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Sample records for pseudophakic corneal edema

  1. Longstanding refractory pseudophakic cystoid macular edema resolved using intravitreal 0.7 mg dexamethasone implants

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    Brynskov, Troels; Laugesen, Caroline Schmidt; Halborg, Jakob

    2013-01-01

    Refractory pseudophakic cystoid macular edema (PCME) following cataract surgery has long posed a challenge to clinicians, but intravitreal injections with a sustained delivery 0.7 mg dexamethasone implant has emerged as a promising therapy for this condition.......Refractory pseudophakic cystoid macular edema (PCME) following cataract surgery has long posed a challenge to clinicians, but intravitreal injections with a sustained delivery 0.7 mg dexamethasone implant has emerged as a promising therapy for this condition....

  2. Corneal collagen cross-linking effects on pseudophakic bullous keratopathy

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    Mohammad Mirzaei

    2014-05-01

    Full Text Available AIM: To evaluate the efficacy of riboflavin administration and ultraviolet A(UVAcross-linking on advanced symptomatic bullous keratopathy. METHODS: Fifteen patients with symptomatic pseudophakic bullous keratopathy(PBKwere included. Slit-lamp examination, visual acuity, foreign body sensation(FBSquestionnaire, corneal clarity grading, ocular pain intensity scale and corneal thickness measures with Pentacam and ultrasound pachymetry(UP, were performed before corneal cross-linking and 1 and 6mo thereafter. After using sodium chloride solution, for one week, the central 8mm(diameterof the corneal epithelium was removed, and cross-linking, with riboflavin instillation every 3min for 30min, and UVA irradiation for 30min was performed. RESULTS: Five males and 10 females with mean age of 66±13y were included. Mean follow up time was 6.2mo. Corneal transparency in all eyes was statistically significantly better 1 month after treatment than preoperatively(PP= 0.218. Foreign body sensation subsided in 70% of patients. The average CCT decreased within 1mo after the procedure(PP=0.006. The improvement in mean CDVA from preoperatively to 1mo postoperatively was statistically significant(P=0.010. At 6mo, no significant differences were observed(P=0.130. The pain scores at 1mo were statistically significantly better than preoperatively(P=0.007. At 6mo, however the mean pain score was higher than at 1mo and not statistically significantly different from the preoperative score(P=0.070. CONCLUSION: Corneal CXL significantly improved corneal transparency, corneal thickness, and ocular pain 1 month postoperatively. However, it did not seem to have a long-lasting effect in decreasing pain and maintaining corneal transparency in patients with PBK. This procedure extends the time interval for corneal transplantation and increases visualization at DSAEK procedure.

  3. Massive corneal edema treated with corneal cross-linking.

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    Laborante, A; Buzzonetti, L; Longo, C

    2012-01-01

    Massive corneal edema disrupts the fine architecture of corneal stroma that guarantees its transparency, causing opacities that seriously impair clear vision and are usually solved by corneal transplant. Corneal cross-linking, a treatment developed to halt keratoconus progression, results in a loss of water and a compaction of corneal stroma. It might therefore be useful to improve the pathologic edematous condition of some corneas, ameliorating visual acuity and allowing more time for a surgical procedure of keratoplasty. Six patients with visual impairing corneal edemas further to lens phacoemulsification, penetrating keratoplasty, or post-infective neovascularization were treated with corneal cross-linking alone, or in combination with amniotic membrane apposition with or without anti-angiogenic therapy. All patients partly resolved the edematous condition, improving both corneal transparency and visual acuity. Corneal cross-linking appears to be a useful method to treat massive corneal edemas, so that keratoplasty can be at least delayed, and need not to be an emergency treatment in these cases.

  4. Evaluation of corneal biomechanical properties using an ocular response analyser to examine aphakic and pseudophakic patients after congenital cataract surgery.

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    Simsek, Tulay; Soba, Dilek Ozçelik; Tırhış, Mehmet Hakan; Yılmazbaş, Pelin; Öztürk, Faruk

    2016-05-01

    We evaluated corneal biomechanical properties in aphakic and pseudophakic patients after congenital cataract surgery and compared the data with those of age-matched normal subjects. We included 43 eyes of 43 aphakic or pseudophakic patients treated via congenital cataract surgery. As controls, 42 healthy age- and sex-matched subjects were enrolled. After a complete ophthalmic examination, central corneal thickness (CCT) and intraocular pressure (IOP) were determined. Corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated IOP (IOPcc) and Goldmann-correlated IOP (IOPg) were recorded using an ocular response analyser. In the study group, 18 eyes were aphakic and 25 eyes pseudophakic. We found a significant difference in CCT between the aphakic, pseudophakic and control groups (p 0.05). We found significant differences in IOPcc, IOPg and IOP measured with Goldmann applanation tonometry (IOPGAT ) between the study and control groups (p 0.05). Although CCT increased after congenital cataract surgery, corneal biomechanical parameters, including CH and the CRF, were not affected by such surgery. Determination of the IOPcc did not provide any additional information on true IOP, which was independent of CCT in both aphakic and pseudophakic patients after congenital cataract surgery. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  5. Dexamethasone 0.7 mg implants in the management of pseudophakic cystoid macular edema

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    José Maurício Botto de Barros Garcia

    2016-04-01

    Full Text Available ABSTRACT Pseudophakic cystoid macular edema (PCME is a common complication following cataract surgery. Although majority of patients with PCME remain asymptomatic, it remains an important cause of vision loss after cataract surgery. The pathogenesis of PCME remains unclear, but most authors agree that inflammation plays a major role in its development. There is no standard algorithm for treatment procedures for PCME. A biodegradable 0.7 mg dexamethasone intravitreal implant can be used to deliver medication into the posterior segment of eyes. This drug acts on all inflammatory mediators and has been approved for the treatment of macular abnormalities secondary to retinal vein occlusion and for non-infectious posterior uveitis. In this case series, we report six patients who presented with PCME and were treated with a 0.7 mg dexamethasone intravitreal implant. Favorable anatomical outcomes were demonstrated by spectral domain-optical coherence tomography images.

  6. 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.

  7. Vitreous hyper-reflective dots in pseudophakic cystoid macular edema assessed with optical coherence tomography.

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    Wilfried Glatz

    Full Text Available This study compares the presence of vitreous hyper-reflective dots (VHDs detected with optical coherence tomography (OCT between eyes with pseudophakic cystoid macular edema (CME and those with no CME after cataract surgery. In addition, we evaluated the impact of VHDs on the responsiveness of pseudophakic CME to cortisone treatment.Department of Ophthalmology, Medical University of Graz, Austria.Retrospective, monocenter case-controlled study.Inclusion criteria for the study group and the control group were CME and no CME within 12 weeks following uneventful phacoemulsification in otherwise healthy eyes, respectively. VHDs (number and size and the macular thickness were assessed with OCT. Furthermore, the number of peribulbar or intravitreal steroid injections was assessed.A total of 284 eyes from 267 patients were analyzed, among which 119 met the inclusion criteria for the study (n = 63 and the control group (n = 56. VHDs were observed in 54 (85.7% study eyes and 21 (37.5%, p = 0.013 control eyes. The number of VHDs was 3.9±3.4 in the study group and 0.7±1 in the control group (p<0.001. The size of the VHDs was 33.5±9.1 μm and 36.6±17.9 μm in the study and control groups, respectively (p = 0.978. Overall, the number of VHDs correlated with central subfield thickness (r = 0.584, p<0.001, cube volume (r = 0.525, p<0.001, and postoperative best-corrected visual acuity (BCVA (r = -0.563, p<0.001. The number of VHDs did not correlate with the frequency of peribulbar or intravitreal steroid injections.VHDs occurred more often in eyes with CME than in eyes without CME following cataract surgery. In addition, the number of VHDs had an impact on the extent of macular thickening and subsequently postoperative BCVA. No correlation was found between the number of VHDs and the frequency of required peribulbar or intravitreal steroid injections.

  8. Changes in Corneal Biomechanical Properties After Descemet Stripping Automated Endothelial Keratoplasty for Pseudophakic Bullous Keratopathy.

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    Faramarzi, Amir; Feizi, Sepehr; Najdi, Danial; Ghiasian, Leila; Karimian, Farid

    2016-01-01

    To compare corneal biomechanical properties and intraocular pressure (IOP) in eyes with pseudophakic bullous keratopathy (PBK) before and after Descemet stripping automated endothelial keratoplasty (DSAEK). This prospective nonrandomized intrasubject comparative study was conducted on 44 eyes of 22 patients with the diagnosis of PBK who underwent DSAEK in one eye. IOP was measured by Goldmann applanation tonometer, and central corneal thickness was measured by ultrasound pachymetry. The ocular response analyzer was used to measure corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-related IOP, and cornea-compensated IOP. The same measurements were performed in the normal fellow eyes which served as controls. All measurements were performed preoperatively and 6 months postoperatively. The mean patient age was 67 ± 14 years. Mean preoperative CH and CRF values in the DSAEK group were 5.77 ± 2.94 and 6.39 ± 2.72 mm Hg, respectively, which were significantly lower than those measured in the control group (8.2 ± 2.47 and 8.43 ± 2.49 mm Hg, respectively, P = 0.001 for both comparisons). Postoperatively, CH and CRF demonstrated a significant increase (7.09 ± 3.68 mm Hg, P = 0.05 and 8.21 ± 3.84 mm Hg, P = 0.03, respectively) in operated eyes approaching the normal values measured in the control eyes. Corneal biomechanical parameters were significantly lower in PBK eyes than in the normal fellow eyes. These metrics significantly increased after DSAEK and reached values measured in the normal fellow eyes.

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

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    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.

  10. Bilateral reversible corneal edema associated with amantadine use.

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    Esquenazi, Salomon

    2009-12-01

    In this article, we report a case of bilateral severe reversible corneal edema caused by amantadine therapy. A 39-year-old women was referred to us for evaluation of bilateral corneal edema. Her past medical history was significant for multiple sclerosis, anorexia, and seizures. She developed painless progressive bilateral loss of vision for the past 6 months. She was evaluated by several ophthalmologists elsewhere who felt that the patient's visual loss was secondary to a nutritional deficiency as opposed to related to multiple sclerosis. She was started on vitamin B-12 medication without improvement in her symptoms. She was then evaluated by neuro-ophthalmology. The examination revealed severe bilateral corneal edema and was referred to our corneal service for further evaluation of her corneal condition. Our examination revealed best corrected visual acuity of 20/400 bilaterally. Corneal thickness was 940 microm in the right eye and 802 microm in the left. Color vision was intact. Conjunctivas were white bilaterally. Cornea evaluation revealed diffuse stromal edema and Descemet's folds and microcystic subepithelial edema with to guttae noted. Anterior chambers were deep and quiet. A specular microscopy revealed significant pleomorphism and polymegathism with an endothelial cell count of 1,504 cells in the right eye and 1,596 in the left eye. Review of the patient's medical information revealed therapy with amantadine 2 months prior to the appearance of the patient's symptoms as a means to control the patient's tremors. The patient experienced rapid resolution of the corneal edema within the next 2 months after discontinuation of the agent with recovery of best corrected visual acuity of 20/40 in the right eye and 20/30 in the left. In cases of unexplained corneal edema and in the absence of any identifiable ocular cause, a review of toxic effects of systemic medications should be performed. Early diagnosis may prevent irreversible endothelial damage. Amantadine

  11. Pseudophakic astigmatism reduction with femtosecond laser-assisted corneal arcuate incisions: a pilot study

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    Blehm C

    2017-01-01

    Full Text Available Clayton Blehm,1 Richard Potvin2 1Gainesville Eye Associates, Gainesville, GA, 2Science in Vision, Akron, NY, USA Purpose: The aim of this study was to assess the effectiveness of the Verion-LenSx guided arcuate incision technique to reduce refractive astigmatism in a pseudophakic population. Patients and methods: A prospective single-arm study was conducted in which one or both eyes of subjects required reduction of 1.0–2.0 D of refractive astigmatism after previous cataract surgery or refractive lens exchange. The surgeon used the refractive cylinder in the eye and the Woodcock astigmatism nomogram for preoperative planning, while the LenSx femtosecond laser with the Verion Image Guided System was used to create all arcuate incisions. The primary outcome measure was the uncorrected monocular distance visual acuity (UCVA. Secondary outcome measures included the change in corneal astigmatism, the change in refractive astigmatism, the best-corrected visual acuity and spectacle independence at distance from preoperative stage to 1 month and 2 months postoperatively. Results: Twenty-eight eyes of 18 subjects were treated. The best-corrected visual acuity at the 2-month postoperative (PO stage was not statistically significantly different from the preoperative visual acuity (0.02 logarithm of the minimum angle of resolution [logMAR] in both cases, P>0.05. Uncorrected visual acuity was statistically significantly better at the 2-month PO stage relative to the preoperative value (0.14 versus 0.34 logMAR, P<0.01. The mean change in refractive cylinder from the preoperative stage to the 2-month PO stage was 1.0 D. At the 2-month PO stage, two-thirds of the subjects (12/18 reported that they did not use glasses for distance vision and that their spectacle use for distance vision at 2 months was “lower” or “much lower” than the preoperative stage; in 71% of eyes (20/28, the residual refractive cylinder was ≤0.50 D. Vector changes in

  12. Comparison of dexamethasone intravitreal implant and intravitreal triamcinolone acetonide for the treatment of pseudophakic cystoid macular edema in diabetic patients

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    Dang Y

    2014-09-01

    Full Text Available Yalong Dang,1,* Yalin Mu,2,* Lin Li,3,* Yahui Mu,2 Shujing Liu,2 Chun Zhang,4 Yu Zhu,1 Yimin Xu4 1Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, 2Department of Ophthalmology, Yellow River Hospital, Henan University of Science and Technology, Sanmenxia, Henan Province, 3Department of Ophthalmology, the First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan Province, 4Department of Ophthalmology, Peking University Third Hospital, Haidian District, Beijing, People's Republic of China *These authors contributed equally to this work. Background and objective: Our objective was to investigate the efficacy and safety of dexamethasone (DEX implant for the treatment of pseudophakic cystoid macular edema (PCME in diabetic patients. Study design: This was a prospective, non-randomized, interventional case series of 43 participants. Eighteen patients were enrolled in the DEX implant group and 25 were enrolled in an intravitreal triamcinolone acetonide (IVTA group. Main outcome measures: The primary efficacy measurement was the percentage of patients who gained improvements of more than ten letters in best corrected visual acuity (BCVA during 6 months of follow-up. Other efficacy measurements included change in BCVA, change in central macular thickness (CMT, and number of retreatments. The primary safety evaluation was the percentage of patients with intraocular hypertension and variation in intraocular pressure (IOP during 6 months of follow-up. Other adverse events, such as conjunctival hemorrhage, eye pain, secondary infection, endophthalmitis, noninfectious inflammation, retinal detachment, and implant migration, were also recorded during follow-up. Results: At month 1, we observed that the percentage of patients gaining improvement of more than ten letters was similar in both groups (P=0.625. As patients in the IVTA group were retreated several times, this

  13. Combined Ab Interno Glaucoma Surgery Does not Increase the Risk of Pseudophakic Cystoid Macular Edema in Uncomplicated Eyes.

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    Schaub, Friederike; Adler, Werner; Koenig, Meike C; Enders, Philip; Dietlein, Thomas S; Cursiefen, Claus; Heindl, Ludwig M

    2017-03-01

    To assess the risk of pseudophakic cystoid macular edema (PCME) following cataract surgery (bimanual phacoemulsification with posterior chamber lens implantation) combined with ab interno glaucoma surgery (trabecular aspiration or ab interno trabeculotomy) compared with solely cataract extraction. In total, 360 consecutive eyes of 180 patients with age-related cataract, and thereof 162 with coexistent glaucoma, who underwent sole cataract surgery or in combination with ab interno glaucoma surgery (trabecular aspiration or ab interno trabeculotomy) were compared retrospectively regarding PCME development. Patients with known risk factors of PCME were excluded. Macular examination was performed using spectral-domain optical coherence tomography before and at 4, 8, 12, 16, 24, 36, and 48 weeks after surgery. Main outcome measure was the incidence of PCME. In total, 126 eyes (35%) underwent cataract surgery combined with ab interno glaucoma surgery (96 trabecular aspiration (76.2%), 30 ab interno trabeculotomy (23.8%), and 234 eyes (65%) received cataract surgery alone. PCME overall occurred in 23 eyes (6.4%). Following combined trabecular aspiration 5 eyes (5.2%) developed PCME, following ab interno trabeculotomy 2 eyes (6.7%), and following sole cataract surgery 16 eyes (6.8%), reaching no significant difference (P=0.676). Risk of PCME in fellow eye was significantly increased (P=0.025; odds ratio 7.177; 95% confidence interval, 5.667-8.687). Additional ab interno glaucoma surgery combined with phacoemulsification does not seem to increase the risk of PCME in uncomplicated eyes. However, in patients with history of PCME a significantly increased risk of PCME in fellow eye should be taken into account.

  14. Efficacy of intravitreal dexamethasone implant for prostaglandin-induced refractory pseudophakic cystoid macular edema: case report and review of the literature

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    Sacchi M

    2014-07-01

    Full Text Available Matteo Sacchi, Edoardo Villani, Francesca Gilardoni, Paolo Nucci University Eye Clinic, San Giuseppe Hospital, University of Milan, Milan, Italy Background: Macular edema is a known complication even after uneventful cataract surgery. The chronic use of prostaglandin analogs is a risk factor for the development of pseudophakic cystoid macular edema (CME. Nonsteroidal anti-inflammatory drugs (NSAIDs are considered first-line therapy but refractory postsurgical CME represents a therapeutic challenge, as there is not an evidence-based treatment.Objective: To report the use of a single implant of intravitreal dexamethasone for tafluprost-associated pseudophakic CME refractory to NSAIDs and to sub-Tenon’s corticosteroid injections.Case report: A 64-year-old female with ocular hypertension treated with tafluprost experienced decreased vision (visual acuity 20/60 and metamorphopsia 2 months after uneventful cataract extraction. Spectral domain optical coherence tomography (SD-OCT revealed CME. After 1 month of topical and oral NSAIDs, CME was still evident on SD-OCT (visual acuity 20/50. Two sub-Tenon’s betamethasone injections were performed at a 2-week interval. As CME was still present, 2 months after the diagnosis of CME (visual acuity 20/40, the patient underwent a single dexamethasone intravitreal implant. One month later, macular appearance was normal, and visual acuity increased to 20/30. This result was maintained throughout the 6 months of follow-up.Conclusion: In this report, a single implant of intravitreal dexamethasone successfully treated pseudophakic CME associated with the use of prostaglandin analogs unresponsive to NSAIDs and sub-Tenon’s betamethasone. The results of this report need to be corroborated by powered, prospective, randomized trials. The need for repeated treatments as well as the retreatment interval in patients requiring more than a single injection are issues still needing further investigations. Keywords

  15. Corona sign: manifestation of peripheral corneal epithelial edema as a possible marker of the progression of corneal endothelial dysfunction.

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    Inoue, Tomoyuki; Hara, Yuko; Kobayashi, Takeshi; Zheng, Xiaodong; Suzuki, Takashi; Shiraishi, Atsushi; Ohashi, Yuichi

    2016-09-01

    To describe a characteristic form of the corona sign and its clinical relevance to the degree of corneal endothelial decompensation and investigate the underlying mechanism using a rabbit model. These observational cases include 31 patients undergoing penetrating keratoplasty (PKP) and 15 patients undergoing Descemet stripping automated endothelial keratoplasty (DSAEK) with special attention to the circumferentially developed corneal epithelial edema. We also conducted a laboratory observation of horizontal water flow in the rabbit cornea. We consistently observed the corona sign at the superior periphery during the initial stage of corneal endothelial decompensation after PKP. With progressive corneal endothelial cellular loss, the epithelial edema gradually expanded circumferentially in the periphery. The endothelial cellular density associated with the corona sign significantly (P corona sign compared with a superior corona sign. After DSAEK, however, the corneal epithelial edema subsided from the center but persisted peripherally as a corona sign in all cases. By 3 months postoperatively, the epithelial edema was confined to the superior periphery along with uneventful corneal endothelial healing. Rabbit experiments showed that total corneal endothelial decompensation decreased the horizontal intracorneal water migration (Inoue-Ohashi phenomenon) in the corneal periphery and induced peripheral corneal edema. The slit-lamp microscopic findings of the corona-like epithelial edema in the peripheral cornea are associated with the stage of corneal endothelial function. To support this, the developmental mechanism of the corona sign was demonstrated experimentally.

  16. Toxic corneal epithelial edema from exposure to high atmospheric concentration of toluene diisocyanates.

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    Luckenbach, M; Kielar, R

    1980-11-01

    Exposure to organic isocyanates in the atmosphere of a polyurethane-foam-producing company resulted in microcystic corneal epithelial edema and conjunctival injection localized primarily in the palpebral fissure. The degree of microcystic edema and decreased visual acuity appeared to be related to location, length of exposure, ventilation, temperature, and amount of chemicals and premold stored. Clearing time varied with amount of exposure. Moderate amounts of microcystic edema caused an average fall of one line in the visual acuity. Pain was absent. The toxic effect of the isocyanates on the metabolism of the corneal epithelium may be the cause of the corneal epithelial edema.

  17. Transient Ingrowth of Lymphatic Vessels into the Physiologically Avascular Cornea Regulates Corneal Edema and Transparency.

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    Hos, Deniz; Bukowiecki, Anne; Horstmann, Jens; Bock, Felix; Bucher, Franziska; Heindl, Ludwig M; Siebelmann, Sebastian; Steven, Philipp; Dana, Reza; Eming, Sabine A; Cursiefen, Claus

    2017-08-03

    Lymphangiogenesis is essential for fluid homeostasis in vascularized tissues. In the normally avascular cornea, however, pathological lymphangiogenesis mediates diseases like corneal transplant rejection, dry eye disease, and allergy. So far, a physiological role for lymphangiogenesis in a primarily avascular site such as the cornea has not been described. Using a mouse model of perforating corneal injury that causes acute and severe fluid accumulation in the cornea, we show that lymphatics transiently and selectively invade the cornea and regulate the resolution of corneal edema. Pharmacological blockade of lymphangiogenesis via VEGFR-3 inhibition results in increased corneal thickness due to delayed drainage of corneal edema and a trend towards prolonged corneal opacification. Notably, lymphatics are also detectable in the cornea of a patient with acute edema due to spontaneous Descemet´s (basement) membrane rupture in keratoconus, mimicking this animal model and highlighting the clinical relevance of lymphangiogenesis in corneal fluid homeostasis. Together, our findings provide evidence that lymphangiogenesis plays an unexpectedly beneficial role in the regulation of corneal edema and transparency. This might open new treatment options in blinding diseases associated with corneal edema and transparency loss. Furthermore, we demonstrate for the first time that physiological lymphangiogenesis also occurs in primarily avascular sites.

  18. Retinal thickness assessed by optical coherence tomography (OCT in pseudophakic macular edema Espessura retiniana medida pela tomografia de coerência óptica (OCT no edema macular do pseudofácico

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    Maria Teresa Brizzi Chizzoti Bonanomi

    2006-08-01

    Full Text Available PURPOSE: To evaluate the usefulness of the optical coherence tomography (OCT retinal map in angiographic pseudophakic macular edema (ACME. METHODS: This is a prospective analysis of a group of 36 pseudophakic eyes at the fifth postoperative week, submitted to optical coherence tomography 2 macular map and fluorescein angiography on the same day and, a control group of twenty-two 20/20 vision eyes with a minimum 6-month postoperative period, submitted to optical coherence tomography 2 macular map only. Exclusion criteria were diabetes, any macular pathology and unreadable optical coherence tomography or angiogram. The angiograms were divided into three groups according to the edema intensity: Group I: level 0 (absence of angiographic pseudophakic macular edema; group II: levels 1 and 2 (incomplete and complete perifoveal angiographic pseudophakic macular edema respectively and group III: levels 3 and 4 (up to one disc diameter and greater than one disc diameter angiographic pseudophakic macular edema area respectively. The nine zones of the optical coherence tomography macular map were compared between the control and the three subgroups of the study group and, between group I and groups II and III. RESULTS: Among the 36 eyes, 23 (64% were classified as group I, 10 (28% as group II and three (8% as group III. The mean thickness of the fovea zone was 185±15 µm for the control group, 189±24 µm for group I, 213±33 µm for group II and 455±38 µm for group III. Significant differences: between group III and the control or group I for all zones (pOBJETIVO: Medir a espessura retiniana pela tomografia de coerência óptica (OCT no edema macular angiográfico do pseudofácico (ACME. MÉTODOS: Trabalho prospectivo composto de um grupo de estudo com 36 olhos pseudofácicos, entre a 4ª e a 6ª semana de pós-operatório, submetidos ao mapa macular com a tomografia de coerência óptica 2 e à angiofluoresceinografia no mesmo dia e, um grupo controle

  19. Preliminary observation on the effects of Huoxuelishuimingmu Granules in treating corneal edema after phacoemulsification

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    Qun-Ying Li

    2013-10-01

    Full Text Available AIM: To investigate the effects of Huoxuelishuimingmu Granules on corneal edema after phacoemulsification.METHODS: Ninety cases with at least second degree corneal edema the first day after phacoemulsification were randomly divided into the routinely treated group and the Huoxuelishuimingmu Granules intervened group, 45 cases for each group. To the routinely treated group, Tobramycin and Dexamethasone Eye Drops, Compound Tropicamide Eye Drops and Recombinant Bovine Basic Fibroblast Growth Factor Eye Drops were administered in turn during the treatment. While to the Huoxuelishuimingmu Granules intervened group, traditional Chinese medicines with the function of promoting blood circulation, alleviating water retention and removing nebula named Huoxuelishuimingmu Granules were additionally administered. The curative effects and the time taken for vanishment of corneal edema in each group were then observed. One week was counted as a course of treatment and curative effects were calculated after two courses.RESULTS: The Huoxuelishuimingmu Granules intervened group showed a much higher clinical cure rate and took quite shorter time for vanishment of corneal edema compared with the group treated with routine drugs(PP>0.05. CONCLUSION: Huoxuelishuimingmu Granules has a preferable clinical effect on corneal edema after phacoemulsification, shortening the duration of corneal edema and restoring the sight of patients in advance.

  20. Amantadine Use as a Risk Factor for Corneal Edema: A Nationwide Cohort Study in Taiwan.

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    Lee, Po Yen; Tu, Hung Pin; Lin, Chang Ping; Chang, Cheng Hsien; Cheng, Kai Chun; Lin, Chia Ching; Hsu, Shiuh Liang

    2016-11-01

    To evaluate the association between amantadine use and corneal toxicity in a nationwide population. Retrospective cohort study of nationwide population-based administrative database. This study analyzed data in the Taiwan Longitudinal Insurance Database for a group of 8195 patients diagnosed with Parkinson disease during a 15-year period (January 1, 1996 to December 31, 2010). A control group of 8195 patients without Parkinson disease was randomly matched with the Parkinson group by age, sex, and comorbidity index. The Kaplan-Meier method was used to calculate the cumulative incidence of corneal edema. Incident rate ratios and Cox proportional hazard regressions were estimated to compare the risk of corneal edema. The same methods were then used to compare the risk between patients with and without amantadine treatment. The incidence of corneal edema in the Parkinson group (123 patients; 1.50%) was significantly higher than that in the control group (82 patients; 1.0%) (P = .004). The incidence ratio for corneal edema in the Parkinson group vs the controls was 5.77. When the Parkinson group was further subgrouped by use and non-use of amantadine, the hazard ratio for corneal edema was 1.79 times higher in the amantadine subgroup. Analyses of the amantadine subgroup by cumulative dose revealed that the 30-day hazard ratio for corneal edema was 2.05 higher in patients given moderate doses (2000-4000 mg) of amantadine and 2.84 times higher in the subgroup of patients given high doses (>4000 mg). Amantadine increases the risk of corneal edema in a dose-dependent manner. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. A Simple Way to Clear the Media for Vitrectomy in Eyes with Corneal Edema

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    Touka Banaee

    2012-01-01

    Full Text Available Herein we introduce a simple approach for clearing an edematous cornea during vitreoretinal surgery in eyes with decompensated corneal endothelium, allowing the surgeon to postpone penetrating keratoplasty. This technique was performed in 3 eyes by filling the anterior chambers with air or silicone oil, and sufficiently cleared the media for completion of vitrectomy. This simple technique enables completion of the vitrectomy without a temporary keratoprosthesis and penetrating keratoplasty in eyes with corneal edema due to endothelial decompensation.

  2. Corneal Thickness as a Predictor of Corneal Transplant Outcome

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    Verdier, David D.; Sugar, Alan; Baratz, Keith; Beck, Roy; Dontchev, Mariya; Dunn, Steven; Gal, Robin L.; Holland, Edward J.; Kollman, Craig; Lass, Jonathan H.; Mannis, Mark J.; Penta, Jeffrey

    2013-01-01

    Purpose Assess corneal thickness (CT) and correlation with graft outcome after penetrating keratoplasty in the Cornea Donor Study. Methods 887 subjects with a corneal transplant for a moderate risk condition (principally Fuchs or pseudophakic corneal edema) had post-operative CT measurements throughout a 5 year follow up time. Relationships between baseline (recipient, donor, and operative) factors and CT were explored. Proportional hazards models were used to assess association between CT and graft failure. Relationship between CT and cell density was assessed with a longitudinal repeated measures model and Spearman correlation estimates. Results Higher longitudinal CT measurements were associated with diagnosis of pseudophakic or aphakic corneal edema (P 25mmHg during the first post-operative month (P=0.003), white (non-Hispanic) donor race (P=0.002) and respiratory causes of donor death (P600μm. In multivariate analysis, both 1 year CT and cell density were associated with subsequent graft failure (P=0.002 and 0.009). CT increase was modestly associated with endothelial cell loss during follow up (r=-0.29). Conclusion During the first 5 years following penetrating keratoplasty, CT can serve as a predictor of graft survival. However, CT is not a substitute for cell density measurement as both measures were independently predictive of graft failure. PMID:23343949

  3. Pseudophakic bullous keratopathy.

    Science.gov (United States)

    Taylor, D M; Atlas, B F; Romanchuk, K G; Stern, A L

    1983-01-01

    Pseudophakic bullous keratopathy (PBK) is a relatively new disease that is rapidly becoming the prime indication for penetrating keratoplasty. From 1977 thru 1981 we performed 81 corneal transplants on 66 eyes for this condition. In our experience, the incidence of PBK, with iris-supported lenses, is five times greater than aphakic bullous keratopathy (ABK). A series of 800 intracapsular cataract extractions (ICCE) with implantation of iris-supported lenses (1975-1979) were reviewed. Thirty-four patients (4.3%) developed PBK (average two years after surgery). In a series of 3,000 simple ICCEs (1955-1980), 24 patients (0.8%) developed ABK. Etiologic factors, methods of prevention, and the results of penetrating keratoplasty are considered. PBK following ICCE is a serious disease entity, usually of multifactorial origin. Though 88% of the patients have clear grafts, a high incidence of associated posterior segment disease tends to nullify the visual result. Planned extracapsular cataract extraction and posterior chamber lens insertion (1979-1982) has reduced our incidence of PBK to 0.3% (1/300). These results are promising but premature.

  4. Changes in corneal hysteresis after clear corneal cataract surgery.

    Science.gov (United States)

    Hager, Annette; Loge, Kristina; Füllhas, Marc-Oliver; Schroeder, Bernd; Grossherr, Martin; Wiegand, Wolfgang

    2007-09-01

    To assess the changes in corneal hysteresis (CH) as measured by the Ocular Response Analyzer (ORA; Reichert Ophthalmic Instruments, Buffalo, New York, USA) to describe the influence of clear corneal cataract surgery on corneal viscoelastic properties and intraocular pressure (IOP) measured by noncontact tonometry (NCT) and Goldmann applanation tonometry (GAT). Retrospective, interventional, comparative study. One hundred and one eyes of 101 consecutive patients who underwent routine clear corneal cataract surgery were evaluated. CH, NCT, and central corneal thickness (CCT) were measured by ORA before surgery and at postoperative day 1. A control group of 48 pseudophakic eyes (surgery >3 months previously) was included. CCT increased from 556.82 +/- 32.5 microm before surgery to 580.26 +/- 45.5 microm after surgery (P corneal cataract surgery, CH is diminished, whereas CCT is increased significantly. Postoperative corneal edema leads to a change of corneal viscoelastic properties, resulting in a lower damping capacity of the cornea. It is supposed that GAT and NCT measurements are significantly different because of postoperative changes in viscoelastic properties of the cornea.

  5. Effect of recombinant human epidermal growth factor eye drops and deproteinized calf blood extract eye drops on corneal edema after phacoemulsification

    National Research Council Canada - National Science Library

    Jia Wang

    2017-01-01

    AIM:To compare the effect of recombinant human epidermal growth factor eye drops and deproteinized calf blood extract eye drops on corneal edema after phacoemulsification. METHODS:Totally 72 cases(72 eyes...

  6. Effect of recombinant human epidermal growth factor eye drops and deproteinized calf blood extract eye drops on corneal edema after phacoemulsification

    Directory of Open Access Journals (Sweden)

    Jia Wang

    2017-08-01

    Full Text Available AIM:To compare the effect of recombinant human epidermal growth factor eye drops and deproteinized calf blood extract eye drops on corneal edema after phacoemulsification. METHODS:Totally 72 cases(72 eyesof patients undergoing phacoemulsification were selected and divided into the observation group and the control group by random number table method. After surgery, the observation group were treated with deproteinized calf blood extract eye drops while the control group were treated with recombinant human epidermal growth factor eye drops. The degree of corneal edema, subjective symptom score, corneal endothelium count, changes of corneal thickness and postoperative visual acuity recovery were compared between the two groups at different time points after surgery. RESULTS:Corneal edema in the two groups was significantly milder at 1wk after surgery than that on the 1st day after surgery(PP>0.05. Compared with 1d after surgery, the subjective symptom score and corneal thickness of the two groups significantly decreased on the 7th day after surgery(PPPCONCLUSION:Both of recombinant human epidermal growth factor eye drops and deproteinized calf blood extract eye drops can significantly relieve corneal edema and improve visual acuity of patients after phacoemulsification. However, the latter has obvious advantages over the former in the repair of corneal endothelial cell injury after surgery.

  7. Effect of Donor and Recipient Factors on Corneal Graft Rejection

    Science.gov (United States)

    Stulting, R. Doyle; Sugar, Alan; Beck, Roy; Belin, Michael; Dontchev, Mariya; Feder, Robert S.; Gal, Robin L.; Holland, Edward J.; Kollman, Craig; Mannis, Mark J.; Price, Francis; Stark, Walter; Verdier, David D.

    2014-01-01

    Purpose To assess the relationship between donor and recipient factors and corneal allograft rejection in eyes that underwent penetrating keratoplasty (PK) in the Cornea Donor Study. Methods 1090 subjects undergoing corneal transplantation for a moderate risk condition (principally Fuchs’ dystrophy or pseudophakic corneal edema) were followed for up to 5 years. Associations of baseline recipient and donor factors with the occurrence of a probable or definite rejection event were assessed in univariate and multivariate proportional hazards models. Results Eyes with pseudophakic or aphakic corneal edema (N=369) were more likely to experience a rejection event than eyes with Fuchs’ dystrophy (N=676) (34% ± 6% versus 22% ± 4%; hazard ratio = 1.56; 95% confidence interval 1.21 to 2.03). Among eyes with Fuchs’dystrophy, a higher probability of a rejection event was observed in phakic post-transplant eyes compared with eyes that underwent cataract extraction with or without intraocular lens implantation during PK (29% vs. 19%; hazard ratio = 0.54; 95% confidence interval 0.36 to 0.82). Female recipients had a higher probability of a rejection event than males (29% vs. 21%; hazard ratio=1.42; 95% confidence interval 1.08 to 1.87), after controlling for the effect of preoperative diagnosis and lens status. Donor age and donor recipient ABO compatibility were not associated with rejection. Conclusions There was a substantially higher graft rejection rate in eyes with pseudophakic or aphakic corneal edema compared with eyes with Fuchs’ dystrophy. Female recipients were more likely to have a rejection event than males. Graft rejection was not associated with donor age. PMID:22488114

  8. Detection of subepithelial fibrosis associated with corneal stromal edema by second harmonic generation imaging microscopy.

    Science.gov (United States)

    Morishige, Naoyuki; Yamada, Naoyuki; Teranishi, Shinichiro; Chikama, Tai-ichiro; Nishida, Teruo; Takahara, Atsushi

    2009-07-01

    Human corneas with or without stromal edema were examined by second harmonic generation (SHG) imaging microscopy to characterize stromal collagen organization. Tissue buttons from 31 corneas with stromal edema and 8 normal corneas were fixed, and 3-mm(2) blocks were cut and stained with phalloidin, to visualize the cytoskeleton. The blocks were examined by SHG imaging with a laser confocal microscope and a mode-locked titanium:sapphire femtosecond laser. Samples were scanned to a depth of 150 microm from the surface of Bowman's layer, and SHG forward- and backscatter signals were collected. Phalloidin staining was detected by conventional laser confocal microscopy. The three-dimensional structure of the anterior segment of the cornea was reconstructed from stacked SHG images. Three-dimensional reconstruction of SHG signals showed adherence of interwoven collagen lamellae in the anterior stroma to Bowman's layer in both normal and edematous corneas. Abnormal SHG signals at the level of Bowman's layer were observed in edematous corneas; three-dimensional images revealed that these signals were actually localized above Bowman's layer and were indicative of subepithelial fibrosis. Phalloidin staining showed transdifferentiation of stromal cells into fibroblastic cells in edematous corneas. The incidence of subepithelial fibrosis or of fibroblastic cells increased beginning 12 months after the onset of clinical stromal edema. SHG imaging of the anterior segment of edematous corneas revealed a normal appearance of interwoven collagen lamellae in the anterior stroma. The development of subepithelial fibrosis beginning 12 months after the onset of edema suggests that stromal edema may be a progressive disease.

  9. Catarata polar anterior piramidal deslocada para a câmara anterior causando edema de córnea: relato de caso Corneal edema caused by a pyramidal anterior polar cataract dislocated to the anterior chamber: case report

    Directory of Open Access Journals (Sweden)

    Ramon Coral Ghanem

    2004-08-01

    Full Text Available Cataratas polares anteriores piramidais são opacidades cônicas que se projetam para a câmara anterior a partir da cápsula anterior do cristalino. Na grande maioria dos pacientes a opacidade permanece aderida e estável durante toda a vida. O objetivo deste trabalho é documentar uma manifestação incomum desse tipo de catarata: a deiscência espontânea das pirâmides para a câmara anterior causando descompensação endotelial e edema corneal bilateral. Relatamos o caso de uma paciente feminina, de 66 anos, branca, que apresentava edema corneal localizado inferiormente no olho direito associado à lesão nodular branco-esclerótica compatível com a pirâmide anterior da catarata polar. O olho esquerdo apresentava edema corneal difuso intenso e presença de uma catarata polar anterior com a região piramidal deslocada para a câmara anterior. Sabe-se que a pirâmide anterior pode permanecer inabsorvida na câmara anterior por longo período, pois é composta de tecido colágeno denso. Isto causa perda endotelial progressiva e edema corneal e deve ser considerada indicação de remoção cirúrgica da catarata polar anterior e de seu fragmento. Ressalta-se, também, a importância do bom senso no julgamento das cataratas polares anteriores, considerando-se tamanho da opacidade, simetria das opacidades e componente cortical associado, na tentativa de se evitar ambliopia.Pyramidal anterior polar cataracts are conical opacities that project into the anterior chamber from the anterior capsule of the lens. In the vast majority of patients the opacity remains bound and stable throughout life. We report an unusual complication of this type of cataract: spontaneous dehiscence of the pyramids to the anterior chamber causing bilateral endothelial damage and corneal edema. 66-year-old white woman presented with inferior corneal edema in the right eye and diffuse corneal edema in the left eye. A white nodular lesion was observed in the inferior angle

  10. Effect of recombinant human epidermal growth factor eye drops and deproteinized calf blood extract eye drops on corneal edema after phacoemulsification

    OpenAIRE

    Jia Wang

    2017-01-01

    AIM:To compare the effect of recombinant human epidermal growth factor eye drops and deproteinized calf blood extract eye drops on corneal edema after phacoemulsification. METHODS:Totally 72 cases(72 eyes)of patients undergoing phacoemulsification were selected and divided into the observation group and the control group by random number table method. After surgery, the observation group were treated with deproteinized calf blood extract eye drops while the control group were treated with rec...

  11. The impact of corneal edema on intraocular pressure measurements using goldmann applanation tonometry, Tono-Pen XL, iCare, and ORA: an in vitro model.

    Science.gov (United States)

    Neuburger, Matthias; Maier, Philip; Böhringer, Daniel; Reinhard, Thomas; F Jordan, Jens

    2013-09-01

    Among other corneal biomechanical properties, Goldmann applanation tonometry (GAT) has been shown to depend on corneal edema. New tonometry devices have been designed, such as the Tono-Pen XL, iCare, and ocular response analyzer (ORA), to measure the intraocular pressure (IOP) accurately. This study aims to investigate the influence of corneal edema on the accuracy of these IOP-measuring devices in an in vitro model. A model of an artificial anterior chamber was developed using a guided trephination system. Eight donor corneas not suitable for keratoplasty were clamped into this artificial anterior chamber. All corneas showed signs of stromal edema. Intracameral pressure (ICP) was adjusted manometrically to 10, 20, 30, 40, and 50 mm Hg. The central corneal thickness (CCT) was determined by ultrasonic pachymetry. For each manometrically defined ICP, tonometry was performed using the iCare, Tono-Pen XL, GAT, and ORA. The mean CCT increased from 616.1±29.6 µm to 626.9±36.1 µm. At 10 mm Hg, GAT yielded a higher ICP than those manometrically adjusted (10.4±3.3 mm Hg); at all other ICP levels, GAT yielded lower ICP levels than those adjusted. The Tono-Pen XL and iCare showed the greatest difference at 10 mm Hg, with the Tono-Pen XL yielding a value of 14.0±4.0 mm Hg and the iCare yielding a value of 12.5±2.6 mm Hg. All other results of the 2 devices fell within a range of ±2 mm Hg from the adjusted ICP. The ORA provided accurate results only at "physiological" ICP levels with a maximum difference of 2.6 mm Hg at 30 mm Hg. At higher ICP levels, corneal hysteresis decreased significantly with increasing ICP. None of the measurement devices revealed a statistically relevant dependence on CCT in this experimental setting. The Tono-Pen XL and the iCare yielded the most accurate ICP values across all the adjusted ICP values. This may be because of their relatively small contact area with the cornea and, consequently, greater independence from corneal biomechanical

  12. Relationship between Corneal Guttae and Quality of Vision in Patients with Mild Fuchs' Endothelial Corneal Dystrophy.

    Science.gov (United States)

    Watanabe, Shinya; Oie, Yoshinori; Fujimoto, Hisataka; Soma, Takeshi; Koh, Shizuka; Tsujikawa, Motokazu; Maeda, Naoyuki; Nishida, Kohji

    2015-10-01

    To investigate the effect of the severity of corneal guttae on quality of vision (QOV) in patients with mild Fuchs' endothelial corneal dystrophy (FECD). Cross-sectional study. Twenty-three eyes of 14 patients with mild FECD without corneal edema on slit-lamp examination (5 pseudophakic eyes and 18 phakic eyes with mild lens opacity; grade 1.0-2.0 nuclear opalescence, grade 1.0-2.0 nuclear color, grade 1.0 cortical cataract, and grade 1.0 posterior subcapsular cataract on the Lens Opacities Classification System, version III). The area ratio of the corneal guttae (ARCG) in the endothelial cells was measured by multifocal specular microscopy. The QOV parameters, that is, corrected distance visual acuity (CDVA), letter contrast sensitivity (LCS), and intraocular straylight, also were measured. The correlations were assessed between the ARCG and QOV parameters and between the straylight and CDVA and LCS. The ARCG, logarithm of the minimum angle of resolution CDVA, LCS, and straylight. Univariate analysis showed that the ARCG was correlated significantly with the CDVA, LCS, and straylight (R(2) = 0.41, P = 0.001; R(2) = 0.55, P = 0.001; and R(2) = 0.39, P = 0.002, respectively). Univariate analysis also showed that straylight was correlated significantly with the CDVA and LCS (R(2) = 0.47, P = 0.001 and R(2) = 0.41, P = 0.001, respectively). Corneal guttae without edema caused the QOV to deteriorate in eyes with FECD. Patients with higher straylight had worse CDVA or LCS. Intraocular forward light scatter caused by corneal guttae may result in visual disturbances. Quantification of corneal guttae can be useful to evaluate the effect of guttae on the QOV and determine the surgical indications of endothelial keratoplasty for eyes with mild FECD. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  13. Refractive change following pseudophakic vitrectomy

    Directory of Open Access Journals (Sweden)

    Danjoux Jean-Pierre

    2008-10-01

    Full Text Available Abstract Background To assess the occurrence and magnitude of refractive change in pseudophakic eyes undergoing 20 gauge pars plana vitrectomy without scleral buckling and to investigate possible aetiological factors. Methods Retrospective case note review of 87 pseudophakic eyes undergoing 20 gauge pars plana vitrectomy for a variety of vitreo-retinal conditions over a three-year period. Anterior chamber depth (ACD was measured before and after vitrectomy surgery in 32 eyes. Forty-three pseudophakic fellow eyes were used as controls. Results Eighty-seven eyes (84 patients were included in the study. Mean spherical equivalent refraction prior to vitrectomy was -0.20 dioptres, which changed to a mean of -0.65 dioptres postoperatively (standard deviation of refractive change 0.59, range-2.13 to 0.75 dioptres (p Mean ACD preoperatively was 3.29 mm and postoperatively 3.27 mm (p = 0.53 (n = 32 and there was no significant change in ACD with tamponade use. Regression analysis revealed no statistically significant association between changes in anterior chamber depth, as well as a wide variety of other pre-, intra and postoperative factors examined, and the refractive change observed. Conclusion Significant refractive changes occur in some pseudophakic patients undergoing 20 g pars plana vitrectomy. The mean change observed was a small myopic shift but the range was large. The aetiology of the refractive change is uncertain.

  14. Traumatic aniridia in a pseudophakic patient 6 years following surgery

    Directory of Open Access Journals (Sweden)

    Mikhail M

    2012-02-01

    Full Text Available Mikel Mikhail1, Keyvan Koushan2, Rajeshvar K Sharda2, Gloria Isaza2, Keith D Mann21Michael G DeGroote School of Medicine, 2Division of Ophthalmology, Department of Surgery, McMaster University, Hamilton, ON, CanadaPurpose: To report a case of aniridia in a pseudophakic patient following blunt trauma to the eye.Case report: The traumatized eye had cataract surgery through a 3.0 mm clear corneal incision 6 years prior to the incident. While there have been previous cases of traumatic aniridia in pseudophakic eyes, previous reports have all occurred closer to the time of the cataract surgery. We believe that the most likely mechanism of loss of iris tissue is through wound dehiscence, which would suggest the relative instability of clear corneal incisions several years postoperatively. The patient's visual acuity returned to 20/20 4 weeks post-trauma, with symptoms of glare which were managed by the use of a colored contact lens.Conclusion: The possibility of wound dehiscence should be recognized as an important clinical entity in the immediate postoperative period, but also several years following cataract surgery.Keywords: anirida, pseudophakia, cataract extraction, cataract, phacoemulsification, trauma

  15. 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.

  16. The trabecular bypass stent in a pseudophakic glaucoma patient: A 1-year follow-up.

    Science.gov (United States)

    Fea, Antonio M; Dogliani, Monica; Machetta, Federica; Lale-Lacroix, Gabriella; Brogliatti, Beatrice; Grignolo, Federico M

    2008-12-01

    To describe the 1-year success of a trabecular stent implant in a pseudophakic glaucoma patient. The stent is implanted through a small corneal incision under gonioscopic control. Intraocular pressure control was reported in cultured human anterior segment. Observational case report. We report the case of a patient who was implanted and followed-up for 1 year at the Dipartimento di Fisiopatologia Clinica. The main outcome measures were intraocular pressure and visual field. The patient's intraocular pressure was controlled with topical beta-blockers for 6 months and without therapy for 6 months. Two diurnal curves demonstrated achievement of target pressure during the day. The 1-year visual field was unchanged. We are not aware of previous reports of trabecular stent implantation in pseudophakic patients. The trabecular stent had minimal peri-operative morbidity. Identification of the implantation site is challenging and reduction of efficacy over time may occur.

  17. Ocular straylight in the normal pseudophakic eye

    NARCIS (Netherlands)

    Łabuz, Grzegorz; Reus, Nicolaas J; van den Berg, Thomas J T P

    PURPOSE: To assess normal values for straylight in the pseudophakic eye as a function of age and to develop a model to predict the improvement in straylight after lens extraction based on preoperative straylight levels. SETTING: Rotterdam Ophthalmic Institute, Rotterdam, the Netherlands. DESIGN:

  18. Correction for near vision in pseudophakic patients

    Directory of Open Access Journals (Sweden)

    Dujić Mirjana

    2004-01-01

    Full Text Available Objective of the study was to show the mean values of correction for near vision and to discuss the presbyopic correction in pseudophakic patients. Setting was the Eye department where authors work. Inclusion criteria for 55 patients were native or corrected distant vision of 0.8-1.0 on Snellen's chart; 0,6 on Jagger's chart for near vision; round pupil and good position of the implant. Biometry of the anterior chamber depth with Alcon biophysics during distant and near vision was performed in our study. „Hi square" test was carried out and it was concluded that patients younger than 59 years (41 eyes had median correction of +2.0 dsph, while patients older than 60 years (36 eyes had correction of+3.0 dsph, but it was not statistically significant. There was no statistically significant difference of the correction between pseudophakic (41 and phakic (19 eyes in patients younger than 59 years. The anterior movement of the IOL was 0.18 mm in the younger group and 0.15 mm in the older group. With good IOL movement and new materials which could have changeable refractive power, the problem of pseudophakic correction for near vision might be solved.

  19. Donor Age and Corneal Endothelial Cell Loss 5 Years after Successful Corneal Transplantation: Specular Microscopy Ancillary Study Results

    Science.gov (United States)

    2010-01-01

    Objective To determine whether endothelial cell loss 5 years after successful corneal transplantation is related to the age of the donor. Design Multicenter, prospective, double-masked clinical trial. Participants Three hundred forty-seven subjects participating in the Cornea Donor Study who had not experienced graft failure 5 years after corneal transplantation for a moderate-risk condition (principally Fuchs’ dystrophy or pseudophakic corneal edema). Testing Specular microscopic images of donor corneas obtained before surgery and postoperatively at 6 months, 12 months, and then annually through 5 years were submitted to a central reading center to measure endothelial cell density (ECD). Main Outcome Measure Endothelial cell density at 5 years. Results At 5 years, there was a substantial decrease in ECD from baseline for all donor ages. Subjects who received a cornea from a donor 12 to 65 years old experienced a median cell loss of 69% in the study eye, resulting in a 5-year median ECD of 824 cells/mm2 (interquartile range, 613–1342), whereas subjects who received a cornea from a donor 66 to 75 years old experienced a cell loss of 75%, resulting in a median 5-year ECD of 654 cells/mm2 (interquartile range, 538–986) (P [adjusted for baseline ECD] = 0.04). Statistically, there was a weak negative association between ECD and donor age analyzed as a continuous variable (r [adjusted for baseline ECD] = −0.19; 95% confidence interval, −0.29 to −0.08). Conclusions Endothelial cell loss is substantial in the 5 years after corneal transplantation. There is a slight association between cell loss and donor age. This finding emphasizes the importance of longer-term follow-up of this cohort to determine if this relationship affects graft survival. PMID:18387408

  20. Optimal amount of anisometropia for pseudophakic monovision.

    Science.gov (United States)

    Hayashi, Ken; Yoshida, Motoaki; Manabe, Shin-Ichi; Hayashi, Hideyuki

    2011-05-01

    To determine the optimal target anisometropia for pseudophakic monovision. Thirty-five bilaterally pseudophakic patients who received monofocal intraocular lenses were included in the study. Binocular corrected distance visual acuity (CDVA) and binocular distance-corrected near visual acuity (DCNVA) and stereoacuity were measured after simulating 1.00, 1.50, and 2.00 diopters (D) of monovision by adding the appropriate spherical lens to the nondominant eye. We presumed that mean binocular DCNVA of 20/40, binocular CDVA of 20/25, and stereoacuity anisometropia, mean binocular DCNVA was 20/97, binocular CDVA was 20/20, and mean stereoacuity was 71 arc sec. With 1.00 D of monovision, mean binocular DCNVA was only 20/60, although binocular CDVA and mean stereoacuity were sufficient. With 1.50 D of monovision, binocular DCNVA was 20/38, binocular CDVA at other distances exceeded 20/21, and stereoacuity was 100 arc sec, which was a 29-arc sec reduction. With 2.00 D of monovision, binocular DCNVA reached 20/31, but stereoacuity was 158 arc sec, which was an 87-arc sec reduction. The number of patients who met the criteria for successful monovision was significantly greater with 1.50 D of monovision than with 1.00 or 2.00 D of monovision (P=.0134). Pseudophakic monovision with anisometropia of 1.50 or 2.00 D provides useful binocular visual acuity from far to near. However, because stereopsis with 2.00 D of monovision is substantially impaired, approximately 1.50 D of anisometropia is thought to be optimal for successful monovision. Copyright 2011, SLACK Incorporated.

  1. Corneal Laceration

    Medline Plus

    Full Text Available ... What Is Corneal Laceration? Corneal Laceration Symptoms What Causes Corneal Laceration? Corneal Laceration Diagnosis Corneal Laceration Treatment ... the corneal laceration is deep enough it can cause a full thickness laceration. This is when the ...

  2. Corneal Laceration

    Medline Plus

    Full Text Available ... What Is Corneal Laceration? Corneal Laceration Symptoms What Causes Corneal Laceration? Corneal Laceration Diagnosis Corneal Laceration Treatment What Is Corneal Laceration? Leer en Español: ¿Qué ...

  3. Pulmonary Edema

    Science.gov (United States)

    ... by viral infections such as the hantavirus and dengue virus. Lung injury. Pulmonary edema can occur after ... it may be fatal even if you receive treatment. Prevention Pulmonary edema is not always preventable, but ...

  4. Ocular biocompatibility testing of intraocular lenses: a 1 year study in pseudophakic rabbit eyes.

    Science.gov (United States)

    Norton, J N; Kohnen, T; Hackett, R B; Patel, A; Koch, D D

    1999-11-01

    To evaluate the appropriate duration for conducting ocular biocompatibility studies with an intraocular lens (IOL) in the pseudophakic rabbit model. Alcon Laboratories, Inc., Fort Worth, Texas, USA. A single-piece biconvex poly(methyl methacrylate) (PMMA) IOL was implanted in the capsular bag of 18 eyes of New Zealand white rabbits; 8 eyes received sham surgeries. Rabbits were monitored clinically and then sacrificed 6 or 12 months after surgery for histopathological examination of ocular tissues. Biomicroscopic examination revealed mild ocular changes in all surgical eyes during the first 3 months postoperatively. After that, there was a high incidence of posterior synechias, flare, and posterior capsule opacification (PCO) in eyes with PMMA IOLs. Posterior synechias and flare scores remained mild to moderate throughout the study, whereas PCO severity increased over time. Similar findings were observed in sham eyes. In addition, several eyes with PMMA IOLs developed IOL dislocation, hyphema, iris bombe, and a fibrous membrane covering the IOL. No discernible differences in biomicroscopic scores were observed in eyes at 6 or 12 months. Intraocular pressures and morphology of the corneal endothelium were normal in both groups. Results from histopathological analysis of the ocular tissues were consistent with observations from the biomicroscopic examinations. The results suggest that IOL implantation studies in the pseudophakic rabbit eye should be conducted for 3 or fewer months. Regulatory guidelines requiring longer ocular implantation studies should be revised to reflect the inherently rapid and extensive ocular response in the rabbit model.

  5. Comparison of central corneal edema and visual recovery between liquefaction and conventional phacoemulsification in soft cataracts Comparação do edema de córnea central e da recuperação visual após facoemulsificação por liquefação e convencional em cataratas moles

    Directory of Open Access Journals (Sweden)

    Celso Takashi Nakano

    2009-02-01

    Full Text Available PURPOSE: The aim of the present study is to assess central corneal edema and visual recovery after cataract surgery performed according to two technologies: conventional ultrasonic and liquefaction (Aqualase®. METHODS:This is a prospective contralateral study in wich 20 patients with comparable preoperative conditions were submitted to cataract surgery were evaluated. Preoperative assessment involved complete ophthalmological examination and the study included patients with bilateral cataracts up to grade 2, according to the Lens Opacity Classification System II. The same cristaline fracture technique was used in all cases, and surgical procedures were performed by the same experienced surgeon, using two technologies: liquefaction or conventional phacoemulsification. Postoperative central corneal edema was measured by corneal optical pachymetry (Orbscan II® on the 1st, 3rd, 7th and 10th postoperative days. RESULTS:None of the 20 patients submitted to surgery was lost during the postoperative follow-up or excluded from the analysis. On the first postoperative, the visual acuity average was 0.031 logMAR in the Aqualase® group and 0.043 logMAR in the conventional surgery group. No statistical difference was detected in the assessment of visual acuity throughout the postoperative period. Central corneal pachymetry varied from 543.93 + 34.69 preoperatively to 545.08 ± 25.67 on the last day of follow-up in the Aqualase® group, and from 543.13 + 30.62 to 536.08 + 34.89 in the conventional technique group, without statistical significance. CONCLUSION:This study suggests that both techniques are equally effective for surgery on lenses with grade I or II cataract, and that they provide similar results in terms of visual recovery and central corneal edema.OBJETIVO: Avaliar o edema corneano central e a recuperação visual após cirurgia de catarata realizada através de duas tecnologias: ultrassônica convencional e liquefação (Aqualase®. M

  6. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Macular Edema Sections What Is Macular Edema? What Causes Macular Edema? Macular Edema Symptoms Macular Edema Diagnosis ... particularly if it is left untreated. Next What Causes Macular Edema? Related Ask an Ophthalmologist Answers Would ...

  7. Factors influencing treatment results in pseudophakic endophthalmitis.

    Science.gov (United States)

    Koç, F; Sen, E; Demirbay, P; Taşkintuna, I; Teke, M Y; Ozdal, P; Ortaç, S; Oz, O; Tarkan, F; Firat, E

    2002-01-01

    To evaluate risk factors, therapeutic approaches and factors associated with the poor visual outcome in pseudophakic endophthalmitis. Data related to 28 cases with the diagnosis of endophthalmitis after cataract surgery and IOL implantation were gathered retrospectively. Preceding surgery was extracapsular cataract extraction (ECCE) in 18, phacoemulsification in 8 and scleral fixated intraocular lens implantation in two cases. Posterior capsule rupture and diabetes mellitus were considered to contribute to the development of endophthalmitis because of their high incidences (50% and 25%) in the study group. Microbiological studies from aqueous and vitreous humour were done in 85% of the cases and 58% were positive. S. Epidermidis was the most common organism, accounting for 50% of the isolates. All cases were given topical and systemic antibiotics. Inflammation was controlled by addition of subconjunctival antibiotics to this regimen in two, intravitreal antibiotic injection in 14, pars plana vitrectomy, total capsular and lens extraction and intravitreal antibiotic injection in three, lens exchange, intracapsular and intravitreal antibiotic injection in three cases. Six (21%) cases eventually needed evisceration. Visual acuity of 20/40 or better was achieved in 25%, and 20/100 or better in 64%. Treatment delay (p=0.039), capsular rupture complicating cataract surgery, especially with extracapsular cataract extraction (p=0.015), and initial visual acuity worse than hand motion (p=0.003) were strong predictors of poor visual outcome. The risk of endophthalmitis was not different forplanned ECCCE (0.26%) andphacoemulsification (0.27%) but the prognosis was better with the latter.

  8. Peripheral refraction in pseudophakic eyes measured by infrared scanning photoretinoscopy.

    Science.gov (United States)

    Tabernero, Juan; Ohlendorf, Arne; Fischer, M Dominik; Bruckmann, Anna R; Schiefer, Ulrich; Schaeffel, Frank

    2012-05-01

    To obtain quantitative data of peripheral refractive errors in pseudophakic eyes including measurements up to ±45 degrees on the retina. University Eye Hospital, Tübingen, Germany. Population-based cross-sectional study. Pseudophakic and phakic subjects were measured with a purpose-built scanning photorefractor. The instrument was improved over previous versions. It permits measurement of semicontinuous peripheral profiles over the central 90-degree field of the retina at a faster speed (4 s/scan). Twenty-four pseudophakic and 43 phakic subjects were enrolled. The intraocular lenses (IOLs) induced a mean myopic shift of 2.00 diopters (D) at ±45 degrees of eccentricity in the vertical pupil meridian. Ray-tracing simulations with phakic eye and pseudophakic eye models agreed well with the experimental data. They showed that changes induced by IOLs were a consequence of an increase in astigmatism with eccentricity and a myopic shift in the spherical equivalent. The peripheral refractions in pseudophakic eyes were more myopic than in phakic eyes as a consequence of the optical design of the IOLs. Whether a more myopic refraction of approximately 2.00 D at 45 degrees has significant effects on visual performance must be tested. Perhaps there is room for improvement in the peripheral optics of IOLs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  9. Spontaneous Corneal Hydrops in a Patient with a Corneal Ulcer

    Directory of Open Access Journals (Sweden)

    Hatim Batawi

    2016-01-01

    Full Text Available Purpose: We report the case of a 77-year-old man with no history of keratoconus or other ectatic disorders who presented with corneal hydrops in the setting of a corneal ulcer. The risk factors, pathogenesis and treatment options of corneal hydrops are discussed. Method: This is an observational case report study. Results: A 77-year-old man presented with a 1-day history of severe pain, redness, mucous discharge and photophobia in the right eye. A slit-lamp examination of the right eye showed an area of focal corneal edema and protrusion. Within the area of edema and protrusion, there was an infiltrate with an overlying epithelial defect consistent with an infectious corneal ulcer. The Seidel test showed no leakage, so a clinical diagnosis of corneal hydrops associated with nonperforated corneal ulcer was made. With appropriate antibiotic treatment, the corneal ulcer and hydrops both resolved over a 1-month period. Conclusion: Corneal hydrops can occur in the setting of corneal infections.

  10. Corneal endothelial cytotoxicity of the Calotropis procera (ushaar) plant.

    Science.gov (United States)

    Al-Mezaine, Hani S; Al-Amry, Mohammed A; Al-Assiri, Abdullah; Fadel, Talal S; Tabbara, Khalid F; Al-Rajhi, Ali A

    2008-05-01

    To report 6 eyes of 5 patients with transient corneal edema after exposure to the milky latex of Calotropis procera (ushaar). Interventional case series. Intracorneal penetration of ushaar latex can lead to permanent endothelial cell loss with morphologic alteration. Corneal edema resolved completely in approximately 2 weeks in all cases, despite reduced endothelial cell count and abnormal morphology. Corneal endothelial toxicity of ushaar latex is caused by its ability to penetrate the corneal stroma and induce permanent loss of endothelial cells. Corneal edema resolves if sufficient endothelial cell viability is still present after resolution of ushaar keratitis.

  11. Binocular visual function of myopic pseudophakic monovision.

    Science.gov (United States)

    Hayashi, Ken; Yoshida, Motoaki; Sasaki, Hiroshi; Hirata, Akira

    2018-02-20

    To compare binocular visual function of myopic pseudophakic patients with myopic monovision to patients without monovision. Randomized comparative study METHODS: Sixty patients were randomized to one of two groups: patients whose refraction was targeted to -2.75 diopters (D) in the dominant eye and -1.75D in the nondominant eye (myopic monovision group), and patients whose refraction was targeted to -2.75D bilaterally (non-monovision group). Binocular uncorrected and corrected visual acuity at various distances was measured using an all-distance vision tester, and contrast visual acuity and near stereoacuity were examined. In the myopic monovision group mean refraction was -2.74D in the dominant eyes and -1.94D in the nondominant eyes, and in the non-monovision group it was -2.96D bilaterally. Mean binocular uncorrected distance (UDVA) and intermediate visual acuity (UIVA) from 0.5 m to 5.0 m were significantly better in the myopic monovision group than in the non-monovision group (P≤ 0.0134), while binocular uncorrected near visual acuity (UNVA) at 0.3 m did not differ significantly between groups. The distribution of UIVA and UDVA was significantly better in the myopic monovision group (P≤ 0.0035). Corrected visual acuity at any distance, photopic and mesopic contrast visual acuity, and stereoacuity did not differ significantly between groups. Patients with myopic monovision exhibited significantly better binocular UIVA and UDVA than those without monovision, while UNVA, corrected visual acuity, contrast sensitivity, and stereoacuity were comparable between groups, suggesting that this method is useful for patients who want to see near and intermediate distances without spectacles.

  12. A systematic review of pseudophakic monovision for presbyopia correction

    Science.gov (United States)

    Labiris, Georgios; Toli, Aspa; Perente, Aslin; Ntonti, Panagiota; Kozobolis, Vassilios P.

