scholarly journals Accelerated corneal endothelial cell loss in two patients with granulomatosis with polyangiitis following phacoemulsification

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fang-Chi Hsiao ◽  
Hung-Ta Chen ◽  
Kuan-Jen Chen ◽  
Yi-Jen Hsueh ◽  
Yaa-Jyuhn James Meir ◽  
...  

Abstract Background Generally, the loss rate of human endothelial cells (HCEC) in routine cataract surgery is 8.5%. When the corneal endothelial cells density (ECD) drops, the HCEC may decompensate to keep cornea dehydration which leads to corneal edema. Granulomatosis with polyangiitis (GPA) is an uncommon autoimmune disease involving multiple organs including eyes such as conjunctivitis, scleritis, uveitis, and corneal ulcer. In this study, we report two cases of GPA whose corneal ECD decreased significantly after phacoemulsification cataract surgery. Case presentation In the first case of 69-year-old male with GPA, the ECD dropped 39.6% (OD) four months after phacoemulsification and 38.1% (OS) six months postoperatively respectively. At the final follow-up, the residual ECD was only 55% in the right eye in the 49th month, and 56% remained in the left eye in the 39th month. In the second case of 54-year old female, left ECD dropped 63.9% at the 4th month after surgery and 69.6% ECD remained at the 15th month postoperatively while similar ECD of right eye before and after left eye surgery. Conclusion Extensive preoperative ophthalmic evaluation and meticulous postoperative inflammation control should be applied to prevent severe loss of HCEC in GPA patients.

2021 ◽  
pp. 659-663
Author(s):  
Shimon Kurtz ◽  
Maayan Fradkin

We describe a case of Urrets-Zavalia syndrome (UZS) in a healthy 56-year-old woman who underwent femtosecond-assisted phacoemulsification with intraocular lens implantation in both eyes. One month after an uneventful postoperative course in the left eye, the right eye was operated. Dilated pupil which was nonreactive to light appeared on day 21 postoperatively. This was discovered upon examination following anterior chamber inflammatory reaction which occurred 2 weeks following her surgery. Our case report emphasizes the importance and danger in developing UZS even if the reaction in the anterior chamber does not occur immediately after surgery. In addition, the importance of intraocular pressure follow-up in the period after UZS is acknowledged.


2013 ◽  
Vol 6 (2) ◽  
pp. 125-130
Author(s):  
Danelina E. Vacheva ◽  
Verjinia K. Simeonova ◽  
Boyko St. Stamenov

Summary Bulgaria ranks first in the world in incidence, morbidity and death associated with cerebrovascular disease. The aim of the study was to investigate, follow-up and register recovery of activities of daily living (using the toilet and maintaining personal hygiene) in patients with sequelae from cerebrovascular disease in a subacute stage, who underwent physiotherapy and rehabilitation. Sixty-one patients were included and followed up. They were given tailored physiotherapy and rehabilitation. This included kinesitherapy, occupational therapy and electrotherapy. All the patients filled in self-assessment questionnaires before and after the rehabilitation course. Major parameters were assessed, irrespective of the limb affected -dominant or non-dominant. Results were analyzed using the Wilcoxon rank test. At the end of the rehabilitation course, the Wilcoxon curves were driven to the right, confirming improvement concerning independence, irrespective of involvement of dominant or non-dominant limb.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruba A. Khasawneh ◽  
Ziyad M. Mohaidat ◽  
Rawand A. Khasawneh ◽  
Sohaib B. Zoghoul ◽  
Yousef M. Henawi

Abstract Background Hydatid disease is an endemic disease in many countries of the world including the Middle East. It mainly affects the liver and lungs. Intramuscular hydatid disease is rarely reported in children. Such uncommon localization of hydatid cyst may pose difficulties in the clinical and radiological diagnosis; hence affecting patient’s management and outcome even in endemic areas. Case presentation We herein describe intramuscular hydatid cysts in 2 different children. The first case is a 5-year-old boy who presented with a painless palpable lump over the right lumbar paraspinal region. His history was remarkable for sheep contact. His laboratory results revealed a mild increase in white blood cell (WBC) count and C-reactive protein. The lesion showed typical features of a hydatid cyst on ultrasound. Further imaging including ultrasound of the abdomen and CT of the chest, abdomen, and pelvis showed infestation of the liver and lung as well. The lesions were resected surgically without complications. The patient received Albendazole preoperatively and after surgery for 3 months. No evidence of recurrence was seen during follow-up. The second case is a 6-year-old girl who presented with an incidental palpable lump in her left thigh during her hospital admission for recurrent meningitis. Ultrasound and MRI imaging were performed demonstrating a unilocular cystic lesion in the left proximal rectus femoris muscle. A provisional diagnosis of hematoma vs. myxoma was given. Biopsy was performed and yielded blood products only. The lesion was resected surgically with a postoperative diagnosis of hydatid cyst. Blood tests performed afterward showed a positive titer for Echinococcus. The patient received Albendazole for 3 months. No evidence of recurrence was seen during follow-up. Conclusions Despite its rarity; skeletal muscle hydatid cyst should always be considered in the differential diagnosis of cystic muscle lesions in children in endemic areas even if imaging studies did not show any of the typical signs. This will improve patient outcome by preventing unnecessary cystic puncture which might lead to serious complications, such as anaphylaxis and local dissemination.


