultant force in robotic suturing is somewhat smaller. Although the difference is not very significant, robotic suturing performs in a more stable way. Moreover, the performance evaluation index M(dmax) (the maximum of square root of the quadratic sum of torque components M(OX) and M(OY)) in robotic suturing is much smaller than that in manual suturing. The force measurement system has been verified to be feasible through experimentation. Compared with conventional manual surgery, robotic suturing has some advantages: more stable suturing, smaller distortion torque and fewer invasions to the corneal tissue, showing that its application in minimally invasive surgery is practical. Copyright © 2011 John Wiley & Sons, Ltd.

  12. A preliminary randomized clinical trial comparing diode laser and scalpel periosteal incision during implant surgery: impact on postoperative morbidity and implant survival.

    Science.gov (United States)

    Shahnaz, Aysan; Jamali, Raika; Mohammadi, Farnush; Khorsand, Afshin; Moslemi, Neda; Fekrazad, Reza

    2017-08-31

    The aim of this preliminary randomized clinical trial was to compare: (1) post-operative morbidity after application of laser or scalpel incision for flap advancement during implant surgery and bone grafting and (2) implant survival rate following flap advancement with laser or scalpel incision after 6 months of loading. Eighteen patients who were scheduled for dental implant placement and simultaneous bone grafting were randomly assigned to test or control groups. Diode laser (810 nm, 2 W, pulse interval 200 μs; pulse length 100 μs, 400-μm initiated fiber tip), or scalpel (control) was used to sever the periosteum to create a tension-free flap. Visual analogue scale (VAS) pain score, rate of nonsteroid anti-inflammatory drug (NSAID) consumption, intensity of swelling, and ecchymosis were measured for the six postsurgical days. Six months after loading, implant survival was assessed. VAS pain score (during the first four postoperative days), rate of NSAID consumption (during the first three postoperative days), and intensity of swelling (during the first five postoperative days) were significantly lower in the test group compared to the control group (All P values < 0.05). One patient in the control group experienced ecchymosis. All implants were successful in function. Application of laser for performing periosteal releasing incision reduced the incidence and severity of postoperative morbidity of the patients undergone implant surgery in conjunction with bone augmentation procedure. We did not find any detrimental effect of laser incision on the implant survival within 6 months of loading.

  13. Investigation of surgically induced astigmatism resulting from femtosecond laser-assisted cataract surgery using a 2.2 mm clear corneal incision%2.2mm透明角膜切口飞秒激光辅助白内障超声乳化手术术源性散光的临床研究

    Institute of Scientific and Technical Information of China (English)

    李博; 张素华; 张哲; 刘建亭; 曹伟芳; 李晓艳; 董慧; 郭彩虹; 张海宁

    2016-01-01

    Objective To evaluate surgically induced astigmatism (SIA) resulting from femtosecond laser-assisted phacoemulsification cataract surgery with a 2.2 mm clear corneal incision.Methods A prospective,comparative analysis was performed in a case series.A total of 105 eyes of 84 patients (from No.1 cataract department of Shanxi Eye Hospital) who underwent femtosecond laser-assisted phacoemulsification cataract surgery between March 2014 and April 2016 were enrolled in this study.The main outcomes were a comparison of SIA,far visual acuity,and spherical refractive power preoperatively and 1,3,and 6 months postoperatively.Distance visual acuity was recorded as logMAR.Based on follow-up times (1,3,and 6 months postoperatively),lens nucleus hardness (grades Ⅱ,Ⅲ,Ⅳ),corneal astigmatism types (with-the-rule,against-the-rule,oblique) and laterality (left,right),SIA was analyzed using Alphins vector analysis.Data were analyzed using repeated measured ANOVA.Results The mean preoperative logMAR visual acuity was 0.65±0.24,which was significantly different from postoperative logMAR visual acuity at 1 month (0.07±0.02),3 months (0.06±0.01),and 6 months (0.06±0.01).No significant logMAR visual acuity differences were found at the three postoperative follow-up times.SIAs at 1,3,and 6 months after surgery were 0.28±0.11 D,0.25±0.13 D,0.24±0.10 D,respectively.No statistically significant differences in SIA were found when postoperative follow-up times (1,3,and 6 months) and factor groups for lens nucleus hardness (grades Ⅱ,Ⅲ,Ⅳ),corneal astigmatism types (with-the-rule,against-the-rule,oblique) and laterality (left,right) were compared.Conclusion Femtosecond laser-assisted phacoemulsification cataract surgery using a 2.2 mm clear corneal incision can provide stable SIA and better postoperative visual acuity.%目的 观察飞秒激光辅助白内障超声乳化手术中2.2 mm透明角膜切口引起的术源性散光(SIA)的影响因素.方法 前瞻性研究.纳入2014

  14. Executive functioning pattern as a prognostic indicator for shunt implantation surgery in patients with normal pressure hydrocephalus - A preliminary report.

    Science.gov (United States)

    Nowak, Marcin M; Fersten, Ewa; Głowacki, Mariusz

    2016-01-01

    The problem of executive functions in patients with normal pressure hydrocephalus (NPH) was investigated in the study. Executive function parameters were assumed to be among factors that may differentiate the clinical pattern in NPH. Two major indicators of executive functioning, i.e. flexibility and productivity of thinking, were assessed in neuropsychological examination using the Trail Making Test (TMT), Verbal Fluency Test (COWAT), and the Wisconsin Card Sorting Test (WCST). Participants in the study were 18 patients with NPH divided using a set of diagnostic criteria into two subgroups: with idiopathic active hydrocephalus (ACT) or with arrested hydrocephalus (ARR). Executive functioning patterns were found to differentiate between the two NPH subgroups. Namely, patients diagnosed with active hydrocephalus (who qualify for shunt implantation surgery) tended to present lower levels of verbal fluency in all semantic categories, which suggests a decreased productivity of thinking. Besides, ACT patients' performance on the WCST was significantly inferior on two measures: (1) they committed more non-perseverative errors (which indicates their chaotic way of working on the test and the occurrence of random responses) and (2) displayed lower ability of "learning to learn" (which suggests their impaired flexibility of thinking). These aspects of executive function, with productivity and flexibility of thinking first and foremost, seem promising as additional prognostic indicators to consider in patient selection for shunt implantation.

  15. Corneal Tattooing (keratopigmentation) to restore cosmetic appearance in severely impaired eyes with new mineral micronized pigments

    OpenAIRE

    Alio, Jorge L; Sirerol, Belucha; Walewska - Szafran, Anna

    2010-01-01

    Abstract Aims: To investigate keratopigmentation (KTP) with new mineral micronized pigments as a surgical alternative to improve cosmetic appearance in severely-impaired eyes. Methods: 40 eyes underwent KTP alternatively to invasive cosmetic reconstructive surgery. Corneal staining with mineral micronized pigments was performed using either an intralamellar or superficial technique. Results: One year postoperatively, all but two patients (95%) were sat...

  16. Long‐term recovery of the human corneal endothelium after toxic injury by benzalkonium chloride

    Science.gov (United States)

    Hughes, E H; Pretorius, M; Eleftheriadis, H; Liu, C S C

    2007-01-01

    Introduction The inadvertent intra‐ocular administration of benzalkonium chloride‐preserved hydroxypropyl methylcellulose during cataract surgery at another hospital in 1999 resulted in toxic corneal endothelial injury and profound postoperative corneal oedema as a result of endothelial decompensation. The long‐term effect of this adverse event was assessed. Methods All 19 patients were invited to return for examination including corneal endothelial specular microscopy and pachymetry seven years after the incident. Results were compared with data from one year after the incident. Results Five patients attended for examination, one had received a penetrating keratoplasty and was, therefore, excluded. Ten patients had died and four had moved out of the region and were unable to attend. All four study patients were pain free and achieved 6/12 or better. Mean central corneal thickness reduced by 13% from 652.6 μm at one year to 563.4 μm. Mean central corneal endothelial cell density (n  =  3) increased 28% from 663.7 cells/mm2 at one year to 835.7 cells/mm2 (p<0.05). Conclusions After toxic injury, corneal endothelial function may have a remarkable capacity for recovery even after the first postoperative year. The rise in central endothelial cell density may represent cell migration from less affected areas or cellular proliferation. Should this unfortunate event recur, clinicians may expect continued recovery beyond one year. PMID:17504856

  17. Segmentation of 830- and 1310-nm LASIK corneal optical coherence tomography images

    Science.gov (United States)

    Li, Yan; Shekhar, Raj; Huang, David

    2002-05-01

    Optical coherence tomography (OCT) provides a non-contact and non-invasive means to visualize the corneal anatomy at micron scale resolution. We obtained corneal images from an arc-scanning (converging) OCT system operating at a wavelength of 830nm and a fan-shaped-scanning high-speed OCT system with an operating wavelength of 1310nm. Different scan protocols (arc/fan) and data acquisition rates, as well as wavelength dependent bio-tissue backscatter contrast and optical absorption, make the images acquired using the two systems different. We developed image-processing algorithms to automatically detect the air-tear interface, epithelium-Bowman's layer interface, laser in-situ keratomileusis (LASIK) flap interface, and the cornea-aqueous interface in both kinds of images. The overall segmentation scheme for 830nm and 1310nm OCT images was similar, although different strategies were adopted for specific processing approaches. Ultrasound pachymetry measurements of the corneal thickness and Placido-ring based corneal topography measurements of the corneal curvature were made on the same day as the OCT examination. Anterior/posterior corneal surface curvature measurement with OCT was also investigated. Results showed that automated segmentation of OCT images could evaluate anatomic outcome of LASIK surgery.

  18. Strabismus Surgery

    Science.gov (United States)

    ... Corneal Abrasions Dilating Eye Drops Lazy eye (defined) Pink eye (defined) Retinopathy of Prematurity Strabismus Stye (defined) Vision ... Corneal Abrasions Dilating Eye Drops Lazy eye (defined) Pink eye (defined) Retinopathy of Prematurity Strabismus Stye (defined) Vision ...

  19. Corneal stroma microfibrils

    KAUST Repository

    Hanlon, Samuel D.

    2015-03-01

    Elastic tissue was first described well over a hundred years ago and has since been identified in nearly every part of the body. In this review, we examine elastic tissue in the corneal stroma with some mention of other ocular structures which have been more thoroughly described in the past. True elastic fibers consist of an elastin core surrounded by fibrillin microfibrils. However, the presence of elastin fibers is not a requirement and some elastic tissue is comprised of non-elastin-containing bundles of microfibrils. Fibers containing a higher relative amount of elastin are associated with greater elasticity and those without elastin, with structural support. Recently it has been shown that the microfibrils, not only serve mechanical roles, but are also involved in cell signaling through force transduction and the release of TGF-β. A well characterized example of elastin-free microfibril bundles (EFMBs) is found in the ciliary zonules which suspend the crystalline lens in the eye. Through contraction of the ciliary muscle they exert enough force to reshape the lens and thereby change its focal point. It is believed that the molecules comprising these fibers do not turn-over and yet retain their tensile strength for the life of the animal. The mechanical properties of the cornea (strength, elasticity, resiliency) would suggest that EFMBs are present there as well. However, many authors have reported that, although present during embryonic and early postnatal development, EFMBs are generally not present in adults. Serial-block-face imaging with a scanning electron microscope enabled 3D reconstruction of elements in murine corneas. Among these elements were found fibers that formed an extensive network throughout the cornea. In single sections these fibers appeared as electron dense patches. Transmission electron microscopy provided additional detail of these patches and showed them to be composed of fibrils (~10nm diameter). Immunogold evidence clearly

  20. Clinical utility of the KAMRA corneal inlay

    Directory of Open Access Journals (Sweden)

    Naroo SA

    2016-05-01

    Full Text Available Shehzad Anjam Naroo, Paramdeep Singh Bilkhu Ophthalmic Research Group, School of Life & Health Sciences, Aston University, Birmingham, UK Abstract: The treatment of presbyopia has been the focus of much scientific and clinical research over recent years, not least due to an increasingly aging population but also the desire for spectacle independence. Many lens and nonlens-based approaches have been investigated, and with advances in biomaterials and improved surgical methods, removable corneal inlays have been developed. One such development is the KAMRA™ inlay where a small entrance pupil is exploited to create a pinhole-type effect that increases the depth of focus and enables improvement in near visual acuity. Short- and long-term clinical studies have all reported significant improvement in near and intermediate vision compared to preoperative measures following monocular implantation (nondominant eye, with a large proportion of patients achieving Jaeger (J 2 to J1 (~0.00 logMAR to ~0.10 logMAR at the final follow-up. Although distance acuity is reduced slightly in the treated eye, binocular visual acuity and function remain very good (mean 0.10 logMAR or better. The safety of the inlay is well established and easily removable, and although some patients have developed corneal changes, these are clinically insignificant and the incidence appears to reduce markedly with advancements in KAMRA design, implantation technique, and femtosecond laser technology. This review aims to summarize the currently published peer-reviewed studies on the safety and efficacy of the KAMRA inlay and discusses the surgical and clinical outcomes with respect to the patient’s visual function. Keywords: presbyopia, refractive surgery, implants, cornea

  1. Corneale crosslinking voor progressieve keratoconus

    NARCIS (Netherlands)

    Wisse, Robert P L; Soeters, Nienke; Godefrooij, Daniel A.; De Koning-Tahzib, Nayyirih G.

    2016-01-01

    Keratoconus is a corneal disease with onset typically occurring during puberty or early adulthood. The cornea progressively thins and acquires a cone-like shape which negatively affects visual acuity. In the early stages, visual acuity can be corrected with glasses or contact lenses. In more

  2. Corneale crosslinking voor progressieve keratoconus

    NARCIS (Netherlands)

    Wisse, Robert P L; Soeters, Nienke; Godefrooij, Daniel A.; De Koning-Tahzib, Nayyirih G.

    2016-01-01

    Keratoconus is a corneal disease with onset typically occurring during puberty or early adulthood. The cornea progressively thins and acquires a cone-like shape which negatively affects visual acuity. In the early stages, visual acuity can be corrected with glasses or contact lenses. In more advance

  3. Direct oxymetric peripheral tissue perfusion monitoring during open heart surgery with the use of cardiopulmonary bypass: preliminary experience.

    Science.gov (United States)

    Lonsky, V; Svitek, V; Brzek, V; Kubicek, J; Volt, M; Horak, M; Mandak, J

    2011-11-01

    Regional hypoperfusion has been associated with the development of postoperative organ dysfunction in cardiac surgery involving cardiopulmonary bypass (CPB). Direct tissue oxymetry is a potentially new method for monitoring the quality of the peripheral tissue perfusion during CPB. The aim of this study was to assess the effects of CPB in skeletal muscle oxygenation when measured in the deltoid muscle by direct oxymetry during perioperative period. Seven patients underwent on-pump coronary artery bypass grafting. Direct oxymetry was performed by an optical cathether introduced into the deltoid muscle. Continuous measurement was made during the surgical procedure and the postoperative period. Mean arterial blood pressure, blood flow during CPB, laboratory markers of tissue hypoperfusion, blood gases and body temperature were also recorded. Interstitial muscle tissue oxygen tension (pO(2)) decreased after the introduction to anaesthesia and, more significantly, during CPB. After the disconnection from CPB at the end of the operation, the pO(2) returned to pre-anaesthetic values. During the first hours after admission of the patients to the intensive care unit, the pO(2) progressively decreased, reached a minimum value after four hours, and increased slowly thereafter. There was a significant correlation of pO(2) with mean arterial blood pressure and blood flow during that time. The result of this first measurement seems to demonstrate that the standard technique of conducting cardiopulmonary bypass produces low muscle oxygen tension and, thus, little perfusion of skeletal muscle. The data also indicate that both high mean arterial blood pressure and high flow are necessary during CPB to ensure skeletal muscle perfusion. The investigation is continuing.

  4. Differential precision of corneal Pentacam HR measurements in early and advanced keratoconus.

    Science.gov (United States)

    Flynn, Tom H; Sharma, Daya P; Bunce, Catey; Wilkins, Mark R

    2016-09-01

    Serial Scheimpflug corneal tomography to monitor the progression of keratoconus has become standard practice in most countries where corneal cross-linking is available. The tomographic definitions of progression are, however, poorly defined. The aims of this study were: (a) to estimate the 95% limits of intraobserver and interobserver agreement of corneal shape parameters on Pentacam in patients with keratoconus and (b) to investigate whether these limits of agreement varied according to disease severity. 96 adult patients with keratoconus and no corneal scarring or history of previous surgery were recruited from a corneal clinic in a tertiary ophthalmology hospital. One eye of each subject was scanned twice by each of the two observers with the Pentacam HR. 95% limits of intraobserver and interobserver agreement for K1, K2, Kmax and corneal thickness at the thinnest corneal location (TCT) were calculated. Reproducibility of keratometry measures was better for early keratoconus than advanced keratoconus. In patients of Pentacam-derived Krumeich stage 1 or 2, the 95% limits of interobserver agreement for Kmax were from -0.90 to 1.01. In patients of Pentacam-derived Krumeich stage >2, the 95% limits of interobserver agreement for Kmax were from -3.71 to 3.86. Keratometric measurements on Pentacam HR are less reproducible in advanced keratoconus than in early keratoconus. In patients of Pentacam-derived Krumeich stage 1 or 2, an increase in K1, K2 or Kmax of more than 1 dioptre is likely to represent the real change in the corneal shape. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. [Neurotrophic keratopathy--studies on substance P and the clinical significance of corneal sensation].

    Science.gov (United States)

    Nishida, T; Nakamura, M; Konma, T; Ofuji, K; Nagano, K; Tanaka, T; Enoki, M; Reid, T W; Brown, S M; Murphy, C J; Mannis, M J

    1997-12-01

    previously reported that interleukin 6 and epidermal growth factor (EGF) facilitate corneal epithelial wound healing by activating the expression of fibronectin receptor (integrin). Reverse transcription-polymerase chain reaction (RT-PCR) revealed that substance P and IGF-1 increased expression of mRNA for integrins alpha 5 and beta 1 in cultured corneal epithelial cells and also increased the number of cells that attached to a fibronectin matrix. These findings strongly suggest that substance P and IGF-1 synergistically increase corneal epithelial migration by activating the expression of integrin. Tachykinins share a five amino acid sequence, phenylalanine-free amino acid-glycine-leucine-methionine amide (FXGLM), at the C-terminus. Studying substance P, we found that a four amino acid sequence at the C-terminus, FGLM, was the minimum amino acid sequence for the synergistic effect on corneal epithelial migration. Structurally similar tetrapeptides mimicking other members of the tachykinin family isoleucine-glycine-leucine-methionine amide (IGLM), valine-glycine-leucine-methionine amide (VGLM), tyrosine-glycine-leucine-methionine amide (YGLM), and the tripeptide glycine-leucine-methionine amide (GLM) did not have any synergistic effect with IGF-1. Based on these findings in vitro, we investigated the effect of eye drops containing substance P plus IGF-1 or FGLM plus IGF-1 on the epithelial wound closure of rabbit corneas in vivo. Both combinations significantly facilitated corneal epithelial wound closure. In a clinical setting, the administration of substance P plus IGF-1 effectively treated corneal epithelial defects in a patient with Riley-Day syndrome, a disease in which corneal epithelial defects persist because of loss of corneal sensation and hypolacrimation. In a patient with neurotrophic keratopathy due to trigeminal nerve paralysis following surgery, eye drops containing FGLM plus IGF-1 eliminated superficial punctate staining. (ABSTRACT TRUNCATED)

  6. Turning the tide of corneal blindness.

    Science.gov (United States)

    Oliva, Matthew S; Schottman, Tim; Gulati, Manoj

    2012-01-01

    Corneal diseases represent the second leading cause of blindness in most developing world countries. Worldwide, major investments in public health infrastructure and primary eye care services have built a strong foundation for preventing future corneal blindness. However, there are an estimated 4.9 million bilaterally corneal blind persons worldwide who could potentially have their sight restored through corneal transplantation. Traditionally, barriers to increased corneal transplantation have been daunting, with limited tissue availability and lack of trained corneal surgeons making widespread keratoplasty services cost prohibitive and logistically unfeasible. The ascendancy of cataract surgical rates and more robust eye care infrastructure of several Asian and African countries now provide a solid base from which to dramatically expand corneal transplantation rates. India emerges as a clear global priority as it has the world's largest corneal blind population and strong infrastructural readiness to rapidly scale its keratoplasty numbers. Technological modernization of the eye bank infrastructure must follow suit. Two key factors are the development of professional eye bank managers and the establishment of Hospital Cornea Recovery Programs. Recent adaptation of these modern eye banking models in India have led to corresponding high growth rates in the procurement of transplantable tissues, improved utilization rates, operating efficiency realization, and increased financial sustainability. The widespread adaptation of lamellar keratoplasty techniques also holds promise to improve corneal transplant success rates. The global ophthalmic community is now poised to scale up widespread access to corneal transplantation to meet the needs of the millions who are currently blind.

  7. Turning the tide of corneal blindness

    Directory of Open Access Journals (Sweden)

    Matthew S Oliva

    2012-01-01

    Full Text Available Corneal diseases represent the second leading cause of blindness in most developing world countries. Worldwide, major investments in public health infrastructure and primary eye care services have built a strong foundation for preventing future corneal blindness. However, there are an estimated 4.9 million bilaterally corneal blind persons worldwide who could potentially have their sight restored through corneal transplantation. Traditionally, barriers to increased corneal transplantation have been daunting, with limited tissue availability and lack of trained corneal surgeons making widespread keratoplasty services cost prohibitive and logistically unfeasible. The ascendancy of cataract surgical rates and more robust eye care infrastructure of several Asian and African countries now provide a solid base from which to dramatically expand corneal transplantation rates. India emerges as a clear global priority as it has the world′s largest corneal blind population and strong infrastructural readiness to rapidly scale its keratoplasty numbers. Technological modernization of the eye bank infrastructure must follow suit. Two key factors are the development of professional eye bank managers and the establishment of Hospital Cornea Recovery Programs. Recent adaptation of these modern eye banking models in India have led to corresponding high growth rates in the procurement of transplantable tissues, improved utilization rates, operating efficiency realization, and increased financial sustainability. The widespread adaptation of lamellar keratoplasty techniques also holds promise to improve corneal transplant success rates. The global ophthalmic community is now poised to scale up widespread access to corneal transplantation to meet the needs of the millions who are currently blind.

  8. Clinical applications of corneal confocal microscopy

    Directory of Open Access Journals (Sweden)

    Mitra Tavakoli

    2008-06-01

    Full Text Available Mitra Tavakoli1, Parwez Hossain2, Rayaz A Malik11Division of Cardiovascular Medicine, University of Manchester and Manchester Royal Infirmary, Manchester, UK; 2University of Southampton, Southampton Eye Unit, Southampton General Hospital, Southampton, UKAbstract: Corneal confocal microscopy is a novel clinical technique for the study of corneal cellular structure. It provides images which are comparable to in-vitro histochemical techniques delineating corneal epithelium, Bowman’s layer, stroma, Descemet’s membrane and the corneal endothelium. Because, corneal confocal microscopy is a non invasive technique for in vivo imaging of the living cornea it has huge clinical potential to investigate numerous corneal diseases. Thus far it has been used in the detection and management of pathologic and infectious conditions, corneal dystrophies and ecstasies, monitoring contact lens induced corneal changes and for pre and post surgical evaluation (PRK, LASIK and LASEK, flap evaluations and Radial Keratotomy, and penetrating keratoplasty. Most recently it has been used as a surrogate for peripheral nerve damage in a variety of peripheral neuropathies and may have potential in acting as a surrogate marker for endothelial abnormalities.Keywords: corneal confocal microscopy, cornea, infective keratitis, corneal dystrophy, neuropathy

  9. 透气性硬性角膜接触镜矫正LASIK手术后角膜后表面膨隆的临床观察%Clinical Study on the Effect of Rigid Gas Permeable Contact Lens Against the Expansion of Corneal Posterior Surface after LASIK Surgery

    Institute of Scientific and Technical Information of China (English)

    黎新; 王骞; 邵毅; 叶向彧; 刘建和

    2012-01-01

    Objective To evaluate the efficacy and safety of rigid gas permeable contact lens in correcting the expansion of corneal posterior surface occurred after LASIK surgery. Methods A prospective descriptive study was carried out from May 1, 2005 to May 1, 2008. Twelve patients (24 eyes) that suffered expansion of comeal posterior surface after LASIK surgery underwent the therapy of rigid gas permeable contact lens. The data of visual acuity, comeal curvature, D1FF value of comeal surface posterior, adaption levels, comfort and complications were collected and obtained for a follow - up of 24 months. Results The corrected visual acuity of the patients was significantly unproved after they wore RGPCL. Twelve eyes (50% ) have a corrected visual acuity 51. 0 and the rest 12 eyes between 0.4 and 0. 9. The difference between the corrected visual acuities when the patients had worn RCPCL for 24 months and when they started to wear RGPCL was statistically significant ( P 0.05 ). All patients were well adapted to RCPCL, and no obvious complication occurred. Conclusions Being able to improve the comeal posterior surface curvature, RGPCL is presently an effective method to correct the cor-neal posterior surface bulge suffered by patients having taken LASIK surgery.%目的 评价透气性硬性角膜接触镜(RGPCL)矫正LASIK手术后角膜后表面膨隆屈光异常的临床疗效.方法 LASIK手术后角膜后表面膨隆患者12例24只眼,配戴RGPCL.随访24个月观察患者视力、角膜曲率、角膜后表面DIFF值、配适状况、舒适度及并发症.结果 患者配戴RGPCL后,矫正视力明显提高,矫正视力≥1.0以上12只眼(50.0%),矫正视力0.4~0.9 12只眼(50.0%).配戴RGPCL 24个月后的矫正视力与初始戴RGPCL矫正视力的差异有显著意义(P<0.05).与配戴RGPCL前比较,戴RGPCL2年后角膜后表面DIFF值均有不同程度的降低,差异有显著意义(P<0.05);配戴RGPCL前后角膜厚度变化差异无显著意义(P>0

  10. Experiment Study of Effect of Perfiuorohexyloctane on Corneal Endothelial Cells

    Institute of Scientific and Technical Information of China (English)

    Xiaoyan Ding; Chunfang Li; Lin Lu; Guanguang Feng; Huling Zheng

    2001-01-01

    Purpose: To investigate the effect of Perfluorohexyloctane (F6H8)on corneal endothelial celIs(CEC) of rabbit eyes. Methods: Fifteen New Zealand white rabbits were devided into two groups:experimental group(F6H8) and control group(BSS) . All rabbits underwent anterior chamber injection of 0. 15ml F6H8 or BSS. Slit-lamp biomicroscopy and corneal endothelium photography were performed pre-operatively and postoperatively. Histopathological examination and Transmission electron microscopy(TEM) were done after the rabbits were sacrificed. Results: All the corneas were clear. Since 4 weeks after operation, the endothelial cells were markedly irregular in size and shape and the number of endothelial cells was markedly decreased. Multilayered retrocorneal membranes (RCM)grew gradually 2 weeks after surgery. Vacuolar degeneration was seen in some endothelial cells. Nuclear degeneration and edema of plasma were seen in TEM. Conclusion: Corneal endothelial cell degenerated after contacting with F6H8 for 2 ~4weeks. As a silicone solvent, it should be removed completely after injection. We don't recommend it to be used as a new intraocular temponade. Eye Science 2001: 17:21 ~ 26.

