1/10. Repair of scleral perforation with preserved scleral and amniotic membrane in Marfan's syndrome.To describe the surgical technique used in the repair of a large scleral perforation in a patient with Marfan's syndrome and a past history of various surgical interventions in both eyes. Scleral homograft and amniotic membrane transplant were used to reconstruct the large scleral defect present in his left eye. One month after surgical intervention, the patient showed excellent restoration of the scleral perforation without signs of inflammation or infection. The combination of scleral homograft and amniotic membrane transplant constitute an effective alternative to autologous scleral and conjunctival grafts when these cannot be used.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
2/10. Orbital inflammation in a patient with extrascleral spread of choroidal malignant melanoma.An elderly woman presented with fever, dehydration, orbital inflammation, total external and internal ophthalmoplegia and blindness, resembling the clinical appearance at presentation of severe orbital inflammatory disease or mucormycosis. Orbital computed tomography scanning demonstrated a retrobulbar orbital mass. Subsequent B-scan ultrasound examination confirmed the orbital mass but also demonstrated a mass within the eye. At lateral orbitotomy, extrascleral spread of an entirely necrotic intraocular melanoma was demonstrated. As computed tomography scanning may not be able to delineate an entirely necrotic intraocular malignant melanoma, B-scan ultrasonography should be considered in patients with orbital inflammation, especially in the presence of a retrobulbar mass.- - - - - - - - - - ranking = 6keywords = inflammation (Clic here for more details about this article) |
3/10. Reversible axial myopia following infectious scleral ulceration--a case report.adult-onset axial myopia is uncommon in comparison with the lenticular myopia. When we dealt with a case of the infectious scleral ulceration, the progressive myopic shift was not only due to the dense nuclear sclerosis but also due to the longer axial length. The elongating axis became shortened after 3-months follow up. Then the patient underwent uneventful cataract surgery. However, the reversal process persisted even after the operation. Although the pathogenesis is not well known, we concluded that the cataract surgery in dealt with the complicated cataract should be delayed in the cases with any inflammation or the axial changes.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
4/10. Repair of scleromalacia using preserved scleral graft with amniotic membrane transplantation.PURPOSE: To evaluate the use of preserved scleral graft with amniotic membrane transplantation (AMT) for the surgical repair of scleromalacia. methods: A prospective study of eight eyes (eight patients) was performed. We grafted glycerin-preserved sclera onto the areas of scleral thinning with impending perforation and then covered them with an amniotic membrane with a thick basement membrane instead of a conjunctival flap. RESULTS: All patients experienced loss of ocular pain and inflammation, rapid reepithelialization of the ocular surface, and marked improvement in visual acuity. All of the scleral grafts remained intact, and no recurrence of scleromalacia was observed. CONCLUSION: Preserved scleral graft with AMT was simple, fast, and effective. It was particularly advantageous when large scleral defects or conjunctival scarring was present. With these therapeutic results, preserved scleral graft with AMT qualifies as a new treatment alternative for scleromalacia.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
5/10. Orbital cysticercosis-associated scleral indentation presenting with pseudo-retinal detachment.PURPOSE: To report a clinical picture similar to retinal detachment caused by orbital myocysticercosis-associated scleral indentation. DESIGN: Interventional case series. methods: Of the 49 cases of orbital myocysticercosis, four eyes of four patients had pseudoretinal detachment presentations that are detailed. RESULTS: Of the four patients with pseudoretinal detachment, three were found to have orbital myocysticerci in lateral and one in inferior recti muscles, mechanically indenting the eyeball, causing scleral indentation, evidenced by ultrasonography or computed tomography. Associated signs of myocysticercosis were orbital inflammation, restricted ocular motility or proptosis. In 2 to 10 days, the cysts traveled forward and came to lie in a sub-Tenon position. Three cysts were removed surgically and one extruded spontaneously. CONCLUSIONS: patients presenting with a clinical picture similar to retinal detachment in the presence of symptoms and signs of orbital cysticercosis, with a history of exposure to an endemic area, should be considered to have orbital myocysticerci causing scleral indentation.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