2020 ◽  
Vol 6 (2) ◽  
pp. 205511692096243
Author(s):  
Sarah Elhamiani Khatat ◽  
Rosario Vallefuoco ◽  
Meryem El Mrini ◽  
Morgane Canonne-Guibert ◽  
Dan Rosenberg

Case summary A 10-year-old neutered male domestic shorthair cat was diagnosed with renal adenocarcinoma associated with hypertrophic osteopathy. The cat was referred for chronic ambulation difficulties. The physical examination showed a painful thickening of all four limbs, a right cranial abdominal mass and a conjunctival hyperaemia. Radiographic findings were consistent with extensive periosteal new bone formation involving not only the diaphyses of the fore- and hindlimbs, but also of the pelvis, tarsus and carpus. Abdominal ultrasonography and CT revealed a mass within the right kidney and a primary neoplasm was suspected. A ureteronephrectomy of the right kidney was performed and histopathology confirmed the diagnosis of renal adenocarcinoma. Although clinical improvement of the lameness occurred after surgery, no radiographic changes of hypertrophic osteopathy lesions were observed at the 9-month follow-up. Relevance and novel information Feline cases of hypertrophic osteopathy are rarely reported in the literature and only a few of them were associated with abdominal neoplastic diseases. To our knowledge, this is the first case of renal adenocarcinoma associated with hypertrophic osteopathy in a cat.


2017 ◽  
Vol 14 (04) ◽  
pp. 209-212
Author(s):  
Bunyada Putthirangsiwong ◽  
Pornchai Mahaisavariya ◽  
Weerawan Chokthaweesak ◽  
Dinesh Selva

Abstract Saksenaea erythrospora is a rare pathogen in humans. Ten adult cases have been previously reported, eight manifested with cutaneous infection, and two presented with invasive rhinosinusitis infection. The authors present a 16-month-old boy with progressive painful mass at the right medial canthus and upper cheek that was unresponsive to broad-spectrum antibiotics. He underwent an anterior orbitotomy and biopsy. Histopathology revealed broad nonseptate sterile hyphae and grew S. erythrospora, which was confirmed by molecular techniques. The patient was treated with intravenous liposomal amphotericin B and oral itraconazole combined with aggressive surgical debridement. The patient made a complete recovery without long-term complications at 4 months of follow-up. Primary cutaneous mucormycosis caused by S. erythrospora may rarely involve the periocular region and mimic chronic dacryocystitis. We report the first case of pediatric periocular cutaneous mucormycosis caused by S. erythrospora.


2019 ◽  
Vol 12 ◽  
pp. 117954761985659
Author(s):  
Christopher M Low ◽  
Daniel L Price ◽  
Jan L Kasperbauer

Background: Mandibular tori are a rare cause of difficult direct visualization of the upper aerodigestive tract. In the setting of aerodigestive tract pathology necessitating direct visualization, removal of mandibular tori may be required to facilitate treatment. Methods: In the first case, large bilateral symmetric mandibular tori were removed to facilitate access to the anterior commissure and removal of a T1 glottic squamous cell carcinoma (SCC). In the second case, large bilateral mandibular tori were removed to access a markedly exophytic SCC in the right vallecula. Subsequently, the tumor was removed with robotic assistance with excellent exposure. Results: Both patients were free of recurrence at last follow-up. Conclusion: Mandibular tori are an uncommon cause of difficult direct laryngoscopy. In situations that require direct visualization of the anterior commissure or base of tongue for diagnosis and management of lesions, surgical removal of the tori may be required as in the cases presented here.


2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Chenglong Wang ◽  
Yijia Cao ◽  
Min Zeng ◽  
Lijuan Wang ◽  
Xiaojing Cao ◽  
...  

