1/78. Malignant glaucoma after diode laser cyclophotocoagulation.PURPOSE: To report a case of malignant glaucoma after diode laser cyclophotocoagulation. METHOD: Case report. RESULTS: A 45-year-old man with uncontrolled secondary glaucoma in his right eye after corneoscleral graft and cataract extraction underwent diode laser cyclophotocoagulation. The right eye was aphakic, with an intact posterior capsule. Two weeks later, the patient presented with blurred vision, edematous cornea, and flat anterior chamber. The posterior capsule was touching the endothelium. intraocular pressure was 20 mm Hg. Repeated Nd:YAG laser capsulotomy was effective in reversing the malignant glaucoma attack, and the anterior chamber deepened. CONCLUSION: Malignant glaucoma can occur after diode laser cyclophotocoagulation.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
2/78. Unusual intermediate-term outcome in three cases of limbal autograft transplantation.OBJECTIVE: To report an unusual intermediate-term outcome after limbal autograft transplantation for unilateral, severe chemical burns. DESIGN: case reports of three consecutive cases. PARTICIPANTS: Three patients with a history of chemical burns. The fellow eye was clinically uninvolved in all patients. Surgery was indicated for conjunctivalization (cases 1 and 3) and persistent epithelial defect (case 2). INTERVENTION: Three (cases 2 and 3) or four (case 1) 1.25-clock-hour-wide limbal grafts were harvested from the fellow eye and transplanted to the limbus in the affected eye. Surface re-epithelialization, improvement in visual acuity, and maintenance of surface stability were monitored. RESULTS: Limbal grafts were effective in re-epithelialization of the corneal surface within 4 weeks in all cases. Symptomatic relief and improvement in visual acuity were noted during early follow-up. However, a progressive conjunctival ingrowth that tended to override the grafts and encroach the visual axis was noted over the course of a year in all three recipient eyes. CONCLUSIONS: Limbal autograft transplantation is an effective method for surface re-epithelialization in strictly unilateral chemical burns. Caution should be exercised in case selection. The authors' experience suggests a variable degree of attenuation in viability of transplanted limbus. Close follow-up of operated eyes is necessary to determine the long-term efficacy of limbal transplants as a source of corneal phenotypic cells.- - - - - - - - - - ranking = 2.5keywords = eye (Clic here for more details about this article) |
3/78. Cyanoacrylate tissue adhesive augmented tenoplasty: a new surgical procedure for bilateral severe chemical eye burns.PURPOSE: To report on cyanoacrylate tissue adhesive augmented tenoplasty, a new surgical procedure for bilateral severe chemical eye injuries. methods: A 26-year-old man presented with bilateral severe (grade IV) chemical burns involving the eye, periorbital tissues, face, and neck. Despite adequate medical therapy, corneal, limbal, and scleral ulceration progressed in both eyes. Secondary pseudomonas keratitis necessitated therapeutic penetrating keratoplasty in the right eye. Tenoplasty and glued-on rigid gas permeable contact lens were unsuccessful to arrest progression of corneolimboscleral ulceration in the left eye. We applied n-butyl cyanoacrylate tissue adhesive directly on the ulcerating corneal, limbal, and scleral surface to augment tenoplasty. RESULTS: The left ocular surface healed with resultant massive fibrous tissue proliferation and symblepharon on the nasal side. Ocular surface rehabilitation resulted in a vascularized leukomatous corneal opacity with upper temporal clear cornea. The patient achieved visual acuity of 6/36 in the left eye. CONCLUSION: We suggest that cyanoacrylate tissue adhesive-augmented tenoplasty can be undertaken to preserve ocular integrity and retain visual potential in a severe chemical eye injury.- - - - - - - - - - ranking = 5.5keywords = eye (Clic here for more details about this article) |
4/78. Limbal transplantation after chemical injuries of the eye.PURPOSE: To illustrate the benefit of limbal stem cell transplantation in three eyes with severe ocular surface failure due to chemical burns. methods: In two patients with monocular corneal scarring and vascularization after chronic chemical burns, a limbal tissue autograft was transferred from the unaffected fellow eye. A complete superficial keratectomy was performed on the host eye. One patient with bilateral ocular surface disorder received an eccentrically trephined corneolimbal allograft. To prevent immunologic rejection of the transplanted limbus, this patient was treated with systemic Ciclosporin A. RESULTS: Postoperatively the limbal autografts grew a normal epithelium on the recipient eye with less vascularization and scarring. Our two patients reported a significant reduction in symptoms (redness, pain, photophobia) and an improved visual acuity. The corneolimbal allograft has remained clear for five months postoperatively. CONCLUSION: In strictly unilateral conditions of limbal deficiency, transplantation of healthy limbal tissue from the normal fellow eye may result in a stable ocular surface and a quiet and comfortable eye. Transplantation of an eccentrically trephined corneolimbal allograft under systemic Ciclosporin A cover may be an option in the rehabilitation of patients with severe bilateral stem cell deficiencies.- - - - - - - - - - ranking = 5keywords = eye (Clic here for more details about this article) |
