Autologous Corneal Transplant from an Enucleated Fellow Eye for Choroidal Melanoma: A Case Report

Background: To report a case of autologous corneal transplant in a patient with corneal leukoma and choroidal melanoma in the fellow eye. Case Presentation: A 56-year-old woman was complaining about decrease in vision in her left eye. The patient was on the waiting list for a corneal transplant on her right eye due to corneal leucoma after a previous herpes infection. The patient was diagnosed with choroidal melanoma in her left eye. Due to the tumor size (longitudinal diameter >10 mm; anterior-posterior diameter >16 mm) the patient decided to undergo enucleation, after being informed about different treatment options (brachytherapy and enucleation). The patient showed her willingness to use the cornea of the left eye as a transplant for her right eye. After discussion with the ethical committee and its approval, and signing informed consent, the patient underwent enucleation of her left eye. The sample was examined by a pathologist and found to be free of melanoma cells in the corneolimbal tissue. Afterwards, trepanation of the donor cornea button was performed and transplanted to the left eye. Conclusion: Autologous corneal transplantation is a safe and feasible procedure in selected cases.

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Glaucoma and Corneal Transplant Procedures

Journal of Ophthalmology ◽

10.1155/2012/576394 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 9

Author(s):

Ammar M. Al-Mahmood ◽

Samar A. Al-Swailem ◽

Deepak P. Edward

Keyword(s):

Intraocular Pressure ◽

Treatment Options ◽

Corneal Transplantation ◽

Lamellar Keratoplasty ◽

Deep Anterior Lamellar Keratoplasty ◽

Corneal Transplant ◽

Anterior Lamellar Keratoplasty ◽

Intraocular Pressure Elevation ◽

High Incidence ◽

Number Of Treatment

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.

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Safety of a Clozapine Trial Following Quetiapine-Induced Leukopenia: A Case Report

Current Drug Safety ◽

10.2174/1574886313666180807094654 ◽

2019 ◽

Vol 14 (1) ◽

pp. 80-83 ◽

Cited By ~ 3

Author(s):

Asma H. Almaghrebi

Keyword(s):

Treatment Options ◽

Young Female ◽

Similar Reaction ◽

Careful Monitoring ◽

Treatment Resistant ◽

Blood Cell Count ◽

Antipsychotic Medications ◽

Case Presentation ◽

Clozapine Treatment ◽

History Of

Background: The clozapine-derivative quetiapine has been shown in some cases to cause leukopenia and neutropenia. Case Presentation: We reported on a case of a young female diagnosed with treatment-resistant schizophrenia. After failed trials of three antipsychotic medications and despite a history of quetiapineinduced leukopenia, clozapine treatment was introduced due to the severity of the patient’s symptoms, the limited effective treatment options, and a lack of guidelines on this issue. Result: Over a ten-week period of clozapine treatment at 700 mg per day, the patient developed agranulocytosis. Her white blood cell count sharply dropped to 1.6 × 10<sup>9</sup> L, and her neutrophils decreased to 0.1 × 10<sup>9</sup> L. There had been no similar reaction to her previous medications (carbamazepine, risperidone, and haloperidol). Conclusion: The safety of clozapine in a patient who has previously experienced leukopenia and neutropenia with quetiapine requires further investigation. Increased attention should be paid to such cases. Careful monitoring and slow titration are advisable.

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Intra-Abdominal Localisation of a Buschke-Lowenstein Tumour: Case Presentation and Review of the Literature

Case Reports in Transplantation ◽

10.1155/2013/187682 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

N. E. Wester ◽

E. M. Hutten ◽

C. Krikke ◽

Robert A. Pol

Keyword(s):

