1/15. Acute transient myopia induced by indapamide.PURPOSE: To report on a case of acute transient myopia associated with ciliochoroidal detachment induced by indapamide. METHOD: Case report. Clinical examination, ultrasonography, and fluorescein angiography were performed during the acute phase of disease and convalescence. RESULTS: After indapamide was discontinued, acute bilateral myopia, which was associated with anterior chamber shallowing and diffuse choroidal thickening, resolved spontaneously 8 days after onset. The initial angiography showed scattered islands of delayed fluorescein filling that disappeared without any permanent change by day 30. CONCLUSION: indapamide can induce spontaneously resolving transient myopia associated with diffuse choroidal thickening.- - - - - - - - - - ranking = 1keywords = island (Clic here for more details about this article) |
2/15. Selective zonal ablations with excimer laser for correction of irregular astigmatism induced by refractive surgery.OBJECTIVE: To demonstrate the safety and efficacy of selective zonal ablations with excimer laser for the correction of irregular astigmatism induced by refractive surgery. DESIGN: Thirty-one eyes of 26 patients. Retrospective and noncomparative case series. methods: The authors reviewed the medical results of the two series of consecutive cases of irregular astigmatism induced by refractive surgery. One group showed a topography map with a defined pattern: decentered ablation, decentered steep central island, central irregularity, and peripheral irregularity. The other group showed an irregular astigmatism without defined pattern. Selective zonal ablation was performed with a broad-beam excimer laser. Laser ablations were adjusted according to the Munnerlyn formula. A phototherapeutic keratectomy (PTK) mode was used in all cases without using viscous masking solution. MAIN OUTCOME MEASURES: Uncorrected visual acuity, best spectacle-corrected visual acuity (BCVA), and Holladay diagnostic summary (eye Sys 2.000) were considered before and after surgery to obtain the qualitative and quantitative characteristics of the visual acuity and corneal topography. The corneal uniformity index (CUI) was used to evaluate the corneal surface changes induced by the selective zonal ablations in the correction of irregular astigmatism. It proved to be a useful tool in the understanding of astigmatic changes when it is not possible to apply the vector analysis. RESULTS: In group 1, the irregular astigmatism was significantly improved in 96.4% of cases. The CUI was improved from 58 /-0.3% to 87 /-0.8%, P < 0.005 (Student's t-test). The improvement of the BCVA was from 20/40 /-20/100 to 20/25 /-20/100, P < 0.005 (Student's t-test). The results obtained in group 2 were not clinically significant in terms of improvement of CUI and BCVA. CONCLUSIONS: Using the corneal topographic map as a guide, selective zonal ablations with excimer laser can be used to create a more regular corneal surface, when a defined pattern of topographic irregularities can be defined.- - - - - - - - - - ranking = 1keywords = island (Clic here for more details about this article) |
3/15. Laser in situ keratomileusis: three unexpected complications.PURPOSE: To report unexpected outcomes in three patients after uneventful laser in situ keratomileusis (LASIK) performed using the Nidek EC-5000 excimer laser and the Hansatome microkeratome (Bausch & Lomb Surgical). methods: LASIK was performed with the Nidek EC-5000 excimer laser and the Hansatome microkeratome (Bausch & Lomb Surgical) in three patients. RESULTS: In three patients, unexpected outcomes were observed. One patient treated for -3.00 D of myopia presented with a central island. One patient treated for 2.00 D ( 1.00 x 90 degrees) of hyperopia in both eyes ended up emmetropic in one eye and overcorrected in the fellow eye. The third patient with -12.00 D (-2.00 x 180 degrees) of myopia was treated as -8.60 -1.00 x 180 degrees and at last examination was 4.00 D. During these sessions, all other patients treated were within /-0.50 D of emmetropia. CONCLUSION: After LASIK with the Nidek EC-5000 excimer laser and the Hansatome microkeratome (Bausch & Lomb Surgical), unexpected outcomes may still occur, despite controlling all the usual variables.- - - - - - - - - - ranking = 1keywords = island (Clic here for more details about this article) |
4/15. Soft contact lenses for irregular astigmatism after laser in situ keratomileusis.PURPOSE: To investigate soft contact lenses for managing irregular astigmatism after laser in situ keratomileusis (LASIK). The prevailing notion has been that soft contacts conform to corneal surface irregularities and have a limited role for managing LASIK-induced irregular astigmatism. methods: A 41-year-old man with bilateral central steep islands following LASIK had best spectacle-corrected visual acuity of 20/40( 1) in the right eye and 20/70 2 in the left eye, despite 20/20 acuity in each eye with rigid contact lenses. Three soft lenses made of etafilcon A (58% H2O) in different center thicknesses were placed sequentially on each eye. All lenses were -2.00 D sphere, in the flatter of the two available base curves. With each lens, corneal topography, spherical over-refraction, and the resulting visual acuity were recorded. RESULTS: In all instances, corneal topography showed reduced surface irregularity although at least some irregularity still transmitted through the lenses. Each spherical over-refraction gave better visual acuity than the corresponding best spectacle-corrected visual acuity. The right eye achieved 20/20 with the thickest lens and spherical over-refraction. The left eye achieved 20/25 with the lens of intermediate thickness and spherical overrefraction. The patient reported functional vision and good comfort with these lenses. CONCLUSIONS: Disposable soft contact lenses can modestly mask irregular astigmatism caused by excimer laser ablation.- - - - - - - - - - ranking = 1keywords = island (Clic here for more details about this article) |
