scholarly journals Penetrating keratoplasty for the management of a severe idiopathic lipid keratopathy

2021 ◽  
pp. 043-043
Author(s):  
Kaisari Eirini
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Slit Lamp ◽  
Visual Axis ◽  
Slit Lamp Examination ◽  
Eccentric Fixation ◽  
Corrected Visual Acuity ◽  
History Of ◽  
Temporal Lesion ◽  
Best Corrected Visual Acuity

An 83-year-old female presented with progressive bilateral lipid keratopathy (LK) during the last 12 years. There was no history of previous ocular disease or trauma. Slit lamp examination of the left eye revealed a diffuse LK obscuring the visual axis and a temporal epithelial papillomatous lesion with superficial neovascularization (Figure A), while Best Corrected Visual Acuity (BCVA) was 20/200 with eccentric fixation. An uneventful Penetrating Keratoplasty (PKP) combined with excision of the temporal lesion was performed.

scholarly journals Lens coloboma secondary to neglected buphthalmos

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Mousumi Banerjee ◽  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Optic Nerve ◽  
Axial Length ◽  
Congenital Glaucoma ◽  
Slit Lamp ◽  
Posterior Subcapsular Cataract ◽  
Slit Lamp Examination ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

A 36-year-old male presented with progressive diminution of vision OS for 3 months. He was a known case of bilateral congenital glaucoma who underwent trabeculectomy at 6 months and 5 years of age OD and OS respectively. Best corrected visual acuity was 6/24 OD and 1/60 OS. Slit lamp examination revealed bilateral Haab striae (Figure 1a) with lens subluxation OS evident by the scalloped border of the lens with broken zonules in the superonasal quadrant and lens coloboma in the inferonasal quadrant with the absence of zonules (Figure 1b,c,d). A posterior subcapsular cataract was also noted OS. Advanced glaucomatous optic nerve cupping was noted OU. An intraocular pressure of 10 mm Hg OD and 16 mm Hg OS was noted. Biometry documented an axial length of 26.30 mm OD and 28.75 mm OS with a keratometry of 42.50D/46.50D @20˚/110˚OD and 37.75D/40.00D @ 45˚/135˚OS. Ultrasound bio-microscopy depicted increased sphericity of the lens with broken zonules OS (Figure 1e).

scholarly journals Descemet membrane suturing to manage recurrent graft detachment in a patient with Descemet membrane endothelial keratoplasty on failed penetrating keratoplasty

2021 ◽  
Vol 13 ◽  
pp. 251584142110277
Author(s):  
Zahra Ashena ◽  
Thomas Hickman-Casey ◽  
Mayank A. Nanavaty
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Anterior Segment ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Ocular Coherence Tomography ◽  
Corrected Visual Acuity ◽  
Intracameral Injection ◽  
History Of

A 65-year-old patient with history of keratoconus, mild cataract and penetrating keratoplasty over 30 years ago developed corneal oedema subsequent of graft failure with best corrected visual acuity (BCVA) of counting fingers. He underwent a successful cataract surgery combined with a 7.25 mm Descemet’s Membrane Endothelial Keratoplasty (DMEK) with Sodium Hexafluoride (SF6) gas. His cornea remained oedematous inferiorly at 4 weeks, despite two subsequent re-bubbling due to persistent DMEK detachment inferiorly. This was managed by three radial full thickness 10-0 nylon sutures placed in the inferior cornea along with intracameral injection of air. Following this, his anterior segment ocular coherence tomography (OCT) confirmed complete attachment of the graft, and the sutures were removed 4 weeks later. Unaided visual acuity was 20/63 and BCVA was 20/32 after 8 months. DMEK suturing can be helpful in persistent DMEK detachments, which is refractory to repeated re-bubbling due to uneven posterior surface of previous PK.

scholarly journals Corneal Neovascularization and Lipid Keratopathy after Intacs SK in Keratoconus

2013 ◽  
Vol 2 (3) ◽  
pp. 133-138
Author(s):  
Ramez Barbara ◽  
David Zadok ◽  
Adel Barbara ◽  
Shay Gutfreund
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Corneal Neovascularization ◽  
Young Female ◽  
Spherical Equivalent ◽  
Corrected Visual Acuity ◽  
Optical Zone ◽  
Positive Results ◽  
Oval Shape ◽  
Best Corrected Visual Acuity