    2017-01-01

    A systematic review of the recent literature regarding pseudophakic monovision as a reliable methods for presbyopia correction was performed based on the PubMed, MEDLINE, Nature and the American Academy of Ophthalmology databases in July 2015 and data from 18 descriptive and 12 comparative studies were included in this narrative review. Pseudophakic monosvision seems to be an effective method for presbyopia with high rates of spectacles independence and minimal dysphotopsia side-effects, that should be considered by the modern cataract surgeons. PMID:28730093

  13. Corneal Laceration

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    Full Text Available ... Corneal Laceration? Corneal Laceration Diagnosis Corneal Laceration Treatment What Is Corneal Laceration? Leer en Español: ¿Qué Es una Laceración de la Córnea? Written By: Daniel ...

  14. Corneal Graft Rejection Ten Years after Penetrating Keratoplasty in the Cornea Donor Study

    Science.gov (United States)

    Dunn, Steven P.; Gal, Robin L.; Kollman, Craig; Raghinaru, Dan; Dontchev, Mariya; Blanton, Christopher L.; Holland, Edward J; Lass, Jonathan H.; Kenyon, Kenneth R.; Mannis, Mark J; Mian, Shahzad I.; Rapuano, Christopher J.; Stark, Walter J.; Beck, Roy W.

    2015-01-01

    Purpose To assess the effect of donor and recipient factors on corneal allograft rejection and evaluate whether a rejection event was associated with graft failure. Methods 1,090 subjects undergoing penetrating keratoplasty for a moderate risk condition (principally Fuchs’ dystrophy or pseudophakic corneal edema) were followed for up to 12 years. Associations of baseline recipient and donor factors with the occurrence of a rejection event were assessed in univariate and multivariate proportional hazards models. Results Among 651 eyes with a surviving graft at 5 years, the 10-year graft failure (± 99% CI) rates were 12% ± 4% among eyes with no rejection events in the first 5 years, 17% ± 12% in eyes with at least one probable, but no definite rejection event, and 22% ± 20% in eyes with at least one definite rejection event. The only baseline factor significantly associated with a higher risk of definite graft rejection was a preoperative history of glaucoma, particularly when prior glaucoma surgery had been performed and glaucoma medications were being used at time of transplant (10-year incidence 35% ± 23% compared with 14% ± 4% in eyes with no history of glaucoma/intraocular pressure treatment, p=0.008). Conclusion Those patients who experienced a definite rejection event frequently went on to graft failure raising important questions as to how we might change acute and long-term corneal graft management. Multivariate analysis indicated that the prior use of glaucoma medications and glaucoma filtering surgery was a significant risk factor related to a definite rejection event. PMID:25119961

  15. Corneal Ulcer

    Science.gov (United States)

    ... Español Eye Health / Eye Health A-Z Corneal Ulcer Sections What Is a Corneal Ulcer? Corneal Ulcer ... Diagnosis Corneal Ulcer Treatment What Is a Corneal Ulcer? Leer en Español: ¿Qué es una Úlcera de ...

  16. Reversible Corneal Toxicity of Retained Intracameral Perfluoro-n-octane.

    Science.gov (United States)

    Alharbi, Saad S; Asiri, Mohammed S

    2016-01-01

    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.

  17. What Is Macular Edema?

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    Full Text Available ... Español Eye Health / Eye Health A-Z Macular Edema Sections What Is Macular Edema? What Causes Macular ... Edema Diagnosis Macular Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué Es un Edema Macular? ...

  18. Aniridia after blunt trauma and presumed wound dehiscence in a pseudophakic eye.

    Science.gov (United States)

    Kim, Kyeong Hwan; Kim, Wan Soo

    2016-02-01

    This was a report about a pseudophakic patient who experienced isolated total aniridia without damage to other intraocular structures following blunt trauma to the eye. This patient had a history of uneventful cataract surgery using a small clear corneal incision (CCI). This 71-year-old male presented at our clinic with glare in his left eye. He reported that he had fallen down while drunk and struck his left eye against a stone on the road 15 days earlier. He had undergone cataract surgery on his left eye nine months before the accident at another eye clinic. Slit-lamp examination showed total aniridia in his left eye, but there was no hyphema or cells in the anterior chamber. The intraocular lens in his left eye was stable, without decentration, dislocation, or zonular dehiscence and remained in an intact capsular bag. Review of the medical records from the surgical clinic at which he had undergone cataract surgery indicated no specific findings for any intraocular structure including the iris. He had previously undergone an uneventful phacoemulsification for his left eye through a 2.2 mm CCI, followed by the implantation of a single piece acrylic intraocular lens inside an intact capsular bag. This report showed that small-sized CCIs can be opened postoperatively by trauma and that this can result in isolated total aniridia without damage to other intraocular structures.

  19. Aniridia after blunt trauma and presumed wound dehiscence in a pseudophakic eye

    Directory of Open Access Journals (Sweden)

    Kyeong Hwan Kim

    2016-02-01

    Full Text Available ABSTRACT This was a report about a pseudophakic patient who experienced isolated total aniridia without damage to other intraocular structures following blunt trauma to the eye. This patient had a history of uneventful cataract surgery using a small clear corneal incision (CCI. This 71-year-old male presented at our clinic with glare in his left eye. He reported that he had fallen down while drunk and struck his left eye against a stone on the road 15 days earlier. He had undergone cataract surgery on his left eye nine months before the accident at another eye clinic. Slit-lamp examination showed total aniridia in his left eye, but there was no hyphema or cells in the anterior chamber. The intraocular lens in his left eye was stable, without decentration, dislocation, or zonular dehiscence and remained in an intact capsular bag. Review of the medical records from the surgical clinic at which he had undergone cataract surgery indicated no specific findings for any intraocular structure including the iris. He had previously undergone an uneventful phacoemulsification for his left eye through a 2.2 mm CCI, followed by the implantation of a single piece acrylic intraocular lens inside an intact capsular bag. This report showed that small-sized CCIs can be opened postoperatively by trauma and that this can result in isolated total aniridia without damage to other intraocular structures.

  20. Tissue Engineering of Corneal Endothelium

    Directory of Open Access Journals (Sweden)

    Satoru Yamagami

    2012-10-01

    Full Text Available Human corneal endothelial cells (HCECs do not replicate after wounding. Therefore, corneal endothelial deficiency can result in irreversible corneal edema. Descemet stripping automated endothelial keratoplasty (DSAEK allows selective replacement of the diseased corneal endothelium. However, DSAEK requires a donor cornea and the worldwide shortage of corneas limits its application. This review presents current knowledge on the tissue engineering of corneal endothelium using cultured HCECs. We also provide our recent work on tissue engineering for DSAEK grafts using cultured HCECs. We reconstructed DSAEK grafts by seeding cultured DiI-labelled HCECs on collagen sheets. Then HCEC sheets were transplanted onto the posterior stroma after descemetorhexis in the DSAEK group. Severe stromal edema was detected in the control group, but not in the DSAEK group throughout the observation period. Fluorescein microscopy one month after surgery showed numerous DiI-labelled cells on the posterior corneal surface in the DSAEK group. Frozen sections showed a monolayer of DiI-labelled cells on Descemet’s membrane. These findings indicate that cultured adult HCECs, transplanted with DSAEK surgery, maintain corneal transparency after transplantation and suggest the feasibility of performing DSAEK with HCECs to treat endothelial dysfunction.

  1. Customised component corneal transplantation: a blessing for three patients.

    Science.gov (United States)

    Sati, Alok; Shankar, Sandeep; Jha, Ashok; Gurunadh, Velamakanni Satyanarayana

    2014-08-21

    The existing acute shortage of good quality donor corneas in a developing country like India, prompted us to attempt customised component corneal transplantation. Using this surgical strategy, one corneoscleral button was used for three recipients. Anterior and posterior lamellar discs were used for anterior lamellar keratoplasty and Descemet's stripping endothelial keratoplasty in patients with superficial corneal scar and pseudophakic bullous keratopathy, respectively. From the remnant peripheral corneoscleral rim, a patch graft was taken and used for a case of perforated corneal ulcer. Postoperatively, the two earlier mentioned cases achieved visual acuities of 20/30 and 20/60, respectively, whereas the latter mentioned patient with the patch graft achieved good tectonic stability. This case report highlights the optimal utilisation of a corneoscleral button by customising it for three recipients. Moreover, a patch graft has been introduced in the armamentarium of customised component corneal transplantation for the first time. 2014 BMJ Publishing Group Ltd.

  2. 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.

  3. Refractive change after vitrectomy for epiretinal membrane in pseudophakic eyes

    DEFF Research Database (Denmark)

    Hamoudi, Hassan; Kofod, Mads; La Cour, Morten

    2013-01-01

    Purpose:  To report the change in refraction in pseudophakic eyes following 23-gauge vitrectomy for epiretinal membrane (ERM), without use of silicone oil, intraocular gas or scleral buckling. Methods:  Retrospective review of the records of 28 pseudophakic eyes in 28 patients undergoing 23-gauge...... pars plana vitrectomy for ERM. All 28 eyes had a measured preoperative refraction in their records and were seen minimum 2 months after vitrectomy for measuring their refraction. Fellow eyes (28 eyes) were used as controls. Results:  The mean preoperative refraction was -0.15 ± 0.85 dioptre (D......), and the mean postoperative refraction was -0.41 ± 0.93 D. Thus, a myopic shift was observed following vitrectomy with a mean change in refraction of -0.26 ± 0.60 D (range +0.75 to -2.13 D, p = 0.032). The postoperative change in refraction was within ±0.25, ±0.50 and ±1.00 D in 39%, 68% and 96% of the eyes...

  4. Corneal Laceration

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    Full Text Available ... or apply pressure to eye avoid giving aspirin, ibuprofen or other non-steroidal, anti-inflammatory drugs. These ... lost sight from a corneal scar as a child. Now that I’m older, will a corneal ...

  5. Corneal Laceration

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    Full Text Available ... rub or apply pressure to eye avoid giving aspirin, ibuprofen or other non-steroidal, anti-inflammatory drugs. ... lost sight from a corneal scar as a child. Now that I’m older, will a corneal ...

  6. Corneal Laceration

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    Full Text Available ... Now that I’m older, will a corneal transplant help me? May 15, 2015 Why Do My ... May Have A Future Alternative to Full Corneal Transplantation Nov 29, 2016 Combating Eye Injuries from Air ...

  7. Post-cataract prevention of inflammation and macular edema by steroid and nonsteroidal anti-inflammatory eye drops

    DEFF Research Database (Denmark)

    Kessel, Line; Tendal, Britta; Jørgensen, Karsten Juhl

    2014-01-01

    PURPOSE: Favorable outcome after cataract surgery depends on proper control of the inflammatory response induced by cataract surgery. Pseudophakic cystoid macular edema is an important cause of visual decline after uncomplicated cataract surgery. DESIGN: We compared the efficacy of topical steroids...... with topical nonsteroidal anti-inflammatory drugs (NSAIDs) in controlling inflammation and preventing pseudophakic cystoid macular edema (PCME) after uncomplicated cataract surgery. PARTICIPANTS: Patients undergoing uncomplicated surgery for age-related cataract. METHODS: We performed a systematic literature...... are more effective in controlling postoperative inflammation after cataract surgery. We found high-quality evidence that topical NSAIDs are more effective than topical steroids in preventing PCME. The use of topical NSAIDs was not associated with an increased events. We recommend using topical NSAIDs...

  8. Corneal dystrophies

    Directory of Open Access Journals (Sweden)

    Klintworth Gordon K

    2009-02-01

    Full Text Available Abstract The term corneal dystrophy embraces a heterogenous group of bilateral genetically determined non-inflammatory corneal diseases that are restricted to the cornea. The designation is imprecise but remains in vogue because of its clinical value. Clinically, the corneal dystrophies can be divided into three groups based on the sole or predominant anatomical location of the abnormalities. Some affect primarily the corneal epithelium and its basement membrane or Bowman layer and the superficial corneal stroma (anterior corneal dystrophies, the corneal stroma (stromal corneal dystrophies, or Descemet membrane and the corneal endothelium (posterior corneal dystrophies. Most corneal dystrophies have no systemic manifestations and present with variable shaped corneal opacities in a clear or cloudy cornea and they affect visual acuity to different degrees. Corneal dystrophies may have a simple autosomal dominant, autosomal recessive or X-linked recessive Mendelian mode of inheritance. Different corneal dystrophies are caused by mutations in the CHST6, KRT3, KRT12, PIP5K3, SLC4A11, TACSTD2, TGFBI, and UBIAD1 genes. Knowledge about the responsible genetic mutations responsible for these disorders has led to a better understanding of their basic defect and to molecular tests for their precise diagnosis. Genes for other corneal dystrophies have been mapped to specific chromosomal loci, but have not yet been identified. As clinical manifestations widely vary with the different entities, corneal dystrophies should be suspected when corneal transparency is lost or corneal opacities occur spontaneously, particularly in both corneas, and especially in the presence of a positive family history or in the offspring of consanguineous parents. Main differential diagnoses include various causes of monoclonal gammopathy, lecithin-cholesterol-acyltransferase deficiency, Fabry disease, cystinosis, tyrosine transaminase deficiency, systemic lysosomal storage

  9. What Is Macular Edema?

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    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Macular Edema ... Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué Es un Edema Macular? Dec. 01, 2010 ...

  10. What Is Macular Edema?

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    Full Text Available ... Macular Edema Symptoms Macular Edema Diagnosis Macular Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué ... common form of vision loss for people with diabetes—particularly if it is left untreated. Next What ...

  11. Acitretin induced bipedal edema.

    Science.gov (United States)

    Tey, Hong Liang; Theng, Thiam Seng Colin

    2006-05-01

    Generalized edema has been reported to be a rare side effect of systemic retinoids. We report a patient who developed localized bipedal edema from acitretin. Other causes of bipedal edema were excluded and withdrawal of acitretin led to resolution of the edema.

  12. One donor cornea for 3 recipients: a new concept for corneal transplantation surgery.

    Science.gov (United States)

    Vajpayee, Rasik B; Sharma, Namrata; Jhanji, Vishal; Titiyal, Jeewan S; Tandon, Radhika

    2007-04-01

    To describe the use of a single donor corneal tissue in 3 patients with corneal pathologic conditions. A donor corneal tissue was divided into 3 parts using a microkeratome and a trephine. The anterior lamellar disc was transplanted into a patient with macular corneal dystrophy using the automated lamellar therapeutic keratoplasty technique. The posterior lamellar disc was transplanted into a patient with pseudophakic bullous keratopathy using the Descemet stripping automated endothelial keratoplasty technique. The peripheral corneoscleral rim was used for limbal stem cell transplantation in a child with limbal stem cell deficiency. All surgical procedures were performed successfully. At 3 months, the best-corrected visual acuities achieved following automated lamellar therapeutic keratoplasty, Descemet stripping automated endothelial keratoplasty, and limbal stem cell transplantation were 20/60, 20/40, and 20/200, respectively. The advent of customized component corneal transplantation techniques may allow the use of 1 donor cornea to treat multiple patients.

  13. Cornea stress test--evaluation of corneal endothelial function in vivo by contact lens induced stress

    Directory of Open Access Journals (Sweden)

    Saini Jagjit

    1997-01-01

    Full Text Available Reliable and valid assessment of corneal endothelial function is a critical input for diagnosing, prognosticating and monitoring progression of disorders affecting corneal endothelium. In 123 eyes, corneal endothelial function was assessed employing data from the corneal hydration recovery dynamics. Serial pachometric readings were recorded on Haag-Striet pachometer with Mishima-Hedbys modification before and after two hours of thick soft contact lens wear. Percentage Recovery Per Hour (PRPH was derived from raw data as an index of endothelial function. Assessed PRPH in pseudophakic corneal oedema and Fuchs′ endothelial dystrophy eyes (35.9 +/- 9.8% was significantly lower than normal controls (61.9 +/- 10.5%. On employing receiver operation characteristics curve analysis the tested results demonstrated high sensitivity (87% and specificity (92% for detection of low endothelial function at PRPH cut off of 47.5%. Using this PRPH cut off, 80% of Fuchs′ endothelial dystrophy and 93.3% of pseudophakic corneal oedema eyes could be demonstrated to have low endothelial function. A total of 66.7% of diabetic eyes also demonstrated PRPH of lower than 47.5%. Clear corneal grafts demonstrated PRPH values of 24.6% to 73.0%. Of 6 corneal grafts that demonstrated initial PRPH of lower than 47.5%, 4 failed within 4 to 6 months. Our data demonstrated high sensitivity and specificity of this corneal stress test. PRPH index was useful in quantifying endothelial function in clinical disorders including diabetes mellitus. The index PRPH was demonstrated to be useful in monitoring and prognosticating outcome of corneal grafts.

  14. Difference in ocular surface temperature by infrared thermography in phakic and pseudophakic patients.

    Science.gov (United States)

    Sniegowski, Matthew; Erlanger, Michael; Velez-Montoya, Raul; Olson, Jeffrey L

    2015-01-01

    To assess the change in ocular surface temperature between healthy phakic and pseudophakic patients. We included patients with no history of ocular disease other than cataract. Patients were divided into three groups: clear lens, cataract, and pseudophakic. All patients had two ocular surface digital thermal scans. An average of five surface points was used as the mean ocular surface temperature. Results were analyzed with a one-way analysis of variance and a Tukey's least significance difference test. The patients were further divided into phakic and pseudophakic groups. Correlation coefficients between several variables were done in order to assess dependencies. Fifty-six eyes (28 cataracts, 12 clear lenses, 16 pseudophakic) were enrolled. The mean ocular surface temperature in the cataract group was 34.14°C±1.51°C; clear lens: 34.43°C±2.27°C; and pseudophakic: 34.97°C±1.57°C. There were no statistical differences among the study groups (P=0.3). There was a nonsignificant negative correlation trend between age and surface temperature in the phakic group. The trend inverted in the pseudophakic group but without statistical significance. Although cataract extraction and intraocular lens implantation seem to induce a mild increase in ocular surface temperature, the effect is not clear and not significant.

  15. Corneal decompensation after intraocular ophthalmic surgery--Missouri, 1998.

    Science.gov (United States)

    1998-04-24

    During January 8-14, 1998, six of eight patients undergoing elective intraocular surgery at a Veterans Affairs medical center (VAMC) in St. Louis, Missouri, developed corneal endothelial decompensation (corneal edema and opacification) instruments sterilized by the Abtox Plazlyte system (Abtox, Inc., Chicago, Illinois). This report summarizes the results of the investigation of these cases and indicates that using the Abtox Plazlyte system to sterilize opthalmologic surgical equipment led to corneal decompensation.

  16. What Is Macular Edema?

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    Full Text Available ... remains. Macular edema is often a complication of diabetic retinopathy , and is the most common form of ... 2016 Study Compares Eylea, Lucentis and Avastin for Diabetic Macular Edema Jul 17, 2015 Top 5 Risk ...

  17. [Corneal biomechanics].

    Science.gov (United States)

    Torres, R M; Merayo-Lloves, J; Jaramillo, M A; Galvis, V

    2005-04-01

    To review the corneal biomechanic concepts and to analyse, clarify and understand their relevance in refractive surgery. A literature review has been done using different databases. Corneal biomechanic concepts are not new and are applied implicitly in numerous surgical procedures. Their origin is related to tonometry studies, but they gained in popularity when they were linked to the treatment of keratoconus, a pathology in which the mechanical properties of the cornea are altered. Factors determining corneal stability were thus defined. Corneal biomechanics have also been used following refractive surgery to study post-operative keratectasia and to improve ablation patterns, which ignores the corneal response. The new ablation systems need to include the biomechanical factors, which motivate research conducted in physical-mathematical models and in corneal wound healing, improving our knowledge about the corneal biomechanical response. The corneal biomechanic concepts have gained in popularity with the advent of refractive surgery, although they did exist previously. Their relevance is linked to improvements in the ablation systems used in an attempt to obtain more accurate and reliable results.

  18. Corneal Laceration

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    Full Text Available ... Answers How often and for how long should I use a hair dryer to treat my Fuchs’ dystrophy? May 06, 2017 I lost sight from a corneal scar as a child. Now that I’m older, will a corneal transplant help me? ...

  19. 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 ... Laceration Treatment What Is Corneal Laceration? Leer en Español: ¿Qué Es una Laceración de la Córnea? Written ...

  20. Corneal Laceration

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    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? ...

  1. Edema associated with quetiapine

    Science.gov (United States)

    Koleva, Hristina K.; Erickson, Mark A.; Vanderlip, Erik R.; Tansey, Janeta; Mac, Joseph; Fiedorowicz, Jess G.

    2010-01-01

    Background Edema associated with quetiapine has been described in only one case report to date and represents a potentially serious adverse reaction. Methods We present a case series of three patients who developed bilateral leg edema following initiation of quetiapine. Results One of these patients had a recurrence of edema with subsequent rechallenge. Another patient developed quetiapine-induced edema following a prior episode of olanzapine-induced edema. All the cases present a compelling temporal relationship between the drug challenge and the adverse event. Conclusions Prompt recognition and intervention with discontinuation of the offending agent is important for this potentially serious, seemingly idiosyncratic, vascular complication. PMID:19439156

  2. Refractive index and its impact on pseudophakic dysphotopsia.

    Science.gov (United States)

    Radmall, Bryce R; Floyd, Anne; Oakey, Zack; Olson, Randall J

    2015-01-01

    It has been shown that the biggest dissatisfier for uncomplicated cataract surgery patients is pseudophakic dysphotopsia (PD). While edge design of an intraocular lens (IOL) impacts this problem, refractive index is still controversial as to its impact. This retrospective cohort study was designed to determine the role of increasing refractive index in PD. This study was conducted at the John A. Moran Eye Center, University of Utah, USA. A retrospective chart review identified patients who received one of two hydrophobic acrylic single piece IOLs (AcrySof WF SP [SN60WF] or Tecnis SP [ZCB00]), which differed mainly by refractive index (1.55 versus 1.47). Eighty-seven patients who had received implantation of a one-piece hydrophobic acrylic IOL were enrolled. Patients were included if the surgery had been uncomplicated and took place at least a year before study participation. All eligible patients had 20/20 best corrected vision, without any disease known to impact visual quality. In addition to conducting a record review, the enrolled patients were surveyed for PD, using a modified National Eye Institute Visual Function questionnaire, as well as for overall satisfaction with visual quality. Statistical analysis demonstrated no difference between the two cohorts regarding PD, general visual function, and overall visual satisfaction. The study suggests that with the two IOLs assessed, increasing the refractive index does not increase incidence of PD or decrease overall visual satisfaction.

  3. Corneal topography.

    Science.gov (United States)

    Seitz, B; Behrens, A; Langenbucher, A

    1997-08-01

    In the review period, limitations of individual Placido disk-based topography systems have been studied and new principles, such as raster photogrammetry, pancorneal slit topography, laser holographic interferometry, and confocal laser scanning topography, have been introduced for laboratory or clinical work. Both Fourier analysis and Zernike decomposition of topographic height data seem to be powerful new tools for cross-sectional analysis of complex topographic corneal images, such as after cataract surgery, penetrating keratoplasty, and refractive surgery, as well as for longitudinal studies of corneal changes, such as in schoolchildren. Subdividing into rational optical components may improve consistency and standardization of topography data from different systems. Topography-based flying-spot-mode excimer laser photoablation after Zernike decomposition of topography height data has been proposed for correction of irregular corneal astigmatism. Topography-based central power measurements are of increasing value for intraocular lens power calculation before cataract surgery in eyes with irregular corneal surfaces, such as in keratoconus or after refractive surgery procedures. Quantitative and qualitative classification of corneal topography maps after corneal transplantation following conventional mechanical and nonmechanical trephination or after refractive surgery may lead to a better understanding of impaired visual acuity despite a clear graft or despite significantly reduced ametropia or corneal astigmatism.

  4. Descemet stripping automated endothelial keratoplasty in Fuchs′ endothelial dystrophy versus pseudophakic bullous keratopathy

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Javadi

    2016-01-01

    Full Text Available Purpose: To compare clinical and confocal scan outcomes after Descemet stripping automated endothelial keratoplasty (DSAEK performed for Fuchs′ endothelial dystrophy (FED versus pseudophakic bullous keratopathy (PBK. Methods: This retrospective comparative study included 47 consecutive eyes of 39 patients with the diagnosis of FED (n = 29, group 1 or PBK (n = 18, group 2 that underwent DSAEK. Clinical outcomes were compared between the study groups. At the final follow-up examination, confocal microscopy was used to measure and compare central corneal and graft thickness as well as endothelial cell density and morphology between the two groups. Results: Mean age at the time of surgery was 65.2 ± 11.8 and 69.4 ± 12.5 years in groups 1 and 2, respectively (P = 0.27. Follow-up period was 23.6 ± 14.0 months in group 1 and 25.6 ± 15.7 months in group 2 (P = 0.79. Postoperative best spectacle-corrected visual acuity was significantly better in group 1 than in group 2 until postoperative month 6. Afterwards, the two study groups were comparable in this regard. At the final follow-up examination, spherical equivalent refractive error was + 0.39 ± 1.46 diopters (D in group 1 and + 0.80 ± 1.47 D in group 2 (P = 0.45. Postoperative keratometric astigmatism was 1.02 ± 0.83 D and 2.36 ± 0.67 D, respectively (P < 0.001. Mean central graft thickness was 98.0 ± 33.3 μm in group 1 and 107.6 ± 28.0 μm in group 2 (P = 0.45. No statistically significant difference was observed between the two groups in terms of the postoperative endothelial cell density. Conclusion: The outcomes of DSAEK surgery were comparable between FED and PBK. All grafts were clear despite the lower than normal endothelial cell counts.

  5. 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 ...

  6. 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 ...

  7. Corneal Laceration

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    Full Text Available ... the blood and may increase bleeding after you have finished protecting the eye, see a physician immediately ... Jun 30, 2017 People with Advanced Keratoconus May Have A Future Alternative to Full Corneal Transplantation Nov ...

  8. Corneal Laceration

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    Full Text Available ... People with Advanced Keratoconus May Have A Future Alternative to Full Corneal Transplantation Nov 29, 2016 Combating Eye Injuries from ... of Service For Advertisers For Media Ophthalmology Job Center © American Academy of Ophthalmology 2017 ...

  9. Corneal Laceration

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    Full Text Available ... inflammatory drugs. These drugs thin the blood and may increase bleeding after you have finished protecting the ... a hair dryer to treat my Fuchs’ dystrophy? May 06, 2017 I lost sight from a corneal ...

  10. 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 ...

  11. 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 ... Ask an Ophthalmologist Answers Did my traumatic brain injury cause early cataracts? Jan 21, 2018 Did I ...

  12. Corneal Laceration

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    Full Text Available ... caused by something striking the eye with significant force, like a metallic hand tool. A corneal laceration ... and preserving your vision. Privacy Policy Related Top 5 Eye Health Stories of 2017 Dec 21, 2017 ...

  13. 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, ...

  14. Isolated unilateral disk edema

    Directory of Open Access Journals (Sweden)

    Varner P

    2011-07-01

    Full Text Available Paul VarnerJohn J Pershing VAMC, Poplar Bluff, MO, USAAbstract: Isolated unilateral disk edema is a familiar clinical presentation with myriad associations. Related, non-consensus terminology is a barrier to understanding a common pathogenesis. Mechanisms for the development of disk edema are reviewed, and a new framework for clinical differentiation of medical associations is presented.Keywords: disk edema, axoplasmic flow, clinical multiplier, optic neuritis, ischemic optic neuropathy, papilledema

  15. Difference in ocular surface temperature by infrared thermography in phakic and pseudophakic patients

    Directory of Open Access Journals (Sweden)

    Sniegowski M

    2015-03-01

    Full Text Available Matthew Sniegowski, Michael Erlanger, Raul Velez-Montoya, Jeffrey L Olson Ophthalmology Department, University of Colorado School of Medicine, Rocky Mountain Lions Eye Institute, Aurora, CO, USA Purpose: To assess the change in ocular surface temperature between healthy phakic and pseudophakic patients.Methods: We included patients with no history of ocular disease other than cataract. Patients were divided into three groups: clear lens, cataract, and pseudophakic. All patients had two ocular surface digital thermal scans. An average of five surface points was used as the mean ocular surface temperature. Results were analyzed with a one-way analysis of variance and a Tukey’s least significance difference test. The patients were further divided into phakic and pseudophakic groups. Correlation coefficients between several variables were done in order to assess dependencies.Results: Fifty-six eyes (28 cataracts, 12 clear lenses, 16 pseudophakic were enrolled. The mean ocular surface temperature in the cataract group was 34.14°C±1.51°C; clear lens: 34.43°C±2.27°C; and pseudophakic: 34.97°C±1.57°C. There were no statistical differences among the study groups (P=0.3. There was a nonsignificant negative correlation trend between age and surface temperature in the phakic group. The trend inverted in the pseudophakic group but without statistical significance.Conclusion: Although cataract extraction and intraocular lens implantation seem to induce a mild increase in ocular surface temperature, the effect is not clear and not significant. Keywords: digital thermal scans, intraocular lens implantation, cataract extraction

  16. Corneal collagens.

    Science.gov (United States)

    Robert, L; Legeais, J M; Robert, A M; Renard, G

    2001-05-01

    Cornea is a highly differentiated tissue rich in extracellular matrix (ECM) specifically distributed in space in order to insure its dual role--transparency and protection of inner eye-tissues. Corneal ECM is especially rich in collagens. Since the characterisation of a number of distinct collagen types it appeared that most of them are present in the cornea. Their synthesis follows a specific program of sequential expression of the different collagen types to be synthesised during the development and maturation of the cornea. The precise regulation of the diameter and orientation of fibers, and of the interfibrillar spaces is partially at least attributed to interactions between glycosaminoglycans and collagens. The 'program' of vectorial collagen synthesis and GAG-collagen interactions changes also with age and in several pathological conditions as corneal dystrophies and wound healing. The Maillard reaction, especially in diabetes, is one of these important factors involved in age-dependent modifications of corneal structure and function. Far from being inert, corneal collagens were shown to have relatively short half-lives. The biosynthesis of corneal collagens was studied also during wound healing. The refibrillation of wounded corneas does not follow the original 'program' of ECM-synthesis as shown by the comparative study of wound healing using biochemical and morphometric methods. This review recapitulates briefly previous and recent studies on corneal collagens in order to present to clinicians and scientists an overview of the state of the art of this important field at the intersection of eye research and matrix biology.

  17. Refractive index and its impact on pseudophakic dysphotopsia

    Directory of Open Access Journals (Sweden)

    Radmall BR

    2015-07-01

    Full Text Available Bryce R Radmall,1 Anne Floyd,2 Zack Oakey,3 Randall J Olson4 1Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, OR, 2Department of Ophthalmology, Louisiana State University Health Sciences Center, Shreveport, LA, 3Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA, 4Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA Purpose: It has been shown that the biggest dissatisfier for uncomplicated cataract surgery patients is pseudophakic dysphotopsia (PD. While edge design of an intraocular lens (IOL impacts this problem, refractive index is still controversial as to its impact. This retrospective cohort study was designed to determine the role of increasing refractive index in PD. Patients and methods: This study was conducted at the John A. Moran Eye Center, University of Utah, USA. A retrospective chart review identified patients who received one of two hydrophobic acrylic single piece IOLs (AcrySof WF SP [SN60WF] or Tecnis SP [ZCB00], which differed mainly by refractive index (1.55 versus 1.47. Eighty-seven patients who had received implantation of a one-piece hydrophobic acrylic IOL were enrolled. Patients were included if the surgery had been uncomplicated and took place at least a year before study participation. All eligible patients had 20/20 best corrected vision, without any disease known to impact visual quality. In addition to conducting a record review, the enrolled patients were surveyed for PD, using a modified National Eye Institute Visual Function questionnaire, as well as for overall satisfaction with visual quality. Results: Statistical analysis demonstrated no difference between the two cohorts regarding PD, general visual function, and overall visual satisfaction. Conclusion: The study suggests that with the two IOLs assessed, increasing the refractive index does not

  18. [Amniotic membrane transplantation in severe corneal epithelial diseases. Preliminary results].

    Science.gov (United States)

    Zito, E; Borderie, V; Touzeau, O; Bourcier, T; Allouch, C; Laroche, L

    2002-11-01

    To evaluate amniotic membrane transplantation (AMT) in severe corneal epithelial diseases. Amniotic membrane transplantation was performed in 14 eyes of 14 patients from four groups: A, five severe ocular burns; B, four cases of cicatricial keratoconjunctivitis; C, three persistent epithelial defects after penetrating keratoplasty; D, two cases of pseudophakic bullous keratopathy. Five patients underwent AMT alone; two patients underwent AMT combined with limbal transplantation; the other three patients had limbal transplantation performed before AMT. Eight patients required combined penetrating keratoplasty. Patients with corneal stable reepithelialization, no corneal neovascularization, and no recurrence of the initial pathology were considered successful. The mean follow-up was 7+/-3 months. All but three patients underwent corneal reepithelialization within 6 weeks of AMT, with a mean healing time of 31+/-23 days. The success rate was 75% at 6 months (Kaplan-Meier method). Three of four procedures in group B failed. In eight patients, visual acuity improved, in one it worsened, and in the last five patients it remained unchanged. Visual acuity increased by an average of 7+/-9 lines. AMT is a useful technique for ocular surface reconstruction, especially in association with limbal transplantation. It could also improve the prognosis of penetrating keratoplasty in patients with severe corneal conditions.

  19. Apical clearance rigid contact lenses induce corneal steepening.

    Science.gov (United States)

    Swarbrick, Helen A; Hiew, Ross; Kee, Ai Vy; Peterson, Sophia; Tahhan, Nina

    2004-06-01

    Anecdotal reports suggest that steeply fitted rigid contact lenses can induce corneal steepening and myopic shifts in refraction. This study investigated changes in corneal topography, corneal thickness, and refraction after short-term wear of apical clearance lenses. : Ten young adults participated in the study in which apical clearance lenses (Conoid, Hydron Pty. Ltd., Frenchs Forest, NSW, Australia), fitted approximately 0.3 mm steeper than the flattest keratometric reading, were worn for 4 h. A polymethyl methacrylate (PMMA) lens was worn in one eye, and a Boston XO lens (Bausch & Lomb, Rochester, NY) was worn in the other. Lenses were nonfenestrated in the first trial, and a single midperipheral fenestration was incorporated for a second trial. Corneal topography was monitored using the EyeSys topographic analysis system (EyeSys Vision, Inc., Houston, TX); central corneal thickness was quantified using ultrasonic pachometry; and refraction and anterior ocular response were also monitored. Significant central corneal edema (8.2 +/- 2.2%) was demonstrated in the PMMA lens-wearing eye only. Fenestration did not reduce the edema response. We found significant corneal steepening over a 5- to 6-mm central zone, which was more pronounced in the PMMA lens-wearing eye and was modified by lens fenestration. The curvature changes altered central corneal shape from prolate (Q = -0.06 +/- 0.10) to oblate (Q = -0.26 +/- 0.31). A slight myopic shift in refraction (-0.38 +/- 0.60 D) was found with the PMMA lenses only. : Apical clearance lenses induce corneal steepening after short-term wear. Although corneal molding is implicated as the primary factor driving the shape change, corneal edema and postlens tear film pressures can modify this response.

  20. What Is Macular Edema?

    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 Macular Edema Sections What Is Macular Edema? ...

  1. Side Effects: Edema

    Science.gov (United States)

    Edema is a condition in which fluid builds up in your body’s tissues. The swelling may be caused by chemotherapy, cancer, and conditions not related to cancer. Learn about signs of edema, including swelling in your feet, ankles, and legs.

  2. What Is Macular Edema?

    Medline Plus

    Full Text Available ... remains. Macular edema is often a complication of diabetic retinopathy , and is the most common form of vision ... 28, 2014 Restoring Vision Lost to Central Serous Retinopathy (CSR) Jun 03, 2014 ... Thought May 31, 2016 Study Compares Eylea, Lucentis and Avastin for Diabetic Macular Edema Jul 17, 2015 Top 5 Risk ...

  3. Approach to leg edema

    Directory of Open Access Journals (Sweden)

    Fulvio Pomero

    2017-09-01

    Full Text Available Edema is defined as a palpable swelling caused by an increase in interstitial fluid volume. Leg edema is a common problem with a wide range of possible causes and is the result of an imbalance in the filtration system between the capillary and interstitial spaces. Major causes of edema include venous obstruction, increased capillary permeability and increased plasma volume secondary to sodium and water retention. In both hospital and general practice, the patient with a swollen leg presents a common dilemma in diagnosis and treatment. The cause may be trivial or life-threatening and it is often difficult to determine the clinical pathway. The diagnosis can be narrowed by categorizing the edema according to its duration, distribution (unilateral or bilateral and accompanying symptoms. This work provides clinically oriented recommendations for the management of leg edema in adults.

  4. Pseudophakic retinal detachment in young-aged patients.

    Directory of Open Access Journals (Sweden)

    Thomas Laube

    Full Text Available To investigate the incidence and risk factors for retinal detachment (RD after cataract surgery or refractive lens exchange (RLE in patients aged below 61 years.Retrospective medical chart review of 7,886 patients (13,925 eyes who underwent cataract surgery or RLE. Patients aged below 61 years were selected. Age, gender, axial length, follow-up times, and the occurrence of RD were recorded. Additional characteristics documented for RD cases were: history of RD, preexisting retinal findings, laser capsulotomy, status of macula at RD, date and details of RD.From a total of 421 patients (677 eyes aged below 61 years 24 cases of RD were identified, resulting in an overall cumulative incidence per eyes of 3.55%. The mean follow-up time was 45 ± 32.8 months. Ninety-two % of all RDs occurred within 3.6 years from surgery. Axial length had a significant effect on the risk of RD after cataract/ RLE surgery (HR = 1.42, P = 0.0001, 95% CI 1.19-1.69. The highest incidence of RD occurred in the subgroup of 25 to 28.9 mm axial length (10.2%. With an increase in age of ten years, the hazard of postoperative RD was not significantly increased by a factor of 1.50 (P = 0.286, 95% CI 0.71-3.15. The highest incidence of RD occurred in patients aged 50-54 years (5.39%. Compared to females, males had an almost twofold not significant risk of postoperative RD (HR = 1.96, P = 0.123, 95% CI 0.83-4.63. None of the RD cases had a history of RD.Axial length is a significant risk factor for pseudophakic RD. The need for cataract surgery or RLE should be carefully considered in patients with axial lengths between 25 and 29 mm, aged 50-54 years, in males, and in case of preexisting retinal findings.

  5. 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...... with less risk of rejection episodes. Besides covering updated chapters on penetrating keratoplasty, and anterior and posterior lamellar procedures, this textbook also gives a thorough overview of the history of corneal transplantation and a detailed presentation of the microstructural components....... Economic considerations on cost and benefi t of medical treatment and surgical procedures are today an integrated part of the health system in many countries, and a chapter covers these aspects of corneal transplantation. This textbook is aimed at presenting an updated review of the new techniques...

  6. STERILE HYPOPYON IRIDOCYCLITIS DURING THE TREATMENT OF PSEUDOPHAKIC BULLOUS KERATOPATHY WITH HYDROPHYLIC BANDAGE LENS

    OpenAIRE

    Toker, Ebru; Bavbek, Tayfun; Kazokoğlu, Haluk; Yenice, Özlem

    2016-01-01

    Hydrophilic bandage lenses have proven to be a useful treatment modality in bullous keratopathy for pain relief and visual improvement. Some complications may arise after the application of bandage lenses. We present a sterile hypopyon iridocyclitis case in a pseudophakic bullous keratopathy using a bandage contact lens.Key Words: Hypopyon iridocyclitis, Bandage contact lens

  7. Selective laser trabeculoplasty in pseudophakic and phakic eyes: a prospective study

    Directory of Open Access Journals (Sweden)

    Myrjam De Keyser

    2017-04-01

    Full Text Available AIM: To compare the efficacy of selective laser trabeculoplasty (SLT in replacing medical therapy in pseudophakic and phakic eyes. METHODS: Subgroup of a prospective randomized clinical trial including patients with primary open angle glaucoma or ocular hypertension controlled with medication. Of 38 pseudophakic eyes were matched with 38 phakic eyes. SLT was offered as a way to decrease medication while maintaining the same low eye pressure. SLT was performed over 360°, at 3ns, spotsize 400 µm, 100 spots. Data [intraocular pressure (IOP, number of medications needed] were measured at 1h, 1wk, 1, 3, 6 and 12mo. An independent-samples t-test was performed to compare baseline characteristics of the phakic and the pseudophakic group and differences in evolution of mean IOP and number of used medications. Chi-squared analysis was performed to investigate proportions of fast, slow and non-responders. RESULTS: The mean IOP measurement was 13.00± 2.88 mm Hg in the phakic group (38 eyes and 13.51± CONCLUSION: IOP lowering effect of SLT is comparable between phakic and pseudophakic eyes.

  8. [Transplantation of corneal endothelial cells].

    Science.gov (United States)

    Amano, Shiro

    2002-12-01

    endothelial cells. Cultured rabbit corneal endothelial cells that endocytosed iron were injected into the anterior chamber of rabbits whose corneal endothelium was cryo-injured, and were pulled to Descemet's membrane by putting a magnet on the eyelid. In these rabbits, corneal edema decreased more quickly than in the control group and no intraocular pressure rise was observed during 8 weeks after the operation, suggesting that the direct delivery of cultured HCECs into the anterior chamber can be an alternative method of choice. The following obstacles should be addressed to make the transplantation of cultured corneal endothelial cells clinically applicable. 1. To reconstruct a cornea that is the same as or superior to the normal cornea, more innovation is necessary in the method of culturing and seeding HCECs. We should consider utilizing HCECs obtained from fetuses after clearing ethical issues. Moreover, we need to develop a method to enhance the cell density and the cell functions. 2. Porcine corneal stroma is promising as a carrier of HCECs instead of human corneal stroma, which is in very limited supply. The usefulness of porcine corneal stroma acellularized to prevent retrovirus infection should be evaluated. 3. To make the self immature cells applicable to corneal transplantation, we should elucidate the corneal endothelial cell specific markers and the factors that are necessary to induce self immature cells to become corneal endothelial cells. 4. The direct delivery of cultured HCECs into the anterior chamber can be an alternative method of choice when its long-term safety is confirmed.

  9. Corneal Backscatters as an Objective Index for Assessing Fuchs’ Endothelial Corneal Dystrophy: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Hsueh-Yen Chu

    2017-01-01

    Full Text Available Purpose. To provide an objective, quantitative approach for monitoring Fuchs’ endothelial corneal dystrophy (FECD, with Scheimpflug imaging. Design. This is a retrospective case-control pilot study. Methods. The study group consisted of 53 eyes in 27 patients diagnosed with FECD, with normal subjects paired as control. Main outcome measures were corneal thickness, morphological patterns on densitograms, and indices of corneal density including the average area density (mean AD and the average ratio of Descemet’s membrane density versus area density (DM/AD in Pentacam Scheimpflug images. Results. There were no significant differences in age and corneal thickness between FECD and normal groups. Morphologically, hanging-hammock patterns were noted on the densitograms of FECD patients, which were different from the high-back chair patterns in normal subjects. Quantitatively, mean AD and DM/AD were both elevated in FECD patients as compared with normal subjects (P=0.01 and 0.025, resp.. In addition, FECD patients with corneal edema had significantly higher mean AD (P=0.018 than those without corneal edema. Conclusions. This pilot study shows that Pentacam system provides an objective, quantitative way to approach FECD corneas. It can assist ophthalmologists in detecting the early change and in monitoring disease progression of FECD. Further studies are needed to consolidate the findings.

  10. Corneal Intelligence

    African Journals Online (AJOL)

    Murdoch3

    the damping effect of the tissue to an applied force) or corneal compliance being the major risk factor. Figure 1. The percentage of participants in the observation group who developed primary open-angle glaucoma (median follow-up, 72 months) ...

  11. Corneal ulcers

    African Journals Online (AJOL)

    visual acuity chart. • fluorescein strips. • topical anaesthetic eye drops. • direct ophthalmoscope. Examination. Assessing vision with a Snellen visual acuity chart gives a clue as to the extent of the problem (e.g. a corneal abrasion with good vision is unlikely to require specialist intervention). Each eye should be tested ...

  12. Corneal Intelligence

    African Journals Online (AJOL)

    Murdoch3

    Corneal Intelligence. Ian Murdoch. Institute of Ophthalmology, Bath Street, London. In 2002, the ocular hypertension treatment study (OHTS) published their results. This study had taken 1636 ocular hypertensives. 1, 2. (IOP 24-32mmHg) and randomized them to receive therapy or no therapy. The primary outcome of the ...

  13. What Is Macular Edema?

    Medline Plus

    Full Text Available ... side) vision remains. Macular edema is often a complication of diabetic retinopathy , and is the most common form of vision loss for people with diabetes—particularly if it is left untreated. Next What ...

  14. What Is Macular Edema?

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    Full Text Available ... Was Beta Carotene Removed From AREDS2 Vitamin Formula? Jul 28, 2014 Restoring Vision Lost to Central Serous ... Eylea, Lucentis and Avastin for Diabetic Macular Edema Jul 17, 2015 Top 5 Risk Factors for AMD ...

  15. What Is Macular Edema?

    Medline Plus

    Full Text Available ... mild to severe, but in many cases, your peripheral (side) vision remains. Macular edema is often a ... Your Laser Pointer Dangerous Enough to Cause Eye Injury? Dec 20, 2013 Study Finds Tablets Help People ...

  16. What Is Macular Edema?

    Medline Plus

    Full Text Available ... a thin layer of light-sensitive tissue that lines the back of the eye. Light rays are ... to severe, but in many cases, your peripheral (side) vision remains. Macular edema is often a complication ...

  17. What Is Macular Edema?

    Medline Plus

    Full Text Available ... may be mild to severe, but in many cases, your peripheral (side) vision remains. Macular edema is ... health and preserving your vision. Privacy Policy Related Studies Show Zika Virus May Cause More Serious Eye ...

  18. Cystoid macular edema

    Directory of Open Access Journals (Sweden)

    Tryfon G Rotsos

    2008-10-01

    Full Text Available Tryfon G Rotsos1, Marilita M Moschos21Medical Retina Service, Moorfields Eye Hospital, London, UK; 2Department of Ophthalmology, University of Athens, GreeceAbstract: We review the epidemiology, pathophysiology, and etiology of cystoid macular edema (CME. Inflammatory, diabetic, post-cataract, and macular edema due to age-related macular degeneration is described. The role of chronic inflammation and hypoxia and direct macular traction is evaluated in each case according to different views from the literature. The different diagnostic methods for evaluating the edema are described. Special attention is given to fluoroangiography and the most modern methods of macula examination, such as ocular coherence tomography and multifocal electroretinography. Finally, we discuss the treatment of cystoid macular edema in relation to its etiology. In this chapter we briefly refer to the therapeutic value of laser treatment especially in diabetic maculopathy or vitrectomy in some selected cases. Our paper is focused mainly on recent therapeutic treatment with intravitreal injection of triamcinolone acetonide and anti-VEGF factors like bevacizumab (Avastin, ranibizumab (Lucentis, pegaptamid (Macugen, and others. The goal of this paper is to review the current status of this treatment for macular edema due to diabetic maculopathy, central retinal vein occlusion and post-cataract surgery. For this reason the results of recent multicenter clinical trials are quoted, as also our experience on the use of intravitreal injections of anti-VEGF factors and we discuss its value in clinical practice.Keywords: cystoid macular edema, anti-VEGF, fluoroangiography, OCT, multifocal electroretinography

  19. Edema: diagnosis and management.

    Science.gov (United States)

    Trayes, Kathryn P; Studdiford, James S; Pickle, Sarah; Tully, Amber S

    2013-07-15

    Edema is an accumulation of fluid in the interstitial space that occurs as the capillary filtration exceeds the limits of lymphatic drainage, producing noticeable clinical signs and symptoms. The rapid development of generalized pitting edema associated with systemic disease requires timely diagnosis and management. The chronic accumulation of edema in one or both lower extremities often indicates venous insufficiency, especially in the presence of dependent edema and hemosiderin deposition. Skin care is crucial in preventing skin breakdown and venous ulcers. Eczematous (stasis) dermatitis can be managed with emollients and topical steroid creams. Patients who have had deep venous thrombosis should wear compression stockings to prevent postthrombotic syndrome. If clinical suspicion for deep venous thrombosis remains high after negative results are noted on duplex ultrasonography, further investigation may include magnetic resonance venography to rule out pelvic or thigh proximal venous thrombosis or compression. Obstructive sleep apnea may cause bilateral leg edema even in the absence of pulmonary hypertension. Brawny, nonpitting skin with edema characterizes lymphedema, which can present in one or both lower extremities. Possible secondary causes of lymphedema include tumor, trauma, previous pelvic surgery, inguinal lymphadenectomy, and previous radiation therapy. Use of pneumatic compression devices or compression stockings may be helpful in these cases.

  20. Risk of pseudophakic retinal detachment in 202 226 patients using the fellow nonoperated eye as reference

    DEFF Research Database (Denmark)

    Bjerrum, Søren S; Mikkelsen, Kim Lyngby; La Cour, Morten

    2013-01-01

    To study the risk of pseudophakic retinal detachment (PRD) after first-eye phacoemulsification cataract surgery in Denmark relative to the risk of retinal detachment (RD) in the patients' fellow nonoperated eyes.......To study the risk of pseudophakic retinal detachment (PRD) after first-eye phacoemulsification cataract surgery in Denmark relative to the risk of retinal detachment (RD) in the patients' fellow nonoperated eyes....

  1. Anterior migration of dexamethasone implant in a pseudophakic patient with intact posterior capsule

    Directory of Open Access Journals (Sweden)

    Nilufer Kocak

    2014-01-01

    Full Text Available Intravitreal application of Ozurdex ® (Allergan, Inc., Irvine, CA, USA which is a biodegradable, sustained-release dexamethasone implant has been reported to be effective in the treatment of macular edema. Migration of such implant into the anterior chamber has been recently described in cases without perfect zonular or the posterior capsular integrity. Herein, we report the first case with anterior migration of Ozurdex ® implant that mislocated just behind the intraocular lens (IOL in an intact capsular bag. It is thought that such implant migrated anteriorly towards into the posterior chamber through weak zonules as the present case had a medical history of uneventful phacoemulsification surgery with the implantation of posterior chamber IOL. However, the migrated implant was well tolerated since there was no sign of the corneal complication, rise in intraocular pressure, and anterior chamber reaction. Close follow-up was scheduled to find out any signs of anterior segment pathology. Meanwhile dexamethasone implant completely degraded at the 4 th month of postoperative follow-up.

  2. Impact of corneal aberrations on through-focus image quality of presbyopia-correcting intraocular lenses using an adaptive optics bench system.

    Science.gov (United States)

    Zheleznyak, Len; Kim, Myoung Joon; MacRae, Scott; Yoon, Geunyoung

    2012-10-01

    To measure the impact of corneal aberrations on the through-focus image quality of presbyopia-correcting intraocular lenses (IOLs) using an adaptive optics IOL metrology system. Flaum Eye Institute, University of Rochester, Rochester, New York, USA. Experimental study. An adaptive optics IOL metrology system comprising a model eye, wavefront sensor, deformable mirror, and an image-capturing device acquired through-focus images of a letter chart with 3.0 mm and 5.0 mm pupil diameters. The system was used to induce corneal astigmatism and higher-order aberrations (HOAs) in previously measured pseudophakic presbyopic eyes. A single-optic accommodating IOL (Crystalens HD (HD500), an apodized (Restor +3.0 diopter [D] SN6AD1) and full-aperture (Tecnis ZM900) diffractive multifocal IOL, and a monofocal IOL (Acrysof SN60AT) were evaluated. Image quality was quantified using the correlation-coefficient image-quality metric. The single-optic accommodating IOL and monofocal IOL performed similarly; however, with a 3.0 mm pupil, the former had better intermediate (1.50 D) image quality. The multifocal IOLs had bimodal through-focus image quality trends. Corneal astigmatism reduced through-focus image quality and depth of focus with all IOLs; however, the multifocal IOLs had the most severe decline in depth of focus. Ocular spherical aberration had the strongest impact on image quality when typical pseudophakic corneal HOAs were present. The uncorrected corneal astigmatism and HOAs in pseudophakic eyes significantly affected through-focus performance of presbyopia-correcting IOLs. Although multifocal IOLs significantly increased depth of focus, this benefit diminished when more than 0.75 D astigmatism remained uncorrected. Residual ocular spherical aberration had a significant effect on image quality in the presence of other corneal HOAs. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  3. Treatment of cystoid macular edema with the new-generation NSAID nepafenac 0.1%

    Directory of Open Access Journals (Sweden)

    Seenu M Hariprasad

    2009-01-01

    Full Text Available Seenu M Hariprasad1, Levent Akduman2, Joseph A Clever2, Michael Ober3,4, Franco M Recchia5, William F Mieler1,61Department of Ophthalmology and Visual Sciences, Vitreoretinal Service; 6Department of Ophthalmology and Visual Sciences, University of Chicago, Chicago, IL, USA; 2Vitreoretinal Service, Saint Louis University Eye Institute, Saint Louis, MO, USA; 3Vitreoretinal Service, Henry Ford Health Systems, West Bloomfield, MI, USA; 4Retinal Consultants of Michigan, Southfield, MI, USA; 5Vitreoretinal Service, Vanderbilt Eye Institute, Nashville, TN, USAPurpose: To describe the use of nepafenac 0.1% for cystoid macular edema (CME.Methods: This was a multicenter retrospective review of 22 CME cases (20 patients treated with nepafenac 0.1% (six with concomitant prednisolone acetate 1% from December 2005 to April 2008: three acute pseudophakic CME cases, 13 chronic/recalcitrant pseudophakic CME cases, and six cases of uveitic CME. Pre- and post-treatment retinal thickness and visual acuity were reported.Results: Following treatment for six weeks to six months, six eyes with uveitic CME showed a mean retinal thickness improvement of 227 ± 168.1 μm; mean best-corrected visual acuity (BCVA improvement was 0.36 ± 0.20 logMAR. All three cases of acute pseudophakic CME improved after four to 10 weeks of nepafenac, with a mean improvement in retinal thickness of 134 ± 111.0 μm. BCVA improved in two patients (0.16 and 0.22 logMAR but not in the third due to underlying retinal pigment epithelium changes. Thirteen eyes with chronic/recalcitrant pseudophakic CME demonstrated a mean improvement in retinal thickness of 178 ± 128.7 μm after nepafenac and mean BCVA improvement of 0.33 ± 0.19 logMAR.Conclusion: The positive outcomes of these 22 eyes strongly suggest that nepafenac 0.1% is a promising drug for the treatment of CME. Additional study under randomized controlled conditions is warranted.Keywords: macular edema, NSAID, nepafenac, cataract surgery

  4. Management of corneal bee sting

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    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. Gamma-irradiated sterile cornea for use in corneal transplants in a rabbit model

    OpenAIRE

    Junko Yoshida; Thomas Heflin; Andrea Zambrano; Qing Pan; Huan Meng; Jiangxia Wang; Stark, Walter J.; Daoud, Yassine J.

    2015-01-01

    Purpose: Gamma irradiated corneas in which the donor keratocytes and endothelial cells are eliminated are effective as corneal lamellar and glaucoma patch grafts. In addition, gamma irradiation causes collagen cross inking, which stiffens collagen fibrils. This study evaluated gamma irradiated corneas for use in corneal transplantations in a rabbit model comparing graft clarity, corneal neovascularization, and edema. Methods: Penetrating keratoplasty was performed on rabbits using four ty...

  6. Osmotherapy in brain edema

    DEFF Research Database (Denmark)

    Grände, Per-Olof; Romner, Bertil

    2012-01-01

    Despite the fact that it has been used since the 1960s in diseases associated with brain edema and has been investigated in >150 publications on head injury, very little has been published on the outcome of osmotherapy. We can only speculate whether osmotherapy improves outcome, has no effect......, osmotherapy can be negative for outcome, which may explain why we lack scientific support for its use. These drawbacks, and the fact that the most recent Cochrane meta-analyses of osmotherapy in brain edema and stroke could not find any beneficial effects on outcome, make routine use of osmotherapy in brain...... edema doubtful. Nevertheless, the use of osmotherapy as a temporary measure may be justified to acutely prevent brain stem compression until other measures, such as evacuation of space-occupying lesions or decompressive craniotomy, can be performed. This article is the Con part in a Pro-Con debate...

  7. Traumatic Aniridia Following a Blunt Ocular Trauma in a Pseudophakic Patient

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    Baran Gencer

    2014-01-01

    Full Text Available Blunt ocular traumas cause serious ocular problems in the anterior and posterior segments of the eye and even may result in globe perforation. In the literature, some cases have been reported with aniridia by traumatic iris expulsion and preserved intraocular lens after blunt trauma in pseudophakic eyes that had undergone cataract surgery with phacoemulsification. In this case, phacoemulsification was performed four months before a blunt trauma to the same eye, intraocular lens remained centralized although traumatic aniridia and partial zonulolysis occurred. This is the first case of traumatic aniridia in a pseudophakic eye in our country, and we aimed to present the possibility of relative protective effects of small cataract incisions after blunt trauma. (Turk J Ophthalmol 2014; 44: 80-2

  8. [Aniseikonia. A clinical study of 51 unilateral pseudophakic patients and practical applications].

    Science.gov (United States)

    Boissonnot, M; Risse, J F; Ingrand, P

    1990-01-01

    The subjective aniseiconia was measured with spatial eiconometer on 51 isometropic and unilateral pseudophakic patients in relation with the post-operative anisometropia. The median value of subjective aniseiconia is 2-3% for anisometropia minus or equal to 5 diopters, without statistic correlation, related to a probably "sensorial brain adaptation". So error of intra-ocular lens power calculation less than 7.5 diopters may be accepted.

  9. [Nanostructured bioplastic material for traumatic corneal injuries].

    Science.gov (United States)

    Kanyukov, V N; Stadnikov, A A; Trubina, O M; Yakhina, O M

    2015-01-01

    To substantiate the use of nanostructured bioplastic material for the treatment of traumatic eye injuries. The study enrolled 96 eyes of 48 rabbits and was carried out in 3 series of experiments, different in the type of induced corneal trauma: mechanical erosion, alkaline or acid burn. The animals were clinically monitored and sacrificed for morphological investigation at days 3, 7, 14, 30, and 90. The size of mechanical corneal erosions was repeatedly evaluated with fluorescein eye stain test. In the experimental group, Hyamatrix biomaterial was topically administered according to an original technique. In the controls, soft contact lenses were inserted and sutured. Complete closure of the epithelial defect with no impact on corneal properties was achieved in 3 days in the experimental group and in4 days in the control group. As for alkaline and acid corneal burns, experimental and control groups received Hyamatrix biomaterial and Solcoseryl eye gel correspondingly. In the experimental group of alkaline burn the defect closed by day 7, in the controls--by day 10-11. Acid-induced corneal edema also resolved by day 7 in the experimental group and by day 14 in the control group. 1. The results of this experimental and morphological study prove the hyaluronic acid-derived nanostructured bioplastic material effective in accelerating corneal re-epithelialization after mechanical erosions as compared with the controls. 2. Topical application of the hyaluronic acid-derived nanostructured bioplastic material shortens the exudative phase of inflammation, promotes corneal defect closure with formation of a more subtle opacification, and stimulates corneal restoration after chemical burns.

  10. What Is Macular Edema?

    Medline Plus

    Full Text Available ... may be mild to severe, but in many cases, your peripheral (side) vision remains. Macular edema is often a complication of diabetic retinopathy , and is the most common form of ... Related Studies Show Zika Virus May Cause More Serious Eye ...

  11. What Is Macular Edema?

    Medline Plus

    Full Text Available ... may be mild to severe, but in many cases, your peripheral (side) vision remains. Macular edema is often a complication of diabetic retinopathy , and is the most common form of vision loss for people with diabetes—particularly if it is left untreated. ... Studies Show Zika Virus May Cause More Serious Eye ...

  12. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Zika Virus May Cause More Serious Eye Damage in Babies Than Thought May 31, 2016 Study Compares Eylea, Lucentis and Avastin for Diabetic Macular Edema Jul 17, 2015 Top 5 Risk Factors for AMD Jan 29, 2014 Is Your ...

  13. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Diabetic Macular Edema Jul 17, 2015 Top 5 Risk Factors for AMD Jan 29, 2014 Is Your Laser Pointer Dangerous ... Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms ...

  14. Long-Term Topical Ganciclovir and Corticosteroids Preserve Corneal Endothelial Function in Cytomegalovirus Corneal Endotheliitis.

    Science.gov (United States)

    Fan, Nai-Wen; Chung, Yu-Chien; Liu, Yao-Chung; Liu, Catherine Jui-Ling; Kuo, Yih-Shiuan; Lin, Pei-Yu

    2016-05-01

    To report the long-term outcomes of topical ganciclovir (GCV) and corticosteroids as a maintenance therapy for cytomegalovirus (CMV) corneal endotheliitis. This retrospective study included 10 eyes of 9 patients diagnosed with CMV corneal endotheliitis with a minimum 1-year follow-up at a tertiary referral hospital between 2008 and 2014. CMV corneal endotheliitis was defined by corneal edema associated with typical keratic precipitates (KPs) and a positive CMV polymerase chain reaction from aqueous humor taps. Patients receiving long-term topical 0.5% GCV and topical corticosteroids without discontinuation were included. The final corneal condition and endothelial cell density (ECD) were reported. The mean age was 45.6 ± 11.7 years. The mean follow-up duration was 48 ± 25 months. All patients exhibited typical coin-shaped and/or linear KPs. A significant resolution of corneal edema and decreased KPs were achieved within 1 month in all patients after initiating topical 0.5% GCV every 2 hours and topical corticosteroids twice a day. The dose frequency was gradually tapered to GCV 4 times and corticosteroids once or twice a day as a maintenance therapy. All 10 eyes had a clear graft or corneas at the end of this study. The mean ECD was 1630 ± 699 cells per millimeter square before treatment and 1776 ± 834 cells per millimeter square at the end of the study period. Topical 0.5% GCV and corticosteroids as a maintenance regimen without interruption effectively preserved long-term corneal endothelial function.

  15. Anasarca edema with amlodipine treatment.

    Science.gov (United States)

    Sener, Didem; Halil, M; Yavuz, Burcu Balam; Cankurtaran, Mustafa; Arioğul, Servet

    2005-04-01

    To report a case of anasarca edema associated with amlodipine use. A 77-year-old woman with essential hypertension who had not been treated with any other drug was prescribed amlodipine 10 mg/day to control her blood pressure. She developed anasarca edema soon after amlodipine treatment was initiated. Laboratory test results for possible etiologies were negative. Discontinuation of amlodipine resulted in dramatic improvement. To our knowledge, as of February 3, 2005, there have been no other reports of amlodipine-related anasarca edema in the English literature, and only one case was described in the Japanese literature. Pretibial edema is the most common adverse effect of amlodipine. Periocular and perioral edema have occurred less frequently, but anasarca edema has not emerged as a problem. An objective causality assessment revealed amlodipine to be a probable cause of anasarca edema. In rare instances, amlodipine may cause generalized edema, which will resolve upon discontinuation of the drug.

  16. Corneal Transplantation in Children

    OpenAIRE

    Gabrić, N.; Dekaris, I.; Vojniković, B.; Karaman, Ž.; Mravičić, I.; Katušić, J.

    2001-01-01

    The main purpose of the study was to describe the surgical success rate and visual results of penetrating keratoplasty in children. This retrospective study included children that underwent corneal transplantation at the Department of Ophthalmology, General Hospital »Sveti Duh«, in the period 1994–1999. Patients’ age ranged from 6 to 16 years. Twenty-five corneal transplants were performed in 24 eyes. Corneal pathologies were corneal leucoma, congenital dystrophy, corneal combu...

  17. Corneal edema and keratitis following selective laser trabeculoplasty

    Directory of Open Access Journals (Sweden)

    Erica Tan Liu

    2017-06-01

    Conclusions and importance: With the increase in usage of SLT as a treatment for glaucoma and subsequent reports of keratitis, it is imperative for ophthalmic surgeons to be aware of herpes simplex as a possible risk factor. Prompt treatment with antivirals and steroids can potentially prevent scarring and permanent damage to the cornea.

  18. Influence of corneal astigmatism, corneal curvature and meridional differences on corneal hysteresis and corneal resistance factor.

    Science.gov (United States)

    Wong, Yin-zhi; Lam, Andrew K C

    2011-09-01

    This study investigated the influence of corneal astigmatism, corneal curvature and meridional differences on corneal hysteresis (CH) and the corneal resistance factor (CRF) in a group of normal Chinese persons. Ninety-five participants were recruited and data from the eye with higher corneal astigmatism were analysed. The anterior corneal curvature was measured by corneal topography. The Goldmann-correlated intraocular pressure (IOPg), corneal-compensated intraocular pressure (IOPcc), CH and CRF at different meridians (default horizontal position, 10°, 20° and 30° along the superotemporal and inferonasal meridians) were obtained from an ocular response analyser. The corneal powers at these specific meridians also were calculated. At the default position, the IOPg and CRF had weak correlations with corneal astigmatism, while the IOPcc and CH were not significantly correlated with corneal astigmatism. Both the IOPg and IOPcc were measured significantly higher at the default position. The CH and CRF were lower at the default position but the difference in the CRF from obliquity could not reach statistical significance. The CH was not significantly correlated with the corneal power at all meridians. The CRF correlated with the corneal power only at 30° superotemporal. Corneal astigmatism and head tilt did not have much effect on the measurement of CH and the CRF, both of which were lowest along the horizontal meridian. Clinically, the difference was small. The influence of corneal power on CH and the CRF was minimal. © 2011 The Authors. Clinical and Experimental Optometry © 2011 Optometrists Association Australia.