5/78. Combined use of an amniotic membrane and tissue adhesive in treating corneal perforation: a case report.We report a new method combining the use of an amniotic membrane and cyanocrylate tissue adhesive to seal a corneal perforation. A 47-year-old male suffered from an alkali injury complicated with corneal melting and perforation in the left eye. We placed an amniotic membrane of optimal size in the anterior chamber directly under the corneal perforation lesion. The cyanocrylate tissue adhesive was then applied over the perforation site and sealed successfully. Three weeks later, the tissue adhesive had dislodged. The amniotic membrane had sealed the perforated lesion and was well adhered to the surrounding corneal tissue with complete epithelial covering. Vision was 20/25 six months after the operation. The combined use of an amniotic membrane and tissue adhesive is a promising method in the treatment of corneal perforation.- - - - - - - - - - ranking = 0.5keywords = eye (Clic here for more details about this article) |
6/78. Amniotic membrane transplantation for acute chemical or thermal burns.PURPOSE: To determine whether preserved human amniotic membrane (AM) can be used to treat ocular burns in the acute stage. DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: Thirteen eyes from 11 patients with acute burns, 10 eyes with chemical burns and 3 with thermal burns of grades II-III (7 eyes) and grade IV (6 eyes), treated at 7 different facilities. methods: patients received amniotic membrane transplantation (AMT) within 2 weeks after the injury. MAIN OUTCOME MEASURES: Integrity of ocular surface epithelium and visual acuity during 9 months of follow-up. RESULTS: Ten patients were male and one patient was female; most were young (38.2 /- 10.6 years). For a follow-up of 8.8 4.7 months, 11 of 13 eyes (84.63%) showed epithelialization within 2 to 5 weeks (23.7 /- 9.8 days), and final visual acuity improved > or = 6 lines (6 eyes), 4 to 5 lines (2 eyes), and 1 to 3 lines (2 eyes); only one eye experienced a symblepharon. Eyes with burns of grade II to III showed more visual improvement (7.3 /- 3 lines) than those with burns of grade IV (2.3 /- 3.0 lines; P < 0.05, unpaired t test). In the group with grade II or III burns, none had limbal stem cell deficiency. All eyes in the group with grade IV burns did experience limbal stem cell deficiency. CONCLUSIONS: Amniotic membrane transplantation is effective in promoting re-epithelialization and reducing inflammation, thus preventing scarring sequelae in the late stage. In mild to moderate burns, AMT alone rapidly restores both corneal and conjunctival surfaces. In severe burns, however, it restores the conjunctival ocular surface without debilitating symblepharon and reduces limbal stromal inflammation, but does not prevent limbal stem cell deficiency, which requires further limbal stem cell transplantation. These results underscore the importance of immediate intervention in the acute stage of eyes with severely damaged ocular surface. Further prospective randomized studies including a control group are required to determine the effectiveness of AMT in acute chemical and thermal burns of the eye.- - - - - - - - - - ranking = 6keywords = eye (Clic here for more details about this article) |
7/78. Anhydrous ammonia burns case report and review of the literature.Chemical burns are associated with significant morbidity, especially anhydrous ammonia burns. Anhydrous ammonia is a colorless, pungent gas that is stored and transported under pressure in liquid form. A 28 year-old patient suffered 45% total body surface area of second and third degree burns as well as inhalational injury from an anhydrous ammonia explosion. Along with fluid resuscitation, the patient's body was scrubbed every 6 h with sterile water for the first 48 h to decrease the skin pH from 10 to 6-8. He subsequently underwent a total of seven wound debridements; initially with allograft and then autograft. On post burn day 45, he was discharged. The injuries associated with anhydrous ammonia burns are specific to the effects of ammonium hydroxide. Severity of symptoms and