  11. Visual outcome after corneal transplantation for corneal perforation and iris prolapse in 37 horses

    DEFF Research Database (Denmark)

    Henriksen, Michala de Linde; Plummer, C. E.; Mangan, B.;

    2012-01-01

    We wanted to investigate the visual outcome of horses presented with iris prolapse and treated with corneal transplantation.......We wanted to investigate the visual outcome of horses presented with iris prolapse and treated with corneal transplantation....

  12. Hevin plays a pivotal role in corneal wound healing.

    Directory of Open Access Journals (Sweden)

    Shyam S Chaurasia

    Full Text Available BACKGROUND: Hevin is a matricellular protein involved in tissue repair and remodeling via interaction with the surrounding extracellular matrix (ECM proteins. In this study, we examined the functional role of hevin using a corneal stromal wound healing model achieved by an excimer laser-induced irregular phototherapeutic keratectomy (IrrPTK in hevin-null (hevin(-/- mice. We also investigated the effects of exogenous supplementation of recombinant human hevin (rhHevin to rescue the stromal cellular components damaged by the excimer laser. METHODOLOGY/PRINCIPAL FINDINGS: Wild type (WT and hevin (-/- mice were divided into three groups at 4 time points- 1, 2, 3 and 4 weeks. Group I served as naïve without any treatment. Group II received epithelial debridement and underwent IrrPTK using excimer laser. Group III received topical application of rhHevin after IrrPTK surgery for 3 days. Eyes were analyzed for corneal haze and matrix remodeling components using slit lamp biomicroscopy, in vivo confocal microscopy, light microscopy (LM, transmission electron microscopy (TEM, immunohistochemistry (IHC and western blotting (WB. IHC showed upregulation of hevin in IrrPTK-injured WT mice. Hevin (-/- mice developed corneal haze as early as 1-2 weeks post IrrPTK-treatment compared to the WT group, which peaked at 3-4 weeks. They also exhibited accumulation of inflammatory cells, fibrotic components of ECM proteins and vascularized corneas as seen by IHC and WB. LM and TEM showed activated keratocytes (myofibroblasts, inflammatory debris and vascular tissues in the stroma. Exogenous application of rhHevin for 3 days reinstated inflammatory index of the corneal stroma similar to WT mice. CONCLUSIONS/SIGNIFICANCE: Hevin is transiently expressed in the IrrPTK-injured corneas and loss of hevin predisposes them to aberrant wound healing. Hevin (-/- mice develop early corneal haze characterized by severe chronic inflammation and stromal fibrosis that can be rescued

  13. Determination of corneal image-forming properties from corneal topography.

    Science.gov (United States)

    Maloney, R K; Bogan, S J; Waring, G O

    1993-01-01

    Keratometry provides useful information about the cornea's image-forming properties, such as corneal astigmatism, but is inaccurate on irregular corneas. Quantitative corneal topographic information is now obtainable on irregular corneas, but is difficult for the clinician to interpret. We developed a method to determine the spherical power, astigmatism, and topographic irregularity of a cornea by finding the best-fit spherocylinder that was closest to its measured topography. Keratometric measurements and two videokeratographs were gathered prospectively on 262 normal and abnormal corneas. The best-fit measurements of spherical power, astigmatism, and topographic irregularity were reproducible with one standard deviation of 0.75 diopter or better; agreement with keratometric measurements in normal eyes was good (0.60 diopter or better). Topographic irregularity averaged 0.1 diopter on precision spheres, 0.4 diopter on 146 normal eyes, 0.8 diopter on 29 eyes after radial keratotomy, 2.0 diopters on 58 eyes after penetrating keratoplasty, and 3.0 diopters on 29 eyes with advanced keratoconus. We conclude the following: basic corneal image-forming properties can be measured from videokeratographs; the properties can be determined, by our methods, on irregular corneas in which keratometry is unreliable; and topographic irregularity provides a measure of irregular astigmatism.

  14. Genetics Home Reference: lattice corneal dystrophy type I

    Science.gov (United States)

    ... corneal dystrophy type I lattice corneal dystrophy type I Enable Javascript to view the expand/collapse boxes. ... All Close All Description Lattice corneal dystrophy type I is an eye disorder that affects the clear, ...

  15. Immunoglobulins in granular corneal dystrophy Groenouw type I

    DEFF Research Database (Denmark)

    Møller, H U; Bojsen-Møller, M; Schrøder, H D

    1993-01-01

    Three patients with granular corneal dystrophy Groenouw type I underwent corneal grafting, and cryostat sections of the corneal buttons were examined immunohistochemically for immunoglobulins. Positive results were obtained for IgG, Kappa-, and Lambda chains with immunofluorescence technique...

  16. Polar Value Analysis of Corneal Astigmatism in Intrastromal Corneal Ring Segment Implantation

    OpenAIRE

    Chang Rae Rho; Min-Ji Kim; Choun-Ki Joo

    2016-01-01

    Purpose. To evaluate surgically induced astigmatism (SIA) and the average corneal power change in symmetric intrastromal corneal ring segment (ICRS) implantation. Methods. The study included 34 eyes of 34 keratoconus patients who underwent symmetric Intacs SK ICRS implantation. The corneal pocket incision meridian was the preoperative steep meridian. Corneal power data were obtained before and 3 months after Intacs SK ICRS implantation using scanning-slit topography. Polar value analysis was ...

  17. [Regeneration and fibrosis of corneal tissues].

    Science.gov (United States)

    Simirskiĭ, V N

    2014-01-01

    In this review, the features of the regeneration of corneal tissue and its disorders leading to the development of fibrosis are considered. The data on the presence of stem (clonogenic) cell pool in the corneal tissues (epithelium, endothelium, stroma) are given; these cells can serve as a source for regeneration of the tissues at injury or various diseases. The main steps of regeneration of corneal tissues and their disorders that lead to outstripping proliferation of myofibroblasts and secretion of extracellular matrix in the wound area and eventually cause the formation of connective tissue scar and corneal opacity are considered. Particular attention is given to the successes of translational medicine in the treatment of corneal tissue fibrosis. The methods of cell therapy aimed at the restoration of stem cell pool of corneal tissues are the most promising. Gene therapy provides more opportunities; one of its main objectives is the suppression of the myofibroblast proliferation responsible for the development of fibrosis.

  18. Obtaining corneal tissue for keratoplasty.

    Science.gov (United States)

    Navarro Martínez-Cantullera, A; Calatayud Pinuaga, M

    2016-10-01

    Cornea transplant is the most common tissue transplant in the world. In Spain, tissue donation activities depend upon transplant coordinator activities and the well-known Spanish model for organ and tissue donation. Tissue donor detection system and tissue donor evaluation is performed mainly by transplant coordinators using the Spanish model on donation. The evaluation of a potential tissue donor from detection until recovery is based on an exhaustive review of the medical and social history, physical examination, family interview to determine will of the deceased, and a laboratory screening test. Corneal acceptance criteria for transplantation have a wider spectrum than other tissues, as donors with active malignancies and infections are accepted for kearatoplasty in most tissue banks. Corneal evaluation during the whole process is performed to ensure the safety of the donor and the recipient, as well as an effective transplant. Last step before processing, corneal recovery, must be performed under standard operating procedures and in a correct environment. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  19. 机器人外科手术系统体外循环心脏手术的初步经验%Total endoscopic robot-assisted on-pump cardiac surgery: preliminary experience with robot-assisted surgery

    Institute of Scientific and Technical Information of China (English)

    魏来; 黄麒; 王春生; 沈金强; 夏利民; 罗红; 廖庆武; 胡克俭; 王萍; 徐竹静

    2011-01-01

    Objective To introduce our preliminary experience in total endoscopic robot-assisted onpump cardiac surgery with da Vinci system. Methods Five patients with mitral insufficiency (MI) and five patients with atrial septai defect (ASD) underwent on-pump cardiac surgical procedures using da Vinci S system from Aug. 2010 to Dec. 2010. After double-lumen endotracheal intubation and intravenous inhalation anesthesia,the peripheral extracorporeal circulation was established with femoral arterial cannula, femoral venous cannula and right internal jugular venous cannula. Through a 3 cm-length working-port and other three 0.8 cm-length mini-ports,the total endoscopic robotic-assisted operations (including mitral valve repair and ASD repair) were performed.Results All procedures were successfully performed without incision expansion or converting to sternotomy.Transesophageal echocardiography (TEE) showed no moderate or severe .m. itral valve regurgitation or atrial septal shunt. There were no in-hospital death or post-operative complications. The patients recovered quickly with less bleeding and shorter hospital stay. All patients were followed-up for 1 - 3 months and had satisfactory TEE results.Conclusion The da Vinci robotic surgery system is safe and reliable for cardiac surgery, with satisfactory outcome, mini-invasiveness, rapid recovery and bright future. (Shanghai Med J, 2011, 34: 38-42)%目的 介绍复旦大学附属中山医院应用达芬奇S机器人外科手术系统辅助开展全内镜体外循环心脏手术的初步经验.方法 2010年8-12月在达芬奇S机器人外科手术系统辅助下完成全内镜二尖瓣成形术5例,房间隔缺损修补术5例.全组患者均采用双腔气管插管、静脉吸入复合麻醉,经股动脉、股静脉及右颈内静脉插管建立外周体外循环.于右胸第4肋间隙作3 cm工作孔,右胸第3、4、6肋间隙分别作0.8 cm器械孔,由术者操控机械臂完成全内镜下心内直视手术.结果 所有

  20. Applications of robot-assisted surgery in gynecologic surgery: a preliminary study%机器人外科手术系统在妇科手术中应用的初步探讨

    Institute of Scientific and Technical Information of China (English)

    夏颖; 高燕

    2011-01-01

    目的 评价达芬奇S机器人外科系统在妇科手术中的应用效果.方法 回顾性分析2010年5-9月在复旦大学附属华东医院应用达芬奇S机器人外科手术系统辅助进行妇科手术的8例患者的临床资料.结果 行子宫肌瘤剥除术2例,子宫肌瘤剥除+卵巢囊肿剥除术1例,卵巢囊肿剥除术2例,附件切除术+左肾切除术1例,附件切除术+子宫肌瘤剥除术1例,全子宫+右侧附件切除术1例.除1例全子宫切除患者在完成子宫切除及阴道缝合后由于创面出血视野不清而转开腹止血外,其余7例均顺利完成手术.平均手术时间为(199±42)min,中位术中出血量为50 mL.均无输血.平均住院时间为(7±3)d.无术后并发症发生.结论 达芬奇S机器人外科系统具有三维图像及灵活的手术器械,应用于妇科手术是安全可靠的.%Objective To evaluate the efficacy of Da Vinci S surgical system in gynecologic surgery.Methods The clinical data of 8 patients, who had undergone robot-assisted gynecologic surgery using Da Vinci S surgical system from May to September 2010 in Huadong Hospital, Fudan University,were retrospective analyzed.Results The 8 operations included 2 myomectomy, 1 myomectomy and ovariocystectomy, 2 ovariocystectomy, 1 ovariosalpingectomy and left nephrectomy, 1 ovariosalpingectomy and myomectomy,and 1 hysterectomy and right ovariosalpingectomy. The operations were successfully done in 7 patients. One receiving hysterectomy had pelvic bleeding after removal of the uterus and vaginal cuff closure and was converted to laparotomy due to poor visualization. The mean operative time was (199± 42) min,with an estimated blood loss of 50 mL and a hospital stay of (7±3) days. No blood transfusion was needed. There were no postoperative complications. Conclusion The Da Vinci S surgical system offers a three-dimensional vision system and wristed instrumentation; our preliminary data confirm that robot-assisted gynecologic surgery is

  1. A native-like corneal construct using donor corneal stroma for tissue engineering.

    Directory of Open Access Journals (Sweden)

    Jing Lin

    Full Text Available Tissue engineering holds great promise for corneal transplantation to treat blinding diseases. This study was to explore the use of natural corneal stroma as an optimal substrate to construct a native like corneal equivalent. Human corneal epithelium was cultivated from donor limbal explants on corneal stromal discs prepared by FDA approved Horizon Epikeratome system. The morphology, phenotype, regenerative capacity and transplantation potential were evaluated by hematoxylin eosin and immunofluorescent staining, a wound healing model, and the xeno-transplantation of the corneal constructs to nude mice. An optically transparent and stratified epithelium was rapidly generated on donor corneal stromal substrate and displayed native-like morphology and structure. The cells were polygonal in the basal layer and became flattened in superficial layers. The epithelium displayed a phenotype similar to human corneal epithelium in vivo. The differentiation markers, keratin 3, involucrin and connexin 43, were expressed in full or superficial layers. Interestingly, certain basal cells were immunopositive to antibodies against limbal stem/progenitor cell markers ABCG2 and p63, which are usually negative in corneal epithelium in vivo. It suggests that this bioengineered corneal epithelium shared some characteristics of human limbal epithelium in vivo. This engineered epithelium was able to regenerate in 4 days following from a 4mm-diameter wound created by a filter paper soaked with 1 N NaOH. This corneal construct survived well after xeno-transplantation to the back of a nude mouse. The transplanted epithelium remained multilayer and became thicker with a phenotype similar to human corneal epithelium. Our findings demonstrate that natural corneal stroma is an optimal substrate for tissue bioengineering, and a native-like corneal construct has been created with epithelium containing limbal stem cells. This construct may have great potential for clinical use in

  2. Novel Technique of Transepithelial Corneal Cross-Linking Using Iontophoresis in Progressive Keratoconus

    Science.gov (United States)

    Raffa, Paolo; Rosati, Marianna

    2016-01-01

    In this work, the authors presented the techniques and the preliminary results at 6 months of a randomized controlled trial (NCT02117999) comparing a novel transepithelial corneal cross-linking protocol using iontophoresis with the Dresden protocol for the treatment of progressive keratoconus. At 6 months, there was a significant average improvement with an average flattening of the maximum simulated keratometry reading of 0.72 ± 1.20 D (P = 0.01); in addition, corrected distance visual acuity improved significantly (P = 0.08) and spherical equivalent refraction was significantly less myopic (P = 0.02) 6 months after transepithelial corneal cross-linking with iontophoresis. The novel protocol using iontophoresis showed comparable results with standard corneal cross-linking to halt progression of keratoconus during 6-month follow-up. Investigation of the long-term RCT outcomes are ongoing to verify the efficacy of this transepithelial corneal cross-linking protocol and to determine if it may be comparable with standard corneal cross-linking in the management of progressive keratoconus. PMID:27597895

  3. Novel Technique of Transepithelial Corneal Cross-Linking Using Iontophoresis in Progressive Keratoconus

    Directory of Open Access Journals (Sweden)

    Marco Lombardo

    2016-01-01

    Full Text Available In this work, the authors presented the techniques and the preliminary results at 6 months of a randomized controlled trial (NCT02117999 comparing a novel transepithelial corneal cross-linking protocol using iontophoresis with the Dresden protocol for the treatment of progressive keratoconus. At 6 months, there was a significant average improvement with an average flattening of the maximum simulated keratometry reading of 0.72±1.20 D (P=0.01; in addition, corrected distance visual acuity improved significantly (P=0.08 and spherical equivalent refraction was significantly less myopic (P=0.02 6 months after transepithelial corneal cross-linking with iontophoresis. The novel protocol using iontophoresis showed comparable results with standard corneal cross-linking to halt progression of keratoconus during 6-month follow-up. Investigation of the long-term RCT outcomes are ongoing to verify the efficacy of this transepithelial corneal cross-linking protocol and to determine if it may be comparable with standard corneal cross-linking in the management of progressive keratoconus.

  4. A review of corneal diameter, curvature and thickness values and influencing factors*

    Directory of Open Access Journals (Sweden)

    K. P. Mashige

    2013-12-01

    Full Text Available The cornea is an important ocular structure involved in the mediation of visual perception. It is the principal refractive surface of the eye and vision can be significantly affected by relatively small changes in its structure and parameters. Measurement of corneal parameters is important in the diagnosis and management of ocular diseasessuch as keratoconus and glaucoma, and also in the fitting of contact lenses or with refractive surgery such as Laser-Assisted in situ Keratomileusis(LASIK and photorefractive keratectomy (PRK. The human corneal diameter, anterior curvature and centre thickness as well as factors influencing them are reviewed in this article. This review will be useful to eye care professionals who routinely measure these parameters when fitting contact lenses and assessing, diagnosing as well as managing corneal and other ocular conditions. (S Afr Optom 2013 72(4 185-194

  5. Clinical efficacy of Toric intraocular lens implantation for cataract patients with corneal astigmatism

    Directory of Open Access Journals (Sweden)

    Guo-Hua Deng

    2015-11-01

    Full Text Available AIM: To investigate the clinical efficacy of Toric intraocular lens(IOLimplantation for cataract patients with corneal astigmatism.METHODS: Thirty-eight patients(46 eyeswith corneal astigmatism undergone phacoemulsification and IOL implantation in our hospital from June 2013 to July 2014 were observed. Twenty cases(24 eyesreceived Toric IOL, 18 cases(22 eyesgot Acrysof IQ IOL. The clinical efficacy of the two groups was analyzed.RESULTS:The difference on visual acuity after surgery between the two groups was statistically significant(F=5.783, PPt=5.248, 2.573, 2.782; all PF=5.482, PPt=6.591, 3.287, 2.167; all PCONCLUSION: Phacoemulsification associated with Toric IOL implantation has good correction effect and prediction for cataract and corneal astigmatism patients, and can improve the visual activity significantly, so it is worthy of clinical application.

  6. 重视更新视觉新理念以不断提升角膜屈光手术后视觉质量%Update the concepts on visual correction and enhance the visual quality after corneal refractive surgery

    Institute of Scientific and Technical Information of China (English)

    王雁

    2016-01-01

    近年来现代眼科学和视光学领域的新技术和新理念不断涌现.波前技术及其衍生的一系列理念不仅将传统屈光不正概念重新定义并补充,出现了更为客观评价人眼光学质量的重要手段和方法,而且基于波前设计的各种手术视觉矫正方案也显示出较好的视觉矫正效果,推动了角膜屈光手术的变革和提高.因此提出临床工作的重点应着眼于视觉新理念的更新,并根据新理念进一步提出提升角膜屈光手术后视觉质量的可能途径.%In recent years, new technologies and ideas of modem ophthalmology and optometry have emerged.Based on the wavefront technology and its derivatives, the traditional concepts of refractive errors and vision correction have been redefined and supplemented.Human optical quality can be evaluated effectively and objectively.Moreover, the studies about the wavefront vision correction have shown preferable vision correction results.Application of these modern methods of wavefront refraction and correction offers important opportunities for better optical quality and visual performance in corneal refractive surgery.It also provides a foundation for creating novel clinical diagnosis and treatment options in vision correction.

  7. Intraocular lens power calculation after corneal refractive surgery using serf-designed computer software programmed with optimized calculation method%应用优化计算方法与计算机软件计算角膜屈光手术后人工晶状体屈光力

    Institute of Scientific and Technical Information of China (English)

    郭海科; 金海鹰; Gerd.U.AUFFARTH; 张洪洋

    2010-01-01

    目的 对准分子激光角膜屈光手术后人工晶状体屈光力的计算方法进行优化,并开发为计算机软件,评价其准确性与可靠性.方法 对人工晶状体屈光力计算方法进行优化,包括:角膜屈光力的矫正计算;人工晶状体有效位置的计算与双K值法(double-K method)的应用;标准化计算公式的应用.将计算方法编写为计算机应用软件(IOL calculator for post-refractive cases).应用该软件对49例角膜屈光手术后的白内障患者的人工晶状体屈光力进行计算,以白内障手术后实际屈光状态为标准,预测屈光状态与实际屈光状态之间的差异为预测误差,预测误差的绝对值为绝对预测误差.以SPSS 11.0软件分析预测误差与绝对预测误差的平均值与分布.结果 白内障手术后屈光状态为-2.50~0.75 D,平均为(-0.78±o.83)D,3眼(6.1%)为正视,36眼(73.5%)为近视,10眼(20.4%)为远视.预测误差为-1.26~1.96 D,平均(-0.02±0.75)D,接近于正视性屈光状态.绝对预测误差为0~1.96 D,平均(0.62±0.42)D,绝对预测误差≤0.5 D者19眼(38.8%),>0.5 D且≤1.0 D者22眼(44.9%),>1.0 D且≤1.5 D者7眼(14.3%),>1.5 D 且≤2.0 D者1眼(2.0%).结论 通过优化计算方法与开发计算机软件,可以充分简化准分子激光角膜屈光手术后人工晶状体屈光力的计算过程,并提高计算的准确性与可靠性.%Objective To evaluate intraocular lens power calculation after laser refractive surgery using an optimized calculation method and self-designed computer software. Methods Intraocular lens power calculation method was optimized in the following aspects: corrective algorithm for corneal power estimation; algorithm for effective lens position estimation and double-K method for intraocular lens power calculation; and standardized formula for intraocular lens power calculation.The calculation method was programmed into self-designed computer software (IOL calculator for post

  8. Corneal tomography and biomechanics in primary pterygium.

    Science.gov (United States)

    Vanathi, M; Goel, Sahil; Ganger, Anita; Agarwal, Tushar; Dada, T; Khokhar, Sudarshan

    2017-05-13

    To study the Scheimpflug's imaging and corneal biomechanics in primary pterygium. A prospective observational study of 55 patients with unilateral primary nasal pterygium was done. The normal fellow eyes of patients with pterygium were taken as controls. Clinical parameters noted included visual acuity, values of corneal curvature by doing Scheimpflug imaging, wavefront aberrations in terms of higher and lower-order aberrations and corneal hysteresis (CH) as well as corneal resistance factor (CRF) values by using ocular response analyzer. Of the total 55 patients, mean age was 43.0 + 11.4 years (range: 20-72 years). Mean LogMar uncorrected visual acuity in pterygium eyes and control eyes was 0.21 + 0.20 and 0.12 + 0.15, respectively (p = 0.016). On Scheimpflug imaging the mean anterior corneal curvature values (Ka1/Ka2 D) were 41.09 + 3.38/44.33 + 2.29 in pterygium eyes, 43.13 + 1.79/43.98 + 2.17 in control eyes (p  0.05). Analysis of corneal aberrations showed significantly higher corneal wavefront aberrations in pterygium eyes. Highest correlation of corneal astigmatism was noted with corneal area encroached by pterygium (ρ = 0.540 for LOA and 0.553 for HOA) and distance from pupillary center (ρ = 0.531 for LOA and 0.564 for HOA). Corneal biomechanical parameters including CH and CRF were found to be lower in the pterygium eyes, though not statistically significant (p value 0.60 and 0.59, respectively). Pterygium leads to deterioration of visual performance not only by causing refractive and topographic changes but also by causing a significant increase in corneal wavefront aberrations.

  9. Changing indications and techniques for corneal transplantations at a tertiary referral center in Turkey, from 1995 to 2014

    Directory of Open Access Journals (Sweden)

    Altay Y

    2016-06-01

    Full Text Available Yesim Altay, Ayse Burcu, Gozde Aksoy, Evin Singar Ozdemir, Firdevs Ornek Department of Ophthalmology, Ankara Training and Research Hospital, Ankara, Turkey Background: Indications for corneal transplantation in developed and developing nations differ according to the different spectrum of corneal disease in each country. Objective: The purpose of this study is to analyze the changing indications and surgical techniques for corneal transplantation over the past 20 years at a tertiary referral center in Turkey. Methods: We retrospectively reviewed the records of patients who underwent keratoplasty from January 1995 to December 2014 (between 1995 and 2004, period 1, and between 2005 and 2014, period 2. Patients’ demographic data, indications for corneal transplantation, and the type of surgery were recorded. Results: The number of keratoplasties performed ranged from 548 in period 1 to 782 in period 2. Between 1995 and 2004, the leading indications were keratoconus (34.1%, bullous keratopathy (17%, and non-herpetic corneal scar (13.3%, and between 2005 and 2014, they were keratoconus (33.8%, corneal stromal dystrophy (14.2%, and bullous keratopathy (12.7%. All the keratoplasties performed in the 1995–2004 period were penetrating keratoplasty (PKP. During the period 2005–2014, PKP accounted for 93%, automated lamellar keratoplasty 5.8%, and deep anterior lamellar keratoplasty 1.2% of all corneal transplantations. Conclusion: Keratoconus was the leading indication for keratoplasty in both periods. In the 2005–2014 period, corneal stromal dystrophy increased significantly. All the keratoplasties performed in period 1 and 93% of all keratoplasties performed in period 2 were PKP. Keywords: corneal transplantation, indication, keratoconus, keratoplasty technique, pene­trating keratoplasty

  10. An unusual case of spontaneous Mycobacterium chelonae corneal ulcer in a healthy middle-aged adult

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    Bhandari V

    2016-05-01

    Full Text Available Vipul Bhandari, R Sriganesh, Kirti RelekarDepartment of Cornea, Nethradhama Eye Hospital, Bengaluru, IndiaBackground: To report a rare presentation of culture-positive Mycobacterium chelonae corneal ulcer and its management.Findings: We report a rare case of a patient with a history of chronic pain and blurriness of vision. Examination revealed a chronic nonhealing paracentral corneal ulcer inferiorly at the 5–7 o'clock meridian with anterior chamber reaction unresponsive to routine antibiotic and antifungal medications with Mantoux test positivity in a middle-aged nondiabetic patient with no prior history of trauma, ocular surgery, and contact lens usage. Ziehl–Neelsen staining of the nonhealing ulcer revealed acid-fast bacilli typical of M. chelonae, with subsequent culture positivity in Löwenstein–Jensen medium. Subsequent treatment with topical fortified amikacin and tobramycin resulted in rapid healing of the corneal ulcer.Conclusion: M. chelonae presenting as a chronic nonhealing corneal ulcer spontaneously occurring in a healthy adult with no predisposing factor draws attention towards the need to have a good index of suspicion by performing a Ziehl–Neelsen stain and culture, and subsequent successful management with topical fortified amikacin and tobramycin.Keywords: spontaneous, M. chelonae, nonhealing corneal ulcer, healthy

  11. Corneal laceration caused by river crab

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    Vinuthinee N

    2015-01-01

    Full Text Available Naidu Vinuthinee,1,2 Anuar Azreen-Redzal,1 Jaafar Juanarita,1 Embong Zunaina2 1Department of Ophthalmology, Hospital Sultanah Bahiyah, Alor Setar, 2Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia Abstract: A 5-year-old boy presented with right eye pain associated with tearing and photophobia of 1-day duration. He gave a history of playing with a river crab when suddenly the crab clamped his fingers. He attempted to fling the crab off, but the crab flew and hit his right eye. Ocular examination revealed a right eye corneal ulcer with clumps of fibrin located beneath the corneal ulcer and 1.6 mm level of hypopyon. At presentation, the Seidel test was negative, with a deep anterior chamber. Culture from the corneal scrapping specimen grew Citrobacter diversus and Proteus vulgaris, and the boy was treated with topical gentamicin and ceftazidime eyedrops. Fibrin clumps beneath the corneal ulcer subsequently dislodged, and revealed a full-thickness corneal laceration wound with a positive Seidel test and shallow anterior chamber. The patient underwent emergency corneal toileting and suturing. Postoperatively, he was treated with oral ciprofloxacin 250 mg 12-hourly for 1 week, topical gentamicin, ceftazidime, and dexamethasone eyedrops for 4 weeks. Right eye vision improved to 6/9 and 6/6 with pinhole at the 2-week follow-up following corneal suture removal. Keywords: corneal ulcer, pediatric trauma, ocular injury

  12. Corneal staining after treatment with topical tetracycline

    NARCIS (Netherlands)

    R. Lapid-Gortzak; C.P. Nieuwendaal; A.R. Slomovic; L. Spanjaard

    2006-01-01

    Purpose: The purpose of this paper is to report a case of corneal staining after treatment with topical tetracycline. Methods: A patient with crystalline keratopathy caused by Streptococcus viridans after corneal transplantation was treated topically with tetracycline eye drops, based on results of

  13. Corneal cellular proliferation and wound healing

    OpenAIRE

    Gan, Lisha

    2000-01-01

    Background. Cellular proliferation plays an important role in both physiological and pathological processes. Epithelial hyperplasia in the epithelium, excessive scar formation in retrocorneal membrane formation and neovascularization are examples of excessive proliferation of cornea cells. Lack of proliferative ability causes corneal degeneration. The degree of proliferative and metabolic activity will directly influence corneal transparency and very evidently refractive res...