  19. Reperfusion pulmonary edema

    Energy Technology Data Exchange (ETDEWEB)

    Klausner, J.M.; Paterson, I.S.; Mannick, J.A.; Valeri, C.R.; Shepro, D.; Hechtman, H.B. (Harvard Medical School, Boston, MA (USA))

    1989-02-17

    Reperfusion following lower-torso ischemia in humans leads to respiratory failure manifest by pulmonary hypertension, hypoxemia, and noncardiogenic pulmonary edema. The mechanism of injury has been studied in the sheep lung lymph preparation, where it has been demonstrated that the reperfusion resulting in pulmonary edema is due to an increase in microvascular permeability of the lung to protein. This respiratory failure caused by reperfusion appears to be an inflammatory reaction associated with intravascular release of the chemoattractants leukotriene B{sub 4} and thromboxane. Histological studies of the lung in experimental animals revealed significant accumulation of neutrophils but not platelets in alveolar capillaries. The authors conclude that thromboxane generated and released from the ischemic tissue is responsible for the transient pulmonary hypertension. Second, it is likely that the chemoattractants are responsible for leukosequestration, and third, neutrophils, oxygen-derived free radicals, and thromboxane moderate the altered lung permeability.

  20. Acute Idiopathic Scrotal Edema

    Directory of Open Access Journals (Sweden)

    Micheál Breen

    2013-01-01

    Full Text Available We report a case of acute idiopathic scrotal edema (AISE in a 4-year-old boy who presented with acute scrotal pain and erythema. The clinical features, ultrasound appearance, and natural history of this rare diagnosis are reviewed. In this report, we highlight the importance of good ultrasound technique in differentiating the etiology of the acute scrotum and demonstrate the color Doppler “Fountain Sign” that is highly suggestive of AISE.

  1. CMV endotheliitis: a cause for recurrent failed corneal transplant

    Directory of Open Access Journals (Sweden)

    Shahrudin, Nurul Ain

    2017-12-01

    Full Text Available Objective: To highlight the clinical presentation of CMV endotheliitis and the challenge in diagnosing this condition in recurrent failed penetrating keratoplasty (PK. Methods: Case seriesResults: There are 3 cases of recurrent failure in PK secondary to CMV endotheliitis presented. Case 1 and 2 were pseudophakic patients, while in case 3, the patient had a previous history of recurrent anterior uveitis. Case 1 and 3 had four and one previous failed PK respectively, while case 2 had endothelial keratoplasty twice before the diagnosis of CMV endotheliitis was made, following positive culture of aqueous humour. The visual acuity ranged from 1/60 to hand movement. All patients had pigmented KP, and two of them had typical coin-shaped KP. Oral valganciclovir was instituted for all patients consisting of bidaily for two weeks, followed by 900 mg once daily for six months. Additionally, topical ganciclovir eyedrop 0.5% was given every four hours with topical dexaminim four times a day. Repeated anterior chamber (AC tap after six months of treatment was negative for CMV in case 3 while cases 1 and 2 are still on treatment. CMV endotheliitis is an increasingly important cause of failed corneal transplant. We recommend anterior chamber tap in suspicious cases of repeatedly failed corneal transplant, regardless of the presence of coin-shaped KP or not. Minim treatment with oral valganciclovir is important to eradicate the problem, before proceeding with another corneal transplant.Conclusion: It is important to make an accurate early diagnosis by good clinical judgement in preventing loss of corneal endothelial cells. High index of suspicion for CMV endotheliitis as a cause of graft failure must be made especially when the patient presents with coin-shaped KP. Therefore unnecessary treatment resulting from misdiagnosis in these patients can be prevented. Early recognition and treatment of this condition is important to prevent permanent endothelial cell

  2. Changing Indications and Surgical Techniques for Corneal Transplantation Between 2004 and 2009 at a Tertiary Referral Center

    Science.gov (United States)

    Zare, Mohammad; Javadi, Mohammad A.; Einollahi, Bahram; Karimian, Farid; Rafie, Ali R. B.; Feizi, Sepehr; Azimzadeh, Ahmad

    2012-01-01

    Purpose: The aim of this study is to report the indications, techniques, and clinical outcomes of corneal transplantation and investigate any changing trends in surgical techniques over a 6 year period. Materials and Methods: Records of patients who had undergone any kind of corneal transplantation at Labbafinejad Medical Center, Tehran, Iran, from January 2004 to December 2009 were reviewed to determine the indications and types of corneal transplantation. Postoperative best-corrected visual acuity, refractive error, graft clarity, and complications were reported. Results: During this period, 1859 eyes of 1624 patients with a mean age of 41.3 ± 21.3 years underwent corneal transplantation. The most common indication was keratoconus (38.4%) followed by aphakic/pseudophakic bullous keratopathy (11.7%), previous failed grafts (10.6%), infectious corneal ulcers (10.1%), non-herpetic corneal scars (7.6%), trachoma keratopathy (4.7%), stromal corneal dystrophies (4.6%), post-herpetic corneal scar (3.7%), Fuchs’ endothelial dystrophy (0.8%), and congenital hereditary endothelial dystrophy (0.4%). Techniques of corneal transplantation included penetrating keratoplasty (PKP; 70.9%), deep anterior lamellar keratoplasty (DALK; 20.1%), conventional lamellar keratoplasty (LKP; 4.4%), and Descemet's stripping automated endothelial keratoplasty (DSAEK; 2.3%). Over the study period, there was a significant increase in the relative frequency of infectious corneal ulcers, failed grafts, and trachoma keratopathy. Additionally, a significant reduction was observed in PKP and LKP procedures, and volume of DALK and DSAEK increased significantly. At final follow-up, 69.0% of grafts were clear in the PKP group. This figure was 82.6%, 82.7%, and 97.6% in the DALK, LKP, and DSAEK groups, respectively. Conclusion: Keratoconus was the most common indication and PKP was the most prevalent technique used for corneal transplantation. However, significant changes in the indications and

  3. Bilateral Keratoconus and Corneal Hydrops Associated with Eye Rubbing in a 7-year-old Girl

    Directory of Open Access Journals (Sweden)

    Mahmoud-Reza Panahi-Bazaz

    2014-01-01

    Full Text Available Purpose: To report a young child with bilateral keratoconus in the context of vernal keratoconjunctivitis (VKC who developed bilateral corneal hydrops associated with eye rubbing, and to discuss the pathogenesis and review the pertinent literature. Case Report: A seven-year-old girl with VKC and asymmetric keratoconus developed corneal hydrops due to habitual eye rubbing. Corneal edema subsided within 16 weeks in her right eye and 9 weeks in the left eye with subsequent corneal scarring. Conclusion: Continuous mechanical trauma, such as eye rubbing, plays a significant role in the pathogenesis of keratoconus and subsequent hydrops even in childhood.

  4. 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

  5. Management of pseudophakic myopic anisometropic amblyopia with piggyback Visian(®) implantable collamer lens.

    Science.gov (United States)

    Eissa, Sherif A

    2017-03-01

    To assess the outcomes of sulcus implantation of the Visian(®) implantable collamer lens (ICL) to correct pseudophakic myopic anisometropic amblyopia with myopic shift and/or primary refractive overcorrection. Prospective case series enrolled 14 pseudophakic eyes of 14 patients, 5-9 years old, with history of cataract surgery and primary in the bag-intraocular lenses (IOL) implantation, followed by myopic shift and/or refractive overcorrection and anisometropic amblyopia of variable degrees. All cases had implantation of a piggyback ICL/toric ICL, to correct the myopia/myopic astigmatism. Preoperatively, we evaluated the uncorrected distance visual acuity (UCVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), intraocular pressure (IOP) and endothelial cell density (ECD). We assessed the position and vaulting of the ICLs on slit lamp examination and confirmed by Scheimpflug tomography. Postoperative follow-up was at 1st week and 1, 3, 6, 9, 12, 18 and 24 months. Uncorrected distance visual acuity improved in all cases, and CDVA improved in 11 amblyopic eyes (2-4 lines). There was no evidence of interlenticular opacification (ILO) throughout the 2-year follow-up. Two cases were complicated with early postoperative acute elevation of IOP and were controlled with topical beta-blockers. Postoperative acute anterior uveitis occurred in six eyes and controlled by topical steroids. Implantable collamer lens (ICL) vault was measured using Pentacam, with mean value of 470 ± 238 μm. Sulcus implantation of the secondary piggyback ICL to correct unilateral pseudophakic myopic refractive error in children was safe, efficient, predictable and well tolerated in management of anisometropic amblyopia in all eyes. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  6. Crossed versus conventional pseudophakic monovision: Patient satisfaction, visual function, and spectacle independence.

    Science.gov (United States)

    Zhang, Fuxiang; Sugar, Alan; Arbisser, Lisa; Jacobsen, Gordon; Artico, Jessica

    2015-09-01

    To compare patient satisfaction, visual function, and spectacle independence in patients with crossed or conventional pseudophakic monovision. Department of Ophthalmology, Henry Ford Health System, Taylor, Michigan, USA. Retrospective comparative cohort study. Cataract surgery patient records from June 1999 to December 2013 were reviewed. Crossed monovision patients were identified. Control conventional monovision cases were matched for age, sex, general health, personal lifestyle/main hobbies, preoperative refractive status, postoperative refractive status, uncorrected distance visual acuity, uncorrected near visual acuity, astigmatism level, and anisometropia level. A survey was mailed to participants, and results were independently analyzed. The review comprised 7311 patient records. Forty-four crossed monovision patients were identified, and 30 of them were enrolled. Thirty matched pairs were surveyed. The mean anisometropia was 1.19 diopters (D) in the conventional and 1.12 D in the crossed monovision groups. No significant difference was identified for eye-hand coordination, eye-foot coordination, or sport-related depth perception, but satisfaction was slightly better in the crossed monovision group (P = .028). No significant difference was identified for 6 of 8 spectacle independence measures, but nighttime driving was a little easier for the crossed monovision group (P = .025). Seventy-seven percent of crossed and 50% of conventional monovision patients did not use glasses for intermediate distance activities (P = .037). Crossed pseudophakic monovision appears to work as well as conventional pseudophakic monovision in terms of patient satisfaction and spectacle independence in patients with a mild degree of anisometropic pseudophakia. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. Global Survey of Corneal Transplantation and Eye Banking.

    Science.gov (United States)

    Gain, Philippe; Jullienne, Rémy; He, Zhiguo; Aldossary, Mansour; Acquart, Sophie; Cognasse, Fabrice; Thuret, Gilles

    2016-02-01

    Corneal transplantation restores visual function when visual impairment caused by a corneal disease becomes too severe. It is considered the world's most frequent type of transplantation, but, to our knowledge, there are no exhaustive data allowing measurement of supply and demand, although such data are essential in defining local, national, and global strategies to fight corneal blindness. To describe the worldwide situation of corneal transplantation supply and demand. Data were collected between August 2012 and August 2013 from a systematic review of published literature in parallel with national and international reports on corneal transplantation and eye banking. In a second step, eye bank staff and/or corneal surgeons were interviewed on their local activities. Interviews were performed during international ophthalmology or eye-banking congresses or by telephone or email. Countries' national supply/demand status was classified using a 7-grade system. Data were collected from 148 countries. Corneal transplantation and corneal procurements per capita in each country. In 2012, we identified 184,576 corneal transplants performed in 116 countries. These were procured from 283,530 corneas and stored in 742 eye banks. The top indications were Fuchs dystrophy (39% of all corneal transplants performed), a primary corneal edema mostly affecting elderly individuals; keratoconus (27%), a corneal disease that slowly deforms the cornea in young people; and sequellae of infectious keratitis (20%). The United States, with 199.10-6 corneal transplants per capita, had the highest transplantation rate, followed by Lebanon (122.10-6) and Canada (117.10-6), while the median of the 116 transplanting countries was 19.10-6. Corneas were procured in only 82 countries. Only the United States and Sri Lanka exported large numbers of donor corneas. About 53% of the world's population had no access to corneal transplantation. Our survey globally quantified the considerable shortage of

  8. Edema pulmonar de gran altura HIGH ALTITUDE PULMONARY EDEMA

    OpenAIRE

    FELIPE UNDURRAGA M; ALVARO UNDURRAGA P

    2003-01-01

    Las enfermedades de altura son de causa cerebral y pulmonar. Las primeras se refieren fundamentalmente al mal agudo de montaña y al edema cerebral de altura y las segundas al edema pulmonar agudo de montaña. Actuales evidencias señalan que el edema cerebral sería un fenómeno universal de los que ascienden a altura y que tres de cada cuatro individuos sanos que se expongan a altura desarrollarán un edema pulmonar agudo de montaña subclínico. La hipoxia de altura es la responsable de estos cuad...

  9. Bone marrow edema syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Korompilias, Anastasios V.; Lykissas, Marios G.; Beris, Alexandros E. [University of Ioannina, Department of Orthopaedic Surgery, School of Medicine, Ioannina (Greece); Karantanas, Apostolos H. [University of Crete School of Medicine, Department of Radiology, Heraklion (Greece)

    2009-05-15

    Bone marrow edema syndrome (BMES) refers to transient clinical conditions with unknown pathogenic mechanism, such as transient osteoporosis of the hip (TOH), regional migratory osteoporosis (RMO), and reflex sympathetic dystrophy (RSD). BMES is primarily characterized by bone marrow edema (BME) pattern. The disease mainly affects the hip, the knee, and the ankle of middle-aged males. Many hypotheses have been proposed to explain the pathogenesis of the disease. Unfortunately, the etiology of BMES remains obscure. The hallmark that separates BMES from other conditions presented with BME pattern is its self-limited nature. Laboratory tests usually do not contribute to the diagnosis. Histological examination of the lesion is unnecessary. Plain radiographs may reveal regional osseous demineralization. Magnetic resonance imaging is mainly used for the early diagnosis and monitoring the progression of the disease. Early differentiation from other aggressive conditions with long-term sequelae is essential in order to avoid unnecessary treatment. Clinical entities, such as TOH, RMO, and RSD are spontaneously resolving, and surgical treatment is not needed. On the other hand, early differential diagnosis and surgical treatment in case of osteonecrosis is of crucial importance. (orig.)

  10. Targeted corneal transplantation.

    Science.gov (United States)

    Jhanji, Vishal; Mehta, Jod S; Sharma, Namrata; Sharma, Bhavana; Vajpayee, Rasik B

    2012-07-01

    Corneal transplantation surgery has moved from an era of conventional penetrating keratoplasty to selective replacement of the diseased corneal layer with complementary healthy donor corneal tissue. Anterior lamellar transplantation surgeries do not involve replacement of corneal endothelium, consequently eliminating the occurrence of endothelial rejection. Similarly, in diseases affecting the corneal endothelium, selective replacement with a lamellar lenticule bearing healthy endothelium provides better outcomes in terms of ocular surface, lesser astigmatism and quick visual recovery. In addition to the advantages of enhanced surgical outcomes, targeted corneal transplantation allows the use of one donor cornea for more than one recipient, thereby offering a viable solution to the problem of paucity of donor corneas. Evolving techniques of corneal transplantation have enabled better utilization of donor corneal tissue. Anterior lamellar as well as endothelial keratoplasty surgeries have become first-choice surgeries in appropriately selected cases. This review briefly discusses some of these novel surgical techniques. A better understanding of targeted corneal transplantation would lead to adaptation of the concept of component corneal surgery. This would further enable the corneal surgeons to circumvent the problem of donor corneal shortage especially in the developing world.

  11. 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...... foreign bodies in horses. They were more commonly diagnosed in horses living in subtropical climatic areas of the world. Therapeutic recommendations to treat equine SAs were historically nearly always a medical approach directed at bacteria and the often associated severe iridocyclitis. Today...... the pathogenesis of most equine SAs appears to be more often related to fungal inoculation of the anterior corneal stroma followed by posterior migration of the fungi deeper into the corneal stroma. There is also now an increased incidence of diagnosis of corneal SAs in horses living in more temperate climates...

  12. Corneal transplantation in children.

    Science.gov (United States)

    Gabrić, N; Dekaris, I; Vojniković, B; Karaman, Z; Mravicić, I; Katusić, J

    2001-01-01

    The main purpose of the study was to describe the surgical success rate and visual results of penetrating keratoplasty in children. This retrospective study included children that underwent corneal transplantation at the Department of Ophthalmology, General Hospital "Sveti Duh", in the period 1994-1999. Patients' age ranged from 6 to 16 years. Twenty-five corneal transplants were performed in 24 eyes. Corneal pathologies were corneal leucoma, congenital dystrophy, corneal combustion, corneal scar after perforating injury, keratoconus, corneal melting, hematocornea and rekeratoplasty. The follow-up period was at least 6 months. The rate of graft survival was 1 year in 75% of eyes with congenital dystrophy and keratoconus. Hematocornea and rekeratoplasty ended with graft failure. Postoperative visual acuity improvement was recorded in 14 out of 25 eyes. Penetrating keratoplasty in children showed very good surgical success. The final visual outcome was affected by irreversible amblyopia.

  13. Ways to Improve (Visual) Outcome in Corneal Transplantation, Corneal Pathology

    NARCIS (Netherlands)

    M.C. Bartels (Marjolijn)

    2005-01-01

    textabstractThe normally transparent cornea can lose its ability to refract light regularly from various conditions. Among these conditions are corneal opacities and corneal diseases leading to a distortion of the corneal contour. Vision might be restored by a corneal transplantation. Corneal

  14. [Corneal transplant in a second level hospital. A survival analysis].

    Science.gov (United States)

    Hernández-Da Mota, Sergio E; Paniagua Jacobo, Margarita; Gómez Revuelta, Gustavo; Páez Martínez, Raymundo Mauricio

    2013-01-01

    To determine the long-term corneal graft survival in patients of General Hospital Dr. Miguel Silva. This was a retrospective cohort study. Records from patients who underwent corneal transplant surgery at General Hospital Dr. Miguel Silva were analyzed. The percentages of graft failure were obtained. Kaplan-Meier survival analysis was performed to evaluate the long-term cumulative probability of graft non-rejection in all patients according to diagnosis. Overall, 71.9% (CI 95%: 64.8-78.9) of the patients did not have any graft rejections, and 12.5% (CI 95%: 7-18) required a regraft and were considered graft failures. Patients with posttraumatic leucoma had a cumulative probability of non-rejection of 100%. Subjects with keratoconus had a 65% likelihood of non-rejection after 40 months of follow-up. The likelihood of non-rejection was greater than 80% at 100 months of follow-up in pseudophakic bullous keratopathy patients and 60% at 20 months of follow-up in inactive herpetic leucoma patients. Posttraumatic leucoma patients had the greatest cumulative survival probability compared with postherpetic leucoma patients and other patient groups.

  15. Extracellular matrix alterations in late-onset Fuchs' corneal dystrophy.

    Science.gov (United States)

    Weller, Julia M; Zenkel, Matthias; Schlötzer-Schrehardt, Ursula; Bachmann, Bjoern O; Tourtas, Theofilos; Kruse, Friedrich E

    2014-05-15

    To characterize the alterations of extracellular matrix proteins in Descemet's membranes (DM) of patients with late-onset Fuchs' corneal dystrophy (FCD) and to differentiate them from nonspecific alterations in pseudophakic bullous keratopathy (PBK). Human DM-endothelial cell complexes were obtained from patients with late-onset FCD (n = 40), PBK (n = 6), and control eyes (n = 5). Gene expression profiles of endothelial cells were compared using a commercial real-time PCR array and quantitative real-time PCR assays for confirmation of differentially expressed genes. A total of 24 extracellular matrix proteins were also localized in cryosections of corneal specimens from FCD (n = 10), PBK (n = 4), and control eyes (n = 5) by immunohistochemistry. Polymerase chain reaction array analysis revealed a significant upregulation of 27 out of 84 extracellular matrix-related genes including collagens, proteoglycans, glycoproteins, cell adhesion molecules, and matrix metalloproteinases in FCD specimens as compared to normal controls, which could be partly confirmed and quantified by real-time PCR. Comparative analysis of FCD and PBK specimens showed a significant and consistent FCD-specific upregulation of collagen types I, III, and XVI; fibronectin; agrin; clusterin; transforming growth factor beta-induced (TGFBI); and integrin α4 (3- to 18-fold, P matrix alterations in the pathophysiology of FCD. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  16. Effects of Hyperbaric Conditions on Corneal Physiology with Hydrogel Contact Lenses

    Science.gov (United States)

    1987-10-02

    option for improving the vision of divers is to use contact lenses. These include standard hard ( PMMA ), gas permeable rigid, and hydrogel contact...rigid ( PMMA ) lenses after exposures to a hyperbaric environment resulting in corneal edema, dimpling of the corneal epithelium, and reduced visual...environments. Lens displacement, which could result in ocular injury or disruption of vision, is also of concern. 8 ■A Several investigations have

  17. Gamma-Irradiated Sterile Cornea for Use in Corneal Transplants in a Rabbit Model.

    Science.gov (United States)

    Yoshida, Junko; Heflin, Thomas; Zambrano, Andrea; Pan, Qing; Meng, Huan; Wang, Jiangxia; Stark, Walter J; Daoud, Yassine J

    2015-01-01

    Gamma irradiated corneas in which the donor keratocytes and endothelial cells are eliminated are effective as corneal lamellar and glaucoma patch grafts. In addition, gamma irradiation causes collagen cross inking, which stiffens collagen fibrils. This study evaluated gamma irradiated corneas for use in corneal transplantations in a rabbit model comparing graft clarity, corneal neovascularization, and edema. Penetrating keratoplasty was performed on rabbits using four types of corneal grafts: Fresh cornea with endothelium, gamma irradiated cornea, cryopreserved cornea, and fresh cornea without endothelium. Slit lamp examination was performed at postoperative week (POW) one, two, and four. Corneal clarity, edema, and vascularization were graded. Confocal microscopy and histopathological evaluation were performed. A P cornea with endothelium compared to the other three groups (P cornea scored better than the cryopreserved and fresh cornea without endothelium groups in clarity (0.9 vs. 1.5 and 2.6, respectively), and edema (0.6 vs. 0.8 and 2.0, respectively). The gamma irradiated corneas, cryopreserved corneas and the fresh corneas without endothelium, developed haze and edema after POW 2. Gamma irradiated cornea remained statistically significantly clearer than cryopreserved and fresh cornea without endothelium during the observation period (P cornea. Gamma irradiated corneas remained clearer and thinner than the cryopreserved cornea and fresh cornea without endothelium. However, this outcome is transient. Gamma irradiated corneas are useful for lamellar and patch grafts, but cannot be used for penetrating keratoplasty.

  18. Tissue and cellular biomechanics during corneal wound injury and repair.

    Science.gov (United States)

    Raghunathan, Vijay Krishna; Thomasy, Sara M; Strøm, Peter; Yañez-Soto, Bernardo; Garland, Shaun P; Sermeno, Jasmyne; Reilly, Christopher M; Murphy, Christopher J

    2017-08-01

    Corneal wound healing is an enormously complex process that requires the simultaneous cellular integration of multiple soluble biochemical cues, as well as cellular responses to the intrinsic chemistry and biophysical attributes associated with the matrix of the wound space. Here, we document how the biomechanics of the corneal stroma are altered through the course of wound repair following keratoablative procedures in rabbits. Further we documented the influence that substrate stiffness has on stromal cell mechanics. Following corneal epithelial debridement, New Zealand white rabbits underwent phototherapeutic keratectomy (PTK) on the right eye (OD). Wound healing was monitored using advanced imaging modalities. Rabbits were euthanized and corneas were harvested at various time points following PTK. Tissues were characterized for biomechanics with atomic force microscopy and with histology to assess inflammation and fibrosis. Factor analysis was performed to determine any discernable patterns in wound healing parameters. The matrix associated with the wound space was stiffest at 7days post PTK. The greatest number of inflammatory cells were observed 3days after wounding. The highest number of myofibroblasts and the greatest degree of fibrosis occurred 21days after wounding. While all clinical parameters returned to normal values 400days after wounding, the elastic modulus remained greater than pre-surgical values. Factor analysis demonstrated dynamic remodeling of stroma occurs between days 10 and 42 during corneal stromal wound repair. Elastic modulus of the anterior corneal stroma is dramatically altered following PTK and its changes coincide initially with the development of edema and inflammation, and later with formation of stromal haze and population of the wound space with myofibroblasts. Factor analysis demonstrates strongest correlation between elastic modulus, myofibroblasts, fibrosis and stromal haze thickness, and between edema and central corneal

  19. Corneal collagen crosslinking for keratoconus. A review

    Directory of Open Access Journals (Sweden)

    M. M. Bikbov

    2014-01-01

    C, and collagen fiber diameter increase by 12.2 % (anterior stroma and 4.6 % (posterior stroma. In mild bullous keratopathy, corneal crosslinking provides antimicrobial effect. In moderate and severe keratopathy, crosslinking reduces pain and corneal edema and improves visual acuity immediately after the procedure. A case of HSV keratitis exacerbation was described. Amongst the complications, infection, halos, and posterior segment damage should be mentioned. Poor refractive results can be improved by the implantation of intrastromal corneal ring segments.

  20. Corneal collagen crosslinking for keratoconus. A review

    Directory of Open Access Journals (Sweden)

    M. M. Bikbov

    2014-10-01

    C, and collagen fiber diameter increase by 12.2 % (anterior stroma and 4.6 % (posterior stroma. In mild bullous keratopathy, corneal crosslinking provides antimicrobial effect. In moderate and severe keratopathy, crosslinking reduces pain and corneal edema and improves visual acuity immediately after the procedure. A case of HSV keratitis exacerbation was described. Amongst the complications, infection, halos, and posterior segment damage should be mentioned. Poor refractive results can be improved by the implantation of intrastromal corneal ring segments.

  1. Vanishing corneal vessels

    Science.gov (United States)

    Nicholson, Luke; Chana, Rupinder

    2013-01-01

    We wish to highlight the importance of acknowledging the accompanying effects of topical phenylephrine drops on the eye other than its intended mydriasis. We reported a case of a 92-year-old woman with a corneal graft who was noted to have superficial corneal vascularisation which was not documented previously. After the instillation of topical tropicamide 1% and phenylephrine 2.5%, for funduscopy, the corneal vascularisation was not visible. When reassessed on another visit, tropicamide had no effect on the vessels and only phenylephrine did. We wish to highlight that when reviewing patients in cornea clinics, instilling phenylephrine prior to being seen may mask important corneal vascularisation. PMID:24121816

  2. Skin edema in first trimester fetuses.

    Science.gov (United States)

    Jenewein, N; Christ, J; Günther, D; Hutsteiner, P; Ortmann, O; Germer, U

    2013-10-01

    The aim of this study was to prove an association between generalized skin edema and nuchal translucency (NT) thickness and its predictive value for aneuploidy and structural anomalies. In this retrospective study fetuses with and without skin edema in the first trimester with an NT above 2.2 mm were compared. Statistical significance was calculated with the Chi-square test (p edema. The rate of skin edema was 1.3 % in the group with an NT edema which was significantly higher than the rate of 10.2 % (20/196) in those without skin edema (p edema and significantly higher compared to 9.1 % (16/176) in those without skin edema (p edema. Skin edema has a high predictive value for aneuploidy or structural malformations. Therefore, fetuses with skin edema should have early malformation scans in case of normal karyotype. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Juvenile Dermatomyositis with Generalized Edema

    OpenAIRE

    J Gordon Millichap

    2001-01-01

    A 7-year-old girl presenting with an 8-week history of fatigue, myalgia, dyspnea, and generalized, nonpitting edema of the extremities, face, chest, and abdomen, is reported from the Walter Reed Army Medical Center, Washington, DC.

  4. Juvenile Dermatomyositis with Generalized Edema

    National Research Council Canada - National Science Library

    J Gordon Millichap

    2001-01-01

    A 7-year-old girl presenting with an 8-week history of fatigue, myalgia, dyspnea, and generalized, nonpitting edema of the extremities, face, chest, and abdomen, is reported from the Walter Reed Army...

  5. Assessing corneal hysteresis using the Ocular Response Analyzer.

    Science.gov (United States)

    McMonnies, Charles W

    2012-03-01

    An examination of studies that have assessed corneal biomechanical performance using the Ocular Response Analyzer (ORA: Reichert Ophthalmic Instruments, Depew, NY) raises some questions regarding the influence of measurement variables and the interpretation of the findings obtained with this instrument. This analysis of those questions describes additional factors which do or may contribute to the assessment of corneal hysteresis (CH). Using key words CH and ORA, English language articles relevant to this analysis were selected after a PubMed search with the addition of some articles referenced in the selected publications. Corneal thickness, the level of edema, intraocular pressure, and corneal temperature as well as the area, location, rate, duration, and sequence of corneal unloading and loading may need to be considered as significant variables when assessing CH. CH values may be specific to measurement method and conditions rather than representing an unequivocal corneal property. Consideration of the uncontrolled variables involved may help explain some of the findings obtained with the ORA. That a CH measurement might vary with the sequence of unloading and loading suggests that the ORA CH finding may not represent the CH, but instead represents a hysteresis value better described as central, applanation-derived hysteresis, which is based on a very short unloading/loading sequence. The potential for the ORA to contribute to improved clinical management appears to be considerable but so does the need for better understanding and further development of its functions and applications.

  6. Clinical study on human lamellar keratoplasty for fungal corneal ulcers with porcine acellular corneal stroma

    Directory of Open Access Journals (Sweden)

    Fu-Hong Liao

    2017-09-01

    Full Text Available AIM: To observe the transplantation of acellular porcine corneal stroma on the treatment of superficial keratitis by drug-resistant fungal. METHODS: We performed a retrospective analysis of 16 cases of fungal keratitis received the transplantation of acellular porcine corneal matrix from June 2015 to March 2016 with a follow-up of 6mo. We analyzed on items as postoperative visual acuity, corneal graft status, postoperative recurrence and postoperative complications. RESULTS: We observed a healing time of corneal epithelium in 7 to 10d postoperatively generally and the absence of corneal edema in 1mo, while the cornea gradually returned transparent in the 16 cases. Two cases required medication for an epithelial recovery and 3 cases received intervention for decreasing intraocular pressure to a certain level. During the follow-up we observed no cases of cornea degeneration, recurrence of infection or rejection. The vision acuity showed 1.27±0.22, 1.11±0.13, 0.79±0.22 in 1, 3 and 6mo after operation respectively. There was no statistical difference between vision in 1mo and the vision before surgery(P=0.06; while we found a statistical difference when comparing the vision of 3 and 6mo with vision before surgery(P=0.01,0.001. The vision in 6mo increased with a statistic difference to the vision at 1 and 3mo(PP=0.11. CONCLUSION: Transplantation of acellular porcine corneal matrix is a safe and efficient treatment for fungal keratitis.

  7. 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.

  8. Predicting extended wear complications from overnight corneal swelling.

    Science.gov (United States)

    Graham, A D; Fusaro, R E; Polse, K A; Lin, M C; Giasson, C J

    2001-12-01

    To examine the hypothesis that the corneal overnight swelling response (ONSR) is a predictor of ocular complications in contact lens extended wear (EW). The Berkeley Contact Lens Extended Wear Study (CLEWS) was a randomized, concurrently controlled clinical trial in which more than 200 subjects in EW with rigid gas-permeable (RGP) lenses were observed for 1 year. After adapting to EW, subjects were randomized to either medium or high oxygen-permeable (Dk) RGP lenses and underwent clinical assessments, keratometry, and corneal pachometry at 3-month intervals. The ONSR was directly related to lens Dk (P = 0.01) and exhibited substantial variability across subjects. The probability of remaining free of complications over time was not significantly lower for subjects with a mild ONSR compared with those with greater edema (P = 0.84). The risk of development of keratopathy was not significantly related to the ONSR (relative risk = 1.00). The corneal ONSR is not a good predictor of ocular complications in 1 year of RGP EW. Lenses that cause little or no corneal edema are not necessarily safer for overnight wear.

  9. CLINICAL OUTCOME OF PENETRATING KERATOPLASTY IN CORNEAL OPACITIES OF DIFFERENT AETIOLOGY- A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Dipak Bhuyan

    2017-01-01

    Full Text Available BACKGROUND Corneal transplantation or grafting is an operation in which abnormal corneal host tissue is replaced by healthy donor cornea. According to the World Health Organization (WHO, corneal diseases are among the major causes of vision loss and blindness in the world today after cataract and glaucoma. The aim of the study is to- 1. Evaluate the different aetiology of corneal opacity including active infective aetiology as indicated for penetrating keratoplasty. 2. Determine the clinical outcome of penetrating keratoplasty in relation to graft survival, graft rejection and peri-operative complications in different aetiology groups. 3. Determine the final visual outcome. MATERIALS AND METHODS Candidates for keratoplasty were selected from- 1. Eye Bank of Regional Institute of Ophthalmology (R.I.O. 2. R.I.O OPD. The study period was from September 2014 to August 2015. 30 cases were taken in the study. Descriptive statistics were applied to analyse the data wherever necessary. RESULTS 34.6±19.73 yrs. (mean±SD was the mean age at which transplants were done in the study. Out of total 30 cases, 13 (43.33% and 17 (56.66% were male and female, respectively. The different indications for penetrating keratoplasty are- Post ulcer corneal opacity in 14 cases (46.66%, posttraumatic corneal opacity 9 cases (30%, pseudophakic bullous keratopathy 4 cases (13.33%, corneal dystrophy in 2 cases (6.66% and non-healing corneal ulcer in 1 case (3.33%. 16 cases (53.33% showed clear graft till the last follow up while 11 (33.33% cases showed partially clear graft resulting in improved visual outcome while 3 cases (10.00% of the grafts were opaque due to graft failure. CONCLUSION The major indications for penetrating keratoplasty in this part of the world are post ulcer and posttraumatic corneal opacity and majority of them are illiterate agricultural workers who failed to get adequate treatment on time. Graft survival rate is high, which can be attributed to the

  10. corneal pyogenic granuloma

    African Journals Online (AJOL)

    GB

    2012-09-14

    Sep 14, 2012 ... Figure 3: A child with pyogenic cornea granuloma intra operatively. After excision of the mass, central corneal stromal defect developed. The patient was followed up for more than a month with topical antibiotic and cycloplegic. Subsequently, the defect healed and leucoma corneal opacity (figure.

  11. Primary vitrectomy with perfluoro-n-octane use in the treatment of pseudophakic retinal detachment with undetected retinal breaks.

    Science.gov (United States)

    Brazitikos, P D; D'Amico, D J; Tsinopoulos, I T; Stangos, N T

    1999-01-01

    This report describes the results of a prospective trial to evaluate the efficacy of pars plana vitrectomy (PPV) in conjunction with perfluoro-n-octane (PFO) as initial treatment of pseudophakic retinal detachment (RD) with no breaks diagnosed preoperatively. Fourteen consecutive eyes presenting with pseudophakic RD in which retinal breaks could not be identified preoperatively underwent primary PPV, internal microsurgical identification of the retinal breaks with endoillumination and noncontact wide angle viewing system, PFO retinal reattachment, transscleral cryopexy or endolaser treatment of breaks, PFO-air exchange, and final injection of 20% sulfur hexafluoride. In five eyes, a scleral buckle was also used. Mean follow-up period was 18 months. In 13 of the 14 eyes in which no breaks had been identified preoperatively, breaks were diagnosed during surgery. Perfluoro-n-octane retinal attachment facilitated accurate microscopic treatment of retinal breaks. The retina was reattached with a single operation in all eyes. Eleven eyes had final visual acuity of 20/60 or better. Complications were minimal. Pars plana vitrectomy in conjunction with PFO expression of subretinal fluid is effective in the initial treatment of pseudophakic RD with no preoperative diagnosis of retinal breaks.

  12. Corneal biomechanics - a review.

    Science.gov (United States)

    Kling, Sabine; Hafezi, Farhad

    2017-05-01

    In recent years, the interest in corneal biomechanics has strongly increased. The material properties of the cornea determine its shape and therefore play an important role in corneal ectasia and related pathologies. This review addresses the molecular origin of biomechanical properties, models for their description, methods for their characterisation, techniques for their modification, and computational simulation approaches. Recent research has focused on developing non-contact techniques to measure the biomechanical properties in vivo, on determining structural and molecular abnormalities in pathological corneas, on developing and optimising techniques to reinforce the corneal tissue and on the computational simulation of surgical interventions. A better understanding of corneal biomechanics will help to improve current refractive surgeries, allow an earlier diagnosis of ectatic disorders and a better quantification of treatments aiming at reinforcing the corneal tissue. © 2017 The Authors Ophthalmic & Physiological Optics © 2017 The College of Optometrists.

  13. Animal study on transplantation of human umbilical vein endothelial cells for corneal endothelial decompensation

    Directory of Open Access Journals (Sweden)

    Li Cui

    2014-06-01

    Full Text Available AIM: To explore the feasibility of culturing human umbilical vein endothelial cells(HUVECon acellular corneal stroma and performing the posterior lamellar endothelial keratoplasty(PLEKtreating corneal endothelial decompensation.METHODS: Thirty New-Zealand rabbits were divided into three groups randomly, 10 rabbits for experimental group, 10 for stroma group and 10 for control group. Corneal endothelial cells were removed to establish animal model of corneal endothelial failure. PLEK was performed on the rabbits of experimental group and stroma group, and nothing was transplantated onto the rabbits of control group with the deep layer excised only. Postoperative observation was taken for 3mo. The degree of corneal edema and central corneal thickness were recorded for statistical analysis.RESULTS: Corneas in experimental group were relieved in edema obviously compared with that in stroma group and the control group, and showed increased transparency 7d after the operation. The average density of endothelial cells was 2 026.4±129.3cells/mm2, and average central corneal thickness was 505.2±25.4μm in experimental group, while 1 535.6±114.5μm in stroma group and 1 493.5±70.2μm in control group 3mo after operation.CONCLUSION:We achieved preliminary success in our study that culturing HUVEC on acellular corneal stroma and performing PLEK for corneal endothelial decompensation. HUVEC transplanted could survive in vivo, and have normal biological function of keeping cornea transparent. This study provides a new idea and a new way clinically for the treatment of corneal endothelial diseases.

  14. Changes in Technique and Indications for Keratoplasty in Poland, 1989 to 2014: An Analysis of Corneal Transplantations Performed at Saint Barbara Hospital, Trauma Center, Sosnowiec, Poland.

    Science.gov (United States)

    Jankowska-Szmul, J; Dobrowolski, D; Krysik, K; Kwas, J; Nejman, M; Wylegala, E

    2016-06-01

    The purpose of this work was to study the evolving trends in techniques and indications for corneal transplantation in Poland. This retrospective, descriptive analysis of corneal transplantations was performed at the Ophthalmology Department of Saint Barbara Hospital, Trauma Center, Sosnowiec, Poland, between 1988 and 2014. Structure of indications and surgery type rates over 26 years were tabulated by means of 5-year intervals. Between 1989 and 2014, 1762 corneal transplantations were performed, including 1375 (78%) cases of penetrating keratoplasty, 137 (8%) lamellar keratoplasty, 112 (6%) patch grafts, and 138 (8%) keratolimbal allografts. The major indications and their respective overall percentage were corneal leucoma (24%), pseudophakic/aphakic bullous keratopathy (22%), Fuchs dystrophy (13%), keratoconus (13%), re-graft (11%), keratitis (9%), and limbal stem cell deficiency (8%), with changes in relative frequency of the leading indications over the following time intervals. The number of corneal transplantations gradually increased during the years reviewed. The rates of lamellar, keratolimbal, and patch grafts have grown dynamically since 2010, reaching 20%, 17%, and 12%, respectively, of procedures performed during 2010 to 2014. Over the past quarter of a century, there has been evolution in corneal transplantation service, from the first penetrating keratoplasty to the wide spectrum of procedures, including femtosecond laser-assisted keratoplasty. Although, since 2010, the rates of lamellar and keratolimbal allografts have grown rapidly, penetrating keratoplasty has remained the leading technique. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. [Insulin edema in hepatic glycogenosis].

    Science.gov (United States)

    Mahévas, T; Gobert, D; Gatfossé, M; Mekinian, A; Fain, O

    2017-03-01

    Hepatic glycogenosis is a rare syndrome, which includes poorly controlled diabetes mellitus, hepatomegaly, delayed puberty, and growth delay. Insulin edema is sometimes associated. An 18-year-old woman presented with diffuse edema, hepatomegaly, amenorrhea, uncontrolled diabetes, and elevated transaminases and cholestasis. Hepatic ultrasonography and abdominal computed tomographic scan confirmed the hepatomegaly. The liver biopsy showed a massive glycogenosis and the diagnosis of hepatic glycogenosis was confirmed. Too large doses of insulin were responsible of diffuse edema. Diabetes equilibration and diminution of insulin intakes allow correction of this disorder. Excess of insulin can lead to excessive hepatic glycogen storage by activation of glycogenosis enzymes. Biological manifestations consist on elevated liver enzymes and hyperlactatemia. There is a link between administration of high dose of insulin and edema. Hepatic glycogenosis should be suspected when diabetes is uncontrolled and be considered as a differential diagnosis of steatosis. It may be associated and revealed by insulin edema directly related to excessive insulin intakes. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  16. Reexpansion pulmonary edema following thoracentesis

    Directory of Open Access Journals (Sweden)

    Ansuman Mukhopadhyay

    2016-01-01

    Full Text Available Reexpansion pulmonary edema is an uncommon complication of the treatment of lung atelectasis, pleural effusion or pneumothorax and pathogenesis is unknown. An elderly male patient presented to us with right-sided pleural effusion. 2 h after thoracentesis, he felt chest discomfort and increased breathlessness. His chest examination showed right-sided crackles. Chest radiograph showed right-sided heterogeneous opacity in right lower zone consistent with unilateral pulmonary edema. He was managed conservatively along with bilevel positive airway pressure ventilator support. His condition improved gradually and was discharged successfully after 2 days.

  17. Limited lateral spread of stromal edema in the human cornea fitted with a ('donut') contact lens with a large central aperture.

    Science.gov (United States)

    Holden, B A; McNally, J J; Egan, P

    1988-06-01

    Topographical corneal thickness changes were monitored in 10 subjects who each wore a hydrogel contact lens with a large central aperture ("donut" lens) for 6 hours. Analysis of local corneal thickness changes indicates that no corneal swelling occurred in the central exposed area of the cornea, but significant swelling occurred in the area of the cornea covered by the lens. The lateral cut-off point of corneal swelling was well-defined, indicating that the contact lens-induced corneal edema did not spread laterally to the exposed area of the cornea over the six-hour wearing period. Swelling of the peripheral cornea covered by the lens was found to be significantly greater with a tightly-fitting, immobile donut lens than with a loosely-fitting lens, suggesting that tear mixing may explain in part the apparent averaging of edema during open-eye wear of hydrogel lenses of varying thickness profile. The possibility that lateral spread of lactate within the stroma may contribute to this apparent averaging of edema was not confirmed in this study. We suggest that rapid metabolism or elimination of lactate in the exposed region of the cornea, or evaporation through the central lens aperture, may have contributed to the maintenance of normal central corneal thickness during open-eye wear of the donut lens.

  18. 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 among 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 (ALK), and endothelial keratoplasty (EK). Indications for corneal transplantation vary among countries, with Fuchs’ dystrophy being the leading indication in the U.S. and keratoconus in Australia. With the exception of the US, 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, e.g., 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. PMID:25268248

  19. Clinico-biochemical correlation of the effect of subconjunctival bevacizumab for corneal neovascularization.

    Science.gov (United States)

    Agarwal, Shweta; Angayarkanni, Narayanasamy; Iyer, Geetha; Srinivasan, Bhaskar; Natarajan, Radhika; Charola, Sanket; Arumugam, Sumathi; Padmanabhan, Prema

    2014-10-01

    The aim of this study was to evaluate the effect of clinical and biochemical effects of subconjunctival bevacizumab injection in eyes with corneal neovascularization (CNV) due to varied etiologies. This prospective interventional case series included 12 eyes of 12 patients with CNV after failed therapeutic penetrating keratoplasty (4 eyes), viral keratitis (4 eyes), adherent leucoma (2 eyes), and pseudophakic bullous keratopathy (2 eyes). Each eye received 3 doses of 1.25 mg (0.05 mL) of bevacizumab at 1-month intervals. Morphological changes in neovascularization were evaluated at each visit by slit-lamp examination and corneal digital photography. Corneal buttons of 4 eyes that underwent optical penetrating keratoplasty after bevacizumab injections were analyzed for vascular endothelial growth factor (VEGF) expression and were compared with untreated vascularized and normal cadaveric donor corneas. Of the 12 patients, 10 were males and 2 were females. Four eyes received injections in the early phase of vascularization (12 weeks) of which 5 showed regression. The follow-up ranged from 1 to 16 months. Five eyes underwent optical penetrating keratoplasty after receiving the last dose of bevacizumab and maintained graft clarity with no episodes of rejection over a mean follow-up of 9.8 months. Four of these 5 corneal buttons analyzed for VEGF expression revealed clinically significant lower levels of expression as compared with the vascular untreated corneas. No local or systemic adverse effects were noted in any patient. Subconjunctival bevacizumab helps to regress CNV due to a decrease in corneal VEGF levels and might prove beneficial for use in clinical conditions leading to CNV.

  20. Changing trends in corneal graft surgery: a ten-year review

    Science.gov (United States)

    de Sanctis, Ugo; Alovisi, Camilla; Bauchiero, Luigi; Caramello, Guido; Girotto, Gianfranco; Panico, Claudio; Vinai, Luisa; Genzano, Federico; Amoroso, Antonio; Grignolo, Federico

    2016-01-01

    AIM To review indications and corneal tissue use for penetrating and lamellar surgery between 2002 and 2011. METHODS The surgical reports of corneal grafts performed during 2002-2011, using tissues supplied by the Eye Bank of Piedmont (Italy), were reviewed retrospectively. Patient demographic data, date of intervention, indication for surgery, and surgical technique used were recorded. Surgical techniques included penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK) and endothelial keratoplasty (EK). The χ2 test was used to compare the distribution of indications and types of surgical technique used, for corneal grafts done during 2002-2006 versus those done during 2007-2011. RESULTS The number of corneal grafts increased by 30.7% from 2002-2006 to 2007-2011 (from 1567 to 2048). Comparing the two periods, both main indications and surgical techniques changed significantly. In 2007-2011, the proportion of interventions for aphakic/pseudophakic bullous keratopathy (from 16.8% to 21.3%), graft failure (from 16.4% to 19.1%) and Fuchs endothelial dystrophy (from 12.8% to 16.7%) all increased significantly (P<0.05), while those for keratoconus decreased significantly (from 35.6% to 27.3%; P<0.001). In 2007-2011, the proportion of PK decreased significantly (from 92.4% to 57.2%; P<0.001) while that of EK and DALK went from 0.4% to 30.2% (P<0.001) and from 7.2% to 12.6% (P<0.001) respectively. CONCLUSION During 2002-2011 the number of interventions increased significantly for corneal endothelial diseases and graft failure. The growing demand for interventions for these diseases corresponded to the widespread adoption of EK techniques. The use of DALK also increased, but more moderately than EK procedures. PMID:26949609

  1. Edema pulmonar pós-pneumonectomia Postpneumonectomy pulmonary edema

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    Marcos Naoyuki Samano

    2005-02-01

    Full Text Available A pneumonectomia, embora seja tecnicamente simples, está associada a alta incidência de complicações (cerca de 60%. As complicações respiratórias correspondem a aproximadamente 15% deste total. A mortalidade global dessa cirurgia é de 8,6%, mas em presença de complicações respiratórias, a taxa de mortalidade chega a 30%. O edema pulmonar pós-pneumonectomia é uma complicação rara (3% a 5%, mas muito grave, sendo fatal na maioria dos casos. Foi descrito pela primeira vez há pouco mais de vinte anos mas, apesar da gravidade alarmante, pouco sabemos acerca de sua fisiopatologia, embora muitas hipóteses tenham sido levantadas. Uma vez instalado, nenhuma medida é comprovadamente eficaz no seu tratamento. Vários fatores de risco estão associados ao aparecimento do edema pulmonar pós-pneumonectomia, dentre os quais a sobrecarga hídrica, que foi o primeiro fator evitado. Entretanto, muitos trabalhos mostram não haver relação direta entre o volume recebido e o desenvolvimento do edema. A prevenção é a melhor forma de evitá-lo e deve ser realizada de maneira multifatorial, envolvendo toda a equipe médica, desde o momento da anestesia até os cuidados cirúrgicos e na terapia intensiva. No entanto, tão importante quanto a prevenção, é a suspeita clínica precoce, identificando os pacientes em risco para essa grave complicação.Although pneumonectomy is a technically simple procedure, it has been associated with a high (60% incidence of complications. Respiratory complications account for approximately 15% of such complications. Worldwide, the mortality rate among patients subjected to pneumonectomy is 8.6%. However, the rate among patients developing respiratory complications is 30%. Although postpneumonectomy pulmonary edema is rare (occurring in 3% to 5% of cases, it is a serious complication and is almost always fatal. It was first described twenty years ago and, despite these alarming statistics, little is known

  2. Corneal transplant - slideshow

    Science.gov (United States)

    ... ency/presentations/100082.htm Corneal transplant - series—Normal anatomy To use the sharing features on this page, ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  3. Cerebral edema in drug addicts

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    Daruši Dragana J.

    2014-01-01

    Full Text Available Background/Aim. The effect of drugs leaves permanent consequences on the brain, organic in type, followed by numerous manifestations, and it significantly affects the development of mental dysfunctions. The clinicians are often given a task to estimate a patient’s personality during treatment or during experts estimate of a drug addict. The aim of this research was to determine the differences, if any, in characteristics of addicts experience and personality traits in drug addicts with or without cerebral edema. Methods. The research was conducted on a sample of 252 male drug addicts, the average age of 23.3 (SD = 4.3 years. Cerebral edema was confirmed on magnetic resonance (MR images of the brain performed during the treatment of the addicts. The participants were tested by the psychologists using Minnesota Multiphasic Personality Inventory (MMPI-201 test, and the data were processed using canonical discriminate analysis within the SPSS program. The dependent variable in the study was cerebral edema. A block of independent variables, designed for the requirements of this study, consisted of two subgroups. The first one consisted of 12 variables describing the relevant characteristics of drug abuse. The second subgroup consisted of 8 psychopathological tendencies in the personality defined by the mentioned test. Results. Cerebral edema was confirmed in 52 (20.63% of the drug addicts. The differences between the groups of drug addicts with and without cerebral edema were determined in the following: the time span of taking drugs (0.301, use of alcohol parallel with drugs (0.466, and treatment for addiction (0.603. In the drug addicts with a cerebral edema, MMPI-201 confirmed the increase in the scales for hypochondria, psychopathic deviations and psychastenia, and the decrease in the scales for schizophrenia and depression. Conclusion. Our study confirmed a possible connection between cerebral edema and personality traits in a number of the

  4. Human Bone Derived Collagen for the Development of an Artificial Corneal Endothelial Graft. In Vivo Results in a Rabbit Model.

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    Natalia Vázquez

    Full Text Available Corneal keratoplasty (penetrating or lamellar using cadaveric human tissue, is nowadays the main treatment for corneal endotelial dysfunctions. However, there is a worldwide shortage of donor corneas available for transplantation and about 53% of the world's population have no access to corneal transplantation. Generating a complete cornea by tissue engineering is still a tough goal, but an endothelial lamellar graft might be an easier task. In this study, we developed a tissue engineered corneal endothelium by culturing human corneal endothelial cells on a human purified type I collagen membrane. Human corneal endothelial cells were cultured from corneal rims after corneal penetrating keratoplasty and type I collagen was isolated from remnant cancellous bone chips. Isolated type I collagen was analyzed by western blot, liquid chromatography -mass spectrometry and quantified using the exponentially modified protein abundance index. Later on, collagen solution was casted at room temperature obtaining an optically transparent and mechanically manageable membrane that supports the growth of human and rabbit corneal endothelial cells which expressed characteristic markers of corneal endothelium: zonula ocluddens-1 and Na+/K+ ATPase. To evaluate the therapeutic efficiency of our artificial endothelial grafts, human purified type I collagen membranes cultured with rabbit corneal endothelial cells were transplanted in New Zealand white rabbits that were kept under a minimal immunosuppression regimen. Transplanted corneas maintained transparency for as long as 6 weeks without obvious edema or immune rejection and maintaining the same endothelial markers that in a healthy cornea. In conclusion, it is possible to develop an artificial human corneal endothelial graft using remnant tissues that are not employed in transplant procedures. This artificial endothelial graft can restore the integrality of corneal endothelium in an experimental model of

  5. Macular Edema - Rationale for Therapy.

    Science.gov (United States)

    Wolfensberger, Thomas J

    2017-01-01

    Macular edema represents the end-stage of multiple pathophysiological pathways in a multitude of ocular vascular, inflammatory, and other diseases. The rationale for clinical treatment of macular edema is based on the understanding and the inhibition of these pathophysiological mechanisms. When macular edema is caused by a generalized health problem such as diabetes, high blood pressure, or generalized inflammatory conditions, treatment of these generalized diseases can in many cases cure macular edema directly. In ocular diseases, the local exudation of fluid from blood vessels is governed by Starling's law as well as by intricate cellular mechanisms linked to the tight junctions in the inner and outer blood-retinal barrier. Drugs used in clinical practice, such as nonsteroidal anti-inflammatory drugs, corticosteroids, carbonic anhydrase inhibitors, and anti-vascular endothelial growth factor agents, all act in one way or another through these cellular mechanisms. Novel treatments such as neuroprotective agents like nerve growth factors, somatostatins and antiapoptotic agents like calpain, the glutamate blocker memantine, and different caspase inhibitors may in the future inhibit neuronal cell death in the retina by separate pathways. Using dimmed nocturnal illumination may be an additional novel method to reduce hypoxic stress during dark adaptation of the rod photoreceptors in diabetes. Successful surgical treatment of macular edema using vitrectomy and peeling relies, apart from the evident release of vitreomacular traction, on many other cellular and biochemical mechanisms activated by the surgery such as oxygenation of the inner retina, removal of the posterior hyaloid as a growth factor sink, and possible Müller cell remodeling with fluid redirection after internal limiting membrane peeling. © 2017 S. Karger AG, Basel.

  6. Reexpansion pulmonary edema Edema pulmonar de reexpansão

    OpenAIRE

    Eduardo Henrique Genofre; FRANCISCO S. VARGAS; Teixeira, Lisete R.; Marcelo Alexandre Costa Vaz; Evaldo Marchi

    2003-01-01

    Reexpansion pulmonary edema (RPE) is a rare, but frequently lethal, clinical condition. The precise pathophysiologic abnormalities associated with this disorder are still unknown, though decreased pulmonary surfactant levels and a pro-inflammatory status are putative mechanisms. Early diagnosis is crucial, since prognosis depends on early recognition and prompt treatment. Considering the high mortality rates related to RPE, preventive measures are still the best available strategy for patient...

  7. Reexpansion pulmonary edema Edema pulmonar de reexpansão

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    Eduardo Henrique Genofre

    2003-04-01

    Full Text Available Reexpansion pulmonary edema (RPE is a rare, but frequently lethal, clinical condition. The precise pathophysiologic abnormalities associated with this disorder are still unknown, though decreased pulmonary surfactant levels and a pro-inflammatory status are putative mechanisms. Early diagnosis is crucial, since prognosis depends on early recognition and prompt treatment. Considering the high mortality rates related to RPE, preventive measures are still the best available strategy for patient handling. This review provides a brief overview of the pathophysiology, diagnosis, treatment, and prevention of RPE, with practical recommendations for adequate intervention.O edema pulmonar de reexpansão é uma entidade rara, mas de notável mortalidade. Sua fisiopatologia ainda não é bem esclarecida, porém envolve fatores conhecidos, como a diminuição do surfactante pulmonar, e outros ainda incertos, como o papel dos mediadores inflamatórios na gênese e manutenção do processo. É imperativo o diagnóstico precoce, uma vez que o desfecho depende da agilidade no reconhecimento e tratamento dessa entidade. Tendo em vista a alta mortalidade, as medidas de prevenção ainda são a melhor estratégia no manuseio dos pacientes com doenças que podem levar ao edema pulmonar de reexpansão. Esta revisão discute os principais aspectos relacionados à fisiopatologia, diagnóstico, tratamento e prevenção do edema pulmonar de reexpansão, com recomendações práticas para o reconhecimento e adequada abordagem dessa entidade.

  8. Another Risk From Cigarette Smoking: Corneal Burn

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    Volkan Hürmeriç

    2012-12-01

    Full Text Available A 21-year-old male presented with corneal injury in his left eye after one of his friends had moved his arm backwards and accidentally hit his eye with the lit end of a cigarette. Slit lamp examination revealed epithelial defect and significant stromal edema at the superior temporal quadrant of the cornea. Cigarette ashes were noted in his lashes and inferior conjunctival fornix at the initial examination in the emergency service. 6 weeks after the injury, slit lamp examination revealed stromal thinning and haze in the temporal part of the cornea. His best spectacle-corrected distance visual acuity was 20/25 with a refractive error of -6.75x135 diopters in the left eye. Our case demonstrates that ocular thermal injury due to cigarette smoking can cause serious damage to the ocular tissues. (Turk J Oph thal mol 2012; 42: 484-5

  9. 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 

  10. Acute dermatomyositis associated with generalized subcutaneous edema.

    Science.gov (United States)

    Lee, Ki-Hong; Lim, Sung-Ryoun; Kim, Yeon-Joo; Lee, Kyung-Ju; Myung, Dae-Seong; Jeong, Hae-Chang; Yoon, Woong; Lee, Shin-Seok; Park, Yong-Wook

    2008-06-01

    Generalized subcutaneous edema is an uncommon manifestation of inflammatory myopathy. We report a 48-year-old female patient who presented with severe generalized edema, an erythematous skin rash, dysphagia and proximal muscle weakness. She was diagnosed with dermatomyositis from the clinical signs, increased muscle enzymes, electromyographic findings and a muscle biopsy. Magnetic resonance imaging revealed increased signal intensity in the muscular and subcutaneous layers. The conditions causing generalized edema were excluded. It was concluded that the generalized edema was secondary to dermatomyositis. Aggressive treatments with high-dose glucocorticoids and immunosuppressive agents were used to control the severe subcutaneous edema.

  11. Pathogenesis of Brain Edema and Investigation into Anti-Edema Drugs

    OpenAIRE

    Shotaro Michinaga; Yutaka Koyama

    2015-01-01

    Brain edema is a potentially fatal pathological state that occurs after brain injuries such as stroke and head trauma. In the edematous brain, excess accumulation of extracellular fluid results in elevation of intracranial pressure, leading to impaired nerve function. Despite the seriousness of brain edema, only symptomatic treatments to remove edema fluid are currently available. Thus, the development of novel anti-edema drugs is required. The pathogenesis of brain edema is classified as vas...

  12. Distrofia corneal de Schnyder

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    Michel Guerra Almaguer

    Full Text Available La principal entidad hereditaria con depósitos de lípidos en el estroma corneal es la distrofia cristalina central, conocida como distrofia de Schnyder, quien la describió en Suiza en 1927. Se caracteriza por depósitos blanco-amarillentos en el estroma corneal central y superficial. Se presenta un paciente de 28 años, del sexo masculino y piel negra, con antecedente de salud anterior. Acudió a consulta y refirió una disminución de la visión y cambio de coloración progresiva de ambos ojos, de años de evolución. En la exploración oftalmológica de ambos ojos se apreciaron lesiones blanquecinas anulares a nivel del estroma corneal, con ligera turbidez corneal central. Los estudios refractivos realizados constataron un astigmatismo hipermetrópico simple. El resto del examen oftalmológico fue negativo. Para el diagnóstico de certeza se empleó el microscopio confocal. Se concluye que el caso presenta una distrofia corneal estromal de tipo cristalina, de Schnyder.

  13. Research progress of corneal transplantation

    OpenAIRE

    Bing-Jie Zhang; Heng Sun; Yuan-Ping Zhang; Lin-Kun Ma

    2015-01-01

    Corneal transplantation is an ophthalmology treatment technique for corneal disease to help restore vision or control the development of corneal diseases by removing a scarred or damaged host cornea and replacing it with a clear and healthy donor cornea. Traditional corneal transplantation includes penetrating keratoplasty and lamellar keratoplasty. In recent ten years, deep lamellar keratoplasty and endothelial keratoplasty have gradually developed. At present, the development of keratoprost...

  14. Amlodipine-induced bilateral upper extremity edema.

    Science.gov (United States)

    Ganeshalingham, Anusha; Wong, William

    2007-09-01

    To report a case of bilateral upper extremity edema associated with amlodipine use in a child. A previously well and normotensive 6-year-old girl presented with a generalized vasculitis of unknown origin and severe hypertension. Large vessels predominantly affecting the neck, chest, and abdomen were found to be involved, resulting in abnormal arterial circulation and significant blood pressure differences between the upper and lower extremities. Multiple antihypertensive agents were initially required to control blood pressure. She was stabilized and discharged on amlodipine 10 mg each evening, atenolol 50 mg/day, and warfarin. Three days later she was noted to have facial and bilateral upper extremity pitting edema. Laboratory and radiologic assessments for possible etiologies were negative. Discontinuation of amlodipine resulted in resolution of edema. As of June 2007, there had been no cases of bilateral upper extremity edema associated with amlodipine use reported in the English literature. Adverse effects of amlodipine, a widely used antihypertensive, have been well reported. These include flushing, headache, and peripheral edema. Lower limb edema is the most common, while periocular and perioral edema have occurred less frequently. Anasarca edema has been described only once in the English literature. According to the Naranjo probability scale, amlodipine was a probable cause of bilateral upper extremity edema in this child. Bilateral upper extremity edema has been associated with amlodipine use in a child with an abnormal arterial circulation. The edema resolved upon discontinuation of the drug.

  15. 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.

  16. TSG-6 protects corneal endothelium from transcorneal cryoinjury in rabbits.

    Science.gov (United States)

    Kim, Jeong-Ah; Ko, Jung Hwa; Ko, Ah Young; Lee, Hyun Ju; Kim, Mee Kum; Wee, Won Ryang; Lee, Ryang Hwa; Fulcher, Samuel F; Oh, Joo Youn

    2014-07-17

    To investigate the effect of an anti-inflammatory protein, TNF-α stimulated gene/protein (TSG)-6 and an antiapoptotic protein, stanniocalcin (STC)-1 on corneal endothelium in rabbits with transcorneal cryoinjury. Transcorneal freezing (-80°C) was applied to rabbit corneas for 30 seconds. Immediately post injury, either TSG-6 (10 μg/100 μL), STC-1 (10 μg/100 μL), or the same volume of balanced salt solution (BSS) was injected into the anterior chamber. Each eye was examined for corneal opacity, corneal thickness, endothelial cell density, and endothelial hexagonality every 2 to 6 hours for 48 hours post injury. The concentrations of myeloperoxidase (MPO) and IL-1β were measured in the aqueous humor every 6 hours. At 48 hours post injury, each cornea was assayed for TNF-α, IL-1β, IL-6, and MPO, and histologically evaluated with alizarin red-trypan blue staining, hematoxylin-eosin staining, and immunostaining for neutrophils. Tumor necrosis factor-α stimulated gene/protein-6 significantly decreased the development of corneal opacity and edema after cryoinjury compared with STC-1 or BSS. The corneal endothelial cell density and hexagonality were markedly preserved by TSG-6. The mRNA levels of TNF-α, IL-1β, and IL-6 in the cornea and the protein levels of MPO and IL-1β in the aqueous humor and cornea were significantly lower in TSG-6-treated eyes than BSS-treated controls. Similarly, the expression of fibroblast growth factor-2 was reduced by TSG-6 treatment. Histologic evaluation demonstrated that neutrophil infiltration of the cornea was decreased in TSG-6-treated eyes. Tumor necrosis factor-α stimulated gene/protein-6 protected corneal endothelial cells from transcorneal cryoinjury through suppression of inflammation. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  17. Airbag induced corneal ectasia.

    Science.gov (United States)

    Mearza, Ali A; Koufaki, Fedra N; Aslanides, Ioannis M

    2008-02-01

    To report a case of airbag induced corneal ectasia. Case report. A patient 3 years post-LASIK developed bilateral corneal ectasia worse in the right eye following airbag deployment in a road traffic accident. At last follow up, best corrected vision was 20/40 with -4.00/-4.00 x 25 in the right eye and 20/25 with -1.25/-0.50 x 135 in the left eye. This is a rare presentation of trauma induced ectasia in a patient post-LASIK. It is possible that reduction in biomechanical integrity of the cornea from prior refractive surgery contributed to this presentation.

  18. Research progress of corneal transplantation

    Directory of Open Access Journals (Sweden)

    Bing-Jie Zhang

    2015-06-01

    Full Text Available Corneal transplantation is an ophthalmology treatment technique for corneal disease to help restore vision or control the development of corneal diseases by removing a scarred or damaged host cornea and replacing it with a clear and healthy donor cornea. Traditional corneal transplantation includes penetrating keratoplasty and lamellar keratoplasty. In recent ten years, deep lamellar keratoplasty and endothelial keratoplasty have gradually developed. At present, the development of keratoprosthesis provides a new choice for the patients no suitable for traditional. The review describes current surgical techniques in the field of corneal transplantation about indications, postoperative complications, and so on.

