scholarly journals Corneal Edema with Anterior Uveitis after Exposure to the Sap of Euphorbia trigona: A Case Report

2021 ◽  
pp. 699-705
Author(s):  
Takashi Ono ◽  
Yosai Mori ◽  
Ryohei Nejima ◽  
Takuya Iwasaki ◽  
Takashi Miyai ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Anterior Uveitis ◽  
Corneal Thickness ◽  
Corneal Edema ◽  
Corneal Epithelial ◽  
Good Visual Acuity ◽  
Keratic Precipitates ◽  
Corneal Endothelial Dysfunction ◽  
Minimum Angle ◽  
Corneal Endothelial Cell Density

Although a few cases of dermatitis or keratitis caused by exposure to the sap of <i>Euphorbia trigona</i> have been reported, we present a rare case of transient corneal endothelial dysfunction following exposure to the sap, resulting in corneal edema. A woman in her 70s complained of reduced vision, redness, and teariness in her left eye 2 days after exposure to the sap of <i>E</i>. <i>trigona</i> at home. Upon examination, hyperemia, serious corneal edema, and anterior uveitis with hypopyon were observed in her left eye, without corneal epithelial defects or keratic precipitates. The best-corrected visual acuity (BCVA) was 2.0 (logarithm of the minimum angle of resolution), and the measured central corneal thickness (CCT) was 812 µm. The patient was treated with topical instillation of 1.5% levofloxacin and 0.1% dexamethasone to reduce intraocular inflammation and corneal edema. Three weeks later, the BCVA reached 0, the CCT was 519 μm, and the corneal endothelial cell density was 3,233 cells/mm<sup>2</sup>. Six months after the injury, the patient had good visual acuity, and the cornea was completely transparent. No recurrence of corneal edema or anterior uveitis was observed. Exposure to the sap of <i>E</i>. <i>trigona</i> can lead to severe corneal edema with anterior uveitis, impairing visual acuity. Taking precautions to prevent the exposure of the eye to the sap of this plant is crucial.

scholarly journals Safety and efficacy of repeated crosslinking assisted by transepithelial double-cycle iontophoresis in keratoconus progression after primary corneal crosslinking

Eye ◽  
2021 ◽  
Author(s):  
Huping Wu ◽  
Lan Li ◽  
Shunrong Luo ◽  
Xie Fang ◽  
Xumin Shang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Good Alternative ◽  
Persistent Epithelial Defect ◽  
Safety And Efficacy ◽  
Corneal Epithelial ◽  
Epithelial Damage ◽  
Corneal Confocal Microscopy

Abstract Objectives To evaluate the safety and efficacy of repeated corneal collagen crosslinking assisted by transepithelial double-cycle iontophoresis (DI-CXL) in the management of keratoconus progression after primary CXL. Methods A retrospective analysis was conducted in the patients who underwent repeated CXL between 2016 and 2018. These patients were treated with DI-CXL if keratoconus progression was confirmed after primary CXL. Scoring of ocular pain and corneal epithelial damage, visual acuity, corneal tomography, in vivo corneal confocal microscopy (IVCM) was performed before and at 3, 6, 12, and 24 months after DI-CXL. Results Overall, 21 eyes of 12 patients (mean age 17.3 ± 1.9 years) were included in this study. Before DI-CXL, an average increase of 4.26 D in Kmax was detected in these patients with a mean follow-up interval of (23.0 ± 13.7) months. After DI-CXL, corneal epithelial damage rapidly recovered within days. Visual acuity remained unchanged with follow-up of 24 months. When compared to baseline, significant decreases were observed in Kmax (at 3 months) and K2 (at 3 and 6 months) after DI-CXL. Corneal thickness of thinnest point significantly decreased at 3 months postoperatively. When compared to baseline, no significant differences were found in any of the refractive or tomographic parameters at 12 and 24 months. IVCM revealed trabecular patterned hyperdense tissues after DI-CXL in the anterior stroma at the depth of 200 μm or more. No corneal infiltration or persistent epithelial defect was recorded after DI-CXL. Conclusion DI-CXL is safe and effective as a good alternative in stabilizing keratoconus progression after primary CXL.