Interferon Therapy ◽

Verrucous Carcinoma ◽

Treatment Options ◽

Condyloma Acuminata ◽

Review Of The Literature ◽

Case Presentation ◽

Advantages And Disadvantages ◽

Literature Overview ◽

Mucosal Surfaces ◽

Tumour Reduction

Giant condyloma acuminatum or Buschke-Lowenstein tumour is a very rare disease which usually is located in the genital, anorectal, and perianal regions. It is regarded as a type of verrucous carcinoma occurring on anogenital mucosal surfaces where it is locally invasive but displays a benign cytology. We describe a case of a 24-year-old woman with persisting condyloma acuminata progressing to a large intra-abdominal Buschke-Lowenstein tumour. To our knowledge such an advanced stage has only been reported once before. The severity and extent of the tumour both determine the treatment and patient outcome. Treatment was impeded by cachexia, an immunosuppressive state after kidney transplantation and difficulties in establishing a reliable diagnose. Interferon treatment was started which initially led to tumour reduction but was complicated by an interferon-induced pancreatitis, pneumonia, and fasciitis necroticans resulting in death. We present a literature overview on the treatment options for a Buschke-Lowenstein tumour, with emphasis on interferon therapy, with all the advantages and disadvantages.

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Comparison of anterior and posterior chamber implantation of iris claw lens in corneal transplant patients

European Eye Research ◽

10.14744/eer.2021.09719 ◽

2021 ◽

Vol 1 (1) ◽

Author(s):

Mine Esen Baris

Keyword(s):

Corneal Transplantation ◽

Posterior Chamber ◽

Corneal Transplant ◽

Complication Rates ◽

Transplant Patients ◽

Support Methods ◽

Iris Claw Lens ◽

Iris Claw ◽

Rejection Rates

INTRODUCTION: To compare the surgical outcomes of anterior chamber (AC) and posterior chamber (PC) implantation of iris claw lens (ICL) combined with penetrating corneal transplantation (P-CT), in eyes with no capsular support. METHODS: The records of 20 P-CT cases who underwent ICL implantation were retrospectively evaluated. The eyes were grouped according to the location of implantation; AC ICL and PC ICL. Pre- and post-surgical best-corrected visual acuity (BCVA), post-operative complications and graft rejection rates were compared between the two groups. Mean follow-up time was 28 (range, 12 and 76) months. RESULTS: ICLs were implanted during P-CT surgery in 14 (70%) eyes, and as a secondary procedure after P-CT in 6 (30%) eyes. ICLs were implanted in PC in 12 (60%) and in AC in 8 (40%) eyes. Mean preoperative BCVA was 0.064 (range, 0.001-0.02) in PC group and 0.02 (range, 0.001-0.1) in AC group (p=0.86). Mean postoperative BCVA was 0.17 (range, 0.0001-1.0) in PC group and 0.14 (range, 0.0001-0.4) in AC group (p=0.81). Glaucoma developed in 5 (41.6%) eyes with PC ICL. No eye with AC ICL developed glaucoma over time. DISCUSSION AND CONCLUSION: Both AC and PC ICL implantation provide favorable visual outcomes and complication rates in CT patients. However, PC implantation of ICL seems to increase glaucoma incidence.

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Comparing plaque brachytherapy and proton therapy for choroidal melanoma: a review of the literature

Journal of Radiotherapy in Practice ◽

10.1017/s1460396909990197 ◽

2010 ◽

Vol 9 (1) ◽

pp. 53-61

Author(s):

Jeremy P. Appleton ◽

Peter Bridge

Keyword(s):

Conservative Treatment ◽

Proton Therapy ◽

Normal Tissue ◽

Treatment Options ◽

Choroidal Melanoma ◽

Review Of The Literature ◽

Tumour Control ◽

Local Tumour Control ◽

Local Tumour ◽

Plaque Brachytherapy

AbstractThe aims of conservative treatment in patients with ocular melanoma are globe retention, good visual acuity (VA) and local control. Two well-established radiation conservative treatment options are proton beam radiotherapy and episcleral plaque brachytherapy (EPB). Patients who receive treatment with either of these options will experience some degree of radiation-related ocular complications and poor VA. The purpose of this review of the literature is to establish whether there is a significant clinical difference in normal tissue morbidity and local tumour control between proton therapy and EPB, and whether this difference can justify the purchase and implementation of additional proton therapy facilities. Based on this review, evidence suggested that both treatment options are comparable, and that neither proton therapy nor EPB is clinically superior than the other regarding normal tissue morbidity and local tumour control. This review highlighted the need for further research on a larger scale in order to bridge the gap that is apparent within the literature.