  19. Triple procedure: cataract extraction, intraocular lens implantation, and corneal graft.

    Science.gov (United States)

    Oie, Yoshinori; Nishida, Kohji

    2017-01-01

    Corneal triple procedures consist of combined keratoplasty surgery and cataract surgery. Currently, anterior lamellar keratoplasty, endothelial keratoplasty, and conventional penetrating keratoplasty, are very often simultaneously performed with cataract surgery. The present article reviews the recent advances and current developments in corneal triple procedures. Many new findings have been reported. Core vitrectomy before host trephination and retroillumination during continuous curvilinear capsulorhexis has enabled us to perform penetrating keratoplasty triple procedures more safely. Type-1 big-bubble, baring Dua's layer, facilitates well tolerated anterior lamellar triple keratoplasty without Descemet membrane perforation. Descemet membrane endothelial keratoplasty triple procedure can provide excellent expected postoperative refraction. New techniques, including manual medium incision cataract surgery or glued intrascleral fixation of the intraocular lens with pupilloplasty, can be used for endothelial keratoplasty triple procedure, and frequent topical steroid administration can contribute to the reduction of postoperative cystoid macular edema. Recent technical advancements could contribute to safer and more effective corneal triple procedures. Triple surgery combined with novel procedures, including regenerative medicine and bioengineered corneal transplantation, will be performed in the near future.

  20. Personalised lamellar keratoplasty and keratopigmentation in Asian corneal leucoma patients.

    Science.gov (United States)

    Liu, Xin; Shen, Jun-Hui; Zhou, Qi; Liu, Zhen-Xing; Tang, Shen-Fei; Chen, Ran-Ran; Sui, Gui-Qin; Bi, Yan-Long

    2015-01-01

    To describe a personalised lamellar keratoplasty (LK) associated with the keratopigmentation (KTP) technique for corneal leucoma among Asian patients. This report was a non-randomised, retrospective clinical study performed in 32 consecutive eyes of 32 patients to improve cosmetic appearance. Twenty-two patients underwent LK combined with KTP, either by intralamellar or superficial route. Ten patients underwent the single personalised keratopigmentation method. The subjective and objective cosmetic results, ocular irritation, colour fading, neovascularisation formation and incidence of immune rejection were evaluated until three years after surgery. No complications occurred, and the corneal leucoma was successfully stained with India ink in all 32 patients. Most of the patients showed good cosmetic appearance. Pain, conjunctival congestion, corneal edema and foreign body sensation disappeared gradually within two to three weeks after surgery in all patients. Graft swelling, non-healing, or detaching was not observed during follow-up. However, two patients had slight opacity three years after LK. Colour fading was observed in one patient who underwent intralamellar corneal staining 10 months after surgery. Re-staining was performed. KTP combined with personalised LK is an effective personalised technique that presents long-standing colour staining and good cosmetic efficacy.

  1. Alternatives to allograft corneal transplantation.

    Science.gov (United States)

    Jhanji, Vishal; Sharma, Namrata; Agarwal, Tushar; Vajpayee, Rasik B

    2010-07-01

    Corneal transplantation is the most commonly performed solid organ transplantation in the world. Despite a glorious history of more than a 100 years, the success of conventional corneal transplantation surgery is marred by problems like graft rejection,graft infection and associated glaucoma due to long-term use of topical corticosteroids.In addition there is a dearth of donor corneal tissue in some parts of the world which subsequently adds on to the existing burden on the eye banks every year. We propose alternatives to the conventional corneal transplantation surgery for the management of corneal scarring. The potential use of alternatives to allograft corneal transplantation surgery has been described by corneal surgeons around the world. These techniques consist of nonsurgical interventions like contact lens fitting. Surgical alternatives include excimer laser phototherapeutic keratectomy, optical iridectomy, rotational autokeratoplasty and contralateral autokeratoplasty. Although these techniques are not practiced routinely, however, their appropriate utilization would clearly help the corneal surgeons to get rid of certain problems associated with allograft corneal transplantation. Careful selection of patients can yield encouraging results with the use of these alternative techniques. Visual outcomes may not be as good as after a routine keratoplasty; nevertheless, this setback is outweighed by advantages such as absence of corneal graft rejection. We also believe that the use of these techniques would at least partially resolve the issue of scarcity of donor corneal tissue in the developing world.

  2. Effects of long-term soft contact lens wear on the corneal thickness and corneal epithelial thickness of myopic subjects.

    Science.gov (United States)

    Lei, Yulin; Zheng, Xiuyun; Hou, Jie; Xu, Baozeng; Mu, Guoying

    2015-03-01

    To perform safe and successful corneal refractive surgery on myopic patients, corneal thickness (CT) and corneal epithelial thickness (CET) must be accurately measured. Numerous individuals with myopia wear soft contact lenses (SCLs) for the correction of visual acuity but may subsequently undergo corneal refractive surgery. The aim of the present study was therefore to investigate the effects of long-term SCL wear on the CT and the CET of myopic subjects in order to guarantee the safety and accuracy of subsequent corneal refractive surgeries. Fifty-six subjects prepared to receive refractive surgery at Jinan Mingshui Eye Hospital (Zhangqiu, China) from April to July 2013 were included in the study. CT and CET were measured in subjects immediately following discontinued SCL wear (group I, 56 eyes), and subsequently following >two weeks of discontinued SCL wear (group II, 56 eyes). Ninety-four subjects with no history of corneal contact lens wear were enrolled as a control group. The CT and CET were measured at positions with a radius of 0.0‑1.0, 1.0-2.5 (divided into eight quadrants) and 2.5-3.0 mm (divided into eight quadrants) away from the corneal center using the RTVue-100 Fourier-domain anterior segment optical coherence tomography system. A significant decrease in the CT of the subjects in group II was observed, compared with that of group I and the control group (P<0.05). A significant decrease was observed in the CET of groups I and II compared with that of the control group (P<0.05). Following discontinuation of SCL wear, CET increased. However, the increased CET was unable to reach the normal range exhibited by the control group. Edema and thinning of the corneal stroma, as well as thinning of the corneal epithelium were observed in groups I and II. In conclusion, it was proposed that in clinical practice, for myopic patients following long-term SCL wear, CT and CET should be determined ≥ two weeks following discontinuation of SCL wear, once a stable

  3. Corneal Opacity in a Participant of a 161-km Mountain Bike Race at High Altitude.

    Science.gov (United States)

    Khodaee, Morteza; Torres, David R

    2016-06-01

    Visual dysfunction is a relatively uncommon complaint among athletes during ultraendurance races. The pathophysiology of most of these cases is unknown. Corneal opacity has been speculated as the etiology for most of reported cases. We are presenting a case of a 56-year-old man with a partial unilateral corneal opacity and edema at kilometer 150 of a 161-km mountain bike race in high altitude. He was not able to finish the race (12-hour cutoff) because of his visual symptoms. He completely recovered in 3 days with no sequelae. Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  4. Corneal biomechanical properties from air-puff corneal deformation imaging

    Science.gov (United States)

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

    2014-02-01

    The combination of air-puff systems with real-time corneal imaging (i.e. Optical Coherence Tomography (OCT), or Scheimpflug) is a promising approach to assess the dynamic biomechanical properties of the corneal tissue in vivo. In this study we present an experimental system which, together with finite element modeling, allows measurements of corneal biomechanical properties from corneal deformation imaging, both ex vivo and in vivo. A spectral OCT instrument combined with an air puff from a non-contact tonometer in a non-collinear configuration was used to image the corneal deformation over full corneal cross-sections, as well as to obtain high speed measurements of the temporal deformation of the corneal apex. Quantitative analysis allows direct extraction of several deformation parameters, such as apex indentation across time, maximal indentation depth, temporal symmetry and peak distance at maximal deformation. The potential of the technique is demonstrated and compared to air-puff imaging with Scheimpflug. Measurements ex vivo were performed on 14 freshly enucleated porcine eyes and five human donor eyes. Measurements in vivo were performed on nine human eyes. Corneal deformation was studied as a function of Intraocular Pressure (IOP, 15-45 mmHg), dehydration, changes in corneal rigidity (produced by UV corneal cross-linking, CXL), and different boundary conditions (sclera, ocular muscles). Geometrical deformation parameters were used as input for inverse finite element simulation to retrieve the corneal dynamic elastic and viscoelastic parameters. Temporal and spatial deformation profiles were very sensitive to the IOP. CXL produced a significant reduction of the cornea indentation (1.41x), and a change in the temporal symmetry of the corneal deformation profile (1.65x), indicating a change in the viscoelastic properties with treatment. Combining air-puff with dynamic imaging and finite element modeling allows characterizing the corneal biomechanics in-vivo.

  5. [Pathogenesis of edema and its classification].

    Science.gov (United States)

    Kimura, Genjiro

    2005-01-01

    Pathogenesis of edema is in depth considered based on Starling's rule on capillary fluid dynamics. Edema can be divided into 4 types based on the mechanisms causing edema: increased capillary hydrostatic pressure, decreased plasma oncotic pressure, enhanced hydraulic permeability of capillary walls, and lymphatic obstruction. Each of the types can be further divided into generalized and local forms. Edema, defined as the expansion of interstitial fluid compartment, is initiated by imbalance of Starling forces across capillary walls between plasma and interstitium, but is maintained by enhanced sodium reabsorption from renal tubules.

  6. Bone marrow edema in sports: General concepts

    Energy Technology Data Exchange (ETDEWEB)

    Vanhoenacker, F.M. [AZ Sint-Maarten Duffel-Mechelen, Department of Radiology, Rooienberg 25, B-2570 Duffel (Belgium) and University Hospital Antwerp, Department of Radiology, Wilrijkstraat 10, B-2650 Edegem (Belgium)]. E-mail: filip.vanhoenacker@telenet.be; Snoeckx, A. [AZ Sint-Maarten Duffel-Mechelen, Department of Radiology, Rooienberg 25, B-2570 Duffel (Belgium); University Hospital Antwerp, Department of Radiology, Wilrijkstraat 10, B-2650 Edegem (Belgium)

    2007-04-15

    This paper will discuss the value of medical imaging in the detection and follow-up of bone marrow edema (BME), resulting from acute and chronic trauma in sports. MR imaging is the only imaging technique that allows direct evaluation of bone marrow edema in sports medicine. The use of fat suppressed T2-weighted or STIR images is particularly appropriate to detect bone marrow edema. The extent of bone marrow edema reflects the biomechanics of trauma. Compressive forces between two bony structures will result in extensive areas of bone marrow edema, whereas distraction forces provoke more subtle areas of bone marrow edema at the insertion of supporting structures of joints. In most clinical situations, a combination of compression and distraction forces is present, causing a complex pattern of bone marrow edema. A meticulous pattern approach of the distribution of these bone marrow changes around a joint can reveal in most instances the underlying mechanism of trauma. This may be helpful to analyze which joint supporting structures may be at risk. In the acute setting, plain radiography and CT scan may have an additional role in the detection of small avulsion fractures occurring at the site of minor areas of bone marrow edema. The clinical significance and natural history of bone marrow edema is still a matter of debate.

  7. Coexistent transient pulmonary edema and pericardial effusion

    Energy Technology Data Exchange (ETDEWEB)

    Newman, B.; Oh, K.S.; Park, S.C.

    1988-09-01

    Eight (23%) of 35 children with acute pericardial effusions due to infection or juvenile rheumatoid arthritis (JRA) had associated transient pulmonary edema demonstrated on plain chest radiographs. The presence or absence of radiographic pulmonary edema correlated well with clinical and hemodynamic parameters in patients with JRA but not in those with infectious pericarditis. There was no definite relationship between radiographic edema and amount of pericardial fluid as estimated echocardiographically or removed at pericardiocentesis. Rapidity of pericardial fluid accumulation could not be assessed in this study. Children of young age with underlying JRA were the most likely subjects to have radiographic pulmonary edema in conjunction with an acute pericardial effusion.

  8. Evaluation of clinical validity of the Rabin cone contrast test in normal phakic or pseudophakic eyes and severely dichromatic eyes.

    Science.gov (United States)

    Fujikawa, Masato; Muraki, Sanae; Niwa, Yuichi; Ohji, Masahito

    2017-05-29

    To evaluate the clinical validity of the Rabin cone contrast test (RCCT; Innova Systems, Inc.) in patients with normal phakic/pseudophakic eyes and severe dichromatic colour vision deficiency (CVD). We evaluated age-related changes in the RCCT scores in 166 phakic eyes and 34 pseudophakic eyes and the RCCT sensitivity and specificity in 28 men with severe dichromatic CVD (10 with protanopia, 18 with deutanopia) and nine age-matched controls. All participants had 20/20 or better Snellen best-corrected visual acuity (BCVA). The RCCT was used to measure the L, M and S-CCT scores (range, 0-100). In normal phakic eyes, the mean L, M and S-CCT scores decreased gradually with ageing, with normal levels in patients in the second to seventh decades of life and some below normal in the eighth and ninth decades of life. In normal pseudophakic eyes, the mean L, M and S-CCT scores were normal in patients in the seventh to ninth decades of life. In eyes with severe CVD, the mean L, M and S-CCT scores were, respectively, 31.5 ± 18.3, 86.0 ± 12.6 and 98.0 ± 6.3 in patients with protanopia; 92.8 ± 10.5, 50.8 ± 19.6 and 97.8 ± 5.2 in patients with deutanopia; and 99.4 ± 1.7, 98.3 ± 5.0 and 99.4 ± 1.7 in controls. The RCCT sensitivity and specificity were 100% for diagnosing the CVD type. The RCCT can be used in non-visually impaired patients up to the seventh decade of life and after cataract surgery in elderly patients. The RCCT is available for CVD screening and typing and the score has a wide distribution range even in patients with severe CVD. © 2017 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.

  9. Pathogenesis of Brain Edema and Investigation into Anti-Edema Drugs

    Directory of Open Access Journals (Sweden)

    Shotaro Michinaga

    2015-04-01

    Full Text Available Brain edema is a potentially fatal pathological state that occurs after brain injuries such as stroke and head trauma. In the edematous brain, excess accumulation of extracellular fluid results in elevation of intracranial pressure, leading to impaired nerve function. Despite the seriousness of brain edema, only symptomatic treatments to remove edema fluid are currently available. Thus, the development of novel anti-edema drugs is required. The pathogenesis of brain edema is classified as vasogenic or cytotoxic edema. Vasogenic edema is defined as extracellular accumulation of fluid resulting from disruption of the blood-brain barrier (BBB and extravasations of serum proteins, while cytotoxic edema is characterized by cell swelling caused by intracellular accumulation of fluid. Various experimental animal models are often used to investigate mechanisms underlying brain edema. Many soluble factors and functional molecules have been confirmed to induce BBB disruption or cell swelling and drugs targeted to these factors are expected to have anti-edema effects. In this review, we discuss the mechanisms and involvement of factors that induce brain edema formation, and the possibility of anti-edema drugs targeting them.

  10. 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

  11. Computational Model for Corneal Transplantation

    Science.gov (United States)

    Cabrera, Delia

    2003-10-01

    We evaluated the refractive consequences of corneal transplants using a biomechanical model with homogeneous and inhomogeneous Young's modulus distributions within the cornea, taking into account ablation of some stromal tissue. A FEM model was used to simulate corneal transplants in diseased cornea. The diseased cornea was modeled as an axisymmetric structure taking into account a nonlinearly elastic, isotropic formulation. The model simulating the penetrating keratoplasty procedure gives more change in the postoperative corneal curvature when compared to the models simulating the anterior and posterior lamellar graft procedures. When a lenticle shaped tissue was ablated in the graft during the anterior and posterior keratoplasty, the models provided an additional correction of about -3.85 and -4.45 diopters, respectively. Despite the controversy around the corneal thinning disorders treatment with volume removal procedures, results indicate that significant changes in corneal refractive power could be introduced by a corneal transplantation combined with myopic laser ablation.

  12. The Quest for Spectacle Independence: A Comparison of Multifocal Intraocular Lens Implants and Pseudophakic Monovision for Patients with Presbyopia.

    Science.gov (United States)

    Greenstein, Steven; Pineda, Roberto

    2017-01-01

    We performed a literature review comparing multifocal intraocular lens (IOL) implantation with pseudophakic monovision to treat presbyopia. Multifocal IOLs utilize refractive or diffractive principles to treat both distance and near vision, with a single lens implant. Monovision uses traditional monofocal lens implants to treat the dominant eye for emmotropia, and the non-dominant eye for myopia. This planned anisometropia is designed to enhance intermediate or near vision. Generally, distance vision was similar with both types of lens implantation, near vision was better with multifocal IOLs, and intermediate vision appeared to be better in the monovision group. For patients requiring cataract surgery, both multifocal IOLs and monovision appear to address presbyopia with a high level of patient satisfaction. More patients reported complete spectacle independence with multifocal IOLs, but more glare and halos were reported by multifocal IOL patients as well.

  13. Simultaneous bilensectomy and endothelial keratoplasty for angle-supported phakic intraocular lens-induced corneal decompensation

    Directory of Open Access Journals (Sweden)

    Vikas Mittal

    2011-01-01

    Full Text Available A 40-year-old lady presented with severe endothelial cell loss in both eyes 14 years after angle-supported phakic intraocular lens (AS PIOL implantation. The left eye had severe corneal edema with bullous keratopathy. The right eye had markedly reduced endothelial cell count (655 cells/mm 2 although the cornea was clear. She underwent simultaneous bilensectomy (AS PIOL explantation and phacoemulsification and Descemet′s stripping and endothelial keratoplasty (DSEK in the left eye. Explanted AS PIOL was identified as ZSAL-4 (Morcher, Stuttgart, Germany model. Corneal edema cleared completely in 2 months with a best corrected visual acuity (-2.25 D sph of 20/60. No intervention was done in the right eye. The present case illustrates that AS PIOL-induced endothelial decompensation can be effectively managed by simultaneous bilensectomy and endothelial keratoplasty.

  14. Human corneal epithelial subpopulations

    DEFF Research Database (Denmark)

    Søndergaard, Chris Bath

    2013-01-01

    subpopulations in human corneal epithelium using a combination of laser capture microdissection and RNA sequencing for global transcriptomic profiling. We compared dissociation cultures, using either expansion on γ-irradiated NIH/3T3 feeder cells in serum-rich medium or expansion directly on plastic in serum......-free EpiLife medium, using a range of physiologically relevant oxygen concentrations (2%, 5%, 10%, 15% and 20%). Using immunocytochemistry and advanced fluorescence microscopy, cells were characterized regarding growth, cell cycle distribution, colony-forming efficiency (CFE), phenotypes...... was not dependent on the system used for propagation (Bath et al. 2013a). Laser capture microdissection was used to isolate cellular subpopulations in situ from the spatially defined differentiation pathway in human corneal epithelium according to an optimized protocol for maintenance of expression profiles...

  15. Biomechanics of Corneal Ring Implants

    OpenAIRE

    Daxer, Albert

    2015-01-01

    Purpose: To evaluate the biomechanics of corneal ring implants by providing a related mathematical theory and biomechanical model for the treatment of myopia and keratoconus. Methods: The spherical dome model considers the inhomogeneity of the tunica of the eye, dimensions of the cornea, lamellar structure of the corneal stroma, and asphericity of the cornea. It is used in this study for calculating a strengthening factor sf for the characterization of different ring-shaped corneal implant de...

  16. Cardiopulmonary bypass and edema: physiology and pathophysiology.

    Science.gov (United States)

    Hirleman, E; Larson, D F

    2008-11-01

    Edema is a common morbidity following cardiopulmonary bypass (CPB) and can result in injury to many organs, including the heart, lungs, and brain. Generalized edema is also common and can lead to increased post-operative hospital stay and other morbidities. Pediatric patients are more susceptible to post-CPB edema and the consequences are more severe for this population. Hemodilution and systemic inflammatory responses are two suspected causes of CPB-related edema; however, the mechanisms involved are far from understood. Also, the common strategies to improve edema have not been completely successful and there is a need for new strategies at maintaining a fluid balance of patients as close to physiological as possible, especially for pediatric patients. An integrative approach to understanding edema is necessary as the forces involved in fluid homeostasis are dynamic and interdependent. Therefore, this review will focus on the physiology of fluid homeostasis and the pathologies of fluid shifts during CPB which lead to general edema as well as tissue-specific edema.

  17. Reexpansion pulmonary edema after drainage of tension ...

    African Journals Online (AJOL)

    Glucocorticoids, diuretic stimulants, analgesic and bronchodilatators were administered in the intensive care unit. Gradually, the edema and dyspnea diminished and the patient could be discharged in good clinical condition. Reexpansion pulmonary edema (RPE) is a clinical syndrome characterized by the development of ...

  18. Corneal biomechanics: a review

    OpenAIRE

    Piñero Llorens, David Pablo; Alcón, Natividad

    2014-01-01

    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 a...

  19. Airbag-induced corneal flap.

    Science.gov (United States)

    Liyanage, Sidath E; Mearza, Ali A

    2009-02-01

    To describe a case of airbag-induced corneal flap in a previously normal cornea. Case report. A 27-year-old woman presented with complete loss of vision in her left eye following a road traffic accident which involved airbag deployment. There was no previous ocular history. Examination revealed a large corneal flap of 6mm in diameter, extending to the depth of anterior stroma. This was accompanied by a traumatic optic neuropathy. One month follow-up revealed complete reattachment of the corneal flap. This is the first reported case of a corneal flap induced by airbag deployment in a cornea with previously normal architecture.

  20. Immersion Pulmonary Edema in Female Triathletes

    Directory of Open Access Journals (Sweden)

    Eric A. Carter

    2011-01-01

    Full Text Available Pulmonary edema has been reported in SCUBA divers, apnea divers, and long-distance swimmers however, no instances of pulmonary edema in triathletes exist in the scientific literature. Pulmonary edema may cause seizures and loss of consciousness which in a water environment may become life threatening. This paper describes pulmonary edema in three female triathletes. Signs and symptoms including cough, fatigue, dyspnea, haemoptysis, and rales may occur within minutes of immersion. Contributing factors include hemodynamic changes due to water immersion, cold exposure, and exertion which elevate cardiac output, causing pulmonary capillary stress failure, resulting in extravasation of fluid into the airspace of the lung. Previous history is a major risk factor. Treatment involves immediate removal from immersion and in more serious cases, hospitalization, and oxygen administration. Immersion pulmonary edema is a critical environmental illness of which triathletes, race organizers, and medical staff, should be made aware.

  1. Wound closure and tissue adhesives in clear corneal incision cataract surgery.

    Science.gov (United States)

    Tong, Amy Y; Gupta, Preeya K; Kim, Terry

    2018-01-01

    Achieving secure wound closure in clear corneal incision cataract surgery remains highly desired for its role in reducing infection risk and leak-related complications, including hypotony, corneal edema, and lens dislocation. Although classic techniques of stromal hydration or wound suturing represent traditional approaches, the introduction of newer and more effective ocular surface adhesives has increased the options that are available. This review aims to provide an update on the peer-reviewed literature regarding wound closure and the currently available and investigational tissue adhesives used to seal clear corneal incisions in cataract surgery. Stromal hydration and sutured closure of clear corneal incisions remain viable options for wound closure. Wound sealants, particularly polyethylene glycol (PEG)-based hydrogels, have been found to provide watertight wound seal with less foreign-body sensation and surgically induced astigmatism compared with sutures, and less adverse effects and greater ease of use compared with cyanoacrylate and fibrin glues. Stromal hydration, sutured closure, and use of a corneal adhesive are all wound closure options for clear corneal incisions. Of the currently available tissue adhesives, PEG hydrogel sealants have become the most widely accepted, with an improved side-effect and biocompatibility profile.

  2. Treatment of corneal chemical alkali burns with a crosslinked thiolated hyaluronic acid film.

    Science.gov (United States)

    Griffith, Gina L; Wirostko, Barbara; Lee, Hee-Kyoung; Cornell, Lauren E; McDaniel, Jennifer S; Zamora, David O; Johnson, Anthony J

    2018-02-08

    The study objective was to test the utilization of a crosslinked, thiolated hyaluronic acid (CMHA-S) film for treating corneal chemical burns. Burns 5.5mm in diameter were created on 10 anesthetized, male New Zealand white rabbits by placing a 1N NaOH soaked circular filter paper onto the cornea for 30s. Wounds were immediately rinsed with balanced salt solution (BSS). CMHA-S films were placed in the left inferior fornix of five injured and five uninjured animals. Five animals received no treatment. At 0h, 48h, 96h, and on day 14 post chemical burn creation, eyes were evaluated by white light imaging, fluorescein staining, and optical coherence tomography (OCT). Corneal histology was performed using H&E and Masson's Trichrome stains. Image analysis indicated biocompatible CMHA-S treatment resulted in significant decreases in the areas of corneal opacity at 48h, 96h, and on day 14 postoperatively. A significant increase in re-epithelialization was seen 14days post injury. CMHA-S treated corneas showed significantly less edema than untreated burns. No pathological differences were observed in corneal histological samples as a result of CMHA-S treatment. CMHA-S films facilitate re-epithelialization and decrease the area of corneal opacity in our corneal alkali burn rabbit model. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  3. Volumetric and ionic regulation during the in vitro development of a corneal endothelial barrier.

    Science.gov (United States)

    Alaminos, M; González-Andrades, M; Muñoz-Avila, J I; Garzón, I; Sánchez-Quevedo, M C; Campos, A

    2008-05-01

    Corneal endothelium is responsible for generating an ion flux between the corneal stroma and the anterior chamber of the eye that is necessary for the cornea to remain transparent. However, the ion transport regulatory mechanisms that develop during the formation of the endothelial barrier are not known. In this study, we determined the influence of cell confluence on cell volume and intracellular ionic content on the corneal endothelial cells of rabbits. Our results demonstrate that non-confluent endothelial cells display a hypertrophic volume increase, with higher intracellular contents of potassium and chlorine than those of confluent cells. In contrast, when cells reach confluence and the endothelial barrier forms, cell volume decreases and the intracellular contents of potassium and chlorine decrease. Our genetic analysis showed a higher expression of CFTR and CA2 genes in non-confluent cells, and of the gene KCNC3 in confluent cells. These results suggest that the normal ionic current that keeps the corneal stroma dehydrated and transparent is regulated by cell-cell contacts and endothelial cell confluence, and could explain why the loss of corneal endothelial cells is often associated with corneal edema and even blindness.

  4. Corneal thickness and intraocular pressure in edematous corneas before and after Descemet stripping with automated endothelial keratoplasty.

    Science.gov (United States)

    Chang, Diane T W; Pantcheva, Mina B; Noecker, Robert J

    2010-10-01

    It is important to accurately measure intraocular pressure (IOP) in eyes with corneal endothelial dysfunction both before and after Descemet stripping with automated endothelial keratoplasty (DSAEK). Glaucoma is a common comorbidity in this population, and IOP elevation can worsen corneal edema. Additionally, preexisting glaucoma and steroid-responsive ocular hypertension are significant risk factors for graft rejection after DSAEK. Accurate tonometry is limited by variations in central corneal thickness (CCT) and corneal hydration that may affect corneal biomechanical properties. We analyzed CCT and IOP in eyes before and after DSAEK to determine whether changes in corneal biomechanics because of edema, grafted tissue, and subsequent stromal deturgescence affect IOP measurement. A retrospective chart review was performed on 32 eyes from 31 patients with corneal edema secondary to Fuchs endothelial dystrophy, bullous keratopathy, or prior graft failure, or rejection that received uncomplicated DSAEK with no evidence of persistent corneal edema or steroid-induced ocular hypertension. IOP was measured by Tono-Pen XL, and CCT was measured by ultrasound pachymetry before and approximately 3 months after surgery. We used paired t tests to evaluate changes in CCT and IOP after DSAEK and linear regression to determine the relationship between CCT and IOP before and after surgery. CCT significantly decreased from 703 ± 82 to 650 ± 52 μm after DSAEK (P = 0.0026), but there was no significant change in measured IOP (16.7 ± 3.4 mm Hg preoperatively and 16.3 ± 4.1 mm Hg postoperatively; P = 0.61). There was no significant relationship between CCT and IOP before (slope = 0.10 ± 0.07 mm Hg/10 μm; r = 0.062; P = 0.17) or after (slope = 0.21 ± 0.14 mm Hg/10 μm; r = 0.072; P = 0.14) DSAEK. CCT is significantly reduced by DSAEK but remains well above the normal range. IOP remains near the preoperative level 3 months after DSAEK. Furthermore, no correction is required for

  5. Correlations between corneal hysteresis, intraocular pressure, and corneal central pachymetry.

    Science.gov (United States)

    Touboul, David; Roberts, Cynthia; Kérautret, Julien; Garra, Caroline; Maurice-Tison, Sylvie; Saubusse, Elodie; Colin, Joseph

    2008-04-01

    To analyze the correlation between corneal hysteresis (CH) measured with the Ocular Response Analyzer (ORA, Reichert) and ultrasonic corneal central thickness (CCT US) and intraocular pressure measured with Goldmann applanation tonometry (IOP GA). Bordeaux 2 University, Ophthalmology Department, Bordeaux, France. This study comprised 498 eyes of 258 patients. Corneal hysteresis, corneal resistance factor (CRF), and IOP corneal-compensated (IOPcc) were provided by the ORA device; CCT US and IOP GA were also measured in each eye. The study population was divided into 5 groups: normal (n = 122), glaucoma (n = 159), keratoconus (n = 88), laser in situ keratomileusis (LASIK) (n = 78), and photorefractive keratectomy (n = 39). The Pearson correlation was used for statistical analysis. Corneal hysteresis was not strongly correlated with IOP or CCT US. The mean CH in the LASIK (8.87 mm Hg) and keratoconus (8.34 mm Hg) groups was lower than in the glaucoma (9.48 mm Hg) and normal (10.26 mm Hg) groups. The lower the CH, the lower its correlation with IOPcc and IOP GA. A CH higher than the CRF was significantly associated with the keratoconus and post-LASIK groups. Corneal hysteresis, a new corneal parameter, had a moderate dependence on IOP and CCT US. Weaker corneas could be screened with ORA parameters, and low CH could be considered a risk factor for underestimation of IOP. The CCT US should continue to be considered a useful parameter.

  6. Acute Corneal Hydrops Mimicking Infectious Keratitis as Initial Presentation of Keratoconus in a 10-Year-Old Child

    Directory of Open Access Journals (Sweden)

    Elise A. Slim

    2015-01-01

    Full Text Available Purpose. To report a case of acute hydrops in a 10-year-old child with advanced keratoconus. Case Presentation. A ten-year-old boy diagnosed as having right eye (RE infectious keratitis, not responding to antimicrobial therapy, was referred to our hospital. The diagnosis of infectious keratitis was established one month prior to his presentation following an episode of acute corneal whitening, pain, and drop in visual acuity. Topical fortified antibiotics followed by topical antiviral therapy were used with no improvement. Slit lamp examination showed significant corneal protrusion with edema surrounding a rupture in Descemet’s membrane in the RE. The diagnosis of acute corneal hydrops from advanced keratoconus was highly suspected and confirmed with corneal topography. Conclusion. Although a relatively rare disease at the age of 10 years, keratoconus can be rapidly progressive in the pediatric group. Keratoconus should always be considered in the differential diagnosis of progressive vision loss in this age group.

  7. An unusual case of feline acute corneal hydrops: atypical disease presentation and possible in vivo detection of Descemet's membrane detachment in the cat's unaffected eye.

    Science.gov (United States)

    Schlesener, Brittany N; Scott, Erin M; Vallone, Lucien V

    2017-11-07

    A 1-year-old, female spayed, domestic shorthair cat presented for blepharospasm of the right eye. Slit-lamp biomicroscopic examination showed focal corneal ulceration and presumptive keratomalacia of the right eye. Examination of the left eye was normal apart from a focal endothelial opacity. Within the first 24 h of medical management, the right eye developed marked corneal edema and globular anterior protrusion of the corneal surface consistent with feline acute corneal hydrops (FACH). Surgical management consisted of a bridge conjunctival graft, nictitating membrane flap, and temporary tarsorrhaphy. Resolution of corneal edema and pain occurred in the right eye within 24 days. Spectral domain optical coherence tomography (SD-OCT) of the anterior segment was performed in both eyes. Conjunctival tissue from the bridge graft precluded examination of deeper corneal structures in the right eye. The left eye displayed a focal separation of the corneal endothelium and Descemet's membrane from the overlying stroma. These SD-OCT findings are similar to the analogous syndrome found in humans and represent a potential etiology for FACH of the right eye in the case presented here. Unfortunately, the cat was lost to follow-up and the progression of this lesion to FACH in the left eye could not be determined. © 2017 American College of Veterinary Ophthalmologists.

  8. A Case Report of Severe Corneal Toxicity following 0.5% Topical Moxifloxacin Use

    Directory of Open Access Journals (Sweden)

    A.P. Vignesh

    2015-02-01

    Full Text Available Moxifloxacin is a widely used topical antibiotic in various bacterial infections of the eye. Its safety and efficacy have been proved by many studies. We report a case of a rare adverse effect following its use. A 10-year-old female who had presented with acute bacterial conjunctivitis in both eyes with no corneal involvement was started on preservative-free 0.5% topical moxifloxacin four times a day. The child developed a severe form of corneal toxicity in both eyes with circumcorneal congestion and corneal edema following its use. The child's visual acuity had dropped from 20/20 to 20/400 in both the eyes. Topical moxifloxacin was discontinued, following which the cornea cleared dramatically and the visual acuity became normal. This case indicates that though rare, topical moxifloxacin can cause severe keratitis and that more studies need to be conducted to evaluate its safety.

  9. Descemet membrane endothelial keratoplasty with a stromal rim in the treatment of posterior polymorphous corneal dystrophy

    Directory of Open Access Journals (Sweden)

    Pavel Studeny

    2012-01-01

    Full Text Available A 20-year-old patient, diagnosed with posterior polymorphous corneal dystrophy, developed corneal edema for which he underwent Descemet membrane endothelial keratoplasty with a stromal rim (DMEK-S in the right eye. No intra- or postoperative complications were noted. At the last follow-up 2 years and 9 months after the procedure, the best corrected visual acuity was 1.0 and endothelial cell density declined from 3533 cells/mm 2 to 1012 cells/mm 2 . Despite the endothelial cell loss, DMEK-S appears to be a good alternative to other surgical techniques for the treatment of corneal endotheliopathies, and it may be of benefit to young patients.

  10. Transplantation of tissue-engineered human corneal endothelium in cat models.

    Science.gov (United States)

    Fan, Tingjun; Ma, Xiya; Zhao, Jun; Wen, Qian; Hu, Xiuzhong; Yu, Haoze; Shi, Weiyun

    2013-01-01

    To evaluate the performance of reconstructed tissue-engineered human corneal endothelium (TE-HCE) by corneal transplantation in cat models. TE-HCE reconstruction was performed by culturing 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate (DiI)-labeled monoclonal HCE cells on denuded amniotic membranes (dAMs) in 20% fetal bovine serum-containing Dulbecco's Modified Eagle's Medium/Ham's Nutrient Mixture F12 (1:1) medium and 5% CO(2) at 37 ° C on a 24-well culture plate. The reconstructed TE-HCE was transplanted into cat corneas via lamellar keratoplasty with all of the endothelium and part of Descemet's membrane stripped. Postsurgical corneas were monitored daily with their histological properties examined during a period of 104 days after transplantation. The reconstructed TE-HCE at a density of 3,413.33 ± 111.23 cells/mm(2) in average established intense cell-cell and cell-dAM junctions. After lamellar keratoplasty surgery, no obvious edema was found in TE-HCE-transplanted cat corneas, which were transparent throughout the monitoring period. In contrast, intense corneal edema developed in dAM-transplanted cat corneas, which were turbid. The corneal thickness gradually decreased to 751.33 ± 11.37 μm on day 104 after TE-HCE transplantation, while that of dAM eye was over 1,000 μm in thickness during the monitoring period. A monolayer of endothelium consisting of TE-HCE-originated cells at a density of 2,573.33 ± 0.59 cells/mm(2) attached tightly to the surface of remnant Descemet's membrane over 104 days; this was similar to the normal eye control in cell density. The reconstructed TE-HCE was able to function as a corneal endothelium equivalent and restore corneal function in cat models.

  11. Corneal response to different oxygen levels during extended wear.

    Science.gov (United States)

    Rivera, R K; Polse, K A

    1991-04-01

    In this study we explored the relationship between hypoxic exposure level and corneal response by assuming that the partial pressure of oxygen (PO2) under a contact lens during eye closure is directly related to oxygen transmissibility (Dk/L). To study this relationship, we monitored a group of subjects who wore RGP lenses of various Dk/L values on an extended wear basis. The results revealed that as Dk/L increases, there is a substantial decrease in overnight corneal edema and epithelial microcysts. However, other responses seemingly related to purely mechanical properties (e.g., lens adherence, corneal topographical changes, and 3-9 limbal superficial punctate keratitis) appear to be independent of Dk/L. Results also suggest that sufficient PO2 levels under a contact lens can minimize endothelial morphological changes associated with hypoxia. We conclude that metabolically driven complications accompanying RGP extended wear can be substantially eliminated with lenses having Dk/L values of 80 x 10(-9) (cm x mL O2)/(sec x mL x mm Hg) or greater.

  12. Tectonic DSAEK for the Management of Impending Corneal Perforation

    Science.gov (United States)

    Graue-Hernandez, Enrique O.; Zuñiga-Gonzalez, Isaac; Hernandez-Camarena, Julio C.; Jaimes, Martha; Chirinos-Saldaña, Patricia; Navas, Alejandro; Ramirez-Miranda, Arturo

    2012-01-01

    Purpose. To report a case of severe corneal thinning secondary to dry eye treated with a tectonic Descemet stripping automated lamellar keratoplasty (DSAEK) and amniotic membrane graft. Methods. A 72-year-old man with a history of long standing diabetes mellitus type 2 and dry eye presented with 80% corneal thinning and edema on the right eye and no signs of infectious disease, initially managed with topical unpreserved lubrication and 20% autologous serum drops. Eight weeks after, the defect advanced in size and depth until Descemetocele was formed. Thereafter, he underwent DSAEK for tectonic purposes. One month after the procedure, the posterior lamellar graft was well adhered but a 4 mm epithelial defect was still present. A multilayered amniotic membrane graft was then performed. Results. Ocular surface healed quickly and reepithelization occurred over a 2-week period. Eight months after, the ocular surface remained stable and structurally adequate. Conclusion. Tectonic DSAEK in conjunction with multilayered amniotic graft may not only provide structural support and avoid corneal perforation, but may also promote reepithelization and ocular surface healing and decrease concomitant inflammation. PMID:23259100

  13. Tectonic DSAEK for the Management of Impending Corneal Perforation

    Directory of Open Access Journals (Sweden)

    Enrique O. Graue-Hernandez

    2012-01-01

    Full Text Available Purpose. To report a case of severe corneal thinning secondary to dry eye treated with a tectonic Descemet stripping automated lamellar keratoplasty (DSAEK and amniotic membrane graft. Methods. A 72-year-old man with a history of long standing diabetes mellitus type 2 and dry eye presented with 80% corneal thinning and edema on the right eye and no signs of infectious disease, initially managed with topical unpreserved lubrication and 20% autologous serum drops. Eight weeks after, the defect advanced in size and depth until Descemetocele was formed. Thereafter, he underwent DSAEK for tectonic purposes. One month after the procedure, the posterior lamellar graft was well adhered but a 4 mm epithelial defect was still present. A multilayered amniotic membrane graft was then performed. Results. Ocular surface healed quickly and reepithelization occurred over a 2-week period. Eight months after, the ocular surface remained stable and structurally adequate. Conclusion. Tectonic DSAEK in conjunction with multilayered amniotic graft may not only provide structural support and avoid corneal perforation, but may also promote reepithelization and ocular surface healing and decrease concomitant inflammation.

  14. Extended incubation times improve corneal endothelial cell transplantation success.

    Science.gov (United States)

    Insler, M S; Lopez, J G

    1991-05-01

    To investigate the ability of extended incubation times to improve the success of endothelial cell transplantation, eight human donor corneas were denuded of their native endothelium, seeded twice during a 1-hr interval with a suspension of cultured infant human corneal endothelial cells, and then incubated for 144 hr under standard conditions. Subsequently the corneas were transplanted into African green monkeys using routine penetrating keratoplasty techniques. Rotational autografts and corneas devoid of endothelial cells served as controls. The seeded corneas appeared hazy at the time of surgery (mean pachymetry 48 hr postoperatively, 0.794 mm). Six corneas (75%) subsequently cleared, yielding a mean corneal thickness of 0.541 +/- 0.040 and 0.554 +/- 0.040 at 6 and 12 postoperative months, respectively. All control eyes showed advanced edema (thickness, greater than 1.0 mm) and developed extensive neovascularization. Clinically, the extended postseeding incubation corneas were observed to clear more rapidly and stabilize their thickness earlier than corneas incubated for only 24-48 hr. Scanning electron microscopy of extended postseeding incubation corneas revealed an intact monolayer of contact-inhibited cells with the hexagonal mosaic typical of corneal endothelium in vivo and improved intercellular contact compared with corneas incubated for only 24-48 hr.

  15. [Corneal metabolism with contact lenses in competitive sports].

    Science.gov (United States)

    Schnell, D; Khaireddin, R

    2013-06-01

    The corneal metabolism during the use of contact lenses plays an important role for permanent corneal health, especially in competitive sports. Thus, it is important to understand the steps of corneal metabolism in general and during highly competitive sports activity in particular. The aim of this review is to summarize the current knowledge on physiological and biochemical effects of contact lens wear. Of the energy requirements of the cornea 75 % is supplied by aerobic processes; therefore, the eye needs the highest possible amount of oxygen and sufficient glucose which can be obtained from external air and to a lesser degree from within the anterior chamber. If the oxygen supply is too low this results in hypoxic edema. Fitting athletes with contact lenses must still be viewed with caution as the visual needs of athletes are usually much more demanding than those of the general public. An indiscriminate choice of lens design can adversely affect athletic performance and may even create a hazardous situation. An intelligent choice of contact lens can provide some subtle advantages that may improve athletic performance and provide the decisive margin for victory.

  16. Role of corneal collagen fibrils in corneal disorders and related pathological conditions

    Directory of Open Access Journals (Sweden)

    Hong-Yan Zhou

    2017-05-01

    Full Text Available The cornea is a soft tissue located at the front of the eye with the principal function of transmitting and refracting light rays to precisely sense visual information. Corneal shape, refraction, and stromal stiffness are to a large part determined by corneal fibrils, the arrangements of which define the corneal cells and their functional behaviour. However, the modality and alignment of native corneal collagen lamellae are altered in various corneal pathological states such as infection, injury, keratoconus, corneal scar formation, and keratoprosthesis. Furthermore, corneal recuperation after corneal pathological change is dependent on the balance of corneal collagen degradation and contraction. A thorough understanding of the characteristics of corneal collagen is thus necessary to develop viable therapies using the outcome of strategies using engineered corneas. In this review, we discuss the composition and distribution of corneal collagens as well as their degradation and contraction, and address the current status of corneal tissue engineering and the progress of corneal cross-linking.

  17. Stromal Edema in Klf4 Conditional Null Mouse Cornea is Associated with Altered Collagen Fibril Organization and Reduced Proteoglycans

    Science.gov (United States)

    Young, Robert D.; Swamynathan, Shivalingappa K.; Boote, Craig; Mann, Mary; Quantock, Andrew J.; Piatigorsky, Joram; Funderburgh, James L.; Meek, Keith M.

    2009-01-01

    Purpose Klf4, one of the highly expressed transcription factors in mouse cornea, plays an important role in maturation and maintenance of the ocular surface. Here, the authors examined the structure and proteoglycan composition of the Klf4 conditional null (Klf4CN) corneal stroma, to further characterize the previously reported Klf4CN stromal edema. Methods Collagen fibril spacing and diameter were calculated from scattering intensity profiles from small angle synchrotron X-ray scattering patterns obtained across the cornea along a vertical meridian at 0.5mm intervals. Collagen fibril organization and proteoglycans were visualised by electron microscopy (EM) with or without the cationic dye Cuprolinic blue. Proteoglycans and glycosaminoglycans were further analyzed by fluorophore-assisted carbohydrate electrophoresis (FACE) and immunoblots. Q-RT-PCR was used to measure the transcript levels. Results In the central cornea the average collagen interfibrillar Bragg spacing increased from 44.5nm (SD +/-1.8nm) in wild type to 66.5nm (SD +/-2.3nm) in Klf4CN, as measured by X-ray scattering and confirmed by EM. Mean collagen fibril diameter increased from 32nm (SD+/-0.4nm) in wild type to 42.3nm (SD+/-4.8nm) in Klf4CN corneal stroma. Downregulation of proteoglycans detected by EM in the Klf4CN stroma was confirmed by FACE and immunoblots. Q-RT-PCR showed that while the Klf4CN corneal proteoglycan transcript levels remained unchanged, matrix metalloproteinase (MMP) transcript levels were significantly upregulated. Conclusions The Klf4CN corneal stromal edema is characterized by increased collagen interfibrillar spacing and increased diameter of individual fibrils. The stroma also exhibits reduced interfibrillar proteoglycans throughout the corneal stroma, which is possibly caused by increased expression of MMPs. PMID:19387067

  18. Clinical observation of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis

    Directory of Open Access Journals (Sweden)

    Huang Zhang

    2014-09-01

    Full Text Available AIM:To evaluate the clinical efficacy of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis.METHODS:Totally 22 cases(22 eyeswith superficial fungal keratitis were referred to our hospital from April 2012 to October 2013. The patients with persistent cornea ulcer after treatment of local and systemic antifungal drugs underwent corneal lamellar debridement combined with sutureless amniotic membrane transplantation, and the recipient bed was covered with an amniotic membrane using fibrin sealant during the operation. All patients were still given topical antifungal therapy for 1-2mo after operation. The followed-up time was 3mo or above. We observed the corneal healing and amniotic membrane adhesion by split lamp microscope, and investigated the transformation of amniotic membrane and fungal infection recurrence with confocal microscope. RESULTS: Corneal edema and anterior chamber reaction of 21 patients disappeared gradually, and no amniotic membrane graft dissolved and shed off within 1-2wk postoperatively. Two weeks after operation, the graft integrated into the corneal and the corneal wounds' thickness increased gradually, the corneal epithelium reconstructed and corneas became clear. Four weeks after operation, the corneal scarring developed gradually and fluorescence staining was negative. Nineteen cases' amniotic membranes that adhered with the cornea dissolved 4wk after operation. There were different degrees of corneal nebula or macula remained 3mo postoperatively. All patients' vision improved in varying degrees, except in 1 case with fungal keratitis who had been cured by lamellar keratoplasty.CONCLUSION:Corneal lamellar debridement combined with sutureless amniotic membrane transplantation can effectively remove the foci of inflammation, improve the local efficacy, shorten the operation time, relieve the postoperative reaction, and promote cornea

  19. Comparison of sutures and cyanoacrylate tissue adhesives for wound repair in a rat model of corneal laceration.

    Science.gov (United States)

    Nuhoglu, Fadime; Altiparmak, Ugur E; Hazirolan, Dicle O; Kasim, Remzi; Duman, Sunay

    2013-01-01

    The aim of the present study was to evaluate the cicatricial repair of a corneal artificial perforation in rats with 10-0 nylon suture, N-butyl-2-cyanoacrylate (NBCA) adhesive, or NBCA + methacryloxysulfolane (NBCA-MS) adhesive through microscopic and histological assays. Twenty Wistar rats were randomly divided into 4 groups each containing 5 rats: (1) control group (corneal trauma without suturing and tissue adhesives), (2) suture group, (3) NBCA group and (4) NBCA-MS group. A central full-thickness 2-mm laceration was performed in the left eyes of the studied rats in all 4 groups. The presence of corneal edema, corneal neovascularization and tissue adhesive/suture were evaluated. On the 21st day, the rats were sacrificed and histological examination was performed to determine irregularity of corneal layers, superficial epithelization, polymorphonuclear leucocytes and neovascularization. Tissue adhesives were as effective as suturing in closing full-thickness corneal wounds and no difference in postoperative healing was observed clinically. As for the histological results, suture-treated eyes had persistent corneal irregularity that can limit visual acuity and may also lead to astigmatism. The use of tissue adhesives constitutes a viable alternative clinical procedure to conventional sutures. Possible influences on astigmatism are hypothetical, as no objective measure of astigmatism was performed in the test animals. Copyright © 2013 S. Karger AG, Basel.

  20. Pulmonary Edema: Classification, Mechanisms of Development, Diagnosis

    Directory of Open Access Journals (Sweden)

    V. V. Moroz

    2009-01-01

    Full Text Available Pulmonary edema remains a topical problem of modern reanimatology. In clinical practice, there is a need for continuous monitoring of the content of extravascular water in the lung and the pulmonary vascular permeability index for the timely detection and treatment of pulmonary edema. This literature review considers the minor mechanisms of pulmonary extravas-cular water exchange in health and in different types of pulmonary edema (acute lung injury, pneumonia, sepsis, postoperative period, burns, injuries etc., as well as the most accessible current (irradiation and dilution studies permitting an estimate of the level of pulmonary extravascular water and the pulmonary vascular permeability index in clinical practice. Key words: pulmonary edema, acute lung injury, pulmonary extravascular water, pulmonary vascular permeability index.

  1. Corneal structure and transparency

    Science.gov (United States)

    Meek, Keith M.; Knupp, Carlo

    2015-01-01

    The corneal stroma plays several pivotal roles within the eye. Optically, it is the main refracting lens and thus has to combine almost perfect transmission of visible light with precise shape, in order to focus incoming light. Furthermore, mechanically it has to be extremely tough to protect the inner contents of the eye. These functions are governed by its structure at all hierarchical levels. The basic principles of corneal structure and transparency have been known for some time, but in recent years X-ray scattering and other methods have revealed that the details of this structure are far more complex than previously thought and that the intricacy of the arrangement of the collagenous lamellae provides the shape and the mechanical properties of the tissue. At the molecular level, modern technologies and theoretical modelling have started to explain exactly how the collagen fibrils are arranged within the stromal lamellae and how proteoglycans maintain this ultrastructure. In this review we describe the current state of knowledge about the three-dimensional stromal architecture at the microscopic level, and about the control mechanisms at the nanoscopic level that lead to optical transparency. PMID:26145225

  2. Shifting bone marrow edema of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Moosikasuwan, Josh B.; Schultz, Elizabeth [Department of Radiology, North Shore University Hospital, 300 Community Drive, NY 11030, Manhasset (United States); Miller, Theodore T. [Department of Radiology, North Shore University Hospital, 300 Community Drive, NY 11030, Manhasset (United States); Department of Radiology, North Shore University Hospital, 825 Northern Boulevard, NY 11021, Great Neck (United States); Math, Kevin [Department of Radiology, Beth Israel Medical Center, First Avenue at 16th Street, NY 10003, New York (United States)

    2004-07-01

    The purpose of our study is to describe shifting bone marrow edema in the knee as the MR imaging feature of intra-articular regional migratory osteoporosis of the knee. Five men, aged 45-73 years, were referred by orthopedic surgeons for MR imaging evaluation of knee pain, which had been present for 2 weeks to 6 months. One patient had a prior history of blunt trauma. None had risk factors for osteonecrosis. Four patients had two MR examinations and the patient with prior blunt trauma had four. Plain radiographs were obtained in all patients. In all cases, a large area of marrow edema initially involved a femoral condyle, with migration of the bone marrow edema to the other femoral condyle, tibia, and/or patella occurring over a 2- to 4-month period. Adjacent soft tissue edema was present in all five patients, while none had a joint effusion. Radiographs of two patients showed generalized osteopenia. In the absence of acute trauma or clinical suspicion of infection, a large area of bone marrow edema without a zone of demarcation may represent intra-articular regional migratory osteoporosis. Demonstration of shifting bone marrow edema on follow-up examinations suggests this diagnosis. (orig.)

  3. Shifting bone marrow edema of the knee.

    Science.gov (United States)

    Moosikasuwan, Josh B; Miller, Theodore T; Math, Kevin; Schultz, Elizabeth

    2004-07-01

    The purpose of our study is to describe shifting bone marrow edema in the knee as the MR imaging feature of intra-articular regional migratory osteoporosis of the knee. Five men, aged 45-73 years, were referred by orthopedic surgeons for MR imaging evaluation of knee pain, which had been present for 2 weeks to 6 months. One patient had a prior history of blunt trauma. None had risk factors for osteonecrosis. Four patients had two MR examinations and the patient with prior blunt trauma had four. Plain radiographs were obtained in all patients. In all cases, a large area of marrow edema initially involved a femoral condyle, with migration of the bone marrow edema to the other femoral condyle, tibia, and/or patella occurring over a 2- to 4-month period. Adjacent soft tissue edema was present in all five patients, while none had a joint effusion. Radiographs of two patients showed generalized osteopenia. In the absence of acute trauma or clinical suspicion of infection, a large area of bone marrow edema without a zone of demarcation may represent intra-articular regional migratory osteoporosis. Demonstration of shifting bone marrow edema on follow-up examinations suggests this diagnosis.

  4. Corneal Confocal Microscopy Detects Corneal Nerve Damage in Patients Admitted With Acute Ischemic Stroke.

    Science.gov (United States)

    Khan, Adnan; Akhtar, Naveed; Kamran, Saadat; Ponirakis, Georgios; Petropoulos, Ioannis N; Tunio, Nahel A; Dargham, Soha R; Imam, Yahia; Sartaj, Faheem; Parray, Aijaz; Bourke, Paula; Khan, Rabia; Santos, Mark; Joseph, Sujatha; Shuaib, Ashfaq; Malik, Rayaz A

    2017-11-01

    Corneal confocal microscopy can identify corneal nerve damage in patients with peripheral and central neurodegeneration. However, the use of corneal confocal microscopy in patients presenting with acute ischemic stroke is unknown. One hundred thirty patients (57 without diabetes mellitus [normal glucose tolerance], 32 with impaired glucose tolerance, and 41 with type 2 diabetes mellitus) admitted with acute ischemic stroke, and 28 age-matched healthy control participants underwent corneal confocal microscopy to quantify corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length. There was a significant reduction in corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length in stroke patients with normal glucose tolerance ( P stroke. Corneal confocal microscopy is a rapid noninvasive ophthalmic imaging technique that identifies corneal nerve fiber loss in patients with acute ischemic stroke. © 2017 American Heart Association, Inc.

  5. Corneal ring infiltration in contact lens wearers

    Directory of Open Access Journals (Sweden)

    Seyed Ali Tabatabaei

    2017-01-01

    Full Text Available To report a case of atypical sterile ring infiltrates during wearing soft silicone hydrogel contact lens due to poor lens care. A 29-year-old woman presented with complaints of pain, redness, and morning discharge. She was wearing soft silicone hydrogel contact lens previously; her current symptoms began 1 week before presentation. On examination, best-corrected visual acuity was 20/40 in that eye. Slit-lamp examination revealed dense, ring-shaped infiltrate involving both the superficial and deep stromal layers with lucid interval to the limbus, edema of the epithelium, epithelial defect, and vascularization of the superior limbus. Cornea-specific in vivo laser confocal microscopy (Heidelberg Retina Tomograph 2 Rostock Cornea Module, HRT 2-RCM, Heidelberg Engineering GmbH, Dossenheim, Germany revealed Langerhans cells and no sign of Acanthamoeba or fungal features, using lid scraping and anti-inflammatory drops; her vision completely recovered. We reported an atypical case of a sterile corneal ring infiltrate associated with soft contact lens wearing; smear, culture, and confocal microscopy confirmed a sterile inflammatory reaction.

  6. Corneal ring infiltration in contact lens wearers.

    Science.gov (United States)

    Tabatabaei, Seyed Ali; Soleimani, Mohammad; Johari, Mohammadkarim

    2017-01-01

    To report a case of atypical sterile ring infiltrates during wearing soft silicone hydrogel contact lens due to poor lens care. A 29-year-old woman presented with complaints of pain, redness, and morning discharge. She was wearing soft silicone hydrogel contact lens previously; her current symptoms began 1 week before presentation. On examination, best-corrected visual acuity was 20/40 in that eye. Slit-lamp examination revealed dense, ring-shaped infiltrate involving both the superficial and deep stromal layers with lucid interval to the limbus, edema of the epithelium, epithelial defect, and vascularization of the superior limbus. Cornea-specific in vivo laser confocal microscopy (Heidelberg Retina Tomograph 2 Rostock Cornea Module, HRT 2-RCM, Heidelberg Engineering GmbH, Dossenheim, Germany) revealed Langerhans cells and no sign of Acanthamoeba or fungal features, using lid scraping and anti-inflammatory drops; her vision completely recovered. We reported an atypical case of a sterile corneal ring infiltrate associated with soft contact lens wearing; smear, culture, and confocal microscopy confirmed a sterile inflammatory reaction.

  7. Edema: a systematic approach to diagnosis and management.

    Science.gov (United States)

    Mandal, Anil Kumar

    2008-01-01

    Edema is defined by fluid accumulation in the tissues and its onset frequently first noticed by the patients. Mild edema is common and reversible. Generalized edema requires intensive therapy. Causes of edema are numerous. Investigation of the causes is essential for appropriate therapy.

  8. Corneal Biomechanical Findings in Contact Lens Induced Corneal Warpage

    OpenAIRE

    Fateme Alipour; Mojgan Letafatnejad; Amir Hooshang Beheshtnejad; Seyed-Farzad Mohammadi; Seyed Reza Ghaffary; Narges Hassanpoor; Mehdi Yaseri

    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...

  9. Differing roles for TCF4 and COL8A2 in central corneal thickness and fuchs endothelial corneal dystrophy.

    Directory of Open Access Journals (Sweden)

    Robert P Igo

    Full Text Available Fuchs endothelial corneal dystrophy (FECD is the most common late-onset, vision-threatening corneal dystrophy in the United States, affecting about 4% of the population. Advanced FECD involves a thickening of the cornea from stromal edema and changes in Descemet membrane. To understand the relationship between FECD and central corneal thickness (CCT, we characterized common genetic variation in COL8A2 and TCF4, genes previously implicated in CCT and/or FECD. Other genes previously associated with FECD (PITX2, ZEB1, SLC4A11, and genes only known to affect CCT (COL5A1, FOXO1, AVGR8, ZNF469 were also interrogated. FECD probands, relatives and controls were recruited from 32 clinical sites; a total of 532 cases and 204 controls were genotyped and tested for association of FECD case/control status, a 7-step FECD severity scale and CCT, adjusting for age and sex. Association of FECD grade with TCF4 was highly significant (OR= 6.01 at rs613872; p = 4.8×10(-25, and remained significant when adjusted for changes in CCT (OR= 4.84; p = 2.2×10(-16. Association of CCT with TCF4 was also significant (p = 6.1×10(-7, but was abolished with adjustment for FECD grade (p = 0.92. After adjusting for FECD grade, markers in other genes examined were modestly associated (p ∼ 0.001 with FECD and/or CCT. Thus, common variants in TCF4 appear to influence FECD directly, and CCT secondarily via FECD. Additionally, changes in corneal thickness due to the effect of other loci may modify disease severity, age-at-onset, or other biomechanical characteristics.

  10. Intrastromal Corneal Ring Implants for Corneal Thinning Disorders

    Science.gov (United States)

    2009-01-01

    Executive Summary Objective The purpose of this project was to determine the role of corneal implants in the management of corneal thinning disease conditions. An evidence-based review was conducted to determine the safety, effectiveness and durability of corneal implants for the management of corneal thinning disorders. The evolving directions of research in this area were also reviewed. Subject of the Evidence-Based Analysis The primary treatment objectives for corneal implants are to normalize corneal surface topography, improve contact lens tolerability, and restore visual acuity in order to delay or defer the need for corneal transplant. Implant placement is a minimally invasive procedure that is purported to be safe and effective. The procedure is also claimed to be adjustable, reversible, and both eyes can be treated at the same time. Further, implants do not limit the performance of subsequent surgical approaches or interfere with corneal transplant. The evidence for these claims is the focus of this review. The specific research questions for the evidence review were as follows: Safety Corneal Surface Topographic Effects: Effects on corneal surface remodelling Impact of these changes on subsequent interventions, particularly corneal transplantation (penetrating keratoplasty [PKP]) Visual Acuity Refractive Outcomes Visual Quality (Symptoms): such as contrast vision or decreased visual symptoms (halos, fluctuating vision) Contact lens tolerance Functional visual rehabilitation and quality of life Patient satisfaction: Disease Process: Impact on corneal thinning process Effect on delaying or deferring the need for corneal transplantation Clinical Need: Target Population and Condition Corneal ectasia (thinning) comprises a range of disorders involving either primary disease conditions such as keratoconus and pellucid marginal corneal degeneration or secondary iatrogenic conditions such as corneal thinning occurring after LASIK refractive surgery. The condition

  11. Lipolymphedema Associated with Idiopathic Cyclic Edema: A Therapeutic Approach

    OpenAIRE

    Jose Maria Pereira de Godoy; Henrique Jose Pereira de Godoy; Aline Aparecida de Sene Souza; Ricardo Budtinger Filho; Maria de Fatima Guerreiro Godoy

    2017-01-01

    Idiopathic cyclic edema is a type of generalized edema that mainly affects women. Diagnosis is made by the patient's clinical history and an evaluation of the accumulation of weight during the day. The objective of this study is to report the clinical control of lymphedema associated with idiopathic cyclic edema using calcium dobesilate. A 55-year-old female patient reported generalized edema for years in that she woke up in the morning with her legs swollen and the edema worsened during the ...

  12. Corneal epithelium following penetrating keratoplasty.

    OpenAIRE

    Tsubota, K; Mashima, Y; Murata, H; Yamada, M.; Sato, N.

    1995-01-01

    AIMS--This study was designed to observe any changes to the corneal epithelium after penetrating keratoplasty. METHODS--The corneal epithelia of 26 patients were observed by specular microscopy 1 week, 1 month, 3 months, and 6 months following penetrating keratoplasty. RESULTS--After re-epithelialisation was confirmed by biomicroscopy 1 week after surgery, specular microscopy revealed many abnormal cells, including spindle shaped cells, nucleated cells, large cells, as well as irregular cell ...

  13. 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.

  14. Corticosteroid Treatment in Diabetic Macular Edema

    Directory of Open Access Journals (Sweden)

    Burcu Nurözler Tabakcı

    2017-06-01

    Full Text Available Diabetic macular edema is the most common cause of visual impairment in patients with diabetes mellitus. The pathogenesis of macular edema is complex and multifactorial. For many years, laser photocoagulation has been considered the standard therapy for the treatment of diabetic macular edema; however, few patients achieve significant improvements in visual acuity. Today the intravitreal administration of anti-inflammatory or anti-angiogenic agents together with the use of laser photocoagulation represents the standard of care for the treatment of this complication. The intravitreal route of administration minimizes the systemic side effects of corticosteroids. Steroid-related ocular side effects are elevated intraocular pressure and cataract, while injection-related complications include endophthalmitis, vitreous hemorrhage, and retinal detachment. In order to reduce the risks and complications, intravitreal implants have been developed recently to provide sustained release of corticosteroids and reduce repeated injections for the management of diabetic macular edema. In this review, the efficacy, safety, and therapeutic potential of intravitreal corticosteroids in diabetic macular edema are discussed with a review of recent literature.

  15. Neurogenic Pulmonary Edema (A Case Report

    Directory of Open Access Journals (Sweden)

    Funda Gümüş

    2012-08-01

    Full Text Available Neurogenic pulmonary edema is a life threatening complication of severe central nervous system injury. The most common cause of neurogenic pulmonary edema is subarachnoid hemorrhage followed by head trauma and epilepsy. The rare causes are cervical spine trauma, multiplesclerosis, cerebellar hemorrhage and intracranial tumors. Neurogenic pulmonary edema is characterized by an increase in extravascular lung water in patients who have sustained a sudden change in neurologic condition. The exact pathophysiology is unclear but it probably involves an adrenergic response to the central nervous system injury which leads to increased catecholamine, pulmonary hydrostatic pressure and increased lung capillary permeability. The presenting symptoms are nonspecific and often include dyspnea, tachypnea, tachycardia, hypoxemia, pinkfroty secretion, bilateral pulmonary infiltrates and crackles. These symptoms start within minutes or hours and resolves 48-72 hours that typically for neurogenic pulmonary edema. Basic principles of treatment, surgical decompression, reduce intracranial pressure, controlled ventilation with suplemental oxygen, positive end expiratory pressure and diuresis. We report a case with neurogenic pulmonary edema that occured after head trauma. (Journal of the Turkish Society Intensive Care 2012; 10: 59-62

  16. Biomechanical model of corneal transplantation.

    Science.gov (United States)

    Cabrera Fernández, D; Niazy, A M; Kurtz, R M; Djotyan, G P; Juhasz, T

    2006-03-01

    Refractive consequences of corneal transplants are analyzed using corneal biomechanical models assuming homogeneous and inhomogeneous stiffness distributions across the cornea. Additionally, refractive effects of grafts combined with volume removal procedures are also evaluated to develop methods to reduce postoperative refractive management of patients. Refinements of a two-dimensional finite element model are applied to simulate the biomechanical and refractive effects of different corneal transplant procedures: anterior lamellar keratoplasty, posterior lamellar keratoplasty, and penetrating keratoplasty. The models are based on a nonlinearly elastic, isotropic formulation. Predictions are compared with published clinical data. The model simulating the penetrating keratoplasty procedure predicts more change in the postoperative corneal curvature than models simulating anterior lamellar keratoplasty or posterior lamellar keratoplasty procedures. When a lenticle-shaped tissue with a central thickness of 50 microns and a diameter of 4 mm is removed from the anterior corneal surface along with the anterior lamellar keratoplasty or posterior lamellar keratoplasty, the models predict a refractive correction of -8.6 and -8.9 diopters, respectively. Simulations indicate that a posterior lamellar keratoplasty procedure is preferable for obtaining a better corneal curvature profile, eliminating the need for specific secondary treatments.