scholarly journals Quantification of Ocular Parameters To Create An Anatomical Eye Model for The Japanese Population

2021 ◽  
Author(s):  
Takushi Kawamorita ◽  
Hiroshi Uozato ◽  
Tetsuro Oshika ◽  
Kazuno Negishi ◽  
Takashi Fujikado ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Anterior Chamber Depth ◽  
Age Related ◽  
Corrected Distance Visual Acuity ◽  
Minimum Angle ◽  
Refractive Correction ◽  
Corneal Asphericity ◽  
The Mean ◽  
Posterior Corneal Curvature

Abstract This prospective observational study aimed to evaluate the eye shape and visual function of Japanese people through a multicenter approach and to create a Japanese model eye. Uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively) in the log minimum angle of resolution (logMAR), subjective and objective spherical equivalent values (SE) of ocular refraction, anterior and posterior corneal curvature (ACC and PCC, respectively), anterior and posterior corneal asphericity (ACA and PCA, respectively), central corneal thickness (CCT), anterior chamber depth (ACD), and ocular axial length (AL) were measured in the eyes of 250 participants (mean age = 46.5 ± 18.0 years, range: 20–90 years) across five institutions in Japan. The mean UDVA, CDVA, subjective SE, objective SE, ACC, PCC, ACA, PCA, CCT, ACD, and AL were 0.68, -0.08, -2.42 D, -2.66 D, 7.77 mm, 6.33 mm, -0.31, -0.39, 0.55 mm, 2.92 mm, and 24.78 mm, respectively. Age-related changes and sex-based differences were observed in the visual acuity, refraction, corneal shape, ACD, and AL. Although the sample size needs to be increased, the results of this study can be applied to the development of refractive correction methods and various vision-related fields.

scholarly journals Effects of carbonic anhydrase inhibitors on pseudophakic corneal edema

2012 ◽  
Vol 59 (3) ◽  
pp. 27-32
Author(s):  
Zihret Abazi ◽  
Lidija Magarasevic ◽  
Aleksandar Markovic ◽  
Dusica Risovic
Keyword(s):  
Visual Acuity ◽  
Carbonic Anhydrase ◽  
Corneal Thickness ◽  
Corneal Edema ◽  
Mean Value ◽  
Average Value ◽  
Postoperative Visual Acuity ◽  
Group I ◽  
The Mean ◽  
Group Ii

INTRODUCTION: Acetazolamide as inhibitor of carbonic anhydrase, in glaucoma therapy, has an effect on lowering intraocular pressure. In addition to this primary effects, we attempted to determine the effect on the cornea after phacoemulsification. In our study, we determined the effects of systemically applied dose of 500 mg of acetazolamide on the edema, thickness, and corneal morphology after phacoemulsification, with the Anterior Segment Optical Coherence Tomography (AS OCT). MATERIAL AND METHODS: The study included 53 patients who were divided into two groups. Groups were stratified by type of cataract (nuclear), age (62+1.5), preoperative visual acuity (5/60) Snellen table, and preoperative findings on AS-OCT. Phacoemulsification has done the same surgeon, with the same ultrasound probe length using ultrasonic force of the average value of 14 for a period of 72+2.5 seconds. Group of 33 patients were administered systemic acetazolamide at a dose of 250 mg per scheme 01 hours +24 hours after phacoemulsification (group I). Another group of 20 patients did not receive acetazolamide( group II). AS OCT recordings were performed before surgery, 6 hours and 24 hours after surgery. RESULTS: The mean value in both groups was 549+ 9 ?m before surgery. Group I had average value of 648+6 ?m after 6h, and the mean value was 612+4 ?m after 24h. The group II, had a mean thickness of the cornea after 6 hours of 720+5 ?m, and after 24 hours 708+4?m. Morphological changes in the tomograms of the group I showed minimal creases Descemet?s membrane. Postoperative visual acuity was 0,6,24h after the surgery in the I group of patients, and 0,3 in the II group. CONCLUSION: In our study the patients who administered systemic acetazolamide had significant reduction of central corneal thickness. The folds of Descemet?s membrane and endothelial dysfunction in AS OCT tomograms showed less structural changes in group I. Significant better postoperative visual acuity in these patients is probably because of the smaller corneal edema after 24 h, which improves patients? comfort.

