1/20. Retrieval of a dropped corneal button from a vitrectomized eye.A successful retrieval of a dropped corneal button from an aphakic vitrectomized eye during penetrating keratoplasty is reported. A 52-year-old female patient underwent penetrating keratoplasty for aphakic corneal edema in a vitrectomized eye. The donor button inadvertently dropped into the vitreous cavity and was retrieved successfully. The dropped corneal button was visualized after focusing the operating microscope on the retina. The visualization significantly improved after aspiration of the fluid from the vitrectomized eye. The donor button was picked up by McPherson's forceps and subsequently sutured to the recipient's cornea. Corneal surgeons need to be aware of this rare complication in aphakic vitrectomized eyes and its retrieval after accurate visualization.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
2/20. Management of post-traumatic aniridia with retinal detachment.PURPOSE: To reconstruct the anatomic and functional impairment in patients with post-traumatic aniridia, aphakia, and retinal detachment. methods: Four patients with unilateral aniridia and aphakia as well as retinal detachment as results of severe eye injuries underwent scleral buckling, vitrectomy, membrane peeling, endolaser photocoagulation, silicone oil or gas temponade, combined with iris diaphragm-IOL implantation. RESULTS: All four patients achieved successfully anatomic and functional reconstruction after surgery. During five to 22 months postoperative follow-up, all retinas remained attached. The final visual acuity increased from finger counting to 0.1-0.3. CONCLUSIONS: The combination of vitreoretinal surgery and iris diaphrgm-IOL implantation is an effective method for post-traumatic aniridia, aphakia and traumatic retinal detachment. It could ameliorate photophobia and improve the biocular vision. Furthermore, artificial iris diaphragm implantation could prevent silicone oil-endothelia contact and salvage silicone keratopathy.- - - - - - - - - - ranking = 0.125keywords = eye (Clic here for more details about this article) |
3/20. Modified surgical technique for repeated epikeratophakia surgery in aphakic eyes.BACKGROUND: Incomplete epithelial removal from the peripheral keratectomy at the time of repeat epikeratophakia surgery can lead to interface downgrowth and consequent failure, as observed in the case reported herein. We present a modification of the standard surgical technique aimed at avoiding such complication. methods: A 69-year-old white female underwent a third aphakic epikeratophakia modified to reduce the risk of epithelial interface downgrowth, which had caused a previous failure. The aphakic tissue lens, 8.5 mm in diameter, was sutured into a corneal pocket obtained at a deeper level, inside the peripheral keratectomy used for the previous two procedures. RESULTS: Useful visual acuity (20/60) was obtained and the refractive outcome remained stable up to 1 year postoperatively. Epithelial interface downgrowth did not recur. CONCLUSIONS: Despite the possible risk of perforation while undermining the recipient cornea at a deeper level, the modified technique might offer a more effective method of preventing epithelial downgrowth after repeat epikeratophakia surgery.- - - - - - - - - - ranking = 0.5keywords = eye (Clic here for more details about this article) |
4/20. Congenital corneal staphyloma associated with aphakia.A neonate had a globular mass bulging through the eyelids of the left eye. Computed tomography revealed a large ectatic corneal lesion and the absence of a lens. The enucleated globe revealed that the posterior surface of the ectatic cornea was lined by iris tissue, indicating corneal staphyloma.- - - - - - - - - - ranking = 0.25keywords = eye (Clic here for more details about this article) |
5/20. corneal perforation with secondary congenital aphakia in Peters anomaly.PURPOSE: To describe two cases of secondary congenital aphakia in association with Peters anomaly. methods: Two infants were noted to have corneal opacification at birth. Each child was found to have Peters anomaly requiring corneal transplantation in 1 or both eyes. RESULTS: Each child underwent penetrating keratoplasty, revealing absence of the crystalline lens in 1 eye. Histopathologic evaluation of the corneal buttons was performed. Each specimen showed full-thickness corneal defects with lens remnants. CONCLUSIONS: Secondary congenital aphakia from corneal perforation should be considered in the presentation of severe Peters anomaly.- - - - - - - - - - ranking = 0.25keywords = eye (Clic here for more details about this article) |
6/20. Combined relaxing incisions and epikeratophakia for the correction of aphakia and high postkeratoplasty degree astigmatism.A combined surgical procedure consisting of corneal relaxing incisions and epikeratophakia was used to correct high-degree postkeratoplasty astigmatism and aphakia in two patients. Both patients achieved their final refractive result as soon as 1 month after suture removal (2 and 3 months after surgery, respectively). Keratometric readings showed a reduction of approximately 20.00 diopters in one case and 10.00 D in the other, while the spherical equivalent changed from 10.00 D to 0.50 D in one eye and from 7.50 D to 1.75 D in the other. Spectacle correction was prescribed for both patients. At the last follow-up visit, about 2 years after surgery, these values were unchanged. The main advantage of the combined technique over two separate procedures was that postoperative visual rehabilitation was faster. Equally important was the stability of the refractive result over a long period of time after surgery, as well as the absence of negative effects on the preexisting corneal graft. In spite of the technical complexity of a combined surgical procedure, this approach probably represents the best choice in rare cases such as the ones reported here.- - - - - - - - - - ranking = 0.125keywords = eye (Clic here for more details about this article) |