  17. Paradigm shifts in corneal transplantation.

    Science.gov (United States)

    Tan, Donald T H; Anshu, Arundhati; Mehta, Jodhbir S

    2009-04-01

    Conventional corneal transplantation, in the form of penetrating keratoplasty (PK), involves full-thickness replacement of the cornea, and is a highly successful procedure. However, the cornea is anatomically a multi-layered structure. Pathology may only affect individual layers of the cornea, hence selective lamellar surgical replacement of only the diseased corneal layers whilst retaining unaffected layers represents a new paradigm shift in the field. Recent advancements in surgical techniques and instrumentation have resulted in several forms of manual, microkeratome and femto-second laser-assisted lamellar transplantation procedures. Anterior lamellar keratoplasty (ALK) aims at replacing only diseased or scarred corneal stroma, whilst retaining the unaffected corneal endothelial layer, thus obviating the risk of endothelial allograft rejection. Posterior lamellar keratoplasty/endothelial keratoplasty (PLK/EK) involves the replacement of the dysfunctional endothelial cell layer only. Whilst significant technical and surgical challenges are involved in performing lamellar micro-dissection of a tissue which is only 0.5 mm thick, the benefits of a more controlled surgical procedure and improved graft survival rates have resulted in a shift away from conventional PK. This review details the current advances in emerging lamellar corneal surgical procedures and highlights the main advantages and disadvantages of these new lamellar corneal procedures.

  18. Corneal topography in cataract surgery.

    Science.gov (United States)

    Martinez, C E; Klyce, S D

    1996-02-01

    Keratometry and corneal topography remain the most important means of evaluating induced corneal changes after surgery and have comparable sensitivities in the paracentral region of the cornea. However, keratometry gives no information about the peripheral cornea or about asymmetry of the cornea. Videokeratography should be performed after cataract surgery in cases in which best-corrected visual acuity is not adequate and there are no other obvious causes for poor vision to determine whether corneal irregularities are present. The recent literature on corneal topographic evaluation of induced astigmatism after cataract surgery suggests that in general, smaller, temporal incisions result in less astigmatism. Preoperatively, corneal topography can be used in the calculation of intraocular lens power as well as incision planning. Postoperatively, it can be used to detect tight sutures, torsion of the wound, internal wound gape, and irregular astigmatism, as well as to guide suture removal. In the future, corneal topography will become increasingly important in the determination of intraocular lens power in difficult cases such as patients undergoing combined cataract extraction and penetrating keratoplasty as well as patients with a history of radial keratotomy or photorefractive surgery.

  19. CONTACT LENS RELATED CORNEAL ULCER

    Directory of Open Access Journals (Sweden)

    AGARWAL P

    2010-01-01

    Full Text Available A corneal ulcer caused by infection is one of the major causes of blindness worldwide. One of the recent health concerns is the increasing incidence of corneal ulcers associated with contact lens user especially if the users fail to follow specific instruction in using their contact lenses. Risk factors associated with increased risk of contact lens related corneal ulcers are:overnight wear, long duration of continuous wear, lower socio-economic classes, smoking, dry eye and poor hygiene. The presenting symptoms of contact lens related corneal ulcers include eye discomfort, foreign body sensation and lacrimation. More serious symptoms are redness (especially circum-corneal injection, severe pain, photophobia, eye discharge and blurring of vision. The diagnosis is established by a thorough slit lamp microscopic examination with fluorescein staining and corneal scraping for Gram stain and culture of the infective organism. Delay in diagnosing and treatment can cause permanent blindness, therefore an early referral to ophthalmologist and commencing of antimicrobial therapy can prevent visual loss.

  20. Corneal wound healing after excimer laser keratectomy.

    Science.gov (United States)

    Kaji, Yuichi; Yamashita, Hidetoshi; Oshika, Tetsuro

    2003-03-01

    Excimer laser keratectomy is widely used to correct refractive errors. Several complications of excimer laser keratectomy are reported including corneal infection, regression, corneal haze formation, glare and halo. Most of the complications are closely related to the corneal stromal wound healing process. In order to perform the excimer laser keratectomy with minimum complications, we should understand the mechanism of the corneal stroma wound healing process. In addition, such knowledge will help us to regulate the corneal stromal wound healing process in the future. In the present article, we discuss the molecular mechanism of the corneal stromal wound healing process after excimer laser keratectomy and its regulation by anti-inflammatory agents.

  1. Treatment of Edema Disease of Swine

    Science.gov (United States)

    Pan, I. C.; Chen, H. C.; Morter, R. L.

    1970-01-01

    Antihistamine (Allermin) was used sucessfully in the treatment of naturally occurring edema disease of swine under the field and laboratory conditions. A high recovery rate (88.8%) was obtained in the group of pigs with mild clinical signs. The intravenous route of Allermin administration had definite beneficial value. The release of histamine induced by circulating immune-complexes may be responsible for the clinical signs characteristic of edema disease. Three pigs that recovered clinically following the Allermin treatment were examined histologically. Fibrinoid persisted in the vascular walls at least 30 days after the initiation of the treatment. The fibrinoid vasculitis, generalized eosinophilia at the tissue level, and favorable response of pigs to antihistamine treatment suggest that edema disease may be caused by allergy. ImagesFig. 1.Fig. 2.Fig. 3.Fig. 4.Fig. 5.Fig. 6.Fig. 7.Fig. 8.Fig. 9. PMID:4392719

  2. Corneal thickness changes after corneal collagen crosslinking for keratoconus and corneal ectasia: one-year results.

    Science.gov (United States)

    Greenstein, Steven A; Shah, Vinnie P; Fry, Kristen L; Hersh, Peter S

    2011-04-01

    To determine the changes in corneal thickness over time after corneal collagen crosslinking (CXL) for keratoconus and corneal ectasia. Cornea and refractive surgery subspecialty practice. Prospective randomized controlled clinical trial. Corneal thickness at the apex, thinnest point, and pupil center were measured using Scheimpflug imaging (Pentacam) at baseline and 1, 3, 6, and 12 months after CXL. The treatment group was compared with both a sham-procedure control group and a fellow-eye control group. Associations with clinical outcomes (uncorrected and corrected distance visual acuities and maximum keratometry) were analyzed. The study comprised 82 eyes, 54 with keratoconus and 28 with ectasia after laser in situ keratomileusis. The mean preoperative thinnest pachymetry was 440.7 μm ± 52.9 (SD). After CXL, the cornea thinned at 1 month (mean change -23.8 ± 28.7 μm; Pdegree of corneal thinning at 3 months and clinical outcomes after CXL. After CXL, the cornea thins and then recovers toward baseline thickness. The cause and implications of corneal thickness changes after CXL remain to be elucidated. No author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  3. Lipolymphedema Associated with Idiopathic Cyclic Edema: A Therapeutic Approach

    Science.gov (United States)

    Pereira de Godoy, Henrique Jose; de Sene Souza, Aline Aparecida; Budtinger Filho, Ricardo; de Fatima Guerreiro Godoy, Maria

    2017-01-01

    Idiopathic cyclic edema is a type of generalized edema that mainly affects women. Diagnosis is made by the patient's clinical history and an evaluation of the accumulation of weight during the day. The objective of this study is to report the clinical control of lymphedema associated with idiopathic cyclic edema using calcium dobesilate. A 55-year-old female patient reported generalized edema for years in that she woke up in the morning with her legs swollen and the edema worsened during the day. The physical examination revealed generalized edema. After four days of treatment with calcium dobesilate, the patient returned to the Clínica Godoy, Brazil, with less edema and reductions in body weight and the amount of extracellular and intracellular fluid. With further treatment, there was a total reduction of the edema. It is concluded that calcium dobesilate helps to control lymphedema secondary to idiopathic cyclic edema. PMID:28913000

  4. Lipolymphedema Associated with Idiopathic Cyclic Edema: A Therapeutic Approach

    Directory of Open Access Journals (Sweden)

    Jose Maria Pereira de Godoy

    2017-01-01

    Full Text Available Idiopathic cyclic edema is a type of generalized edema that mainly affects women. Diagnosis is made by the patient’s clinical history and an evaluation of the accumulation of weight during the day. The objective of this study is to report the clinical control of lymphedema associated with idiopathic cyclic edema using calcium dobesilate. A 55-year-old female patient reported generalized edema for years in that she woke up in the morning with her legs swollen and the edema worsened during the day. The physical examination revealed generalized edema. After four days of treatment with calcium dobesilate, the patient returned to the Clínica Godoy, Brazil, with less edema and reductions in body weight and the amount of extracellular and intracellular fluid. With further treatment, there was a total reduction of the edema. It is concluded that calcium dobesilate helps to control lymphedema secondary to idiopathic cyclic edema.

  5. Lipolymphedema Associated with Idiopathic Cyclic Edema: A Therapeutic Approach.

    Science.gov (United States)

    Pereira de Godoy, Jose Maria; Pereira de Godoy, Henrique Jose; de Sene Souza, Aline Aparecida; Budtinger Filho, Ricardo; de Fatima Guerreiro Godoy, Maria

    2017-01-01

    Idiopathic cyclic edema is a type of generalized edema that mainly affects women. Diagnosis is made by the patient's clinical history and an evaluation of the accumulation of weight during the day. The objective of this study is to report the clinical control of lymphedema associated with idiopathic cyclic edema using calcium dobesilate. A 55-year-old female patient reported generalized edema for years in that she woke up in the morning with her legs swollen and the edema worsened during the day. The physical examination revealed generalized edema. After four days of treatment with calcium dobesilate, the patient returned to the Clínica Godoy, Brazil, with less edema and reductions in body weight and the amount of extracellular and intracellular fluid. With further treatment, there was a total reduction of the edema. It is concluded that calcium dobesilate helps to control lymphedema secondary to idiopathic cyclic edema.

  6. 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

  7. Observation on ultrastructure and histopathology of cornea following femtosecond laser-assisted deep lamellar keratoplasty for acute corneal alkaline burns

    Directory of Open Access Journals (Sweden)

    Wen-Jing Li

    2016-04-01

    Full Text Available AIM: To demonstrate the changes in ultrastructure and histopathology of the cornea in acute corneal alkaline burns after femtosecond laser-assisted deep lamellar keratoplasty. METHODS: The New Zealand white rabbits treated with alkaline corneal burn were randomized into two groups, Group A (16 eyes with femtosecond laser-assisted deep lamellar keratoplasty 24h after burn and Group B (16 eyes without keratoplasty as controls. All eyes were evaluated with transmission electron microscopy (TEM at 1, 2, 3, and 4wk follow-up, then all corneas were tested by hematoxylin and eosin staining histology. RESULTS: The corneal grafts in Group A were transparent, while those in Group B showed corneal stromal edema and loosely arranged collagen fibers. One week after treatment, TEM revealed the intercellular desmosomes in the epithelial layers and intact non-dissolving nuclei in Group A. At week 4, the center of the corneas in Group A was transparent with regularly arranged collagen fibers and fibroblasts in the stroma. In Group B, squamous cells were observed on the corneal surface and some epithelial cells were detached. CONCLUSION: Femtosecond laser-assisted deep lamellar keratoplasty can suppress inflammatory responses, prevent toxic substance-induced injury to the corneal endothelium and inner tissues with quicker recovery and better visual outcomes.

  8. Stromal edema in klf4 conditional null mouse cornea is associated with altered collagen fibril organization and reduced proteoglycans.

    Science.gov (United States)

    Young, Robert D; Swamynathan, Shivalingappa K; Boote, Craig; Mann, Mary; Quantock, Andrew J; Piatigorsky, Joram; Funderburgh, James L; Meek, Keith M

    2009-09-01

    Klf4, one of the highly expressed transcription factors in the mouse cornea, plays an important role in maturation and maintenance of the ocular surface. In this study, the structure and proteoglycan composition of the Klf4 conditional null (Klf4CN) corneal stroma was investigated, to further characterize the previously reported Klf4CN stromal edema. Collagen fibril spacing and diameter were calculated from scattering intensity profiles from small angle synchrotron x-ray scattering patterns obtained across the cornea along a vertical meridian at 0.5-mm intervals. Collagen fibril organization and proteoglycans were visualized by electron microscopy (EM), with or without the cationic dye cuprolinic blue. Proteoglycans and glycosaminoglycans were further analyzed by fluorophore-assisted carbohydrate electrophoresis (FACE) and immunoblot analysis. Q-RT-PCR was used to measure the transcript levels. In the central cornea, the average collagen interfibrillar Bragg spacing increased from 44.5 nm (SD +/-1.8) in wild-type to 66.5 nm (SD +/-2.3) in Klf4CN, as measured by x-ray scattering and confirmed by EM. Mean collagen fibril diameter increased from 32 nm (SD +/-0.4) in wild-type to 42.3 nm (SD +/-4.8) in Klf4CN corneal stroma. Downregulation of proteoglycans detected by EM in the Klf4CN stroma was confirmed by FACE and immunoblot analysis. Q-RT-PCR showed that, whereas the Klf4CN corneal proteoglycan transcript levels remained unchanged, matrix metalloproteinase (MMP) transcript levels were significantly upregulated. The Klf4CN corneal stromal edema is characterized by increased collagen interfibrillar spacing and increased diameter of individual fibrils. The stroma also exhibits reduced interfibrillar proteoglycans throughout, which is possibly caused by increased expression of MMPs.

  9. Corneal Sparing Conjunctival Abrasion

    Directory of Open Access Journals (Sweden)

    Hamid Ehsani-Nia

    2017-07-01

    Full Text Available History of present illness: A 15-year-old male was transported to the emergency department via ambulance as a trauma activation after being struck by an automobile while jogging. Patient was alert and oriented, with no focal neurological deficits and no loss of consciousness. The patient complained of right eye foreign body sensation. Significant findings: Physical exam was significant for multiple broken teeth, multiple minor abrasions on the face, and fine shards of shattered glass on his face and hair. His right eye had conjunctival injection, with no signs of subconjunctival hemorrhage or ocular penetration. Vision, extraocular movement, and pupillary exam were grossly intact. Fluorescein staining with slit lamp exam with cobalt blue filter examination of the right eye revealed superficial bulbar conjunctival uptake of fluorescein dye staining an area of the conjunctiva inferior to the limbus 5 mm vertical by 2 mm horizontal (estimation by photo provided. No foreign bodies were visualized in the inferior fornix. These findings were consistent with superficial conjunctival abrasion. The exam noted sparing of the corneal epithelium. Discussion: The conjunctiva is a thin, transparent membrane covering the ocular surface from the corneal limbus to the posterior eyelid margin.1 When damaged, the patient will classically have a “foreign body” sensation. It is important to identify the extent of the injury as not extending over the cornea, and also to search for lodged foreign bodies that damage the conjunctiva further with each blink. Classically retained foreign bodies will form a linear and vertical pattern of staining with fluorescein.2,3 Fluorescein stains expose basement membrane and fluoresces bright green under ultraviolet light, thus indicating areas of damage in contrast to its surrounding tissue.4,5 In the setting of acute trauma, urgent Ophthalmologic consultation is indicated if there is anterior chamber hemorrhage, a ruptured or

  10. Central corneal thickness and corneal hysteresis associated with glaucoma damage.

    Science.gov (United States)

    Congdon, Nathan G; Broman, Aimee T; Bandeen-Roche, Karen; Grover, Davinder; Quigley, Harry A

    2006-05-01

    We sought to measure the impact of central corneal thickness (CCT), a possible risk factor for glaucoma damage, and corneal hysteresis, a proposed measure of corneal resistance to deformation, on various indicators of glaucoma damage. Observational study. Adult patients of the Wilmer Glaucoma Service underwent measurement of hysteresis on the Reichert Ocular Response Analyzer and measurement of CCT by ultrasonic pachymetry. Two glaucoma specialists (H.A.Q., N.G.C.) reviewed the chart to determine highest known intraocular pressure (IOP), target IOP, diagnosis, years with glaucoma, cup-to-disk ratio (CDR), mean defect (MD), pattern standard deviation (PSD), glaucoma hemifield test (GHT), and presence or absence of visual field progression. Among 230 subjects, the mean age was 65 +/- 14 years, 127 (55%) were female, 161 (70%) were white, and 194 (85%) had a diagnosis of primary open-angle glaucoma (POAG) or suspected POAG. In multivariate generalized estimating equation models, lower corneal hysteresis value (P = .03), but not CCT, was associated with visual field progression. When axial length was included in the model, hysteresis was not a significant risk factor (P = .09). A thinner CCT (P = .02), but not hysteresis, was associated with a higher CDR at the most recent examination. Neither CCT nor hysteresis was associated with MD, PSD, or GHT "outside normal limits." Thinner CCT was associated with the state of glaucoma damage as indicated by CDR. Axial length and corneal hysteresis were associated with progressive field worsening.

  11. 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.

  12. Substrates for Expansion of Corneal Endothelial Cells towards Bioengineering of Human Corneal Endothelium

    Directory of Open Access Journals (Sweden)

    Jesintha Navaratnam

    2015-09-01

    Full Text Available Corneal endothelium is a single layer of specialized cells that lines the posterior surface of cornea and maintains corneal hydration and corneal transparency essential for vision. Currently, transplantation is the only therapeutic option for diseases affecting the corneal endothelium. Transplantation of corneal endothelium, called endothelial keratoplasty, is widely used for corneal endothelial diseases. However, corneal transplantation is limited by global donor shortage. Therefore, there is a need to overcome the deficiency of sufficient donor corneal tissue. New approaches are being explored to engineer corneal tissues such that sufficient amount of corneal endothelium becomes available to offset the present shortage of functional cornea. Although human corneal endothelial cells have limited proliferative capacity in vivo, several laboratories have been successful in in vitro expansion of human corneal endothelial cells. Here we provide a comprehensive analysis of different substrates employed for in vitro cultivation of human corneal endothelial cells. Advances and emerging challenges with ex vivo cultured corneal endothelial layer for the ultimate goal of therapeutic replacement of dysfunctional corneal endothelium in humans with functional corneal endothelium are also presented.

  13. Quiste dermoide corneal bilateral

    Directory of Open Access Journals (Sweden)

    Michel Guerra Almaguer

    Full Text Available El dermoide es un tipo de coristoma (tejido embrionario normal en una localización anormal que afecta con frecuencia la córnea. Aparece como una masa sólida, blanca, redonda y elevada. Suele localizarse en el limbo inferotemporal, aunque puede hacerlo en cualquier lugar del globo ocular o de la órbita. Se presenta un paciente masculino, de 8 años de edad, quien desde su nacimiento muestra una mancha blanca en ambos ojos, agudeza visual sin corrección de movimiento de mano a 33 centímetros en el ojo derecho y percepción luminosa en el ojo izquierdo. En la exploración oftalmológica de ambos ojos se apreciaron lesiones blanquecinas sobre la córnea. Se le realizó exéresis del quiste y queratoplastia lamelar de ambos ojos, con resultados visuales satisfactorios. Se concluye que el caso presenta un quiste dermoide corneal bilateral.

  14. 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. © 2014 The Authors. Clinical and Experimental Optometry © 2014 Optometry Australia.

  15. Facial Edema Evaluation Using Digital Image Processing

    Directory of Open Access Journals (Sweden)

    A. E. Villafuerte-Nuñez

    2013-01-01

    Full Text Available The main objective of the facial edema evaluation is providing the needed information to determine the effectiveness of the anti-inflammatory drugs in development. This paper presents a system that measures the four main variables present in facial edemas: trismus, blush (coloration, temperature, and inflammation. Measurements are obtained by using image processing and the combination of different devices such as a projector, a PC, a digital camera, a thermographic camera, and a cephalostat. Data analysis and processing are performed using MATLAB. Facial inflammation is measured by comparing three-dimensional reconstructions of inflammatory variations using the fringe projection technique. Trismus is measured by converting pixels to centimeters in a digitally obtained image of an open mouth. Blushing changes are measured by obtaining and comparing the RGB histograms from facial edema images at different times. Finally, temperature changes are measured using a thermographic camera. Some tests using controlled measurements of every variable are presented in this paper. The results allow evaluating the measurement system before its use in a real test, using the pain model approved by the US Food and Drug Administration (FDA, which consists in extracting the third molar to generate the facial edema.

  16. Vasogenic edema characterizes pediatric acute disseminated encephalomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Zuccoli, Giulio; Panigrahy, Ashok; Sreedher, Gayathri; Bailey, Ariel [Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Section of Neuroradiology, Pittsburgh, PA (United States); Laney, Ernest John [Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Section of Neuroradiology, Pittsburgh, PA (United States); Rush University Medical Center, Department of Diagnostic Radiology, Chicago, IL (United States); La Colla, Luca [University of Parma, Department of Anesthesiology, Parma (Italy); UPMC Shadyside Hospital, Department of Emergency Medicine, Pittsburgh, PA (United States); Alper, Gulay [Children' s Hospital of Pittsburgh of UPMC, Department of Pediatric Neurology, Neuroimmunology Clinic, Pittsburgh, PA (United States)

    2014-08-15

    MR imaging criteria for diagnosing acute disseminated encephalomyelitis (ADEM) have not been clearly established. Due to the wide spectrum of differential considerations, new imaging features allowing early and accurate diagnosis for ADEM are needed. We hypothesized that ADEM lesions would be characterized by vasogenic edema due to the potential reversibility of the disease. Sixteen patients who met the diagnostic criteria for ADEM proposed by the International Pediatric Multiple Sclerosis Study Group (IPMSSG) and had complete MR imaging studies performed at our institution during the acute phase of the disease were identified retrospectively and evaluated by experienced pediatric neuroradiologists. Vasogenic edema was demonstrated on diffusion-weighted imaging (DWI) and corresponding apparent diffusion coefficient (ADC) maps in 12 out of 16 patients; cytotoxic edema was identified in two patients while the other two patients displayed no changes on DWI/ADC. ADC values for lesions and normal-appearing brain tissue were 1.39 ± 0.45 x 10{sup -3} and 0.81 ± 0.09 x 10{sup -3} mm/s{sup 2}, respectively (p = 0.002). When considering a cutoff of 5 days between acute and subacute disease, no difference between ADC values in acute vs. subacute phase was depicted. However, we found a significant correlation and an inverse and significant relationship between time and ADC value. We propose that vasogenic edema is a reliable diagnostic sign of acute neuroinflammation in ADEM. (orig.)

  17. Dysphagia Caused by Chronic Laryngeal Edema.

    Science.gov (United States)

    Delides, Alexander; Sakagiannis, George; Maragoudakis, Pavlos; Gouloumi, Αlina-Roxani; Katsimbri, Pelagia; Giotakis, Ioannis; Panayiotides, John G

    2015-10-01

    A rare case of a young female with chronic diffuse laryngeal edema causing severe swallowing difficulty is presented. The patient was previously treated with antibiotics and steroids with no improvement. Diagnosis was made with biopsy of the epiglottis under local anesthesia in the office.

  18. Successful Conservative Management of Scrotal Edema Resulting ...

    African Journals Online (AJOL)

    Introduction: Peritoneal fluid leaks are frequent in continuous ambulatory peritoneal dialysis (CAPD) patients and may manifest as subcutaneous or genital edema or as apparent ultrafiltration (UF) failure. Genital swelling in CAPD patients is often due to dialysate leak through a small clinically-undetectable inguinal hernia, ...

  19. Etoricoxib-induced pretibial erythema and edema

    Directory of Open Access Journals (Sweden)

    Pramod Kumar

    2015-01-01

    Full Text Available Cyclooxygenase inhibitors were developed in the quest of enhanced analgesic efficacy devoid of gastric side effects. Etoricoxib is a second-generation cox-2 inhibitor and as its use increases so do the reports of side effects. We report a case of extoricoxib-induced pretibial erythema and edema; and review the literature.

  20. Interstitial lung edema triggered by marathon running.

    Science.gov (United States)

    Zavorsky, Gerald S; Milne, Eric N C; Lavorini, Federico; Rienzi, Joseph P; Lavin, Kaleen M; Straub, Allison M; Pistolesi, Massimo

    2014-01-01

    The purpose of this study was to determine whether marathon running causes lung edema, and if so, to determine its effects on runners. Posterior/anterior (PA) radiographs were taken one day before the marathon and at 19, 55, and 98min post-marathon in 26 runners. The pre and post exercise radiographs of each runner were collated, and then read simultaneously. Two physicians interpreted the images independently in a blinded fashion. The PA radiographs were viewed together at each time-point and findings suggestive for interstitial lung edema were rated as 'mild,' 'moderate,' or 'severe' based on four different radiological criteria. Forty-six percent of the runners presented radiographic findings suggestive of mild to severe interstitial lung edema. Radiographic findings persisted until 98-min post-marathon, with at least moderate degree increases found more frequently in women (55%) than men (6%) (p<0.01). In conclusion, about half of the runners developed interstitial lung edema of varying degrees post-exercise with the incidence being higher in women compared to men. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. Peritumoral brain edema in angiomatous supratentorial meningiomas

    DEFF Research Database (Denmark)

    Nassehi, Damoun; Sørensen, Lars Peter; Dyrbye, Henrik

    2013-01-01

    The aim of this work was to study the vascular endothelial growth factor A (VEGF-A) pathway and peritumoral brain edema (PTBE) through comparison of non-angiomatous and angiomatous meningiomas. Meningiomas are common intracranial tumors, which often have PTBE. VEGF-A is an integral part of PTBE...

  2. Femtosecond laser corneal refractive surgery

    Science.gov (United States)

    Kurtz, Ron M.; Spooner, Greg J. R.; Sletten, Karin R.; Yen, Kimberly G.; Sayegh, Samir I.; Loesel, Frieder H.; Horvath, Christopher; Liu, HsiaoHua; Elner, Victor; Cabrera, Delia; Muenier, Marie-Helene; Sacks, Zachary S.; Juhasz, Tibor

    1999-06-01

    We evaluated the efficacy, safety, and stability of femtosecond laser intrastromal refractive procedures in ex vivo and in vivo models. When compared with longer pulsewidth nanosecond or picosecond laser pulses, femtosecond laser-tissue interactions are characterized by significantly smaller and more deterministic photodisruptive energy thresholds, as well as reduced shock waves and smaller cavitation bubbles. We utilized a highly reliable, all-solid-state femtosecond laser system for all studies to demonstrate clinical practicality. Contiguous tissue effects were achieved by scanning a 5 μm focused laser spot below the corneal surface at pulse energies of approximately 2 - 4 microjoules. A variety of scanning patterns was used to perform three prototype procedures in animal eyes; corneal flap cutting, keratomileusis, and intrastromal vision correction. Superior dissection and surface quality results were obtained for lamellar procedures (corneal flap cutting and keratomileusis). Preliminary in vivo evaluation of intrastromal vision correction in a rabbit model revealed consistent and stable pachymetry changes, without significant inflammation or loss of corneal transparency. We conclude that femtosecond laser technology may be able to perform a variety of corneal refractive procedures with high precision, offering advantages over current mechanical and laser devices and techniques.

  3. Corneal complications of vernal keratoconjunctivitis.

    Science.gov (United States)

    Solomon, Abraham

    2015-10-01

    Vernal keratoconjunctivitis (VKC) is a severe bilateral chronic allergic inflammatory disease of the ocular surface. In most of the cases, the disease is limited to the tarsal conjunctiva and to the limbus. However, in the more severe cases, the cornea may be involved, leading to potentially sight threatening complications. Prompt recognition of these complications is crucial in the management of VKC, which is one of the most severe ocular allergic diseases. A vicious cycle of inflammation occurs as a result of a set of reciprocal interactions between the conjunctiva and the cornea, which results in damage to the corneal epithelium and corneal stoma, and to the formation of shield ulcers and plaques, infectious keratitis, keratoconus, scarring, and limbal stem cell deficiency. These corneal complications can cause permanent decrease or loss of vision in children suffering from VKC. Corneal complications in VKC are the result of an on-going process of uncontrolled inflammation. Proper recognition of the corneal complications in VKC is crucial, as most of these can be managed or prevented by a combination of medical and surgical measures.

  4. An accessible approach for corneal topography

    OpenAIRE

    André Luís Beling da Rosa

    2013-01-01

    Corneal topography consists of measuring the corneal shape, which is a key factor for visual acuity. The exam is used, for instance, in keratoconus detection, personalized contact lens fitting, in pre- and post-procedures associated with refractive surgery and corneal transplants. This thesis presents an accessible, inexpensive and portable approach to perform corneal topographies. The results obtained with our prototype show a mean difference of about 0.02 millimeters, equivalent to 0.5% of ...

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

    Directory of Open Access Journals (Sweden)

    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.

  6. [The expression level of MMP-2 and collagen of hydroxyapatite modified titanium for keratoprosthesis in the corneal stroma of rabbits].

    Science.gov (United States)

    Yang, Min; Du, Gai-ping; Wang, Li-qiang; Wang, Xiao-ping; Cui, Fu-zhai; Lu, Yu-jie; Huang, Yi-fei

    2013-10-01

    To investigate the expression level of metalloproteinases-2(MMP-2) and Collagen in a hydroxyapatite surfaced-modified of three Pan type titanium keratoprosthesis after that implanted into the corneal stroma of rabbits, further evaluate its biological compatibility. Experimental study. Twenty-four New Zealand white rabbits, 2.0-2.5 kg, were respectively divided into three groups. Surgery was performed in right eye of all animals. skirt of HA-Ti and Ti were respectively inserted into the corneal stroma of rabbit of experimental group A and group B; only a sack was made without implantation in control group C . Cornea edema and corneal neovascularization were observed at scheduled times after operation; animals were sacrificed 2, 4 and 16 weeks after operation and their cornea was removed and examined under light microscopy; the surface of skirt was observed under scanning electron microscope. During the study period, all skirts were stable without infected, dissolved and excluded. Different degree of cornea edema and neovascularization was revealed after surgery. MMP-2 were absent in the normal corneal matrix. The expression level of MMP-2 in group A was higher than group C at all time points (F = 6.083, P collagen and yellow red type I collagen, 16 weeks corneal mainly for bright red when within the collagen type I, still have a small amount of collagen type III. Rabbit cornea implanted HA-Ti skirts cause MMP-2 activation, continuous high expression didn't cause the cornea to dissolve; Collagen -III turned into collagen-I gradually in the extracellular matrix around the skirts. Hydroxyapatite modified titanium for Keratoprosthesis promoted the corneal neovascularization and improve the interfacial bio integration of skirt and host cornea.

  7. 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.

  8. [Corneal toxicity due to amantadine].

    Science.gov (United States)

    Avendaño-Cantos, E M; Celis-Sánchez, J; Mesa-Varona, D; Gálvez-Martínez, J; López-Arroquia, E; González Del Valle, F

    2012-09-01

    A 64 year-old female with Parkinson disease treated with amantadine for two years who suddenly suffered bilateral corneal oedema. It was initially treated as herpetic endotheliitis without improvement as we lacked information on her chronic treatment. The corneal oedema finally resolved after withdrawing the drug. Amantadine hydrochloride may produce endothelial dysfunction. Once the amantadine treatment is stopped, the corneal oedema may be reversible but endothelial density remains low. An ophthalmologist examination should be performed before the initiation of amantadine treatment in order to establish a risk: benefit ratio, especially in those patients with low endothelial density or any endothelial anomaly. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  9. 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.

  10. Discovery of molecular markers to discriminate corneal endothelial cells in the human body.

    Directory of Open Access Journals (Sweden)

    Masahito Yoshihara

    Full Text Available The corneal endothelium is a monolayer of hexagonal corneal endothelial cells (CECs on the inner surface of the cornea. CECs are critical in maintaining corneal transparency through their barrier and pump functions. CECs in vivo have a limited capacity in proliferation, and loss of a significant number of CECs results in corneal edema called bullous keratopathy which can lead to severe visual loss. Corneal transplantation is the most effective method to treat corneal endothelial dysfunction, where it suffers from donor shortage. Therefore, regeneration of CECs from other cell types attracts increasing interests, and specific markers of CECs are crucial to identify actual CECs. However, the currently used markers are far from satisfactory because of their non-specific expression in other cell types. Here, we explored molecular markers to discriminate CECs from other cell types in the human body by integrating the published RNA-seq data of CECs and the FANTOM5 atlas representing diverse range of cell types based on expression patterns. We identified five genes, CLRN1, MRGPRX3, HTR1D, GRIP1 and ZP4 as novel markers of CECs, and the specificities of these genes were successfully confirmed by independent experiments at both the RNA and protein levels. Notably none of them have been documented in the context of CEC function. These markers could be useful for the purification of actual CECs, and also available for the evaluation of the products derived from other cell types. Our results demonstrate an effective approach to identify molecular markers for CECs and open the door for the regeneration of CECs in vitro.

  11. Discovery of molecular markers to discriminate corneal endothelial cells in the human body.

    Science.gov (United States)

    Yoshihara, Masahito; Ohmiya, Hiroko; Hara, Susumu; Kawasaki, Satoshi; Hayashizaki, Yoshihide; Itoh, Masayoshi; Kawaji, Hideya; Tsujikawa, Motokazu; Nishida, Kohji

    2015-01-01

    The corneal endothelium is a monolayer of hexagonal corneal endothelial cells (CECs) on the inner surface of the cornea. CECs are critical in maintaining corneal transparency through their barrier and pump functions. CECs in vivo have a limited capacity in proliferation, and loss of a significant number of CECs results in corneal edema called bullous keratopathy which can lead to severe visual loss. Corneal transplantation is the most effective method to treat corneal endothelial dysfunction, where it suffers from donor shortage. Therefore, regeneration of CECs from other cell types attracts increasing interests, and specific markers of CECs are crucial to identify actual CECs. However, the currently used markers are far from satisfactory because of their non-specific expression in other cell types. Here, we explored molecular markers to discriminate CECs from other cell types in the human body by integrating the published RNA-seq data of CECs and the FANTOM5 atlas representing diverse range of cell types based on expression patterns. We identified five genes, CLRN1, MRGPRX3, HTR1D, GRIP1 and ZP4 as novel markers of CECs, and the specificities of these genes were successfully confirmed by independent experiments at both the RNA and protein levels. Notably none of them have been documented in the context of CEC function. These markers could be useful for the purification of actual CECs, and also available for the evaluation of the products derived from other cell types. Our results demonstrate an effective approach to identify molecular markers for CECs and open the door for the regeneration of CECs in vitro.

  12. 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

  13. Generalized edema associated with parvovirus B19 infection.

    Science.gov (United States)

    Vlaar, Pieter J; Mithoe, Glen; Janssen, Wilbert M

    2014-12-01

    Generalized edema is a rare presentation of human parvovirus B19 infection. The etiology of this edema is unclear, particularly because signs of heart or renal failure are often not present. We report the case of a young adult presenting with generalized edema with serological and PCR evidence of parvovirus B19 infection, and discuss the potential mechanisms of edema based on the previous literature. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Generalized edema associated with parvovirus B19 infection

    Directory of Open Access Journals (Sweden)

    Pieter J. Vlaar

    2014-12-01

    Full Text Available Generalized edema is a rare presentation of human parvovirus B19 infection. The etiology of this edema is unclear, particularly because signs of heart or renal failure are often not present. We report the case of a young adult presenting with generalized edema with serological and PCR evidence of parvovirus B19 infection, and discuss the potential mechanisms of edema based on the previous literature.

  15. Generalized edema associated with parvovirus B19 infection

    OpenAIRE

    Vlaar, Pieter J.; Mithoe, Glen; Janssen, Wilbert M

    2014-01-01

    Generalized edema is a rare presentation of human parvovirus B19 infection. The etiology of this edema is unclear, particularly because signs of heart or renal failure are often not present. We report the case of a young adult presenting with generalized edema with serological and PCR evidence of parvovirus B19 infection, and discuss the potential mechanisms of edema based on the previous literature.

  16. Oxygen diffusion and edema with modern scleral rigid gas permeable contact lenses.

    Science.gov (United States)

    Compañ, Vicente; Oliveira, Cristina; Aguilella-Arzo, Marcel; Mollá, Sergio; Peixoto-de-Matos, Sofia C; González-Méijome, José M

    2014-09-04

    We defined the theoretical oxygen tension behind modern scleral contact lenses (CLs) made of different rigid gas permeable (RGP) materials, assuming different thickness of the tear layer behind the lens. A second goal was to show clinically the effect of the postlens tear film on corneal swelling. We simulated the partial pressure of oxygen across the cornea behind scleral CLs made of different lens materials (oxygen permeability Dk, 75-200 barrer) and different thickness (Tav, 100-300 μm). Postlens tear film thicknesses (Tpost-tear) ranging from 150 to 350 μm were considered. Eight healthy subjects were fitted randomly with a scleral lens with a thin and a thick postlens tear layer in two different sessions for a period of 3 hours under open-eye conditions. The CLs with less than 125 barrer of Dk and a thickness over 200 μm depleted the oxygen availability at the lens-cornea interface below 55 mm Hg for a postlens tear film of 150 μm. For a postlens tear film thickness of 350 μm, no combination of material or lens thickness will meet the criteria of 55 mm Hg. Our clinical measures of corneal edema showed that this was significantly higher (P oxygen permeability and up to 200 μm thick to avoid hypoxic effects even under open eye conditions. Postlens tear film layer should be below 150 μm to avoid clinically significant edema. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  17. Macular edema in uveitis with emphasis on ocular sarcoidosis

    NARCIS (Netherlands)

    Norel, J. van

    2015-01-01

    This thesis investigates the accumulation of fluid in the yellow spot (macular edema) in ocular inflammation (uveitis). Macular edema may result in definitive loss of vision.Two methods of imaging of macular edema are fluorescein angiography (FA) and optical coherence tomography (OCT). The first

  18. MASSIVE VULVAR EDEMA IN A WOMAN WITH SEVERE ...

    African Journals Online (AJOL)

    2010-06-11

    Jun 11, 2010 ... We report a case of massive vulvar edema in a 20 years old primigravida woman with severe preeclampsia at 32 weeks gestation. Other causes of vulvar edema were excluded. The vulvar edema appeared as the blood pressure increased, and cesarean section was performed for increasing preeclampsia ...

  19. Massive vulvar edema in a woman with severe preeclampsia. A ...

    African Journals Online (AJOL)

    We report a case of massive vulvar edema in a 20 years old primigravida woman with severe preeclampsia at 32 weeks gestation. Other causes of vulvar edema were excluded. The vulvar edema appeared as the blood pressure increased, and cesarean section was performed for increasing preeclampsia and fetal distress.

  20. Edema pulmonar neurogênico: relato de dois casos Neurogenic pulmonary edema: report of two cases

    Directory of Open Access Journals (Sweden)

    Desanka Dragosavac

    1997-06-01

    Full Text Available O edema pulmonar neurogênico é rara e grave complicação de pacientes com traumatismo craniencefálico (TCE. Pode ocorrer também em outras patologias do sistema nervoso central, tais como acidentes vasculares cerebrais (AVC, tumores ou após crises epilépticas, entre outras. Foram avaliados 36 casos com TCE grave e quatro pacientes com AVC, internados na UTI geral, no período de janeiro a setembro 1995. Nesse intervalo de tempo foram diagnosticados dois casos de edema pulmonar neurogênico, um ocorrendo em paciente com TCE grave e outro em paciente com AVC hemorrágico. O diagnóstico foi estabelecido pelo rápido desenvolvimento de edema pulmonar, com hipoxemia grave, queda da complacência pulmonar e infiltrados difusos bilaterais sem história prévia de aspiração traqueal ou outro fator de risco para o desenvolvimento de síndrome de angústia respiratória aguda. No primeiro paciente com trauma craniencefálico, o edema neurogênico foi diagnosticado na internação, uma hora após o trauma, com concomitante reação inflamatória grave e boa evolução em três dias. O outro caso, com AVC hemorrágico, desenvolveu edema neurogênico no quarto dia após drenagem de hematoma intraparenquimatoso, evoluindo para o óbito.Neurogenic pulmonary edema is a rare and serious complication in patients with head injury. It also may develop after a variety of cerebral insults such as subarachnoid hemorrhage, brain tumors and after epileptic seizures. Thirty six patients with severe head injury and four patients with cerebrovascular insults treated in Intensive Care Unit of HC-UNICAMP from January to September 1995 were evaluated. In this period there were two patients with neurogenic pulmonary edema, one with head injury and other with intracerebral hemorrhage. Diagnosis was made by rapid onset of pulmonary edema, severe hypoxemia, decrease of pulmonary complacence and diffuse pulmonary infiltrations, without previous history of tracheal

  1. Treatment of progressive keratoconus by riboflavin-UVA-induced cross-linking of corneal collagen: ultrastructural analysis by Heidelberg Retinal Tomograph II in vivo confocal microscopy in humans.

    Science.gov (United States)

    Mazzotta, Cosimo; Balestrazzi, Angelo; Traversi, Claudio; Baiocchi, Stefano; Caporossi, Tomaso; Tommasi, Cristina; Caporossi, Aldo

    2007-05-01

    To assess ultrastructural stromal modifications after riboflavin-UVA-induced cross-linking of corneal collagen in patients with progressive keratoconus. This was a second-phase prospective nonrandomized open study in 10 patients with progressive keratoconus treated by riboflavin-UVA-induced cross-linking of corneal collagen and assessed by means of Heidelberg Retinal Tomograph II Rostock Corneal Module (HRT II-RCM) in vivo confocal microscopy. The eye in the worst clinical condition was treated for each patient. Treatment under topical anesthesia included corneal deepithelization (9-mm diameter) and instillation of 0.1% riboflavin phosphate-20% dextran T 500 solution at 5 minutes before UVA irradiation and every 5 minutes for a total of 30 minutes. UVA irradiation was 7 mm in diameter. Patients were assessed by HRT II-RCM confocal microscopy in vivo at 1, 3, and 6 months after treatment. Rarefaction of keratocytes in the anterior and intermediate stroma, associated with stromal edema, was observed immediately after treatment. The observation at 3 months after the operation detected keratocyte repopulation in the central treated area, whereas the edema had disappeared. Cell density increased progressively over the postoperative period. At approximately 6 months, keratocyte repopulation was complete, accompanied by increased density of stromal fibers. No endothelial damage was observed at any time. Reduction in anterior and intermediate stromal keratocytes followed by gradual repopulation has been confirmed directly in vivo in humans by HRT II-RCM confocal microscopy after riboflavin-UVA-induced corneal collagen cross-linking.

  2. Metalloproteinases in corneal diseases: degradation and processing.

    Science.gov (United States)

    Sakimoto, Tohru; Sawa, Mitsuru

    2012-11-01

    Matrix metalloproteinases (MMPs) are zinc-dependent endopeptidases with the potential to degrade all types of extracellular matrix. The ADAM (a disintegrin and metalloproteinase) family of peptidases was recently identified as cleaving the extracellular domain of transmembrane proteins. This was termed ectodomain shedding. We investigated the MMP expression in patients with corneal diseases and the potential role of ADAMs in corneal pathophysiology. We detected upregulation of the active form of MMP-2 and MMP-9 in the tear fluid from patients with corneal melting or recurrent corneal erosion. Using human corneal epithelial cells, we observed ADAM17-dependent ectodomain shedding of soluble tumor necrosis factor receptor 1 and soluble interleukin-6 (IL-6) receptor (sIL-6R). The production of sIL-6R was also induced by messenger RNA splicing in the human corneal epithelial cells. IL-6/sIL-6R-induced signal transducer and activator of transcription 3 phosphorylation was observed in cultured human corneal fibroblasts, suggesting that IL-6 trans-signaling induced inflammatory cellular signaling in the human corneal fibroblasts. We demonstrated that MMPs are significantly upregulated in collagen-destructive disorders of the cornea. Additionally, we observed that ectodomain shedding by ADAMs in corneal epithelial cells mediated the production of soluble cytokine receptors. Trans-signaling of IL-6 can induce an inflammatory response in corneal stroma, indicating the significance of IL-6 trans-signaling in ocular surface inflammation. Thus, MMPs and ADAMs play an important role in the pathophysiology of corneal diseases.

  3. Corneal Regeneration After Photorefractive Keratectomy: A Review☆

    Science.gov (United States)

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

    2014-01-01

    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. PMID:25444646

  4. 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.

  5. History of corneal transplantation in Australia.

    Science.gov (United States)

    Coster, Douglas J

    2015-04-01

    Corneal transplantation is a triumph of modern ophthalmology. The possibility of corneal transplantation was first raised in 1797 but a century passed before Zirm achieved the first successful penetrating graft in 1905. Gibson reported the first corneal graft in Australia from Brisbane in 1940 and English established the first eye bank there a few years later. Corneal transplantation evolved steadily over the twentieth century. In the second half of the century, developments in microsurgery, including surgical materials such as monofilament nylon and strong topical steroid drops, accounted for improvements in outcomes. In 2013, approximately 1500 corneal transplants were done in Australia. Eye banking has evolved to cope with the rising demands for donor corneas. Australian corneal surgeons collaborated to establish and support the Australian Corneal Graft Registry in 1985. It follows the outcomes of their surgery and has become an important international resource for surgeons seeking further improvement with the procedure. © 2014 Royal Australian and New Zealand College of Ophthalmologists.

  6. Corneal biomechanical properties in floppy eyelid syndrome.

    Science.gov (United States)

    Muniesa, MaJesús; Muniesa Royo, MaJesús; March, Ana; March de Ribot, Ana; Sánchez-de-la-Torre, Manuel; Huerva, Valetín; Huerva Escanilla, Valetín; Jurjo, Carmen; Jurjo Campo, Carmen; Barbé, Ferran; Barbé Illa, Ferran

    2015-05-01

    To determine corneal biomechanical properties in patients with floppy eyelid syndrome (FES) and to compare them with eyes of controls. This case-control study included 208 eyes (72 eyes with FES and 136 without FES) of 107 patients (37 patients with FES and 70 without FES). Patients underwent a complete clinical eye examination that included corneal biomechanical evaluation carried out with the Reichert Ocular Response Analyzer. Corneal hysteresis (CH), corneal resistance factor (CRF), central corneal thickness (CCT), Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated intraocular pressure (IOPcc) were evaluated. Mean CH was significantly lower in patients with FES than in those without FES (9.51 ± 1.56 vs. 11.66 ± 9.11; P corneal biomechanical properties could be changed in patients with FES, reflecting additional structural changes in FES.

  7. 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

  8. Acute pulmonary edema after intramyometrial prostodin

    Directory of Open Access Journals (Sweden)

    Neha Baduni

    2011-01-01

    Full Text Available A 25 year old, 68 kg, primigravida, was taken up for emergency caesarean section for meconium stained liquor and fetal distress. She was a known case of pre eclampsia and her blood pressure was controlled on tab methyl dopa. she was administered general anaesthesia. after delivery of baby she went into postpartum hemorrhage which was controlled with intramyometrial prostodin. but immediately after its administration she went into acute pulmonary edema.

  9. Acute dermatomyositis with subcutaneous generalized edema.

    Science.gov (United States)

    Werner de Castro, Gláucio R; Appenzeller, Simone; Bértolo, Manoel B; Costallat, Lílian T L

    2006-11-01

    The authors report a 40-year-old Caucasian man with relapsing muscle and skin involvement of dermatomyositis treated with high-dose corticosteroids, taken orally, and methotrexate and human gamma globulin, both administered intravenously. After 4 months of aggressive treatment, he presented with generalized edema, considered secondary to dermatomyositis. Aggressive immunosuppression did not stop disease progression. The literature concerning anasarca due to inflammatory myopathies is revised.

  10. Methysergide attenuates systemic burn edema in rats.

    Science.gov (United States)

    Hernekamp, Jochen Frederick; Hu, S; Schmidt, K; Walther, A; Lehnhardt, M; Kremer, Thomas

    2013-09-01

    Thermal injuries of more than 20% total body surface area result in systemic shock with generalized edema. Burn shock is induced by a variety of mediators, mainly immunomodulative cytokines. Administration of methysergide (Met), a serotoninergic receptor blocking agent, reduces generalized edema in endotoxemia in rats. In this study we evaluated the systemic effects of Met after thermal injury. Donor rats (DR [n=8]) for positive controls and study groups underwent thermal injury (100°C water, 30% TBSA (Total Burn Surface Area), 12s). Shamburn plasma was harvested after a shamburn procedure ([n=4], 37°C water, 30% TBSA, 12s). Plasma was harvested 4h posttrauma and was transferred to healthy individuals. Recipient animals were randomized in 3 groups (1: burnplasma, 2: shamburn, 3: burnplasma plus methysergide (Bolus of 1mg/kg body weight)). Intravital microscopy was performed in mesenteric venules (0/60/120min). Edema was assessed by FITC-albumin extravasation. Leukocyte sticking (cells/mm(2)) and microhemodynamic parameters were assessed. Significant systemic capillary leakage was observed after burnplasma-transfer. Edema formation was significantly lower in negative controls. Application of methysergide reduced FITC-efflux to baseline levels. Adherent leukocytes increased in all groups, at 120min the amount of adherent leukocytes in positive controls was significantly higher in comparison to shamburn, differences to MET-groups were not significant. Burnplasma transfer to healthy individuals induces leukocyte activation and plasma extravasation and this effect is reduced by administration of Met. This may be attributed to leukocyte dependent as well as independent mechanisms. Evaluation of more specific serotoninergic antagonists is required to distinguish between systemic and local effects. Copyright © 2013. Published by Elsevier Inc.

  11. Biomechanics of Corneal Ring Implants

    Science.gov (United States)

    2015-01-01

    Purpose: To evaluate the biomechanics of corneal ring implants by providing a related mathematical theory and biomechanical model for the treatment of myopia and keratoconus. Methods: The spherical dome model considers the inhomogeneity of the tunica of the eye, dimensions of the cornea, lamellar structure of the corneal stroma, and asphericity of the cornea. It is used in this study for calculating a strengthening factor sf for the characterization of different ring-shaped corneal implant designs. The strengthening factor is a measure of the amount of strengthening of the cornea induced by the implant. Results: For ring segments and incomplete rings, sf = 1.0, which indicates that these implants are not able to strengthen the cornea. The intracorneal continuous complete ring (MyoRing) has a strengthening factor of up to sf = 3.2. The MyoRing is, therefore, able to strengthen the cornea significantly. Conclusions: The result of the presented biomechanical analysis of different ring-shaped corneal implant designs can explain the different postoperative clinical results of different implant types in myopia and keratoconus. PMID:26312619

  12. Corneal Protection for Burn Patients

    Science.gov (United States)

    2013-10-01

    report, Figs. 2-7. Rose Bengal (RB) photosensitization was tested because RB is FDA-allowed as a diagnostic for corneal abrasions...incisions. J Cataract Refract Surg, 30, 2420-4. Personnel supported by this grant All personnel are employed by the Massachusetts General Hospital

  13. Biomechanics of Corneal Ring Implants.

    Science.gov (United States)

    Daxer, Albert

    2015-11-01

    To evaluate the biomechanics of corneal ring implants by providing a related mathematical theory and biomechanical model for the treatment of myopia and keratoconus. The spherical dome model considers the inhomogeneity of the tunica of the eye, dimensions of the cornea, lamellar structure of the corneal stroma, and asphericity of the cornea. It is used in this study for calculating a strengthening factor sf for the characterization of different ring-shaped corneal implant designs. The strengthening factor is a measure of the amount of strengthening of the cornea induced by the implant. For ring segments and incomplete rings, sf = 1.0, which indicates that these implants are not able to strengthen the cornea. The intracorneal continuous complete ring (MyoRing) has a strengthening factor of up to sf = 3.2. The MyoRing is, therefore, able to strengthen the cornea significantly. The result of the presented biomechanical analysis of different ring-shaped corneal implant designs can explain the different postoperative clinical results of different implant types in myopia and keratoconus.

  14. 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

  15. Macula-On Versus Macula-Off Pseudophakic Rhegmatogenous Retinal Detachment Following Primary 23-Gauge Vitrectomy Plus Endotamponade.

    Science.gov (United States)

    Rezar, Sandra; Sacu, Stefan; Blum, Robert; Eibenberger, Katharina; Schmidt-Erfurth, Ursula; Georgopoulos, Michael

    2016-04-01

    To evaluate anatomical and functional outcomes of macula-on and macula-off rhegmatogenous retinal detachment (RRD) after 23-gauge vitrectomy and gas endotamponade, in eyes after successful cataract surgery. Forty-six pseudophakic eyes of 46 consecutive patients who underwent surgery for RRD repair were included. Based on the severity degree and extension of the RRD, diluted C3F8, SF6 or C2F6 gases were used for endotamponade. Patients were followed 1 month, 3 months, 6 months and 12 months after surgery. Main outcome variables were functional and anatomic outcomes till 12 months after surgery. Proliferative vitreoretinopathy of grade B or C was observed in 43%. C3F8 was used in 59%, SF6 in 28% and C2F6 in 13%. Reattachment after the first intervention was achieved in 89%. Preoperatively, 63% of patients presented with fovea-off retinal detachment. No intraoperative complications were registered. Preoperatively, eyes with macula-on RRD had a logMar BCVA of 0.3 ± 0.6 compared with 1.2 ± 0.7 in the macula-off group (p = 0.01). The mean visual acuity significantly improved to 0.06 ± 0.1 logMar in macula-on eyes and to 0.2 ± 0.3 logMar in macula-off eyes at 12 months (p = 0.01 compared to baseline and p = 0.04 between both the groups). The mean final postoperative CRT was 318 ± 48 µm in the macula-on group compared with 305 ± 71 µm in the macula-off group (p = 0.5). Even morphological improvement after 23-gauge vitrectomy and gas endotamponade was comparable between macula-on and macula-off eyes, macula-off RRDs showed delayed visual rehabilitation. Both groups showed significant visual acuity improvement until 12 months, however, macula-on RRDs showed significantly more improvement than macula-off RRDs.

  16. Current Treatments of Diabetic Macular Edema

    Directory of Open Access Journals (Sweden)

    Wei-Chun Chan

    2011-12-01

    Full Text Available Diabetic macular edema (DME is a major cause of visual impairment in diabetic patients. Laser photocoagulation is the standard management strategy for macular edema, but its results remain unsatisfactory. Several clinical trials of new treatment modalities for DME have been conducted over the past 10 years. We performed a literature search of English articles, published between 2000 and 2010, by using the PubMed database. The keywords searched included “diabetic macular edema and treatment” with limits set to include only clinical trials and review articles, over 50 articles were reviewed. Among the newer treatment modalities reviewed, therapy with anti-vascular endothelial growth factor (VEGF antibodies showed significantly better efficacy, with level I evidence. However, multiple injections were required to maintain its efficacy. Therefore, the associated complications and cost implications are the major limitations of this treatment. Several combinations of different modalities have been evaluated in the literature, but none are more efficacious than monotherapy with anti-VEGF antibodies. Since DME is a multifactorial disease, further studies involving combinations of modalities or new treatments modalities may be needed to reduce the number of injections required or improve the visual outcomes in case of DME.

  17. Lipolymphedema Associated with Idiopathic Cyclic Edema: A Therapeutic Approach

    OpenAIRE

    Pereira de Godoy, Jose Maria; Pereira de Godoy, Henrique Jose; de Sene Souza, Aline Aparecida; Budtinger Filho, Ricardo; de Fatima Guerreiro Godoy, Maria

    2017-01-01

    Idiopathic cyclic edema is a type of generalized edema that mainly affects women. Diagnosis is made by the patient’s clinical history and an evaluation of the accumulation of weight during the day. The objective of this study is to report the clinical control of lymphedema associated with idiopathic cyclic edema using calcium dobesilate. A 55-year-old female patient reported generalized edema for years in that she woke up in the morning with her legs swollen and the edema worsened during the ...

  18. Corneal biomechanical parameters during pregnancy.

    Science.gov (United States)

    Sen, Emine; Onaran, Yüksel; Nalcacioglu-Yuksekkaya, Pinar; Elgin, Ufuk; Ozturk, Faruk

    2014-01-01

    To evaluate the variation in biomechanical properties and central corneal thickness (CCT) for each trimester during pregnancy and to compare the values with those in nonpregnant women. We prospectively studied the eyes of 32 pregnant and 34 age-matched non-pregnant women. The parameters included corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOP), and corneal-compensated IOP measured by the Ocular Response Analyzer (ORA). The CCT was also measured with an ultrasonic pachymeter attached to the ORA. The mean age was 27.0 ± 3.8 years in the study group and 28.0 ± 4.1 years in the control group. The mean CH measurement was 10.6 ± 1.4 mmHg in the study group and 10.1 ± 1.3 mmHg in the control group. The mean CRF value was 9.6 ± 1.7 mmHg in the study group and 10.0 ± 1.4 mmHg in the control group. The mean CCT value was 541.1 ± 22.4 µm in the study group and 536.5 ± 27.1 µm in the control group. No statistically significant differences were found regarding CH, CRF, or CCT values between the 2 groups (independent t test, p = 0.160, p = 0.355, p = 0.450, respectively). Hormonal changes during pregnancy may not affect corneal biomechanics. This may be due to the balanced effect of the various hormones on the cornea during pregnancy.

  19. Laparoscopic Surgery Can Reduce Postoperative Edema Compared with Open Surgery

    Science.gov (United States)

    Guo, Dong; Gong, Jianfeng; Cao, Lei; Wei, Yao; Guo, Zhen

    2016-01-01

    Aim. The study aimed to investigate the impact of laparoscopic surgery and open surgery on postoperative edema in Crohn's disease. Methods. Patients who required enterectomy were divided into open group (Group O) and laparoscopic group (Group L). Edema was measured using bioelectrical impedance analysis preoperatively (PRE) and on postoperative day 3 (POD3) and postoperative day 5 (POD5). The postoperative edema was divided into slight edema and edema by an edema index, defined as the ratio of total extracellular water to total body water. Results. Patients who underwent laparoscopic surgery had better clinical outcomes and lower levels of inflammatory and stress markers. A total of 31 patients (26.05%) developed slight edema and 53 patients (44.54%) developed edema on POD3. More patients developed postoperative edema in Group O than in Group L on POD3 (p = 0.006). The value of the edema index of Group O was higher than that of Group L on POD3 and POD5 (0.402 ± 0.010 versus 0.397 ± 0.008, p = 0.001; 0.401 ± 0.009 versus 0.395 ± 0.007, p = 0.039, resp.). Conclusions. Compared with open surgery, laparoscopic surgery can reduce postoperative edema, which may contribute to the better outcomes of laparoscopic surgery over open surgery. PMID:27777583

  20. Laparoscopic Surgery Can Reduce Postoperative Edema Compared with Open Surgery

    Directory of Open Access Journals (Sweden)

    Dong Guo

    2016-01-01

    Full Text Available Aim. The study aimed to investigate the impact of laparoscopic surgery and open surgery on postoperative edema in Crohn’s disease. Methods. Patients who required enterectomy were divided into open group (Group O and laparoscopic group (Group L. Edema was measured using bioelectrical impedance analysis preoperatively (PRE and on postoperative day 3 (POD3 and postoperative day 5 (POD5. The postoperative edema was divided into slight edema and edema by an edema index, defined as the ratio of total extracellular water to total body water. Results. Patients who underwent laparoscopic surgery had better clinical outcomes and lower levels of inflammatory and stress markers. A total of 31 patients (26.05% developed slight edema and 53 patients (44.54% developed edema on POD3. More patients developed postoperative edema in Group O than in Group L on POD3 (p=0.006. The value of the edema index of Group O was higher than that of Group L on POD3 and POD5 (0.402±0.010 versus 0.397±0.008, p=0.001; 0.401±0.009 versus 0.395±0.007, p=0.039, resp.. Conclusions. Compared with open surgery, laparoscopic surgery can reduce postoperative edema, which may contribute to the better outcomes of laparoscopic surgery over open surgery.

  1. Improvement in corneal scarring following bacterial keratitis.

    Science.gov (United States)

    McClintic, S M; Srinivasan, M; Mascarenhas, J; Greninger, D A; Acharya, N R; Lietman, T M; Keenan, J D

    2013-03-01

    Bacterial keratitis results in corneal scarring and subsequent visual impairment. The long-term evolution of corneal scars has not been well described. In this case series, we identified patients who had improvement in corneal scarring and visual acuity from a clinical trial for bacterial keratitis. We searched the records of the Steroids for Corneal Ulcers Trial (SCUT) for patients who had improvement in vision between the 3-month and 12-month visits and reviewed their clinical photographs. Of the 500 patients enrolled in SCUT, five patients with large central corneal scars due to bacterial keratitis are presented. All experienced improvement in rigid contact lens-corrected visual acuity from months 3 to 12. All patients also had marked improvement in corneal opacity during the same time period. None of the patients opted to have penetrating keratoplasty. Corneal scars may continue to improve even many months after a bacterial corneal ulcer has healed. The corneal remodeling can be accompanied by considerable improvement in visual acuity, such that corneal transplantation may not be necessary.

  2. Imaging, Reconstruction, And Display Of Corneal Topography

    Science.gov (United States)

    Klyce, Stephen D.; Wilson, Steven E.

    1989-12-01

    The cornea is the major refractive element in the eye; even minor surface distortions can produce a significant reduction in visual acuity. Standard clinical methods used to evaluate corneal shape include keratometry, which assumes the cornea is ellipsoidal in shape, and photokeratoscopy, which images a series of concentric light rings on the corneal surface. These methods fail to document many of the corneal distortions that can degrade visual acuity. Algorithms have been developed to reconstruct the three dimensional shape of the cornea from keratoscope images, and to present these data in the clinically useful display of color-coded contour maps of corneal surface power. This approach has been implemented on a new generation video keratoscope system (Computed Anatomy, Inc.) with rapid automatic digitization of the image rings by a rule-based approach. The system has found clinical use in the early diagnosis of corneal shape anomalies such as keratoconus and contact lens-induced corneal warpage, in the evaluation of cataract and corneal transplant procedures, and in the assessment of corneal refractive surgical procedures. Currently, ray tracing techniques are being used to correlate corneal surface topography with potential visual acuity in an effort to more fully understand the tolerances of corneal shape consistent with good vision and to help determine the site of dysfunction in the visually impaired.

  3. Corneal biomechanical properties in thyroid eye disease.

    Science.gov (United States)

    Karabulut, Gamze Ozturk; Kaynak, Pelin; Altan, Cıgdem; Ozturker, Can; Aksoy, Ebru Funda; Demirok, Ahmet; Yılmaz, Omer Faruk

    2014-06-01

    The purpose of this study is to investigate the effect of thyroid eye disease (TED) on the measurement of corneal biomechanical properties and the relationship between these parameters and disease manifestations. A total of 54 eyes of 27 individuals with TED and 52 eyes of 30 healthy control participants were enrolled. Thyroid ophthalmopathy activity was defined using the VISA (vision, inflammation, strabismus, and appearance/exposure) classification for TED. The intraocular pressure (IOP) measurement with Goldmann applanation tonometer (GAT), axial length (AL), keratometry, and central corneal thickness (CCT) measurements were taken from each patient. Corneal biomechanical properties, including corneal hysteresis (CH) and corneal resistance factor (CRF) and noncontact IOP measurements, Goldmann-correlated IOP (IOPg) and corneal-compensated IOP (IOPcc) were measured with the Ocular Response Analyzer (ORA) using the standard technique. Parameters such as best corrected visual acuity, axial length, central corneal thickness, and corneal curvature were not statistically significant between the two groups (p > 0.05). IOP measured with GAT was higher in participants with TED (p corneal resistance factor between groups. However, IOPg and IOPcc were significantly higher in TED patients. CH and VISA grading of TED patients showed a negative correlation (p = 0.007). In conclusion, TED affects the corneal biomechanical properties by decreasing CH. IOP with GAT and IOPg is found to be increased in these patients. As the severity of TED increases, CH decreases in these patients. Copyright © 2014. Published by Elsevier B.V.

  4. 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

  5. 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.

  6. Localization of angiotensin converting enzyme in rabbit cornea and its role in controlling corneal angiogenesis in vivo.

    Science.gov (United States)

    Sharma, Ajay; Bettis, Daniel I; Cowden, John W; Mohan, Rajiv R

    2010-04-23

    The renin angiotensin system (RAS) has been shown to modulate vascular endothelial growth factor and angiogenesis. In this study we investigated (i) the existence of the RAS components angiotensin converting enzyme (ACE) and angiotensin II receptors (AT(1) and AT(2)) in the rabbit cornea using in vitro and ex vivo models and (ii) the effect of enalapril, an ACE inhibitor, to inhibit angiogenesis in rabbit cornea in vivo. New Zealand White rabbits were used. Cultured corneal fibroblasts and corneal epithelial cells were used for RNA isolation and cDNA preparation using standard molecular biology techniques. PCR was performed to detect the presence of ACE, AT(1), and AT(2) gene expression. A corneal micropocket assay to implant a vascular endothelial growth factor (VEGF) pellet in the rabbit cornea was used to induce corneal angiogenesis. Rabbits of the control group received sterile water, and the treated group received 3 mg/kg enalapril intramuscularly once daily for 14 days starting from day 1 of pellet implantation. The clinical eye examination was performed by slit-lamp biomicroscopy. We monitored the level of corneal angiogenesis in live animals by stereomicroscopy at days 4, 9, and 14 after VEGF pellet implantation. Collagen type IV and lectin immunohistochemistry and fluorescent microscopy were used to measure corneal angiogenesis in tissue sections of control and enalapril-treated corneas of the rabbits. Image J software was used to quantify corneal angiogenesis in the rabbit eye in situ. Our data demonstrated the presence of ACE, AT(1), and AT(2) expression in corneal fibroblasts. Cells of corneal epithelium expressed AT(1) and AT(2) but did not show ACE expression. Slit-lamp examination did not show any significant difference between the degree of edema or cellular infiltration between the corneas of control and enalapril-treated rabbits. VEGF pellet implantation caused corneal angiogenesis in the eyes of vehicle-treated control rabbits, and the mean area

  7. Changes of corneal biomechanics with keratoconus.

    Science.gov (United States)

    Wolffsohn, James S; Safeen, Saima; Shah, Sunil; Laiquzzaman, Mohammad

    2012-08-01

    To perform advanced analysis of the corneal deformation response to air pressure in keratoconics compared with age- and sex-matched controls. The ocular response analyzer was used to measure the air pressure-corneal deformation relationship of 37 patients with keratoconus and 37 age (mean 36 ± 10 years)- and sex-matched controls with healthy corneas. Four repeat air pressure-corneal deformation profiles were averaged, and 42 separate parameters relating to each element of the profiles were extracted. Corneal topography and pachymetry were performed with the Orbscan II. The severity of the keratoconus was graded based on a single metric derived from anterior corneal curvatures, difference in astigmatism in each meridian, anterior best-fit sphere, and posterior best-fit sphere. Most of the biomechanical characteristics of keratoconic eyes were significantly different from normal eyes (P corneal applanation. With increasing keratoconus severity, the cornea was thinner (r = -0.407, P corneal concave deformation past applanation was quicker (dive; r2 = -0.314, P = 0.01), and the tear film index was lower (r = -0.319, P = 0.01). The variance in keratoconus severity could be accounted for by the corneal curvature and central corneal thickness (r = 0.80) with biomechanical characteristics contributing an additional 4% (total r = 0.84). The area under the receiver operating characteristic curve was 0.919 ± 0.025 for keratometry alone, 0.965 ± 0.014 with the addition of pachymetry, and 0.972 ± 0.012 combined with ocular response analyzer biomechanical parameters. Characteristics of the air pressure-corneal deformation profile are more affected by keratoconus than the traditionally extracted corneal hysteresis and corneal resistance factors. These biomechanical metrics slightly improved the detection and severity prediction of keratoconus above traditional keratometric and pachymetric assessment of corneal shape.