ABSTRACT Intacs have yielded positive results for the treatment of keratoconus in terms of reducing the keratometry readings astigmatism and spherical equivalent and consequently improving the uncorrected and best corrected visual acuity. Intacs severe keratoconus (SK) are new design of Intacs with a smaller optical zone (6 mm) and oval shape, they are indicated for severe keratocnus. Pannus is one of the complications of Intacs, as it has never been reported after Intacs SK. We report on corneal neovascularization in the corneal periphery which developed few months after Intacs SK implantation in the cornea of a young female who suffered from advanced keratoconus. The uncorrected visual (UCVA) acuity was satisfactory and the Intacs SK where not removed. Four years after the implantation she presented to our clinic complaining about eye irritation and photophobia, lipid keratopathy was observed. We gave here the choice of explanting the Intacs SK or to try to treat the neovascularization by subconjunctival Avastin, she preferred the second option because of a satisfactory UCVA (0.9). Avastin was injected in the subconjunctival, 10 weeks later Avastin and Kenelog were injected in the subconjunctival, few days after the second injection perforation and melting developed in the cornea, the patient underwent a tectonic graft and few months later penetrating keratoplasty with no intraoperative or postoperative complications. How to cite this article Barbara A, Zadok D, Gutfreund S, Barbara R. Corneal Neovascularization and Lipid Keratopathy after Intacs SK in Keratoconus. J Kerat Ect Cor Dis 2013;2(3):133-138.

When the Trauma Draws a Rose: Rosette Cataract

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Madbouhi K ◽  
◽  
Cherkaoui O ◽  
Keyword(s):  
Visual Acuity ◽  
Emergency Room ◽  
Male Patient ◽  
Slit Lamp ◽  
Posterior Subcapsular Cataract ◽  
Slit Lamp Examination ◽  
Corrected Visual Acuity ◽  
The Hours ◽  
Rose Rosette

A 40-year-old male patient referred to the ophthalmologic emergency room for complaints of diminution of vision in the left eye since three months after a trauma. Examination of the left eye showed a corrected visual acuity of 20/70. Slit-lamp examination revealed a rosette cataract (Figure 1). The patient underwent phacoemulsification with implantation of an IOL in the bag. The rosette cataract is a posterior subcapsular cataract due to a violent contusion with a closed globe. It can develop in the hours that follow, or on the contrary several years later.

Ellipsoid layer restoration after Ozurdex® treatment in a patient with acute posterior multifocal placoid pigment epitheliopathy

2019 ◽  
pp. 112067211988359 ◽  
Author(s):  
Arnau Mora-Cantallops ◽  
M Dolores Pérez ◽  
Marcelino Revenga ◽  
Julio Jose González-López
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Optical Coherence ◽  
Dexamethasone Implant ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Intravitreal Dexamethasone Implant ◽  
History Of ◽  
Intravitreal Dexamethasone ◽  
Consequent Improvement

An atypical case of acute posterior multifocal placoid pigment epitheliopathy with a clear reappearance of the ellipsoid layer of the retina after Ozurdex® intravitreal implantation is presented. A 51-year-old woman reported a 3-week history of left eye photopsia. On slit-lamp examination, yellowish placoid lesions were found on her left eye fundus. Ancillary tests were performed. The patient was diagnosed as a left eye acute posterior multifocal placoid pigment epitheliopathy, and observational approach was decided. Later, the condition started to progress in an ampiginous manner and a decrease of visual acuity caused by an increase in number and size of the lesions was observed. As the disease was progressing with the conservative, observational approach, and the macula was menaced, an intravitreal dexamethasone implant was injected in the left eye with a consequent improvement of the visual acuity and lesion stabilization. The ellipsoid layer, unidentifiable inside the placoid lesions in previous optical coherence tomography tests, reappeared after the treatment. Intravitreal dexamethasone implants can be used to stabilize acute posterior multifocal placoid pigment epitheliopathy lesions and help resolve the condition. Spectral domain optical coherence tomography can also be useful for monitoring these lesions, as the ellipsoid layer may reappear upon resolution.

Surgical management of pterygium in a rural hospital using bare sclera versus conjunctival autograft technique

2017 ◽  
Vol 5 (5) ◽  
pp. 2076
Author(s):  
Dinesh P. ◽  
Sundip Shenoy ◽  
Nidhi Pandey ◽  
Pavan Kumar Reddy D.
Keyword(s):  
Visual Acuity ◽  
Connective Tissue ◽  
Medical Sciences ◽  
Visual Axis ◽  
Recurrence Rates ◽  
Conjunctival Autograft ◽  
Corrected Visual Acuity ◽  
Department Of Ophthalmology ◽  
Best Corrected Visual Acuity ◽  
Conjunctival Autografting

