1/15. Refractive error in cataract surgery after previous refractive surgery.Bilateral cataract extraction with posterior chamber intraocular lens (IOL) implantation was performed in a patient after previous photorefractive keratectomy, radial keratotomy (RK) combined with astigmatic keratotomy, and retreatment of RK. Significant hyperopic error was observed after cataract surgery, and the IOLs were eventually exchanged in both eyes. A review of this case found that the refractive error was smaller when a refraction-derived keratometric value was selected for IOL power calculation. Nevertheless, hyperopic error still occurred.- - - - - - - - - - ranking = 1keywords = refractive error, error (Clic here for more details about this article) |
2/15. eye injuries in a terrorist bombing: Dhahran, saudi arabia, June 25, 1996.OBJECTIVE: We report the experience of our institution in the evaluation and care of multiple simultaneous ocular trauma patients after a terrorist bomb attack on a united states military base in saudi arabia. DESIGN: Retrospective, noncomparative small case series. PARTICIPANTS: Three patients who received severe ocular injuries after a terrorist bombing. INTERVENTION: All patients underwent surgical repair of the injuries that were inflicted as a result of the terrorist bombing. MAIN OUTCOME MEASURES: Baseline ocular characteristics, intraoperative findings, surgical procedures, and final (3 years after injury) anatomic and visual outcomes were noted. RESULTS: glass fragments caused by the blast were the mechanism of all the ocular injuries in these patients. All patients had primary repair of the injuries done in saudi arabia and were sent to our institution for tertiary care. Three of the four eyes injured had stable or improved visual acuity and one eye was enucleated. Two patients had no serious injury other than the globe trauma. One patient had extensive eyelid trauma and required serial procedures to allow fitting of a prosthesis. CONCLUSIONS: Blast-injury patients are at risk for open globe injury as a result of glass fragments. The types of injury that can occur from terrorist blasts can be extensive and involve all the tissues of the eye, the ocular adnexa, and the orbit.- - - - - - - - - - ranking = 0.015743353521238keywords = error (Clic here for more details about this article) |
3/15. Rapid onset phacolysis.BACKGROUND: Phacolysis involves the breakdown of a hypermature cataract, causing an antigenic reaction to the lens proteins released into the anterior chamber with subsequent inflammation. To date, the time it takes for a crystalline lens to reach hypermaturity and induce a phacolytic response has never been clearly detailed. It is believed that cataract maturation is a slow process. The process by which the lens proteins begin to leak is thought by many to be similarly slow. However, the immune-related inflammatory process that develops when the lens proteins begin to leak may be quite rapid. It may be an error to consider this aspect of the phacolytic process to be slow. methods: We present a case with a clear, timed delineation of the phacolytic process. A mature cataract became hypermature with subsequent phacolysis and inflammatory pressure rise over the course of 17 days. It appears that this is the first published account of the time involved in the development of phacolysis and, we believe, the fastest onset of the process. CONCLUSION: While cataract maturation is generally considered to be a slow, insidious process, it should be recognized that the phacolytic process might not be slow. Once a lens reaches hypermaturity, phacolysis could occur quite rapidly over the course of several days. This case could be an important consideration in management of the removal of advanced cataracts. This case may be the shortest reported time from diagnosis of a mature cataract to the development of inflammatory phacolysis and secondary glaucoma, occurring over a period of only 17 days.- - - - - - - - - - ranking = 0.0019679191901548keywords = error (Clic here for more details about this article) |
4/15. Delta1-pyrroline-5-carboxylate synthase deficiency: neurodegeneration, cataracts and connective tissue manifestations combined with hyperammonaemia and reduced ornithine, citrulline, arginine and proline.Delta1-pyrroline-5-carboxylate synthase (P5CS) catalyses the reduction of glutamate to Delta1-pyrroline-5-carboxylate, a critical step in the biosynthesis of proline, ornithine and arginine. Recently, we reported a newly recognised inborn error due to deficiency of P5CS in two sibs, one presenting at birth with hypotonia, dysmorphic signs, pes planus and clonic seizures. Both developed progressive neurodegeneration and peripheral neuropathy, joint laxity, skin hyperelasticity and bilateral subcapsular cataracts. Their metabolic phenotype includes mild hyperammonaemia, hypo-ornithinaemia, hypocitrullinaemia, hypo-argininaemia and hypoprolinaemia. Incorporation of 3H-proline into protein was deficient in fibroblasts incubated with 3H-glutamate. Both patients are homozygous for the missense mutation R84Q in P5CS. Here, we describe the clinical phenotype of the sibs in detail and show that a relative deficiency of urea cycle intermediates (ornithine, citrulline and arginine) during fasting periods results in a paradoxical hyperammonaemia. Furthermore, we show the results of ornithine loading tests and indirect enzyme studies corroborating the biological significance of the defect in P5CS in vivo. CONCLUSION: The metabolic phenotype of Delta1-pyrroline-5-carboxylate synthase deficiency is easily missed. The combination of low levels of ornithine, citrulline, arginine and proline plus a tendency to hyperammonaemia or one of the above together with a clinical phenotype of neurodegeneration with peripheral neuropathy and/or cataracts and connective tissue manifestations should suggest this disorder. Early recognition would allow a therapeutic trial with citrulline and proline.- - - - - - - - - - ranking = 0.0019679191901548keywords = error (Clic here for more details about this article) |