5/15. Successful management of retinal tear post-laser in situ keratomileusis retreatment.PURPOSE: To report a successful case management of a retinal tear post-Laser in situ Keratomileusis (LASIK) and retreatment. RESULTS: A patient with the history of ocular trauma underwent LASIK procedure for myopic astigmatism. Three months post-LASIK, she received additional excimer laser treatment for a symptomatic persistent central island. One month later; the patient experienced a flap tear at the edge of a prior chorioretinal scar. Retinal tear repair was successfully accomplished by indirect application of photocoagulation laser without damage to the corneal flap. CONCLUSIONS: To date, no definitive causal relationship has been established between retinal tear(s) and corneal refractive surgery. This report describes a retinal tear and repair, post-LASIK retreatment. The use of the indirect binocular argon laser alleviates the need to compress the LASIK flap and minimizes the potential for creating flap folds and striae, especially in the early post operative period. Clinicians should be on alert to consider this possible complication, post-LASIK and excimer laser; especially within a population whose clinical findings place them at greater risk.- - - - - - - - - - ranking = 1keywords = island (Clic here for more details about this article) |
6/15. Recurrent lens binding and central island formations in a fast-responding orthokeratology lens wearer.A 12-year-old girl with a history of fast myopia progression underwent advanced orthokeratology (ortho-k) treatment and suffered from recurrent lens binding and central corneal staining. The problem could not be fixed by lens fenestration and refitting with a less aggressive lens (three-zone ortho-k) design. After refitting with a lower target advanced ortho-k lens, these complications were no longer occurring, and the amount of power reduction was greater than expected considering the target designed for the refitted lenses. During the following 15 months of ortho-k lens wear, there was no clinically significant change to her refractive error. The patient and her parents were happy with the outcome, although the refractive error was not totally eliminated and she still needed to wear spectacles for clear vision. Possible etiologies of the complications are discussed.- - - - - - - - - - ranking = 4keywords = island (Clic here for more details about this article) |
7/15. Central island treatment using Technolas 217 based on Orbscan II assessment.PURPOSE: To present a case of central island after myopic laser in situ keratomileusis and the treatment technique using Technolas 217 laser based on topography findings. methods: Serial corneal topographies with Orbscan were taken and an ablation profile was generated with subsequent treatment using the phototherapeutic keratectomy mode and surface ablation technique. RESULTS: Marked reduction was noted in the height of central island and the best spectacle-corrected visual acuity improved from 20/40 to 20/25. CONCLUSIONS: Ablation profile based on corneal topography can provide a possible treatment option for patients with central island.- - - - - - - - - - ranking = 7keywords = island (Clic here for more details about this article) |
8/15. Transient central corneal steepening after radial keratotomy.Three case studies are presented illustrating topographic transient central steep island following radial keratotomy. Three stages are apparent: first, a central corneal steepening; next, an overcorrection with exaggerated central flattening; and, finally, the final refractive correction. The steepening is probably caused by temporary midperipheral swelling of the cornea.- - - - - - - - - - ranking = 1keywords = island (Clic here for more details about this article) |
9/15. Management and treatment of central steep islands after excimer laser photorefractive keratectomy.BACKGROUND: Permanent central steep islands are an undesirable phenomenon that cause distorted images and a significant reduction in visual acuity. We describe treatment of central steep islands with repeat excimer laser photoablation in the central cornea. methods: Three patients with preoperative refractions of -7.50 -2.50 x 170 degrees D (right eye), -8.00 -2.25 x 10 degrees D (right eye) and -6.00 -1.50 x 90 degrees (right eye) developed central steep islands which persisted more than 12 months. All patients lost more than two lines of spectacle-corrected visual acuity and complained of visual disturbances. We retreated the central steep islands with a VISX 20/20 excimer laser PRK ablation that matched the size of the central island measured on videokeratography. RESULTS: Symptomatic glare and distortion were significantly reduced and the central steep islands were resolved. Several weeks after reablation, spectacle-corrected visual acuity improved to the preoperative level. CONCLUSION: Central steep island, an infrequent complication of excimer laser photorefractive keratectomy, can be safely removed with a repeat laser ablation that matches the central circular steep area.- - - - - - - - - - ranking = 11keywords = island (Clic here for more details about this article) |
10/15. Central islands of corneal steepening after automated lamellar keratoplasty for myopia.BACKGROUND: Central steep islands are a phenomena of videokeratography that demonstrate local central steepening within a larger diameter area of the cornea treated by refractive surgery that removed stromal tissue to reduce myopia. This report details four cases in which central steep islands occurred following automated lamellar keratoplasty (keratomileusis in situ). methods: A total of 43 automated lamellar keratoplasty procedures were performed on 32 patients between January 1993 and September 1993. Central islands were identified using video-keratography. RESULTS: Out of 43 cases of automated lamellar keratoplasty, central steep islands developed in six eyes of four patients. These steep areas developed within a few weeks after surgery; increases in the elevation of these islands correlated with recurring myopia. Slit-lamp microscopy revealed no epithelial surface abnormalities or difficulties with the interface of the resection. A central steep island did not prevent excellent uncorrected visual acuity. After subsequent refractive keratotomy for residual myopia, central steep islands either regressed or disappeared. CONCLUSION: Central islands of corneal steepening may occur after automated lamellar keratoplasty for myopia. The etiology is unknown.- - - - - - - - - - ranking = 12keywords = island (Clic here for more details about this article) |
| | Next -> |