Background: Pterygium is defined as a triangular fibrovascular subepithelial ingrowth of degenerative bulbar conjunctival tissue over limbus onto the cornea. Commonly seen among farmers, fishermen, stone cutters and welders. Both blue and ultraviolet light have been implicated in its causation. Histologically the true Pterygium shows elastotic degeneration of the subconjunctival connective tissue. Pterygium warrant treatment when they encroach the visual axis, induces significant astigmatism or become cosmetically bothersome. My present study was undertaken to evaluate the efficacy, safety and recurrence rates of conjunctival autograft and bare sclera techniques in treatment of progressive true pterygium in a rural hospital.Methods: The prospective study was done in the Department of Ophthalmology, Adichunchanagiri Institute of Medical Sciences, B.G Nagara, Mandya District, Karnataka, India. The study was conducted for a period of 18 months. About 70 patients who presented with progressive pterygium were included in the study.Results: In our study pterygium recurred in 10 cases (14.28%), among which pterygium recurred in 8 cases (22.85 %) using bare sclera technique and in 2 patients (5.71%) using conjunctival autograft technique, best corrected visual acuity remained stable in 37 cases (52.85 %), improved in 33 cases (47.14 %) and worsened in none (0%) of the cases.Conclusions: Conjunctival autografting is a safe and effective procedure in the management of pterygium. The recurrence rate following limbal conjunctival autografting is significantly lower than that following primary conjunctival closure by bare sclera technique.

scholarly journals Correction of postkeratoplastic astigmatism by intrastromal corneal segments implantation using a femtosecond laser

2021 ◽  
Vol 6 (6-1) ◽  
pp. 48-55
Author(s):  
N. A. Pozdeyeva ◽  
M. V. Sinitsyn ◽  
A. E. Terentieva ◽  
O. V. Shlenskaya
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Penetrating Keratoplasty ◽  
Biomechanical Properties ◽  
Corneal Graft ◽  
Corneal Resistance Factor ◽  
Astigmatism Correction ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Best Corrected Visual Acuity

Background. After penetrating keratoplasty, mild to high induced corneal astigmatism was observed in each case. The existing choice of correction of postkeratoplastic astigmatism is aimed at fi nding an individual approach in order to compensate for it and not weaken the biomechanical properties of the corneal graft.The aim: to analyze the clinical, functional, and morphological results of postkeratoplastic astigmatism correction by implantation of intrastromal corneal segments using a femtosecond laser.Methods. 22 patients were examined before and 1 year after surgery. The operation was performed under local anesthesia: stage I – an intrastromal tunnel was formed using a femtosecond laser “Femto Visum” 1 MHz (Optosystems, Russia); stage II – the intrastromal corneal segments were implanted. The results were assessed using standard and special research methods using optical coherence tomography Visante OCT (Zeiss, Germany), keratotopography (Tomey-5, Japan), optical corneal analyzer ORA (Reichert, USA), laser tindalemetry FC-2000 (Kowa, Japan) and confocal microscope Confoscan-4 (Nidek, Japan).Results. Before the operation, uncorrected visual acuity averaged 0.09 ± 0.05, after a year – 0.50 ± 0.16; best corrected visual acuity – 0.30 ± 0.12 and 0.60 ± 0.05 respectively; cylindrical component of refraction – –10.29 ± 3.12 and –2.20 ± 0.64 D respectively; mean keratometry value – 43.59 ± 2.14 and 38.56 ± 1.75 D respectively; corneal hysteresis – 7.92 ± 1.22 and 8.95 ± 1.05 mm Hg respectively; corneal resistance factor – 7.01 ± 1.81 and 8.44 ± 1.44 mm Hg respectively; protein fl ux in the moisture of the anterior chamber – 2.97 ± 0.28 and 3.04 ± 0.24 f/ms respectively; endothelial cell density – 1521 ± 327 and 1475 ± 419 cells/mm2 respectively.Conclusion. Intrastromal corneal segments implantation into a corneal graft using a femtosecond laser has efficiency and safety method in correcting postkeratoplastic astigmatism.

scholarly journals ND: YAG LASER

2018 ◽  
Vol 25 (12) ◽  
pp. 1848-1851
Author(s):  
Mohammad Alam
Keyword(s):  
Visual Acuity ◽  
Nd:Yag Laser ◽  
Posterior Capsular Opacification ◽  
Eye Drops ◽  
Slit Lamp ◽  
Yag Laser ◽  
Corrected Visual Acuity ◽  
Nd:Yag Laser Capsulotomy ◽  
Department Of Ophthalmology ◽  
Best Corrected Visual Acuity