  8. Effect of 1- and 6-Hour-Delayed Corneal Collagen Cross-Linking on Corneal Healing in a Rabbit Alkali-Burn Model: Clinical and Histological Observations.

    Science.gov (United States)

    Karti, Omer; Zengin, Mehmet Ozgur; Cinar, Esat; Tutuncu, Merve; Karahan, Eyyup; Celik, Asl; Kucukerdonmez, Cem

    2016-12-01

    To study the effect of 1- and 6-hour-delayed corneal collagen cross-linking (CXL) on wound-healing of experimental alkali burns of the cornea. Twenty-four albino rabbits were used. Alkali burns were created using 1 M NaOH. The animals were divided randomly into 2 groups: group 1 (control group, n = 6) and group 2 (experimental group, n = 18). The experimental group was further divided into 3 subgroups as follows: group 2A, untreated (non-CXL) subgroup; group 2B, 1-hour-delayed CXL treatment subgroup; and group 2C, 6-hour-delayed CXL treatment subgroup. All rabbits were examined periodically for 21 days after treatment and then killed. The corneas were excised and histologically examined. Corneal ulceration, edema, and opacity scores were 4.0 ± 1.64, 1.6 ± 0.65, and 3.5 ± 1.21 in group 2A, 1.5 ± 1.76, 1.3 ± 0.87, and 3.1 ± 1.12 in group 2B, and 2.0 ± 1.90, 1.5 ± 0.79, and 3.3 ± 1.09 in group 2C, respectively. These scores were significantly less in groups 2B and 2C than in group 2A (P = 0.023, P = 0.043, and P = 0.034, respectively). Corneal epithelialization, evident upon staining, was best in group 2B and worst in group 2A (P = 0.012). Histopathology revealed that destruction of corneal collagen fibers and infiltration of inflammatory cells into corneal tissue were reduced in groups 2B and 2C compared with group 2A. We found that CXL treatment exerted positive effects on severe alkali-induced corneal burns. However, the effects were more pronounced in the 1-hour treatment group. We believe that CXL treatment may be a possible treatment for corneal alkali burn.

  9. Aloe vera gel facilitates re-epithelialization of corneal alkali burn in normal and diabetic rats

    Directory of Open Access Journals (Sweden)

    Atiba A

    2015-10-01

    Full Text Available Ayman Atiba,1 Tamer Wasfy,2 Walied Abdo,3 Ahmed Ghoneim,2 Tarek Kamal,4 Mustafa Shukry5 1Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, 2Department of Ophthalmology, Faculty of Medicine, Tanta University, 3Department of Pathology, 4Department of Biochemistry, 5Department of Physiology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt Purpose: To investigate the efficacy of topical applied aloe vera (AV and to facilitate the repair of the standardized alkaline corneal ulcer in normal and diabetic rats.Materials and methods: The corneal alkali-burn injury model was established unilaterally in Wistar rats by filter paper saturated with 0.01 M NaOH contacting the eyes for 45 seconds. Rats were divided into four groups: normal control (NC, normal AV (NAV, diabetic control (DC, and diabetic AV (DAV. NAV and DAV groups were treated with AV gel eye drops four times daily, and NC and DC groups were treated with normal saline for 3 days. Corneal epithelial wound closure and degree of edema were recorded using slit lamp and optical coherence tomography at 0, 24, 48, and 72 hours postwounding. Histological examination was conducted to evaluate the degree of inflammation and the healing effect.Results: Corneal epithelial wound healing was better in the NAV group than in the NC group, and it was significantly higher in the DAV group than in the DC group (P<0.05. In comparison to the DC group, DAV treated with AV demonstrated a marked reduction in edema at 48 and 72 hours. Histologically, corneal re-epithelialization was complete and higher in DAV group than that in DC group; moreover, the inflammatory cells were increased in DC group than DAV group (P<0.05.Conclusion: This study demonstrated the efficacy of AV for enhanced corneal re-epithelialization, as well as reduced inflammatory response after alkali burn in rats; therefore, it could be useful as a

  10. Evaluation of corneal symmetry after UV corneal crosslinking for keratoconus.

    Science.gov (United States)

    Mofty, Hanan; Alzahrani, Khaled; Carley, Fiona; Harper, Sophie; Brahma, Arun; Au, Leon; Morley, Debbie; Hillarby, M Chantal

    2017-01-01

    The purpose of this study was to assess UV corneal crosslinking (CXL) treatment outcomes for keratoconus by evaluating the corneal regularity in patients through follow-up using the Oculus Pentacam. A total of 18 eyes from CXL patients with keratoconus were studied before and after CXL treatment, and six eyes from six patients who were not treated with CXL served as controls. Treated patients had Pentacam images taken before CXL treatment and regularly 3 months post treatment up to the 12th month. Controls were imaged during their first appointment and after 12 months. Symmetry and asphericity were evaluated and correlated with both best-corrected visual acuity (BCVA) and maximum K -readings. In the CXL-treated group, there was a significant improvement in the index of symmetrical variation (ISV) and keratoconus index (KI) at 3 months and in the index of height asymmetry (IHA) and minimum radius of curvature ( R min ) at 9 months post treatment. On the contrary, the untreated group's indices showed some significant worsening in ISV, KI, central keratoconus index (CKI), and R min . A novel finding in our study was a slight positive shift of anterior asphericity in the 6 mm, 7 mm, and 8 mm 3 months after treatment, which had a correlation with BCVA ( R 2 =0.390, p =0.053) and a strong correlation with maximum K -reading ( R 2 =0.690, p =0.005). However, the untreated group had no significant changes after 1 year. The corneal asymmetrical shape is associated with the spherical aberration alteration influenced by temporal evolution of surface ablation and increased corneal haze. However, insignificant changes in symmetry attest the stabilization effect on cornea postoperatively as compared with controls.

  11. Corneal haze induced by excimer laser photoablation in rabbits is reduced by preserved human amniotic membrane graft

    Science.gov (United States)

    Wang, Ming X.; Gray, Trevor; Prabhasawat, Pinnita; Ma, Xiong; Culbertson, William; Forster, Richard; Hanna, Khalil; Tseng, Scheffer C. G.

    1998-06-01

    We conducted a study to determine if preserved human amniotic membrane can reduce corneal haze induced by excimer laser photoablation. Excimer photoablation was performed bilaterally on 40 New Zealand white rabbits with a 6 mm ablation zone and 120 micrometer depth (PTK) using the VISX Star. One eye was randomly covered with a preserved human amniotic membrane and secured using four interrupted 10 - 0 nylon sutures; the other eye served as control. The amniotic membranes were removed at one week, and the corneal haze was graded with a slit-lamp biomicroscopy by three masked corneal specialists (WC, KH and RF) biweekly for the ensuing 12 weeks. Histology and in situ TUNEL staining (for fragmented DNA as an index for apoptosis) was performed at days 1, 3 and 7 and at 12 weeks. One week after excimer photoablation, the amniotic membrane-covered corneas showed more anterior stromal edema, which resolved at the second week. A consistent grading of organized reticular corneal haze was noted among the three masked observers. Such corneal haze peaked at the seventh week in both groups. The amniotic membrane-covered group showed statistically significant less corneal haze (0.50 plus or minus 0.15) than the control groups (1.25 plus or minus 0.35) (p less than 0.001). The amniotic membrane-covered corneas had less inflammatory response at days 1 and 3, showing nearly nil DNA fragmentation on keratocytes on the ablated anterior stromal and less stromal fibroblast activation. There is less altered epithelial cell morphology and less epithelial hyperplasia at 1 week in these amniotic membrane-treated eyes. We concluded from this study that amniotic membrane matrix is effective in reducing corneal haze induced by excimer photoablation in rabbits and may have clinical applications.

  12. Posterior corneal shape : Comparison of height data from 3 corneal topographers

    NARCIS (Netherlands)

    de Jong, Tim; Sheehan, Matthew T.; Koopmans, Steven A.; Jansonius, Nomdo M.

    Purpose: To compare the ability of 3 clinical corneal topographers to describe the posterior corneal shape. Setting: University Medical Center Groningen, the Netherlands. Design: Prospective observational study. Methods: Corneas of healthy participants were measured twice with a dual Scheimpflug

  13. Value of recombinant human epidermal growth factor in corneal wound repair after corneal foreign body elimination

    OpenAIRE

    Hong-Jie Han

    2013-01-01

    AIM: To investigate the repair efficacy of recombinant human epidermal growth factor on corneal epithelium after corneal foreign body eliminating operation. METHODS: There were 102 patients with corneal foreign body(188 affected eyes)chosen for the study. All patients were divided into treatment group and control group according to the random number table. Both groups received corneal foreign body elimination by slit lamp. Postoperatively, the treatment group was given eye drops containing ep...

  14. Variation of corneal refractive index with hydration

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young L; Walsh, Joseph T Jr.; Goldstick, Thomas K; Glucksberg, Matthew R [Biomedical Engineering Department, Northwestern University, Evanston, IL 60208 (United States)

    2004-03-07

    We report the effect of changes in the corneal hydration on the refractive index of the cornea. Using optical coherence tomography (OCT), the geometrical thickness and the group refractive index of the bovine cornea were derived simultaneously as the corneal hydration was varied. The corneal hydration was then calculated from the corneal thickness. The group refractive index of the cornea increased non-linearly as the cornea dehydrated. In addition, a simple mathematical model was developed, based on the assumption that changes in corneal hydration occur only in the interfibrilar space with constant water content within the collagen fibrils. Good agreement between the experimental results and the mathematical model supports the assumption. The results also demonstrate that the measurement of refractive index is a quantitative indicator of corneal hydration.

  15. Corneal Toxicity Following Exposure to Asclepias Tuberosa

    DEFF Research Database (Denmark)

    Mikkelsen, Lauge Hjorth; Hamoudi, Hassan; Gül, Cigdem Altuntas

    2017-01-01

    PURPOSE: To present a case of corneal toxicity following exposure to milky plant latex from Asclepias tuberosa. METHODS: A 70-year-old female presented with blurred vision and pain in her left eye after handling an Ascepias tuberosa. Clinical examination revealed a corneal stromal oedema with small...... that inhibit the Na+/ K+-ATPase in the corneal endothelium. The oedema resolved after 96 hours. After nine months the best corrected visual acuity was 20/20. CONCLUSION: Corneal toxicity has previously been reported for plants of the Asclepias family. This is a rare case describing severe corneal toxicity...... caused by exposure to latex from Asclepias tuberosa. Handling of plants of the Asclepias family should be kept as a differential diagnosis in cases of acute corneal toxicity....

  16. Genetics Home Reference: lattice corneal dystrophy type I

    Science.gov (United States)

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

  17. 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. The...

  18. Sensitivity of the corneal-plane refractive compen- sation to change in power and axial position of an intraocular lens

    Directory of Open Access Journals (Sweden)

    W. F. Gool

    2009-12-01

    Full Text Available If an intraocular lens is displaced or if its power is changed what are the consequences for the refractive compensation of the eye?  Gaussian optics is used to obtain explicit formulae for the sensitivityof the corneal-plane refractive compensation (also called the refraction, refractive state, etc to change in power and axial displacement of a thin intraocular lens implanted in a simple eye.  In particular, for a pseudophakic Gullstrand simplified eye withintraocular lens placed 5 mm behind the cornea the sensitivity to errors in the power of the intraocular lens is about  71 . 0 − 71 for an intraocular lens of power   for an intraocular lens of power 20 D, that is, the refractive compensation decreases by about 0.71 dioptres per dioptre increase in the power of the intraocular lens.  More generally the sensitivity is approximately  ( I m   0037 . 0 63 . 0 F − − 0.63 ( 003 . 0 63 . 0 − − (0.0037mFIwhere FI is the power of the intraocular lens.  Also for Gullstrand’s simplified eye the sensitivity of refractive compensation to axial displacement of the intraocular lens is approximately linear in FI , about  (64D FI, in fact.  That is, for each dioptre of the power of the intraocular lens the refractive compensation increases by about 0.064 dioptres per millimetre of axial displacement towards the retina.

  19. Corneal epithelium in penetrating keratoplasty.

    Science.gov (United States)

    Meyer, R F; Bobb, K C

    1980-08-01

    We studied corneal epithelium in 66 patients with bullous keratopathy treated with penetrating keratoplasty using McCarey-Kaufman stored donor corneas. Epithelium was evaluated at times of storage, surgery, and postoperative dressing changes. Epithelium was intact in 43 of the donor corneas at storage, and 23 had 5 to 100% (median, 50%) epithelium missing. At the end of the keratoplasty procedure, 16 grafts had epithelium intact, and 50 had 5 to 100% (median, 20%) epithelium missing. Postoperative epithelial healing time ranged from one to 12 days, with a median of two days. Postoperative healing was significantly prolonged when donor corneal epithelium was missing at keratoplasty. As the amount of epithelium intact at the end of surgery decreased, the number of days to heal postoperatively increased. We found that donor corneas could be stored as long as 79 hours, with 63 hours in McCarey-Kaufman medium, and still have epithelium intact at the end of the keratoplasty procedure.

  20. Corneal astigmatism following cataract extraction.

    Science.gov (United States)

    Wishart, M S; Wishart, P K; Gregor, Z J

    1986-01-01

    The changes in corneal curvature in the first six months after cataract extraction were studied by performing sequential keratometry on a group of 57 patients. 8/0 Virgin silk interrupted sutures were used for the closure of corneoscleral incisions, and 10/0 monofilament tied in double running (bootlace) or single running (continuous) fashion was used for corneal wound closure. A high degree of with-the-rule astigmatism was evident in all patients two weeks postoperatively, but thereafter the character of the astigmatism produced by 8/0 virgin silk and 10/0 monofilament closure was quite different: in the 8/0 virgin silk group there was an early and pronounced shift in the axis of astigmatism to against-the-rule, whereas in the 10/0 monofilament group there was little further change in the astigmatism unless the sutures were removed. Wound compression and wound gape as factors responsible for these changes are discussed. PMID:3539177

  1. Glaucoma and Corneal Transplant Procedures

    Directory of Open Access Journals (Sweden)

    Ammar M. Al-Mahmood

    2012-01-01

    Full Text Available Glaucoma after corneal transplantation is a leading cause of ocular morbidity after penetrating keratoplasty. The incidence reported is highly variable and a number of etiologic factors have been identified. A number of treatment options are available; surgical intervention for IOP control is associated with a high incidence of graft failure. IOP elevation is less frequently seen following deep anterior lamellar keratoplasty. Descemet's striping-automated endothelial keratoplasty is also associated with postprocedure intraocular pressure elevation and secondary glaucoma and presents unique surgical challenges in patients with preexisting glaucoma surgeries. Glaucoma exists in up to three-quarters of patients who undergo keratoprosthesis surgery and the management if often challenging. The aim of this paper is to highlight the incidence, etiology, and management of glaucoma following different corneal transplant procedures. It also focuses on the challenges in the diagnosis of glaucoma and intraocular pressure monitoring in this group of patients.

  2. Corneal hemangiosarcoma in a cat.

    Science.gov (United States)

    Cazalot, G; Regnier, A; Deviers, A; Serra, F; Lucas, M N; Etienne, C L; Letron, I Raymond

    2011-09-01

    A 10 year-old castrated male Domestic Short-hair cat with a history of chronic bilateral keratitis was referred for assessment of a red, elevated mass involving the left cornea. The rapid growth of the mass, over a month period in combination with pronounced vascularization and invasion of the corneal surface suggested an aggressive inflammatory or neoplastic process. Following keratectomy, the lesion was diagnosed histopathologically as a hemangiosarcoma. The tumor recurred locally within 3 weeks and enucleation was performed. Histopathologic examination of the globe confirmed the diagnosis and did not reveal infiltration of the limbus and conjunctiva. No signs of local recurrence or metastatic disease have been observed 18 months following enucleation. To the authors' knowledge this is the first case of primary corneal hemangiosarcoma described in the feline species. © 2011 American College of Veterinary Ophthalmologists.

  3. Evaluation of corneal symmetry after UV corneal crosslinking for keratoconus

    Directory of Open Access Journals (Sweden)

    Mofty H

    2017-11-01

    Full Text Available Hanan Mofty,1,2 Khaled Alzahrani,2 Fiona Carley,3 Sophie Harper,3 Arun Brahma,3 Leon Au,3 Debbie Morley,3 M Chantal Hillarby2 1Optometry Department, College of Applied Medical Science, King Saud University, Riyadh, Kingdom of Saudi Arabia; 2Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, 3Manchester Royal Eye Hospital, Manchester, UK Purpose: The purpose of this study was to assess UV corneal crosslinking (CXL treatment outcomes for keratoconus by evaluating the corneal regularity in patients through follow-up using the Oculus Pentacam.Patients and methods: A total of 18 eyes from CXL patients with keratoconus were studied before and after CXL treatment, and six eyes from six patients who were not treated with CXL served as controls. Treated patients had Pentacam images taken before CXL treatment and regularly 3 months post treatment up to the 12th month. Controls were imaged during their first appointment and after 12 months. Symmetry and asphericity were evaluated and correlated with both best-corrected visual acuity (BCVA and maximum K-readings.Results: In the CXL-treated group, there was a significant improvement in the index of symmetrical variation (ISV and keratoconus index (KI at 3 months and in the index of height asymmetry (IHA and minimum radius of curvature (Rmin at 9 months post treatment. On the contrary, the untreated group’s indices showed some significant worsening in ISV, KI, central keratoconus index (CKI, and Rmin. A novel finding in our study was a slight positive shift of anterior asphericity in the 6 mm, 7 mm, and 8 mm 3 months after treatment, which had a correlation with BCVA (R2=0.390, p=0.053 and a strong correlation with maximum K-reading (R2=0.690, p=0.005. However, the untreated group had no significant changes after 1 year.Conclusion: The corneal asymmetrical shape is associated with the spherical aberration alteration

  4. Corneal Donor Tissue Preparation for Endothelial Keratoplasty

    OpenAIRE

    Woodward, Maria A.; Titus, Michael; Mavin, Kyle; Shtein, Roni M.

    2012-01-01

    Over the past ten years, corneal transplantation surgical techniques have undergone revolutionary changes1,2. Since its inception, traditional full thickness corneal transplantation has been the treatment to restore sight in those limited by corneal disease. Some disadvantages to this approach include a high degree of post-operative astigmatism, lack of predictable refractive outcome, and disturbance to the ocular surface. The development of Descemet's stripping endothelial keratoplasty (DSEK...

  5. Corneal Biomechanics Determination in Healthy Myopic Subjects

    OpenAIRE

    Kunliang Qiu; Xuehui Lu; Riping Zhang; Geng Wang; Mingzhi Zhang

    2016-01-01

    Purpose. To determine the corneal biomechanical properties by using the Ocular Response Analyzer? and to investigate potential factors associated with the corneal biomechanics in healthy myopic subjects. Methods. 135 eyes from 135 healthy myopic subjects were included in this cross-sectional observational study. Cornea hysteresis (CH), corneal resistance factor (CRF), cornea-compensated intraocular pressure (IOPcc), and Goldmann-correlated intraocular pressure (IOPg) were determined with the ...

  6. Corneal and retinal effects of ultraviolet-B exposure in a soft contact lens mouse model.

    Science.gov (United States)

    Ibrahim, Osama M A; Kojima, Takashi; Wakamatsu, Tais Hitomi; Dogru, Murat; Matsumoto, Yukihiro; Ogawa, Yoko; Ogawa, Junko; Negishi, Kazuno; Shimazaki, Jun; Sakamoto, Yasuo; Sasaki, Hiroshi; Tsubota, Kazuo

    2012-04-30

    To investigate the lipid and DNA oxidative stress as well as corneal and retinal effects after ultraviolet B (UV-B) exposure in mice, with or without silicon hydrogel soft contact lenses (SCL). Twenty-eight C57BL6-strain male mice were divided into four groups: group I, control group with no SCL (SCL [-]) and no UV-B exposure (UV-B [-]); group II, senofilcon A SCL (senofilcon [+]) with UV-B exposure (UV-B [+]); group III, lotrafilcon A SCL (lotrafilcon [+]) with UV-B exposure (UV-B [+]); and group IV, no SCL (SCL [-]), but with UV-B exposure (UV-B [+]). All mice except group I received UV-B exposure for 5 days for a total dose of 2.73 J/cm(2). All mice underwent tear hexanoyl-lysine (HEL) and tear cytokine ELISA measurements, and fluorescein and rose bengal corneal staining before and after UV-B exposure. Corneal specimens underwent immunohistochemistry staining with CD45, HEL, 4-hydroxynonenal (4-HNE), and 8-hydroxy-2'-deoxyguanosine (8-OHdG) antibodies and evaluation with electron microscopy. All mice without SCL but exposed to UV-B developed corneal edema, ulcers, or epithelial damage compared with mice with senofilcon A SCL and exposure to UV-B. Tear HEL and cytokine levels significantly increased in mice without SCL after UV-B exposure. Immunohistochemistry showed a significantly higher number of cells positively stained for CD45, 8-OHdG, HEL, and 4-HNE in the corneas of mice without SCLs compared with those with senofilcon A after UV-B exposure. Silicon hydrogel SCL showed corneal and retinal protective effects, owing to UV blocking properties, against oxidative stress-related membrane lipid and cellular DNA damage.

  7. Altered corneal stromal matrix organization is associated with mucopolysaccharidosis I, III and VI.

    Science.gov (United States)

    Alroy, J; Haskins, M; Birk, D E

    1999-05-01

    The presence of cloudy corneas is a prominent feature of mucopolysaccharidosis (MPS) types I and VI, but not MPS IIIA or IIIB. The cause of corneal cloudiness in MPS I and VI is speculative. Transparency of the cornea is dependent on the uniform diameter and the regular spacing and arrangement of the collagen fibrils within the stroma. Alterations in the spacing of collagen fibrils in a variety of conditions including corneal edema, scars, and macular corneal dystrophy is clinically manifested as corneal opacity. The purpose of this study was to compare the structural organization of the stromal extracellular matrix of normal corneas with that of MPS corneas. The size and arrangement of collagen fibrils in cloudy corneas from patients with MPS I were examined. The alterations observed were an increased mean fibril diameter with a broader distribution in the MPS corneas. The MPS I corneas also had altered fibril spacing and more irregular packing compared with normal control corneas. The clear corneas of patients with MPS IIIA and IIIB also showed increases in mean fibril diameter and fibril spacing. However, there was less variation indicating more regularity than seen in MPS I. In addition, corneas from cat models of certain MPS were compared to the human corneas. Cats with MPS I and VI, as well as normal control cats, were examined. Structural alterations comparable to those seen in human MPS corneas were seen in MPS I and VI cats relative to normal clear corneas. The findings suggest that cloudy corneas in MPS I and VI are in part a consequence of structural alterations in the corneal stroma, including abnormal spacing, size, and arrangement of collagen fibrils. Copyright 1999 Academic Press.

  8. Refractive surgery following corneal graft.

    Science.gov (United States)

    Alió, Jorge L; Abdou, Ahmed A; Abdelghany, Ahmed A; Zein, Ghassam

    2015-07-01

    To review the different surgical procedures for management of postkeratoplasty refractive errors after total suture removal. There are different surgical options to address residual refractive errors that frequently occur after corneal transplantation. The correction can be done on the corneal surface or intraocular with intraocular lens (IOL) implantation which requires complete tectonic and refractive stability after suture removal. The most commonly used procedures are photorefractive keratectomy, laser in-situ keratomileusis and Phakic IOLs. Keratoplasty has been profited by recent advances in refractive surgery. Custom excimer laser ablation is an alternative way to treat irregular errors. New IOL modalities are good practical options for a wide range of errors. Femtosecond laser, as a new option in the toolbox, can modify corneal grafting refractive results and assist corrective refractive procedures. Although being the most successful organ transplantation, keratoplasty is usually followed by significant ametropia. Different corrective modalities exist and the choice should fit ocular conditions, patient requirements, surgeon skills and the available technologies. Recent advances in ophthalmic surgery have improved the outcomes.

  9. Refractive surgery after corneal transplantation.

    Science.gov (United States)

    Chang, Daniel H; Hardten, David R

    2005-08-01

    Many patients who have undergone corneal transplantation are unable to achieve satisfactory visual acuity with spectacle and contact lens correction alone. For these patients, refractive surgery becomes a viable option to reduce the post-keratoplasty ametropia. With the many recent advances in refractive surgery for naturally occurring refractive error, new possibilities arise for application to this complicated set of patients. This review discusses key recent developments in refractive surgery after corneal transplantation. The biomechanical effects of incisional keratotomy on post-keratoplasty corneas continue to be studied, and these techniques remain a common and simple method of reducing astigmatism. Photorefractive keratectomy, previously problematic for regression and haze formation, is gaining new prominence as early experience with the adjunctive use of mitomycin C has demonstrated good results. Long-term studies with laser in-situ keratomileusis (LASIK) have continued to show good safety and efficacy. Modern developments in cataract surgery appear to have lower incidences of graft rejection and failure. Developments in lens implantation technology continue to offer expanding options for intraocular refractive surgery. Although visual rehabilitation after corneal transplantation remains a formidable challenge, developments in refractive surgery for naturally occurring ametropias directly translate into an improved ability to help these most challenging refractive cases. Continued research will bring about improved efficacy while maintaining a high level of safety.

  10. Experimental assessment of corneal anisotropy.

    Science.gov (United States)

    Elsheikh, Ahmed; Brown, Michael; Alhasso, Daad; Rama, Paolo; Campanelli, Marino; Garway-Heath, David

    2008-02-01

    To determine the variation of corneal biomechanical properties with anatomical orientation. Strip specimens extracted from fresh porcine corneas were tested under uniaxial tension with strain rates representing static and dynamic loading conditions. The specimens were extracted from the vertical, horizontal, and 45 degrees diagonal directions. The load elongation results were used to derive the stress-strain behavior of each specimen. The average behavior for specimens taken in each anatomical direction was determined along with the effect of strain rate. Specimens from a small number of human corneas were included in the study to verify the findings. Specimens extracted from the vertical direction of porcine and human corneas demonstrated the highest strength (fracture stress) followed by horizontal then diagonal specimens. Vertical specimens were 10% to 20% stronger than horizontal specimens in porcine and human corneas. At low strain rates (1%/min), vertical specimens displayed similar stiffness (resistance to deformation) to horizontal specimens but greater stiffness than diagonal specimens. On increasing the strain rate to 500%/min, the stiffness behavior matched that of strength with vertical specimens being 10% to 20% stiffer than horizontal specimens in porcine and human corneas. The corneal anisotropic behavior is compatible with the preferential orientation of stromal fibrils in the vertical and horizontal directions. Quantifying the effect of this nonuniform fibril organization on corneal anisotropic behavior will be useful in developing numerical models of the cornea for applications where its integrity is compromised such as in simulating refractive surgery procedures.

  11. 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.

  12. Central corneal thickness in glaucoma.

    Science.gov (United States)

    Sng, Chelvin C A; Ang, Marcus; Barton, Keith

    2017-03-01

    The purpose of this review is to summarize the role of central corneal thickness (CCT) in the clinical management of a glaucoma patient. The prognostic value of CCT is well recognized in patients with ocular hypertension. However, its predictive value in other glaucoma suspects and patients with established glaucoma is less certain. Tonometry artefacts can result from variations in CCT. However, an adequately validated correction algorithm for Goldmann applanation tonometry measurements does not exist. Newer methods of tonometry are potentially less influenced by CCT but are limited in their clinical use. There may also be biological and genetic associations between corneal thickness and glaucoma. Demographics, environmental factors, glaucoma treatment and the measurement device used have a significant influence on CCT, and should be considered when interpreting the effect of cornea thickness in patients with glaucoma. New measurements of the biomechanical properties of the cornea are likely to be better approximations of the globe biomechanics than CCT, but these require further evaluation. The clinical significance of CCT is well recognized in the context of glaucoma diagnosis and management, though the extent of its importance remains debatable. Corneal biomechanical properties may be more significantly associated with glaucoma than CCT.

  13. Visual Impairment Caused by Periorbital Edema in an Infant with Acute Hemorrhagic Edema of Infancy

    DEFF Research Database (Denmark)

    Freitas, Priscila; Bygum, Anette

    2013-01-01

    Acute hemorrhagic edema of infancy (AHEI) is a cutaneous vasculitis seen in children. Many consider it to be a clinical variant of Schönlein-Henoch purpura, but others regard it as a separate entity because of its benign nature, age of onset, lack of visceral involvement, and frequent absence...

  14. Edema agudo hemorrágico da infância Acute hemorrhagic edema of infancy

    Directory of Open Access Journals (Sweden)

    Fabiana Britto Goulart

    2004-06-01

    Full Text Available Relatamos o caso de uma criança de oito meses de idade com infecção das vias aéreas superiores, seguida de irritabilidade e pelo aparecimento de lesões purpúricas na face, extremidades e pavilhões auriculares e edema de dorso dos pés e das mãos. Inicialmente recebeu dexametasona, ampicilina e cloranfenicol para tratamento de suposta meningococcemia. Entretanto, as lesões características e a boa evolução clínica do quadro levaram-nos ao diagnóstico de uma forma rara de vasculite cutânea: edema agudo hemorrágico da infância.We report the case of an eight-month child with upper airway infection followed by irritability and purpuric lesions in his face, ears and extremities and peripheral soft tissue edema. He was treated with dexamethasone, ampicillin and chloramphenicol for presumed meningococcemia, but the characteristics lesions and the benign course of the disease led us to the diagnosis of a rare form of cutaneous vasculitis called Acute Hemorrhagic Edema of Infancy (AHEI.

  15. Relationship between Corneal Sensation, Blinking, and Tear Film Quality

    National Research Council Canada - National Science Library

    Nosch, Daniela Sonja; Pult, Heiko; Albon, Julie; Purslow, Christine; Murphy, Paul John

    2016-01-01

    PURPOSETo examine the possible role of corneal sensitivity and tear film quality in triggering a blink by investigating the relationship between blink rate, central corneal sensitivity threshold (CST...

  16. Fecal impaction causing pelvic venous compression and edema

    Directory of Open Access Journals (Sweden)

    Sara Naramore

    2015-09-01

    Full Text Available Chronic constipation is a common condition which may result in fecal impaction. A 13-year-old male with chronic constipation and encopresis presented with fecal impaction for three weeks. The impaction caused abdominal pain, distension, encopresis, and decreased oral intake. He was found in severe distress with non-pitting edema of his feet and ankles along with perineal edema. The pedal edema worsened after receiving a fluid bolus, so concern arose for venous compression or a thrombus. A Duplex Ultrasound demonstrated changes in the venous waveforms of the bilateral external iliac and common femoral veins without thrombosis. Manual disimpaction and polyethylene glycol 3350 with electrolytes resolved the pedal and perineal edema. Four months later, he had soft bowel movements without recurrence of the edema. A repeat Duplex Ultrasound was normal. We present a child in whom severe fecal impaction caused pelvic venous compression resulting in bilateral pedal and perineal edema.

  17. Severe subcutaneous generalized edema in a patient with dermatomyositis.

    Science.gov (United States)

    Ito, Yoshinaga; Kawabata, Daisuke; Yukawa, Naoichiro; Yoshifuji, Hajime; Usui, Takashi; Tanaka, Masao; Fujii, Takao; Mimori, Tsuneyo

    2007-01-01

    Subcutaneous generalized edema associated with dermatomyositis (DM)/polymyositis (PM) is extremely rare. Herein we report a case of severe subcutaneous generalized edema complicating DM. A 78-year-old woman was hospitalized in our department because of massive edema in the four limbs. Elevated muscle enzymes, heliotrope rash, results of electromyography, and muscle biopsy confirmed the diagnosis of DM. The absence of other diseases that could cause the symptoms indicated that massive edema was correlated with the pathophysiology of DM. Although myopathy and edema responded well to oral prednisolone, dysphagia persisted. We conclude that subcutaneous generalized edema can occur during the course of DM/PM, and subcutaneous vasculopathy may be involved in the pathogenesis of DM/PM.

  18. New Compton densitometer for measuring pulmonary edema

    Energy Technology Data Exchange (ETDEWEB)

    Loo, B.W.; Goulding, F.S.; Simon, D.S.

    1985-10-01

    Pulmonary edema is the pathological increase of extravascular lung water found most often in patients with congestive heart failure and other critically ill patients who suffer from intravenous fluid overload. A non-invasive lung density monitor that is accurate, easily portable, safe and inexpensive is needed for clinical evaluation of pulmonary edema. Other researchers who have employed Compton scattering techniques generally used systems of extended size and detectors with poor energy resolution. This has resulted in significant systematic biases from multiply-scattered photons and larger errors in counting statistics at a given radiation dose to the patient. We are proposing a patented approach in which only backscattered photons are measured with a high-resolution HPGe detector in a compact system geometry. By proper design and a unique data extraction scheme, effects of the variable chest wall on lung density measurements are minimized. Preliminary test results indicate that with a radioactive source of under 30 GBq, it should be possible to make an accurate lung density measurement in one minute, with a risk of radiation exposure to the patient a thousand times smaller than that from a typical chest x-ray. The ability to make safe, frequent lung density measurements could be very helpful for monitoring the course of P.E. at the hospital bedside or outpatient clinics, and for evaluating the efficacy of therapy in clinical research. 6 refs., 5 figs.

  19. Intravitreal Injection of Dexamethasone Implant and Ranibizumab in Cystoid Macular Edema in the Course of Irvine-Gass Syndrome

    Directory of Open Access Journals (Sweden)

    Vito Fenicia

    2014-08-01

    Full Text Available Purpose: To evaluate the efficacy of 2 dexamethasone intravitreal implants and 1 ranibizumab intravitreal injection after a bilateral postoperative complication of cataract surgery as pseudophakic cystoid macular edema. Patients and Methods: A 70-year-old male patient with systemic hypertension developed a progressive cystoid macular edema (CME in both eyes starting between 10 and 20 days after cataract surgery. Two intravitreal dexamethasone implants and 1 ranibizumab injection were administered; first in the right eye (RE and then in the left eye (LE. The patient was checked for 1 whole week and then once a month for 5 months after the injections. Results: One month after the first dexamethasone implant in his RE, the spectral domain optical coherence tomography (SD-OCT showed a progressive reduction of the foveal thickness until a complete resolution of the CME occurred, which was associated with an improvement of visual acuity. After 3 months, the SD-OCT showed a relapse of the CME, which was then treated with 1 injection of ranibizumab. One month after this injection, there was a complete resolution of the CME. A new CME in his RE was diagnosed 2 months after the last ranibizumab injection; it was treated with a new dexamethasone implant. A complete resolution of the CME was obtained; a normal foveal profile was still present 5 months after the last injection, and the best-corrected visual acuity was 20/20. His LE developed a CME 40 days after surgery. One intravitreal injection of ranibizumab was first administered in his LE, with a complete resolution of the CME at SD-OCT 2 weeks later. As observed in his RE, 40 days after the ranibizumab injection, there was a relapse of the CME that was treated with 1 intravitreal injection of dexamethasone implant. Five months later, the patient showed a worsening of the CME, but it was completely resolved with a second dexamethasone injection. After 3 months, the foveal thickness was back to normal

  20. Intravitreal injection of dexamethasone implant and ranibizumab in cystoid macular edema in the course of irvine-gass syndrome.

    Science.gov (United States)

    Fenicia, Vito; Balestrieri, Marco; Perdicchi, Andrea; MauriziEnrici, Maurizio; DelleFave, Martina; Recupero, Santi Maria

    2014-05-01

    To evaluate the efficacy of 2 dexamethasone intravitreal implants and 1 ranibizumab intravitreal injection after a bilateral postoperative complication of cataract surgery as pseudophakic cystoid macular edema. A 70-year-old male patient with systemic hypertension developed a progressive cystoid macular edema (CME) in both eyes starting between 10 and 20 days after cataract surgery. Two intravitreal dexamethasone implants and 1 ranibizumab injection were administered; first in the right eye (RE) and then in the left eye (LE). The patient was checked for 1 whole week and then once a month for 5 months after the injections. One month after the first dexamethasone implant in his RE, the spectral domain optical coherence tomography (SD-OCT) showed a progressive reduction of the foveal thickness until a complete resolution of the CME occurred, which was associated with an improvement of visual acuity. After 3 months, the SD-OCT showed a relapse of the CME, which was then treated with 1 injection of ranibizumab. One month after this injection, there was a complete resolution of the CME. A new CME in his RE was diagnosed 2 months after the last ranibizumab injection; it was treated with a new dexamethasone implant. A complete resolution of the CME was obtained; a normal foveal profile was still present 5 months after the last injection, and the best-corrected visual acuity was 20/20. His LE developed a CME 40 days after surgery. One intravitreal injection of ranibizumab was first administered in his LE, with a complete resolution of the CME at SD-OCT 2 weeks later. As observed in his RE, 40 days after the ranibizumab injection, there was a relapse of the CME that was treated with 1 intravitreal injection of dexamethasone implant. Five months later, the patient showed a worsening of the CME, but it was completely resolved with a second dexamethasone injection. After 3 months, the foveal thickness was back to normal with a BCVA of 20/20. Treatment with dexamethasone

  1. Response of corneal hysteresis and central corneal thickness following clear corneal cataract surgery.

    Science.gov (United States)

    Kandarakis, Artemios; Soumplis, Vasileios; Karampelas, Michalis; Koutroumanos, Ioannis; Panos, Christos; Kandarakis, Stylianos; Karagiannis, Dimitrios

    2012-09-01

    To evaluate the effect of routine phacoemulsification in corneal viscoelastic properties determined by corneal hysteresis (CH) and central corneal thickness (CCT) and to explore the impact of phaco energy on the above parameters. Forty-one eyes of 41 patients undergoing cataract surgery were enrolled in this prospective study. CH and CCT were measured preoperatively, 1 day and 1 week postoperatively. CCT measurement was performed using a non-contact optical pachymeter followed by ocular response analyzer (ORA) examination. Intraoperatively ultrasound time, average phaco power and effective phaco time (EPT) were recorded. Mean CH was 10.05±1.86 mmHg preoperatively, 8.25±1.85 mmHg 1 day and 9.12±1.37 mmHg 1 week postoperatively (pcorneal alterations following cataract surgery resulted in a statistical change in CH and CCT. These two parameters responded in a different manner that clearly demarcates their different nature. On the first postoperative day, CCT increase was correlated at a statistically significant level with intraoperative EPT. This correlation was not found with CH reduction. Other factors, besides cornea oedema or phacoemulsification energy, could be responsible for this CH modification. © 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.

  2. Corneal donor tissue preparation for endothelial keratoplasty.

    Science.gov (United States)

    Woodward, Maria A; Titus, Michael; Mavin, Kyle; Shtein, Roni M

    2012-06-12

    Over the past ten years, corneal transplantation surgical techniques have undergone revolutionary changes. Since its inception, traditional full thickness corneal transplantation has been the treatment to restore sight in those limited by corneal disease. Some disadvantages to this approach include a high degree of post-operative astigmatism, lack of predictable refractive outcome, and disturbance to the ocular surface. The development of Descemet's stripping endothelial keratoplasty (DSEK), transplanting only the posterior corneal stroma, Descemet's membrane, and endothelium, has dramatically changed treatment of corneal endothelial disease. DSEK is performed through a smaller incision; this technique avoids 'open sky' surgery with its risk of hemorrhage or expulsion, decreases the incidence of postoperative wound dehiscence, reduces unpredictable refractive outcomes, and may decrease the rate of transplant rejection. Initially, cornea donor posterior lamellar dissection for DSEK was performed manually resulting in variable graft thickness and damage to the delicate corneal endothelial tissue during tissue processing. Automated lamellar dissection (Descemet's stripping automated endothelial keratoplasty, DSAEK) was developed to address these issues. Automated dissection utilizes the same technology as LASIK corneal flap creation with a mechanical microkeratome blade that helps to create uniform and thin tissue grafts for DSAEK surgery with minimal corneal endothelial cell loss in tissue processing. Eye banks have been providing full thickness corneas for surgical transplantation for many years. In 2006, eye banks began to develop methodologies for supplying precut corneal tissue for endothelial keratoplasty. With the input of corneal surgeons, eye banks have developed thorough protocols to safely and effectively prepare posterior lamellar tissue for DSAEK surgery. This can be performed preoperatively at the eye bank. Research shows no significant difference in

  3. Optic disc planimetry, corneal hysteresis, central corneal thickness, and intraocular pressure as risk factors for glaucoma.

    Science.gov (United States)

    Carbonaro, Francis; Hysi, Pirro G; Fahy, Samantha J; Nag, Abhishek; Hammond, Christopher J

    2014-02-01

    To determine whether corneal hysteresis and central corneal thickness are independent risk factors for glaucoma. A cross-sectional population-based cohort study. Associations were tested between corneal hysteresis, measured in 1754 population-based subjects from the TwinsUK cohort, and glaucoma-related endophenotypes, including intraocular pressure (IOP), vertical cup-to-disc ratio, optic disc area, and optic disc cup area. Corneal hysteresis, IOP, and central corneal thickness (CCT) were measured; optic disc photographs were analyzed; and multivariable linear regression analysis was performed. Data were available on 1645 individuals. Multiple regression analysis showed corneal hysteresis to be significantly negatively associated with age (beta coefficient = -0.03, P Corneal hysteresis was also found to be associated with CCT (beta coefficient = 0.02, P corneal hysteresis and optic disc area (P = .6), cup area (P = .77), vertical cup-to-disc ratio (P = .51), or spherical equivalent (P = .08). CCT was also found to be significantly associated with IOP (beta coefficient = 3.3, P corneal hysteresis (beta coefficient = 9.4, P corneal hysteresis or CCT and quantitative measures of optic disc cupping, suggesting that corneal hysteresis and CCT are not independent risk factors for glaucoma. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Delayed corneal epithelial wound healing after penetrating keratoplasty in individuals with lattice corneal dystrophy.

    Science.gov (United States)

    Kawamoto, Koji; Morishige, Naoyuki; Yamada, Naoyuki; Chikama, Tai-Ichiro; Nishida, Teruo

    2006-07-01

    To investigate whether corneal epithelial cells of individuals with lattice corneal dystrophy (LCD) possess an intrinsic defect. Retrospective case-control study. The medical charts of nine individuals with LCD and those of 14 patients with keratoconus and 11 patients with corneal leukoma (controls), all of whom underwent penetrating keratoplasty (PKP) in one eye at Yamaguchi University Hospital between February 1998 and November 2001, were examined for the time for epithelial resurfacing after surgery. The time required for resurfacing of the corneal epithelium after PKP was significantly greater in LCD patients (8.56 +/- 4.95 days, mean +/- SD) than in patients with either keratoconus (1.71 +/- 0.91 days, P = .006) or corneal leukoma (3.00 +/- 1.95 days, P = .03). Corneal epithelial wound healing was delayed in LCD patients after PKP, suggesting that the keratoepithelin gene mutations responsible for this condition affect corneal epithelial cells.

  5. Association between corneal hysteresis and central corneal thickness in glaucomatous and non-glaucomatous eyes.

    Science.gov (United States)

    Mangouritsas, George; Morphis, George; Mourtzoukos, Spyridon; Feretis, Elias

    2009-11-01

    We aimed to determine corneal hysteresis values (CH) using the ocular response analyser (ORA) in non-glaucomatous and glaucomatous eyes and their relationship with central corneal thickness (CCT). Corneal hysteresis, intraocular pressure (IOP) as measured by Goldmann applanation tonometry (GAT) and CCT were prospectively evaluated in 74 non-glaucoma subjects with IOP Corneal hysteresis was significantly lower in eyes with treated POAG than in non-glaucomatous eyes. The corneal biomechanical response was strongly associated with CCT in non-glaucoma subjects, but only moderately so in glaucoma patients. It can be assumed that diverse structural factors, in addition to thickness, determine the differences in the corneal biomechanical profile between non-glaucomatous and glaucomatous eyes. Corneal hysteresis could be a useful tool in the diagnosis of glaucoma.

  6. Laser Therapy in Diabetic Macular Edema

    Science.gov (United States)

    Zacharia, George; Bhat, Varsha K.; Joseph, Mary K.; Ideculla, Thara

    2008-01-01

    Objectives Diabetic macular edema results in irreversible loss of vision and is the major cause of visual morbidity in patients with Diabetes of adult onset. DCCT trial has linked this to poorer control and increased duration of DM. laser treatment in such cases is known to reduce visual impairment by 50% for a period of 5 years. The aim of this study is to evaluate the effect of laser on visual outcome in patients with clinically significant macular edema and also evaluate the effect of some factors like control of blood sugar, hypertension, nephropathy etc. Methods Retrospective analysis of 165 eyes of patients with diabetic maculopathy who underwent laser as per the ETDRS (early treatment diabetic retinopathy study) protocol was made. All these patients underwent Visual Acuity check, slit lamp examination of anterior segment, IOP check and after dilatation detailed examination of macula with 78/90 d lens and areas of retinal thickening recorded and subjected to focal laser/grid laser depending upon whether the maculopathy was focal/diffuse. Patients were assessed for control of sugar and presence of hypertension/nephropathy or any other related systemic diseases. Patients were followed up for a minimum of 6 months to a maximum of 24 months. The visual acuity at the end of 3-4 months was taken as final visual acuity after laser. Results 165 eyes of patients having CSME (clinically significant macular edema) were subjected to laser. 108 (64.54%) eyes underwent focal laser and the rest were given grid laser. 153 eyes underwent macular laser without PRP (Pan retinal photocoagulation) while rest had even PRP along with macular laser. 92 eyes (55.75%) totally, 39 eyes (59.1%) in controlled group and 26 eyes (56.5%) in the controlled group and 12 eyes (54.5%) in patients with hypertension had stable vision 3-4 months after laser. 44 eyes (26.7%) overall, 18 eyes (27.3%) in controlled group, 16 eyes (34.8%) in uncontrolled group and 7 eyes (31.8%) in hypertensive showed

  7. Laser therapy in diabetic macular edema.

    Science.gov (United States)

    Zacharia, George; Bhat, Varsha K; Joseph, Mary K; Ideculla, Thara

    2008-01-01

    Diabetic macular edema results in irreversible loss of vision and is the major cause of visual morbidity in patients with Diabetes of adult onset. DCCT trial has linked this to poorer control and increased duration of DM. laser treatment in such cases is known to reduce visual impairment by 50% for a period of 5 years. The aim of this study is to evaluate the effect of laser on visual outcome in patients with clinically significant macular edema and also evaluate the effect of some factors like control of blood sugar, hypertension, nephropathy etc. Retrospective analysis of 165 eyes of patients with diabetic maculopathy who underwent laser as per the ETDRS (early treatment diabetic retinopathy study) protocol was made. All these patients underwent Visual Acuity check, slit lamp examination of anterior segment, IOP check and after dilatation detailed examination of macula with 78/90 d lens and areas of retinal thickening recorded and subjected to focal laser/grid laser depending upon whether the maculopathy was focal/diffuse. Patients were assessed for control of sugar and presence of hypertension/nephropathy or any other related systemic diseases. Patients were followed up for a minimum of 6 months to a maximum of 24 months. The visual acuity at the end of 3-4 months was taken as final visual acuity after laser. 165 eyes of patients having CSME (clinically significant macular edema) were subjected to laser. 108 (64.54%) eyes underwent focal laser and the rest were given grid laser. 153 eyes underwent macular laser without PRP (Pan retinal photocoagulation) while rest had even PRP along with macular laser. 92 eyes (55.75%) totally, 39 eyes (59.1%) in controlled group and 26 eyes (56.5%) in the controlled group and 12 eyes (54.5%) in patients with hypertension had stable vision 3-4 months after laser. 44 eyes (26.7%) overall, 18 eyes (27.3%) in controlled group, 16 eyes (34.8%) in uncontrolled group and 7 eyes (31.8%) in hypertensive showed improvement of vision

  8. Finite element modeling of corneal strip extensometry

    CSIR Research Space (South Africa)

    Botha, N

    2012-12-01

    Full Text Available symmetric conicoid [19]: (x xo) 2+(y yo) 2+(1+Q)(z zo) 2 2R(z zo) 2 = 0; (2) c SACAM 2012 25 Top view Isometric view Initial corneal curvature z y x x y z Fig. 3: Finite element model of the vertical corneal strip, including the orthogonal...

  9. Corneal staining after treatment with topical tetracycline

    NARCIS (Netherlands)

    Lapid-Gortzak, Ruth; Nieuwendaal, Carla P.; Slomovic, Allan R.; Spanjaard, Lodewijk

    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

  10. Corynebacterium macginleyi isolated from a corneal ulcer

    Directory of Open Access Journals (Sweden)

    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.

  11. Corneal hysteresis and its relevance to glaucoma

    Science.gov (United States)

    Deol, Madhvi; Taylor, David A.; Radcliffe, Nathan M.

    2015-01-01

    Purpose of review Glaucoma is a leading cause of irreversible blindness worldwide. It is estimated that roughly 60.5 million people had glaucoma in 2010 and that this number is increasing. Many patients continue to lose vision despite apparent disease control according to traditional risk factors. The purpose of this review is to discuss the recent findings with regard to corneal hysteresis, a variable that is thought to be associated with the risk and progression of glaucoma. Recent findings Low corneal hysteresis is associated with optic nerve and visual field damage in glaucoma and the risk of structural and functional glaucoma progression. In addition, hysteresis may enhance intraocular pressure (IOP) interpretation: low corneal hysteresis is associated with a larger magnitude of IOP reduction following various glaucoma therapies. Corneal hysteresis is dynamic and may increase in eyes after IOP-lowering interventions are implemented. Summary It is widely accepted that central corneal thickness is a predictive factor for the risk of glaucoma progression. Recent evidence shows that corneal hysteresis also provides valuable information for several aspects of glaucoma management. In fact, corneal hysteresis may be more strongly associated with glaucoma presence, risk of progression, and effectiveness of glaucoma treatments than central corneal thickness. PMID:25611166

  12. Corneal Biomechanics Determination in Healthy Myopic Subjects

    Science.gov (United States)

    Qiu, Kunliang; Lu, Xuehui; Zhang, Riping; Wang, Geng

    2016-01-01

    Purpose. To determine the corneal biomechanical properties by using the Ocular Response Analyzer™ and to investigate potential factors associated with the corneal biomechanics in healthy myopic subjects. Methods. 135 eyes from 135 healthy myopic subjects were included in this cross-sectional observational study. Cornea hysteresis (CH), corneal resistance factor (CRF), cornea-compensated intraocular pressure (IOPcc), and Goldmann-correlated intraocular pressure (IOPg) were determined with the Reichert Ocular Response Analyzer (ORA). Univariate and multivariate regression analyses were performed to investigate factors associated with corneal biomechanics. Results. The mean CH and CRF were 9.82 ± 1.34 mmHg and 9.64 ± 1.57 mmHg, respectively. In univariate regression analysis, CH was significantly correlated with axial length, refraction, central corneal thickness (CCT), and IOPg (r = −0.27, 0.23, 0.45, and 0.21, resp.; all with p ≤ 0.015), but not with corneal curvature or age; CRF was significantly correlated with CCT and IOPg (r = 0.52 and 0.70, resp.; all with p corneal curvature, or age. In multivariate regression analysis, axial length, IOPcc, and CCT were found to be independently associated with CH, while CCT and IOPg were associated with CRF. Conclusions. Both CH and CRF were positively correlated with CCT. Lower CH but not CRF was associated with increasing degree of myopia. Evaluation of corneal biomechanical properties should take CCT and myopic status into consideration. PMID:27525109

  13. Corneal hysteresis and its relevance to glaucoma.

    Science.gov (United States)

    Deol, Madhvi; Taylor, David A; Radcliffe, Nathan M

    2015-03-01

    Glaucoma is a leading cause of irreversible blindness worldwide. It is estimated that roughly 60.5 million people had glaucoma in 2010 and that this number is increasing. Many patients continue to lose vision despite apparent disease control according to traditional risk factors. The purpose of this review is to discuss the recent findings with regard to corneal hysteresis, a variable that is thought to be associated with the risk and progression of glaucoma. Low corneal hysteresis is associated with optic nerve and visual field damage in glaucoma and the risk of structural and functional glaucoma progression. In addition, hysteresis may enhance intraocular pressure (IOP) interpretation: low corneal hysteresis is associated with a larger magnitude of IOP reduction following various glaucoma therapies. Corneal hysteresis is dynamic and may increase in eyes after IOP-lowering interventions are implemented. It is widely accepted that central corneal thickness is a predictive factor for the risk of glaucoma progression. Recent evidence shows that corneal hysteresis also provides valuable information for several aspects of glaucoma management. In fact, corneal hysteresis may be more strongly associated with glaucoma presence, risk of progression, and effectiveness of glaucoma treatments than central corneal thickness.

  14. Inhibition of Corneal Neovascularization by Hydrazinocurcumin ...

    African Journals Online (AJOL)

    Purpose: To investigate the effect of hydrazinocurcumin on a human vascular endothelial growth factor (VEGF)-induced corneal neovascularization in rabbit model. Methods: Murine corneal neovascularization (CorNV) was induced via two intrastromal implantations of VEGF polymer 2 mm from the limbus.

  15. Corneal plaque containing levofloxacin in a dog.

    Science.gov (United States)

    Park, Young-Woo; Kang, Byung-Jae; Lim, Jae Hyun; Ahn, Jung-Mo; Lim, Hyun Sook

    2015-11-01

    A 13-year-old castrated male Yorkshire terrier developed a corneal ulcer 2 weeks after intracapsular lens extraction (ICLE) in the right eye. The corneal ulcer was treated with levofloxacin eye drops. A plaque with a white luster developed in the central cornea 2 weeks after treatment with levofloxacin eye drops. The corneal plaque was surgically removed under inhalant anesthesia. The corneal plaque displayed antimicrobial activity against Escherichia coli. Furthermore, levofloxacin content in the plaque was confirmed by matrix-assisted laser desorption/ionization time-of-flight/time-of-flight (MALDI-TOF/TOF) mass spectrometry (MS). The corneal ulcer completely resolved 2 weeks after the surgical removal of the corneal lesion and replacement of levofloxacin eye drops with tobramycin eye drops. Although the topical use of levofloxacin is unlikely to lead to corneal chemical deposits due to the high water solubility of the drug compared to other topical fluoroquinolones, this patient developed corneal plaque of the antibiotic drop. © 2015 American College of Veterinary Ophthalmologists.

  16. Corneal laceration caused by river crab

    Directory of Open Access Journals (Sweden)

    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

  17. Complications from Infective Corneal Conditions Treated by ...

    African Journals Online (AJOL)

    Background: Complications from infective corneal conditions are an important cause of blindness in adults and children. The eyelids play a major role in the pathogenesis of staphyloma and the perforation of descemetoceles. Tarsorrhaphy could, therefore, be beneficial in treating serious complications from infective corneal ...

  18. Facts about the Cornea and Corneal Disease

    Science.gov (United States)

    ... the Cornea and Corneal Disease Facts About the Cornea and Corneal Disease What is the cornea? The cornea is the eye’s outermost layer. It ... your vision. What are the parts of the cornea? Although the cornea may look clear and seem ...

  19. Corneal ulcers: For the general practitioner

    African Journals Online (AJOL)

    153 CME April 2013 Vol. 31 No. 4. Corneal ulcers: For the general practitioner. A corneal ulcer is a defect in the epithelial layer of the cornea. e general practitioner may play an important role in early management and appropriate referral. Incidence varies and depends on aetiology. S Ballim, MB ChB, Dip Ophth (SA), FC ...

  20. Inhibition of Corneal Neovascularization by Hydrazinocurcumin

    African Journals Online (AJOL)

    Purpose: To investigate the effect of hydrazinocurcumin on a human vascular endothelial growth factor. (VEGF)-induced corneal neovascularization in rabbit model. Methods: Murine corneal neovascularization (CorNV) was induced via two intrastromal implantations of. VEGF polymer 2 mm from the limbus.

  1. Edema pulmonar postobstructivo: reporte de 3 casos

    OpenAIRE

    Juan Ignacio Padilla; Donato Salas-Segura; Suen Kwoh-Sánchez

    2002-01-01

    El edema pulmonar postobstructivo (EPPO) es una complicación postoperatoria cuyo manejo adecuado depende de un diagnóstico etiológico correcto. El EPPO se clasifica en dos tipos. El tipo I es secundario a la obstrucción aguda de la vía aérea superior. Por su parte, el tipo II ocurre luego de corregir quirúrgicamente una obstrucción crónica de la vía aérea. Fisiopatológicamente, el mecanismo que explica el cuadro es una disminución marcada de la presión intersticial en el nivel pericapilar pul...

  2. Noncardiac Pulmonary Edema induced by Sitagliptin Treatment.

    Science.gov (United States)

    Belice, Tahir; Yuce, Suleyman; Kizilkaya, Bayram; Kurt, Aysel; Cure, Erkan

    2014-01-01

    A 74-year-old male patient with type 2 diabetes mellitus admitted to the emergency department with the complaints of progressive breathlessness, dry cough, and swollen lower extremities. Our patient had type 2 diabetes mellitus and hypertension for 3 years. His HbA1c was not within the target range so sitagliptin was added to on-going therapy. After 1 week of starting sitagliptin therapy, even though the patient had not heart failure he applied to the emergency department with a complaint of dyspnea. The cardiovascular safety and efficacy of many anti-hyperglycemic agents such as sitagliptin, saxagliptin are unclear. Our case has shown that dipeptidyl peptidase 4 inhibitors may cause pulmonary edema. Hence, it should be used with cautious, especially in patients with heart failure.

  3. Noncardiac pulmonary edema induced by sitagliptin treatment

    Directory of Open Access Journals (Sweden)

    Tahir Belice

    2014-01-01

    Full Text Available A 74-year-old male patient with type 2 diabetes mellitus admitted to the emergency department with the complaints of progressive breathlessness, dry cough, and swollen lower extremities. Our patient had type 2 diabetes mellitus and hypertension for 3 years. His HbA1c was not within the target range so sitagliptin was added to on-going therapy. After 1 week of starting sitagliptin therapy, even though the patient had not heart failure he applied to the emergency department with a complaint of dyspnea. The cardiovascular safety and efficacy of many anti-hyperglycemic agents such as sitagliptin, saxagliptin are unclear. Our case has shown that dipeptidyl peptidase 4 inhibitors may cause pulmonary edema. Hence, it should be used with cautious, especially in patients with heart failure.

  4. Pheochromocytoma presenting with pulmonary edema and hyperamylasemia.

    Science.gov (United States)

    Munk, Z.; Tolis, G.; Jones, W.; Fallen, E.; McLean, P.

    1977-01-01

    A 28-year-old woman was admitted to hospital with acute pulmonary edema, mild abdominal discomfort and hyperamylasemia. From the 2nd hospital day hypertensive episodes occurred daily. The furosemide screening test for renovascular hypertension revealed elevated plasma renin activity (PRA) but an intravenous pyelogram revealed a right suprarenal mass and no evidence of renovascular compression. Elevated values of plasma and urinary catecholamines indicated a pheochromocytoma, and a single chromaffin tumour was resected. It is important to monitor left ventricular filling pressure during operative removal of a pheochromocytoma. Postoperatively the patient had normal blood pressure and PRA. Decreased urinary amylase clearance and abnormal pancreatic and salivary amylase isoenzymes were found. Images FIG. 1 FIG. 4 PMID:844016

  5. Molecular expression in transfected corneal endothelial cells

    Science.gov (United States)

    Wang, Fan; Miao, Zhuang; Lu, Chengwei; Hao, Jilong

    2017-10-01

    To investigate the capability of human corneal endothelial cells serving as immunological cells. Expression of HLA-DP, -DQ, -DR, CD40, CD80, and CD86 was determined by immunohistochemical methods. Meanwhile, purified peripheral blood mononuclear cells were cocultured with human corneal endothelial cells which were pre-treated with and without -IFN respectively, activation of lymphocytes was determined by FACS analysis. In coculture system, T lymphocyte was activated by corneal endothelial cells, HLA-DP, -DQ, -DR and CD40 expression were increased by - IFN induction. Costimulatory molecular CD80 was shown on the endothelial cells. Human corneal endothelial cells were assumed to be involved in the corneal transplantation rejection process as potential antigen presenting cells.

  6. Corneal biomechanical properties in thyroid eye disease

    Directory of Open Access Journals (Sweden)

    Gamze Ozturk Karabulut

    2014-06-01

    Full Text Available The purpose of this study is to investigate the effect of thyroid eye disease (TED on the measurement of corneal biomechanical properties and the relationship between these parameters and disease manifestations. A total of 54 eyes of 27 individuals with TED and 52 eyes of 30 healthy control participants were enrolled. Thyroid ophthalmopathy activity was defined using the VISA (vision, inflammation, strabismus, and appearance/exposure classification for TED. The intraocular pressure (IOP measurement with Goldmann applanation tonometer (GAT, axial length (AL, keratometry, and central corneal thickness (CCT measurements were taken from each patient. Corneal biomechanical properties, including corneal hysteresis (CH and corneal resistance factor (CRF and noncontact IOP measurements, Goldmann-correlated IOP (IOPg and corneal-compensated IOP (IOPcc were measured with the Ocular Response Analyzer (ORA using the standard technique. Parameters such as best corrected visual acuity, axial length, central corneal thickness, and corneal curvature were not statistically significant between the two groups (p > 0.05. IOP measured with GAT was higher in participants with TED (p < 0.001. The CH of TED patients was significantly lower than that of the control group. There was no significant difference in the corneal resistance factor between groups. However, IOPg and IOPcc were significantly higher in TED patients. CH and VISA grading of TED patients showed a negative correlation (p = 0.007. In conclusion, TED affects the corneal biomechanical properties by decreasing CH. IOP with GAT and IOPg is found to be increased in these patients. As the severity of TED increases, CH decreases in these patients.

  7. Corneal manifestations of ocular demodex infestation.

    Science.gov (United States)

    Kheirkhah, Ahmad; Casas, Victoria; Li, Wei; Raju, Vadrevu K; Tseng, Scheffer C G

    2007-05-01

    To report the corneal manifestations in eyes with Demodex infestation of the eyelids. Noncomparative, interventional case series. This retrospective review included six patients with Demodex blepharitis who also exhibited corneal abnormalities, which led to suspicion of limbal stem cell deficiency in three cases. All patients received weekly lid scrubs with 50% tea tree oil and a daily lid scrubs with tea tree shampoo for a minimum of six weeks. Improvement of symptoms and corneal and conjunctival signs were evaluated. All six patients exhibited ocular irritation and conjunctival inflammation, while meibomian gland dysfunction (n = 5), rosacea (n = 4), and decreased vision (n = 3) also were noted despite prior treatments with oral tetracycline, topical steroids with antibiotics, and lid scrub with baby shampoo. These patients were proven to have Demodex folliculorum (n = 6) and Demodex brevis (n = 3) by microscopic examination of epilated lashes. Their corneal manifestation included superficial corneal vascularization (six eyes of five cases), marginal corneal infiltration (two eyes of two cases), phlyctenule-like lesion (one eye of one case), superficial corneal opacity (two eyes of two cases), and nodular corneal scar (two eyes of two cases). After treatment, the Demodex count was reduced from 6.8 +/- 2.8 to 1 +/- 0.9 (standard deviation; P = .001). All patients showed dramatic resolution of ocular irritation, conjunctival inflammation, and all inflammatory, but not scarred, corneal signs; three patients showed improved vision. A variety of corneal pathologic features together with conjunctival inflammation, commonly noted in rosacea, can be found in patients with Demodex infestation of the eyelids. When conventional treatments for rosacea fail, one may consider lid scrub with tea tree oil to eradicate mites as a new treatment.

  8. Effect of corticosteroid therapy in acute pain edema caused by ...

    African Journals Online (AJOL)

    Keywords: Herpes zoster, Corticosteroids, Local edema, Scab, Skin lesions, Acute pain, Blisters, ... their medication. Among the 24 cases in the corticosteroid application group (male 13, female. 11), all had obvious edema and acute pain in their head and face from herpes zoster ..... Oral complication and nursing of patients.