  14. Corynebacterium macginleyi isolated from a corneal ulcer

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    Kathryn Ruoff

    2010-02-01

    Full Text Available We report the isolation of Corynebacterium macginleyi from the corneal ulcer culture of a patient, later enrolled in the Steroids for Corneal Ulcer Trial (SCUT. To our knowledge this is the first published report from North America of the recovery of C. macginleyi from a serious ocular infection.

  15. Dorsally located corneal dermoid in a cat

    Directory of Open Access Journals (Sweden)

    Alexander J LoPinto

    2016-04-01

    Full Text Available Case summary A 2-month-old, male kitten was presented for evaluation of unilateral blepharospasm and epiphora involving the right eye. Ocular examination revealed conjunctivitis, a superficial corneal ulcer, reflex anterior uveitis and a haired mass within the dorsal cornea of the right eye. The mass was subsequently removed surgically via a lamellar keratectomy. Histologic evaluation of the mass via light microscopy revealed it to be comprised of normal-haired skin with mild inflammation. One week after surgical removal and medical management of the corneal ulcer, all ocular clinical signs had resolved with minimal corneal scarring. On re-examination 6 months following surgical excision of the mass, the kitten was noted to be comfortable with no significant corneal scarring. Relevance and novel information To our knowledge, this is the first case report of a dorsally located corneal dermoid in a cat.

  16. Corneal neovascularization and contemporary antiangiogenic therapeutics.

    Science.gov (United States)

    Hsu, Chih-Chien; Chang, Hua-Ming; Lin, Tai-Chi; Hung, Kuo-Hsuan; Chien, Ke-Hung; Chen, Szu-Yu; Chen, San-Ni; Chen, Yan-Ting

    2015-06-01

    Corneal neovascularization (NV), the excessive ingrowth of blood vessels from conjunctiva into the cornea, is a common sequela of disease insult that can lead to visual impairment. Clinically, topical steroid, argon laser photocoagulation, and subconjunctival injection of bevacizumab have been used to treat corneal NV. Sometimes, the therapies are ineffective, especially when the vessels are large. Large vessels are difficult to occlude and easily recanalized. Scientists and physicians are now dedicated to overcoming this problem. In this article, we briefly introduce the pathogenesis of corneal NV, and then highlight the existing animal models used in corneal NV research-the alkali-induced model and the suture-induced model. Most of all, we review the potential therapeutic targets (i.e., vascular endothelial growth factor and platelet-derived growth factor) and their corresponding inhibitors, as well as the immunosuppressants that have been discovered in recent years by corneal NV studies.

  17. Corneal ectasia 6.5 months after small-incision lenticule extraction.

    Science.gov (United States)

    Wang, Yumeng; Cui, Chuanbo; Li, Zhiwei; Tao, Xiangchen; Zhang, Chunxiao; Zhang, Xiao; Mu, Guoying

    2015-05-01

    Our case involves a 19-year-old patient with forme fruste keratoconus. Small-incision lenticule extraction was performed, and 6.5 months after surgery, corneal ectasia was diagnosed. Preoperatively, the minimum central corneal thickness was 546 μm in the right eye and 542 μm in the left eye; the refractive correction was -6.75 -1.00 × 45 and -6.75 -0.75 × 140, respectively; the lenticular thickness was 137 μm and 135 μm, respectively. At 6.5 months, ectasia was diagnosed based on anterior and posterior surface keratometry of 38.4/39.5 diopters (D) and -6.3/-6.8 D, respectively, in the right eye and 38.6/40.8 D and -7.1/-6.6 D, respectively, in the left eye. The keratometry increased gradually and the corneal thickness decreased after surgery, and these trends continued during the 13-month follow-up. This report documents corneal ectasia as a complication of small-incision lenticule extraction and highlights the importance of preoperative evaluation and the need for long-term follow-up. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  18. An Ultra-thin Amniotic Membrane as Carrier in Corneal Epithelium Tissue-Engineering.

    Science.gov (United States)

    Zhang, Liying; Zou, Dulei; Li, Sanming; Wang, Junqi; Qu, Yangluowa; Ou, Shangkun; Jia, Changkai; Li, Juan; He, Hui; Liu, Tingting; Yang, Jie; Chen, Yongxiong; Liu, Zuguo; Li, Wei

    2016-02-15

    Amniotic membranes (AMs) are widely used as a corneal epithelial tissue carrier in reconstruction surgery. However, the engineered tissue transparency is low due to the translucent thick underlying AM stroma. To overcome this drawback, we developed an ultra-thin AM (UAM) by using collagenase IV to strip away from the epithelial denuded AM (DAM) some of the stroma. By thinning the stroma to about 30 μm, its moist and dry forms were rendered acellular, optically clear and its collagen framework became compacted and inerratic. Engineered rabbit corneal epithelial cell (RCEC) sheets generated through expansion of limbal epithelial cells on UAM were more transparent and thicker than those expanded on DAM. Moreover, ΔNp63 and ABCG2 gene expression was greater in tissue engineered cell sheets expanded on UAM than on DAM. Furthermore, 2 weeks after surgery, the cornea grafted with UAM based cell sheets showed higher transparency and more stratified epithelium than the cornea grafted with DAM based cell sheets. Taken together, tissue engineered corneal epithelium generated on UAM has a preferable outcome because the transplanted tissue is more transparent and better resembles the phenotype of the native tissue than that obtained by using DAM for this procedure. UAM preserves compact layer of the amniotic membrane and maybe an ideal substrate for corneal epithelial tissue engineering.

  19. Effect of lateral temporal corneal incision for intraocular pressure and tear film stability in cataract patients

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    Ying Wang

    2017-02-01

    Full Text Available AIM: To investigate therapeutic effect of lateral temporal corneal incision phacoemulsification combined with intraocular lens(IOLon cataract and its effect on intraocular pressure(IOPand tear film. METHODS: The clinical data of patients with cataract who received treatment in our hospital from March 2014 to December 2015 were retrospectively analyzed. According to the location of the incision, they were divided into temporal corneal incision group and upper corneal incision group. We observed the incidence of complications of the two groups, compared the intraocular pressure, visual acuity, refraction and tear film break-up time of the two groups before and after surgery. RESULTS: The operation time and postoperative pain score of the two groups had no significant difference(P>0.05. The IOP and visual acuity between the two groups before operation had no significant difference(P>0.05. At the intraocular pressure of the two groups was lower than that before operation, and the visual acuity was higher than before operation, and the changes of the anterior lateral incision group were more obvious(PPCONCLUSION: The temporal corneal incision phacoemulsification combined with intraocular lens implantation has a good therapeutic effect on cataract patients, can effectively improve the intraocular pressure and tear film stability, improve eye function, promote the recovery of the body after surgery.

  20. Corneal Regeneration by Deep Anterior Lamellar Keratoplasty (DALK Using Decellularized Corneal Matrix.

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    Yoshihide Hashimoto

    Full Text Available The purpose of this study is to demonstrate the feasibility of DALK using a decellularized corneal matrix obtained by HHP methodology. Porcine corneas were hydrostatically pressurized at 980 MPa at 10°C for 10 minutes to destroy the cells, followed by washing with EGM-2 medium to remove the cell debris. The HHP-treated corneas were stained with H-E to assess the efficacy of decellularization. The decellularized corneal matrix of 300 μm thickness and 6.0 mm diameter was transplanted onto a 6.0 mm diameter keratectomy wound. The time course of regeneration on the decellularized corneal matrix was evaluated by haze grading score, fluorescein staining, and immunohistochemistry. H-E staining revealed that no cell nuclei were observed in the decellularized corneal matrix. The decellularized corneal matrices were opaque immediately after transplantation, but became completely transparent after 4 months. Fluorescein staining revealed that initial migration of epithelial cells over the grafts was slow, taking 3 months to completely cover the implant. Histological sections revealed that the implanted decellularized corneal matrix was completely integrated with the receptive rabbit cornea, and keratocytes infiltrated into the decellularized corneal matrix 6 months after transplantation. No inflammatory cells such as macrophages, or neovascularization, were observed during the implantation period. The decellularized corneal matrix improved corneal transparency, and remodelled the graft after being transplanted, demonstrating that the matrix obtained by HHP was a useful graft for corneal tissue regeneration.

  1. The accuracy of posterior curvature method in corneal power calculation after LASIK surgery%后曲率实测法计算准分子激光角膜原位磨镶术后角膜屈光力的准确性

    Institute of Scientific and Technical Information of China (English)

    胡毅倩; 周秀莉; 李音; 徐承慧; 田琳璐; 冯婕好; 朱煌; 盛耀华

    2009-01-01

    目的 探讨后曲率实测法计算准分子激光原位角膜磨镶术(LASIK)后角膜屈光力的准确性.方法 多种测量角膜屈光力方法的比较性研究.回顾性分析按后曲率实测法计算人工晶状体度数的LASIK术后人工晶状体植入眼8例(11只眼,10只为超声乳化白内障吸除及人工晶状体植入术,1只为人工晶状体置换术),计算术后稳定屈光状态与目标屈光度的差异,并据此推导实际角膜屈光力.分析其他角膜曲率法(自动曲率计、角膜地形图、球镜当量法、前曲率法、Pentacam提供的EKR曲率)计算人工晶状体度数可能造成的届光偏差.对LASIK术后6个月随访眼23例行详细屈光检查,根据术前角膜屈光力及手术前后眼屈光度改变推导术后理论角膜屈光力.分析后曲率实测法计算所得角膜屈光力与理论角膜屈光力的差异,并与其他角膜曲率法作比较.结果 采用后曲率实测法计算的人工晶状体植入眼术后平均裸眼视力0.8±0.2,与目标屈光度绝对偏差平均为(0.36±0.36)D(-0.63~+0.85 D),绝对偏差≤0.25 D、≤0.50 D、≤1.00 D的眼比例数分别为55%、73%和91%.其屈光偏差显著低于自动曲率计[(2.50±1.08)D]、角膜地形图[(1.90±0.88)D]、球镜当量法[(2.09±1.62)D](P 0.05 ).For the 23 post LASIK eyes, the absolute difference between the corrected corneal power using posterior curvature method and theoretical power was (0.67±0.45)D, also showed least bias compared with other methods.Conclusion It is a practical and accurate way to calculate the corneal power after LASIK surgery using posterior curvature method.

  2. First Identification of a Triple Corneal Dystrophy Association: Keratoconus, Epithelial Basement Membrane Corneal Dystrophy and Fuchs' Endothelial Corneal Dystrophy

    Directory of Open Access Journals (Sweden)

    Cosimo Mazzotta

    2014-09-01

    Full Text Available Purpose: To report the observation of a triple corneal dystrophy association consisting of keratoconus (KC, epithelial basement membrane corneal dystrophy (EBMCD and Fuchs' endothelial corneal dystrophy (FECD. Methods: A 55-year-old male patient was referred to our cornea service for blurred vision and recurrent foreign body sensation. He reported bilateral recurrent corneal erosions with diurnal visual fluctuations. He underwent corneal biomicroscopy, Scheimpflug tomography, in vivo HRT confocal laser scanning microscopy and genetic testing for TGFBI and ZEB1 mutations using direct DNA sequencing. Results: Biomicroscopic examination revealed the presence of subepithelial central and paracentral corneal opacities. The endothelium showed a bilateral flecked appearance, and the posterior corneal curvature suggested a possible concomitant ectatic disorder. Corneal tomography confirmed the presence of a stage II KC in both eyes. In vivo confocal laser scanning microscopy revealed a concomitant bilateral EBMCD with hyperreflective deposits in basal epithelial cells, subbasal Bowman's layer microfolds and ridges with truncated subbasal nerves as pseudodendritic elements. Stromal analysis revealed honeycomb edematous areas, and the endothelium showed a strawberry surface configuration typical of FECD. The genetic analysis resulted negative for TGFBI mutations and positive for a heterozygous mutation in exon 7 of the gene ZEB1. Conclusion: This is the first case reported in the literature in which KC, EBMCD and FECD are present in the same patient and associated with ZEB1 gene mutation. The triple association was previously established by means of morphological analysis of the cornea using corneal Scheimpflug tomography and in vivo HRT II confocal laser scanning microscopy.

  3. A comparative study of autokeratometric and Scheimpflug keratometric measurements of the anterior corneal surface: results for a single subject

    Directory of Open Access Journals (Sweden)

    S. Mathebula

    2007-01-01

    Full Text Available One purpose of the broader study was to determine whether keratometric measurements obtained with an autokeratometer (Nidek ARK-700 would be comparable with those measured using the Oculus Pentacam(model 70700. Ten healthy subjects without ocular abnormality, no previous or current contact lens wear or history of ocular surgery were recruited and at least 43 successive keratometric measurements were obtained for the right eye of each subject using both instruments, namely the autokeratometer and the Pentacam. This paper will concern itself with data from only one of the ten subjects involved, namely Subject 1. The corneal powers were analyzed using multivariate methods for analyzing dioptric power. Scatter plots and meridional profiles of skewness and kurtosis were used to compare the results for the two instruments. Mean dioptric powers in conventional and scientific notation were determined.The results for this subject indicated that there was a statistically significant difference between the autokeratometry and the Pentacam. Although the means  between the two instruments were found to be significantly different at a 95% level of confidence, there was minimal clinical difference between the means of the two instruments. That is, this preliminary investigation suggests that in normal eyes, clinically, keratometric results obtained by means of an autokeratometer and a Pentacam are reasonably similar and can be used interchangeably.

  4. Fuchs endothelial corneal dystrophy: clinical characteristics of surgical and nonsurgical patients

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    Goldberg RA

    2014-09-01

    Full Text Available Roger A Goldberg,1,2 Sabri Raza,1 Eric Walford,1 William J Feuer,1 Jeffrey L Goldberg1,3 1Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA; 2Tufts-New England Eye Center/Ophthalmic Consultants of Boston, Boston, MA, USA; 3Shiley Eye Center, University of California San Diego, San Diego, CA, USA Purpose: To review the patient and clinical characteristics of patients with Fuchs endothelial corneal dystrophy (FECD. Methods: Review of records for every patient who presented to the Bascom Palmer Eye Institute between 2003 and 2009 whose visit was coded for endothelial corneal dystrophy (International Classification of Diseases, Ninth Revision [ICD9] 371.57, bullous keratopathy (ICD9 371.23, or who underwent a corneal surgery with or without cataract extraction. Demographic, clinical, and ancillary testing data were collected from the time of presentation, diagnosis, and follow-up, and the use, timing, and type of surgical interventions was documented, with 6-month and final visual acuities recorded. Results: A total of 2,370 charts were included in this study, of which 966 patients had a diagnosis of FECD. Of these, 197 patients (21% received a corneal transplantation procedure. The surgery most often performed was penetrating keratoplasty with or without cataract extraction (66%, followed by endothelial keratoplasty with or without cataract extraction (34%. The risk factors for surgery include worse visual acuity at presentation (20/60 Snellen visual acuity in surgical patients versus 20/40 Snellen visual acuity in nonsurgical patients, P<0.001, greater average central corneal thickness (635 µm versus 592 µm, P<0.001, loss of visual acuity over time (two lines lost versus zero lines lost, P<0.001, increasing age (P<0.001, and male sex (P=0.008. Over half of patients (52% did not receive surgery despite poor vision. Conclusion: During this time period, FECD did not have a consistent pattern for management or treatment, and despite

  5. Anterior ciliary sclerotomy: effect on corneal topography, globe integrity, and the role of a novel antifibrotic gel

    Science.gov (United States)

    Lamar, Peggy; Fernandez, Viviana; Manns, Fabrice; Dubovy, Sander; Zipper, Stanley; Sandadi, Samith; Nakagawa, Natsushi; Weiser, Marc; Malecaze, Francois; Parel, Jean-Marie A.

    2002-06-01

    To (1) quantify changes in corneal topography induced by radial anterior sclerostomy for restoring accommodation and, (2) assess safety and ant fibrosis activity of cross-linked sodium hyaluronic acid (cSHA) based gels in ACS procedures. Methods (ex-vivo study): 6 fresh human Eye-Bank eyes were used. A 15% Dextran solution was injected in the anterior chamber and the vitreous cavity, the corneal epithelium was removed by scraping, and the whole eye was immersed in 15% Dextran solution until corneal thickness reached a physiological value. The conjunctiva and tenon capsule were removed and the eye was mounted on a custom-made holder. Preoperative corneal topography was measured with a PAR corneal topography system. Five to eight 3mm-long linear equidistant anterior radial incisions starting from the limbus were performed in the sclera at 90% depth with a diamond blade. Postoperative corneal topography was measured. The files providing the pre and postoperative tangential curvature along meridians separated by 5 degrees were exported. The axial curvature along the 0 and 90-degree meridians before and after surgery were compared. Methods (in-vivo study): Of 24 rabbits, 4 were operated following Thornton's (90% depth incision) and 20 following Fukasaku's (100% depth) techniques (total peritomy, four 4mm long radial scleral incisions starting 0.5 mm from the limbus).

  6. Combined effects of interleukin-1β and cyclic stretching on metalloproteinase expression in corneal fibroblasts in vitro.

    Science.gov (United States)

    Feng, Pengfei; Li, Xiaona; Chen, Weiyi; Liu, Chengxing; Rong, Shuo; Wang, Xiaojun; Du, Genlai

    2016-06-10

    Corneal tensile strain increases if the cornea becomes thin or if intraocular pressure increases. However, the effects of mechanical stress on extracellular matrix (ECM) remodelling in the corneal repair process and the corneal anomalies are unknown. In this study, the combined effects of interleukin-1β (IL-1β) on matrix metalloproteinases (MMPs) in corneal fibroblasts under cyclic stretching were investigated in vitro. Cultured rabbit corneal fibroblasts were subjected to 5, 10 or 15 % cyclic equibiaxial stretching at 0.1 Hz for 36 h in the presence of IL-1β. Conditioned medium was harvested for the analysis of MMP2 and MMP9 protein production using the gelatin zymography and western blot techniques. Cyclic equibiaxial stretching changed the cell morphology by increasing the contractility of F-actin fibres. IL-1β alone induced the expression of MMP9 and increased the production of MMP2, and 5 % stretching alone decreased the production of MMP2, which indicates that a low stretching magnitude can reduce ECM degradation. In the presence of IL-1β, 5 and 10 % stretching increased the production of MMP2, whereas 15 % stretching increased the production of MMP9. These results indicate that MMP expression is enhanced by cyclic mechanical stimulation in the presence of IL-1β, which is expected to contribute to corneal ECM degradation, leading to the development of post-refractive surgery keratectasia.

  7. Factors Affecting Corneal Hysteresis in Taiwanese Adults

    Institute of Scientific and Technical Information of China (English)

    Jia-Kang Wang; Tzu-Lun Huang; Pei-Yuan Su; Pei-Yao Chang

    2015-01-01

    Purpose: To investigate the correlation of various corneal hysteresis (CH) factors in Chinese adults. Methods: From January 2009 to November 2011, the healthy right eyes of a total of 292 adults were recruited into the study. Goldmann-correlated intraocular pressure (IOPG) and CH were measured using an ocular response analyzer (ORA). Central corneal thickness was measured using the ORA’s in-tegrated handheld ultrasonic pachymeter. The IOLMaster was used to obtain the ocular biometric measurements including axial length, anterior chamber depth, and keratometric values. The Pearson correlation coefficient was used to test correla-tions between CH and quantitative factors. The chi-square test was used to detect differences in categorical values. Results: Longer axial length (P=0.0001), lower IOPG (P=0.03), older age(P=0.003),and thinner central corneal thick-ness (P=0.0001) were significantly associated with lower CH. The anterior chamber depth (P=0.34), gender (P=0.23), and corneal curvature (P=0.18) had no relationship to CH. Conclusion:Various factors including axial length, intraocular pressure, age, and central corneal thickness can affect measure-ment of corneal biomechanical properties in Chinese adults. But the anterior chamber depth, gender, and corneal curvature were irrelevant to CH.

  8. Corneal sensitivity in five horse breeds

    Directory of Open Access Journals (Sweden)

    Eunice Santos de Andrade

    Full Text Available ABSTRACT: This study aimed to determine and compare corneal sensitivity values in different regions of the cornea in five horse breeds. One hundred and forty five healthy horses, adults of both sexes, of the following breeds - Arabian horse (AH; n=20, Mangalarga Marchador (MM; n=50, Pure Blood Lusitano (PBL; n=35, Quarter Horse (QH; n=20, Brazilian Sport Horse (BSH; n=20-were investigated. Corneal touch threshold (CTT was measured with a Cochet-Bonnet esthesiometer in five different corneal regions. Measurements of the median central CTT were: 4.50±0.50cm (AH, 3.50±0.56cm (MM, 3.00±0.25cm (PBL, 2.50±0.44cm (QH and 2.50±0.00cm (BSH. The central region was the most sensitive and the dorsal region the least sensitive corneal region for all breeds. CTT values differed for corneal regions and horse breeds. The CTT values were different among the corneal regions and the horse breeds. Arabian horses presented higher sensitivity values being the most sensitive in all of the corneal regions.

  9. 医师手术权限管理研究%Preliminary study on classified management of surgical doctors surgery permission

    Institute of Scientific and Technical Information of China (English)

    马金红; 姚华; 付玲玲

    2011-01-01

    According to the related requirements of medical technology clinical application management, the specific implementation approaches of surgery physicians surgery permission management were made, including establishing surgery classification project directory library, developing surgery classification management system and the surgery permission declared, and audit program, and investigating to determine the steps of surgery permission owned by surgery physicians currently, and finding problems and solution measures in implementation surgery permission management. To prevent surgical risk, improve the quality of operation, and evaluate surgical doctors scientifically, it provides management experience and references.%依据医疗技术临床应用管理相关要求,提出医师手术分级管理的具体实施办法,包括建立手术分级项目录库、制定手术分级管理制度及手术权限申报、审核程序、调查确定医师目前具有的手术权限的步骤,提出在实施手术权限管理中存在和发现的问题及解决措施,为防范手术风险、提高手术质量、科学评价手术医师,提供管理经验及参考.

  10. Corneal tattooing (keratopigmentation) with new mineral micronised pigments to restore cosmetic appearance in severely impaired eyes.

    Science.gov (United States)

    Alio, Jorge L; Sirerol, Belucha; Walewska-Szafran, Anna; Miranda, Mauricio

    2010-02-01

    To investigate keratopigmentation (KTP) with new mineral micronised pigments as a surgical alternative to improve cosmetic appearance in severely impaired eyes. 40 eyes underwent KTP alternatively to invasive cosmetic reconstructive surgery. Corneal staining with mineral micronised pigments was performed using an intralamellar or superficial technique. One year postoperatively, all but two patients (95%) were satisfied. Pigmented eyes were improving patient's appearance. Eight cases needed a second KTP. Two patients with preoperative corneal oedema did not obtain an adequate cosmetic appearance due to progressive pigment clearance observed from 6 months postoperatively. Three eyes with traumatic aniridia observed good cosmetic outcome and a significant reduction in glare. KTP achieves good cosmetic results and is associated with high patient satisfaction, avoiding extensive and mutilating reconstructive surgery.

  11. Corneal Molecular and Cellular Biology for the Refractive Surgeon: The Critical Role of the Epithelial Basement Membrane.

    Science.gov (United States)

    Marino, Gustavo K; Santhiago, Marcony R; Torricelli, Andre A M; Santhanam, Abirami; Wilson, Steven E

    2016-02-01

    To provide an overview of the recent advances concerning the corneal molecular and cellular biology processes involved in the wound healing response after excimer laser surface ablation and LASIK surgery. Literature review. The corneal wound healing response is a complex cascade of events that impacts the predictability and stability of keratorefractive surgical procedures such as photorefractive keratectomy and LASIK. The generation and persistence of corneal myofibroblasts (contractile cells with reduced transparency) arise from the interaction of cytokines and growth factors such as transforming growth factor beta and interleukin 1 produced by epithelial and stromal cells in response to the corneal injury. Myofibroblasts, and the opaque extracellular matrix they secrete into the stroma, disturb the precise distribution and spacing of collagen fibers related to corneal transparency and lead to the development of vision-limiting corneal opacity (haze). The intact epithelial basement membrane has a pivotal role as a structure that regulates corneal epithelial-stromal interactions. Thus, defective regeneration of the epithelial basement membrane after surgery, trauma, or infection leads to the development of stromal haze. The apoptotic process following laser stromal ablation, which is proportional to the level of attempted correction, leads to an early decrease in anterior keratocyte density and the diminished contribution of these non-epithelial cells of components such as perlecan and nidogen-2 required for normal regeneration of the epithelial basement membrane. Haze persists until late repair of the defective epithelial basement membrane. Defective regeneration of the epithelial basement membrane has a critical role in determining whether a cornea heals with late haze after photorefractive keratectomy or with scarring at the flap edge in LASIK. Copyright 2016, SLACK Incorporated.