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O significado dos olhos nas representações sociais de clientes transplantados de córnea e suas implicações para o cuidado de si

Enfermagem em Foco ◽

10.21675/2357-707x.2012.v3.n4.385 ◽

2012 ◽

Vol 3 (4) ◽

pp. 202-205

Author(s):

Ralrizônia Fernandes Sousa ◽

Sílvio Éder Dias Da Silva ◽

Esleane Vilela Vasconcelos ◽

Lucialba Maria Silva Dos Santos ◽

Vander Monteiro Da Conceição ◽

...

Keyword(s):

Qualitative Study ◽

Representation Theory ◽

Social Representations ◽

Corneal Transplantation ◽

Self Care ◽

Social Representation ◽

Corneal Transplant ◽

The Social ◽

De Se ◽

Social Representation Theory

Objetivou-se identificar o significado dos olhos nas representações sociais de clientes transplantados de córnea e suas implicações para o cuidado de si. Tratase de uma pesquisa descritiva qualitativa, adotando a Teoria das Representações Sociais na perspectiva de Moscovici. Fizeram parte deste estudo, 15 clientes submetidos a transplantes de córnea e que se encontravam em acompanhamento no Consultório de Oftalmologia do Ambulatório do Hospital Ophir Loyola, em Belém, PA. Os depoentes atribuíram significados diversos aos seus olhos, substanciados por sentimentos de tristeza e insatisfação, que contribuíram para mudanças significativas no cuidado de si. Há necessidade de se cogitar sobre o compromisso do enfermeiro com o cliente transplantado de córnea que, muitas vezes, encontra-se fragilizado, necessitando de um olhar mais atento.Descritores: Enfermagem, Transplante de Córnea, Cuidado de Si.Eye on the meaning of social representations corneal transplantation customers and it’s implications for the care of youThe aim of this study was to identify the meaning of the eyes of customers in the social representations of corneal transplant and its implications for self-care. It is a descriptive and qualitative study, adopting the Social Representation Theory in the context of Moscovici. The sample comprised 15 clients who underwent corneal transplantation and were followed up in the office of the Ophthalmology Clinic of the Ophir Loyola Hospital, in Belem, Pará. The respondents attributed different meanings to their eyes; substantiated by feelings of sadness and dissatisfaction, that contributed to significant changes in self-care. There is need to think about the commitment of the nurse with the client cornea transplant, which often is fragile, requiring a closer look.Descriptors: Nursing, Corneal Transplantation, Self-care.Los ojos sobre el significado de los clientes representataciones sociales transplante de córnea y sus conscuencias para el cuidad de ustedEl objetivo fue identificar el significado de los ojos de los clientes en las representaciones sociales de trasplante de córnea y sus implicaciones para el autocuidado. Se trata de un estudio descriptivo cualitativo, adoptando laTeoría de las Representaciones Sociales en el contexto de Moscovici. La muestra es compuesta por 15 clientes que se sometieron a trasplante de córnea que se siguió en la oficina de la Clínica de Oftalmología del Hospital Ophir Loyola, en Belem, Pará. Los encuestados atribuyen diferentes significados a sus ojos, motivada por sentimientos de tristeza e insatisfacción, que han contribuido a cambios significativos en el auto-cuidado. Hay que pensar en el compromiso de la enfermera con el trasplante de cornea del cliente, que a menudo es frágil, lo que requiere una mirada más cercana.Descriptores: Enfermería, Trasplante de Córnea, Cuidar de si.