tissue damage produced is directly related to the concentration of hydroxyl ions. Liquefactive necrosis results in superficial to full-thickness tissue loss. The affinity of anhydrous ammonia and its byproducts for mucous membranes can result in hemoptysis, pharyngitis, pulmonary edema, and bronchiectasis. Ocular sequelae include iritis, glaucoma, cataracts, and retinal atrophy. The desirability of treating anhydrous ammonia burns immediately cannot be overemphasized. clothing must be removed quickly, and irrigation with water initiated at the scene and continued for the first 24 h. Resuscitative measures should be started as well as early debridement of nonviable skin. patients with significant facial or pharyngeal burns should be intubated, and the eyes irrigated until a conjunctivae sac pH below 8.5 is achieved. Although health care professionals need to be prepared to treat chemical burns, educating the public, especially those workers in the agricultural and industrial setting, should be the first line of prevention.- - - - - - - - - - ranking = 0.5keywords = eye (Clic here for more details about this article) |
8/78. Inadvertent topical exposure to isocyanates caused damage to the entire eyeball.isocyanates are part of a group of important chemicals necessary in the production of adhesives, synthetic rubbers, and a variety of plastics. They are known to have minimal toxic effects when administered locally. However, we experienced a case of damage involving the entire eyeball in a person who accidentally exposed his eye to isocyanates. The patient presented with inflamed conjunctiva, and shrunken cornea and sclera, with focal atrophic changes in the iris. The lens and vitreous were opacified. After removal of the lens and vitreous, there were large areas of atrophic retina and areas of retinal necrosis with holes. We found that locally absorbed isocyanates can cause damage to the entire eyeball. Therefore, we recommend that if there is any evidence of isocyanate penetration, early vitrectomy should be performed to help in determining the extent of retina damage and to decrease the amount of toxic substance in the vitreous.- - - - - - - - - - ranking = 3.5keywords = eye (Clic here for more details about this article) |
9/78. Autologous limbal transplantation in unilateral chemical burns.PURPOSE: To describe the results of autologous limbal transplantation in the treatment of unilateral chemical burns. patients AND methods: Two patients, a 40-year-old male (case 1) and a 35-year-old male (case 2), experienced grade III chemical trauma and were treated with autologous limbal grafting (case 1) after a postaccident period of 3 and 9 months, respectively. Change in visual acuity, epithelial healing time and postsurgical topography healing patterns were documented. RESULTS: Snellen visual acuity improved from 0.1 to 1.0 in both cases. Epithelial healing time for cases 1 and 2 were 4 and 2 weeks, respectively. corneal topography of case 1 showed an induced inferior steepness type of asymmetrical astigmatism in the graft area. Serial topography showed no induced astigmatism in the donor eyes. CONCLUSION: Autologous limbal grafting is an adequate treatment for selected cases of unilateral chemical burns and facilitates rapid improvement in visual function. Early limbal grafting in case 1 resulted in rapid re-epithelialization and prevention of complications.- - - - - - - - - - ranking = 0.5keywords = eye (Clic here for more details about this article) |
10/78. Amniotic membrane transplantation in acute chemical and thermal injury.PURPOSE: To present a case of chemical injury and a case of thermal injury treated by amniotic membrane transplantation in acute phase. methods: case reports. An eye with sodium hydroxide injury, opaque cornea, and limbal ischemia of more than 180 degrees and an eye with hot tea injury, opaque cornea, stromal edema, and scarring were treated by amniotic membrane transplantation within the first few weeks of injury. RESULTS: In the eye with sodium hydroxide injury, 4 months after amniotic membrane transplantation, the ocular surface is stable, superficial corneal scarring with vascularization is present, and visual acuity is 20/25. In the eye with thermal injury, 6 months after amniotic membrane transplantation, the ocular surface is stable, but there is superficial scarring and vascularization, and visual acuity is 20/20. CONCLUSIONS: Amniotic membrane transplantation can be considered in chemical injury with severe limbal ischemia and in severe thermal injury in acute phase. Long-term studies are warranted to evaluate further the efficacy of amniotic membrane transplantation in these clinical situations.- - - - - - - - - - ranking = 2keywords = eye (Clic here for more details about this article) |
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