  12. Morphological evaluation of normal human corneal epithelium

    DEFF Research Database (Denmark)

    Ehlers, Niels; Heegaard, Steffen; Hjortdal, Jesper

    2010-01-01

    PURPOSE: The human corneal epithelium is usually described as a 50-µm-thick layer of regular stratified squamous non-keratinized cells with a thickness of 5-7 cells. The purpose of this study is systemically to revisit the histopathological appearance of 100 corneas. METHODS: 5-µm-thick sections...... in Bowman's membrane. No intraepithelial microcysts, as found in Meesmann corneal dystrophy, were observed. CONCLUSION: The total corneal thickness was higher than reported in in vivo studies and with a wider variation. This may be an effect of uncontrolled swelling and dehydration during preparation...

  13. Multilayered Gore-Tex patch for temporary coverage of deep noninfectious corneal defects: surgical procedure and clinical experience.

    Science.gov (United States)

    Rüfer, Florian; Eisenack, Johannes; Klettner, Alexa; Zeuner, Rainald; Hillenkamp, Jost; Westphal, Gundolf; Roider, Johann; Nölle, Bernhard

    2011-04-01

    To evaluate the multilayer Gore-Tex patch as temporary coverage of deep, noninfectious corneal defects. Retrospective, interventional case series. University Medical Center Schleswig-Holstein, Kiel, Germany. Thirty-nine eyes of 38 patients with noninfectious, deep corneal defects. Underlying disorders included neurotrophic or immunologic ulcers in 37 eyes (94.9%) and traumatic defects in 2 eyes (5.1%). Intervention procedures: Corneal defects were covered with multiple Gore-Tex layers, of which the uppermost was sutured to the cornea. The Gore-Tex patch was kept in place until an appropriate corneal transplant was obtained and effective systemic immunosuppression was initiated. Long-term preservation of the eye, frequency of resuturing of the Gore-Tex patch, and best-corrected visual acuity. In 38 cases, the eye could be preserved. In 10 eyes, additional sutures were required. Before surgery, the mean best-corrected visual acuity (logMAR) was 1.14 ± 0.45 (20/250), and that at final follow-up was 1.13 ± 0.41 (20/250). The Gore-Tex patch remained in place 4 days to 32 months (mean, 6.4 ± 8.3 months) until corneal transplantation (27 eyes) or until an alternative way of defect coverage could be performed. Three eyes did not require further coverage after explantation of the Gore-Tex patch. In 6 eyes, either the Gore-Tex patch was kept in place or the patients died. Temporary coverage of deep corneal defects with multilayer Gore-Tex patches allows time until an appropriate corneal transplant is obtained. The technique is particularly useful in patients with underlying autoimmune disorders, because an effective systemic immunosuppression can be initiated before corneal transplantation. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. Preliminary clinical results with the ISL laser

    Science.gov (United States)

    Hoppeler, Thomas; Gloor, Balder

    1992-08-01

    The ISL laser (Intelligent Surgical Lasers, Inc.), a Nd:YLF picosecond pulse laser, is currently being used under investigational device exemption to perform microsurgery of the anterior segment of the eye. At different study sites procedures for cataract fragmentation and iridotomy, as well as for posterior capsulotomy after cataract surgery, are under evaluation. Other potential applications include: sclerostomy ab interno, the cutting of membranes in the anterior and posterior segment of the eye; corneal incisions; and corneal intrastromal effects. We discuss various clinically relevant aspects of the use of this picosecond laser. An overview of different computer controlled laser patterns is given.

  15. Increase in number of circulating disseminated epithelial cells after surgery for non-small cell lung cancer monitored by MAINTRAC® is a predictor for relapse: A preliminary report

    Directory of Open Access Journals (Sweden)

    Höffken Klaus

    2005-03-01

    Full Text Available Abstract Background Lung cancer still remains one of the most commonly occurring solid tumors and even in stage Ia, surgery fails in 30% of patients who develop distant metastases. It is hypothesized that these must have developed from occult circulating tumor cells present at the time of surgery, or before. The aim of the present study was to detect such cells in the peripheral blood and to monitor these cells following surgery. Methods 30 patients treated for lung cancer with surgery were monitored for circulating epithelial cells (CEC by taking peripheral blood samples before, 2 weeks and 5 months after surgery and/or radiotherapy (RT chemotherapy (CT or combined RT/CT using magnetic bead enrichment and laser scanning cytometry (MAINTRAC® for quantification of these cells. Results In 86% of the patients CEC were detected before surgery and in 100% at 2 weeks and 5 months after surgery. In the control group, which consisted of 100 normal donors without cancer, 97 % were negative for CEC. A significantly higher number of CEC was found preoperatively in patients with squamous cell carcinoma than in those with adenocarcinoma. In correlation to the extent of parenchymal manipulation 2 weeks after surgery, an increase in numbers of CEC was observed with limited resections (18/21 whereas pneumonectomy led to a decrease (5/8 of CEC, 2 weeks after surgery. The third analysis done 5 months after surgery identified 3 groups of patients. In the group of 5 patients who received neo- or adjuvant chemo/radiotherapy there was evidence that monitoring of CEC can evaluate the effects of therapy. Another group of 7 patients who underwent surgery only showed a decrease of CEC and no signs of relapse. A third group of 11 patients who had surgery only, showed an increase of CEC (4 with an initial decrease after surgery and 7 with continuous increase. In the group with a continuous increase during the following 24 months, 2 early relapses in patients with stage Ia

  16. Polar Value Analysis of Corneal Astigmatism in Intrastromal Corneal Ring Segment Implantation

    Science.gov (United States)

    Rho, Chang Rae; Kim, Min-Ji

    2016-01-01

    Purpose. To evaluate surgically induced astigmatism (SIA) and the average corneal power change in symmetric intrastromal corneal ring segment (ICRS) implantation. Methods. The study included 34 eyes of 34 keratoconus patients who underwent symmetric Intacs SK ICRS implantation. The corneal pocket incision meridian was the preoperative steep meridian. Corneal power data were obtained before and 3 months after Intacs SK ICRS implantation using scanning-slit topography. Polar value analysis was used to evaluate the SIA. Hotelling's trace test was used to compare intraindividual changes. Results. Three months postoperatively, the combined mean polar value for SIA changed significantly (Hotelling's T2 = 0.375; P = 0.006). The SIA was 1.54 D at 99° and the average corneal power decreased significantly by 3.8 D. Conclusion. Intacs SK ICRS placement decreased the average corneal power and corneal astigmatism compared to the preoperative corneal power and astigmatism when the corneal pocket incision was made at the preoperative steep meridian. PMID:27795856

  17. Polar Value Analysis of Corneal Astigmatism in Intrastromal Corneal Ring Segment Implantation

    Directory of Open Access Journals (Sweden)

    Chang Rae Rho

    2016-01-01

    Full Text Available Purpose. To evaluate surgically induced astigmatism (SIA and the average corneal power change in symmetric intrastromal corneal ring segment (ICRS implantation. Methods. The study included 34 eyes of 34 keratoconus patients who underwent symmetric Intacs SK ICRS implantation. The corneal pocket incision meridian was the preoperative steep meridian. Corneal power data were obtained before and 3 months after Intacs SK ICRS implantation using scanning-slit topography. Polar value analysis was used to evaluate the SIA. Hotelling’s trace test was used to compare intraindividual changes. Results. Three months postoperatively, the combined mean polar value for SIA changed significantly (Hotelling’s T2=0.375; P=0.006. The SIA was 1.54 D at 99° and the average corneal power decreased significantly by 3.8 D. Conclusion. Intacs SK ICRS placement decreased the average corneal power and corneal astigmatism compared to the preoperative corneal power and astigmatism when the corneal pocket incision was made at the preoperative steep meridian.

  18. Corneal Volume Measurements with Pentacam for Detection of Keratoconus and Subclinical Keratoconus

    OpenAIRE

    Nurullah Çağıl; Nagihan Uğurlu; Hasan Basri Çakmak; Sucattin İlker Kocamış; Hüseyin Simavlı; Şaban Şimşek

    2013-01-01

    Pur po se: To estimate the sensitivity and specificity of corneal volume (CV) measurements in discriminating keratoconus and subclinical keratoconus from normal corneas. Ma te ri al and Met hod: Clinical records and Pentacam measurements of ninety-four patients with keratoconus, 36 patients with subclinical keratoconus, and 166 refractive surgery candidates with normal corneas were evaluated retrospectively. CV within 3, 5, 7, and 10 mm circles around the central cornea was measur...

  19. Traumatic Wound Dehiscence following Corneal Transplantation

    Directory of Open Access Journals (Sweden)

    Mohammad-Reza Jafarinasab

    2012-01-01

    Full Text Available Purpose: To investigate the incidence, mechanisms, characteristics, and visual outcomes of traumatic wound dehiscence following keratoplasty. Methods: Medical records of 32 consecutive patients with traumatic globe rupture following keratoplasty who had been treated at our center from 2001 to 2009 were retrospectively reviewed. Results: The study population consisted of 32 eyes of 32 patients including 25 men and 7 women with history of corneal transplantation who had sustained eye trauma leading to globe rupture. Mean patient age was 38.1 (range, 8 to 87 years and median interval between keratoplasty and the traumatic event was 9 months (range, 30 days to 20 years. Associated anterior segment findings included iris prolapse in 71.9%, lens extrusion in 34.4%, and hyphema in 40.6% of eyes. Posterior segment complications included vitreous prolapse (56%, vitreous hemorrhage (28% and retinal detachment (18%. Eyes which had undergone deep anterior lamellar keratoplasty (DALK; 5 cases, 15.6% tended to have less severe presentation and better final visual acuity. There was no correlation between the time interval from keratoplasty to the traumatic event, and final visual outcomes. Conclusion: The host-graft interface demonstrates decreased stability long after surgery and the visual prognosis of traumatic wound dehiscence is poor in many cases. An intact Descemet′s membrane in DALK may mitigate the severity of ocular injuries, but even in these cases, the visual outcome of globe rupture is not good and prevention of ocular trauma should be emphasized to all patients undergoing any kind of keratoplasty.

  20. Consistency of corneal sublayer thickness measurements using Fourier-domain optical coherence tomography after phacoemulsification.

    Science.gov (United States)

    López-Miguel, Alberto; Calabuig-Goena, María; Marqués-Fernández, Victoria; Fernández, Itziar; Alió, Jorge L; Maldonado, Miguel J

    2016-11-04

    To assess the reliability of corneal epithelial thickness (CET), nonepithelial central corneal thickness (NECCT), and central corneal thickness (CCT) measurements using Cirrus high-definition optical coherence tomography (HD-OCT) in patients who did and did not undergo cataract surgery. Forty patients who underwent uneventful phacoemulsification and 40 healthy participants were recruited to evaluate the intraobserver repeatability and interobserver reproducibility of CET, NECCT, and CCT measurements using Cirrus HD-OCT. To analyze repeatability, one examiner obtained 5 consecutive scans in each participant; for interobserver reproducibility, another examiner randomly obtained another scan. Within-subject standard deviation, coefficient of variation (CV), limits of agreement, and intraclass correlation coefficient (ICC) data were obtained. For intraobserver repeatability, the intrasession CV (CVw) and ICC values of the CET in the operated and nonoperated groups were 3.7% and 0.80 and 3.8% and 0.73, respectively; for NECCT, 0.7% and 0.98 and 0.8% and 0.97; and for CCT, 0.6% and 0.99 and 0.7% and 0.98. For interobserver reproducibility, the CVw and ICC values for the CET in the operated and nonoperated groups were 2.6% and 0.82 and 2.3% and 0.62, respectively; for NECCT, 0.7% and 0.98 and 0.5% and 0.98; and for CCT, 0.5% and 0.99 and 0.4% and 0.99. The corneal sublayer thickness can be measured reliably using Cirrus HD-OCT in patients who underwent cataract surgery and elderly participants; however, the CET consistency is poorer than the NECCT. Corneal epithelial thickness modifications exceeding 4% reflect true thickness changes instead of random error variations using HD-OCT.

  1. Image-guided modified deep anterior lamellar keratoplasty (DALK) corneal transplant using intraoperative optical coherence tomography

    Science.gov (United States)

    Tao, Yuankai K.; LaBarbera, Michael; Ehlers, Justis P.; Srivastava, Sunil K.; Dupps, William J.

    2015-03-01

    Deep anterior lamellar keratoplasty (DALK) is an alternative to full-thickness corneal transplant and has advantages including the absence of allograft rejection; shortened duration of topical corticosteroid treatment and reduced associated risk of glaucoma, cataract, or infection; and enables use of grafts with poor endothelial quality. DALK begins by performing a trephination of approximately 80% stromal thickness, as measured by pachymetry. After removal of the anterior stoma, a needle is inserted into the residual stroma to inject air or viscoelastic to dissect Descemet's membrane. These procedures are inherently difficult and intraoperative rates of Descemet's membrane perforation between 4-39% have been reported. Optical coherence tomography (OCT) provides high-resolution images of tissue microstructures in the cornea, including Descemet's membrane, and allows quantitation of corneal layer thicknesses. Here, we use crosssectional intraoperative OCT (iOCT) measurements of corneal thickness during surgery and a novel micrometeradjustable biopsy punch to precision-cut the stroma down to Descemet's membrane. Our prototype cutting tool allows us to establish a dissection plane at the corneal endothelium interface, mitigates variability in cut-depths as a result of tremor, reduces procedure complexity, and reduces complication rates. iOCT-guided modified DALK procedures were performed on 47 cadaveric porcine eyes by non-experts and achieved a perforation rate of ~5% with a mean corneal dissection time <18 minutes. The procedure was also successful performed on a human donor eye without perforation. Our data shows the potential for iOCT-guided precision anterior segment surgery without variability as a result of tremor and improvements to standard clinical care.

  2. Derivation of corneal endothelial cell-like cells from rat neural crest cells in vitro.

    Directory of Open Access Journals (Sweden)

    Chengqun Ju

    Full Text Available The aim of this study was to investigate the feasibility of inducing rat neural crest cells (NCC to differentiate to functional corneal endothelial cell (CEC-like cells in vitro. Rat NCC were induced with adult CEC-derived conditioned medium. Immunofluorescence, flow cytometry and real time RT-PCR assay were used to detect expression of the corneal endothelium differentiation marker N-cadherin and transcription factors FoxC1 and Pitx2. CFDA SE-labeled CEC-like cells were transplanted to the corneal endothelium of a rat corneal endothelium deficiency model, and an eye-down position was maintained for 24 hours to allow cell attachment. The animals were observed for as long as 2 months after surgery and underwent clinical and histological examination. Spindle-like NCC turned to polygonal CEC-like after induction and expressed N-cadherin, FoxC1, Pitx2, zonula occludens-1 and sodium-potassium pump Na(+/K(+ ATPase. The corneas of the experimental group were much clearer than those of the control group and the mean corneal thickness in the experimental group was significantly less than in the control group7, 14, 21 and 28 days after surgery. Confocal microscopy through focusing and histological analysis confirmed that green fluorescence-positive CEC-like cells formed a monolayer covering the Descemet's membrane in the experimental group. In conclusion, CEC-like cells derived from NCCs displayed characters of native CEC, and the induction protocol provides guidance for future human CEC induction from NCC.

  3. Outcomes of a Management Strategy in Eyes with Corneal Irregularity and Cataract

    Science.gov (United States)

    Shetty, Rohit; Paryani, Mukesh

    2016-01-01

    Purpose. To evaluate the outcomes of a management strategy in patients with irregular corneas and cataract. Methods. Six eyes of four patients presented for cataract surgery with irregular corneas following corneal refractive surgery. Topoguided ablation regularised the cornea, followed by phacoemulsification and intraocular lens implantation. Zonal keratometric coefficient of variation (ZKCV) measured structural changes and visual quality metrics measured functional improvement. Results. The mean duration after corneal refractive surgery was 7.83 ± 2.40 years. The logmar uncorrected distance visual acuity (0.67 ± 0.25) and the corrected distance visual acuity (0.38 ± 0.20) improved to 0.34 ± 0.14 and 0.18 ± 0.10, respectively. The changes in the standard deviations of the zonal keratometry values and the ZKCV were statistically significant in the 2, 3, and 4 mm zones. The changes in the Strehl ratio (ANOVA p = 0.043) were also statistically significant. Conclusions. Corneal regularisation followed by phacoemulsification resulted in lower residual refractive error with improved visual quality metrics. This strategy is a viable option in patients with symptomatic cataracts and irregular corneas. PMID:27563677

  4. Toric Intraocular Lens Implantation for Correction of Astigmatism in Cataract Patients with Corneal Ectasia

    Directory of Open Access Journals (Sweden)

    Efstratios A. Parikakis

    2013-11-01

    Full Text Available Our purpose was to examine the long-term efficacy of toric intraocular lens (IOL implantation in cataract patients with high astigmatism due to corneal ectasia, who underwent phacoemulsification cataract surgery. Five eyes of 3 cataract patients with topographically stable keratoconus or pellucid macular degeneration (PMD, in which phacoemulsification with toric IOL implantation was used to correct high astigmatism, are reported. Objective and subjective refraction, visual acuity measurement and corneal topography were performed in all cases before and after cataract surgery. In all cases, there was a significant improvement in visual acuity, as well as refraction, which remained stable over time. Specifically, in subjective refraction, all patients achieved visual acuity from 7/10 to 9/10 with up to -2.50 cyl. Corneal topography also remained stable. Postoperative follow-up was 18-28 months. Cataract surgery with toric IOL implantation seems to be safe and effective in correcting astigmatism and improving visual function in cataract patients with topographically stable keratoconus or PMD.

  5. Surgical compensation of presbyopia with corneal inlays.

    Science.gov (United States)

    Konstantopoulos, Aris; Mehta, Jodhbir S

    2015-05-01

    Presbyopia, the physiological change in near vision that develops with ageing, gradually affects individuals older than 40 years and is a growing cause of visual disability due to ageing demographics of the global population. The routine use of computers and 'smartphones', combined with the affluence of the 'baby boomers' generation has set high standards for near vision correction. Corneal inlays are a relatively new treatment modality that is effective at compensating for presbyopia. The dimensions of these devices vary from 2 to 3.8 mm in diameter and 5 to 32 μm in thickness. They are implanted in the anterior corneal stroma of the non-dominant eye, most commonly, in a femtosecond laser created corneal pocket. They improve near vision by increasing the depth of focus, creating a hyper-prolate region of increased central cornea power or providing a refractive add power. This article reviews the literature on the efficacy and safety of corneal inlays.

  6. Conjunctival intraepithelial neoplasia with corneal furrow degeneration

    Directory of Open Access Journals (Sweden)

    Pukhraj Rishi

    2014-01-01

    Full Text Available A 68-year-old man presented with redness of left eye since six months. Examination revealed bilateral corneal furrow degeneration. Left eye lesion was suggestive of conjunctival squamous cell carcinoma, encroaching on to cornea. Anterior segment optical coherence tomography (AS-OCT confirmed peripheral corneal thinning. Fluorescein angiography confirmed intrinsic vascularity of lesion. Patient was managed with "no touch" surgical excision, dry keratectomy without alcohol, cryotherapy, and primary closure. Pathologic examination of removed tissue confirmed clinical diagnosis. Management of this particular case required modification of standard treatment protocol. Unlike the alcohol-assisted technique of tumor dissection described, ethyl alcohol was not used for risk of corneal perforation due to underlying peripheral corneal thinning. Likewise, topical steroids were withheld in the post-operative period. Three weeks post-operatively, left eye was healing well. Hence, per-operative usage of absolute alcohol and post-operative use of topical steroids may be best avoided in such eyes.

  7. Corneal topography and soft contact lens fit.

    Science.gov (United States)

    Young, Graeme; Schnider, Cristina; Hunt, Chris; Efron, Suzanne

    2010-05-01

    To determine which ocular topography variables affect soft contact lens fit. Fifty subjects each wore three pairs of soft lenses in random succession (Vistakon Acuvue 2, Vistakon Acuvue Advance, Ciba Vision Night & Day), and various aspects of lens fit were evaluated. The steeper base curves of each type were worn in one eye and the flatter base curves in the other eye. Corneal topography data were collected using a Medmont E300 corneal topographer (Camberwell, Australia). Corneal curvature, shape factor (SF), and corneal height were measured over a 10 mm chord and also over the maximum measurable diameter. These were measured in the horizontal, vertical, steepest, and flattest meridians. With each lens type, the steeper base curve provided the best fit on the greatest proportion of eyes and the significant differences in various aspects of fit were noted between base curves. For each lens type, there was no significant difference in mean K-reading between those eyes best fit with the steeper base curve and those eyes best fit with the flatter base curve. Two of the lenses showed a positive correlation between centration and horizontal corneal height (maximum), whereas one lens showed a negative correlation between centration and horizontal SF (SF = e). Several lenses showed a positive correlation between post-blink movement and horizontal or vertical corneal SF. The measurement of corneal topography using current Placido disc instrumentation allows a better prediction of soft lens fit than by keratometry, but it is not reliable enough to enable accurate selection of the best fitting base curve. Some correlations are evident between corneal measurements; however, trial fitting remains the method of choice for selection of soft lens base curve.

  8. Serological profile of candidates for corneal donation

    OpenAIRE

    Adroaldo Lunardelli; Richard Beraldini Alvarenga; Maria Luiza Assmann; Dário Eduardo de Lima Brum; Mirna Adolfina Barison

    2014-01-01

    Objetive: The purpose of this study is to map the serological profile of candidates to corneal donation at Irmandade Santa Casa de Misericórdia de Porto Alegre, identifying the percentage of disposal by serology and the marker involved. Methods: There have been analised – retrospectively – the results of serology of all corneal donors, made between the period of 1st january 2006 and 31st december 2012. Data analised were related to age, gender and the results of serology pert...

  9. Non-contact investigation of the corneal biomechanics with air-puff swept source optical coherence tomography

    Science.gov (United States)

    Maczynska, Ewa; Karnowski, Karol; Kaluzny, Bartlomiej; Grulkowski, Ireneusz; Wojtkowski, Maciej

    2016-08-01

    In this paper, we use swept source optical coherence tomography combined with air-puff module (air-puff SS-OCT) to investigate the properties of the cornea. During OCT measurement the cornea was stimulated by short, air pulse, and corneal response was recorded. In this preliminary study, the air-puff SS-OCT instrument was applied to measure behavior of the porcine corneas under varied, well-controlled intraocular pressure conditions. Additionally, the biomechanical response of the corneal tissue before, during and after crosslinking procedure (CXL) was assessed. Air-puff swept source OCT is a promising tool to extract information about corneal behavior as well as to monitor and assess the effect of CXL.

  10. The effect of Gonioscopy on keratometry and corneal surface topography

    Directory of Open Access Journals (Sweden)

    DeBroff Brian M

    2006-06-01

    Full Text Available Abstract Background Biometric procedures such as keratometry performed shortly after contact procedures like gonioscopy and applanation tonometry could affect the validity of the measurement. This study was conducted to understand the short-term effect of gonioscopy on corneal curvature measurements and surface topography based Simulated Keratometry and whether this would alter the power of an intraocular lens implant calculated using post-gonioscopy measurements. We further compared the effect of the 2-mirror (Goldmann and the 4-mirror (Sussman Gonioscopes. Methods A prospective clinic-based self-controlled comparative study. 198 eyes of 99 patients, above 50 years of age, were studied. Exclusion criteria included documented dry eye, history of ocular surgery or trauma, diabetes mellitus and connective tissue disorders. Auto-Keratometry and corneal topography measurements were obtained at baseline and at three follow-up times – within the first 5 minutes, between the 10th-15th minute and between the 20th-25th minute after intervention. One eye was randomized for intervention with the 2-mirror gonioscope and the other underwent the 4-mirror after baseline measurements. t-tests were used to examine differences between interventions and between the measurement methods. The sample size was calculated using an estimate of clinically significant lens implant power changes based on the SRK-II formula. Results Clinically and statistically significant steepening was observed in the first 5 minutes and in the 10–15 minute interval using topography-based Sim K. These changes were not present with the Auto-Keratometer measurements. Although changes from baseline were noted between 20 and 25 minutes topographically, these were not clinically or statistically significant. There was no significant difference between the two types of gonioscopes. There was greater variability in the changes from baseline using the topography-based Sim K readings

  11. Methicillin-Resistant Staphylococcus aureus Ocular Infection after Corneal Cross-Linking for Keratoconus: Potential Association with Atopic Dermatitis.

    Science.gov (United States)

    Fasciani, Romina; Agresta, Antonio; Caristia, Alice; Mosca, Luigi; Scupola, Andrea; Caporossi, Aldo

    2015-01-01

    Purpose. To report the risk of methicillin-resistant Staphylococcus aureus (MRSA) ocular infection after UVA-riboflavin corneal collagen cross-linking in a patient with atopic dermatitis. Methods. A 22-year-old man, with bilateral evolutive keratoconus and atopic dermatitis, underwent UVA-riboflavin corneal cross-linking and presented with rapidly progressive corneal abscesses and cyclitis in the treated eye five days after surgery. The patient was admitted to the hospital and treated with broad-spectrum antimicrobic therapy. Results. The patient had positive cultures for MRSA, exhibiting a strong resistance to antibiotics. Antibiotic therapy was modified and targeted accordingly. The intravitreal reaction is extinguished, but severe damage of ocular structures was unavoidable. Conclusion. Riboflavin/UVA corneal cross-linking is considered a safe procedure and is extremely effective in halting keratoconus' progression. However, this procedure is not devoid of infectious complications, due to known risk factors and/or poor patients' hygiene compliance in the postoperative period. Atopic dermatitis is a common disease among patients with keratoconus and Staphylococcus aureus colonization is commonly found in patients with atopic dermatitis. Therefore, comorbidity with atopic dermatitis should be thoroughly assessed through clinical history before surgery. A clinical evaluation within three days after surgery and the imposition of strict personal hygiene rules are strongly recommended.