scholarly journals Ocular Effects of Exposure to 40, 75, and 95 GHz Millimeter Waves

2018 ◽  
Vol 39 (9) ◽  
pp. 912-925 ◽  
Author(s):  
Masami Kojima ◽  
Yukihisa Suzuki ◽  
Kensuke Sasaki ◽  
Masao Taki ◽  
Kanako Wake ◽  
...  
Keyword(s):  
Millimeter Waves ◽  
Corneal Thickness ◽  
Corneal Edema ◽  
Incident Power ◽  
Fluorescence Staining ◽  
Corneal Epithelial ◽  
Incident Power Density ◽  
Focus Type ◽  
Power Densities ◽  
Cornea Thickness

Abstract The objective of this study was to develop a model of ocular damage induced by 40, 75, and 95 GHz continuous millimeter waves (MMW), thereby allowing assessment of the clinical course of ocular damage resulting from exposure to thermal damage-inducing MMW. This study also examined the dependence of ocular damage on incident power density. Pigmented rabbit eyes were exposed to 40, 75, and 95 GHz MMW from a spot-focus-type lens antenna. Slight ocular damage was observed 10 min after MMW exposure, including reduced cornea thickness and reduced transparency. Diffuse fluorescein staining around the pupillary area indicated corneal epithelial injury. Slit-lamp examination 1 day after MMW exposure revealed a round area of opacity, accompanied by fluorescence staining, in the central pupillary zone. Corneal edema, indicative of corneal stromal damage, peaked 1 day after MMW exposure, with thickness gradually subsiding to normal. Three days after exposure, ocular conditions had almost normalized, though corneal thickness was slightly greater than that before exposure. The 50% probability of ocular damage (DD50) was in the order 40 > 95 ≈ 75 GHz at the same incident power densities.

scholarly journals In vivo Confocal Microscopy in Differentiating Ipilimumab-Induced Anterior Uveitis from Metastatic Uveal Melanoma

2016 ◽  
Vol 7 (3) ◽  
pp. 404-409 ◽  
Author(s):  
Hayyam Kiratli ◽  
Mehmet C. Mocan ◽  
Murat İrkeç
Keyword(s):  
Visual Acuity ◽  
Confocal Microscopy ◽  
Uveal Melanoma ◽  
Anterior Uveitis ◽  
Choroidal Melanoma ◽  
Inflammatory Cells ◽  
In Vivo Confocal Microscopy ◽  
Keratic Precipitates ◽  
Metastatic Process

This report aims to describe the facilitating role of in vivo confocal microscopy in differentiating inflammatory cells from a metastatic process in a patient with uveal melanoma and multiple systemic metastases who developed anterior uveitis while under ipilimumab treatment. A 43-year-old woman developed systemic metastases 11 months after treatment of amelanotic choroidal melanoma in her right eye with 30 Gy fractionated stereotactic radiotherapy. She first received temozolomide and then 4 cycles of ipilimumab 3 mg/kg/day. After the third cycle, severe anterior uveitis with coarse pigment clumps on the lens was seen in the left eye. Her left visual acuity declined from 20/20 to 20/80. Confocal microscopy revealed globular keratic precipitates with hyperreflective inclusions and endothelial blebs all suggestive of granulomatous uveitis. The uveitic reaction subsided after a 3-week course of topical corticosteroids, and her visual acuity was 20/20 again. Although uveal melanoma metastatic to the intraocular structures of the fellow eye is exceedingly rare and metastasis masquerading uveitis without any identifiable uveal lesion is even more unusual, it was still mandatory to rule out this distant possibility in our particular patient who already had widespread systemic metastases. Confocal microscopy was a useful complementary tool by identifying the inflammatory features of the keratic precipitates.