Objectives: To find out the visual acuity outcome after Nd: YAG laser capsulotomy in posterior capsular opacification in pseudophakic patients after cataract surgery. Study Design: Analytical study. Setting: Department of Ophthalmology Khyber Medical University Institute of Medical Sciences / K.D.A Teaching Hospital Kohat. Period: January 2016 to June 2017. Materials and methods: Special proforma was designed for record of patients. PreNd:YAG laser posterior capsulotomy best corrected visual acuity was checked and noted. Anterior and posterior segments examination was done with slit lamp and indirect slit lamp bimicroscopy. Pupils were dilated with tropicamide eye drops. Nd:YAG laser capsulotomy was done. All these procedure were conducted as out door. Patients were put on topical steroid and antiglaucoma drops for ten days to control inflammation and rise in IOP. Post laser best corrected visual acuity was recorded after one month of laser. Results: Total 92 patients were selected with age range from 21 to 83 years. Out of these patients 43(46.74%) were male and 49(53.26%) were female. Post surgical laser period was from 7 months to 13 years. Prelaser best corrected visual acuity of 6/24-6/36 was present in 59(64.13%) patients, 6/60 in 24(26.08%) patients while 9(9.78%) patients had visual acuity of counting finger (CF). Post laser best corrected visual acuity after one month of 6/6-6/9 was recorded in 43(46.39%) patients ,6/12-6/18 in 27(29.34%), 6/24-6/36 in 13(14.13%)and 6/60 & below in 9(9.71%) patients. Conclusion: Post laser best corrected visual acuity is highly improved with Nd:YAG laser capsulotomy in posterior capsular opacification.

scholarly journals Penetrating Keratoplasty for Keratoconus in Vietnamese Patients

2019 ◽  
Vol 7 (24) ◽  
pp. 4287-4291
Author(s):  
Le Xuan Cung ◽  
Duong Mai Nga ◽  
Nguyen Dinh Ngan ◽  
Nguyen Xuan Hiep ◽  
Do Quyet ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Contact Lenses ◽  
High Rate ◽  
Posterior Subcapsular Cataract ◽  
Corrected Visual Acuity ◽  
Severe Stage ◽  
Hard Contact ◽  
Best Corrected Visual Acuity ◽  
Corneal Disorder

BACKGROUND: Keratoconus is an ectatic corneal disorder that can impair the visual acuity. Up to now, penetrating keratoplasty (PK) remains the most common surgical procedure to treat severe keratoconus. In Vietnam, most keratoconus patients come to visit doctor at severe stage and were treated by PK, so we conduct this study. AIM: To evaluate the results of PK for keratoconus in Vietnamese patients. METHODS: This was a retrospective study of 31 eyes with keratoconus who underwent PK in VNIO from January 2005 to December 2014. RESULTS: The average visual acuity was 0.86 ± 0.37 logMAR (20/145). In the group of patients without amblyopia, best spectacle-corrected visual acuity of 20/60 or better was recorded in 75.9% of eyes and 93.1% of eyes achieved a best corrected visual acuity with hard contact lenses of 20/40 or better. Mean postoperative corneal power was 43.8 ± 4.5D. Mean corneal astigmatism was 5.9 ± 2.7D. 94.6% of grafts remained clear. Posterior subcapsular cataract developed in 22.6% of eyes. Graft rejection was recognized in 12.9% of eyes. CONCLUSION: PK is an effective procedure with high rate of graft survival for keratoconus patients. However, patients should be aware of the necessary of optical correction to gain the best VA after surgery.

Unilateral spontaneous filtering bleb dissecting into the cornea in a patient with high myopia

2019 ◽  
pp. 112067211987715
Author(s):  
Pablo Sanjuán ◽  
Borja Salvador-Culla ◽  
Maria Isabel Canut ◽  
Rafael I Barraquer
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
High Myopia ◽  
Anterior Segment ◽  
Cataract Extraction ◽  
Posterior Chamber ◽  
Visual Axis ◽  
Filtering Bleb ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Purpose: To report a case of a unilateral spontaneous filtering bleb dissecting into the cornea in a patient with high myopia. Clinical case: A 33-year-old woman with high myopia (–18 D) presented with discomfort in the left eye. Ocular history included pars plana vitrectomy and cataract extraction and posterior chamber intraocular lens implantation in the left eye. Best-corrected visual acuity was 0.65 and intraocular pressure was 20 mmHg. Slit-lamp examination showed a filtering bleb in the upper-temporal quadrant, which extended and dissected the proximal cornea without affecting the visual axis. The morphology and content of the bleb was studied with anterior segment optical coherence tomography, which ruled out a corneal-scleral fistulization into the subconjunctival space. The spontaneous filtering bleb was resected surgically. Due to her high myopia, two strips of fascia lata were used to strengthen the area. In the postoperative period, a complete resection of the bleb was confirmed, without apparent leaking points and with a well-vascularized conjunctiva. No complications were noted. The patient maintained the same best-corrected visual acuity and intraocular pressure than before surgery. Conclusion: The formation of a spontaneous filtering bleb is a rare entity in patients with high myopia, whose risk increases due to their thinned sclerae. The risk is even greater if they have undergone ocular surgeries. Resection of the filtering bleb in our case halted the progression of the corneal dissection, therefore respecting the transparency of the visual axis and preserving visual acuity.

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