1/8. iris synechia after laser goniopuncture in a patient having deep sclerectomy with a collagen implant.neodymium:YAG (Nd:YAG) goniopuncture is an efficient and safe treatment for low filtration through the trabeculo-Descemet's membrane after deep sclerectomy with a collagen implant (DSCI). The only reported complication of this procedure is choroidal detachment. However, we found an iris synechia in a patient whose intraocular pressure (IOP) was elevated again 1 month after Nd:YAG goniopuncture. Synechiolysis and peripheral iridectomy with Nd:YAG and argon lasers effectively removed the iris synechia, and IOP immediately dropped to the normal range. We believe that iris synechia is a potential complication that may cause elevated IOP after laser goniopuncture in patients having DSCI.- - - - - - - - - - ranking = 1keywords = puncture (Clic here for more details about this article) |
2/8. Corneoscleral cyst treated with distilled water injection.To describe the first case of the treatment of a corneoscleral cyst by distilled water injection into a corneal cyst. The anterior wall of a cyst of the limbal communication was punctured with a surgical blade. Aspiration and irrigation of the contents of the cyst with a 27-gauge anterior chamber cannula were performed repeatedly, three times. Distilled water, instead of balanced salt solution, was injected into the collapsed cyst, and was then aspirated completely after 5 minutes. The injection and aspiration of distilled water was repeated once more. The scleral cyst was surgically excised. Twelve months after surgery, several small white granular opacities, presumably epithelial cell nests, were observed on the interface of the collapsed cyst cavity, but there was no recurrence of the cyst. The best spectacle-corrected visual acuity (BSCVA) was 1.0 with a correction of 1.25-2.00 X 45. No significant change in central corneal endothelial cell density was noted. We suggest that this simple technique may represent an alternative method for the management of corneal cysts, and may have less risk of developing a corneal opacity or causing other serious damage to surrounding tissues.- - - - - - - - - - ranking = 0.14285714285714keywords = puncture (Clic here for more details about this article) |
3/8. Anterior stromal puncture for bullous keratopathy.BACKGROUND AND OBJECTIVE: To evaluate the effects of anterior stromal punctures on the symptomatic relief of patients with bullous keratopathy considered ineligible for penetrating keratoplasty. patients AND methods: Five eyes of five patients with bullous keratopathy who had intolerable pain, tearing, and photophobia and were ineligible for penetrating keratoplasty were enrolled. Under slit-lamp magnification, anterior stromal punctures were applied directly at the bullae with a 24-gauge needle. Supplementary anterior stromal punctures were applied for recurrent bullae, if any, during the follow-up. The condition of the cornea was recorded by taking photographs. pain and discomfort were subjectively evaluated. RESULTS: A significant reduction in pain and tearing was achieved. Epithelial and subepithelial fibrosis with scarred small bullae formation was observed during the follow-up. CONCLUSIONS: The anterior stromal puncture is an effective and low-cost method to relieve troublesome symptoms in patients with bullous keratopathy who are not eligible for corneal grafts.- - - - - - - - - - ranking = 1.1428571428571keywords = puncture (Clic here for more details about this article) |
4/8. Anterior stromal puncture for recurrent corneal erosion after laser in situ keratomileusis.A 55-year-old woman had bilateral laser in situ keratomileusis (LASIK). An epithelial defect was observed in the left eye after the flap was cut. Postoperatively, the patient developed recurrent corneal erosion in the left eye related to the traumatic epithelial defect sustained during LASIK. The erosion led to secondary diffuse lamellar keratitis (DLK). Anterior stromal puncture was required to treat the erosion after conventional treatment failed. The secondary DLK resolved quickly after the erosion healed, without the need for topical corticosteroids. Anterior stromal puncture may be a useful treatment for recurrent corneal erosions that do not respond to conventional therapy.- - - - - - - - - - ranking = 0.85714285714286keywords = puncture (Clic here for more details about this article) |