6/10. Expanding MIRAgel scleral buckle simulating an orbital tumor in four cases.PURPOSE: To describe four patients with an enlarging orbital mass from a swollen MIRAgel scleral buckle that simulated an orbital neoplasm. methods: In a retrospective, single-center case series at the Ocular Oncology Service at wills Eye Hospital of Thomas Jefferson University, 4 eyes of 4 patients were referred for evaluation and treatment of a suspected orbital tumor. RESULTS: The initial presenting features were orbital mass (case 1), strabismus (case 2), and conjunctival mass with orbital extension (cases 3 and 4). Each patient vaguely recalled previous uncomplicated retinal detachment surgery 12 to 20 years earlier. Confirmation of the buckling implant material was made with the retina surgeon in 3 cases. A nontender, forniceal conjunctival mass, deep to the Tenon fascia and appearing as a translucent firm elevation was seen in all 4 cases. Axial CT (case 1) revealed a circumscribed anterior temporal orbital mass, believed to be a large inclusion cyst, 4 times thicker than the nasal scleral buckle. Ocular ultrasonography depicted an echolucent mass in the episcleral region (cases 3 and 4) that was 2 times thicker than the nasal scleral buckle (case 3). Excision was attempted in case 1, but only piecemeal removal was achieved, leading to extensive postoperative inflammation and decreased vision. The other 3 cases were followed conservatively without excision because they were each recognized to be a swollen MIRAgel implant and not an orbital tumor. CONCLUSIONS: MIRAgel scleral buckle material can greatly enlarge over a period of 10 years and simulate an orbital tumor or orbital cyst. patients often do not recall details of the retinal surgery. Caution is advised regarding excision of this material because it is friable and can lead to extensive postoperative inflammation.- - - - - - - - - - ranking = 2keywords = inflammation (Clic here for more details about this article) |
7/10. N-acetylglucose aminidase activity in corneoscleral ulceration after severe eye burns.In some patients with severe burns, major problems were delayed regeneration of the surface epithelium, extensive ulceration of the sclera near the limbus, subsequent corneal ulceration, and subconjunctival scarring. Human tissues surrounding ulcerations in severe eye burns were obtained from surgical interventions in 12 such patients. High activities of the lysosomal marker enzyme N-acetyl-glucose aminidase were found. As is known from histological examinations, these tissues do not represent regeneration of conjunctiva, but rather inflammatory proliferation. The tissues adjacent to corneoscleral ulceration release large amounts of lysosomal destructive enzymes. The rather simple assay of the activity of the N-acetylglucose aminidase proved useful in clinical cases to assess the activity of the inflammation of eye burns and to estimate the efficacy of the therapy applied.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
8/10. The use of processed pericardium in the repair of corneo-scleral fistulas.Explantation of glaucoma valve implants may be complicated by wound closure problems. Prolonged implantation of these valves can lead to development of corneo-scleral fistulas that may not be adequately sealed with the use of sutures alone. The authors report the use of processed pericardium as tissue replacement material for the repair of such fistulas. A 45-year-old woman underwent explantation of a Baerveldt glaucoma valve implant, resulting in the development of a corneo-scleral fistula. To repair the fistula, processed pericardium was inserted into it and secured with 10-0 nylon sutures. Postoperatively, a good wound seal was achieved with no leakage of aqueous humor from the anterior chamber, nor any inflammation. Processed pericardium appears to be an effective tissue replacement material for sealing corneo-scleral fistulas.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
9/10. Calcification at the posterior pole in scleritis. A case report.We report a case with unilateral recurrent anterior scleritis which developed sclerochoroidal calcification at the posterior pole without any overt sign of posterior scleritis during the follow-up period of nine years. We believe that subtle posterior scleral inflammation might lead to sclerochoroidal calcification which might be dystrophic in nature.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
10/10. Histopathologic and electron-microscopic features of corneal and scleral collagen fibers in osteogenesis imperfecta type III.BACKGROUND: This report describes the histopathologic and electron-microscopic features of an eye from a patient with osteogenesis imperfecta type III. In particular, the diameters of corneal stromal and scleral collagen fibers were determined. methods: The eyes of an 18-year-old white male with osteogenesis imperfecta type III were examined by light and electron microscopy and the pathological features were compared with an age-matched control eye. RESULTS: The cornea was clear. The sclera had a blue color and was moderately thinned, especially at the equator. light microscopy revealed absence of Bowman's layer. Transmission electron microscopy confirmed complete absence of Bowman's layer without evidence of scarring or inflammation. The collagen fibers of the corneal stromal lamellae were about 25% narrower than in the control, but the cornea was otherwise unremarkable ultrastructurally. The collagen fibers of the sclera were approximately 50% narrower than in the control and were much more uniform in size. Prominent portions of elastic fibers, which are usually only present in a small number in the inner portion of the sclera, were present throughout the sclera. CONCLUSION: We propose that it is the uniformity of the scleral collagen fibers which gives the sclera translucence, producing the blue color often observed clinically in osteogenesis imperfecta. Absence of Bowman's layer of the cornea did not interfere with the stability of the cornea in this case. This appears to be the first published pathological examination of the eye in osteogenesis imperfecta type III.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
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