scholarly journals Three-year follow-up of accelerated transepithelial corneal cross-linking for progressive paediatric keratoconus

2020 ◽  
pp. bjophthalmol-2019-315260 ◽  
Author(s):  
Mi Tian ◽  
Weijun Jian ◽  
Xiaoyu Zhang ◽  
Ling Sun ◽  
Xingtao Zhou
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Safety And Efficacy ◽  
Manifest Refraction ◽  
Corrected Distance Visual Acuity ◽  
Minimum Angle

PurposeTo investigate the long-term safety and efficacy of accelerated transepithelial corneal cross-linking (ATE-CXL) in children with progressive keratoconus.MethodsFifty-three eyes of 41 paediatric patients (34 boys, 7 girls; mean age 14.81±1.96 years) undergoing ATE-CXL were enrolled in the study. Corrected distance visual acuity (CDVA) and manifest refraction were assessed preoperatively and 36 months postoperatively. Corneal keratometry, corneal thickness and posterior elevation were measured using Pentacam preoperatively and 1, 6, 12 and 36 months postoperatively. Pachymetry and epithelial thicknesses were measured using optical coherence tomography preoperatively and 6, 12, and 36 months postoperatively.ResultsThirty-six months postoperatively, CDVA improved from 0.32±0.28 to 0.26±0.25 in logarithm of the minimum angle resolution (p=0.025). Maximum keratometry was 58.73±9.70 D preoperatively and 59.20±10.24, 58.28±9.33, 57.88±9.99 and 58.98±10.79 D at 1, 6, 12 and 36 months postoperatively throughout the 36-month follow-up period (p>0.05). Similarly, corneal central thickness, which was 492.42±33.83 µm postoperatively, also remained stable during the 36-month follow-up (p>0.05). Both posterior central elevation and posterior highest elevation were stable at 12 months after ATE-CXL (p>0.05), but increased at 36 months postprocedure (p<0.05). Corneal pachymetry and epithelial thicknesses remained stable throughout the follow-up period (p>0.05).ConclusionsATE-CXL is a safe and effective treatment in paediatric progressive keratoconus patients, leading to stable keratometry and corneal thickness throughout the 36-month follow-up.

scholarly journals Epithelial Remodelling After Epithelium-off Continuous Accelerated Corneal Collagen Cross-linking in Progressive Keratoconus

2021 ◽  
Author(s):  
Junjie Piao ◽  
Ying Li ◽  
Meng Wang ◽  
Sun Joo Kim ◽  
Choun-Ki Joo ◽  
...  
Keyword(s):  
Corneal Thickness ◽  
Anterior Segment ◽  
Cross Linking ◽  
Ultraviolet A ◽  
Corneal Epithelial ◽  
Postoperative Changes ◽  
Uncorrected Distance Visual Acuity ◽  
Minimum Angle ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Abstract Background: To analyse regional corneal epithelial and stromal remodelling after epithelium-off (epi-off) continuous accelerated corneal collagen cross-linking (CXL) for keratoconus (KC).Methods: In this retrospective study, 20 patients (33 eyes) who were treated with epi-off continuous accelerated CXL (KXL system; Avedro, Inc., Waltham, MA, USA). All treatments were performed with ultraviolet-A (UVA) (energy, 7.2 J/cm2; irradiance, 30 mW/cm2), using continuous (4 min) illumination. The postoperative changes in corneal biometric and visual outcomes were compared. The corneal thickness changes were evaluated using anterior segment optical coherence tomography (Optovue). All patients were followed up for 12 months postoperatively.Results: Uncorrected distance visual acuity significantly improved from 1.06 ± 0.49 logarithm of the minimum angle resolution (logMAR) to 0.71 ± 0.37 logMAR at 3 months after epi-off continuous accelerated CXL (p<0.001). The corneal epithelial thickness changes were significant in the inner nasal at -1.48 ± 3.65 µm (p=0.024), -1.76 ± 4.21 µm in the inner superior-nasal (p=0.024), -1.52 ± 4.02 µm in the inner superior (p=0.046), -1.97 ± 4.57 µm in the inner superior-temporal (p=0.018), -2.12 ± 4.46 µm in the outer inferior (p=0.014), -2.15 ± 4.82 µm in the outer inferior-nasal (p=0.022), -1.73 ± 4.45 µm in the outer temporal (p=0.019) at 6 months after epi-off continuous accelerated CXL.Conclusions: Significant regional epithelial remodelling occurs after epi-off continuous accelerated CXL; a more regular corneal thickness profile and keratometric variations were observed after treatment.