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A Rare Case of Urinary Tract Fungal Ball Leading to Fungemia and Bilateral Chorioretinitis

Case Reports in Urology ◽

10.1155/2020/8828289 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Christopher Ferari ◽

Chad Crigger ◽

Chad Morley ◽

David Duchene

Keyword(s):

Urinary Tract ◽

Type Ii Diabetes ◽

Rare Complication ◽

Obstructive Uropathy ◽

Treatment Options ◽

Type Ii ◽

Invasive Treatment ◽

Case Presentation ◽

Fungal Ball

Background. Fungemia due to obstructive urinary tract fungal ball is exceedingly rare. These patients often have multiple predisposing conditions, including diabetes or antimicrobial exposure. While candiduria can be relatively common in this population, urinary tract fungal balls are a rare entity. Hospitalists should be aware of this rare complication in patients presenting with funguria. Case Presentation. We present a case of a 44-year-old male with type II diabetes, chronic hepatitis C secondary to injection drug use, and chronic kidney disease who developed a urinary tract fungal ball leading to fungemia and subsequent bilateral chorioretinitis, additionally complicated by emphysematous cystitis and pyelonephritis. Additional invasive treatment options beyond typical antifungals are often required in the case of urinary tract fungal ball, and in this case, bilateral nephrostomy tubes and micafungin were employed. Hospital course was complicated by C. tropicalis fungemia with subsequent bilateral fungal chorioretinitis on dilated fundus exam. This was effectively treated with cyclogyl and prednisolone drops along with bilateral voriconazole injections. Follow-up imaging and cultures showed resolution of fungemia, urinary tract masses, and chorioretinal infiltrates; however, recurrent polymicrobial UTIs continue to be an issue for this patient. Conclusions. Special multidisciplinary management is required in the treatment of urinary tract fungal balls with subsequent fungemia, including nephrostomy tubes, antifungal irrigation, ureterorenoscopy, and more powerful antifungals such as amphotericin B and 5-flucytosine. This management draws from a myriad of specialties, including urology, infectious disease, and interventional radiology. Additionally, the literature has demonstrated that only approximately half of patients with fungemia receive an ophthalmologic evaluation. Ophthalmologic and urologic cooperation is essential in the case of obstructive uropathy leading to fungemia as the obstructive uropathy must be relieved and these patients should receive a dilated fundus exam.

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Corneal transplantation activity in Catalonia, Spain, from 2011 to 2018: Evolution of indications and surgical techniques

PLoS ONE ◽

10.1371/journal.pone.0249946 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249946

Author(s):

Noelia Sabater-Cruz ◽

Marc Figueras-Roca ◽

Lydia Padró-Pitarch ◽

Jaume Tort ◽

Ricardo P. Casaroli-Marano

Keyword(s):

Corneal Transplantation ◽

Surgical Techniques ◽

Annual Reports ◽

Bullous Keratopathy ◽

Corneal Transplant ◽

Endothelial Keratoplasty ◽

Descemet Membrane Endothelial Keratoplasty ◽

Eye Bank ◽

Increasing Trend ◽

Fuchs Endothelial Dystrophy

Purpose To report corneal transplant activity carried out in Catalonia (Spain) and the evolving indications for keratoplasty over an 8-year period. Methods Annual reports from the Catalan Transplant Organization, Spain, on corneal graft indications and techniques from 2011 to 2018 were reviewed. Results A total of 9457 keratoplasties were performed in Catalonia, from January 2011 to December 2018. The most frequent indications were bullous keratopathy (BK; 20.5%), Fuchs endothelial dystrophy (FED; 17.9%), re-graft (13.7%), and keratoconus (11.3%). Penetrating keratoplasty (PKP) accounted for 63.4% of all performed keratoplasties. Since the introduction of eye bank precut tissue for Descemet stripping automated endothelial keratoplasty (DSAEK) in 2013 and for Descemet membrane endothelial keratoplasty (DMEK) in 2017 the number of endothelial keratoplasties has drastically increased. An increasing trend of posterior lamellar techniques over the total of keratoplasties was found (p<0.001). Endothelial keratoplasties for different endothelial diseases indications (BK, FED, and re-graft), also showed and increasing trend (p<0.001). DMEK is the technique with the highest increase (statistically significantly different from linearity) over other endothelial keratoplasties in FED (p<0.001) but not in BK (p = 0.67) or re-grafts (p = 0.067). Conclusion Endothelial diseases represented the top indication for keratoplasty over the 8-year period. PKP is still the most used technique in Catalonia, but endothelial keratoplasties and especially DMEK showed a significant increasing trend over the last years. This is congruent with the main rationale nowadays for keratoplasties: to customize and transplant as less tissue as possible. Therefore, the availability of precut tissue could have definitely enforced such approach.