5/8. Anterior stromal puncture in the treatment of loose epithelium after LASIK.PURPOSE: To describe anterior stromal puncture, with or without a bandage contact lens, as a means to treat LASIK epithelial defects and potentially reduce the likelihood of secondary diffuse lamellar keratitis (DLK). methods: Six eyes of five LASIK patients had their microkeratome pass complicated by loose epithelium, central in one case. After repositioning the flap, a 25-gauge needle on a tuberculin syringe was used to puncture the anterior corneal stroma to just beneath Bowman's layer in the affected area of irregular epithelium. A bandage contact lens was placed on two eyes, including the one with loose epithelium centrally. RESULTS: Normal appearance of the corneal epithelium was noted by postoperative day 1; no eye developed DLK or significant epithelial ingrowth postoperatively. All eyes achieved > or = 20/20 vision. CONCLUSIONS: By obviating, in select cases, the need for bandage contact lenses, anterior stromal puncture could increase patient comfort and remove a potential source of infection.- - - - - - - - - - ranking = 1keywords = puncture (Clic here for more details about this article) |
6/8. Successful treatment of recurrent corneal erosion with Nd:YAG anterior stromal puncture.I used a new technique to create anterior corneal stromal punctures for the treatment of traumatic recurrent corneal erosions that had not responded to conventional therapy. Three patients with such erosions within the visual axis were successfully treated by using multiple applications of the Nd: YAG laser set at energy levels between 1.8 and 2.2 mJ. One of these patients had previous stromal puncture with a bent 25-gauge needle. The erosions of all patients healed without complications and have remained symptom-free for four to six months. Compared with needle puncture, the laser punctures were more reproducible, shallow, and translucent.- - - - - - - - - - ranking = 1.1428571428571keywords = puncture (Clic here for more details about this article) |
7/8. Recurrent erosion. Treatment by anterior stromal puncture.The majority of patients with recurrent corneal erosion respond to conventional forms of therapy such as topical lubricants, patching, debridement, or bandage soft contact lenses. However, there remain a small number who do not. For the small number of patients who do not respond to this type of treatment, this report describes a procedure: multiple anterior stromal punctures are created that presumably stimulate more secure epithelial adhesion to the underlying stroma. Of 21 eyes in 18 patients treated in this manner, three eyes required retreatment of adjacent areas; otherwise, there were no recurrences in follow-up periods ranging from 5 months to 12 years. This procedure is a simple and effective method for safe office treatment of patients with recalcitrant recurrent erosion.- - - - - - - - - - ranking = 0.71428571428571keywords = puncture (Clic here for more details about this article) |
8/8. Phototherapeutic keratectomy in recurrent corneal erosions refractory to other forms of treatment.BACKGROUND: Recurrent corneal erosions can occur as a sequel of trauma, of dystrophies or spontaneously. Therapeutic options include topical lubricating and desiccating agents, therapeutic contact lenses, anterior stromal puncture and, most recently, phototherapeutic keratectomy. At present there are no studies available assessing the value of these different therapeutic options. methods: Fifteen eyes of 12 patients underwent therapeutic excimer photoablation after failure of other forms of treatment (lubricating agents in all cases, therapeutic contact lenses in 8, anterior stromal puncture in 2). Ablation depth was 5 microns, except in patients with stromal dystrophy or myopia (6 eyes), who had a deeper ablation. RESULTS: After a first photokeratectomy 9 eyes remained asymptomatic (mean follow-up 12.8 months), 2 eyes had persistent symptoms and 4 had recurrent corneal erosions after 1-24 months. The chance of success after one treatment was 60% after 12 months as calculated by the Kaplan-Meier method. CONCLUSIONS: The method of photoablation as applied in this study has a similar chance of success to other surgical methods such as anterior surgical stromal puncture. patients included in this study, however, were highly selected and were refractory to other forms of treatment.- - - - - - - - - - ranking = 0.42857142857143keywords = puncture (Clic here for more details about this article) |