1/585. Iridocorneal melanoma associated with type 1 neurofibromatosis: a clinicopathologic study.OBJECTIVE: A clinicopathologic study of an iridocorneal melanoma associated with type 1 (peripheral) neurofibromatosis is presented. DESIGN: Case report with clinicopathologic correlation. PARTICIPANT: A 32-year-old white woman with type 1 neurofibromatosis presented with long-standing blindness of her right eye due to diffuse intrastromal brown corneal discoloration. INTERVENTION: The patient underwent penetrating keratoplasty and the corneal button was inspected. RESULTS: Histopathologic evaluation of the corneal button after penetrating keratoplasty revealed an intrastromal mixed-type malignant melanoma, which stained positively with HMB-45 and S-100 protein and spared the corneal epithelium and limbus. The corneal graft remained transparent, with best-corrected visual acuity of 20/30. Twenty-two months after surgery, the tumor involved the anterior chamber angle and the iris. Three years later, it caused refractory glaucoma necessitating enucleation. The iris tumor did not extend beyond the iris-lens diaphragm and showed the same cytologic features as the corneal stromal tumor. CONCLUSION: To our best knowledge, this is the first report of iridocorneal melanoma associated with peripheral neurofibromatosis. The location of the tumor in the deep corneal stroma, without initial macroscopic involvement of the angle or iris, may suggest that the corneal portion of the tumor may have developed "in situ" rather than as an extension of iris melanoma. The common origin of melanoma cells and schwann cells from the neural crest and the proliferation of the schwann cells in neurofibromatosis provides additional support for this hypothesis.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
2/585. Corneal iron ring after hyperopic laser-assisted in situ keratomileusis.PURPOSE: To report a new corneal iron ring after hyperopic laser-assisted in situ keratomileusis (LASIK). methods: Three patients underwent hyperopic LASIK for the correction of hyperopia in both eyes. Spherical equivalent refraction of the patients ranged from 3.37 to 6.50 diopters. LASIK procedure was performed using automated corneal shaper and 193-nm argon fluoride excimer laser. RESULTS: Both eyes of the patients were noted to have a corneal iron ring located at the paracentral area at 6-7 months after surgery. The localization of iron ring corresponded with outside border of central steep zone. Twelve-month examination showed there was no change in color, shape, and density of corneal iron ring. CONCLUSIONS: Corneal topographic changes induced by hyperopic LASIK may cause corneal iron ring to develop.- - - - - - - - - - ranking = 2keywords = eye (Clic here for more details about this article) |
3/585. Long-term outcome of aqueous shunt surgery in ten patients with iridocorneal endothelial syndrome.PURPOSE: To report the long-term outcome of ten patients with iridocorneal endothelial (ice) syndrome who underwent aqueous shunt surgery for uncontrolled glaucoma. DESIGN: Noncomparative, retrospective case series. PARTICIPANTS: The authors reviewed charts of ten patients with ice syndrome-related glaucoma who underwent aqueous shunt surgery at one institution between 1987 and 1996. MAIN OUTCOME MEASURES: intraocular pressure (IOP), number of glaucoma medications, and further surgical interventions were measured. RESULTS: With a median follow-up of 55 months, four eyes had adequate IOP control (IOP <21 mm Hg) with one or two medications after the initial aqueous shunt surgery. An additional three eyes achieved adequate IOP control after one or more tube repositionings or revisions of the initial aqueous shunt. In this series, the aqueous shunt surgery most often failed because of blocking of the tube ostium by iris, ice membrane, or membrane-induced tube migration. CONCLUSION: Aqueous shunt surgery appears to be an effective method for IOP lowering in some eyes with ice syndrome-related glaucoma when medical treatment or conventional filtration surgeries fail, but additional glaucoma procedures and/or aqueous shunt revisions and tube repositionings are not uncommon.- - - - - - - - - - ranking = 3keywords = eye (Clic here for more details about this article) |
4/585. Regression and epithelial hyperplasia after myopic photorefractive keratectomy in a human cornea.We present the histology of a cornea of a woman who had excimer laser photorefractive keratectomy (PRK) for myopia 6 months before she died in an accident. Preoperative spherical refraction was -6.00 diopters (D) with an astigmatism of -0.50 D. Six months postoperatively, refraction was -4.50 D. Slight corneal haze was noted at 1 and 3 months. The corneal histology showed marked epithelial hyperplasia in the center of the ablation zone without subepithelial deposition of newly synthesized collagen, proteoglycans, or both. The epithelial thickness was 38 microns in the untreated area and 93 microns in the center of the ablation. In conclusion, postoperative epithelial hyperplasia was responsible for regression after PRK in this eye.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
5/585. fluorescein test for the detection of striae in the corneal flap after laser in situ keratomileusis.PURPOSE: To report a technique for detecting striae in the corneal flap after laser in situ keratomileusis. methods: fluorescein dye was instilled in the eye, and the patient was asked to blink. The tear film was examined at the slit lamp with the cobalt filter 1 or 2 seconds after blinking. RESULTS: The uneven pattern of pooling in the tear film was a sensitive indicator of the presence of striae in the flap. CONCLUSION: This technique may be useful in detecting minimal striae in the corneal flap in patients with unexplained suboptimal visual acuity after laser in situ keratomileusis.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