  9. A Tuberculosis Pericarditis Case Admitted with Proteinuria and Widespread Edema

    OpenAIRE

    Cihangiroğlu, Mustafa; ARTAŞ, Hakan; Abdullah ÖZTÜRK; Demirçin, Mustafa; Çelik, İlhami; Bayındır, Yaşar

    2004-01-01

    Tuberculous pericarditis was diagnosed in a patient who was hospitalized for investigation of etiology of proteinuria, widespread edema, pericardial fluid and ascites. Fever and arythmia developed during clinical course, Mycobacterium tuberculosis was isolated from sputum, and pericardial fluid. Tuberculous pericarditis is a rare but life thereatening health problem. Because of initial clinical signs were proteinuria and widespread edema, this case was presented. In endemi...

  10. Periorbital edema as initial manifestation of chronic cutaneous lupus ...

    African Journals Online (AJOL)

    Periorbital edema occurs frequently in dermatomyositis, but it has rarely been noted in systemic systemic lupus erythematosus. We describe a patient who developed bilateral periorbital edema and erythema as the sole manifestation of systemic lupus erythematosus. Pan African Medical Journal 2012; 12:57 ...

  11. Toxicity of intrastromal voriconazole injection on corneal endothelium in rabbits.

    Science.gov (United States)

    Park, Chang Hyun; Lee, Hyun Soo; Chung, Sung Kun

    2014-09-01

    The aim of this study was to evaluate the toxicity of intrastromally injected voriconazole on corneal endothelial cells in rabbits. In total, 32 eyes of 16 rabbits (8 eyes for each group) were divided into 4 groups according to the concentration of voriconazole [group A: 50 μg/0.1 mL (0.05%), group B: 100 μg/0.1 mL (0.1%), group C: 250 μg/0.1 mL (0.25%), or group D: 500 μg/0.1 mL (0.5%)]. Right eyes were injected intrastromally with voriconazole at concentrations of 50 μg/0.1 mL, 100 μg/0.1 mL, 250 μg/0.1 mL, or 500 μg/0.1 mL. Left eyes were injected intrastromally with isotonic saline as controls. Central corneal thickness and endothelial cell counts were measured before and at 6 hours, 1 day, and 1 week after the injection was given. Corneas were then harvested for transmission electron microscopy. Only the 0.5% group did not significantly recover from corneal edema 1 week after the injection (P = 0.167, P = 0.051, P = 0.086, P = 0.001 in groups A-D, respectively). There were significant differences in endothelial cell counts for the 0.1% and 0.25% groups (P = 0.077, P = 0.019, P = 0.008 in groups A-C, respectively). Transmission electron microscopy evaluation revealed definite necrotic changes in endothelial cells at concentrations of 0.1%, 0.25%, and 0.5%, but only microstructural changes at a concentration of 0.05%. Our results suggest that voriconazole could be injected safely into the intrastromal layer at a concentration of 0.05% with low endothelial cell toxicity. However, injections should be administered with caution because of the risk of microstructural damage.

  12. Influence of corneal hydration on optical coherence elastography

    Science.gov (United States)

    Twa, Michael D.; Vantipalli, Srilatha; Singh, Manmohan; Li, Jiasong; Larin, Kirill V.

    2016-03-01

    Corneal biomechanical properties are influenced by several factors, including intraocular pressure, corneal thickness, and viscoelastic responses. Corneal thickness is directly proportional to tissue hydration and can influence corneal stiffness, but there is no consensus on the magnitude or direction of this effect. We evaluated the influence of corneal hydration on dynamic surface deformation responses using optical coherence elastography (OCE). Fresh rabbit eyes (n=10) were prepared by removing the corneal epithelium and dropping with 0.9% saline every 5 minutes for 1 hour, followed by 20% dextran solution every 5 minutes for one hour. Corneal thickness was determined from structural OCT imaging and OCE measurements were performed at baseline and every 20 minutes thereafter. Micron-scale deformations were induced at the apex of the corneal tissue using a spatially-focused (150μm) short-duration (corneal thickness due to hydration process. Corneal thickness rapidly increased and remained constant following epithelium removal and changed little thereafter. Likewise, corneal stiffness changed little over the first hour and then decreased sharply after Dextran application (thickness: -46% [-315/682 μm] RR: - 24% [-0.7/2.88 ms-1]; GV: -19% [-0.6/3.2 m/s]). Corneal thickness and corneal stiffness (RR) were well correlated (R2 = .66). Corneal biomechanical properties are highly correlated with tissue hydration over a wide range of corneal thickness and these changes in corneal stiffness are quantifiable using OCE.

  13. 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.

  14. High interocular corneal symmetry in average simulated keratometry, central corneal thickness, and posterior elevation.

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    Myrowitz, Elliott H; Kouzis, Anthony C; O'Brien, Terrence P

    2005-05-01

    The purpose of this study was to assess interocular corneal symmetry in average simulated keratometry, corneal thickness, and posterior corneal elevation. This retrospective analysis included data from scanning slit topography (Orbscan II; Bausch and Lomb, Rochester, NY) on 242 eyes from 121 consecutive patients undergoing standard evaluation for consideration of elective laser vision correction. The symmetry between the right and left eye in average simulated keratometry, minimum central corneal thickness, and posterior corneal elevation was assessed by comparative data analysis. Simulated keratometry ranged from 39.9 to 48.6 D. The interocular difference in average simulated keratometry was 0.47 D (standard deviation [SD] 0.43). The interocular Pearson correlation coefficient for average simulated keratometry was 0.90 (p central corneal thickness was 0.95 (p symmetry in all these parameters was very high in this group of consecutive patients. Asymmetry of these interocular parameters may warrant repeat clinical testing for accuracy and may predict corneal abnormalities. Normative data on posterior cornea elevation is presented. This study points out potentially clinically important high interocular corneal symmetry data in simulated keratometry, corneal thickness, and posterior corneal elevation.

  15. Dermatomyositis associated with generalized subcutaneous edema and Evans syndrome.

    Science.gov (United States)

    Jung, Kyu Dong; Kim, Pyoung Su; Park, Hae Young; Kim, Cho Rok; Byun, Ji Yeon; Lee, Dong Youn; Lee, Joo Heung; Yang, Jun-Mo; Lee, Eil-Soo

    2012-01-01

    Although periorbital edema is a common manifestation of dermatomyositis (DM), generalized subcutaneous edema associated with DM is extremely rare. Evans syndrome is an autoimmune disease in which an individual's antibodies attack one's own red blood cells and platelets. Evans syndrome is rarely a presenting feature of DM. DM has been rarely reported to be associated with either generalized edema or Evans syndrome. We report the case of a 52-year-old Korean woman who presented with generalized subcutaneous edema, an erythematous rash, dysphagia, and proximal muscle weakness, and subsequently developed features of Evans syndrome. Treatment with high-dose glucocorticoids and an immunosuppressive agent controlled the DM, the generalized subcutaneous edema, and the Evans syndrome. Copyright © 2009 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

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

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    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.

  17. The inhibitory effect of different concentrations of KH902 eye drops on corneal neovascularization induced by alkali burn

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    Yan Wu

    2017-01-01

    Full Text Available Purpose: The aim of this study was to evaluate the inhibitory effect of different concentrations of KH902 eye drops on rabbit corneal neovascularization (CNV induced by alkali burn. Methods: Forty-eight adult rabbits were randomized into four groups after alkali burning: Group A (2.5 mg/ml, Group B (5 mg/ml, and Group C (10 mg/ml by different concentrations of KH902 eye drops and Group D by saline solution as control with three times a day for 2 weeks. At days 7, 14, and 28, the anterior segment photographs, confocal microscopy, and histopathology were performed to evaluate corneal opacity, neovascularization, inflammatory cell density, vessel size, and edema. Immunohistochemistry was applied to analyze the vascular endothelial growth factor (VEGF level. Results: (1 The CNV in the medicine-treated groups showed a reduction without obvious corneal side effects histologically. (2 Compared to the control group, the three medicine-treated groups showed a reduction in the VEGF levels and CNV areas on days 7, 14, and 28 and in the inflammatory cell density on days 14 and 28 (P 0.05. Conclusion: KH902 eye drops in lower concentration showed an obvious reduction of the CNV growing for rabbit corneal alkali burn without side effects.

  18. Surgical Management of Limbal Dermoids Using Anterior Corneal Buttons From Descemet Stripping Automated Endothelial Keratoplasty Donor Tissue as Patch Grafts.

    Science.gov (United States)

    Wu, Kuan-I; Chu, Hsiao-Sang; Pai, Amy Shih-I; Hou, Yu-Chih; Lin, Szu-Yuan; Chen, Wei-Li; Hu, Fung-Rong

    2017-01-01

    To assess the surgical and clinical outcomes of anterior lamellar keratoplasty using anterior corneal buttons from Descemet stripping automated endothelial keratoplasty (DSAEK) donor tissue. Retrospective data from 8 patients with unilateral limbal dermoids, treated between February 2011 and January 2016 at National Taiwan University Hospital, were analyzed. Donor corneas for DSAEK were divided into anterior and posterior lamellae using a 350-μm microkeratome. Anterior corneal buttons were stored for up to 4 weeks in storage media before being used as patch grafts for anterior lamellar keratoplasty. Corneoscleral integrity was preserved in all cases. Three of the 8 patients showed improved best-corrected visual acuity after surgery. Three patients' astigmatism reduced by more than 0.75 diopters. All 8 patients had satisfactory cosmesis after surgery. Neovascularization at the graft-host junction and graft edema was noted in 1 patient and was treated using bevacizumab injection and topical steroid. Anterior corneal buttons obtained from DSAEK can be used as patch grafts for surgical management of limbal dermoids. This procedure achieved satisfactory cosmetic and visual outcomes in our study. This procedure may potentially allow one corneal tissue to be received by multiple patients.

  19. Corneal epithelium following penetrating keratoplasty.

    Science.gov (United States)

    Tsubota, K; Mashima, Y; Murata, H; Yamada, M; Sato, N

    1995-03-01

    This study was designed to observe any changes to the corneal epithelium after penetrating keratoplasty. The corneal epithelia of 26 patients were observed by specular microscopy 1 week, 1 month, 3 months, and 6 months following penetrating keratoplasty. After re-epithelialisation was confirmed by biomicroscopy 1 week after surgery, specular microscopy revealed many abnormal cells, including spindle shaped cells, nucleated cells, large cells, as well as irregular cell configurations. Although these abnormal findings tended to decrease with time, they were still present in some cases as much as 6 months postoperatively. Computerised morphometric analysis yielded mean cell areas of 1121 (SD 168) microns 2, 1139 (675) microns 2, 1712 (496) microns 2, and 1400 (377) microns 2 at 1 week, 1 month, 3 months, and 6 months respectively, all significantly greater than that of age matched controls (710 (151) microns 2). The shape factor decreased with time, but was still greater than the control level at 6 months. This study demonstrates that epithelial abnormalities persist longer than expected after penetrating keratoplasty, and that these subtle changes can be detected by specular microscopic observation, potentially allowing for modification and enhancement of the wound healing process.

  20. Intrastromal corneal ring implants for corneal thinning disorders: an evidence-based analysis.

    Science.gov (United States)

    2009-01-01

    The purpose of this project was to determine the role of corneal implants in the management of corneal thinning disease conditions. An evidence-based review was conducted to determine the safety, effectiveness and durability of corneal implants for the management of corneal thinning disorders. The evolving directions of research in this area were also reviewed. SUBJECT OF THE EVIDENCE-BASED ANALYSIS: The primary treatment objectives for corneal implants are to normalize corneal surface topography, improve contact lens tolerability, and restore visual acuity in order to delay or defer the need for corneal transplant. Implant placement is a minimally invasive procedure that is purported to be safe and effective. The procedure is also claimed to be adjustable, reversible, and both eyes can be treated at the same time. Further, implants do not limit the performance of subsequent surgical approaches or interfere with corneal transplant. The evidence for these claims is the focus of this review. The specific research questions for the evidence review were as follows: SafetyCorneal Surface Topographic Effects:Effects on corneal surface remodellingImpact of these changes on subsequent interventions, particularly corneal transplantation (penetrating keratoplasty [PKP])Visual AcuityRefractive OutcomesVISUAL QUALITY (SYMPTOMS): such as contrast vision or decreased visual symptoms (halos, fluctuating vision)Contact lens toleranceFunctional visual rehabilitation and quality of lifePatient satisfaction:Disease Process:Impact on corneal thinning processEffect on delaying or deferring the need for corneal transplantation TARGET POPULATION AND CONDITION Corneal ectasia (thinning) comprises a range of disorders involving either primary disease conditions such as keratoconus and pellucid marginal corneal degeneration or secondary iatrogenic conditions such as corneal thinning occurring after LASIK refractive surgery. The condition occurs when the normally round dome-shaped cornea

  1. Current treatment options for corneal ectasia.

    Science.gov (United States)

    Tan, Donald T H; Por, Yong-Ming

    2007-07-01

    The approach to the management of various forms of corneal ectasia is changing, with the advent of new surgical and nonsurgical options. The purpose of this review is to summarize and evaluate relevant studies on new treatments for keratoconus, postrefractive surgery keratectasia, and peripheral ectatic corneal disorders. Various alternatives to corneal transplantation for the management of keratoconus aim to enhance corneal rigidity by means of nonsurgical collagen cross-linking, or with the use of intrastromal corneal ring segments, and studies suggest that these treatments may reduce astigmatism or ectatic progression to varying degrees. Recent developments in anterior lamellar keratoplasty enable targeted replacement or augmentation of corneal stroma without replacement of endothelium, and include procedures such as deep anterior lamellar keratoplasty, microkeratome or laser-assisted anterior lamellar surgery, and peripheral tectonic lamellar keratoplasty procedures demonstrate successful reinforcement of peripheral stroma to reduce astigmatism. These new forms of surgery are viable alternatives to conventional penetrating keratoplasty and bring added safety profiles for long-term visual rehabilitation and restoration of tectonic integrity in central and peripheral forms of corneal ectasia.

  2. Factors Affecting Corneal Hysteresis in Taiwanese Adults.

    Science.gov (United States)

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

    2015-09-01

    To investigate the correlation of various corneal hysteresis (CH) factors in Chinese adults. 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 integrated 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 correlations between CH and quantitative factors. The chi-square test was used to detect differences in categorical values. Longer axial length (P = 0.0001), lower IOPG (P = 0.03), older age (P = 0.003), and thinner central corneal thickness (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. Various factors including axial length, intraocular pressure, age, and central corneal thickness can affect measurement of corneal biomechanical properties in Chinese adults. But the anterior chamber depth, gender, and corneal curvature were irrelevant to CH.

  3. Analysis of ethanol effects on corneal epithelium.

    Science.gov (United States)

    Oh, Joo Youn; Yu, Ji Min; Ko, Jung Hwa

    2013-06-04

    Ethanol is widely used in ocular surface surgeries and for the treatment of corneal diseases. However, ethanol is a toxic agent that is related to the development of a number of alcohol-related diseases. Despite the common use of ethanol for therapeutic purposes in ophthalmology, effects of ethanol on the ocular surface have been poorly defined. Hence, we performed this study to investigate effects of ethanol on corneal epithelium from various aspects. We exposed corneal epithelial cells in culture to different concentrations of ethanol for 30 seconds and evaluated the cells for toxicity, survival, and expression of cell-specific markers and inflammatory cytokines at 24, 48, and 72 hours after ethanol exposure. We found that ethanol markedly decreased the viability of cells in a concentration-dependent manner by causing cell lysis, suppressing proliferation, and inducing apoptosis. Also, expression of corneal epithelial cell-specific markers, both stem cell and differentiation markers, was significantly reduced by ethanol exposure. Expression of proinflammatory cytokines and chemokines was highly increased in corneal epithelial and stromal cells that were exposed to ethanol. Together, data suggest that brief exposure of the corneal surface to ethanol may have long-term effects by disrupting the integrity of corneal epithelium and generating inflammation, both of which are precursors to a number of ocular surface diseases.

  4. Electrospun Scaffolds for Corneal Tissue Engineering: A Review

    OpenAIRE

    Bin Kong; Shengli Mi

    2016-01-01

    Corneal diseases constitute the second leading cause of vision loss and affect more than 10 million people globally. As there is a severe shortage of fresh donated corneas and an unknown risk of immune rejection with traditional heterografts, it is very important and urgent to construct a corneal equivalent to replace pathologic corneal tissue. Corneal tissue engineering has emerged as a practical strategy to develop corneal tissue substitutes, and the design of a scaffold with mechanical pro...

  5. Current concepts and techniques in corneal transplantation.

    Science.gov (United States)

    Laibson, Peter R

    2002-08-01

    The corneal endothelium is the most important single layer in corneal transplantation. In his Castroviejo Lecture, William Bourne, MD, summarizes his work on the corneal endothelium and its importance to corneal transplantation. Almost half the corneal transplants performed in the United States are done so because of malfunctioning, diseased, or absent endothelial cells. If just this layer could be transplanted, the long wait for better vision after keratoplasty (up to two years in some countries) can be eliminated, as well as the problems of epithelial and subepithelial graft rejection. The significant astigmatism after keratoplasty could also be reduced. Transplantation of the endothelium in deep lamellar keratoplasty is being done in limited fashion throughout the world and the first patients have now been done in the United States. In many countries where corneal tissue is difficult to obtain, keratoplasty is only performed on one eye, even though both eyes may need it. One article this year discusses binocular vision recovery in bilateral keratoplasty and the objective and subjective improvements after bilateral keratoplasty. Patients who are bilaterally blind from diseases such as Stevens-Johnson syndrome, and ocular pemphigoid have little hope of visual recovery from conventional corneal transplants. The use of a keratoprosthesis to bypass the totally abnormal conjunctival surface has helped many people in the past. The preoperative prognostic categories of patients who may benefit from keratoprosthesis has been carefully reviewed in a large number of keratoprosthesis patients and this information will help ophthalmologists decide who will benefit the most benefit from keratoprosthesis. This year, articles on corneal transplantation after conjunctival flaps, suture-related complications in keratoplasty, the implantation of an intraocular lens after penetrating keratoplasty, and long-term results of penetrating keratoplasty with glaucoma drainage tube

  6. Corneal Biomechanical Properties in Rheumatoid Arthritis.

    Science.gov (United States)

    Can, Mehmet Erol; Erten, Sukran; Can, Gamze Dereli; Cakmak, Hasan Basri; Sarac, Ozge; Cagil, Nurullah

    2015-11-01

    To investigate the variations in biomechanical properties of the cornea in rheumatoid arthritis (RA) patients. A total of 53 RA patients, and 25 healthy individuals (control group) were enrolled. Rheumatoid arthritis patients were classified as in active phase (group 1; n=24) or in remission phase (group 2; n=29). Corneal biomechanical parameters including corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated intraocular pressure (IOPcc), and Goldmann-correlated IOP (IOPg) were measured with the Reichert Ocular Response Analyzer. Topographical measurements, including central corneal thickness (CCT), anterior chamber depth, iridocorneal angle, and corneal volume were measured using a Sirius corneal topographer. The mean CH was 9.43±1.17 mm Hg in group 1, 9.42±1.84 mm Hg in group 2, and 10.47±1.68 mm Hg in the control group (P=0.03). The mean IOPcc was 17.85±3.2 mm Hg in group 1, 17.95±3.49 mm Hg in group 2, and 15.36±3.11 mm Hg in the control group (P=0.008). The CH showed a significant positive correlation with CRF (P=0.000, r=0.809) and CCT (P=0.000, r=0.461), and a significant negative correlation with IOPcc (P=0.000, r=-0.469). Decrease in the mean CH measurements indicates that ultrastructural changes in the cornea may occur in the active phase, and these changes persist in the remission period. In addition, IOPcc is significantly affected by the corneal biomechanical properties. In RA patients, it is important to control the corneal parameters and IOP measurements against the irreversible changes on the optic nerve.

  7. Visual outcomes of Boston keratoprosthesis implantation as the primary penetrating corneal procedure.

    Science.gov (United States)

    Kang, Joann J; de la Cruz, Jose; Cortina, Maria Soledad

    2012-12-01

    To report the short-term visual outcomes and complications of keratoprosthesis surgery as the primary penetrating corneal procedure for patients at high risk for conventional corneal transplantation. A retrospective chart review was conducted of 21 eyes of 19 patients who underwent either Boston keratoprosthesis type I or type II as the primary penetrating corneal procedure from February 2007 to March 2011. Nineteen type I (90.5%) and 2 type II (9.5%) Boston keratoprosthesis procedures were performed in 19 patients. Mean follow-up was 14.6 months (range, 6-36.3 mo). Primary indications for surgery included chemical or thermal injury, aniridia, and Stevens-Johnson syndrome. Preoperative best-corrected visual acuity (BCVA) ranged from 20/100 to light perception and was count fingers or worse in 20 eyes (95.2%). At last follow-up for all eyes, 15 eyes (71.4%) achieved BCVA≥20/200 and 4 eyes (19%) improved to BCVA≥20/50. No intraoperative complications occurred. Postoperative complications include retroprosthetic membrane formation (47.6%), cystoid macular edema (33.3%), elevated intraocular pressure (23.8%), glaucoma progression (14.3%), and endophthalmitis (4.8%). The initial keratoprosthesis was retained in 19 eyes (90.5%). The Boston keratoprosthesis, based on early follow-up, is a good alternative as a primary penetrating corneal procedure in a select group of patients with very poor prognosis for penetrating keratoplasty. Although complications can occur and require close monitoring, visual acuity significantly improved in the majority of patients.

  8. Technology needs for corneal transplant surgery

    Science.gov (United States)

    Vaddavalli, Pravin K.; Yoo, Sonia H.

    2011-03-01

    Corneal transplant surgery has undergone numerous modifications over the years with improvements in technique, instrumentation and eye banking. The main goals of corneal transplantation are achieving excellent optical clarity with long-term graft survival. Penetrating, anterior and posterior lamellar surgery along with femtosecond laser technology have partially met these goals, but outcomes are often unpredictable and surgeon dependent. Technology to predictably separate stroma from Descemet's membrane, techniques to minimize endothelial cell loss, improvements in imaging technology and emerging techniques like laser welding that might replace suturing, eventually making corneal transplantation a refractively predictable procedure are on the wish list of the cornea surgeon.

  9. The Effect of Smoking on Corneal Biomechanics.

    Science.gov (United States)

    Kilavuzoglu, Ayse Ebru; Celebi, Ali Riza Cenk; Altiparmak, Ugur Emrah; Cosar, Cemile Banu

    2017-01-01

    To determine the effect of smoking on corneal biomechanical behavior. The medical records of consecutive patients that presented to the ophthalmology department were reviewed. History of smoking and ophthalmological examination findings were recorded. The smoking group met the following criteria: a clear history of and present smoking habit, negative history of corneal disease and surgery, ocular response analyzer measurement at the time of examination, and a waveform score ≥3.7. Nonsmokers (never smoked or quit smoking ≥6 months earlier) that met the same criteria constituted the control group. Corneal biomechanical parameters were measured using ocular response analyzer. Data were analyzed using Pearson's χ(2) test, Mann-Whitney U test, and Spearman's correlation coefficient. The smoking group included 166 eyes of 166 patients with a mean age of 38.7 ± 11.95 years, and the control group consisted of 170 eyes of 170 patients with a mean age of 38.40 ± 12.2 years. Mean cumulative smoking dose in the smoking group was 9.59 ± 11.87 pack-years (0.04- 75.00). There was no significant correlation between cumulative smoking dose and corneal hysteresis and corneal resistance factor (P = 0.382 and 0.074, respectively). There were no significant differences in corneal hysteresis or the corneal resistance factor between the two groups (P > 0.05). There was no significant difference in corneal hysteresis between those in the smoking group aged 18-44 years and those aged 45-64 years (P = 0.258), whereas in the control group mean corneal hysteresis was significantly lower in the 45-64 year olds than in the 18-44 year olds (P = 0.034). Although there was no significant difference in corneal biomechanics between smoking and control groups, the decrease in corneal hysteresis with aging was less apparent in the smoking group, which may be due to the potential changes in the cornea's microstructure induced by smoking during aging and the effect of smoking in aged corneal

  10. Should nylon corneal sutures be routinely removed?

    Science.gov (United States)

    Jackson, H.; Bosanquet, R.

    1991-01-01

    Three groups of patients who had undergone cataract extraction through a corneal incision closed with 10/0 nylon sutures one, two, and three years previously were recalled to determine the incidence of suture related complications. Broken corneal sutures were found in 87.5% of patients after two years and 90% after three years and were causing symptoms in over half the patients. It is recommended that 10/0 nylon corneal sutures be routinely removed no later than one year after surgery. Images PMID:1751460

  11. Vitrectomy with or without encircling band for pseudophakic retinal detachment: a multi-centre, three-arm, randomised clinical trial. VIPER Study Report No. 1--design and enrolment.

    Science.gov (United States)

    Mazinani, B; Baumgarten, S; Schiller, P; Agostini, H; Helbig, H; Limburg, E; Hellmich, M; Walter, P

    2016-03-01

    Scleral buckling is currently used in addition to vitrectomy for the treatment of pseudophakic retinal detachment (PRD) to better support the vitreous base and better visualisation of the periphery. The aims of this study are to evaluate (1) whether the combination of 20 G vitrectomy and scleral buckling is superior to 20 G vitrectomy alone (control) (confirmatory), and (2) whether transconjunctival 23/25 G vitrectomy is non-inferior to 20 G vitrectomy (both without scleral buckling) regarding operation success (exploratory). The VIPER (Vitrectomy Plus Encircling Band Vs. Vitrectomy Alone For The Treatment Of Pseudophakic Retinal Detachment) study is an unmasked, multi-centre, three-arm randomised trial. Patients with PRD were eligible, excluding complicated retinal detachment or otherwise severe ophthalmologic impairment. Patients were randomised to one of three interventions: 20 G vitrectomy alone (control C), combination of 20 G vitrectomy and circumferential scleral buckling (experimental treatment E1) or 23/25 G vitrectomy alone (experimental treatment E2). The primary endpoint is the absence of any indication for a retina re-attaching procedure during 6 months of follow-up. Secondary endpoints include best corrected visual acuity, retina re-attaching procedures, complications and adverse events. From June 2011 to August 2013, 257 patients were enrolled in the study. The internet randomisation service assigned 100 patients each to the treatment arms C and E1, and 57 patients to treatment E2. The imbalance is due to the fact that several retinal surgeons did not qualify for performing E2. The random assignment was stratified and balanced (ie, 1:1 or 1:1:1 ratio) by surgeon. The described study represents a methodologically rigorous protocol evaluating the benefits of three different vitrectomy approaches to PRD. The projected results will help to establish their overall efficacy and will permit conclusions regarding their relative value. DRKS

  12. Clinical study on human lamellar keratoplasty for fungal corneal ulcers with porcine acellular corneal stroma

    OpenAIRE

    Fu-Hong Liao; Zi-Zhong Yu; Bin Hu

    2017-01-01

    AIM: To observe the transplantation of acellular porcine corneal stroma on the treatment of superficial keratitis by drug-resistant fungal. METHODS: We performed a retrospective analysis of 16 cases of fungal keratitis received the transplantation of acellular porcine corneal matrix from June 2015 to March 2016 with a follow-up of 6mo. We analyzed on items as postoperative visual acuity, corneal graft status, postoperative recurrence and postoperative complications. RESULTS: We observed a hea...

  13. Corneal-Wavefront guided transepithelial photorefractive keratectomy after corneal collagen cross linking in keratoconus

    OpenAIRE

    Camellin, Massimo; Guidotti, Jacopo Maria; Arba Mosquera, Samuel

    2016-01-01

    Purpose To evaluate the efficacy and safety of Corneal-Wavefront guided transepithelial photorefractive keratectomy (TransPRK) after corneal collagen cross linking (CXL) in keratoconic patients. Methods In this retrospective, non-comparative, consecutive case series, 39 keratoconic eyes underwent Corneal-Wavefront guided TransPRK for the correction of aberrations at least 4 months after conventional CXL at SEKAL Rovigo Microsurgery Centre, Rovigo, Italy. Two eyes (5%) underwent a secondary la...

  14. Role of Corneal Epithelium in Riboflavin/Ultraviolet-A Mediated Corneal Cross-Linking Treatment in Rabbit Eyes

    OpenAIRE

    Xiangchen Tao; Haiqun Yu; Yong Zhang; Zhiwei Li; Vishal Jhanji; Shouxiang Ni; Ya Wang; Guoying Mu

    2013-01-01

    Purpose. To evaluate the role of corneal epithelium in riboflavin/ultraviolet-A (UVA) mediated corneal collagen cross-linking treatment. Methods. Fifty New Zealand rabbits were divided into 5 groups: UVA treatment with or without corneal epithelium, UVA+riboflavin treatment with or without corneal epithelium, and control without any treatment. All rabbits were sacrificed after irradiation and subsequently 4?mm???10?mm corneal strips were harvested for biomechanical evaluation. Results. UVA ir...

  15. Edema in renal diseases – current view on pathogenesis

    Directory of Open Access Journals (Sweden)

    Irina Bobkova

    2016-10-01

    Full Text Available Edema is a common complication of numerous renal disease. In the recent past several aspects of the pathophysiology of this condition have been elucidated. We herein present a case of nephrotic syndrome in a 30 year-old men. The discussion revolves around the following key questions on fluid accumulation in renal disease: 1. What is edema? What diseases can cause edema? 2. What are the mechanisms of edema in nephrotic syndrome?   2a. The “underfill” theory   2b. The “overfill” theory   2c. Tubulointerstitial inflammation   2d. Vascular permeability 3. What are the mechanisms of edema in nephritic syndrome? 4. How can the volume status be assessed in patients with nephrotic syndrome? 5. What are therapeutic strategies for edema management? 6. What are the factors affecting response to diuretics? 7. How can we overcome the diuretics resistance?   7a. Effective doses of loop diuretics   7b. Combined diuretic therapy   7c. Intravenous administration of diuretics   7d. Albumin infusions   7e. Alternative methods of edema management 8. Conclusion.

  16. Exercise-Induced Pulmonary Edema in a Triathlon

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    Hirotomo Yamanashi

    2015-01-01

    Full Text Available Introduction. Family physicians have more opportunities to attend athletic competitions as medical staff at first-aid centers because of the increasing popularity of endurance sports. Case. A 38-year-old man who participated in a triathlon race experienced difficulty in breathing after swimming and was moved to a first-aid center. His initial oxygen saturation was 82% and a thoracic computed tomography scan showed bilateral ground glass opacity in the peripheral lungs. His diagnosis was noncardiogenic pulmonary edema associated with exercise or swimming: exercise-induced pulmonary edema (EIPE or swimming-induced pulmonary edema (SIPE. Treatment with furosemide and corticosteroid relieved his symptoms of pulmonary edema. Discussion. Noncardiogenic pulmonary edema associated with endurance sports is not common, but knowledge about EIPE/SIPE or neurogenic pulmonary edema associated with hyponatremia, which is called Ayus-Arieff syndrome, is crucial. Knowledge and caution for possible risk factors, such as exposure to cold water or overhydration, are essential for both medical staff and endurance athletes. Conclusion. To determine the presence of pulmonary edema associated with strenuous exercise, oxygen saturation should be used as a screening tool at a first-aid center. To avoid risks for EIPE/SIPE, knowledge about these diseases is essential for medical staff and for athletes who perform extreme exercise.

  17. Multimodality imaging findings of massive ovarian edema in children

    Energy Technology Data Exchange (ETDEWEB)

    Dahmoush, Hisham [Stanford University Medical Center, Department of Radiology, Neuroradiology Division, Stanford, CA (United States); Anupindi, Sudha A.; Chauvin, Nancy A. [University of Pennsylvania, The Children' s Hospital of Philadelphia, Department of Radiology, Perelman School of Medicine, Philadelphia, PA (United States); Pawel, Bruce R. [University of Pennsylvania, The Children' s Hospital of Philadelphia, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Philadelphia, PA (United States)

    2017-05-15

    Massive ovarian edema is a rare benign condition that predominantly affects childbearing women as well as preadolescent girls. It is thought to result from intermittent or partial torsion of the ovary compromising the venous and lymphatic drainage but with preserved arterial supply. The clinical features of massive ovarian edema are nonspecific and can simulate tumors, leading to unnecessary oophorectomy. To demonstrate imaging features that should alert radiologists to consider the diagnosis of massive ovarian edema preoperatively so that fertility-sparing surgery may be considered. We identified five girls diagnosed with massive ovarian edema at pathology. Presenting symptoms, sidedness, imaging appearance, preoperative diagnosis, and operative and histopathological findings were reviewed. Age range was 9.6-14.3 years (mean age: 12.5 years). Common imaging findings included ovarian enlargement with edema of the stroma, peripherally placed follicles, isointense signal on T1-W MRI and markedly hyperintense signal on T2-W MRI, preservation of color Doppler flow by US, and CT Hounsfield units below 40. The uterus was deviated to the affected side in all patients. Two of the five patients had small to moderate amounts of free pelvic fluid. Mean ovarian volume on imaging was 560 mL (range: 108-1,361 mL). While the clinical presentation of massive ovarian edema is nonspecific, an enlarged ovary with stromal edema, peripherally placed follicles and preservation of blood flow may be suggestive and wedge biopsy should be considered intraoperatively to avoid unnecessary removal of the ovary. (orig.)

  18. Critical Care Management of Cerebral Edema in Brain Tumors.

    Science.gov (United States)

    Esquenazi, Yoshua; Lo, Victor P; Lee, Kiwon

    2017-01-01

    Cerebral edema associated with brain tumors is extremely common and can occur in both primary and metastatic tumors. The edema surrounding brain tumors results from leakage of plasma across the vessel wall into the parenchyma secondary to disruption of the blood-brain barrier. The clinical signs of brain tumor edema depend on the location of the tumor as well as the extent of the edema, which often exceeds the mass effect induced by the tumor itself. Uncontrolled cerebral edema may result in increased intracranial pressure and acute herniation syndromes that can result in permanent neurological dysfunction and potentially fatal herniation. Treatment strategies for elevated intracranial pressure consist of general measures, medical interventions, and surgery. Alhough the definitive treatment for the edema may ultimately be surgical resection of the tumor, the impact of the critical care management cannot be underestimated and thus patients must be vigilantly monitored in the intensive care unit. In this review, we discuss the pathology, pathophysiology, and clinical features of patients presenting with cerebral edema. Imaging findings and treatment modalities used in the intensive care unit are also discussed. © The Author(s) 2015.

  19. [Early onset of fingolimod-associated macular edema].

    Science.gov (United States)

    Schelenz, D; Kleiter, I; Schöllhammer, J; Rehrmann, J; Elling, M; Dick, H B; Kakkassery, V

    2017-06-26

    Fingolimod, a disease-modifying sphingosine 1‑phosphate receptor modulator, which was approved in Germany in 2011, decreases the relapse rate and reduces neuroinflammation in patients with relapsing-remitting multiple sclerosis. Macular edema is a well-known ocular side effect of fingolimod therapy. Specific intervals for ophthalmologic check-ups after starting fingolimod and definite treatment schedules for fingolimod-associated macular edema are, however, still lacking. We present a case of early fingolimod-associated macular edema in a 45-year-old female patient with relapsing-remitting multiple sclerosis. The patient complained about visual impairment 1 month after the start of fingolimod and visited an eye specialist. Funduscopic examination and imaging diagnostics revealed macular edema in both eyes. The treatment with fingolimod was immediately stopped. For therapy of macular edema topical application of nepafenac and oral acetazolamide were given. During the 6 months of treatment the macular edema completely disappeared and visual function recovered completely. At the time of diagnosis, it is fundamentally important to discuss the continuation of fingolimod administration with the attending neurologist and if necessary to discontinue the drug. Regular ophthalmologic check-ups at 4‑week intervals over a period of 3 months are meaningful after beginning fingolimod treatment. As before, it is still a key aspect to determine predictive opthalmologic and neurological factors before beginning treatment to evaluate which patients are at risk of fingolimod-associated macular edema.

  20. Diabetic Macular Edema Pathophysiology: Vasogenic versus Inflammatory

    Directory of Open Access Journals (Sweden)

    Pedro Romero-Aroca

    2016-01-01

    Full Text Available Diabetic macular edema (DME can cause blindness in diabetic patients suffering from diabetic retinopathy (DR. DM parameters controls (glycemia, arterial tension, and lipids are the gold standard for preventing DR and DME. Although the vascular endothelial growth factor (VEGF is known to play a role in the development of DME, the pathological processes leading to the onset of this disease are highly complex and the exact sequence in which they occur is still not completely understood. Angiogenesis and inflammation have been shown to be involved in the pathogenesis of this disease. However, it still remains to be clarified whether angiogenesis following VEGF overexpression is a cause or a consequence of inflammation. This paper provides a review of the data currently available, focusing on VEGF, angiogenesis, and inflammation. Our analysis suggests that angiogenesis and inflammation act interdependently during the development of DME. Knowledge of DME etiology seems to be important in treatments with anti-VEGF or anti-inflammatory drugs. Current diagnostic techniques do not permit us to differentiate between both etiologies. In the future, diagnosing the physiopathology of each patient with DME will help us to select the most effective drug.

  1. Aquaporins in Brain Edema and Neuropathological Conditions

    Directory of Open Access Journals (Sweden)

    Aristotelis S. Filippidis

    2016-12-01

    Full Text Available The aquaporin (AQP family of water channels are a group of small, membrane-spanning proteins that are vital for the rapid transport of water across the plasma membrane. These proteins are widely expressed, from tissues such as the renal epithelium and erythrocytes to the various cells of the central nervous system. This review will elucidate the basic structure and distribution of aquaporins and discuss the role of aquaporins in various neuropathologies. AQP1 and AQP4, the two primary aquaporin molecules of the central nervous system, regulate brain water and CSF movement and contribute to cytotoxic and vasogenic edema, where they control the size of the intracellular and extracellular fluid volumes, respectively. AQP4 expression is vital to the cellular migration and angiogenesis at the heart of tumor growth; AQP4 is central to dysfunctions in glutamate metabolism, synaptogenesis, and memory consolidation; and AQP1 and AQP4 adaptations have been seen in obstructive and non-obstructive hydrocephalus and may be therapeutic targets.

  2. Clinical assessment of the soft corneal contact lens on corneal epithelium defect after vitrectomy

    Directory of Open Access Journals (Sweden)

    Meng-Su Tang

    2017-03-01

    Full Text Available AIM: To investigate the effect of soft corneal contact lens on the recovery of corneal epithelial defects and the comfort in patients with diabetic retinopathy after vitrectomy. METHODS: Twenty patients(20 eyeswith diabetic retinopathy whose corneal epithelium defected after vitrectomy were randomly divided into 2 groups. The trial group(10 eyesreceived the combination treatment of wearing soft corneal contact lenses and eyedrops to promote corneal epithelial repair, and the control group(10 eyesonly received eyedrops. The corneal epithelial healing time was observed postoperatively. And the scores of the comfort in patients between two groups were compared. RESULTS: The average duration of corneal epithelial defects was 4.1±1.20d in the trial group, and 14.2±6.07d in the control group, which was statistically significant different between the two groups(PP>0.05. CONCLUSION: The soft corneal contact lens could effectively treat patients with corneal epithelial defects after vitrectomy, and improve their comfort.

  3. Correlation of both corneal surfaces in corneal ectasia after myopic LASIK.

    Science.gov (United States)

    Peinado, Teresa Fernández; Piñero, David P; López, Ignacio Alcaraz; Alio, Jorge L

    2011-04-01

    We report a case of corneal ectasia in a 25-year-old man after myopic laser in situ keratomileusis in which a complete characterization of the corneal structure was performed by means of a Scheimpflug photography-based system. The patient presented in the ectatic eye with a subjective refraction of +0.50 to 6.00 × 100°, which with correction gave a visual acuity of 20/25. With the topographic analysis, corneal shapes from both corneal surfaces at the four different quadrants were found to be complementary, maintaining the meniscus-shaped profile of the cornea. This correlation between the anterior and posterior corneal surfaces was also confirmed with an optical tomography evaluation. Corneal biomechanics was also evaluated by means of the Ocular Response Analyzer (Reichert), which confirmed the biomechanical alteration. In summary, biomechanical changes leading to corneal ectasia in this case affected the global corneal structure, inducing alterations in the shape of both anterior and posterior corneal surfaces.

  4. [The effect of cataract and vitreoretinal surgery on central corneal thickness and corneal hysteresis].

    Science.gov (United States)

    Hager, A; Loge, K; Kutschan, A; Wiegand, W

    2008-03-01

    Intraocular irrigating solutions remain for several hours beyond the actual time of surgery in the eye. The irrigating solution ought to resemble biochemically aqueous humor and vitreous and offer protection for sensitive structures of the eye, such as the corneal endothelium. Impairment of the corneal endothelium may lead to corneal oedema and biomechanical alterations of the cornea. 54 eyes after pars-plana vitrectomy (PPV) in elective macular surgery were evaluated by measuring corneal thickness (CCT) using ultrasound pachymetry (20 MHz) and corneal hysteresis (CH) using the ocular response analyser (Reichert Ophthalmic Instruments, Buffalo, NY, USA). Measurements were performed not earlier than 2 weeks prior to surgery and 1 to 3 days after surgery. Results were compared to a control group (n = 39) and to 101 eyes after clear cornea cataract extraction (KAT). The two groups (PPV and KAT) did not differ with respect to age (p = 0.555). Corneal thickness has increased significantly in both groups (p corneal hysteresis decreased significantly postoperatively (p corneal thickness but also by biomechanical parameters such as corneal hysteresis.

  5. Corneal hysteresis, resistance factor, topography, and pachymetry after corneal lamellar flap.

    Science.gov (United States)

    Gatinel, Damien; Chaabouni, Slim; Adam, Pierre-Alexandre; Munck, Jacques; Puech, Michel; Hoang-Xuan, Thanh

    2007-01-01

    To measure prospectively the early changes in corneal hysteresis, topography, and pachymetry after the creation of a stromal flap cut without laser photoablation. A 37-year-old man was referred for a bioptic procedure to correct for compound myopic astigmatism in the left eye. A 159-microm-thick 8x8.5-mm superior hinged flap was created with a mechanical microkeratome in the left cornea. Changes in the corneal hysteresis, corneal resistance factor, Goldmann correlated intraocular pressure (lOP), corneal compensated IOP, anterior and posterior topography, and optical and ultrasound pachymetry were monitored prospectively before and at 1 hour, 1 day, 5 days, and 25 days after flap creation. The right eye served as a control. In the left eye, corneal hysteresis and corneal resistance factor decreased immediately after the flap cut and remained lower than preoperatively at 1 hour, 1 day, 5 days, and 25 days. Corneal compensated IOP varied significantly less than Goldmann correlated IOP in both eyes. Central flattening of the horizontal meridians was observed on the difference topography maps. The values of the left eye posterior best fit sphere increased after the flap cut. Increased central corneal thickness occurred immediately after the flap cut and decreased over time without returning to its preoperative value. The creation of a stromal flap can modify the biomechanical properties of the cornea, including a reduction in corneal hysteresis. The topographic changes were consistent with previously reported cases of flap cut in normal corneas.

  6. Repair of corneal ulcer or perforation using the corneal stromal lenticule

    Directory of Open Access Journals (Sweden)

    Xiao-Feng Hao

    2018-01-01

    Full Text Available AIM: To describe the outcomes of corneal stromal lenticules in repairing of corneal ulcer and/or perforation. METHODS: This was a retrospective chart review of 6 eyes of 6 patients from January to June 2017,who underwent corneal ulcer repair with the corneal, stromal lenticules harvested from femtosecond laser refractive surgery and kept in pure glycerin for use. Three cases of infectious corneal ulcers were bacterial, fungal, and infection with foreign bodies in corneal deep layer, one each. The other 3 were corneal ulcer perforation. Making sure no air bubble between donor graft and Descemet membrane. The mean follow-up time was 3.71±1.56mo(range 1-6mo. RESULTS: All eyes were successfully treated under control of infection without intra-operative complications, and early postoperative evaluation showed a clear graft in all cases. The last follow-up visit showed the mean best corrected visual acuity(VAsignificantly improved after surgery. There was significant difference from 0.48±0.12 to 1.50±0.08(PCONCLUSION: The preliminary results suggest that the use of corneal stromal lenticules may be a safe and effective surgical alternative for corneal ulcer, even though the long-term outcome of the graft needs to be further observed.

  7. Targeted photocoagulation of peripheral ischemia to treat rebound edema

    Directory of Open Access Journals (Sweden)

    Singer MA

    2015-02-01

    Full Text Available Michael A Singer,1 Colin S Tan,2 Krishna R Surapaneni,3 Srinivas R Sadda4 1Medical Center Ophthalmology Associates, San Antonio, TX, USA; 2National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore; 3University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; 4Doheny Eye Institute, Los Angeles, CA, USA Introduction: Peripheral retinal ischemia not detectable by conventional fluorescein angiography has been proposed to be a driving force for rebound edema in retinal vein occlusions. In this report, we examine the treatment of peripheral retinal ischemia with targeted retinal photocoagulation (TRP to manage a patient’s rebound edema.Methods: To assess the extent of peripheral nonperfusion, an Optos 200Tx device was used. To target the treatment to peripheral ischemia areas, a Navilas Panretinal Laser was used.Results: A 64-year-old male with a central retinal vein occlusion and a visual acuity 20/300, and central macular thickness 318 µm presented with rubeosis. Angiography revealed extensive peripheral nonperfusion. Despite TRP to areas of irreversible ischemia, after 2 months, he continued show rubeosis and rebound edema. Additional TRP laser was repeatedly added more posteriorly to areas of reversible nonperfusion, resulting in eventual resolution of rubeosis and edema.Conclusion: In this study, we demonstrate the use of widefield imaging with targeted photocoagulation of peripheral ischemia to treat rebound edema, while preserving most peripheral vision. In order to treat rebound edema, extensive TRP, across reversible and nonreversible areas of ischemia, had to be performed – not just in areas of nonreversible peripheral ischemia. These areas need to be mapped during episodes of rebound edema, when ischemia is at its maximum. In this way, by doing the most TRP possible, the cycle of rebound edema can be broken. Keywords: macular edema, retinal vein occlusion 

  8. Superolateral Hoffa's Fat Pad Edema in Collegiate Volleyball Players.

    Science.gov (United States)

    Mehta, Kaushal; Wissman, Robert; England, Eric; Dʼheurle, Albert; Newton, Keith; Kenter, Keith

    2015-01-01

    Superolateral Hoffa's fat pad (SHFP) edema is a previously described magnetic resonance (MR) finding located between the patellar tendon and the lateral femoral condyle. The purpose of our study was to determine the prevalence and clinical significance of SHFP edema in female collegiate volleyball players. Sixteen female collegiate volleyball players were consented for bilateral knee evaluations which consisted of history, physical examination and MR imaging. Each MR study was reviewed for the presence of SHFP edema, and 6 patellar maltracking measurements were done. These were tibial tuberosity-trochlear groove distance, patellar translation, lateral patellofemoral angle, trochlear depth, trochlear sulcus angle, and lateral trochlear inclination angle. A total of 16 athletes, 32 knees (16 girls; age range, 18-22 years; mean, 19.9) were enrolled in the study. Sixteen knees (50%) in 8 athletes had SHFP edema, with 100% bilaterality; 16 knees in 8 athletes had no evidence of SHFP edema (50%). Functional outcomes and physical examination findings were within normal limits for all athletes with no difference noted between SHFP edema-positive and -negative individuals. There was a statistically significant difference in the tibial tuberosity-trochlear groove distance, patellar translation, and patellofemoral angle (P value of volleyball athletes have a very high prevalence of SHFP edema, which is always bilateral. Although the exact etiology of SHFP edema remains inconclusive, it could potentially be a sensitive indicator of subtle patellar maltracking which cannot be distinguished by history and physical examination findings. Given the very high prevalence of SHFP edema and this being an asymptomatic finding, there is likely little clinical significance of this in majority of high-performance athletes.

  9. Association between culture results of corneal scrapings and culture and histopathology results of corneal tissues in therapeutic keratoplasty.

    Science.gov (United States)

    Das, Sujata; Sharma, Savitri; Priyadarshini, Omega; Sahu, Srikant K; Kar, Sarita; Vemuganti, Geeta K

    2011-09-01

    To correlate the culture results of corneal scrapings with culture and histopathology results of corneal tissues in therapeutic keratoplasty. A retrospective analysis of the culture results of corneal scrapings and corneal tissues of eyes that received therapeutic penetrating keratoplasty at a tertiary eye care center between December 2006 and November 2008 was conducted. As per the preferred practice, those cases that did not respond to appropriate antimicrobial therapy and/or presented with a large infiltrate/perforation received therapeutic keratoplasty. The microbiology and histopathology findings of the corneal tissues were compared. Thirty-eight therapeutic keratoplasties were performed on 36 patients. Although all cases had histopathology and culture of the corneal tissue, corneal scrapings were not performed in 4 cases. Corneal scrapings and corneal tissues were culture-positive in 76% (26 of 34) and 60% (23 of 38) of cases, respectively. In 8 cases, the corneal scrapings and corneal tissues yielded identical organisms, whereas different organisms grew in 4 cases. In 6 cases, the corneal tissues were culture-positive but the corneal scrapings were sterile. In 20 cases, the corneal tissues were culture-positive for fungus and also showed fungal filaments in their corresponding histopathology specimens. Corneal tissue culture can provide additional information in cases undergoing therapeutic keratoplasty. It helps to determine the management of patients after keratoplasty.

  10. Recent aspects on physiopathology of diabetic macular edema

    OpenAIRE

    Mário Martins dos Santos Motta; Jacqueline Coblentz; Laura Gomes Nunes de Melo

    2008-01-01

    O edema macular é a principal causa de baixa visual em pacientes diabéticos. Seu mecanismo de formação é complexo e envolve alterações bioquímicas e estruturais. Os autores fazem uma revisão e atualização dos conceitos fisiopatológicos envolvidos na maculopatia diabética.Macular edema is the leading cause of poor vision in diabetic patients.The mechanism of edema formation is complex and involves biochemical and structural changes. The authors review and update the physiopathologic concepts r...

  11. Edema de pulmón precipitado por amlodipino

    OpenAIRE

    Teresa Chapela Castaño; José Luis Penas Ríos

    2013-01-01

    Múltiples fármacos pueden causar edema agudo de pulmón no cardiogénico. Establecer esta relación causal resulta muy difícil en muchos casos debido a la escasa incidencia documentada con algunos fármacos y a que la sintomatología no es específica. Si bien el edema periférico es un efecto secundario frecuente del amlodipino, solamente se han publicado en la literatura dos casos de edema pulmonar causado por amlodipino y ambos ocurrieron en el contexto de dosis supraterapéuticas. Se describe un ...

  12. Thrombomodulin promotes corneal epithelial wound healing

    National Research Council Canada - National Science Library

    Huang, Yi-Hsun; I, Ching-Chang; Kuo, Cheng-Hsiang; Hsu, Yun-Yan; Lee, Fang-Tzu; Shi, Guey-Yueh; Tseng, Sung-Huei; Wu, Hua-Lin

    2015-01-01

    To determine the role of thrombomodulin (TM) in corneal epithelial wound healing, and to investigate whether recombinant TM epidermal growth factor-like domain plus serine/threonine-rich domain (rTMD23...

  13. Femtosecond Lasers and Corneal Surgical Procedures.

    Science.gov (United States)

    Marino, Gustavo K; Santhiago, Marcony R; Wilson, Steven E

    2017-01-01

    Our purpose is to present a broad review about the principles, early history, evolution, applications, and complications of femtosecond lasers used in refractive and nonrefractive corneal surgical procedures. Femtosecond laser technology added not only safety, precision, and reproducibility to established corneal surgical procedures such as laser in situ keratomileusis (LASIK) and astigmatic keratotomy, but it also introduced new promising concepts such as the intrastromal lenticule procedures with refractive lenticule extraction (ReLEx). Over time, the refinements in laser optics and the overall design of femtosecond laser platforms led to it becoming an essential tool for corneal surgeons. In conclusion, femtosecond laser is a heavily utilized tool in refractive and nonrefractive corneal surgical procedures, and further technological advances are likely to expand its applications. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

  14. Clear corneal incision in cataract surgery.

    Science.gov (United States)

    Al Mahmood, Ammar M; Al-Swailem, Samar A; Behrens, Ashley

    2014-01-01

    Since the introduction of sutureless clear corneal cataract incisions, the procedure has gained increasing popularity worldwide because it offers several advantages over the traditional sutured scleral tunnels and limbal incisions. Some of these benefits include lack of conjunctival trauma, less discomfort and bleeding, absence of suture-induced astigmatism, and faster visual rehabilitation. However, an increasing incidence of postoperative endophthalmitis after clear corneal cataract surgery has been reported. Different authors have shown a significant increase up to 15-fold in the incidence of endophthalmitis following clear corneal incision compared to scleral tunnels. The aim of this report is to review the advantages and disadvantages of clear corneal incisions in cataract surgery, emphasizing on wound construction recommendations based on published literature.

  15. Corneal biomechanical properties in thyroid eye disease

    National Research Council Canada - National Science Library

    Karabulut, Gamze Ozturk; Kaynak, Pelin; Altan, Cıgdem; Ozturker, Can; Aksoy, Ebru Funda; Demirok, Ahmet; Yılmaz, Omer Faruk

    2014-01-01

    The purpose of this study is to investigate the effect of thyroid eye disease (TED) on the measurement of corneal biomechanical properties and the relationship between these parameters and disease manifestations...

  16. 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.

  17. 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.

  18. IOL Power Calculation after Corneal Refractive Surgery

    OpenAIRE

    Maddalena De Bernardo; Luigi Capasso; Luisa Caliendo; Francesco Paolercio; Nicola Rosa

    2014-01-01

    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...

  19. Corneal collagen crosslinking for keratoconus. A review

    OpenAIRE

    M. M. Bikbov; V. K. Surkova

    2014-01-01

    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, co...

  20. Corneal biomechanical properties of patients with acromegaly.

    Science.gov (United States)

    Ozkok, Ahmet; Hatipoglu, Esra; Tamcelik, Nevbahar; Balta, Burcu; Gundogdu, Ahmet Sadi; Ozdamar, Mehmet Akif; Kadioglu, Pinar

    2014-05-01

    Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) excess in acromegaly have various effects on many organs. The ophthalmologic effects of GH and IGF-1 excess have not yet been investigated in detail. The aim of the current study is to compare the corneal biomechanical properties of patients with acromegaly and those of healthy subjects. 45 patients with acromegaly (F/M=27/18) and 42 age-matched and gender-matched healthy individuals (F/M=24/18) were enrolled in this cross-sectional study. Central corneal thickness (CCT), corneal resistance factor (CRF), corneal hysteresis (CH), corneal compensated intraocular pressure (IOPcc) and Goldmann correlated IOPG were measured in patients with acromegaly and in healthy individuals using the Ocular Response Analyser (ORA). GH and IGF1 values were also determined in the study group. The mean CH and CRF values were higher in acromegalic patients (12.1±2.2 and 12.3±2.4, respectively) than in healthy subjects (11.0±1.6 and 10.8±1.5, respectively; for CH, p=0.014; for CRF, p=0.001). Mean IOPG measurement was higher in the acromegaly group than in the control group (p=0.017). There was no statistically significant difference in measured CCT (p=0.117) and IOPcc (p=0.594) values between acromegalic patients and healthy subjects. These findings indicate that acromegaly has target organ effects on the eye. Consequently, it can change corneal biomechanical properties such as corneal hysteresis and the CRF. Corneal biomechanical properties are known to affect the accuracy of IOP measurements. These findings should be taken into account when measuring IOP values in acromegaly patients, as IOP readings may be overestimated.

  1. Corneal Biomechanics Determination in Healthy Myopic Subjects

    Directory of Open Access Journals (Sweden)

    Kunliang Qiu

    2016-01-01

    Full Text Available Purpose. To determine the corneal biomechanical properties by using the Ocular Response Analyzer™ and to investigate potential factors associated with the corneal biomechanics in healthy myopic subjects. Methods. 135 eyes from 135 healthy myopic subjects were included in this cross-sectional observational study. Cornea hysteresis (CH, corneal resistance factor (CRF, cornea-compensated intraocular pressure (IOPcc, and Goldmann-correlated intraocular pressure (IOPg were determined with the Reichert Ocular Response Analyzer (ORA. Univariate and multivariate regression analyses were performed to investigate factors associated with corneal biomechanics. Results. The mean CH and CRF were 9.82±1.34 mmHg and 9.64±1.57 mmHg, respectively. In univariate regression analysis, CH was significantly correlated with axial length, refraction, central corneal thickness (CCT, and IOPg (r=-0.27, 0.23, 0.45, and 0.21, resp.; all with p≤0.015, but not with corneal curvature or age; CRF was significantly correlated with CCT and IOPg (r=0.52 and 0.70, resp.; all with p<0.001, but not with axial length/refraction, corneal curvature, or age. In multivariate regression analysis, axial length, IOPcc, and CCT were found to be independently associated with CH, while CCT and IOPg were associated with CRF. Conclusions. Both CH and CRF were positively correlated with CCT. Lower CH but not CRF was associated with increasing degree of myopia. Evaluation of corneal biomechanical properties should take CCT and myopic status into consideration.

  2. Corneal hysteresis in mucopolysaccharidosis I and VI.

    Science.gov (United States)

    Fahnehjelm, Kristina Teär; Chen, Enping; Winiarski, Jacek

    2012-08-01

    High intraocular pressure (IOP) and glaucoma are often suspected in patients with mucopolysaccharidosis (MPS). To determine corneal hysteresis (CH) and IOP in children with mucopolysaccharidosis I-Hurler (MPS I-H) and MPS VI. Clinical measurements with ocular response analyzer (ORA). In seven patients, five with MPS I-H treated with stem cell transplantation (SCT), and two with MPS VI, one treated with SCT and the other with enzyme therapy, the IOP was examined with ORA. Ocular response analyzer measurements were made at a median age of 8.7 years in the patients with MPS I-H and at a median age of 9.3 years in the patients with MPS VI. Earlier measurements had raised suspicion of high IOP in one patient. The ORA showed an increased CH and a falsely high IOP values in all 14 eyes. The recalculated IOPs were normal in all 14 eyes. Mild to severe corneal opacities were present in all 14 eyes. Optic disc areas, borders and cupping were clinically normal in the 12 of 14 eyes that were possible to examine. Severe corneal opacities hampered optic disc evaluation in the older patient with MPS VI. Three eyes in two patients had normal thickness of the retinal nerve fibre layer measured with scanning laser polarimetry with corneal compensation (GDx VCC). No patient was diagnosed or treated for glaucoma. The IOPs are often falsely high because of an increased resistance of the cornea and correlate to the extent of corneal clouding. In this small, cross-sectional study, it appears that corneal resistance is directly correlated with corneal clouding, although a longitudinal study that evaluates resistance as the cornea clears with treatment would provide more direct evidence that corneal deposits are directly related to resistance. A correct measured IOP can avoid unnecessary medical or surgical hypotensive treatment. © 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.

  3. 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.

  4. Corneal Collagen Cross-Linking Outcomes: Review

    OpenAIRE

    Jankov II,Mirko R.; Jovanovic,Vesna; Delevic, Sladjana; Coskunseven, Efekan

    2011-01-01

    Keratoconus is a condition characterized by biomechanical instability of the cornea, presenting in a progressive, asymmetric and bilateral way. Corneal collagen cross-linking with riboflavin and UVA (CXL) is a new technique of corneal tissue strengthening that combines the use of riboflavin as a photo sensitizer and UVA irradiation. The studies showed that CXL was effective in halting the progression of keratoconus over a period of up to four years. The published studies also revealed a reduc...

  5. Intraocular pressure, corneal thickness, and corneal hysteresis in Steinert's myotonic dystrophy

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    Carlos Alexandre de A. Garcia Filho

    2011-06-01

    Full Text Available PURPOSE: Low intraocular pressure (IOP measured by Goldmann applanation tonometry (GAT is one of the ocular manifestations of Steinert's myotonic dystrophy. The goal of this study was to evaluate the corneal-compensated IOP as well as corneal properties (central corneal thickness and corneal hysteresis in patients with myotonic dystrophy. METHODS: A total of 12 eyes of 6 patients with Steinert's myotonic dystrophy (dystrophy group and 12 eyes of 6 age-, race-, and gender-matched healthy volunteers (control group were included in the study. GAT, Dynamic Contour Tonometry (DCT-Pascal and Ocular Response Analyzer (ORA were used to assess the IOP. Central corneal thickness was obtained by ultrasound pachymetry, and corneal hysteresis was analyzed using the ORA device. In light of the multiplicity of tests performed, the significance level was set at 0.01 rather than 0.05. RESULTS: The mean (standard deviation [SD] GAT, DCT, and corneal-compensated ORA IOP in the dystrophy group were 5.4 (1.4 mmHg, 9.7 (1.5 mmHg, and 10.1 (2.6 mmHg, respectively. The mean (SD GAT, DCT, and corneal-compensated ORA IOP in the control group was 12.6 (2.9 mmHg, 15.5 (2.7 mmHg, and 15.8 (3.4 mmHg, respectively. There were significant differences in IOP values between dystrophy and control groups obtained by GAT (mean, -7.2 mmHg; 99% confidence interval [CI], -10.5 to -3.9 mmHg; P<0.001, DCT (mean, -5.9 mmHg; 99% CI, -8.9 to -2.8 mmHg; P<0.001, and corneal-compensated ORA measurements (mean, -5.7 mmHg; 99% CI, -10.4 to -1.0 mmHg; P=0.003. The mean (SD central corneal thickness was similar in the dystrophy (542 [31] µm and control (537 [11] µm groups (P=0.65. The mean (SD corneal hysteresis in the dystrophy and control groups were 11.2 (1.5 mmHg and 9.7 (1.2 mmHg, respectively (P=0.04. CONCLUSIONS: Patients with Steinert's myotonic dystrophy showed lower Goldmann and corneal-compensated IOP in comparison with healthy individuals. Since central corneal thickness and

  6. Effects of axial length and corneal curvature on corneal biomechanics in elderly population

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    Sha-Sha Song

    2018-02-01

    Full Text Available AIM:To explore the corneal biomechanical properties of the elderly with different axial length(ALand corneal curvature by corneal visualization Scheimpflug Technology(Corvis ST. METHODS: Cross-sectional study. A total of 161 patients(297 eyesundergoing phacoemulsification were collected in this study. They were divided into 22-24mm, 24-26mm, more than 26mm groups according to axial length(190 eyes, 54 eyes and 53 eyes, respectively. Those of whom axial length was 22-24mm and the corneal curvature was 42-44D were divided into male and female groups(44 eyes and 49 eyes, respectively. Those of whom axial length was 22-24mm were divided into 42-44D group, more than 44D group according to corneal curvature(88 eyes, 102 eyes, respectively. Corvis ST was used to measure the biomechanical parameters of the cornea. The differences in the parameters between different groups were analyzed using the independent-samples t test or one-way analysis of variance and correlation analyses were performed using Pearson correlation analysis. RESULTS: When comparing the corneal biomechanical parameters, no statistically significant differences were found between male and female groups(P>0.05. The first applanation length and second applanation length among different corneal curvatures were statistically significant(PPr=0.429, 0.278; Pr=-0.291, -0.415; PCONCLUSION: The corneal curvature and ocular axial length may be the factors affecting the corneal biomechanical characteristics. The longer axial length, the thinner corneal thickness, the more easily the corneal is deformed, and with the increase of the axial length, intraocular pressure also increases.

  7. Aspectos atuais na fisiopatologia do edema macular diabético Recent aspects on physiopathology of diabetic macular edema

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    Mário Martins dos Santos Motta

    2008-02-01

    Full Text Available O edema macular é a principal causa de baixa visual em pacientes diabéticos. Seu mecanismo de formação é complexo e envolve alterações bioquímicas e estruturais. Os autores fazem uma revisão e atualização dos conceitos fisiopatológicos envolvidos na maculopatia diabética.Macular edema is the leading cause of poor vision in diabetic patients.The mechanism of edema formation is complex and involves biochemical and structural changes. The authors review and update the physiopathologic concepts related to diabetic maculopathy.

  8. High altitude pulmonary edema among "Amarnath Yatris"

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    Parvaiz A Koul

    2013-01-01

    Full Text Available Background: Annual pilgrimage (Yatra to the cave shrine of Shri Amarnath Ji′ is a holy ritual among the Hindu devotees of Lord Shiva. Located in the Himalayan Mountain Range (altitude 13,000 ft in south Kashmir, the shrine is visited by thousands of devotees and altitude sickness is reportedly common. Materials and Methods: More than 600,000 pilgrims visited the cave shrine in 2011 and 2012 with 239 recorded deaths. Thirty one patients with suspected altitude sickness were referred from medical centers en-route the cave to Sher-i-Kashmir Institute of Medical Sciences, a tertiary-care center in capital Srinagar (5,000 ft. The clinical features and the response to treatment were recorded. Results: Thirty-one patients (all lowlanders, 19 male; age 18-60 years, median 41 had presented with acute onset breathlessness of 1-4 days (median 1.9 d starting within 12-24 h of a rapid ascent; accompanied by cough (68%, headache (8%, dizziness and nausea (65%. Sixteen patients had associated encephalopathy. Clinical features on admission included tachypnea ( n = 31, tachycardia ( n = 23, bilateral chest rales ( n = 29, cyanosis ( n = 22 and grade 2-4 encephalopathy. Hypoxemia was demonstrable in 24 cases and bilateral infiltrates on radiologic imaging in 29. Ten patients had evidence of high-altitude cerebral edema. All patients were managed with oxygen, steroids, nifedipine, sildenafil and other supportive measures including invasive ventilation ( n = 3. Three patients died due to multiorgan dysfunction. Conclusions: Altitude sickness is common among Amaranath Yatris from the plains and appropriate educational strategies should be invoked for prevention and prompt treatment.