Abstract Background Lymph node inclusions are foci of ectopic tissue in lymph nodes, which were reported in different areas of the body. However, inclusions in the mediastinal lymph node are rare. Here, we report the first case of glandular inclusion within the parenchyma of the intrapulmonary lymph node in a patient with primary lung adenocarcinoma. Case presentation A computed tomography (CT) scan showed a solid pulmonary nodule in the right upper lobe in a 44-year-old man. After a fine needle aspiration biopsy diagnosis of adenocarcinoma, lobectomy and lymph dissection were performed. Histological sections of the lung demonstrated a papillary predominant adenocarcinoma and one intrapulmonary lymph node, which displayed glandular inclusion occupying the node parenchyma. The gland inclusion was very similar to metastasis, but was formed by two layers of epithelial cells, and the abluminal cells were positive for P63, P40, and CK5/6. The patient has remained alive without recurrence and metastasis at the last follow-up before publication. Conclusions It is very important to correctly diagnose a lymph node inclusion for proper clinical management.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Susana Pina ◽  
Catarina Pedrosa ◽  
Cristina Santos ◽  
Bernardo Feijóo ◽  
Peter Pego ◽  
...  

We report a case of a 65-year-old woman with symptoms of blurred vision and ocular irritation a few hours after accidental contact of the right eye withAsclepias physocarpamilky latex. Observation showed a diffuse conjunctival hyperemia and stromal corneal edema with Descemet’s membrane folds. Recovery was fast and apparently complete in less than one month. However, specular microscopy at 6-months follow-up showed an abnormal endothelial morphology as sequelae, suggesting this condition is not as innocuous as it has been suggested.


2016 ◽  
Vol 7 (2) ◽  
pp. 124-134
Author(s):  
Rahul Bhargava ◽  
Shiv Kumar Sharma ◽  
Mini Chandra ◽  
Prachi Kumar ◽  
Yogesh Arora

Introduction: Endothelial cell loss and complications after cataract surgery may be higher when cataract is complicated by uveitis.Objective: To compare endothelial cell damage and complication rates after phacoemulsification and manual small incision cataract surgery (SICS) in patients with uveitis.Materials and methods: Patients with uveitic cataract were randomly allocated for phacoemulsification (n=75) or manual SICS (n=80) in a double blind prospective study. In the bag implantation of a hydrophobic acrylic intraocular lens was aimed in all cases. Patients with follow up of less than six months were excluded. Main outcome measures were alteration in endothelial cell counts (ECC) and morphology, improvement in vision and complication rates. ECC was measured preoperatively and at 1 week, 3 months and six months, postoperatively.Results: Six patients were lost to follow up and another three due inability to implant IOL. There were no significant difference in endothelial cell counts (P= 0.032), the variance of endothelial cell size (CV) and percentage of hexagonal cells between both the groups at six months (Mann-Whitney test, P=0.283). Endothelial cell density was significantly less in the group in which vitrectomy and/or pupil dilatation procedures were performed (2290±31.5 cells/mm2) versus (2385±50.3 cells/mm2), respectively (t test, P<0.001). Incidence of postoperative complications that were observed like persistent uveitis (P=0.591), macular edema (P=0.671) and PCO (P=0.678) and visual outcome (P=0.974) were comparable between the two groups.Conclusions: Manual SICS and phacoemulsification do not differ significantly in endothelial cell loss and complication rates in uveitic eyes. However, increased anterior chamber manoeuvring due to additional procedures may lead to significantly higher endothelial cell loss.


2013 ◽  
Vol 127 (6) ◽  
pp. 614-618 ◽  
Author(s):  
Y W Kim ◽  
M-J Baek ◽  
K H Jung ◽  
S K Park

AbstractObjective:We report two extremely rare cases of symptomatic nasopharyngeal branchial cleft cyst treated by powered instrument assisted marsupialisation.Methods:Case report and literature review concerning nasopharyngeal branchial cleft cyst and surgical treatment methods.Results:The first case was a two-year-old boy with a 1 × 2 cm, cystic, oropharyngeal mass, who also had severe snoring and sleep apnoea. The second case was a 56-year-old man with right nasal obstruction and a sensation of fullness in the right ear. In both cases, we performed endoscopic marsupialisation using a powered instrument. There was no recurrence in either case over two years of follow up.Conclusion:Powered instrument marsupialisation is a simple, effective and less invasive technique for the treatment of nasopharyngeal branchial cleft cyst.


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