scholarly journals Phacoemulsification surgery by a nationally-trained cataract surgeon of Nepal

2012 ◽  
Vol 4 (2) ◽  
pp. 248-255
Author(s):  
S Bajimaya ◽  
B R Sharma ◽  
J B Shrestha ◽  
I M Maharjan ◽  
H Matsushima ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Corneal Edema ◽  
Visual Outcome ◽  
Corneal Epithelial ◽  
Corneal Epithelial Defect ◽  
Posterior Capsule Rupture ◽  
The Mean ◽  
Phaco Time

Introduction: A one month phacoemulsification training course had been implemented by the Nepal Netra Jyoti Sangh (NNJS) in collaboration with Association for Ophthalmic Cooperation to Asia, Japan (AOCA). Objective: To evaluate the visual outcomes of phacoemulsification surgery by a nationally trained surgeon in Nepal. Materials and methods: A retrospective study of patients that underwent phacoemulsification with foldable intraocular lens implantation during a period of 18 months was carried out. Cases that had a six-week follow-up period were included. Effective phaco time (EPT), intra-operative and postoperative complications were noted. Uncorrected visual acuity (UCVA) at day 1 and best corrected visual acuity (BCVA) at week 6 were noted. The data were analyzed using SPSS 11.5. Results: A total of172 patients that had completed a 6 week follow-up evaluation were included in the study. The mean age of patients was 57.12±10.19 years. The mean effective phaco time (EPT) was 9.74±7.41 seconds. Posterior capsule rupture (PCR) with vitreous loss occurred in 2 eyes (1.2%), Descemet’s membrane detachment in 1 eye (0.6%), capsulorhexis extension in 1 eye (0.6%) and wound site thermal injury (WSTI) occurred in 3 eyes (1.7%). Postoperative complications were mild to moderate striate keratopathy (9/ 172), corneal edema (1/172), corneal epithelial defect (1/172) and uveitis (1/172). At 6 weeks post-operatively, 165 eyes (95.9%) had a BCVA better than 6/18 and 7 eyes (4.1%) had a BCVA of 6/18 to 6/60.Conclusion: Patients undergoing phacoemulsification had a good visual outcome as a result of the procedure performed by cataract surgeon trained from AOCA/NNJS national phacoemulsification training program of Nepal.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6540 Nepal J Ophthalmol 2012; 4 (2): 248-255 

CLINICAL CHARACTERISTICS AND RESULTS OF CATARACT SURGERY IN THE SMALL PUPIL EYE BY PHACOEMUSIFICATION

2018 ◽  
pp. 79-82
Author(s):  
Van Minh Pham ◽  
Van Nam Phan ◽  
Thi Thu Nguyen
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Clinical Characteristics ◽  
Low Vision ◽  
Sample Selection ◽  
Posterior Chamber ◽  
Good Visual Acuity ◽  
Before And After ◽  
Grade Ii ◽  
Small Pupil