  9. Intracorneal Ring Segments Implantation for Corneal Ectasia.

    Science.gov (United States)

    Giacomin, Natalia T; Mello, Glauco R; Medeiros, Carla S; Kiliç, Alyin; Serpe, Cristine C; Almeida, Hirlana G; Kara-Junior, Newton; Santhiago, Marcony R

    2016-12-01

    To provide an overview of the predictability, safety, and efficacy of intrastromal corneal ring segment (ICRS) implantation as a tool to improve visual acuity and its association with other techniques such as corneal collagen cross-linking (CXL), addressing biomechanical outcomes, models, surgical planning and technique, indications, contraindications, and complications in ectatic corneas. Literature review. ICRSs have been used to regularize the corneal shape and reduce corneal astigmatism and higher order aberrations, improve visual acuity to acceptable limits, and delay, or eventually prevent, a corneal keratoplasty in keratoconic eyes. Changes in ICRS thickness and size, combination of techniques, and the addition of femtosecond lasers to dissect more foreseeable channels represent an improvement toward more predictable results. Several studies have shown, over time, the long-term efficacy and safety of ICRS treatment for keratoconus, with variable predictability, maintaining the early satisfactory outcomes regarding visual acuity, keratometry, and corneal thickness. It is just as important to ensure that the disease will not progress as it is to improve the visual acuity. Therefore, many studies have shown combined techniques using ICRS implantation and CXL. Also, further limitations of ICRS implantation can be addressed when associated with phakic intraocular lens implantation and photorefractive keratectomy. ICRS implantation has shown effectiveness and safety in most cases, including combined procedures. In properly selected eyes, it can improve both refraction and vision in patients with keratoconus. [J Refract Surg. 2016;32(12):829-839.]. Copyright 2016, SLACK Incorporated.

  10. Comparison of characteristic CT findings of lymphedema, cellulitis, and generalized edema in lower leg swelling.

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    Shin, Sung Ui; Lee, Whal; Park, Eun-Ah; Shin, Cheong-Il; Chung, Jin Wook; Park, Jae Hyung

    2013-12-01

    To determine the different computed tomography (CT) findings of lymphedema, cellulitis, and generalized edema in the lower leg. CT images of 44 patients with confirmed lymphedema (n = 19), cellulitis (n = 11), or generalized edema (n = 14) were retrospectively reviewed. The following characteristics were evaluated: extent of edema, laterality, skin thickening, honeycombing, taller than wide appearance, muscle edema, conglomeration of septum of fat lobule, fluid collection, fascial enhancement, inguinal lymph node (LN) enlargement, medullary fat obliteration of inguinal LN, trunk subcutaneous edema, and bone marrow edema. Fisher's exact test with Bonferroni correction was used for multiple comparisons. Honeycombing and taller than wide appearance of fat lobules were more common in lymphedema (P edema of the trunk were more common in generalized edema (P edema and bone marrow edema were specific findings of generalized edema.

  11. Hemorrhagic Lacrimation and Epistaxis in Acute Hemorrhagic Edema of Infancy

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    Shireen Mreish

    2016-01-01

    Full Text Available Acute hemorrhagic edema of infancy is an uncommon benign cutaneous vasculitis. Despite its worrisome presentation, it carries good prognosis with rarely reported systemic involvement. Management of these cases has been an area of debate with majority of physicians adopting conservative modalities. We report a case that presented with classic triad of rash, low grade fever, and peripheral edema along with two rarely reported manifestations in literature: hemorrhagic lacrimation and epistaxis.

  12. Edema pulmonar agudo neurogênico: relato de caso

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    José Correia De Farias Brito

    1995-06-01

    Full Text Available Os autores apresentam um caso de edema pulmonar agudo numa paciente de 28 anos de idade acometida de hemorragia subaracnóidea secundária à rotura de aneurisma intracraniano. A sintomatologia respiratória ocorreu durante o agravamento do quadro neurológico. Alguns aspectos etiológicos e fisiopatogênicos do edema pulmonar agudo neurogênico são analisados.

  13. Post-tracheal extubation negative pressure pulmonary edema

    OpenAIRE

    Pinhal, F; Rebelo, L.; Mondim, V; Botelho, M.

    2014-01-01

    Pulmonary edema negative pressure (NPPE) also described in the literature as acute pulmonary edema or post-obstructing after extubation, corresponds to an unusual event, with an incidence of approximately 0.1% in anesthetized patients. ¹ The authors describe the case of NPPE occurred after tracheal extubation in a patient undergoing laparoscopic orchidectomy under general anesthesia. They report the pathophysiology, radiological and bronchoscopic pattern and therapeutic measures instituted.

  14. Insulin Edema in Newly Diagnosed Type 1 Diabetes Patient

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    Ayten Oğuz

    2016-09-01

    Full Text Available Insulin edema is a rare complication seen in patients with newly diagnosed, poorly controlled diabetes in a short period of time after starting intensive insulin therapy. It frequently limits itself. In this case report, we present an underweight patient with newly diagnosed type 1 diabetes mellitus who presented with diabetic ketosis and developed insulin edema following hydration and high-dose insulin therapy.

  15. Edema pulmonar agudo neurogênico: relato de caso

    OpenAIRE

    José Correia De Farias Brito; Maria Cerly Almeida Diniz; Roberto Ramalho Rosas; José Alberto Gonçalves Da Silva

    1995-01-01

    Os autores apresentam um caso de edema pulmonar agudo numa paciente de 28 anos de idade acometida de hemorragia subaracnóidea secundária à rotura de aneurisma intracraniano. A sintomatologia respiratória ocorreu durante o agravamento do quadro neurológico. Alguns aspectos etiológicos e fisiopatogênicos do edema pulmonar agudo neurogênico são analisados.

  16. Acute hemorrhagic edema of infancy-a rare entity

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    Saurabh R Jindal

    2013-01-01

    Full Text Available A patient presenting with fever and purpura often presents a diagnostic challenge for the dermatologist. Acute hemorrhagic edema of infancy (AHEI is a rare acute cutaneous leukocytoclastic vasculitic syndrome of infants leading to this presentation. We present an 18-month-old girl with AHEI who presented with fever, edema, and purpuric lesions involving the face, ears and extremities with uneventful complete recovery.

  17. Transient increase of fractional anisotropy in reversible vasogenic edema

    OpenAIRE

    Kimura-Ohba, Shihoko; Yang, Yi; Thompson, Jeffrey; Kimura, Tomonori; Salayandia, Victor M; Cosse, Melissa; Yang, Yirong; Sillerud, Laurel O.; Rosenberg, Gary A.

    2016-01-01

    Brain vasogenic edema, involving disruption of the blood-brain barrier, is a common pathological condition in several neurological diseases, with a heterogeneous prognosis. It is sometimes reversible, as in posterior reversible encephalopathy syndrome, but often irreversible and our current clinical tools are insufficient to reveal its reversibility. Here, we show that increased fractional anisotropy in magnetic resonance imaging is associated with the reversibility of vasogenic edema. Sponta...

  18. Relationship among Corneal Biomechanics, Anterior Segment Parameters, and Geometric Corneal Parameters

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    Sadık Görkem Çevik

    2016-01-01

    Full Text Available Purpose. To investigate the relationship between corneal biomechanical parameters, anterior segment parameters, and geometric corneal parameters in a healthy Caucasian group. Methods. This retrospective study included the healthy eyes with best corrected visual acuity of at least 20/40 of 122 Caucasian subjects. The anterior segment parameters and geometric corneal parameters such as corneal volume, central corneal thickness, horizontal and vertical corneal radii, anterior and posterior steep, and flat keratometric values were measured with a Scheimpflug camera. The biomechanical properties were measured with Ocular Response Analyzer. Results. One hundred and twenty-two healthy Caucasian subjects (67 males, 55 females with a mean age of 45.32±20.23 were enrolled. Both corneal hysteresis and corneal resistance factor were positively correlated with CCT (r=0.529, p<0.001; r=0.638, p<0.001 and CV (r=0.635, p<0.001; r=0.579, p<0.001 and negatively correlated with age (r=-0.373, p<0.001; r=-0.249, p<0.001. Both in age-gender and multivariate models, CH and CRF had statistically significant negative association with the posterior steep K value. Conclusions. CH and CRF are negatively correlated with posterior steep and average posterior K values.

  19. The scale of substratum topographic features modulates proliferation of corneal epithelial cells and corneal fibroblasts.

    Science.gov (United States)

    Liliensiek, S J; Campbell, S; Nealey, P F; Murphy, C J

    2006-10-01

    The cornea is a complex tissue composed of different cell types, including corneal epithelial cells and keratocytes. Each of these cell types are directly exposed to rich nanoscale topography from the basement membrane or surrounding extracellular matrix. Nanoscale topography has been shown to influence cell behaviors, including orientation, alignment, differentiation, migration, and proliferation. We investigated whether proliferation of SV40-transformed human corneal epithelial cells (SV40-HCECs), primary human corneal epithelial cells (HCECs), and primary corneal fibroblasts is influenced by the scale of topographic features of the substratum. Using basement membrane feature sizes as our guide and the known dimensions of collagen fibrils of the corneal stroma (20-60 nm), we fabricated polyurethane molded substrates, which contain anisotropic feature sizes ranging from 200-2000 nm on pitches ranging from 400 to 4000 nm (pitch = ridge width + groove width). The planar regions separating each of the six patterned regions served as control surfaces. Primary corneal and SV40-HCEC proliferation decreased in direct response to decreasing nanoscale topographies down to 200 nm. In contrast to corneal epithelial cells, corneal fibroblasts did not exhibit significantly different response to any of the topographies when compared with planar controls at 5 days. However, decreased proliferation was observed on the smallest feature sizes after 14 days in culture. Results from these experiments are relevant in understanding the potential mechanisms involved in the control of proliferation and differentiation of cells within the cornea. (c) 2006 Wiley Periodicals, Inc

  20. [The influence of corneal hysteresis and corneal resistance factor on the measurement of intraocular pressure].

    Science.gov (United States)

    Hager, A; Schroeder, B; Sadeghi, M; Grossherr, M; Wiegand, W

    2007-06-01

    The influence of central corneal thickness (CCT) on the measurement of intraocular pressure (IOP) has been discussed extensively in recent years. The problem, however, has not been solved so far. In addition to CCT there are probably further biomechanical properties that play a role in IOP measurement. We wanted to find out whether these properties are related to Goldmann applanation tonometry (GAT), noncontact tonometry (NCT), or CCT. Biomechanical properties of the cornea such as corneal hysteresis (CH) and corneal resistance factor (CRF) can be measured with the Ocular Response Analyzer (ORA, Reichert Ophthalmic Instruments, Depew, NY, USA). Furthermore, a corneal compensated IOP (IOPcc) is given. We examined 156 normal eyes of 80 patients who did not show corneal pathology nor glaucoma. In each eye GAT, NCT, and ORA data as well as CCT were measured. Data were statistically analyzed with respect to agreement and the influence of CH and CRF on IOP measurement. In our patients the following average values were calculated: GAT 14.8+/-3.0 mmHg, NCT 16.4+/-3.9 mmHg, IOPcc 16.2+/-4.1 mmHg, CH 10.6+/-2.3 mmHg, CRF 10.9+/-2.4 mmHg, and CCT 557+/-36 microm. IOPcc was not related to CCT in normal eyes and the only IOP value related to CH (pcorneal thickness. Corneal hysteresis and corneal resistance factor provide further information about biomechanical properties of the cornea beyond central corneal thickness.

  1. Corneal Thickness During Corneal Collagen Cross-Linking with Isotonic Riboflavin Solution without Dextran

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    Refik Oltulu

    2014-08-01

    Full Text Available Objectives: To monitor the corneal thickness change during the dextran-free isotonic riboflavin solution-aided corneal collagen crosslinking procedure in keratoconus patients. Materials and Methods: Corneal thickness measurements during the corneal collagen cross-linking (CXL treatment for progressive keratoconus were evaluated. The corneal thickness measurements were obtained with ultrasonic pachymetry device at five different time points: 0, 15, and 30 minutes after epithelial removal and 15 and 30 minutes after the initiation of UVA irradiation. Results: Twenty-four eyes of 24 patients with progressive keratoconus were included in the study. The thinnest pachymetric values obtained at the 0, 15, and 30 minute measurements after corneal deepithelisation were 409.38±10.43 µm (383-435 µm, 434.56±17.68 µm (400-485 µm, and 457.44±21.78 µm (428-516 µm, respectively. Pachymetric values obtained at 15 and 30 minutes after UVA application to the cornea were 471.69±23.38 µm (439-526 µm and 482.63±23.69 µm (436-524 µm, respectively. The gradual increase was found to be statistically significant when each measurement was compared with the previous values (p<0.001. Conclusion: We found that the corneal thickness was not decreased during the CXL with dextran-free isotonic riboflavin solution; on the contrary, corneal thickness was increased regularly during the procedure. (Turk J Ophthalmol 2014; 44: 272-4

  2. Spatial and temporal variations in extracellular matrix of periocular and corneal regions during corneal stromal development.

    Science.gov (United States)

    Doane, K J; Ting, W H; McLaughlin, J S; Birk, D E

    1996-03-01

    The development of the avian corneal stroma occurs in discrete developmental stages. During this sequence of events, the neural crest-derived corneal fibroblast precursor cells are surrounded by distinct extracellular matrices which change both spatially and temporally. To elucidate the role of these matrices, extracellular matrix components in the periocular mesenchyme and cornea were analysed prior to and during migration and differentiation of corneal fibroblasts using antibodies against collagens, proteoglycans and glycoproteins. Previous work has concentrated on the matrix of the corneal stroma rather than the matrix of the periocular mesenchyme. Since the precursors of the corneal fibroblasts are present within the must migrate through the periocular mesenchyme prior to entry into the cornea proper, this environment was fully evaluated. The present study documents the matrix composition of both the cornea and periocular mesenchyme at developmental stages that are prior to and after initiation of corneal invasion by the corneal fibroblast precursors. Variations in matrix molecules comprising both the periocular mesenchyme and cornea were demonstrated. These include changes in the distribution of collagen types I, II, III, IV and VI; the proteoglycans decorin and lumican; as well as the adhesive glycoproteins tenascin, fibronectin and laminin. It is hypothesized that the variations in matrix localization are important in the regulation of cell migration and differentiation during normal corneal development. Any regulation is likely to involve a combination of components found in the extracellular matrices and therefore, a consideration of the matrix rather than isolated components is required.

  3. Aquaporin-4: A Potential Therapeutic Target for Cerebral Edema

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    Guanghui Tang

    2016-09-01

    Full Text Available Aquaporin-4 (AQP4 is a family member of water-channel proteins and is dominantly expressed in the foot process of glial cells surrounding capillaries. The predominant expression at the boundaries between cerebral parenchyma and major fluid compartments suggests the function of aquaporin-4 in water transfer into and out of the brain parenchyma. Accumulating evidences have suggested that the dysregulation of aquaporin-4 relates to the brain edema resulting from a variety of neuro-disorders, such as ischemic or hemorrhagic stroke, trauma, etc. During edema formation in the brain, aquaporin-4 has been shown to contribute to the astrocytic swelling, while in the resolution phase, it has been seen to facilitate the reabsorption of extracellular fluid. In addition, aquaporin-4-deficient mice are protected from cytotoxic edema produced by water intoxication and brain ischemia. However, aquaporin-4 deletion exacerbates vasogenic edema in the brain of different pathological disorders. Recently, our published data showed that the upregulation of aquaporin-4 in astrocytes probably contributes to the transition from cytotoxic edema to vasogenic edema. In this review, apart from the traditional knowledge, we also introduce our latest findings about the effects of mesenchymal stem cells (MSCs and microRNA-29b on aquaporin-4, which could provide powerful intervention tools targeting aquaporin-4.

  4. Pathophysiology, Evaluation and Management of Edema in Childhood Nephrotic Syndrome

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    Demetrius eEllis

    2016-01-01

    Full Text Available Generalized edema is a major presenting clinical feature of children with nephrotic syndrome (NS exemplified by such primary conditions as minimal change disease (MCD. In these children with classical NS and marked proteinuria and hypoalbuminemia, the ensuing tendency to hypovolemia triggers compensatory physiologic mechanisms which enhance renal sodium (Na+ and water retention; this is known as the underfill hypothesis. Edema can also occur in secondary forms of NS and several other glomerulonephritides, in which the degree of proteinuria and hypoalbuminemia, are variable. In contrast to MCD, in these latter conditions the predominant mechanism of edema formation is primary or pathophysiologic, Na+ and water retention; this is known as the overfill hypothesis. A major clinical challenge in children with these disorders is to distinguish the predominant mechanism of edema formation, identify other potential contributing factors, and prevent the deleterious effects of diuretic regimens in those with unsuspected reduced effective circulatory volume (i.e., underfill. This article reviews the Starling forces that become altered in NS so as to tip the balance of fluid movement in favor of edema formation. An understanding of these pathomechanisms then serves to formulate a more rational approach to prevention, evaluation and management of such edema

  5. Pathophysiology of lower extremity edema in acute heart failure revisited.

    Science.gov (United States)

    Breidthardt, Tobias; Irfan, Affan; Klima, Theresia; Drexler, Beatrice; Balmelli, Cathrin; Arenja, Nisha; Socrates, Thenral; Ringger, Rebekka; Heinisch, Corinna; Ziller, Ronny; Schifferli, Jürg; Meune, Christophe; Mueller, Christian

    2012-11-01

    The pathophysiology and key determinants of lower extremity edema in patients with acute heart failure are poorly investigated. We prospectively enrolled 279 unselected patients presenting to the Emergency Department with acute heart failure. Lower extremity edema was quantified at predefined locations. Left ventricular ejection fraction, central venous pressure quantifying right ventricular failure, biomarkers to quantify hemodynamic cardiac stress (B-type natriuretic peptide), and the activity of the arginine-vasopressin system (copeptin) also were recorded. Lower extremity edema was present in 218 (78%) patients and limited to the ankle in 22%, reaching the lower leg in 40%, reaching the upper leg in 11%, and was generalized (anasarca) in 3% of patients. Patients in the 4 strata according to the presence and extent of lower leg edema had comparable systolic blood pressure, left ventricular ejection fraction, central venous pressure, and B-type natriuretic peptide levels, as well as copeptin and glomerular filtration rate (P=NS for all). The duration of dyspnea preceding the presentation was longer in patients with more extensive edema (P=.006), while serum sodium (P=.02) and serum albumin (P=.03) was lower. Central venous pressure, hemodynamic cardiac stress, left ventricular ejection fraction, and the activity of the arginine-vasopressin system do not seem to be key determinants of the presence or extent of lower extremity edema in acute heart failure. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. Pathophysiology, Evaluation, and Management of Edema in Childhood Nephrotic Syndrome.

    Science.gov (United States)

    Ellis, Demetrius

    2015-01-01

    Generalized edema is a major presenting clinical feature of children with nephrotic syndrome (NS) exemplified by such primary conditions as minimal change disease (MCD). In these children with classical NS and marked proteinuria and hypoalbuminemia, the ensuing tendency to hypovolemia triggers compensatory physiological mechanisms, which enhance renal sodium (Na(+)) and water retention; this is known as the "underfill hypothesis." Edema can also occur in secondary forms of NS and several other glomerulonephritides, in which the degree of proteinuria and hypoalbuminemia, are variable. In contrast to MCD, in these latter conditions, the predominant mechanism of edema formation is "primary" or "pathophysiological," Na(+) and water retention; this is known as the "overfill hypothesis." A major clinical challenge in children with these disorders is to distinguish the predominant mechanism of edema formation, identify other potential contributing factors, and prevent the deleterious effects of diuretic regimens in those with unsuspected reduced effective circulatory volume (i.e., underfill). This article reviews the Starling forces that become altered in NS so as to tip the balance of fluid movement in favor of edema formation. An understanding of these pathomechanisms then serves to formulate a more rational approach to prevention, evaluation, and management of such edema.

  7. [Macular Edema in Uveitis - Steroids or VEGF Inhibitors?

    Science.gov (United States)

    Heinz, Carsten; Heiligenhaus, Arnd

    2017-06-09

    Macular edema in uveitis patients is certainly the most frequent complication leading to a permanent and irreversible reduction in vision during the course of the disease. Thanks to optical coherence tomography (OCT) technology and fluorescein angiography (FAG), significantly more macular edemas are detected. Macular edema can be found in various uveitis varieties and can show different clinical patterns. All macular edema should be treated. Macular edema with active inflammation usually reacts very well to general uveitis treatment. In the case of eyes without visible inflammation, however, the response to such therapy is usually less effective. According to the latest treatment recommendations, dexamethasone implants should be used as the first intravitreal therapy. Vascular endothelial growth factor inhibitors (VEGF inhibitors) are second-line treatment regimens. The choice of therapy is, therefore, primarily based on the degree of inflammation and the individual complications, such as glaucoma, lens situation or previous increase in IOP after steroid administration. These individual complications may allow using VEGF inhibitors as first line treatment. An improvement in the macular edema can be achieved with both groups of active substances. Georg Thieme Verlag KG Stuttgart · New York.

  8. Diagnosis, prevention and management of postoperative pulmonary edema.

    Science.gov (United States)

    Bajwa, Sj Singh; Kulshrestha, A

    2012-07-01

    Postoperative pulmonary edema is a well-known postoperative complication caused as a result of numerous etiological factors which can be easily detected by a careful surveillance during postoperative period. However, there are no preoperative and intraoperative criteria which can successfully establish the possibilities for development of postoperative pulmonary edema. The aims were to review the possible etiologic and diagnostic challenges in timely detection of postoperative pulmonary edema and to discuss the various management strategies for prevention of this postoperative complication so as to decrease morbidity and mortality. The various search engines for preparation of this manuscript were used which included Entrez (including Pubmed and Pubmed Central), NIH.gov, Medknow.com, Medscape.com, WebMD.com, Scopus, Science Direct, MedHelp.org, yahoo.com and google.com. Manual search was carried out and various text books and journals of anesthesia and critical care medicine were also searched. From the information gathered, it was observed that postoperative cardiogenic pulmonary edema in patients with serious cardiovascular diseases is most common followed by noncardiogenic pulmonary edema which can be due to fluid overload in the postoperative period or it can be negative pressure pulmonary edema (NPPE). NPPE is an important clinical entity in immediate post-extubation period and occurs due to acute upper airway obstruction and creation of acute negative intrathoracic pressure. NPPE carries a good prognosis if promptly diagnosed and appropriately treated with or without mechanical ventilation.

  9. Intraocular pressure, corneal thickness, and corneal hysteresis in Steinert's myotonic dystrophy.

    Science.gov (United States)

    Garcia Filho, Carlos Alexandre de A; Prata, Tiago Santos; Sousa, Aline Katia Siqueira; Doi, Larissa Morimoto; Melo Jr, Luiz Alberto Soares

    2011-01-01

    Low intraocular pressure (IOP) measured by Goldmann applanation tonometry (GAT) is one of the ocular manifestations of Steinert's myotonic dystrophy. The goal of this study was to evaluate the corneal-compensated IOP as well as corneal properties (central corneal thickness and corneal hysteresis) in patients with myotonic dystrophy. A total of 12 eyes of 6 patients with Steinert's myotonic dystrophy (dystrophy group) and 12 eyes of 6 age-, race-, and gender-matched healthy volunteers (control group) were included in the study. GAT, Dynamic Contour Tonometry (DCT-Pascal) and Ocular Response Analyzer (ORA) were used to assess the IOP. Central corneal thickness was obtained by ultrasound pachymetry, and corneal hysteresis was analyzed using the ORA device. In light of the multiplicity of tests performed, the significance level was set at 0.01 rather than 0.05. The mean (standard deviation [SD]) GAT, DCT, and corneal-compensated ORA IOP in the dystrophy group were 5.4 (1.4) mmHg, 9.7 (1.5) mmHg, and 10.1 (2.6) mmHg, respectively. The mean (SD) GAT, DCT, and corneal-compensated ORA IOP in the control group was 12.6 (2.9) mmHg, 15.5 (2.7) mmHg, and 15.8 (3.4) mmHg, respectively. There were significant differences in IOP values between dystrophy and control groups obtained by GAT (mean, -7.2 mmHg; 99% confidence interval [CI], -10.5 to -3.9 mmHg; Pcorneal-compensated ORA measurements (mean, -5.7 mmHg; 99% CI, -10.4 to -1.0 mmHg; P=0.003). The mean (SD) central corneal thickness was similar in the dystrophy (542 [31] µm) and control (537 [11] µm) groups (P=0.65). The mean (SD) corneal hysteresis in the dystrophy and control groups were 11.2 (1.5) mmHg and 9.7 (1.2) mmHg, respectively (P=0.04). Patients with Steinert's myotonic dystrophy showed lower Goldmann and corneal-compensated IOP in comparison with healthy individuals. Since central corneal thickness and corneal hysteresis did not differ significantly between groups, the lower IOP readings documented in this

  10. Lung ultrasound for monitoring cardiogenic pulmonary edema.

    Science.gov (United States)

    Cortellaro, Francesca; Ceriani, Elisa; Spinelli, Monica; Campanella, Carlo; Bossi, Ilaria; Coen, Daniele; Casazza, Giovanni; Cogliati, Chiara

    2017-10-01

    Several studies address the accuracy of lung ultrasound (LUS) in the diagnosis of cardiogenic pulmonary edema (CPE) evaluating the interstitial syndrome, which is characterized by multiple and diffuse vertical artifacts (B-lines), and correlates with extravascular lung water. We studied the potential role of LUS in monitoring CPE response to therapy, by evaluating the clearance of interstitial syndrome within the first 24 h after Emergency Department (ED) admission. LUS was performed at arrival (T0), after 3 (T3) and 24 (T24) hours. Eleven regions were evaluated in the antero-lateral chest; the B-lines burden was estimated in each region (0 = no B-lines, 1 = multiple B-lines, 2 = confluent B-lines/white lung) and a mean score (B-Score, range 0-2) was calculated. Patients received conventional CPE treatment. Blood chemistry, vital signs, blood gas analysis, diuresis at T0, T3, T24 were also recorded. A complete echocardiography was obtained during hospitalization. Forty-one patients were enrolled. Respiratory and hemodynamic parameters improved in all patients between T0 and T3 and between T3 and T24. Mean B-score significantly decreased at T3 (from 1.59 ± 0.40 to 0.73 ± 0.44, P < 0.001) and between T3 and T 24 (from 0.73 ± 0.44 to 0.38 ± 0.33, P < 0.001). B-score was higher in the lower pulmonary regions at any time. At final evaluation (T24) 75 % of apical and only 38 % of basal regions were cleared. LUS allows one to assess the clearance of interstitial syndrome and its distribution in the early hours of treatment of CPE, thus representing a possible tool to guide therapy titration.

  11. The corneal volume and biomechanical corneal factors: Is there any orrelation?

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    Mohammad Reza Sedaghat

    2012-01-01

    Full Text Available Background: The aim of this study was to determine the correlation between corneal hysteresis (CH and the corneal resistance factor (CRF, which are both novel methods of analyzing ocular rigidity/elasticity, and various corneal cha-racteristics, mainly corneal volume in normal subjects. Methods: This cross-sectional study included 500 normal eyes of volunteers. An ocular response analyzer (ORA was used to measure CH and CRF. Patient age and the Pentacam-measured corneal volume (CV, posterior elevation, ante-rior elevation, corneal curvature, central corneal thickness (CCT, corneal thickness of apex (CTA, and corneal thinnest thickness (CTT were compared with CH and CRF. Statistical significance was defined at p < 0.05. Results: The mean CH and CRF for all eyes were 9.9 ± 1.4 mmHg and 10.1 ± 1.6 mmHg, respectively. The mean CVs of the 3, 5, 7, and 10 mm zones for all eyes were 3.8 ± 0.2 mm3, 11.2 ± 0.6 mm3, 24.3 ± 1.4 mm3, and 60.1 ± 3.5 mm3, respectively. The correlations between CV and the hysteresis or CRF were significant in all zones. The CV of the 7-mm zone had the strongest correlation with CH (r = 0.438 and the CV of the 5-mm zone had the strongest correlation with CRF (r = 0.574. Conclusions: CH and CRF correlate with CV. Moreover, the correlation between CV and CRF is stronger than that between CV and CH. The CV may be valuable for determining patient′s qualification for and predicting the outcome of refractive surgery. It would also be helpful in other cases in which corneal biomechanics are important.

  12. Reliability of the Effect of Artificial Anterior Chamber Pressure and Corneal Drying on Corneal Graft Thickness.

    Science.gov (United States)

    Romano, Vito; Steger, Bernhard; Chen, Jern Y; Hassaan, Sherif; Batterbury, Mark; Willoughby, Colin E; Ahmad, Sajjad; Elsheikh, Ahmed; Kaye, Stephen B

    2015-08-01

    To investigate the effect of artificial anterior chamber (AAC) pressure and corneal drying on the graft thickness in preparation for Descemet stripping automated endothelial keratoplasty. Twenty-seven corneoscleral discs were placed in an AAC. The AAC pressure (15, 45, 92, 109, and 198 mm Hg) was controlled using the height of an infusion bottle and a roller clamp. The endothelium was removed in 1 subgroup. Corneas were exposed to room air or repeatedly dried using cellulose spears. Central corneal thickness was measured every 90 seconds for the first 15 minutes and again at 20 minutes using an ultrasound pachymeter (SP-100, Tomey). There was a significant linear relationship between the corneal thickness and both AAC pressure and corneal drying. Very high coefficients of determination and narrow 95% confidence intervals were present, in particular for high pressures and drying. The rate of thinning increased with increasing pressure and drying to 1.6% per minute. At the maximum rate of thinning, a 10% reduction in corneal thickness occurred in 6 minutes or 100 μm in 8.8 minutes. Removal of the corneal endothelium reduced the rate of thinning to 0.3% per minute (R = 0.72). Increasing AAC pressure and corneal drying reduced the graft thickness at a very predictable rate. Adequate corneal thinning can be achieved by increasing the pressure in the AAC by closing the clamp followed by removal of the residual corneal epithelium and repeated drying with a cellulose spear for 5 to 10 minutes, depending on the initial corneal thickness. This method is simple and is both suitable for use in the eye bank and by the surgeon.

  13. Desarrollo tecnológico de una formulación de cloruro de sodio al 5 % para el tratamiento del edema corneal en Cuba Technological development of a 5 % sodium chloride formula for treatment of corneal edema in Cuba

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    Anna Karelia Collado Coello

    2010-12-01

    Full Text Available Se desarrolló una formulación para uso oftálmico, que contenía cloruro de sodio al 5 %, estable desde el punto de vista físico, químico y microbiológico. Se realizaron los estudios de formulación correspondientes, seleccionándose la composición y procedimiento tecnológico más adecuados. Además, se estudió la efectividad antimicrobiana de los preservativos antimicrobianos empleados según se establece en la Farmacopea de los Estados Unidos 30 y se comprobó la seguridad del uso de este medicamento a través de los resultados del ensayo de irritabilidad oftálmica. Se elaboraron 3 lotes del medicamento y se envasaron en frascos plásticos de polietileno de baja densidad con tapa de polipropileno de alta densidad y se almacenaron a temperatura ambiente durante 24 meses; se estudió su estabilidad física y química por el método acelerado y de vida de estante. Se comprobó su estabilidad microbiológica a cada uno de los lotes elaborados, al inicio y final del estudio, según se establece en la Farmacopea de los Estados Unidos 30, y se obtuvieron resultados satisfactorios. Todos los resultados cumplieron con los límites de calidad establecidos en la literatura oficial para este tipo de forma farmacéutica, por lo que se concluyó que el medicamento desarrollado está correctamente formulado desde el punto de vista galénico con un tiempo de vida útil de 24 meses almacenado bajo las condiciones estudiadas, demostrado según el otorgamiento del certificado de registro por el organismo regulador (Centro Estatal para el Control de Medicamentos, CECMED. Finalmente el medicamento fue introducido al nivel industrial sin que se presentaran problemas tecnológicos.A formula for ophthalmic use was developed containing 5 % sodium chloride stable from the physical, chemical and microbiological point of view. Studies of corresponding formulae were conducted selecting the more suitable composition and technological procedure. Also, the antimicrobial effectiveness of animicrobials preservatives used according to United States Pharmacopeia was studied demonstrating the safe use of this drug by the results of the ophthalmic irritability trial. Three batchs of this drug were elaborated packing in low density polyethylene plastic flasks with a high density polypropylene top stored at room temperature during 24 monhts and its physical and cchemical stability was studied y accelerated method and of shield-life. At onset and the end of study microbiological stability was demonstrate in each of batches made (30, according to USP with satisfactory results. All results fulfill with the established quality limits in official literature for this type of pharmaceutical way concluding that this developeddrug is appropriately formulated fro the doctoral point of view with a useful life time of 24 months stored under study conditions, demonstrated according to award of registry certificate by regulator institution (State Center for Drugs' Control, CECMED. Finally, the drug was introduced at industrial level without technological problems.

  14. Human tears reveal insights into corneal neovascularization.

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    Zakaria, Nadia; Van Grasdorff, Sigi; Wouters, Kristien; Rozema, Jos; Koppen, Carina; Lion, Eva; Cools, Nathalie; Berneman, Zwi; Tassignon, Marie-José

    2012-01-01

    Corneal neovascularization results from the encroachment of blood vessels from the surrounding conjunctiva onto the normally avascular cornea. The aim of this study is to identify factors in human tears that are involved in development and/or maintenance of corneal neovascularization in humans. This could allow development of diagnostic tools for monitoring corneal neovascularization and combination monoclonal antibody therapies for its treatment. In an observational case-control study we enrolled a total of 12 patients with corneal neovascularization and 10 healthy volunteers. Basal tears along with reflex tears from the inferior fornix, superior fornix and using a corneal bath were collected along with blood serum samples. From all patients, ocular surface photographs were taken. Concentrations of the pro-angiogenic cytokines interleukin (IL)-6, IL-8, Vascular Endothelial Growth Factor (VEGF), Monocyte Chemoattractant Protein 1 (MCP-1) and Fas Ligand (FasL) were determined in blood and tear samples using a flow cytometric multiplex assay. Our results show that the concentration of pro-angiogenic cytokines in human tears are significantly higher compared to their concentrations in serum, with highest levels found in basal tears. Interestingly, we could detect a significantly higher concentration of IL- 6, IL-8 and VEGF in localized corneal tears of patients with neovascularized corneas when compared to the control group. This is the first study of its kind demonstrating a significant difference of defined factors in tears from patients with neovascularized corneas as compared to healthy controls. These results provide the basis for future research using animal models to further substantiate the role of these cytokines in the establishment and maintenance of corneal neovascularization.

  15. Phototherapeutic Keratectomy Outcomes in Superficial Corneal Opacities

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    Khalid Al Arfaj

    2011-01-01

    Full Text Available Purpose Compare the effectiveness of Phototherapeutic keratectomy (PTK in treatment corneal dystrophies versus superficial corneal scars: visual outcomes, recurrence rate and safety profile. Methods PTK was performed in 51 eyes of 51 patients. Data regarding the indications for PTK, ablation depth, symptomatic relief, pre-and postoperative best spectacle-corrected visual acuity (BSCVA, spherical equivalent changes, recurrence and complications were analyzed. The indications for PTK in our study were classified into two categories – group A: patients with corneal dystrophies (n = 23 and the other group B (n = 28 with other indications. Results The average age of the patients was 47 years (±16.4. The mean follow up period was 15.16 months (±10.01 months. Post operatively, there were no significant complications. While the overall BSCVA in the patients improved from 20/41 (0.484 to 20/32 (0.645, group A showed improvement from 20/35 (0.561 to 20/29 (0.687, as compared to group B in which BSCVA improved from 20/47 (0.421 to 20/33 (0.611. The most common indication in group A was granular corneal dystrophy (n = 10 and the most common indication in group B was post traumatic/infectious corneal scar or opacity (n = 10. Eighty-six percent (n = 44 of all patients had alleviation of symptoms. Recurrence of symptoms was seen in 3 eyes of recurrent corneal erosions which required retreatment. Conclusion PTK is a safe and effective procedure. The outcome of this study suggests that PTK improves BSCVA. PTK appears to improve ocular surface health. Furthermore, PTK can be recommended to most patients with corneal dystrophies as a treatment modality prior to other more invasive procedure (viz. penetrating keratoplasty.

  16. Herpetic keratouveitis mixed with bilateral Pseudomonas corneal ulcers in vitamin A deficiency

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    Hung-Yuan Hsu

    2015-02-01

    Full Text Available A 56-year-old woman complained of blurred vision and pain in her right eye for several days. Slit lamp examination revealed a large epithelial defect and disciform stromal edema with ring infiltration in her right cornea. Unfortunately, hypopyon and purulent discharge subsequently developed in both eyes. Herpetic keratouveitis and a superimposed pseudomonas infection were diagnosed. A systemic review on the patient showed malnutrition due to her dietary preference and vegetarianism. After the infection was controlled, bilateral epithelial defects persisted for a long time. We performed amniotic membrane transplantation on both eyes and the clinical status improved with administration of vitamin and protein supplements. Although rare in Taiwan, vitamin A deficiency should be kept in mind when conjunctival and corneal xerosis occurred. Vitamin A supplements are suggested because of the increased susceptibility to infection in patients with this clinical status.

  17. Sensitivity of the corneal-plane refractive compensation to change in power and axial position of an intraocular lens

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    W. F. Harris

    2009-12-01

    Full Text Available If an intraocular lens is displaced or if its power is changed what are the consequences for the refractive compensation of the eye?  Gaussian optics is used to obtain explicit formulae for the sensitivityof the corneal-plane refractive compensation (also called the refraction, refractive state, etc to change in power and axial displacement of a thin intraocular lens implanted in a simple eye.  In particular, for a pseudophakic Gullstrand simplified eye with intraocular lens placed 5 mm behind the cornea the sensitivity to errors in the power of the intraocular lens is about  71 . 0 − 71 for an intraocular lens of power   for an intraocular lens of power 20 D, that is, the refractive compensation decreases by about 0.71 dioptres per dioptre increase in the power of the intraocular lens.  More generally the sensitivity is approximately  ( m   0037 . 0 63 . 0 F − − 0.63 ( 003 . 0 63 . 0 − − (0.0037mF where FI is the power of the intraocular lens.  Also for Gullstrand’s simplified eye the sensitivity of refractive compensation to axial displacement of the intraocular lens is approximately linear in FI about  (64D FI, in fact.  That is, for each dioptre of the power of the intraocular lens the refractive compensation increases by about 0.064 dioptres per millimetre of axial displacement towards the retina. 

  18. Development of a rabbit corneal equivalent using an acellular corneal matrix of a porcine substrate.

    Science.gov (United States)

    Xu, Yong-Gen; Xu, Yong-Sheng; Huang, Chen; Feng, Yun; Li, Ying; Wang, Wei

    2008-01-01

    The tissue equivalent that mimics the structure and function of normal tissue is a major bioengineering challenge. Tissue engineered replacement of diseased or damaged tissue has become a reality for some types of tissue such as skin and cartilage. The tissue engineered corneal epithelium, stroma, and endothelium scaffold are promising concepts in overcoming the current limitations of a cornea replacement with an allograft. The acellular corneal matrix from porcine (ACMP) was examined as a potential corneal cell sheet frame. The physical and mechanical properties of strength, expansion, transparency, and water content of the ACMP were measured. The major antigens of the cell components were completely removed with series of extraction methods, the major antigens of the cell components were identified by hematoxylin and eosin (HE), immunofluorescence staining, and scanning electron microscopy. The structural properties were investigated by HE stain and scanning electron microscopy. The three types of rabbit corneal cells were cultured in vitro, and characteristics were investigated by colony formation efficiency (CFE), BrdU staining, immunofluorescence staining, and western blot assay of keratin 3 (K3), vimentin, and aquaporin A. The biocompatibility of the ACMP was investigated for one month using rabbit corneal stroma and three types of cultured corneal cells both in vivo and in vitro. The three types of cultured rabbit corneal cells were seeded onto ACMP of each side at a cell density of 5.0 x 10(3) cells/mm(2). The optical and mechanical properties of the ACMP were similar to the normal porcine cornea. The collagen fiber interconnected to the network, formed regular collagen bundles of the ACMP, and was parallel to the corneal surface. The ACMP was transferred to the rabbit cornea stroma, which showed an intact epithelium and keratocytes in the implant region. There were no inflamed cells or new vessel invasion one month after transplantation. The three types of

  19. Corneal biomechanical properties and intraocular pressure in high myopic anisometropia.

    Science.gov (United States)

    Xu, Suzhong; Xu, Aiqin; Tao, Aizhu; Wang, Jianhua; Fan, Fan; Lu, Fan

    2010-07-01

    To investigate corneal biomechanical properties and intraocular pressure (IOP) in patients with high myopic anisometropia. Patients with high myopic anisometropia (n = 23) and emmetropic subjects (n = 55) were enrolled. Corneal hysteresis (CH), Goldmann-correlated intraocular pressure (IOPg), corneal resistance factor, and corneal-compensated IOP (IOPcc) were measured with Ocular Response Analyzer. Central corneal thickness was measured by optical coherence tomography. Zeiss IOL-Master determined the values of corneal refractive power and ocular axial length. Significant differences were presented in CH, IOPg, and IOPcc among the high myopic, contralateral, and normal eyes (analysis of variance, Panisometropia. High myopic eyes showed decreased CH, but not corneal resistance factor, which indicates that some aspects of corneal biomechanical properties may be altered in high myopic eye of anisometropia. It is also suggested that anisometropic eyes with different refractive errors do not share the same biomechanical properties, which may impact IOP measurement.

  20. 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.

  1. Peritumoral brain edema in intracranial meningiomas Edema peritumoral em meningiomas intracranianos

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    Nelson de Azambuja Pereira-Filho

    2010-06-01

    Full Text Available Occurrence of peritumoral brain edema (PBE in meningiomas has been associated with several factors in recent years, although its pathophysiological mechanism has not yet been fully elucidated. The aim of this study was to analyze the correlation between the presence / degree of PBE and factors such as gender, age, size and histological subtype of tumor. We analyzed the MRI images of 74 patients operated on Hospital Beneficência Portuguesa de Porto Alegre for the presence / degree of PBE and data was statistically correlated with the parameters of the patient. PBE was present in 70.1% of patients. Tumors with higher volume had more PBE. Tumors of the olfactory groove showed more PBE than sphenoid wing and parassagittal tumors. Transitional subtype showed more PBE than fibroblastic and meningothelial subtypes.A presença de edema cerebral peritumoral (ECP em meningiomas tem sido associada a diversos fatores nos últimos anos, embora o seu mecanismo fisiopatológico ainda não tenha sido inteiramente elucidado. O objetivo desse estudo foi analisar a correlação entre a presença/grau de ECP e fatores como sexo, idade, volume e subtipo histológico do tumor. Foram analisadas imagens de RM de 74 pacientes operados no Hospital Beneficência Portuguesa de Porto Alegre quanto à presença/grau de ECP e os dados correlacionados estatisticamente com os parâmetros do paciente. ECP estava presente em 70,1% dos pacientes. Tumores com maior volume apresentaram mais ECP. Tumores da goteira olfatória apresentaram mais ECP que os da asa do esfenóide e que os parassagitais. Meningiomas transicionais apresentaram mais ECP que os fibroblásticos e que os meningoteliais.

  2. [Use of the confocal laser scanning method for determining corneal topography and corneal tissue effects in refractive corneal surgery].

    Science.gov (United States)

    Koop, N; Brinkmann, R; Schirner, G

    1996-06-01

    Refraction of the cornea head been generally measured with ophthalmometers or computer disk keratometers. We therefore used a confocal laser scanning system for measurement of the corneal topography. Enucleated tonicized pig eyes were measured before and after laser thermokeratoplasty (LTK). The topographical data were used to determine refraction and refractive change; the data were stored digitally. The single images and their differences were displayed on a PC. Unlike conventional ophthalmometry, confocal laser scanning can demonstrate the topographical shape, showing the overall topography of the cornea and local corneal effects, e.g., coagulation, mechanical lesions or high-energy laser effects. Topographical laser scanning has proven to be a generally useful method of determining refraction and surface alterations in corneal refractive surgery.

  3. 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

  4. Corneal collagen cross-linking outcomes: review.

    Science.gov (United States)

    Jankov Ii, Mirko R; Jovanovic, Vesna; Delevic, Sladjana; Coskunseven, Efekan

    2011-02-11

    Keratoconus is a condition characterized by biomechanical instability of the cornea, presenting in a progressive, asymmetric and bilateral way. Corneal collagen cross-linking with riboflavin and UVA (CXL) is a new technique of corneal tissue strengthening that combines the use of riboflavin as a photo sensitizer and UVA irradiation. The studies showed that CXL was effective in halting the progression of keratoconus over a period of up to four years. The published studies also revealed a reduction of max K readings by more than 2 D, while the postoperative SEQ was reduced by an average of more than 1 D, and refractive cylinder decreased by about 1 D. No eyes lost any line of BCDVA. Moreover, there was no significant decrease in endothelial cell density. It was also found that CXL treatment was effective with reducing corneal and total wavefront aberrations. Corneal cross-linking has also led to an arrest and/or even a partial reversal of keratectasia in the treatment of iatrogenic ectasia after excimer laser ablation. A primary intervention such as CXL should be considered to potentially increase the biomechanical stability of the corneal tissue and postpone the need of lamellar or penetrating keratoplasty.

  5. Trends in corneal transplantation: indications and techniques.

    Science.gov (United States)

    Ple-Plakon, Patricia A; Shtein, Roni M

    2014-07-01

    To describe trends in corneal transplantation surgery, including indications for surgery, evolution of lamellar keratoplasty, current surgical techniques, and future directions. Over the past decade, anterior and posterior lamellar keratoplasty have begun to supplant penetrating keratoplasty. Surgical techniques continue to change and improve outcomes. In recent years, Descemet membrane endothelial keratoplasty (DMEK) has gained interest as it eliminates the corneal stromal interface, which may limit visual acuity after Descemet stripping automated endothelial keratoplasty. Despite the promising results with improved visual acuity and decreased rejection, the technical challenges associated with DMEK have limited widespread acceptance. With technical refinements and more eye banks providing precut tissue for both Descemet stripping automated endothelial keratoplasty and DMEK, it is likely both procedures will continue to increase over time. Corneal transplantation has evolved rapidly over the past decade, from full-thickness penetrating keratoplasty towards lamellar keratoplasty to only remove and replace damaged layers of the cornea. Achieving minimal induced astigmatism with excellent visual acuity remains a challenge in corneal transplantation. Further refinements in surgical technique may help improve technical challenges and visual outcomes. In this article, we review changing trends in corneal transplantation and highlight developing medical treatments that may be available in the future.

  6. Corneal transplantation: A new view of life.

    Science.gov (United States)

    Amiri, Fardin; Ghiyasvandian, Shahrzad; Navab, Elham; Zakerimoghadam, Masoumeh

    2017-04-01

    The consequences of a corneal transplant are evaluated and classified by care providers, but understanding and interpretation of the results varies between patients, and creates different views for them and influences their lives in different ways while these influences are largely unknown. This study aimed to explore understanding of new life in patients after corneal transplantation. This qualitative study was conducted using a hermeneutic phenomenological approach in Tehran in 2016. Twelve corneal transplant recipients (7 men, 5 women) who were chosen purposefully from penetrating corneal transplant recipients, participated in this study. Semi-structured interviews were used to collect data. The content of the interviews was transcribed and analyzed using Van Manen's methodology. Data analysis led to the emergence of several main themes, among which "having a new sense" and "fear and hope" were two of the most important themes. It can be inferred from the overall participants' experiences that corneal transplant has brought about a new look at life for patients. However, transplant-related issues are endless and continuous, and a sense of fear and hope has always surrounded them.

  7. MicroRNA-184 Regulates Corneal Lymphangiogenesis.

    Science.gov (United States)

    Grimaldo, Sammy; Yuen, Don; Theis, Jaci; Ng, Melissa; Ecoiffier, Tatiana; Chen, Lu

    2015-11-01

    MicroRNAs are a class of small noncoding RNAs that negatively regulate gene expression by binding to complimentary sequences of target messenger RNA. Their roles in corneal lymphangiogenesis are largely unknown. This study was to investigate the specific role of microRNA-184 (mir-184) in corneal lymphangiogenesis (LG) in vivo and lymphatic endothelial cells (LECs) in vitro. Standard murine suture placement model was used to study the expressional change of mir-184 in corneal inflammatory LG and the effect of synthetic mir-184 mimic on this process. Additionally, a human LEC culture system was used to assess the effect of mir-184 overexpression on cell functions in vitro. Expression of mir-184 was significantly downregulated in corneal LG and, accordingly, its synthetic mimic suppressed corneal lymphatic growth in vivo. Furthermore, mir-184 overexpression in LECs inhibited their functions of adhesion, migration, and tube formation in vitro. These novel findings indicate that mir-184 is involved critically in LG and potentially could be used as an inhibitor of the process. Further investigation holds the promise for divulging new therapies for LG disorders, which occur inside and outside the eye.

  8. In-vitro corneal transparency measuring system

    Science.gov (United States)

    Ventura, Liliane; da Costa Vieira, Marcelo A.; Isaac, Flavio; Chiaradia, Caio; Faria de Sousa, Sidney J.

    2001-06-01

    A system for measuring the average corneal transparency of preserved corneas has been developed in order to provide a more accurate and standard report of the corneal tissue. The donated cornea transparency is one of the features to be analyzed previously to its indication for the transplant. The small portable system consists of two main parts: the optical and the electronic parts. The optical system consists of a white light, lenses and pin-holes that collimate white light beams that illuminates the cornea in its preservative medium. The light that passes through the cornea is detected by a resistive detector and the average corneal transparency is shown in a display. In order to obtain just the tissue transparency, the electronic circuit was built in a way that there is a baseline input of the preservative medium, previous to the measurement of the corneal transparency. Manipulating the system consists of three steps: (1) Adjusting the zero percentage in the absence of light (at this time the detectors in the dark); (2) Placing the preservative medium in the system and adjusting the 100% value (this is the baseline input); (3) Preserving the cornea and placing it in the system. The system provides the tissue transparency. The system is connected to an endothelium evaluation system for Slit Lamp, that we have developed, and statistics about the relationship of the corneal transparency and density of the endothelial cells will be provided in the next years. The system is being used in a public Eye Bank in Brasil.

  9. Riboflavin for corneal cross-linking.

    Science.gov (United States)

    O'Brart, D P S

    2016-06-01

    Corneal collagen cross-linking (CXL) with riboflavin and ultraviolet A (UVA) radiation is the first therapeutic modality that appears to arrest the progression of keratoconus and other corneal ectasias. Riboflavin is central to the process, acting as a photosensitizer for the production of oxygen singlets and riboflavin triplets. These free radicals drive the CXL process within the proteins of the corneal stroma, altering its biomechanical properties. Riboflavin also absorbs the majority of the UVA radiation, which is potentially cytotoxic and mutagenic, within the anterior stroma, preventing damage to internal ocular structures, such as the corneal endothelium, lens and retina. Clinical studies report cessation of ectatic progression in over 90% of cases and the majority document significant improvements in visual, keratometric and topographic parameters. Clinical follow-up is limited to 5-10 years, but suggests sustained stability and enhancement in corneal shape. Sight-threatening complications are rare. The optimal stromal riboflavin dosage for CXL is as yet undetermined. Copyright 2016 Prous Science, S.A.U. or its licensors. All rights reserved.

  10. Primary central corneal hemangiosarcoma in a dog.

    Science.gov (United States)

    Haeussler, David J; Rodríguez, Laura Muñoz; Wilkie, David A; Premanandan, Chris

    2011-03-01

    To report a case of primary central corneal hemangiosarcoma in the dog. An 11-year-old, neutered, female, German shepherd mixed breed dog was referred to the Hospital Veterinario Sierra de Madrid (Spain) for evaluation of an enlarging corneal mass of the left eye (OS). The dog was predominantly housed outdoors and was diagnosed with a history of chronic superficial keratitis of both eyes (OU) by the referring veterinarian. The corneal mass was resected by routine superficial keratectomy and submitted for histopathology and Factor VIII immunohistochemical staining. The mass was diagnosed as a corneal hemangiosarcoma with complete excision. Postoperatively, the keratectomy site healed without complication and there was no evidence of recurrence three and a half months postoperatively. Complete systemic evaluation, including abdominal ultrasound and CT scan of the head and thorax, indicated no other detectable neoplasia in the dog. Outdoor housing and ultraviolet exposure, breed, and chronic superficial keratitis were all suspected as contributing factors to the development of a primary corneal hemangiosarcoma. Surgical removal and postoperative treatment for chronic superficial keratitis provided effective therapy. © 2011 American College of Veterinary Ophthalmologists.

  11. Corneal Biomechanics in Ectatic Diseases: Refractive Surgery Implications

    OpenAIRE

    Ambr?sio, Jr, Renato; Correia, Fernando Faria; Lopes,Bernardo; Salom?o, Marcella Q.; Luz,Allan; Daniel G Dawson; Elsheikh, Ahmed; Vinciguerra, Riccardo; Vinciguerra, Paolo; Roberts, Cynthia J.

    2017-01-01

    Background: Ectasia development occurs due to a chronic corneal biomechanical decompensation or weakness, resulting in stromal thinning and corneal protrusion. This leads to corneal steepening, increase in astigmatism, and irregularity. In corneal refractive surgery, the detection of mild forms of ectasia pre-operatively is essential to avoid post-operative progressive ectasia, which also depends on the impact of the procedure on the cornea. Method: The advent of 3D tomography is proven as a ...

  12. The value of corneal transplantation in reducing blindness.

    Science.gov (United States)

    Garg, P; Krishna, P V; Stratis, A K; Gopinathan, U

    2005-10-01

    To analyse the role of keratoplasty in reducing world blindness due to corneal diseases. Review of published literature. We collected and analysed articles published in the English language literature related to the prevalence and causes of blindness in different parts of the world, causes of corneal blindness, and outcome of corneal transplantation for various corneal diseases. A total of 80% of the world's blind live in developing countries. Retinal diseases are the most important causes of blindness (40-54%) in established economy nations while cataract (44-60%) and corneal diseases (8-25%) are the most common causes of blindness in countries with less developed economies. Keratitis during childhood, trauma, and keratitis during adulthood resulting in a vascularized corneal scar and adherent leucoma are the most frequent causes of corneal blindness in developing countries. Corneal diseases are responsible for 20% of childhood blindness. Nearly 80% of all corneal blindness is avoidable. The outcome of keratoplasty for vascularized corneal scar and adherent leucoma is unsatisfactory, necessitating repeat surgery in a high proportion of these cases. Other barriers for keratoplasty in these nations are suboptimal eye banking, lack of trained human resources, and infrastructure. Since the developing world carries most of the load of corneal blindness and the major causes of corneal blindness are corneal scar and active keratitis, development of corneal transplantation services need a comprehensive approach encompassing medical standards in eye banking, training of cornea specialists and eye banking personnel and exposure of ophthalmologists to care of corneal transplants for better follow-up care. However, concerted efforts should be made to develop and implement prevention strategies since most corneal blindness is preventable.

  13. Corneal hysteresis, corneal resistance factor, and intraocular pressure measurements in eyes implanted with a small aperture corneal inlay.

    Science.gov (United States)

    Agca, Alper; Demirok, Ahmet; Celik, Haci Ugur; van de Pol, Corina; Cankaya, Kadir Ilker; Celik, Nimet Burcu; Yasa, Dilek; Yilmaz, Ihsan; Yilmaz, Omer Faruk

    2014-12-01

    To compare the postoperative corneal hysteresis (CH) and corneal resistance factor (CRF) of eyes implanted with a small aperture corneal inlay versus fellow eyes. Medical records of patients who underwent small aperture corneal inlay (KAMRA; AcuFocus, Inc., Irvine, CA) implantation were retrospectively reviewed. There were two groups: the implanted and non-implanted. Main outcome measures were CH, CRF, Goldmann-correlated intraocular pressure (IOPg), corneal-compensated IOP (IOPcc), and Goldmann applanation tonometry measurements performed preoperatively and at postoperative week 1 and months 1, 3, and 6. The study included 68 eyes of 34 patients. CH was higher in the implanted group when compared with the non-implanted group at postoperative week 1 (12.2 ± 3.1 vs 10.9 ± 1.7 mm Hg; P = .007) and month 1 (12.3 ± 2.5 vs 10.9 ± 1.8 mm Hg; P = .001). CRF was higher in the implanted group when compared with the non-implanted group at postoperative week 1 (11.9 ± 2.9 vs 10.7 ± 1.6 mm Hg; P = .003) and month 1 (12.5 ± 2.5 vs 10.4 ± 1.8 mm Hg; P .05). At the 3-month postoperative visit, all parameters had returned to baseline and there was no change at the 6-month visit. Implantation of the KAMRA corneal inlay does not induce a permanent change in CH or CRF. A transient increase in both was seen in the early postoperative period. Copyright 2014, SLACK Incorporated.

  14. Corneal Stroma Regeneration with Acellular Corneal Stroma Sheets and Keratocytes in a Rabbit Model.

    Science.gov (United States)

    Ma, Xiao Yun; Zhang, Yun; Zhu, Dan; Lu, Yang; Zhou, Guangdong; Liu, Wei; Cao, Yilin; Zhang, Wen Jie

    2015-01-01

    Acellular corneal stroma matrix has been used for corneal stroma engineering. However, because of its compact tissue structure, regrowth of keratocytes into the scaffold is difficult. Previously, we developed a sandwich model for cartilage engineering using acellular cartilage sheets. In the present study, we tested this model for corneal stroma regeneration using acellular porcine corneal stroma (APCS) sheets and keratocytes. Porcine corneas were decellularized by NaCl treatment, and the APCS was cut into 20-μm-thick sheets. A rabbit corneal stroma defect model was created by lamellar keratoplasty and repaired by transplantation of five pieces of APCS sheets with keratocytes. Six months after transplantation, transparent corneas were present in the experimental group, which were confirmed by anterior segment optical coherence tomography examination and transmittance examination. The biomechanical properties in the experimental group were similar to those of normal cornea. Histological analyses showed an even distribution of keratocytes and well-oriented matrix in the stroma layer in the experimental group. Together, these results demonstrated that the sandwich model using acellular corneal stroma sheets and keratocytes could be potentially useful for corneal stroma regeneration.

  15. Value of recombinant human epidermal growth factor in corneal wound repair after corneal foreign body elimination

    Directory of Open Access Journals (Sweden)

    Hong-Jie Han

    2013-11-01

    Full Text Available AIM: To investigate the repair efficacy of recombinant human epidermal growth factor on corneal epithelium after corneal foreign body eliminating operation. METHODS: There were 102 patients with corneal foreign body(188 affected eyeschosen for the study. All patients were divided into treatment group and control group according to the random number table. Both groups received corneal foreign body elimination by slit lamp. Postoperatively, the treatment group was given eye drops containing epidermal growth factor(JinYinShucombined with tobramycin while the control group was only administrated with tobramycin. Treatment effects were compared 3d after treatment. RESULTS: Three days after treatment, the cure rate in the treatment group(93.7%, was significantly higher than that in the control group(76.6%(PPCONCLUSION: The recombinant human epidermal growth factor is capable of integrating with corneal epithelial cells and endothelial cell receptor, shortening healing time of corneal epithelial wound, thus making it an effective treatment of traumatic corneal epithelial defect.

  16. Randomized Trial Comparing Amniotic Membrane Transplantation with Lamellar Corneal Graft for the Treatment of Corneal Thinning.

    Science.gov (United States)

    de Farias, Charles C; Allemann, Norma; Gomes, José Á P

    2016-04-01

    There are few studies comparing different surgical procedures for the treatment of corneal thinning. Lamellar corneal transplantation (LCT) has been reported to be efficient, but its results can be jeopardized by allograft rejection, opacification, or high astigmatism. Amniotic membrane transplantation (AMT) has been considered a good alternative, but it is not as resistant as LCT and the tissue can be reabsorbed after surgery. A prospective, randomized, interventional, and comparative study of consecutive patients with corneal thinning over 6 months was performed. Ophthalmological examination was performed before transplant surgery and then repeated 1, 7, 15, 30, 90, and 180 days after surgery and ultrasound biomicroscopy was performed before and then 30, 90, and 180 days after surgery to assess corneal thinning. Herpes simplex infection was the main cause of corneal thinning (9 eyes), followed by surgery (cataract, glaucoma, 5 cases), rheumatoid arthritis (1), chemical burn (1), perforating trauma (1), previous band keratopathy treatment (1), and Stevens-Johnson syndrome (1). Although all patients showed significant increase in final thickness in the area of thinning, it was higher in those submitted to LCT at 180 days postoperatively. Regardless of the surgical technique, all patients showed epithelialization. Patients undergoing AMT showed an 89% decrease in neovascularization. Final corrected distance visual acuity was better in patients submitted to AMT. LCT proved to be the best option for treating corneal thinning. AMT represents an alternative that allows good visual recovery but does not restore corneal thickness as efficiently as LCT.

  17. [Evaluation of corneal biomechanical properties in glaucoma and control patients by dynamic Scheimpflug corneal imaging technology].

    Science.gov (United States)

    Coste, V; Schweitzer, C; Paya, C; Touboul, D; Korobelnik, J-F

    2015-06-01

    To compare corneal biomechanical properties measured with Corvis Scheimpflug technology (Corvis ST) between a group of patients with chronic open-angle glaucoma and a group of control patients. Prospective observational case-control study. This study enrolled 56 right eyes of 56 patients (G1 [chronic open-angle glaucoma] n=37/G2 [control] n=19). Each patient underwent measurement of corneal biomechanical properties by dynamic Scheimpflug (Corvis ST) camera and the Ocular Response Analyser (ORA), then a measurement of intraocular pressure (IOP) by Goldmann applanation tonometry (GAT) and measurement of central corneal thickness (CCT) by optical coherence tomography during the same visit, by a single clinician. The parameters determined by Corvis ST are: Corvis IOP (IOP Corvis ST), the corneal deformation amplitude (CDA), corneal velocity, the time at highest concavity (TIME CONCAV), the lengths of applanation and their corresponding applanation time. Those studied by ORA are: compensated IOP (IOPcc), non-compensated IOL (IOPg), corneal hysteresis (CH) and corneal resistance factor (CRF). IOP measured on all patients by Corvis ST was positively correlated to GAT (Spearman r=0.569, Pcorneal biomechanical properties between glaucoma and control patients. The cornea of glaucoma patients appears less deformable. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. Relationship Between Corneal Hysteresis and Corneal Resistance Factor with Other Ocular Parameters.

    Science.gov (United States)

    Rosa, Nicola; Lanza, Michele; De Bernardo, Maddalena; Signoriello, Giuseppe; Chiodini, Paolo

    2015-01-01

    To evaluate the relationship between corneal hysteresis (CH) and corneal resistance factor (CRF) with age, central corneal thickness (CCT), corneal curvature (KM), corneal volume (CV), and refractive error in naïve eyes. 105 healthy subjects (58 male and 47 female) were included in this study. The ages ranged from 19 to 82 years (mean 43.1 ± 15.4 years) and refraction between -11 D and +6 D (mean -0.79 ± 2.95 D). CH and CRF obtained with the Ocular Response Analyzer (ORA) were correlated with age, refractive error, Goldmann Applanation Tonometry (GAT), and with CCT, KM, CV obtained with the Pentacam, and with Corneal-Compensated Intraocular Pressure (IOPcc) and Goldmann-correlated intraocular pressure measurement (IOPg) obtained with ORA. A multivariable mixed effect model was used to evaluate associations among these parameters. CH ranged from 6.9 to 14.6 mmHg (mean 10.26 ± 1.49 mmHg); CRF ranged from 5.8 to 17 mmHg (mean 10.38 ± 1.64 mmHg). Multivariate analysis showed a statistically significant correlation between CH with CCT (p corneal shape and thickness, and show a decrease of CH with age.

  19. Clinical significance of central corneal thickness and comparison of central corneal thickness

    Directory of Open Access Journals (Sweden)

    Özgür Çakıcı

    2014-03-01

    Full Text Available Significance of central corneal thickness has been increasing in ophthalmology practice. It is an important clinical evaluation tool especially prior to refractive surgery and in diagnosis of glaucoma and keratoconus. Refractive surgery is planned according to preoperative central corneal thickness measurements. Besides, in order to determine actual intraocular pressure, central corneal thickness is measured and corrected eye pressure is obtained. Today, devices used in measurement of central corneal thickness do the measurement according to two principles. First and relatively older method is ultrasonic method. Optic method is the second and more recent method. In daily practice, the most commonly used clinical method in measurement of central corneal thickness is ultrasound pachymeter. However, this measurement technique requires contact between cornea and probe and gives thinner measurement results compared to the methods that use optic principle. Recently, several technologic methods based on optics have been put in use; they provide advantages of non-contact technique and objective determination of central corneal thickness. Of these methods, most commonly used include Specular Microscopy, Optical coherence tomography, Laser Doppler Interferometry, Optical low coherence reflectometry pachymetry, Optic based topographic mapping (also called screening section pachymetry and Pentacam. In this article, it was aimed to evaluate importance of central corneal thickness in clinical use and compare measurement methods. J Clin Exp Invest 2014; 5 (1: 153-158

  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.