6/585. Pseudo-endothelial dystrophy associated with emulsified silicone oil.PURPOSE: To describe endothelial changes associated with emulsified silicone oil. methods: Report of a case. RESULTS: A 77-year-old man had multiple and diffuse clear vesicles on the endothelium of his left eye (LE). The cornea was clear and thin. He had undergone pars plana vitrectomy and intraocular silicone oil injection 5 years before presentation. Specular microscopy revealed numerous small bubbles of emulsified silicone oil and a mild degree of endothelial damage. CONCLUSION: Emulsified silicone oil can adhere to the endothelium and induce an apparent droplet-like endotheliopathy.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
7/585. Characterization of epithelial downgrowth by confocal microscopy.A 43-year-old white woman with a history of multiple ocular surgeries, including 4 penetrating keratoplasties, developed a concentric retrocorneal membrane at the graft periphery in the right eye. A white-light, tandem, scanning confocal microscope using a 24x/0.60 contact objective was used to examine the right eye in vivo. At the endothelial layer, confocal microscopic images similar to corneal epithelial cells were detected at the graft periphery. Unlike normal endothelial cells, the imaged cells demonstrated easily recognizable nuclei.- - - - - - - - - - ranking = 2keywords = eye (Clic here for more details about this article) |
8/585. Noninfectious crystalline keratopathy after postoperative subconjunctival 5-fluorouracil.PURPOSE: To describe a case of transient, noninfectious crystalline keratopathy after postoperative subconjunctival 5-fluorouracil. METHOD: Case report. Slit-lamp biomicroscopic examinations were performed during serial office examinations. RESULTS: A 69-year-old woman underwent an uncomplicated trabeculectomy with adjunctive sponge 5-fluorouracil application for 5 minutes in her left eye. Postoperative treatment included topical prednisolone acetate, ciprofloxacin, and scopolamine. She was initially examined with intrastromal corneal crystalline deposits 5 days after her first postoperative subconjunctival injection of 5-fluorouracil. The deposits completely disappeared 4 days later without addition to or change in treatment. CONCLUSION: Transient, noninfectious, crystalline, intrastromal corneal deposits may develop after adjunctive subconjunctival 5-fluorouracil administration.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
9/585. The peripheral corneal melting syndrome and psoriasis: coincidence or association?The peripheral corneal melting syndrome (PCMS) is a rare disease consisting of marginal corneal thinning that can progress to perforation. The PCMS carries a grave prognosis and it is of vital importance that dermatologists are aware that this may be responsible for a painful red eye in a patient with psoriasis. We highlight the features of the PCMS developing in an elderly woman with long-standing psoriasis to increase awareness of its significance, and hypothesize that an association may exist between the two conditions. Only one previous report has been published in which the authors speculate on the possible association of this syndrome with psoriasis. That few other cases have been described is either a consequence of under-reporting by both ophthalmologists and dermatologists unaware of a link or because the relationship between the syndrome and psoriasis is genuinely coincidental.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
10/585. Neurotrophic corneal endothelial failure complicating acute horner syndrome.PURPOSE: The authors report the clinical findings of a unique case of rapid corneal endothelial decompensation in association with acute horner syndrome. STUDY DESIGN: Case report and literature review. methods: The authors followed a 38-year-old woman who developed horner syndrome after right jugular vein catheterization during cardiac valvular surgery. Shortly after the operation, horner syndrome accompanied by conjunctival hyperemia and stromal corneal edema developed in the right eye. Over the course of 4 months, the eye became painful, the corneal endothelial cell count dropped precipitously, and the stromal edema worsened, causing a difference of 100 microm in central corneal thickness compared to the unaffected eye. Deep stromal vascularization started at the limbus, resembling interstitial keratitis. RESULTS: A 3-week course of topical steroid treatment resulted in a dramatic improvement in the stromal corneal edema and regression of the deep stromal vascularization. Ocular and right hemicranial pain subsided shortly thereafter. CONCLUSION: The authors hypothesize that corneal endothelial failure in this unique case may have resulted from traumatic sympathectomy. According to experimental evidence in the reviewed ophthalmologic literature, sympathetic innervation may have a neurotrophic role in the cornea. Corneal pathology similar to the authors' case has been described in hemifacial atrophy (Parry-Robson syndrome), a disorder that is assumed to result from sympathetic denervation and that can be produced in animals by cervical sympathectomy. The authors therefore hypothesize that sympathetic denervation of the cornea may rarely cause endothelial decompensation and corneal edema. To the authors' knowledge, this is the first reported case of corneal endothelial failure in horner syndrome.- - - - - - - - - - ranking = 3keywords = eye (Clic here for more details about this article) |
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