  12. Methicillin-Resistant Staphylococcus aureus Ocular Infection after Corneal Cross-Linking for Keratoconus: Potential Association with Atopic Dermatitis

    Directory of Open Access Journals (Sweden)

    Romina Fasciani

    2015-01-01

    Full Text Available Purpose. To report the risk of methicillin-resistant Staphylococcus aureus (MRSA ocular infection after UVA-riboflavin corneal collagen cross-linking in a patient with atopic dermatitis. Methods. A 22-year-old man, with bilateral evolutive keratoconus and atopic dermatitis, underwent UVA-riboflavin corneal cross-linking and presented with rapidly progressive corneal abscesses and cyclitis in the treated eye five days after surgery. The patient was admitted to the hospital and treated with broad-spectrum antimicrobic therapy. Results. The patient had positive cultures for MRSA, exhibiting a strong resistance to antibiotics. Antibiotic therapy was modified and targeted accordingly. The intravitreal reaction is extinguished, but severe damage of ocular structures was unavoidable. Conclusion. Riboflavin/UVA corneal cross-linking is considered a safe procedure and is extremely effective in halting keratoconus’ progression. However, this procedure is not devoid of infectious complications, due to known risk factors and/or poor patients’ hygiene compliance in the postoperative period. Atopic dermatitis is a common disease among patients with keratoconus and Staphylococcus aureus colonization is commonly found in patients with atopic dermatitis. Therefore, comorbidity with atopic dermatitis should be thoroughly assessed through clinical history before surgery. A clinical evaluation within three days after surgery and the imposition of strict personal hygiene rules are strongly recommended.

  13. Comprehensive Evaluation of Anterior Corneal Change in Asphericity Calculated by the Tangential Radius of Curvature after LASIK

    Science.gov (United States)

    Ying, Jinglu; Cai, Jianqiu; Zhu, Leru

    2017-01-01

    To evaluate the change in the anterior corneal asphericity (ΔQ) comprehensively calculated using the tangential radius (rt) after LASIK. Forty-two right eyes were evaluated using the Orbscan II corneal topographer. The pre- and postoperative Q-values of the flat principal semimeridians calculated by the sagittal radius were compared to those by the tangential radius. The Q-value of each semimeridian in the horizontal region was calculated by rt. Fourier fitting was used to model the 360-semimeridional variation of Q-values and to fit the Q-values in the vertical region before and after surgery. There were significant differences in Q-values between the two methods before (P < 0.001) and after surgery (P = 0.003). A significant increase in postoperative Q-value was detected compared to preoperative Q-value (P < 0.001) calculated by rt. The 360-semimeridional variation of the Q-values was well fitted with a third- and fourth-degree Fourier function before and after surgery. The ΔQ-value distribution presented double valley variation, with the amount of ΔQ being lowest in the near-vertical regions and highest in the near-horizontal regions. Calculating the Q-value with rt combined with Fourier fitting, we evaluated 360 ΔQ-values' variation of semimeridians of the entire anterior corneal surface and then displayed true and complete anterior corneal shape after LASIK.

  14. Update on pathologic diagnosis of corneal infections and inflammations

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    Geeta K Vemuganti

    2011-01-01

    Full Text Available One of the most frequent types of corneal specimen that we received in our pathology laboratory is an excised corneal tissue following keratoplasty. Several of these cases are due to corneal infections or the sequelae, like corneal scar. Advances in the histological and molecular diagnosis of corneal infections and inflammations have resulted in rapid and accurate diagnosis of the infectious agent and in the overall understanding of the mechanisms in inflammatory diseases of the cornea. This review provides an update of histopathological findings in various corneal infections and inflammations.

  15. Effects of central corneal thickness, central corneal power, and axial length on intraocular pressure measurement assessed with goldmann applanation tonometry.

    Science.gov (United States)

    Ozcura, Fatih; Aydin, Sayime; Uzgören, Nevin

    2008-01-01

    To determine the effects of central corneal thickness (CCT), central corneal power (CCP), and axial length (AL) on the measurement of intraocular pressure (IOP) using Goldmann applanation tonometry, and the effects of CCP and AL on CCT. Charts of 147 consecutive patients undergoing preoperative examinations for cataract surgery between April 2006 and April 2007 in our clinic were reviewed retrospectively. CCT, CCP, and AL were measured by ultrasonic pachymeter (Micropach Model 200P, Sonomed, Lake Success, N.Y. USA), autorefractokeratometer (KR 8800, Topcon, Tokyo, Japan), and ultrasound biometry (EZ Scan AB 5500+ Sonomed, Lake Success, N.Y. USA). Pearson correlation analysis and multiple linear regression analysis were used as indicated, and only one eye of each subject was included in the statistical analysis. Ninety-eight eyes of 98 patients were included in the study. IOP and CCT were significantly and positively correlated (P<0.001), and CCT and CCP (P=0.001) were inversely correlated. Multiple regression analysis showed that the effect of CCT on IOP was statistically significant (P<0.001), but the effects of CCP and AL on IOP were not significant (P=0.614, P=0.831, respectively). IOP increased by 0.29 mmHg for each 10 microm increase in CCT. CCT, but not CCP or AL, significantly affected IOP readings obtained by Goldmann applanation tonometry. The effect of CCP on IOP was weak and not significant despite the significant inverse correlation between CCT and CCP.

  16. Survival and integration of tissue-engineered corneal stroma in a model of corneal ulcer.

    Science.gov (United States)

    Zhang, Chao; Nie, Xin; Hu, Dan; Liu, Yuan; Deng, Zhihong; Dong, Rui; Zhang, Yongjie; Jin, Yan

    2007-08-01

    Tissue-engineered replacement of diseased or damaged tissue has become a reality for some types of tissue, such as skin and cartilage. Tissue-engineered corneal stroma represents a promising concept to overcome the limitations of cornea replacement with allograft. In this study, porcine cornea was decellularized by a series of extraction methods, and the in vivo biocompatibility of the scaffold was measured subcutaneously in rabbits (n = 8). These were not acutely rejected and no abscesses were observed by hematoxylin and eosin staining at the 8th week, indicating that the scaffolds had good biocompatibility. To investigate the potential value of clinical applications, rabbit stromal keratocytes were implanted onto decellularized scaffolds to fabricate tissue-engineered corneal stroma. Allograft, tissue-engineered corneal stroma, or scaffolds were implanted into a model of corneal ulcer. The survival and reconstruction of corneal transplantation were morphologically evaluated by light and electron microscopy until the 32nd week after implantation. Experiments involving transplantation indicated that the epithelial and stromal defect healed quickly, with improvement in corneal clarity. The integration of the graft was accompanied by neurite ingrowth from the host tissue. By 16 weeks after transplantation, the cornea had gradually regained an intact state similar to that of normal cornea. Our results demonstrate that the tissue-engineered corneal stroma with allogenetic cells is a promising therapeutic method for corneal injury.

  17. Control of Scar Tissue Formation in the Cornea: Strategies in Clinical and Corneal Tissue Engineering

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    Samantha L. Wilson

    2012-09-01

    Full Text Available Corneal structure is highly organized and unified in architecture with structural and functional integration which mediates transparency and vision. Disease and injury are the second most common cause of blindness affecting over 10 million people worldwide. Ninety percent of blindness is permanent due to scarring and vascularization. Scarring caused via fibrotic cellular responses, heals the tissue, but fails to restore transparency. Controlling keratocyte activation and differentiation are key for the inhibition and prevention of fibrosis. Ophthalmic surgery techniques are continually developing to preserve and restore vision but corneal regression and scarring are often detrimental side effects and long term continuous follow up studies are lacking or discouraging. Appropriate corneal models may lead to a reduced need for corneal transplantation as presently there are insufficient numbers or suitable tissue to meet demand. Synthetic optical materials are under development for keratoprothesis although clinical use is limited due to implantation complications and high rejection rates. Tissue engineered corneas offer an alternative which more closely mimic the morphological, physiological and biomechanical properties of native corneas. However, replication of the native collagen fiber organization and retaining the phenotype of stromal cells which prevent scar-like tissue formation remains a challenge. Careful manipulation of culture environments are under investigation to determine a suitable environment that simulates native ECM organization and stimulates keratocyte migration and generation.

  18. Control of scar tissue formation in the cornea: strategies in clinical and corneal tissue engineering.

    Science.gov (United States)

    Wilson, Samantha L; El Haj, Alicia J; Yang, Ying

    2012-09-18

    Corneal structure is highly organized and unified in architecture with structural and functional integration which mediates transparency and vision. Disease and injury are the second most common cause of blindness affecting over 10 million people worldwide. Ninety percent of blindness is permanent due to scarring and vascularization. Scarring caused via fibrotic cellular responses, heals the tissue, but fails to restore transparency. Controlling keratocyte activation and differentiation are key for the inhibition and prevention of fibrosis. Ophthalmic surgery techniques are continually developing to preserve and restore vision but corneal regression and scarring are often detrimental side effects and long term continuous follow up studies are lacking or discouraging. Appropriate corneal models may lead to a reduced need for corneal transplantation as presently there are insufficient numbers or suitable tissue to meet demand. Synthetic optical materials are under development for keratoprothesis although clinical use is limited due to implantation complications and high rejection rates. Tissue engineered corneas offer an alternative which more closely mimic the morphological, physiological and biomechanical properties of native corneas. However, replication of the native collagen fiber organization and retaining the phenotype of stromal cells which prevent scar-like tissue formation remains a challenge. Careful manipulation of culture environments are under investigation to determine a suitable environment that simulates native ECM organization and stimulates keratocyte migration and generation.

  19. Preoperative corneal astigmatism among adult patients with cataract in Northern Nigeria

    Directory of Open Access Journals (Sweden)

    Mohammed Isyaku

    2014-01-01

    Full Text Available The prevalence and nature of corneal astigmatism among patients with cataract has not been well-documented in the resident African population. This retrospective study was undertaken to investigate preexisting corneal astigmatism in adult patients with cataract. We analyzed keratometric readings acquired by manual Javal-Schiotz keratometry before surgery between January 1, 2011 and December 31, 2011. There were 3,169 patients (3286 eyes aged between 16 and 110 years involved with a Male to female ratio of 1.4:1. Mean keratometry in diopters was K1 = 43.99 and K2 = 43.80. Mean corneal astigmatism was 1.16 diopter and a majority (45.92% of eyes had astigmatism between 1.00 and 1.99 diopters. Two-thirds of the eyes (66.9% in this study had preoperative corneal astigmatism equal to or above 1.00 diopter. Findings will help local cataract surgeons to estimate the potential demand for toric intraocular lenses.

  20. Impaired corneal wound healing associated with ketorolac 0.5% after uncomplicated extracapsular cataract extraction.

    Science.gov (United States)

    Arey, Mark L; Sullivan, Brian R; Reinert, Carol G; McCulley, James P

    2007-12-01

    To describe an apparent association between the use of ketorolac 0.5% (Acular; Allergan) for cystoid macular edema (CME) prophylaxis and impaired corneal wound healing in patients undergoing extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation. A retrospective case series reviewing 7 eyes of 7 patients who underwent uncomplicated ECCE with IOL implantation and were treated postoperatively with ketorolac 0.5% 4 times daily as a prophylactic measure against CME. Patients were treated with ketorolac 0.5% 4 times a day for an average of 30 days (range, 20-44 days) after uncomplicated ECCE with IOL implantation. Two eyes developed postoperative endophthalmitis necessitating vitreous tap with intravitreal antibiotic injection; 1 eye went on to require pars plana vitrectomy with corneal wound resuturing. One eye developed corneal wound dehiscence that required wound resuturing in the operating room. One eye developed an inadvertent filtering bleb despite the lack of postoperative suture lysis. Three others were followed up closely postoperatively with slit-lamp evidence of impaired wound healing, manifested by wound avascularity and/or wound gape, and did not require surgical intervention. The use of nonsteroidal anti-inflammatory agents for prophylaxis of CME after cataract surgery is an evolving trend. This retrospective case series showed a possible link between the use of ketorolac 0.5% and impaired corneal wound healing, and caution is urged in the liberal use of this agent postoperatively after ECCE.

  1. [Incisions for biaxial and coaxial microincision cataract surgery].

    Science.gov (United States)

    Müller, M; Kohnen, T

    2010-02-01

    Microincision cataract surgery (MICS) represents a new level in the development of cataract surgery. Phacoemulsification with intraocular lens (IOL) implantation via incisions of phaco tip (C-MICS), or by the biaxial approach, with separation of the phaco tip and irrigation (B-MICS). Compared with standard small-incision cataract surgery, the advantages of MICS are less corneal astigmatism and fewer corneal surface irregularities, with favorable implications for visual quality and early rehabilitation. In the effort toward smaller incisions, special interest should be given to wound integrity, especially regarding the risk of endophthalmitis. With limited corneal elastic capacity, irreversible expansion of the incision with tissue laceration may occur. Smaller incisions are superior only if they cause less trauma. This requires an optimized relationship between incision size and manipulation during IOL implantation as well as attention to safety issues. MICS offers a platform for new benchmarks in phacoemulsification.

  2. Ultrasound biomicroscopy confirmation of corneal overriding due to improper suturing of full-thickness corneal laceration

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    Murat Kucukevcilioglu

    2014-12-01

    Full Text Available We herein present a case with corneal overriding due to improper suturing of a full-thickness corneal laceration. There was a 2.5-mm difference between horizontal and vertical white-to-white measurements in the cornea. However, slit lamp examination failed to demonstrate the exact architecture of the laceration. Ultrasound biomicroscopy defined the wound edges thoroughly and confirmed the presence of corneal overriding. Six weeks after suture enhancement, the abnormal oval appearance of the cornea was absent and correct apposition of the corneal edges was seen on ultrasound biomicroscopy. Ultrasound biomicroscopy can be used in preoperative surgical planning of cases with complicated corneal lacerations. It can be used to adjust and enhance wound architecture in eyes with penetrating injury.

  3. Superficial keratectomy and topical mitomycin C as therapy for a corneal squamous cell carcinoma in a dog.

    Science.gov (United States)

    Karasawa, K; Matsuda, H; Tanaka, A

    2008-04-01

    A 10-year-old female West Highland white terrier was presented with refractory hyperplastic keratitis of the left cornea of one month's duration. At this time, a vascularised and rough lesion 5 mm in diameter was observed on the left cornea. No other abnormality was recognised on the affected eye. The corneal neoplasm was surgically removed and histologically diagnosed as a squamous cell carcinoma. For two months after the surgery, 0.04 percent mitomycin C (MMC) eye drops were applied as adjuvant chemotherapy. Primary corneal squamous cell carcinoma with no history of keratoconjunctivitis sicca is rare in dogs. In the present report, surgical removal of the neoplasm was combined with the topical administration of the anticancer drug mitomycin C and a good prognosis was obtained. The result indicates that the combination treatment used in this case may be an appropriate therapeutic choice for corneal squamous cell carcinoma in dogs.

  4. Quantitative assessment of rat corneal thickness and morphology during stem cell therapy by high-speed optical coherence tomography

    Science.gov (United States)

    Lal, Cerine; McGrath, James; Subhash, Hrebesh; Rani, Sweta; Ritter, Thomas; Leahy, Martin

    2016-03-01

    Optical Coherence Tomography (OCT) is a non-invasive 3 dimensional optical imaging modality that enables high resolution cross sectional imaging in biological tissues and materials. Its high axial and lateral resolution combined with high sensitivity, imaging depth and wide field of view makes it suitable for wide variety of high resolution medical imaging applications at clinically relevant speed. With the advent of swept source lasers, the imaging speed of OCT has increased considerably in recent years. OCT has been used in ophthalmology to study dynamic changes occurring in the cornea and iris, thereby providing physiological and pathological changes that occur within the anterior segment structures such as in glaucoma, during refractive surgery, lamellar keratoplasty and corneal diseases. In this study, we assess the changes in corneal thickness in the anterior segment of the eye during wound healing process in a rat corneal burn model following stem cell therapy using high speed swept source OCT.

  5. Changes on the corneal thickness and curvature after orthokeratology

    Science.gov (United States)

    Mitsui, Iwane; Yamada, Yoshiya

    2004-07-01

    To evaluate the corneal thickness and curvature changes after Orthokeratology contact lens wear, using the ORBSCAN II corneal topography system, corneal thickness and corneal curvature were measured on one hundred and twenty eyes of sixty patients before and after wearing the custom rigid gas permeable contact lenses for Orthokeratology. The contact lenses were specially designed for each eye. The subjects wore the orthokeratology lenses for approximately Four hours with their eyes closed. The corneal thickness of the subjects was increased on fifty-five eyes at not only the peripheral zone but also the center of the cornea. The average increase of central and peripheral corneal thickness was 18 micrometer and 22micrometer, respectively. The mean anterior curvature of corneal surface changed 1.25D. The mean posterior curvature of corneal endothelium side changed 0.75D.

  6. Clinical Observation of Transepithelial Corneal Collagen Cross-linking by Iontophoresis of Riboflavin in Treatment of Keratoconus

    Institute of Scientific and Technical Information of China (English)

    Na Li; Zhengjun Fan; Xiujun Peng; Xu Pang; Chunyu Tian

    2014-01-01

    Purpose: To evaluate the efficacy and safety of transepithelial collagen cross-linking by iontophoretic delivery of riboflavin in treatment of progressive keratoconus.Methods:.Eleven patients (15 eyes) with progressive kerato-conus were enrolled. After 0.1% riboflavin-distilled water so-lution was deliveried via transepithelial iontophpresis for 5 min with 1 mA current, and ultraviolet radiation (370 nm,.3 mW /cm2) was performed at a 1.5 cm distance for 30 min. The fol-low up were 6 months in all eyes. The uncorrected visual acu-ity, corrected visual acuity,endothelial cell counting, corneal thickness,.intraocular pressure, corneal curvature, corneal to-pography,.OCT and corneal opacity before and 6-month after surgery were analyzed.Results: At 6 month postoperatively, mean uncorrected visual acuity and corrected visual acuity changed from 0.36 to 0.30 and from 0.42 to 0.57 without statistical significance..The mean value of each index of corneal curvature declined with-out statistical significance.Kmax value dereased from 60.91 to 59.91, and the astigmatism declined from 3.86 to 3.19. Cen-tral corneal thickness decreased from 460.93 μm to 455.40μm,.and thinnest corneal thickness declined from 450.87 μm to 440.60 μm with no statistical significance..Intraocular pres-sure was significantly elevated from 10.85 mmHg to 12.62 mmHg. Endothelial cell count did not change significantly. No corneal haze occurred. Mean depth of corneal demarcation line was 288.46 μm at 1 month postoperatively..Conclusion:.Transepithelial corneal collagen cross-linking by iontophoresis is effective and safe in the treatment of progres-sive keratoconus, and yields stable clinical outcomes during 6-month follow up..However,.long-term follow up is urgently required. (Eye Science 2014; 29:160-164)

  7. Bariatric Surgery

    Science.gov (United States)

    ... Metabolic and Bariatric Surgery MedlinePlus What is bariatric surgery? Bariatric surgery helps people who are very obese to ... What are the endocrine-related benefits of bariatric surgery? Bariatric surgery and the weight loss that results can: ...

  8. Acute Corneal Hydrops 3 Years after Intra-corneal Ring Segments and Corneal Collagen Cross-linking

    Science.gov (United States)

    Antonios, Rafic; Dirani, Ali; Fadlallah, Ali; Chelala, Elias; Hamadeh, Adib; Jarade, Elias

    2016-01-01

    This case report describes a 15-year-old male with allergic conjunctivitis and keratoconus, who underwent uneventful intra-corneal ring segment (ICRS) implantation and corneal collagen cross-linking (CXL) in the right eye. During the follow-up periods, the patient was noted to have several episodes of allergic conjunctivitis that were treated accordingly. At the 2 years postoperatively, he presented with another episode of allergic conjunctivitis and progression of keratoconus was suspected on topography. However, the patient was lost to follow-up, until he presented with acute hydrops at 3 years postoperatively. There are no reported cases of acute corneal hydrops in cross-linked corneas. We suspect the young age, allergic conjunctivitis and eye rubbing may be a risk factors associated with possible progression of keratoconus after CXL. Prolonged follow-up and aggressive control of the allergy might be necessary in similar cases. PMID:26957859

  9. The molecular genetics of the corneal dystrophies--current status.

    Science.gov (United States)

    Klintworth, Gordon K

    2003-05-01

    The pertinent literature on inherited corneal diseases is reviewed in terms of the chromosomal localization and identification of the responsible genes. Disorders affecting the cornea have been mapped to human chromosome 1 (central crystalline corneal dystrophy, familial subepithelial corneal amyloidosis, early onset Fuchs dystrophy, posterior polymorphous corneal dystrophy), chromosome 4 (Bietti marginal crystalline dystrophy), chromosome 5 (lattice dystrophy types 1 and IIIA, granular corneal dystrophy types 1, 2 and 3, Thiel-Behnke corneal dystrophy), chromosome 9 (lattice dystrophy type II), chromosome 10 (Thiel-Behnke corneal dystrophy), chromosome 12 (Meesmann dystrophy), chromosome 16 (macular corneal dystrophy, fish eye disease, LCAT disease, tyrosinemia type II), chromosome 17 (Meesmann dystrophy, Stocker-Holt dystrophy), chromosome 20 (congenital hereditary endothelial corneal dystrophy types I and II, posterior polymorphous corneal dystrophy), chromosome 21 (autosomal dominant keratoconus) and the X chromosome (cornea verticillata, cornea farinata, deep filiform corneal dystrophy, keratosis follicularis spinulosa decalvans, Lisch corneal dystrophy). Mutations in nine genes (ARSC1, CHST6, COL8A2, GLA, GSN, KRT3, KRT12, M1S1and TGFBI [BIGH3]) account for some of the corneal diseases and three of them are associated with amyloid deposition in the cornea (GSN, M1S1, TGFBI) including most of the lattice corneal dystrophies (LCDs) [LCD types I, IA, II, IIIA, IIIB, IV, V, VI and VII] recognized by their lattice pattern of linear opacities. Genetic studies on inherited diseases affecting the cornea have provided insight into some of these disorders at a basic molecular level and it has become recognized that distinct clinicopathologic phenotypes can result from specific mutations in a particular gene, as well as some different mutations in the same gene. A molecular genetic understanding of inherited corneal diseases is leading to a better appreciation of the

  10. Contact lens rehabilitation following repaired corneal perforations

    Directory of Open Access Journals (Sweden)

    Sreenivas V

    2006-03-01

    Full Text Available Abstract Background Visual outcome following repair of post-traumatic corneal perforation may not be optimal due to presence of irregular keratometric astigmatism. We performed a study to evaluate and compare rigid gas permeable contact lens and spectacles in visual rehabilitation following perforating corneal injuries. Method Eyes that had undergone repair for corneal perforating injuries with or without lens aspiration were fitted rigid gas permeable contact lenses. The fitting pattern and the improvement in visual acuity by contact lens over spectacle correction were noted. Results Forty eyes of 40 patients that had undergone surgical repair of posttraumatic corneal perforations were fitted rigid gas permeable contact lenses for visual rehabilitation. Twenty-four eyes (60% required aphakic contact lenses. The best corrected visual acuity (BCVA of ≥ 6/18 in the snellen's acuity chart was seen in 10 (25% eyes with spectacle correction and 37 (92.5% eyes with the use of contact lens (p Conclusion Rigid gas permeable contact lenses are better means of rehabilitation in eyes that have an irregular cornea due to scars caused by perforating corneal injuries.

  11. Corneal Phaeohyphomycosis Caused by Bipolaris hawaiiensis

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    Winai Chaidaroon

    2016-07-01

    Full Text Available Purpose: To report a rare case of keratitis infected by Bipolaris hawaiiensis. Methods: A patient who was diagnosed as fungal keratitis caused by B. hawaiiensis was retrospectively reviewed for history, clinical characteristics, risk factors, laboratory findings, treatments, and outcomes. Results: A 63-year-old man with a history of trauma and saw dust in the left eye presented with a corneal ulcer. Eye examination revealed whitish infiltration with a feathery edge and small brownish deposits in the anterior stroma of the left cornea. Numerous septate hyphal fragments were detected in a corneal specimen, and nucleotide sequence analysis identified B. hawaiiensis. Treatment was started with 5% natamycin eyedrops and oral itraconazole. Subsequently, a corneal plaque developed which did not respond to medication and debridement. The patient underwent therapeutic penetrating keratoplasty. Conclusions: B. hawaiiensis is a rare cause of corneal phaeohyphomycosis. A brownish pigmented infiltration is an important diagnostic clue, however microbiologic studies are required to obtain a definite diagnosis. Although antifungal medication and debridement are the mainstay of most corneal fungal infection, therapeutic penetrating keratoplasty can prevent morbidity related to this fungal infection.

  12. Corneal Phaeohyphomycosis Caused by Bipolaris hawaiiensis

    Science.gov (United States)

    Chaidaroon, Winai; Supalaset, Sumet; Tananuvat, Napaporn; Vanittanakom, Nongnuch

    2016-01-01

    Purpose To report a rare case of keratitis infected by Bipolaris hawaiiensis. Methods A patient who was diagnosed as fungal keratitis caused by B. hawaiiensis was retrospectively reviewed for history, clinical characteristics, risk factors, laboratory findings, treatments, and outcomes. Results A 63-year-old man with a history of trauma and saw dust in the left eye presented with a corneal ulcer. Eye examination revealed whitish infiltration with a feathery edge and small brownish deposits in the anterior stroma of the left cornea. Numerous septate hyphal fragments were detected in a corneal specimen, and nucleotide sequence analysis identified B. hawaiiensis. Treatment was started with 5% natamycin eyedrops and oral itraconazole. Subsequently, a corneal plaque developed which did not respond to medication and debridement. The patient underwent therapeutic penetrating keratoplasty. Conclusions B. hawaiiensis is a rare cause of corneal phaeohyphomycosis. A brownish pigmented infiltration is an important diagnostic clue, however microbiologic studies are required to obtain a definite diagnosis. Although antifungal medication and debridement are the mainstay of most corneal fungal infection, therapeutic penetrating keratoplasty can prevent morbidity related to this fungal infection. PMID:27721785

  13. Corneal trephination with the femtosecond laser.

    Science.gov (United States)

    Meltendorf, Christian; Schroeter, Jan; Bug, Reinhold; Kohnen, Thomas; Deller, Thomas

    2006-10-01

    To evaluate the feasibility and cut quality of corneal trephination in human donor corneal tissue with the femtosecond laser. Twelve human corneoscleral discs were inserted in an artificial anterior chamber. After corneal thickness measurement and tonometry, the cornea was mounted on a femtosecond laser (FEMTEC; 20/10 Perfect Vision, Heidelberg, Germany) through a contact lens (patient interface). Trephination was performed with diameters of 7.0, 7.5, 8.0, and 8.5 mm in 3 corneas each. The corneal button was removed from the corneoscleral disc in 2 of the 3 corneas in each case. The cut was not manipulated in the remaining corneas to enable histologic detection of possible tissue bridges. The cut edges were macroscopically and light-microscopically examined for quality. Corneal buttons and corneoscleral discs could be separated by blunt dissection in all cases. Tissue bridges were more common in thicker edematous corneas than in thinner ones. Both the macro- and microscopic examination disclosed smooth rectilinear cut margins with a perpendicular cut edge. This feasibility study shows that the femtosecond laser enables sufficient trephination of human donor corneas.