5/15. The need for optometric investigation in suspected Meares-Irlen syndrome or visual stress.Meares-Irlen syndrome is characterised by symptoms of eye strain, headaches and visual perceptual distortions when viewing text. The symptoms are alleviated with individually prescribed coloured filters, such as precision tinted lenses. Meares-Irlen syndrome, and the related condition of visual stress, are likely to result from hyperexcitability of the visual cortex, which can also occur in migraine. The symptoms of Meares-Irlen syndrome and visual stress are non-specific and the condition needs to be differentially diagnosed from other optometric conditions, such as refractive error, binocular vision anomalies, and accommodative anomalies. Three case reports are described of patients who consulted the author with suspected Meares-Irlen syndrome but were found to have other causes for their symptoms: posterior sub-capsular cataract, high uncorrected astigmatism, and decompensated convergence weakness exophoria. These cases highlight the need for professional eye care for people with suspected Meares-Irlen syndrome. Although this advice is stressed in literature on the well-established MRC/Wilkins Intuitive Colorimeter system, it is not always stressed in literature about other systems. This may be a cause for concern.- - - - - - - - - - ranking = 0.98819248485907keywords = refractive error, error (Clic here for more details about this article) |
6/15. corneal edema and penetrating keratoplasty after anterior chamber phakic intraocular lens implantation.Phakic intraocular lens (IOL) implantation is an increasingly popular option in surgical correction of refractive error. To date, reports of long-term morbidity are infrequent in the literature. We encountered 3 patients who experienced corneal decompensation and cataract progression following angle-fixated anterior chamber phakic IOL placement.- - - - - - - - - - ranking = 0.98819248485907keywords = refractive error, error (Clic here for more details about this article) |
7/15. Green cataract.The green cataract seen in the 16th to 18th centuries was reinterpreted in the 19th century (on the basis of pathological examinations) to be a greenish color of the light returning through the pupil in an eye with absolute glaucoma and not due to a greenish discoloration of a cataract. Were the older observers in error? It seems unlikely. This article presents photographs of true green cataracts--ie, opaque lenses of greenish color--from my own practice; a published photograph of a green cataract; and histopathological documentation of the cause, iron (blood pigment).- - - - - - - - - - ranking = 0.0019679191901548keywords = error (Clic here for more details about this article) |
8/15. Potential complications of ocular surgery in patients with coexistent keratoconus and fuchs' endothelial dystrophy.PURPOSE: To describe the potential complications of cataract and refractive surgery in patients with fuchs' endothelial dystrophy (FED) and keratoconus. DESIGN: Retrospective case series. PARTICIPANTS: Eight patients with FED and keratoconus in a large university group practice. methods: We reviewed the clinical and topographic findings of 8 patients (15 eyes) with FED and keratoconus. Clinical examination, corneal topography, specular microscopy were done, and sequential central corneal thickness (CCT) was obtained. Follow-up ranged from 1 month to 6 years. MAIN OUTCOME MEASURES: Findings of keratoconus and FED in preoperative evaluation. RESULTS: Five patients had concomitant cataracts; 3 had refractive errors and sought surgical correction. Cataract surgery was performed on 3 of 5 patients (5 eyes). LASIK was performed on one eye of 3 patients. Of 5 eyes that underwent cataract extraction, 4 had blurry vision after surgery. The interval between the surgical procedure and onset of symptoms ranged from 1 month to 4 years. The causes of decreased vision after cataract surgery were corneal edema and/or corneal ectasia. The CCT readings ranged from 426 to 824 microm. One of 4 symptomatic eyes underwent penetrating keratoplasty. The CCTs of 3 patients (6 eyes) who presented with refractive error ranged from 507 to 565 microm. One eye had undergone an attempted LASIK procedure resulting in a lost cap. corneal topography and specular microscopy showed the coexistence of keratoconus and FED, and the patients were advised against having LASIK surgery. CONCLUSIONS: Corneal thinning caused by keratoconus and concurrent increase in corneal thickness caused by FED may combine to normalize the corneal pachymetry readings; disease severity may be underestimated, which may lead to unexpected postoperative visual outcomes. Routine use of preoperative topography and specular microscopy may help to avert potential surgical complications.- - - - - - - - - - ranking = 1.9763849697181keywords = refractive error, error (Clic here for more details about this article) |
9/15. Asteroid hyalosis affecting the choice of intraocular lens implant.Asteroid hyalosis can create ultrasonic echoes capable of interfering with A-scan ultrasonic measurement of ocular length. Two cases are reported, one of which includes a measurement error necessitating a second implantation. Surgeons who entrust measurements to technicians should be aware of the measurement technique and should establish protocols that preclude such errors.- - - - - - - - - - ranking = 0.0039358383803095keywords = error (Clic here for more details about this article) |
10/15. Goniomegaly associated with a normal cornea, increased axial length, and minimal refractive error.The association of a large axial length with a small refractive error and a normal corneal diameter should alert the lens implant surgeon to the possibility that goniomegaly is present. We report a patient whose intraoperative anterior chamber diameter was measured as 15 mm. It was necessary to insert a modified posterior chamber intraocular lens instead of an anterior chamber lens.- - - - - - - - - - ranking = 4.9409624242954keywords = refractive error, error (Clic here for more details about this article) |
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