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The Therapeutic Effect of Corneal Transplantation for Refractory Pseudomonas Aeruginosa Corneal Ulcer

10.21203/rs.2.17414/v1 ◽

2019 ◽

Author(s):

Yan Li ◽

Ting Wang ◽

Qiang Wang ◽

Shanhao Jiang ◽

Xin Wang

Keyword(s):

Pseudomonas Aeruginosa ◽

Visual Acuity ◽

Corneal Ulcer ◽

Corneal Transplantation ◽

Corneal Graft ◽

Successful Outcome ◽

Lamellar Keratoplasty ◽

Corneal Transplant ◽

Surgical Method

Abstract Purpose To observe the treatment outcome of corneal transplantation for advanced medically uncontrolled culture-proven pseudomonas aeruginosa corneal ulcer.Design Retrospective analysisSubjects and methods 26 patients (eyes) with refractory culture-positive pseudomonas aeruginosa corneal ulcer who failed to respond to drug therapy and underwent consecutive corneal transplant procedures in a hospital (2008.1-2018.8). Etiology, medical history, clinical features, surgical type, vision, recurrence, complications and treatment were recorded, and the relationship between postoperative recovery and selection of surgical method was analyzed.Results Of the 26 patients with pseudomonas aeruginosa corneal ulcer, 9 (34.6%) received penetrating keratoplasty (PKP) and 17 (65.4%) received lamellar keratoplasty (LKP). 22 patients (84.6%) obtained a successful outcome through one corneal transplantation. Of the 9 patients who received PKP, 1 patient having graft rejection 6 months after surgery (endothelial type) obtained successful outcome through adequate drug treatment., while 1 case received success by graft repair combined with amniotic membrane transplantation on the 5 months postoperatively for fungal corneal graft ulcer. In the 17 patients underwent LKP, 2 received a second successful lamellar corneal transplantation for corneal graft melting 2 months after the first surgery. In all the 26 patients, the corneal infection was effectively brought under control by corneal transplantation, and none of them had recurrent ulcers during at least 6months' follow-up. The visual acuity was significantly improved at the last follow-up compared with that before surgery. The postoperative visual acuity of patients underwent LKP was better than that of those who underwent PKP ( p =0.018).Conclusions Corneal transplantation can effectively treat refractory pseudomonas aeruginosa corneal ulcer worsening despite adequate medical treatment and improve eyesight. Compared with PKP, LKP can be the main surgical method to treat refractory pseudomonas aeruginosa corneal ulcer.

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Arthrogryposis

Genetic Consultations in the Newborn ◽

10.1093/med/9780199990993.003.0028 ◽

2019 ◽

pp. 191-196

Author(s):

Robin D. Clark ◽

Cynthia J. Curry

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Clinical Case ◽

Treatment Options ◽

Recurrence Risk ◽

Case Presentation ◽

Joint Mobilization ◽

Intensive Use ◽

Incidence Risk

This chapter reviews the incidence, risk factors, genetics, recurrence risk, and epidemiology of arthrogryposis. The most common and clinically recognizable type among the congenital contractures is amyoplasia, and treatment options are improving the quality of life for these patients. The distal arthrogryposes are mostly autosomal dominant and caused by an increasing number of genes including variants in PIEZ02 and MYH3 among several others. The lethal contracture syndromes have an expanding number of causes many of which are autosomal recessive. The majority of these conditions are recognized on US. In viable syndromes the early and intensive use of physical therapy is critical and can result in significant joint mobilization. The clinical case presentation features an infant with lethal multiple pterygia syndrome.

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