  14. Corneal reconstruction by stem cells and bioengineering

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    Arjamaa O

    2012-09-01

    Full Text Available Olli ArjamaaDepartment of Biology, University of Turku, Turku, FinlandAbstract: Almost 300 million people are visually impaired worldwide due to various eye diseases such as cataracts, glaucoma, age-related macular degeneration, diabetic retinopathy, and corneal diseases. Notably, ten million people are blind because of severe ocular surface diseases and the majority of cases occur in developing countries. Blinding ocular surface diseases have, however, become treatable by grafting of surface layers, or by full-thickness transplantation of the cornea. As the demand for human corneal tissue for surface reconstruction and transplantation far exceeds the supply, methods are being developed to supplement tissue donation. Xenotransplantation of the cornea or cells from genetically modified pigs may become one of the solutions. Transplantation of limbal stem cells within tissue biopsies, to restore the transparency of the cornea is another remarkable method, which has shown its potential in several clinical studies. The combination of stem cell technology and engineering of biocompatible tissue equivalent, still at preclinical stage, has shown us how synthetic corneal tissue is able to guide cultured corneal stromal stem cells of human origin, to become native-like stroma, the most important layer of the cornea. These findings give hope for a large-quantity production of biomaterial for corneal reconstruction. As such, clinical ophthalmologists should become more familiar with the methods of laboratory science.Keywords: eye, grafting, keratoplasty, xenotransplantation, cell reservoir, biocompatible tissue equivalent

  15. Corneal Complications During and After Vitrectomy for Retinal Detachment in Photorefractive Keratectomy Treated Eyes.

    Science.gov (United States)

    Tosi, Gian Marco; Baiocchi, Stefano; Balestrazzi, Angelo; Martone, Gianluca; Marigliani, Davide; Neri, Giovanni; Caporossi, Tomaso

    2015-12-01

    To evaluate the occurrence of late-onset corneal haze (LOCH) after vitrectomy for rhegmatogenous retinal detachment (RRD) in photorefractive keratectomy (PRK)-treated eyes. This observational cohort study comprised 13 eyes of 13 patients who underwent vitrectomy for RRD and who had been subjected to PRK years earlier. The occurrence of LOCH was evaluated together with all the preoperative, intraoperative, and postoperative factors that could affect final corneal status. LOCH developed in 2 eyes. Both patients had undergone PRK for high myopia--one 3 years and the other 9 years prior to RRD. Both patients presented with RRD due to giant retinal tear and were subjected to scleral buckle, 20-gauge vitrectomy, and silicone oil tamponade. Three months after vitrectomy and 1 month after silicone oil removal they both developed LOCH. During vitreoretinal surgery neither of the 2 patients needed mechanical epithelial debridement. Intraoperative epithelial debridement was performed in 2 of the other patients of the series, who had undergone previous PRK for high myopia and had clear corneas at presentation; in 1 of them this manoeuvre hampered intraoperative visualization. Follow-up after retinal detachment surgery ranged from 6 to 156 months (mean, 37.5 months). Subepithelial corneal scarring may be reactivated many years after PRK. In our series this happened after vitrectomy.

  16. Corneal endothelial rejection after penetrating keratoplasty treated with intravenous and topic corticosteroid: one year follow up

    Directory of Open Access Journals (Sweden)

    Ricardo Yuji Abe

    2013-02-01

    Full Text Available OBJECTIVE: To analyze the recovery of visual acuity (VA and graft survival after first episode of endothelial rejection in penetrating keratoplasty (PKP treated with intravenous (IV and topic corticosteroid. METHODS: Interventional, prospective, non-comparative case series study evolving 32 PKP patients in one year follow up, who presented first episode of corneal endothelial rejection. The patients were submitted to 500 mg IV injection of methylprednisolone in association with topical prednisolone. Main outcome measures included VA recovery and corneal edema regression. Second outcome included new rejections and graft failure. Multivariate analysis techniques were used to estimate rates of graft outcome events and the impact of risk factors. RESULTS: A total of 32 eyes from 32 patients (13 male and 19 female were included in the study. The mean VA (in number of letters before rejection was 48 (22 to 88 letters. Patients treated within 7 days or less of initial symptoms had better VA recovery, corneal edema regression and less graft failure (p<0.001. Patients with previous ocular surgery had worse VA recovery and more graft failure (p<0.047. CONCLUSION: The association between the other risk factors and the outcomes did not reach statistical significance in the multivariate model because of the small numbers of patients. Methylprednisolone in association with topical prednisolone is an alternative treatment for graft rejection. Our study showed that patients treated within 7 days of symptoms and no previous anterior segment surgery had better visual outcome and graft survival after treatment.

  17. Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification for rhegmatogenous retinal detachment repair

    Institute of Scientific and Technical Information of China (English)

    Hoseok; Moon; Hee; Jin; Sohn; Dea; Yeong; Lee; Jong; Yeon; Lee; Dong; Heun; Nam

    2015-01-01

    AIM: To assess the outcomes of combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification with intraocular lens implantation for rhegmatogenous retinal detachment(RRD) repair.METHODS: This was a retrospective, consecutive,noncomparative, interventional case series of 30 eyes of30 patients who underwent combined sutureless vitrectomy and clear corneal cataract surgery for the repair of RRD. The principal outcome measures were primary anatomical success rate, reasons for redetachment, final visual acuity, and surgical complications.RESULTS: Primary reattachment was achieved in 27eyes(90.0%). The reasons for redetachment(3 eyes, 10%)were incomplete laser retinopexy, persistent chronic subretinal fluid, and proliferative vitreoretinopathy,respectively. The logarithm of the minimum angle of resolution visual acuity(mean±SD) improved from 0.76±0.74 preoperatively to 0. 21 ± 0. 37 6 months’ postoperatively(P <0.0001). Postoperative hypotony was not detected,but 1 eye( 3. 3 %) had increased intraocular pressure(30 mm Hg) with spontaneous resolution. No endophthalmitis developed during follow-up. Macular pucker was detected in 3 eyes(10.0%).· CONCLUSION: Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification with intraocular lens implantation for RRD repair was proven safe and effective. It may provide not only the known advantages of conventional combined surgery, but also additional advantages such as less conjunctival fibrosis and the maintenance of stable intraocular pressure with low risks of postoperative hypotony and intraocular pressure elevation.

  18. Corneal Deposit of Ciprofloxacin after Laser Assisted Subepithelial Keratomileusis Procedure: A Case Report

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    Giacomo De Benedetti

    2010-01-01

    Full Text Available Purpose. To report one case of corneal antibiotic deposition after ciprofloxacin administration in Laser Assisted Subepithelial Keratomileusis (LASEK. Methods. One case of post-LASEK treatment resulted in corneal precipitates and poor wound healing. Debris was analyzed with dark field microscopy and placed on a blood-agar plate seeded with a susceptible stain of Staphylococcus aureus (ATCC 29213. Results. The alterations resolved with discontinuation of ciprofloxacin treatment, although some residual deposits persisted subepithelially for 6 months. Analysis of precipitates revealed polydisperse crystalline needles of 183 m average length (SD=54 m and the excised precipitate demonstrated a zone of inhibition. Conclusions. Fluoroquinolone antibiotic drops have been used extensively in postsurgical treatment of refractive surgery. Corneal precipitates have been previously reported in the literature, but up to now nothing has been documented after LASEK. Polypharmacy during refractive surgery may impair epithelialisation, and clinical management should reduce toxic environment and promote ocular surface stability when performing surface ablations.

  19. Measurement of Central Corneal Thickness Using Ultrasound Pachymetry and Orbscan II in Normal Eyes

    Science.gov (United States)

    Sadoughi, Mohammad Mehdi; Einollahi, Bahram; Einollahi, Neda; Rezaei, Javad; Roshandel, Danial; Feizi, Sepehr

    2015-01-01

    Purpose: To compare ultrasound pachymetry and Orbscan II for measurement of central corneal thickness (CCT) in normal eyes. Methods: The current study was performed at Labbafinejad Medical Center (LMC), Tehran, Iran. Three hundred eyes from 150 healthy individuals referred for keratorefractive surgery were assessed first by Orbscan II and then by ultrasound pachymetry, and CCT values were recorded and compared. Results: Overall, Orbscan II overestimated CCT as compared to ultrasound pachymetry by about 2.4% (mean values 547.6 ± 34.7 versus 534.8 ± 34.7, respectively, P < 0.001). The difference was more significant when CCT was less than 500 microns (mean values 493.2 ± 16.9 versus 479.9 ± 15.6, mean overestimation: 2.6%, P < 0.001). There was good linear correlation between the two methods (Pearson's correlation r = 0.968, P < 0.0001). Conclusion: Orbscan II has good correlation with ultrasound pachymetry for measurement of CCT in normal eyes; however Orbscan II should not be used to evaluate corneal thickness before keratorefractive surgeries, as it tends to overestimate corneal thickness and may result in undesirable, low residual stromal thickness. PMID:26005545

  20. Analysis of the horizontal corneal diameter, central corneal thickness, and axial length in premature infants

    Directory of Open Access Journals (Sweden)

    Ozdemir Ozdemir

    2014-08-01

    Full Text Available Purpose: To determine the horizontal corneal diameter, central corneal thickness, and axial length in premature infants. Methods: Infants with a birth weight of less than 2,500 g or with a gestation period of less than 36 weeks were included in the study. Infants with retinopathy of prematurity (ROP were allocated to Group 1 (n=138, while those without ROP were allocated to Group 2 (n=236. All infants underwent a complete ophthalmologic examination, including corneal diameter measurements, pachymetry, biometry, and fundoscopy. Between-group comparisons of horizontal corneal diameter, central corneal thickness, and axial lengths were performed. Independent sample t-tests were used for statistical analysis. Results: Data was obtained from 374 eyes of 187 infants (102 female, 85 male. The mean gestational age at birth was 30.7 ± 2.7 weeks (range 25-36 weeks, the mean birth weight was 1,514 ± 533.3 g (range 750-1,970 g, and the mean postmenstrual age at examination was 40.0 ± 4.8 weeks. The mean gestational age and the mean birth weight of Group 1 were statistically lower than Group 2 (p0.05. Conclusions: The presence of ROP in premature infants does not alter the horizontal corneal diameter, central corneal thickness, or axial length.

  1. 高度近视LASEK术中应用丝裂霉素C预防haze的意义%A clinical observation of applying mitomycin C in LASEK surgery to prevent the formation of subepithelial corneal haze in patients with high myopia

    Institute of Scientific and Technical Information of China (English)

    王怡; 赵大虹

    2011-01-01

    目的 探讨准分子激光上皮下角膜磨镶术(LASEK)术中联合应用丝裂霉素C(MMC)对术后角膜上皮下雾状浑浊(haze)的预防作用.方法 随机对60例(120眼)高度近视(-6.00D以上)左右眼分别做单纯LASEK手术和LASEK+ MMC手术,观察6个月,计算出haze反应的发生率并进行比较.结果 统计术后1、3、6个月haze的发生率,单纯LASEK分别为:0.5级,58.33%、48.33%、40.00%;1级,13.33%、8.33%、5.00%;2级,0、1.67%、1.67%;3级以上均为0.LASEK+MMC 分别为:0.5级,36.67%、26.67%、13.33%;1级,1.67%、1.67%、3.33%;2级以上均为0.两组比较差异有统计学意义(P<0.05).结论 LASEK术中应用MMC能减轻haze反应形成,情况显著优于单纯LASEK手术.%Objective To observe the applying of mitomycin C in LASEK surgery to prevent the formation of subepithelial corneal haze in patients with high myopia.Methods Sixty patients ( 120 eyes) with high myopia were randomly performed LASEK on one eye,and they were performed 0.02% mitomycin C treatment during LASEK on the other eye separately.Regular follow-up of 6 month was done to observe the haze formation.Results In the LASEK group,the rate of the haze of grade 0.5 was 58.33%,48.33%,40.00% in 1 month,3 months and 6 months,that of grade 1 was 13.33%,8.33%,5.00%,that of grade 2 was 0,1.67%,1.67%,that of grade 3 and 4 was 0.In the LASEK + MMC group,the rate of the haze of grade 0.5 was 36.67%,26.67%,13.33% in 1 mouths,3 months and 6 months respectively,that of grade 1 was 1.67%,1.67%,3.33%,that of grade 2,3 and 4 was 0.There was significant difference (P<0.05) in the haze between the two groups.Conclusion The occurrence of the haze in the LASEK + MMCgroup is milder than that in the LASEK group.

  2. 21 CFR 886.1450 - Corneal radius measuring device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Corneal radius measuring device. 886.1450 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1450 Corneal radius measuring device. (a) Identification. A corneal radius measuring device is an AC-powered device intended to...

  3. First report of evaluation of K-M media: A new corneal preservation medium

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    Desai Beena

    2007-01-01

    Full Text Available Purpose: To analyze the outcome of keratoplasty performed using Kalevar-Majumdar (K-M media, a new synthetic viscous medium for preservation of the cornea. Materials and Methods: The K-M media-preserved donor eye balls were kept in a bottle in a refrigerator at 4° C till the corneas were used. Forty-eight consecutive keratoplasty cases of pseudophakic bullous keratopathy with vision less than counting fingers at one meter and operated by a single surgeon have been analyzed. Corneal donor button of 7.5 mm was used on the 7.0 mm recipient bed in all cases. Surgery was done with a standard technique. All the cases were examined daily for the first week and at the end of one month for graft clarity, epithelial defect and stromal edema. Results: The K-M media-preserved corneal grafts remained clear at the end of the first week in 95.8% (46 of 48 cases and at the end of one month in 93.7% (45 of 48 cases. Donor epithelial haze cleared in 24h in all cases. The stromal edema got cleared in the majority (91.7%, 44 of 48 within 24h. Epithelial defect was seen in only 10.4% (five cases. There was no primary graft failure. Conclusion: K-M medium, a new viscous, synthetic corneal preservation medium, is a safe (no primary donor failure alternative to conventional liquid corneal preservation media. K-M media-preserved eyes appear to have better preserved corneal epithelium with faster achievement of graft clarity postoperatively.

  4. Comparative results of corneal curvature measurements with three different keratometers after radial keratotomy

    Institute of Scientific and Technical Information of China (English)

    ZHAO Lu; ZHANG Li; WANG Yan-ling; WANG Wei; YAN Yan

    2011-01-01

    Background Corneal curvatures measured by conventional instruments after refractive surgeries were greater than the real values.This study on the instruments and methods for measuring corneal curvature was carried out with the aim of determining an accurate,simple and effective method to evaluate corneal refractive power after radial keratotomy (RK).Methods A retrospective study was carried out on 52 eyes of 42 patients with a history of RK.The postoperative measurements after RK were performed with a manual keratometer (Rodenstock,Munchen-Hamburg,Germany),a corneal topographer (Tomey TMS-1) and an automated IOLMaster keratometer (Carl Zeiss GmbH,USA).The results obtained from analyzing clinical histories (clinical history method,CHM) were compared to the postoperative measurements with a two-way analysis of variance.Adjusted keratometry was used to correct the corneal central refractive power (K) values of the three keratometers.The CHM results were also compared to the corrected K values obtained with the three keratometers using the same statistical method.Results The smallest mean value was found for the CHM ((36.61±9.23) diopters).The K values obtained with the CHM were very different from the results obtained with the three different instruments.The corrected K values obtained with the IOLMaster were the closest to the K values from the CHM.Conclusions It was shown that K values from measurements with the three instruments were higher.When the power of the intraocular lens of the patients after RK was calculated,the errors of the K values measured with the instruments should be taken into consideration.

  5. [Clinical and histological studies on the intrastromal corneal ring segments (ICRS(R), Intacs(R))].

    Science.gov (United States)

    Ruckhofer, Josef

    2002-08-01

    Intrastromal corneal ring segments (ICRS(R), Intacs(R)) are corneal inlays made of PMMA with an arc length of 150 degrees for the correction of low to moderate myopia. This additive and potentially reversible method has recently been developed to clinical usefulness during the last few years. Besides the historical development und the results of the US FDA studies, we focus on the results of the European experience with this technique. For the first time, long-time follow-up results (5 years from a single surgical center) are presented. Morphological changes after implantation of Intacs(R) were investigated in a series of patients by confocal microscopy. Weeks and months after implantation "lamellar channel deposits" regularly appear around the segments. This material consists of intracellular lipids (cholesterol ester, triglyceride and unesterified cholesterol), as we could show in new histological studies on rabbit eyes. New developments of this technique include short arc length segments (130 degrees ) for the correction of myopia concurrent with astigmatism and radially placed corneal inlays (Intrastromal Corneal Segments, ICS(R)) for the correction of hyperopia. In recent years, Intacs(R) have also been implanted in eyes with keratoconus and keratectasia after LASIK. These early results seem to indicate that in certain cases of early keratoconus, these implants can indeed improve corneal geometry and vision. Even in cases of regression or undercorrection after LASIK (with thin corneas), Intacs(R) seem to give promising results in selected cases. Although Intacs(R) do give comparable results regarding both safety and efficacy when compared with PRK and LASIK, this technology has not yet been widely accepted among refractive surgeons. Whether Intacs(R) will play a greater role in routine refractive surgery in the future or will just remain a special device for the correction of keratectasia, keratoconus or regression after LASIK cannot yet be decided with

  6. Occurrence of viral DNA in paired samples of corneal rim and cornea preservation fluid.

    Science.gov (United States)

    Broniek, G; Langwińska-Wośko, E; Sybilska, M; Szaflik, J P; Przybylski, M; Wróblewska, M

    2017-04-01

    Corneal transplants have one of the highest success rates among all transplantological procedures. Corneas intended for transplantation are stored in a preservation fluid, which is then tested for bacterial and fungal infections. Among all analyses of infectious complications following corneal transplants, infections caused by bacteria or fungi are the most prominent. Surprisingly, however, apart from a few publications, there is a lack of data regarding the occurrence of viruses in donor corneas and the risk of transmitting these to their recipients. The intention of this research was therefore to determine the frequency with which human herpesvirus 1 (HHV-1), human herpesvirus 2 (HHV-2), and human adenovirus (HAdV) occur in transplanted corneal tissue, as well as in samples of preservation fluid. The study comprised 57 paired samples, with each pair consisting of a fragment of the corneal tissue remaining after its trepanation for transplantation surgery and a sample of corneal preservation fluid. Sample pairs were all tested for the presence of the DNA of three viruses (HHV-1, HHV-2, and HAdV) using real time PCR technique. Viral DNA was found in three of the tested corneas-HHV-1 DNA in one paired sample (1.8%) and adenovirus DNA in two single samples (3.5%). We postulate that virological testing of corneas for transplantation should be considered, particularly in the case of donors with increased risk factors for herpesvirus and adenovirus reactivation. J. Med. Virol. 89:732-736, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  7. 角膜地形图在准分子激光角膜屈光手术中的应用及研究进展%Application and research progress of corneal topography in excimer laser corneal refractive operation

    Institute of Scientific and Technical Information of China (English)

    邓晶; 孟欢; 李英俊; 金龙山

    2014-01-01

    In recent years,corneal topography has been widely applied in excimer laser surgery and it equipment update, especially the application of individual excimer laser corneal refractive operation guided by corneal topography,not only reduces postoperative low order aberrations,but also make up the problems such as correct postoperative glare and halo,night declining eyesight which were cannot fixed by the traditional operation,and it greatly improved the safety and stability,validity,and predictive of corneal refractive surgery.In this paper,we reviewed the current development of corneal topography and its application progressin excimer laser surgery.%近年来,角膜地形图在准分子激光手术及设备的更新中得到了广泛应用,尤其是角膜地形图引导的个体化准分子激光角膜屈光手术的开展,不但降低了术后低阶像差,而且弥补了传统术式无法矫正的术后光晕、眩光及夜间视力下降等问题,极大提高了角膜屈光手术的安全性、有效性、预测性和稳定性。本文就角膜地形图的发展现状及其在准分子激光手术中的应用进展等方面作一综述。

  8. Relationship between Corneal Thickness,Corneal Curva-ture,and Intraocular Pressure before and after Laser Treat-ment for Simple Myopia

    Institute of Scientific and Technical Information of China (English)

    Ahmad MA; Edrees MH; Jafarzadehpur E

    2014-01-01

    Purpose:To determine the relationship of central corneal thickness (CCT), curvature (CC), and intraocular pressure (IOP) as determinative factors for corneal biomechanics and in refractive surgery. Methods:.The study investigated 48 eyes from subjects who visited the Excimer Laser Surgery Clinic at the Department of Ophthalmology. The refractive error, IOP, CCT, and CC were measured in all participants. After 3 months, all exami-nations were repeated. Results:.Linear regression demonstrated a significant positive relationship between pre- and postoperative CCT,.CC,.and IOP values..The IOP showed a significant correlation with CCT (P=0.033) for pre-PRK, but no significant relationship was seen post-PRK. The CCT also correlated significantly with CC both pre-and post-PRK (P<0.05). Conclusion:.The IOP was significantly correlated with CCT before PRK, but its behavior differed after surgery. Nearly the same correlation was seen between CCT and CC before and after the PRK;.nevertheless,.IOP measurements should be calculated or estimated more precisely after PRK based on CCT corrections.

  9. Gr-1intCD11b+ myeloid-derived suppressor cells accumulate in corneal allograft and improve corneal allograft survival.

    Science.gov (United States)

    Choi, Wungrak; Ji, Yong Woo; Ham, Hwa-Yong; Yeo, Areum; Noh, Hyemi; Jin, Su-Eon; Song, Jong Suk; Kim, Hyeon Chang; Kim, Eung Kwon; Lee, Hyung Keun

    2016-12-01

    We identified the characteristics of myeloid-derived suppressor cells (MDSCs) and investigated their mechanism of induction and their functional role in allograft rejection using a murine corneal allograft model. In mice, MDSCs coexpress CD11b and myeloid differentiation antigen Gr-1. Gr-1(+)CD11b(+) cells infiltrated allografted corneas between 4 d and 4 wk after surgery; however, the frequencies of Gr-1(+)CD11b(+) cells were not different between accepted and rejected allografts or in peripheral blood or BM. Of interest, Gr-1(int)CD11b(+) cells, but not Gr-1(hi)CD11b(+) cells, infiltrated the accepted graft early after surgery and expressed high levels of immunosuppressive cytokines, including IL-10, TGF-β, and TNF-related apoptosis-inducing ligand. This population remained until 4 wk after surgery. In vitro, only high dose (>100 ng/ml) of IFN-γ plus GM-CSF could induce immunosuppressive cytokine expression in Gr-1(int)CD11b(+) cells. Furthermore, adoptive transfer of Gr-1(int)CD11b(+) cells reduced T cell infiltration, which improved graft survival. In conclusion, high-dose IFN-γ in allograft areas is essential for development of Gr-1(int)CD11b(+) MDSCs in corneal allografts, and subtle environmental changes in the early period of the allograft can result in a large difference in graft survival.

  10. Induced corneal astigmatism by palpebral spring for the treatment of lagophthalmos.

    Science.gov (United States)

    Avni-Zauberman, Noah; Rosen, Nachum; Ben Simon, Guy J

    2008-08-01

    To report a patient with decreased vision after insertion of an upper eyelid palpebral spring. Interventional case report. A 44-year-old man presented with decreased vision in his right eye. Several months before presentation, he underwent palpebral spring insertion in his upper eyelid for lagophthalmos. He had developed seventh cranial nerve palsy after removal of the right facial nerve neuroma. Decreased vision was related to induced astigmatism by upper eyelid pressure. Surgical replacement of the spring resulted in less astigmatism and improvement in visual acuity. Ocular rehabilitation surgery with insertion of a palpebral spring to the upper eyelid may induce corneal astigmatism and decrease vision in the normal eye. This may be reversible by replacing or repositioning the spring so that it will imply less corneal pressure.

  11. Corneal nerve microstructure in Parkinson's disease.

    Science.gov (United States)

    Misra, Stuti L; Kersten, Hannah M; Roxburgh, Richard H; Danesh-Meyer, Helen V; McGhee, Charles N J

    2017-03-03

    Ocular surface changes and blink abnormalities are well-established in Parkinson's disease. Blink rate may be influenced by corneal sub-basal nerve density, however, this relationship has not yet been investigated in Parkinson's disease. This case-control study examined the ocular surface in patients with moderately severe Parkinson's disease, including confocal microscopy of the cornea. Fifteen patients with moderately severe Parkinson's disease (modified Hoehn and Yahr grade 3 or 4) and fifteen control participants were recruited. Ophthalmic assessment included slit-lamp examination, blink rate assessment, central corneal aesthesiometry and in vivo corneal confocal microscopy. The effect of disease laterality was also investigated. Of the 15 patients with Parkinson's disease, ten were male and the mean age was 65.5±8.6years. The corneal sub-basal nerve plexus density was markedly reduced in patients with Parkinson's disease (7.56±2.4mm/mm(2)) compared with controls (15.91±2.6mm/mm(2)) (pParkinson's disease (0.79±1.2mBAR) and the control group (0.26±0.35mBAR), p=0.12. Sub-basal nerve density was not significantly different between the eye ipsilateral to the side of the body with most-severe motor symptoms, and the contralateral eye. There was a significant positive correlation between ACE-R scores and sub-basal corneal nerve density (R(2)=0.66, p=0.02). This is the first study to report a significant reduction in corneal sub-basal nerve density in Parkinson's disease and demonstrate an association with cognitive dysfunction. These results provide further evidence to support the involvement of the peripheral nervous system in Parkinson's disease, previously thought to be a central nervous system disorder.