Objectives: To investigate the clinical characteristics of cataract patients with small pupils and to evaluate the result of cataract surgery on the eye have small pupils by phacotechnique. Subjects and methods: Descriptive study, prospective, uncontrolled interventions. Sample selection. The sample size of 70 patients with 70 eyes of cataracts with small pupils was treated by phaco technique and intraocular lens implant within posterior chamber. Follow up to 3 months. Results: 70 eyes, the percentage of men and women was not different from 54.2% (38 male) compared to 45.8% (32 female). The mean age was 80 ± 8.74, from 58 to 99 years. The disease was mainly found in the age group over 70 years old with over 80% (51.5%). Visual acuity before surgery was very poor under 3m CF (count finger) for 68.6% (48/70). Visual acuity over 1/10 was only a small amount with 2.8% (2 eyes). Pseudoexfoliation was the most common reason complications of mydriasis with 32/70 eyes (45.7%) and 22/70 eyes (31.4%) for age. The preoperative pupilarysizewas mostly small with 63/70 eyes (90.0%), non-dilated pupils (7/70 eyes) (10.0%). Average pupil size was 3.34 mm (2 - 4mm). Iris condition: iris atrophy 20/10 eyes (28.6%), iris synechiae 11/10 (15.7%), irregular iris muscle with 51, 4% and good iris muscle accounted for 48.6%. Grade of cataract: Grade III: 31/70 eyes (44.3%), Grade IV: 32/70 eyes (45.7%), Grade II: 5/70 eyes (7.1%) and V:2/70 eyes (2.9%). Pupil expander technique: OVD injection with 42/70 eyes (60%), using iris hook with 23/70 eyes (32.9%). Pupillary size before and after intervention has changed from 3.7mm to 4.48mm. Conclusions: Iris expander techniques have been shown to have good dilated pupils: 60.0% OVD injection, iris hook was 32.9%, other methods 7.1% One-week visibility of good visual acuity was higher than that of postoperative one day (12.2%) and increased at 1 month and 3 months (20.0%). Very good visual acuity was not available and low vision group was 1.4% after 3 months. Key words: cataract surgery; phacoemusification, small pupil

STUDY CLINICAL FEATURE AND RESULT OF TREATMENT PHACOMORPHIC GLAUCOMA

2015 ◽  
pp. 71-75
Author(s):  
Van Nam Phan ◽  
Ba Ken Tran
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Statistical Significance ◽  
Corneal Edema ◽  
Clinical Feature ◽  
Anterior Chamber Angle ◽  
Male Population ◽  
Significant Difference ◽  
Operative Complications ◽  
Before And After

Purpose: Study clinical feature of phacomorphic glaucoma. To evaluate the result of treatment phacomorphic glaucoma. Method: The retrospective, interventional study on 36 cases with phacomorphic glaucoma who underwent treated at Hue Central Hospital from 6/2010 to 6/2011. Standard of research: visual, IOP, before and after surgery, accompanying lesions and post-operative complications. The surgery is considered successful when postoperative IOP less than 21 mmHg. Results: Age 50-59 presented 30.5 percent, ≥ 60 presented 91.7 percent. There was a slight female preponderance (66.7%) compared to the male population (33.3%) which implies a statistically marginally significant difference. However there was no statistical significance difference when compared by the two subgroups. Patient in country presented 61,1% and city presented 38,9%. The duration between the onset of pain and surgery from 0 to < 5 days (77.8%), from 6 to 10 (16.7%) and >10 days presented 5.5%. The preoperative intraocular pressure 35 to 45mmHg (47.2%), 46-55 (30.6%), 56-65 (13.9%) and more than 65 presented 8.3%. The visual acuity preoperation less than 1metre count finger (94.5%), less than 3 metre count finger presented 5.5%. Close anterior chamber angle presented 80.6% and shallow was presented 19.4%. Corneal edema presented 100%, iritis presented 94.4%, dilated pupil larger 5mm presented 83.3%, Synchynea iris and cataract presented 72.2%. ECCE, implantation IOL combined trabeculectomy presented 11.1%, Phaco, implantation IOL combined trabeculectomy presented 69,5%, ECCE implantation IOL presented 5.6%, Phaco, implantation IOL presented 13.8%. Postoperative visual acuity from 1/10 to 5/10 presented 72.2%, no case have VA larger than 5/10. Postoperative 3 months VA 1/10 to 5/10 presented 72.2%, larger VA 5/10 presented 8.3%. Postoperative 3 months intraocular pressure ≤ 21mmHg presented 91.7%, 22 to 24mmHg presented 8.3%, no case have IOP ≥25mmHg. Postoperative edema presented 58.3%, iritis presented 58.3%. Key words: phacomorphic Glaucoma

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