7/20. Management of traumatic rupture of the globe in aphakic patients.We report the successful treatment of three cases of traumatic ruptures of the globe complicated by massive choroidal hemorrhage, uveal prolapse and retinal detachment. All three of the eyes were aphakic prior to injury and all patients were age 64 or older. The presenting visual acuity in all patients was light perception. The blunt injury in each case caused a wound dehiscence at the site of previous cataract extraction. All injuries were associated with uveal prolapse. Secondary surgical intervention was performed when the hemorrhagic choroidal detachments had decreased as demonstrated by echography in the suprachoroidal space, occurring at an average of 14 days after injury. The management consisted of surgical drainage of the choroidal hemorrhage combined with vitrectomy and silicone oil injection. Successful reattachment of the retina was achieved in all cases. Postoperative epiretinal membranes formed in two cases but all were anatomically successful at six months. Final visual acuities varied from 20/70 to 1/200, visual acuity being a function of secondary contusive damage to the retina and choroid. We believe that in eyes sustaining severe blunt injuries resulting in rupture of the globe complicated by massive choroidal hemorrhage and retinal detachment, properly timed external drainage of the choroidal hemorrhage combined with pars plana vitrectomy and silicone oil injection is a useful approach.- - - - - - - - - - ranking = 0.26297867969365keywords = eye, injury (Clic here for more details about this article) |
8/20. contrast sensitivity after epikeratophakia.epikeratophakia is a rapidly evolving surgical procedure for the refractive correction of aphakia. Even when Snellen acuity after epikeratophakia is normal, patients often report a subjective degradation of the visual image through the surgically corrected eye. To further define visual performance in the patient with optically successful epikeratophakia, we examined contrast sensitivity in two patients surgically corrected for monocular aphakia. Contrast thresholds were measured over a range of spatial frequencies using both computer-generated sinusoidal gratings and a commercially available wall chart system. The eye with epikeratophakia in each case was compared with the opposite normal eye with comparable acuity. One patient was also tested prospectively in the same eye both before and after surgery. Data demonstrate a depression of the contrast sensitivity function in the middle and high spatial frequencies induced by the placement of an epikeratophakia lenticule when compared with the normal eye or contact lens-corrected, preoperative aphakic eye with comparable good acuity. These findings may explain the subjective experience of epikeratophakia patients.- - - - - - - - - - ranking = 0.75keywords = eye (Clic here for more details about this article) |
9/20. Refractive changes from use of silicone oil in vitreous surgery.When silicone oil fills the vitreous cavity of the phakic eye or the entire aphakic eye, the refractive correction can be expected to change by 5-9 diopters and sometimes as much as 14 diopters. Aphakic eyes become less hyperopic when filled with silicone oil, whereas phakic eyes become more hyperopic when the vitreous cavity is filled with silicone oil. Previously emmetropic aphakic eyes that are filled with silicone oil have only 4-6 diopters of hyperopia, whereas the same eyes have 10-12 diopters of hyperopia before insertion or after removal of silicone oil. Phakic eyes develop 5-7 diopters of hyperopia when the vitreous cavity is filled with silicone oil, and this puts them in the same range as the silicone oil filled aphakic eyes. High myopia, incomplete silicone oil filling, and several other factors influence the final optical outcome. The vitreoretinal surgeon must anticipate significant changes in refractive error when silicone is introduced into an eye or removed from the eye. Careful retinoscopy and refraction is essential for obtaining optimal vision in these patients.- - - - - - - - - - ranking = 1.25keywords = eye (Clic here for more details about this article) |
10/20. A case of spontaneous dislocated lenses.There are a great number of causes of dislocated lenses. One such cause is the spontaneous dislocation of a mature or hypermature cataractous lens. The case of an 80-year-old black female with spontaneously dislocated lenses is reported. Because the woman was not aphakic from surgery, but rather from spontaneous dislocation of her lenses, she was not eligible for eyeglasses from medicare.- - - - - - - - - - ranking = 0.125keywords = eye (Clic here for more details about this article) |
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