  12. Normal corneal endothelial cell density in Nigerians

    Directory of Open Access Journals (Sweden)

    Ewete T

    2016-03-01

    Full Text Available Temitope Ewete,1 Efeoghene Uchenna Ani,2 Adegboyega Sunday Alabi1 1MeCure Eye Center, Lagos, 2Department of Ophthalmology, University of Port Harcourt, Port Harcourt, Nigeria Aim: The aim of the study was to describe the corneal endothelial cell density of adults at the MeCure Eye Center and to determine the relationship between age, sex, and corneal endothelial cell density. Methods: This study was a retrospective study looking at those records of individuals who had undergone specular microscopy or corneal endothelial cell count measurement at the MeCure Eye Center. Results: The endothelial cell characteristics of 359 healthy eyes of 201 volunteers were studied. The mean corneal endothelial cell density (MCD was 2,610.26±371.87 cells/mm2 (range, 1,484–3,571 cells/mm2. The MCD decreased from 2,860.70 cells/mm2 in the 20–30-year age group to 2,493.06 cells/mm2 in the >70-year age group, and there was a statistically significant relationship between age and MCD with a P-value of <0.001. There was no statistically significant correlation between sex and corneal endothelial cell density (P=0.45. Conclusion: This study shows that endothelial cell density in Nigerian eyes is less than that reported in the Japanese, American, and Chinese eyes, and is comparable to that seen in Indian and Malaysian eyes. Keywords: corneal, endothelial cell density, Nigerian

  13. Multiple-hook fixation in revision spinal deformity surgery for patients with a previous multilevel fusion mass: technical note and preliminary outcomes.

    Science.gov (United States)

    Liu, Ning; Wood, Kirkham B

    2017-03-01

    OBJECTIVE A previous multilevel fusion mass encountered during revision spinal deformity surgery may obscure anatomical landmarks, making instrumentation unworkable or incurring substantial blood loss and operative time. This study introduced a surgical technique of multiple-hook fixation for fixating previous multilevel fusion masses in revision spinal deformity surgeries and then evaluated its outcomes. METHODS Patients with a previous multilevel fusion mass who underwent revision corrective surgery down to the lumbosacral junction were retrospectively studied. Multiple hooks were used to fixate the fusion mass and linked to distal pedicle screws in the lumbosacral-pelvic complex. Radiological and clinical outcomes were evaluated. RESULTS The charts of 8 consecutive patients with spinal deformity were retrospectively reviewed (7 women, 1 man; mean age 56 years). The primary diagnoses included flat-back deformity (6 cases), thoracolumbar kyphoscoliosis (1 case), and lumbar spondylosis secondary to a previous scoliosis fusion (1 case). The mean follow-up duration was 30.1 months. Operations were performed at T3/4-ilium (4 cases), T7-ilium (1 case), T6-S1 (1 case), T12-S1 (1 case), and T9-L5 (1 case). Of 8 patients, 7 had sagittal imbalance preoperatively, and their mean C-7 plumb line improved from 10.8 ± 2.9 cm preoperatively to 5.3 ± 3.6 cm at final follow-up (p = 0.003). The mean lumbar lordosis of these patients at final follow-up was significantly greater than that preoperatively (35.2° ± 12.6° vs 16.8° ± 11.8°, respectively; p = 0.005). Two perioperative complications included osteotomy-related leg weakness in 1 patient and a stitch abscess in another. CONCLUSIONS The multiple-hook technique provides a viable alternative option for fixating a previous multilevel fusion mass in revision spinal deformity surgery.

  14. Biofeedback assisted control of respiratory sinus arrhythmia as a biobehavioral intervention for depressive symptoms in patients after cardiac surgery: a preliminary study.

    Science.gov (United States)

    Patron, Elisabetta; Messerotti Benvenuti, Simone; Favretto, Giuseppe; Valfrè, Carlo; Bonfà, Carlotta; Gasparotto, Renata; Palomba, Daniela

    2013-03-01

    The current study investigated whether biofeedback training aimed at increasing respiratory sinus arrhythmia (RSA), a measure of cardiac vagal modulation, can reduce depressive symptoms in patients after cardiac surgery. This randomized controlled study enrolled 26 patients after first-time cardiac surgery. The patients were randomly assigned to an RSA-biofeedback group (N = 13) or to a treatment as usual group (N = 13). The biofeedback training consisted of five 45 min sessions designed to increase RSA. The outcome was assessed as changes in RSA and in the Centre for Epidemiologic Studies of Depression (CES-D) values from pre- to post-training. Both groups were comparable for demographic and biomedical characteristics. RSA increased significantly in patients who underwent RSA-biofeedback compared to controls. Moreover, the CES-D scores were reduced significantly from pre- to post-training in the RSA-biofeedback group compared to the controls. Changes in RSA were inversely related to changes in CES-D scores from pre- to post-training. These findings extend the effectiveness of RSA-biofeedback for increasing vagal modulation as well as for reducing depressive symptoms in post-surgical patients. Overall, the current study also suggests that this biobehavioral intervention may add to the efficacy of postoperative risk reduction programs and rehabilitation protocols in cardiac surgery patients.

  15. Animation program used to encourage patients or family members to take an active role for eliminating wrong-site, wrong-person, wrong-procedure surgeries: preliminary evaluation.

    Science.gov (United States)

    See, Lai-Chu; Chang, Yi-Hua; Chuang, Kai-Lan; Lai, Hui-Ru; Peng, Pei-I; Jean, Wen-Chyi; Wang, Chao-Hui

    2011-01-01

    Wrong-site surgeries (including wrong-site, wrong-person and wrong-procedure errors) remain the number one problem among adverse events of health care delivery. Patients and/or family members should be involved when possible to help prevent such errors. 1) Design an educational animation program about patient safety for patients and/or family members to help eliminate wrong-site surgery errors. 2) Evaluate its educational effect. The animation developed for this study includes an introduction, hypothetical story, and guided information, and was presented at a tertiary medical center in northern Taiwan. A single-group pretest and posttest design was used. Forty-six patients and 48 family members participated in the study. The pre-training score was 3.6 (on a scale of 1-4). After watching the animation, there was no significant increase (0.08 ± 0.5) for the patient group, but the family member group showed significant improvement (0.21 ± 0.6, P = .0309). Most participants (98.9%) were satisfied with the animation. The majority of participants reported good practices for avoiding wrong-site surgery mistakes before an operation. A significant improvement of post-training scores in the family member group was seen. The high satisfaction rating given by the participants after seeing the animation indicates that it was generally acceptable. Copyright © 2010 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  16. Preliminary results of CO2 laser-assisted sclerectomy surgery (CLASS) in the treatment of advanced glaucoma in a Chinese population.

    Science.gov (United States)

    Yick, Doris W F; Lee, Jacky W Y; Tsang, Susanna; Yeung, Barry Y M; Yuen, Can Y F

    2016-11-01

    To evaluate the efficacy and safety of CO2 laser-assisted sclerectomy surgery (CLASS) in Chinese patients with advanced glaucoma.Patients with advanced glaucoma who were candidates for glaucoma filtration surgery were included. The intraocular pressure (IOP) and number of antiglaucoma medications were documented before surgery and at all postoperative clinic visits. All intra- and postoperative complications were documented. The primary outcome measures were the changes in IOP and medication use before and after the procedure as well as complications from the procedure. The secondary outcome measure included the CLASS success rate.Twenty patients (23 eyes) underwent CLASS between November 2014 and September 2015. Nineteen eyes had primary open-angle glaucoma, 2 eyes had primary angle-closure glaucoma, and 2 eyes had uveitic glaucoma. One patient was lost to follow-up. The mean age of subjects was 68.1 ± 11.9 years. IOP was significantly reduced at 1 day and 1 week after CLASS. At 6 months, the IOP and number of medications were significantly reduced by 19.0% and 38.2%, respectively (both P glaucoma.

  17. Tomographic Analysis of Anterior and Posterior and Total Corneal Refractive Power Changes After Femtosecond Laser-Assisted Keratotomy.

    Science.gov (United States)

    Löffler, Franziska; Böhm, Myriam; Herzog, Michael; Petermann, Kerstin; Kohnen, Thomas

    2017-08-01

    To analyze the effect of penetrating femtosecond laser-assisted keratotomy (pFLAK) during laser lens surgery on anterior and posterior corneal astigmatism and total corneal refractive power (TCRP) astigmatism (CAant, CApost, CATCRP) measured with Scheimpflug tomography. Prospective, interventional case series. This institutional study included 27 eyes of 23 patients (aged 65 ± 8 years) with low-to-moderate CATCRP determined with Scheimpflug tomography (Pentacam HR; Oculus, Wetzlar, Germany) after penetrating femtosecond laser-assisted keratotomy (pFLAK) and laser lens surgery. The CAant, CApost, and CATCRP were determined before and 1 and 3 months after surgery. Vector analysis according to the Alpins method was used to calculate surgically induced astigmatism (SIA). The mean preoperative CAant (0.97 ± 0.30 diopter [D]) was significantly reduced to 0.63 ± 0.34 D (P low (0.12 ± 0.07 D). The CATCRP showed similar results as CAant. pFLAKs planned according to Scheimpflug-based CATCRP result in a significant reduction of the CAant and CATCRP, but do not affect the posterior corneal curvature significantly, as measured by Scheimpflug tomography. Further research is required to develop a new valid nomogram for laser-assisted lens surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Corneal Topographic Analysis in Patients with Cataract

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    We studied the corneal curvature of 161 eyes in 101 patients, aged from 50 to 80 years (mean: 63 years), with senile cataract using the Topographic Modeling System (IMS) preoperatively. The results revealed that mean surface asymmetry index (SAD was 0. 36 and mean surface regularity index (SRI) 0. 79. Simulated keratometry reading (Sim K) was 44. 46 D, and 43. 56 D. Minimun K reading was 42. 60 D. The same patterns of corneal topography in both eyes were 50% in 60 patients who had binocular examination....

  19. Bessel Function Model for Corneal Topography

    CERN Document Server

    Okrasiński, Wojciech

    2011-01-01

    In this paper we consider a new nonlinear mathematical model for corneal topography formulated as two-point boudary value problem. We derive it from first physical principles and provide some mathematical analysis. The existence and uniqeness theorems are proved as well as various estimates on exact solution. At the end we fit the simplified model based on Modified Bessel Function of the First Kind with the real corneal data consisting of matrix of 123x123 points and obtain an error of order of 1%.

  20. Colletotrichum graminicola: a new corneal pathogen.

    Science.gov (United States)

    Ritterband, D C; Shah, M; Seedor, J A

    1997-05-01

    We report the first case of an ocular infection with the fungus Colletotrichum graminicola causing keratitis in a 27-year-old man. Twenty-four months after a postoperative course complicated by recurrent fungal keratitis requiring two penetrating keratoplasties, two anterior chamber washouts, a conjunctival flap, and medical treatment with topical natamycin, intracameral amphotericin B, and oral fluconazole. The patient has shown no signs of fungal recurrence despite a failed corneal graft. C. graminicola is a new corneal pathogen and should be included in the differential diagnosis of mycotic keratitis.

  1. Research on inhibition of corneal neovascularization

    Directory of Open Access Journals (Sweden)

    Zhang-Hui Yang

    2015-12-01

    Full Text Available Corneal transparency is the basis of the normal physiological functions.However, corneal neovascularization(CNVmay occur in the infection, mechanical and chemical injury or under other pathological conditions,which make the cornea lose original transparency and severe visual impairment. In recent years, along with the development of immunology, molecular biology, biochemistry and other disciplines, there is more in-depth understanding on the CNV, and clinical treatment of CNV has made new breakthroughs. This article provides an overview of the inhibition of CNV.

  2. Robotic-assisted transperitoneal nephron-sparing surgery for small renal masses with associated surgical procedures: surgical technique and preliminary experience.

    Science.gov (United States)

    Ceccarelli, Graziano; Codacci-Pisanelli, Massimo; Patriti, Alberto; Ceribelli, Cecilia; Biancafarina, Alessia; Casciola, Luciano

    2013-09-01

    Small renal masses (T1a) are commonly diagnosed incidentally and can be treated with nephron-sparing surgery, preserving renal function and obtaining the same oncological results as radical surgery. Bigger lesions (T1b) may be treated in particular situations with a conservative approach too. We present our surgical technique based on robotic assistance for nephron-sparing surgery. We retrospectively analysed our series of 32 consecutive patients (two with 2 tumours and one with 4 bilateral tumours), for a total of 37 robotic nephron-sparing surgery (RNSS) performed between June 2008 and July 2012 by a single surgeon (G.C.). The technique differs depending on tumour site and size. The mean tumour size was 3.6 cm; according to the R.E.N.A.L. Nephrometry Score 9 procedures were considered of low, 14 of moderate and 9 of hight complexity with no conversion in open surgery. Vascular clamping was performed in 22 cases with a mean warm ischemia time of 21.5 min and the mean total procedure time was 149.2 min. Mean estimated blood loss was 187.1 ml. Mean hospital stay was 4.4 days. Histopathological evaluation confirmed 19 cases of clear cell carcinoma (all the multiple tumours were of this nature), 3 chromophobe tumours, 1 collecting duct carcinoma, 5 oncocytomas, 1 leiomyoma, 1 cavernous haemangioma and 2 benign cysts. Associated surgical procedures were performed in 10 cases (4 cholecystectomies, 3 important lyses of peritoneal adhesions, 1 adnexectomy, 1 right hemicolectomy, 1 hepatic resection). The mean follow-up time was 28.1 months ± 12.3 (range 6-54). Intraoperative complications were 3 cases of important bleeding not requiring conversion to open or transfusions. Regarding post-operative complications, there were a bowel occlusion, 1 pleural effusion, 2 pararenal hematoma, 3 asymptomatic DVT (deep vein thrombosis) and 1 transient increase in creatinine level. There was no evidence of tumour recurrence in the follow-up. RNSS is a safe and feasible technique

  3. Preliminary Study on Clinical Competence Development of Oral and Maxillofacial Surgery Postgraduates%口腔颌面外科研究生临床能力培养初探

    Institute of Scientific and Technical Information of China (English)

    黄旋平; 周诺; 孙晋虎

    2012-01-01

    作为高技术人才的医学研究生,应具有较强的临床能力、较深的专业知识和较高的科研能力。而其中,临床能力则是医学研究生培养的核心内容之一,是衡量其质量高低的重要标准。口腔颌面外科学是一门既涉及到口腔专业知识,又和临床多学科有着交叉联系的专业,其研究生的培养有着自身的特点。本文着重从医学理论知识、临床思维能力、临床操作能力、医学人文素养几个方面,对如何提高口腔颌面外科研究生的临床能力做了初步的探索和总结。%Medical postgraduates with proficient skills should have strong capacity of scientific research,abundant specialized knowledge and good clinical competence,of which clinical competence is one of the cores in training medical postgraduates,also an important standard of measurement of their qualities.Oral and maxillofacial surgery has its own features in fostering postgraduates.Because it involves not only stomatology but also other subjects such as clinical surgery and etc.As a preliminary study on the methods of developing clinical competence of oral and maxillofacial surgery postgraduates,this article emphasizes the study from the following aspects:theoretical knowledge,clinical elaborative faculty,clinical operational ability and medical humanistic quality.

  4. Corneal invasion of ocular surface squamous neoplasia after clear corneal phacoemulsification: in vivo confocal microscopy analysis.

    Science.gov (United States)

    Balestrazzi, Angelo; Martone, Gianluca; Pichierri, Patrizia; Tosi, Gian Marco; Caporossi, Aldo

    2008-06-01

    We describe an unusual case of ocular surface squamous neoplasia (OSSN) that occurred in a male patient after superonasal clear corneal phacoemulsification with extensive papillomatous corneal invasion near a side port. The features of the macroscopic invasion of the corneal superficial layers were analyzed by in vivo confocal analysis using the Heidelberg Retina Tomograph II. After OSSN was diagnosed, topical mitomycin-C 0.02% eyedrops were prescribed 4 times a day in a cyclic manner (3 cycles of 1 week on drops followed by 1 week off). After 1 month (second cycle), the natural visual acuity was 20/20, the corneal epithelium had healed completely, and the limbal lesion had regressed markedly. The patient remained asymptomatic without recurrence during a 6-month follow-up.

  5. Diabetic Macular Edema at the time of Cataract Surgery trial: a prospective, randomized clinical trial of intravitreous bevacizumab versus triamcinolone in patients with diabetic macular oedema at the time of cataract surgery - preliminary 6 month results.

    Science.gov (United States)

    Lim, Lyndell L; Morrison, Julie L; Constantinou, Marios; Rogers, Sophie; Sandhu, Sukhpal S; Wickremasinghe, Sanjeewa S; Kawasaki, Ryo; Al-Qureshi, Salmaan

    2016-05-01

    To compare visual and anatomical outcomes between intravitreous bevacizumab (BVB, Avastin) and triamcinolone (TA, Triesence) when administered at the time of cataract surgery in patients with diabetic macular oedema (DME). Prospective, single-masked, randomized clinical trial at The Royal Victorian Eye and Ear Hospital, Melbourne. Patients with clinically significant cataract and either centre-involving DME or DME treated within the previous 24 months. Participants were randomized 1:1 to receive intravitreous BVB 1.25 mg or TA 4 mg during cataract surgery, and at subsequent review if required over 6 months. Change in central macular thickness (CMT) and best corrected visual acuity at 6 months. Forty-one patients (mean age 66.4 years, 73.2% male) were recruited. Visual acuity and CMT were similar between groups at baseline (P > 0.2).After six months, both groups gained vision (mean +21.4 letters in TA group P < 0.0001, +12.5 letters in BVB, P = 0.002), with no significant difference between groups (P = 0.085). In addition, 60.9% of eyes receiving TA achieved a VA of ≥6/12 compared to 73.3% in the BVB group (P = 0.501). However, only TA was associated with a sustained reduction in CMT (-43.8-µm reduction TA vs. +37.3-µm increase BVB, P = 0.006 over 6 months). Following surgery, additional injections were required in 70.6% of participants in the BVB group, compared to 16.7% in the TA group (P < 0.0001). Three patients in the TA group experienced a rise of IOP over 21 mmHg (12.5%) during the 6-month follow-up; BVB had no cases (P = 0.130). There were no cases of endophthalmitis in either group. When administered at the time of cataract surgery in patients with DME, at 6 months both TA and BVB improve visual acuity; however, only TA results in a sustained reduction in CMT. Further follow-up will determine whether this translates into better long-term visual outcomes in the TA group. © 2016 Royal Australian and New

  6. Congenital Unilateral Corneal Anaesthesia with Microphthalmos: A Case Report

    Directory of Open Access Journals (Sweden)

    George Voyatzis

    2012-01-01

    Full Text Available Congenital corneal anaesthesia (CCA is an uncommon condition difficult to diagnose. We report the case of a 20-month-old boy who presented with unilateral congenital corneal anaesthesia. The child was referred with a persistent corneal epithelial defect, unresponsive to symptomatic local treatment for over 10 months. Intensive topical treatment and strict corneal protection led to quick corneal healing. Congenital corneal anaesthesia occurs either alone or in association with neurological diseases or systemic congenital abnormalities. It is important to search for corneal anaesthesia in children with chronic ulcerations of the cornea and self-inflicted injuries. Early diagnosis and treatment are important due to the risk of poor visual prognosis. Management of CCA should aim for the prevention of epithelial defects and is a life-long process.

  7. Corneal Higher Order Aberrations in Granular, Lattice and Macular Corneal Dystrophies

    Science.gov (United States)

    Yagi-Yaguchi, Yukari; Yamaguchi, Takefumi; Okuyama, Yumi; Satake, Yoshiyuki; Tsubota, Kazuo; Shimazaki, Jun

    2016-01-01

    Purpose To evaluate the corneal higher-order aberrations (HOAs) in granular, lattice and macular corneal dystrophies. Methods This retrospective study includes consecutive patients who were diagnosed as granular corneal dystrophy type2 (GCD2; 121 eyes), lattice corneal dystrophies type 1, type 3A (LCDI; 20 eyes, LCDIIIA; 32 eyes) and macular corneal dystrophies (MCD; 13 eyes), and 18 healthy control eyes. Corneal HOAs were calculated using anterior segment optical coherence tomography, and the correlations between HOAs and visual acuity were analyzed. Results HOAs of the total cornea within 4 mm diameter were significantly larger in GCD2 (0.17 ± 0.35 μm), in LCDI (0.33 ± 0.27), LCDIIIA (0.61 ± 1.56) and in MCD (0.23 ± 0.18), compared with healthy controls (0.09 ± 0.02μm, all P GCD2 (0.32 ± 0.48), in LCDI (0.60 ± 0.46), LCDIIIA (0.83 ± 2.29) and in MCD (0.44 ± 0.24), compared with healthy controls (0.19 ± 0.06, all P GCD2, there was no significant correlation between logMAR and HOAs (r = 0.113, P = 0.227). In MCD, LCDI and LCDIIIA, logMAR was positively significantly correlated with HOAs (r = 0.620 and P = 0.028, r = 0.587 and P = 0.007, r = 0.614 and P < 0.001, respectively). Conclusions Increased HOAs occur in eyes with corneal dystrophies, especially in eye with LCD and MCD. Larger amount corneal HOAs are associated with poorer visual acuity in patients with LCD and MCD. PMID:27536778

  8. Effect of posterior multilevel vertebral osteotomies on coronal and sagittal balance in fused scoliosis deformity caused by previous surgery: preliminary results.

    Science.gov (United States)

    Yang, Jae Hyuk; Suh, Seung Woo; Cho, Won Tae; Hwang, Jin Ho; Hong, Jae Young; Modi, Hitesh N

    2014-10-15

    Prospective case series study. To study the effect of posterior multilevel vertebral osteotomy (posterior crack osteotomy) on coronal and sagittal balance in patients with the fusion mass over the spine caused by previous surgery. Few studies have investigated revisional scoliosis surgery with the fusion mass using osteotomy. Among patients who had a history of prior surgery for scoliosis correction and posterior fusion, those showing progression of the curve postoperatively due to nonunion, implant failure, or adding-on phenomenon were enrolled. All patients were treated using posterior crack osteotomy. For clinical evaluation, the pre- and postoperative Gross Motor Function Classification System score for walking status and the Berg balanced scale were used. For radiological evaluation, pre- and postoperative Cobb angle, and coronal and sagittal balance factors were used. Ten patients (5 males and 5 females) were enrolled. The preoperative diagnosis was neuromuscular scoliosis (3 cases), syndromic scoliosis (1 case), congenital scoliosis (5 cases), and neurofibromatosis (1 case). Osteotomies were performed at 3.3±1.3 levels on average. Pre- and postoperative Cobb angles were 70.8°±30.0° and 28.1°±20.0° (P=0.002 (0.97)), respectively. In pre- and postoperative evaluation of coronal balance, the coronal balance, clavicle angle, and T1-tilt angle were 36.8±27.1 mm and 10.4±8.5 mm, 6.7°±8.0° and 3.3°±1.5°, and 7.8°±19.0° and 4.7°±2.1°, respectively (P=0.002, 0.002, 0.002). In pre- and postoperative evaluation of sagittal balance, the spinal vertical axis, thoracic kyphosis, and lumbar alignments were 25.1±37.8 mm and 14.1±21.8 mm, 33.5°±51.1° and 29.7°±27.4°, and 45.7°±34.8° and 48.9°±23.1° (P=0.002, 0.169, 0.169). The walking and functional statuses did not change (P=0.317, 0.932). Although pulmonary and gastrointestinal complications were noted, the patients were discharged without complications. Posterior crack osteotomy can be

  9. Elimination of Anterior Corneal Steepening With Descemet Membrane Endothelial Keratoplasty in a Patient With Fuchs Dystrophy and Keratoconus: Implications for IOL Calculation.

    Science.gov (United States)

    Gupta, Reena; Kinderyte, Ruta; Jacobs, Deborah S; Jurkunas, Ula V

    2017-10-01

    To report a case of coexistent Fuchs endothelial corneal dystrophy (FECD) and keratoconus (KCN) in which there was normalization of corneal topography after Descemet membrane endothelial keratoplasty (DMEK). Retrospective medical record review. Preoperative findings revealed a best-corrected visual acuity of 20/40 with -1.00 - 2.50 × 147, topographic maximum keratometry of 50.8 D with inferior steeping, and confluent guttae in the left eye. Medical record review revealed myopic shift, but little change in keratometry or corneal thickness over the previous 3 years. The patient developed epithelial edema with contact lens trial, highlighting endothelial dysfunction and eliminating the option of contact lenses for visual rehabilitation. Combined DMEK and cataract extraction with intraocular lens implantation was undertaken. Postoperatively, best-corrected visual acuity was 20/20 with only spherical correction. Elimination of stromal edema led to flattening of maximum anterior keratometry to 46.3 D and reduction of total corneal refractive power (TCRP) by 4.4 D. There was an unanticipated postoperative refractive error of +3.75 D consistent with this normalization of corneal topography. This is the first case report of the role of DMEK in normalizing corneal topography in coexistent FECD and KCN. The potential impact of DMEK on anterior curvature and TCRP must be considered in intraocular lens power calculation for cataract surgery in patients with FECD and KCN.

  10. The relationship between central corneal thickness and corneal curvature in adult Nigerians

    Directory of Open Access Journals (Sweden)

    E. Iyamu

    2011-12-01

    Full Text Available Purpose: The aim of this study was to provide average values for central corneal thickness (CCT and corneal curvature (CC and also to determine a regression model for the relationship between CCT and CC in adult Nigerians without glaucoma.Methods: A total of 95 subjects consisting of 56 males and 39 females aged between 20 and 69 years with mean age of 47.1 ± 14.1 years were recruited for the study. Central corneal thickness was measured by ultrasound pachymetry (SW-1000P ultrasound pachymeter, Tianjin Suowei Electronic Technology, China and corneal curvature was measured by keratometry (Bausch & Lomb keratometer H-135A, USA.Results: The average values of 550.1 ± 33.1µm and 43.0 ± 1.1 D were obtained for CCT and CC respectively. CCT significantly correlated with age (p=0.01, and the regression model predicts a decrease of 6.0 µm in CCT per decade. No significant association was found between CC and age (p=0.56. Also, no significant association was found between CCT and CC (p=0.07. Female subjects had significantly steeper corneas than their male counterparts.Conclusion: Central corneal thickness decreases with increasing age. Neither CCT nor age appear to be significantly correlated with corneal curvature. (S Afr Optom 2011 70(1 44-50

  11. Quantitative proteomic analysis of mice corneal tissues reveals angiogenesis-related proteins involved in corneal neovascularization.

    Science.gov (United States)

    Shen, Minqian; Tao, Yimin; Feng, Yifan; Liu, Xing; Yuan, Fei; Zhou, Hu

    2016-07-01

    Corneal neovascularization (CNV) was induced in Balb/c mice by alkali burns in the central area of the cornea with a diameter of 2.5mm. After fourteen days, the cornea from one eye was collected for histological staining for CNV examination, while the cornea from the other eye of the same mouse was harvested for proteomic analysis. The label-free quantitative proteomic approach was applied to analyze five normal corneal tissues (normal group mice n=5) and five corresponding neovascularized corneal tissues (model group mice n=5). A total of 2124 proteins were identified, and 1682 proteins were quantified from these corneal tissues. Among these quantified proteins, 290 proteins were significantly changed between normal and alkali burned corneal tissues. Of these significantly changed proteins, 35 were reported or predicted as angiogenesis-related proteins. Then, these 35 proteins were analyzed using Ingenuity Pathway Analysis Software, resulting in 26 proteins enriched and connected to each other in the protein-protein interaction network, such as Lcn-2, αB-crystallin and Serpinf1 (PEDF). These three significantly changed proteins were selected for further Western blotting validation. Consistent with the quantitative proteomic results, Western blotting showed that Lcn-2 and αB-crystallin were significantly up-regulated in CNV model, while PEDF was down-regulated. This study provided increased understanding of angiogenesis-related proteins involved in corneal vascular development, which will be useful in the ophthalmic clinic of specifically target angiogenesis.

  12. Corneal injuries from liquid detergent pods.

    Science.gov (United States)

    Gray, Michael E; West, Constance E

    2014-10-01

    Laundry and dishwasher detergent "pods" were introduced to the United States market in 2010 and are sold by several manufacturers. They represent a high percentage of household cleaning product exposure in the United Kingdom. We present a consecutive case series of 10 children seen in a 9-month period with corneal injuries from exposure to liquid detergent pods.

  13. Serological profile of candidates for corneal donation

    Directory of Open Access Journals (Sweden)

    Adroaldo Lunardelli

    2014-10-01

    Full Text Available Objetive: The purpose of this study is to map the serological profile of candidates to corneal donation at Irmandade Santa Casa de Misericórdia de Porto Alegre, identifying the percentage of disposal by serology and the marker involved. Methods: There have been analised – retrospectively – the results of serology of all corneal donors, made between the period of 1st january 2006 and 31st december 2012. Data analised were related to age, gender and the results of serology pertinent to viral markers (HBsAg, anti-HBc, anti-HCV and anti-HIV, these, determined by immunosorbent tests (ELISA. Results: In the period of the study, there were 2476 corneal donors at the institution, with a major incidence on the male gender, on an average of 58.7 years old. 23% of retention because of serological unfitness was also identified, that is, 570 samples were non-negative to any of the used tests. The marker anti- HBc was the most prevalent on the studied population, followed by the Hepatitis C virus (HCV and by the Human Immunodeficiency Virus (HIV. Conclusion: From the data found through this study, it is essential to have the participation of an efficient service on the serological evaluation of the candidates to corneal donation, once the security of the receptor must be taken into consideration in a population of donors with 23% of unfitness prevalence, in which the most prevalent marker is the one of Hepatits B.

  14. Peptide Amphiphiles in Corneal Tissue Engineering

    Directory of Open Access Journals (Sweden)

    Martina Miotto

    2015-08-01

    Full Text Available The increasing interest in effort towards creating alternative therapies have led to exciting breakthroughs in the attempt to bio-fabricate and engineer live tissues. This has been particularly evident in the development of new approaches applied to reconstruct corneal tissue. The need for tissue-engineered corneas is largely a response to the shortage of donor tissue and the lack of suitable alternative biological scaffolds preventing the treatment of millions of blind people worldwide. This review is focused on recent developments in corneal tissue engineering, specifically on the use of self-assembling peptide amphiphiles for this purpose. Recently, peptide amphiphiles have generated great interest as therapeutic molecules, both in vitro and in vivo. Here we introduce this rapidly developing field, and examine innovative applications of peptide amphiphiles to create natural bio-prosthetic corneal tissue in vitro. The advantages of peptide amphiphiles over other biomaterials, namely their wide range of functions and applications, versatility, and transferability are also discussed to better understand how these fascinating molecules can help solve current challenges in corneal regeneration.

  15. Corneal topography measurements for biometric applications

    Science.gov (United States)

    Lewis, Nathan D.

    The term biometrics is used to describe the process of analyzing biological and behavioral traits that are unique to an individual in order to confirm or determine his or her identity. Many biometric modalities are currently being researched and implemented including, fingerprints, hand and facial geometry, iris recognition, vein structure recognition, gait, voice recognition, etc... This project explores the possibility of using corneal topography measurements as a trait for biometric identification. Two new corneal topographers were developed for this study. The first was designed to function as an operator-free device that will allow a user to approach the device and have his or her corneal topography measured. Human subject topography data were collected with this device and compared to measurements made with the commercially available Keratron Piccolo topographer (Optikon, Rome, Italy). A third topographer that departs from the standard Placido disk technology allows for arbitrary pattern illumination through the use of LCD monitors. This topographer was built and tested to be used in future research studies. Topography data was collected from 59 subjects and modeled using Zernike polynomials, which provide for a simple method of compressing topography data and comparing one topographical measurement with a database for biometric identification. The data were analyzed to determine the biometric error rates associated with corneal topography measurements. Reasonably accurate results, between three to eight percent simultaneous false match and false non-match rates, were achieved.

  16. Aspergillus terreus recovered from a corneal scraping.

    Science.gov (United States)

    Campbell, Suzanne

    2014-01-01

    A 52 year old, healthy male presented to his optometrist complaining of redness and irritation in the right eye. A foreign body was removed from the eye. The patient was started on ophthalmic solutions of vigamox and systane. At 48 hours, the patient reported increased redness, limited vision, and yellow discharge from the eye. The patient was referred to an ophthalmologist for further evaluation. Physical assessment revealed a superlative central infiltrate (extreme, centrally located injury that had permeated the cornea), diffuse corneal haze, and edema with a 3- to 4+ conjunctival injection and a 1 millimeter hypopyon (an effusion of pus into the anterior chamber of the eye). Corneal scrapings were collected for aerobic and anaerobic bacterial and fungal cultures. The patient was then prescribed. vancomycin, tobramycin, and natamycin ophthalmic eyedrops. On day three, fungal culture results indicated possible fungal forms seen. On day 12, results from the fungal culture of the corneal scraping revealed the causative agent to be Aspergillus terreus. Voriconazole eyedrops were added to the treatment regimen and continued for 10 weeks. The physician order for a fungal culture as well as laboratory data providing the final identification of Aspergillus terreus and laboratory comments indicating an elevated minimum inhibitory concentration (MIC) (> 2 microg/mL) to amphotericin B is associated with treatment failure positively impacted the patient outcome. After completion of the treatment regimen, a photo-therapeutic keratectomy (PTK) was performed in an attempt to remove the dense corneal scarring caused by the fungal infection.

  17. [Purulent corneal ulcers: etiology, pathogenesis, classification].

    Science.gov (United States)

    Kasparova, Evg A

    2015-01-01

    Advanced purulent corneal ulcer, as well as abscess, is a serious vision-threatening condition notable for its fulminant course and possible loss of the eye due to endophthalmitis. Its leading causes, pathogenesis, and classifications are described and analyzed in this paper.

  18. Autophagy in granular corneal dystrophy type 2.

    Science.gov (United States)

    Choi, Seung-Il; Kim, Eung Kweon

    2016-03-01

    Autophagy is a lysosomal degradative process that is essential for cellular homeostasis and metabolic stress adaptation. Defective autophagy is involved in the pathogenesis of many diseases including granular corneal dystrophy type 2 (GCD2). GCD2 is an autosomal dominant disorder caused by substitution of histidine for arginine at codon 124 (R124H) in the transforming growth factor β-induced gene (TGFBI) on chromosome 5q31. Transforming growth factor β-induced protein (TGFBIp) is degraded by autophagy, but mutant-TGFBIp accumulates in autophagosomes and/or lysosomes, despite significant activation of basal autophagy, in GCD2 corneal fibroblasts. Furthermore, inhibition of autophagy induces cell death of GCD2 corneal fibroblasts through active caspase-3. As there is currently no pharmacological treatment for GCD2, development of novel therapies is required. A potential strategy for preventing cytoplasmic accumulation of mutant-TGFBIp in GCD2 corneal fibroblasts is to enhance mutant-TGFBIp degradation. This could be achieved by activation of the autophagic pathway. Here, we will consider the role and the potential therapeutic benefits of autophagy in GCD2, with focus on TGFBIp degradation, in light of the recently established role of autophagy in protein degradation.

  19. Polysaccharide coating of human corneal endothelium

    DEFF Research Database (Denmark)

    Schroder, H D; Sperling, S

    1977-01-01

    Electron microscopy revealed the presence of a 600-1500 A thick layer of polysaccharide on the surface of human corneal endothelial cells. The surface layer was visualized by combined fixation and staining in a mixture of ruthenium red and osmium tetroxide. The coating material was stable...

  20. Traumatic wound dehiscence after corneal keratoplasty

    Directory of Open Access Journals (Sweden)

    Patrick Frensel Tzelikis

    2015-10-01

    Full Text Available ABSTRACTPurpose:To assess patient characteristics, risk factors, outcomes, and the treatment of wound dehiscence (WD in patients after corneal keratoplasty.Methods:Retrospective chart review of 11 eyes of 11 patients with corneal grafts who underwent repair of WD from January 1, 2004 to December 31, 2012 at Hospital Oftalmologico de Brasilia.Results:Eight (72.7% patients were men and three were women. Six (54.5% patients had deep anterior lamellar keratoplasty (DALK and 5 had penetrating keratoplasty. The mean age at trauma was 31.1 years. The mean time from corneal keratoplasty to WD was 12.82 months (range, 3-33 months. The mean best-corrected visual acuity of patients before trauma was 20/60 (0.48 logMAR and after final treatment was 20/160 (0.90 logMAR (P=0.15. In one case, visual acuity decreased to no light perception because of retinal detachment and phthisis bulbi. Accidental blunt trauma and fall were the most common causes of WD.Conclusion:Patients who undergo corneal keratoplasty have a life-long risk of WD. The full-thickness rupture at the graft-host junction in our study suggests that the junction remains vulnerable, even following DALK, and can rupture with trauma. In our series, depending upon the severity of the trauma, postkeratoplastic WD can be associated with a good visual prognosis.

  1. The collection of Adipose Derived Stem Cells using Water Jet Assisted Lipoplasty for their use in Plastic and Reconstructive Surgery: a preliminary study

    Directory of Open Access Journals (Sweden)

    Valeria Purpura

    2016-11-01

    Full Text Available The graft of autologous fat for the augmentation of soft tissue is a common practice frequently used in the field of plastic and reconstructive surgery. In addition, the presence of adipose derived stem cells (ASCs in adipose tissue stimulates the regeneration of tissue in which it is applied after the autologous fat grafting improving the final clinical results. Due to these characteristics, there is an increasing interest in the use of ASCs for the treatment of several clinical conditions. As a consequence, the use of clean room environment is required for the production of cell-based therapies. The present study is aimed to describe the biological properties of adipose tissue and cells derived from it cultured in vitro in clean room environment according to current regulation. The collection of adipose tissue was performed using the water – jet assisted liposuction in order to preserve an high cell viability increasing their chances of future use for different clinical application in the field of plastic and reconstructive surgery.

  2. Simultaneous Bimaxillary Surgery and Mandibular Reconstruction With a 3-Dimensional Printed Titanium Implant Fabricated by Electron Beam Melting: A Preliminary Mechanical Testing of the Printed Mandible.

    Science.gov (United States)

    Lee, Ui-Lyong; Kwon, Jae-Sung; Woo, Su-Heon; Choi, Young-Jun

    2016-07-01

    A woman presented with a long history of mandibular defects posterior to the left lower first premolar caused by inadequate reconstruction after removal of a tumor on the left side of the mandible. In the frontal view, extreme facial asymmetry was apparent. The dental midline of the mandible was deviated 10 mm to the left compared with the dental midline of the maxilla, and all maxillary teeth were inclined to the left owing to dental compensation. There was an 8-mm maxillary occlusal cant relative to the maxillary first molar. Bimaxillary surgery using computer-assisted designed and computer-assisted manufactured devices without an intermediate occlusal splint was performed to align the maxilla and mandible at the correct position, and reconstructive surgery for the mandible using a 3-dimensional printed titanium mandible was concurrently performed. In particular, during the virtual mandible design, 2 abutments that enabled the prosthetic restoration were included in the mandible using a computer-assisted design program. This report describes the successful functional and esthetic reconstruction of the mandible using electron beam melting technology, an alternative technique for reconstruction of mandibles that did not undergo radiation therapy. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Detection of non-alcoholic steatohepatitis in patients with morbid obesity before bariatric surgery: preliminary evaluation with acoustic radiation force impulse imaging

    Energy Technology Data Exchange (ETDEWEB)

    Guzman-Aroca, F.; Reus, M.; Dios Berna-Serna, Juan de [Virgen de la Arrixaca University Hospital, Department of of Radiology, El Palmar, Murcia (Spain); Frutos-Bernal, M.D.; Lujan-Mompean, J.A.; Parrilla, P. [Virgen de la Arrixaca University Hospital, Department of Surgery, El Palmar, Murcia (Spain); Bas, A. [Virgen de la Arrixaca University Hospital, Department of Pathology, El Palmar, Murcia (Spain)

    2012-11-15

    To investigate the utility of acoustic radiation force impulse (ARFI) imaging, with the determination of shear wave velocity (SWV), to differentiate non-alcoholic fatty liver disease (NAFLD) from non-alcoholic steatohepatitis (NASH) in patients with morbid obesity before bariatric surgery. Thirty-two patients with morbid obesity were evaluated with ARFI and conventional ultrasound before bariatric surgery. The ARFI and ultrasound results were compared with liver biopsy findings, which is the reference standard. The patients were classed according to their histological findings into three groups: group A, simple steatosis; group B, inflammation; and group C, fibrosis. The median SWV was 1.57 {+-} 0.79 m/s. Hepatic alterations were observed in the histopathological findings for all the patients in the study (100 %), with the results of the laboratory tests proving normal. Differences in SWV were also observed between groups A, B and C: 1.34 {+-} 0.90 m/s, 1.55 {+-} 0.79 m/s and 1.86 {+-} 0.75 m/s (P < 0.001), respectively. The Az for differentiating NAFLD from NASH or fibrosis was 0.899 (optimal cut-off value 1.3 m/s; sensitivity 85 %; specificity 83.3 %). The ARFI technique is a useful diagnostic tool for differentiating NAFLD from NASH in asymptomatic patients with morbid obesity. (orig.)

  4. Treatment of non-healing sternum wound after open-heart surgery with allogenic platelet-rich plasma and fibrin glue-preliminary outcomes

    Directory of Open Access Journals (Sweden)

    Mohammad Abbasi Tashnizi

    2013-01-01

    Full Text Available Introduction: Non-healing wound in the sternal region after coronary arteries bypass graft surgery is a serious complication. For healing a chronic wound, several novel approaches have been proposed recently such as using bone marrow stem cells, platelets and fibrin glue (PFG; but a non-invasive method is highly desirable in the first approach for treatment. The current study was undertaken to evaluate the effect of the combination of PFG in one treatment. Materials and Methods: We report on the treatment of six patients with life-threatening chronic sternum wounds, which caused septicemia with multi-drug resistant pathogens. The ulcers were extensively debrided initially and were measured and photographed at weekly intervals. The combination of PFG was applied topically on the wound after every 2 days. Results: The wounds were completely closed in five patients and significantly reduced in size in one. There was no evidence of local or systemic complications and any abnormal tissue formation, keloid or hypertrophic scarring. Conclusions: Our study suggests, in the first approach, PFG can be used safely in order to heal a non healing sternum wound following coronary artery bypass surgery.

  5. A CT-ultrasound-coregistered augmented reality enhanced image-guided surgery system and its preliminary study on brain-shift estimation

    Science.gov (United States)

    Huang, C. H.; Hsieh, C. H.; Lee, J. D.; Huang, W. C.; Lee, S. T.; Wu, C. T.; Sun, Y. N.; Wu, Y. T.

    2012-08-01

    With the combined view on the physical space and the medical imaging data, augmented reality (AR) visualization can provide perceptive advantages during image-guided surgery (IGS). However, the imaging data are usually captured before surgery and might be different from the up-to-date one due to natural shift of soft tissues. This study presents an AR-enhanced IGS system which is capable to correct the movement of soft tissues from the pre-operative CT images by using intra-operative ultrasound images. First, with reconstructing 2-D free-hand ultrasound images to 3-D volume data, the system applies a Mutual-Information based registration algorithm to estimate the deformation between pre-operative and intra-operative ultrasound images. The estimated deformation transform describes the movement of soft tissues and is then applied to the pre-operative CT images which provide high-resolution anatomical information. As a result, the system thus displays the fusion of the corrected CT images or the real-time 2-D ultrasound images with the patient in the physical space through a head mounted display device, providing an immersive augmented-reality environment. For the performance validation of the proposed system, a brain phantom was utilized to simulate brain-shift scenario. Experimental results reveal that when the shift of an artificial tumor is from 5mm ~ 12mm, the correction rates can be improved from 32% ~ 45% to 87% ~ 95% by using the proposed system.

  6. Thyroid Surgery

    Science.gov (United States)

    ... Fax/Phone Home » Thyroid Surgery Leer en Español Thyroid Surgery GENERAL INFORMATION Your doctor may recommend that ... made in conjunction with your endocrinologist and surgeon. Thyroid Surgery FAQs QUESTIONS AND CONSIDERATIONS When thyroid surgery ...

  7. Plastic Surgery

    Science.gov (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Plastic Surgery KidsHealth > For Teens > Plastic Surgery Print A A ... forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word "plastic" ...

  8. Oxygen-deficient metabolism and corneal edema.

    Science.gov (United States)

    Leung, B K; Bonanno, J A; Radke, C J

    2011-11-01

    Wear of low-oxygen-transmissible soft contact lenses swells the cornea significantly, even during open eye. Although oxygen-deficient corneal edema is well-documented, a self-consistent quantitative prediction based on the underlying metabolic reactions is not available. We present a biochemical description of the human cornea that quantifies hypoxic swelling through the coupled transport of water, salt, and respiratory metabolites. Aerobic and anaerobic consumption of glucose, as well as acidosis and pH buffering, are incorporated in a seven-layer corneal model (anterior chamber, endothelium, stroma, epithelium, postlens tear film, contact lens, and prelens tear film). Corneal swelling is predicted from coupled transport of water, dissolved salts, and especially metabolites, along with membrane-transport resistances at the endothelium and epithelium. At the endothelium, the Na+/K+ - ATPase electrogenic channel actively transports bicarbonate ion from the stroma into the anterior chamber. As captured by the Kedem-Katchalsky membrane-transport formalism, the active bicarbonate-ion flux provides the driving force for corneal fluid pump-out needed to match the leak-in tendency of the stroma. Increased lactate-ion production during hypoxia osmotically lowers the pump-out rate requiring the stroma to swell to higher water content. Concentration profiles are predicted for glucose, water, oxygen, carbon dioxide, and hydronium, lactate, bicarbonate, sodium, and chloride ions, along with electrostatic potential and pressure profiles. Although the active bicarbonate-ion pump at the endothelium drives bicarbonate into the aqueous humor, we find a net flux of bicarbonate ion into the cornea that safeguards against acidosis. For the first time, we predict corneal swelling upon soft-contact-lens wear from fundamental biophysico-chemical principles. We also successfully predict that hypertonic tear alleviates contact-lens-induced edema.

  9. Reasons For Not Performing Keratorefractive Surgery in Patients Seeking Refractive Surgery in a Hospital-Based Cohort in “Yemen”

    Science.gov (United States)

    Bamashmus, Mahfouth A.; Saleh, Mahmoud F.; Awadalla, Mohamed A.

    2010-01-01

    Background: To determine and analyze the reasons why keratorefractive surgery, laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) were not performed in patients who presented for refractive surgery consultation. Materials and Methods: A retrospective observational study was performed between January 2006 and December 2007 in the Yemen Magrabi Hospital. The case records of 2,091 consecutive new patients who presented for refractive surgery were reviewed. Information from the pre-operative ophthalmic examination, such as refractive error, corneal topography and visual acuity, were analyzed. The reasons for not performing LASIK and PRK in the cases that were rejected were recorded and analyzed. Results: In this cohort, 1,660 (79.4%) patients were advised to have LASIK or PRK from the 2,091 patients examined. LASIK and PRK were not advised in 431 (21%) patients. The most common reasons for not performing the surgery were high myopia >-11.00 Diopters (19%), keratoconus (18%), suboptimal central corneal thickness (15%), cataract (12%) and keratoconus suspect (forme fruste keratoconus) (10%). Conclusion: Patients who requested keratorefractive surgery have a variety of problems and warrant comprehensive attention to selection criteria on the part of the surgeon. Corneal topographies and pachymetry of refractive surgery candidates need to be read cautiously. High-refractive error, keratoconus and insufficient corneal thickness were found to be the leading reasons for not performing keratorefractive surgery in this study. PMID:21180437

  10. Outcome of cataract surgery in rural areas of Kaduna State, Nigeria

    African Journals Online (AJOL)

    Aim: To evaluate the visual outcome of all patients who had cataract surgery with ... like striate keratopathy/corneal oedema (18.3%), cortical reminant .... Bio data and clinical data on each patient for cataract surgery were entered into the ...

  11. Delayed Descemet's membrane detachment after successful cataract surgery: a case report

    Directory of Open Access Journals (Sweden)

    Aileen Walsh

    2012-10-01

    Full Text Available The detachment of Descemet's membrane can be a serious complication following cataract surgery, leading to severe corneal edema and reduced visual acuity. This report describes an unusual case of Descemet's membrane detachment 6 months after successful phacoemulsification, documented by anterior segment optic coherence tomography (OCT; RTVue, Optovue. The eye was treated successfully with pneumatic descemetopexy and transcorneal suturing, with reattachment of Descemet's membrane. This report should alert physicians that delayed corneal edema can be related to late-onset Descemet's membrane detachment, which requires proper treatment to avoid permanent corneal decompensation.

  12. Preliminary study on magnetic tracking-based planar shape sensing and navigation for flexible surgical robots in transoral surgery: methods and phantom experiments.

    Science.gov (United States)

    Song, Shuang; Zhang, Changchun; Liu, Li; Meng, Max Q-H

    2017-10-05

    Flexible surgical robot can work in confined and complex environments, which makes it a good option for minimally invasive surgery. In order to utilize flexible manipulators in complicated and constrained surgical environments, it is of great significance to monitor the position and shape of the curvilinear manipulator in real time during the procedures. In this paper, we propose a magnetic tracking-based planar shape sensing and navigation system for flexible surgical robots in the transoral surgery. The system can provide the real-time tip position and shape information of the robot during the operation. We use wire-driven flexible robot to serve as the manipulator. It has three degrees of freedom. A permanent magnet is mounted at the distal end of the robot. Its magnetic field can be sensed with a magnetic sensor array. Therefore, position and orientation of the tip can be estimated utilizing a tracking method. A shape sensing algorithm is then carried out to estimate the real-time shape based on the tip pose. With the tip pose and shape display in the 3D reconstructed CT model, navigation can be achieved. Using the proposed system, we carried out planar navigation experiments on a skull phantom to touch three different target positions under the navigation of the skull display interface. During the experiments, the real-time shape has been well monitored and distance errors between the robot tip and the targets in the skull have been recorded. The mean navigation error is [Formula: see text] mm, while the maximum error is 3.2 mm. The proposed method provides the advantages that no sensors are needed to mount on the robot and no line-of-sight problem. Experimental results verified the feasibility of the proposed method.

  13. CONDUCCIÓN ANESTÉSICA DE LA CIRUGÍA CARDIACA MÍNIMAMENTE INVASIVA. ESTUDIO PRELIMINAR / Anesthetic management of minimally invasive cardiac surgery. Preliminary study

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    Miguel Ángel Carrasco Molina

    2012-10-01

    Full Text Available Resumen Introducción y objetivos: La cirugía cardíaca mínimamente invasiva ofrece muchas ventajas para los pacientes de alto riesgo; pero las dificultades de estos procedimientos no solo dependen de la técnica quirúrgica, sino de la conducta anestésica, lo que constituye un reto para el anestesiólogo cardiovascular. El objetivo de esta investigación fue demostrar la factibilidad de la conducta anestésica diseñada en el Cardiocentro CIMEQ para las técnicas quirúrgicas video−asistidas, y comparar el comportamiento de algunas variables en dos grupos de estudio. Método: Se realizó un estudio retrospectivo de los pacientes operados de corazón en los últimos tres años en el Cardiocentro CIMEQ. Se dividieron en dos grupos, según la técnica quirúrgica empleada. Los pacientes operados mediante cirugía cardíaca convencional (esternotomía media se incluyeron en el grupo 1, y los de cirugía cardíaca mínimamente invasiva se incluyeron en el grupo 2, en los que se utilizó una técnica anestésica diseñada al efecto. Resultados: El tiempo anestésico, quirúrgico, de circulación extracorpórea y de pinzamiento aórtico, así como el número de unidades de glóbulos rojos transfundidas por paciente fue significativamente menor en el grupo de cirugía cardíaca video−asistida. De forma similar se comportó la estadía en la Unidad de Cuidados Intensivos y en la Sala de Cardiología; y de igual manera, el inicio de la deambulación y las complicaciones posquirúrgicas. Conclusiones: La conducción anestésica con este protocolo de trabajo es segura y factible. Los pacientes operados por esta técnica tienen muy buena recuperación, con pocas complicaciones postoperatorias, y menor estadía hospitalaria; además, es una buena opción para los pacientes de alto riesgo necesitados de cirugía, que no cumplen los criterios para el tratamiento percutáneo. / Abstract Introduction and Objectives: Minimally invasive cardiac surgery

  14. Partial-thickness corneal tissue restoration after a chemical burn

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    Galan A

    2016-04-01

    Full Text Available Alessandro Galan, Anton Giulio Catania, Giuseppe Lo Giudice San Paolo Ophthalmic Center, San Antonio Hospital, Padova, Italy Purpose: We describe a case of full-thickness corneal restoration after an acute corneal burn with an acid agent. Methods: A 32-year-old male reported painful discomfort, redness, photophobia, and a decrease in visual acuity in the left eye after a unilateral burn with an acid agent. Slit-lamp examination revealed massive corneal melting involving necrotic sequestrum of the entire corneal surface. Surgical approach was carried out in order to preserve residual ocular tissues. Results: Extensive corneal–conjunctival layer curettage of the necrotic tissue was performed showing perfectly clear undamaged deep lamellar corneal layers. The patient underwent multilayered amniotic membrane transplantation and total capsular–conjunctival flap in order to preserve ocular tissue from further melting or corneal perforation. A complete and spontaneous “restitutio ad integrum” of the corneal layers was shown during the follow-up. The cornea was perfectly clear with restored normal anatomical architecture. Conclusion: In this case, a spontaneous full-thickness corneal tissue restoration occurred after an acute chemical burn. Studies about the mechanisms whereby different cells interact and replicate within the stroma may unveil the biology behind corneal regeneration and transparency. Keywords: amniotic membrane, chemical burn, corneal healing