Cases reported "Aphakia"

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1/18. Management of post-traumatic aniridia with retinal detachment.

    PURPOSE: To reconstruct the anatomic and functional impairment in patients with post-traumatic aniridia, aphakia, and retinal detachment. methods: Four patients with unilateral aniridia and aphakia as well as retinal detachment as results of severe eye injuries underwent scleral buckling, vitrectomy, membrane peeling, endolaser photocoagulation, silicone oil or gas temponade, combined with iris diaphragm-IOL implantation. RESULTS: All four patients achieved successfully anatomic and functional reconstruction after surgery. During five to 22 months postoperative follow-up, all retinas remained attached. The final visual acuity increased from finger counting to 0.1-0.3. CONCLUSIONS: The combination of vitreoretinal surgery and iris diaphrgm-IOL implantation is an effective method for post-traumatic aniridia, aphakia and traumatic retinal detachment. It could ameliorate photophobia and improve the biocular vision. Furthermore, artificial iris diaphragm implantation could prevent silicone oil-endothelia contact and salvage silicone keratopathy.
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2/18. Congenital corneal staphyloma associated with aphakia.

    A neonate had a globular mass bulging through the eyelids of the left eye. Computed tomography revealed a large ectatic corneal lesion and the absence of a lens. The enucleated globe revealed that the posterior surface of the ectatic cornea was lined by iris tissue, indicating corneal staphyloma.
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keywords = aphakia
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3/18. corneal perforation with secondary congenital aphakia in Peters anomaly.

    PURPOSE: To describe two cases of secondary congenital aphakia in association with Peters anomaly. methods: Two infants were noted to have corneal opacification at birth. Each child was found to have Peters anomaly requiring corneal transplantation in 1 or both eyes. RESULTS: Each child underwent penetrating keratoplasty, revealing absence of the crystalline lens in 1 eye. Histopathologic evaluation of the corneal buttons was performed. Each specimen showed full-thickness corneal defects with lens remnants. CONCLUSIONS: Secondary congenital aphakia from corneal perforation should be considered in the presentation of severe Peters anomaly.
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4/18. neodymium:YAG pupilloplasty in pediatric aphakia.

    An adequate pupillary aperture is required for accurate ophthalmoscopy and retinoscopy in pediatric aphakia. When pupillary miosis does not respond to pharmacologic dilation, optical iridectomy performed with a vitreous suction-cutting instrument under general anesthesia may be required. We report a 27-month-old aphakic child whose pupillary aperture was enlarged from 1 mm to 3.5 mm with neodymium (Nd):YAG pupilloplasty, following intramuscular sedation with meperidine, promethazine, and chlorpromazine. Removal of the laser chin rest and positioning of the patient on a table with adjustable height facilitated delivery of 140 applications at 2.5 to 4.3 mJ to the pupillary border. levobunolol 0.5% controlled the transient posttreatment rise in intraocular pressure. We suggest that Nd:YAG pupilloplasty performed with sedation be considered as an alternative to intraocular surgery when pupillary miosis in pediatric aphakia does not respond to dilating agents.
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5/18. Combined relaxing incisions and epikeratophakia for the correction of aphakia and high postkeratoplasty degree astigmatism.

    A combined surgical procedure consisting of corneal relaxing incisions and epikeratophakia was used to correct high-degree postkeratoplasty astigmatism and aphakia in two patients. Both patients achieved their final refractive result as soon as 1 month after suture removal (2 and 3 months after surgery, respectively). Keratometric readings showed a reduction of approximately 20.00 diopters in one case and 10.00 D in the other, while the spherical equivalent changed from 10.00 D to 0.50 D in one eye and from 7.50 D to 1.75 D in the other. Spectacle correction was prescribed for both patients. At the last follow-up visit, about 2 years after surgery, these values were unchanged. The main advantage of the combined technique over two separate procedures was that postoperative visual rehabilitation was faster. Equally important was the stability of the refractive result over a long period of time after surgery, as well as the absence of negative effects on the preexisting corneal graft. In spite of the technical complexity of a combined surgical procedure, this approach probably represents the best choice in rare cases such as the ones reported here.
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keywords = aphakia
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6/18. Chromatopsia.

    More than half of the cases with complaints of chromatopsia had recent-onset retinal pathology. Erythropsia due to bright (sun-)light is a relatively common finding in aphakia and pseudophakia. UV-coated intraocular lenses do not provide complete protection. Cerebrovascular chromatopsia usually occurs in transient attacks.
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keywords = aphakia
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7/18. epikeratophakia: clinical results and experimental development.

    The clinical course and visual, refractive, and keratometric results of a consecutive series of epikeratophakia procedures carried out by the author are presented. Indications for the procedure included keratoconus and adult and paediatric aphakia. Follow up time ranged from two to fourteen months. The first five patients operated on received commercially obtained cryolathed lenticules. The final three cases received lenticules which were lathed by the author at room temperature using a recently developed technique.
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keywords = aphakia
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8/18. contrast sensitivity after epikeratophakia.

    epikeratophakia is a rapidly evolving surgical procedure for the refractive correction of aphakia. Even when Snellen acuity after epikeratophakia is normal, patients often report a subjective degradation of the visual image through the surgically corrected eye. To further define visual performance in the patient with optically successful epikeratophakia, we examined contrast sensitivity in two patients surgically corrected for monocular aphakia. Contrast thresholds were measured over a range of spatial frequencies using both computer-generated sinusoidal gratings and a commercially available wall chart system. The eye with epikeratophakia in each case was compared with the opposite normal eye with comparable acuity. One patient was also tested prospectively in the same eye both before and after surgery. Data demonstrate a depression of the contrast sensitivity function in the middle and high spatial frequencies induced by the placement of an epikeratophakia lenticule when compared with the normal eye or contact lens-corrected, preoperative aphakic eye with comparable good acuity. These findings may explain the subjective experience of epikeratophakia patients.
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keywords = aphakia
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9/18. epikeratophakia following rotational autokeratoplasty in a child.

    A 3-year-old child with posttraumatic aphakia and a corneal scar was treated with a rotational penetrating ipsilateral autokeratoplasty followed by epikeratophakia 2 months later. His final best corrected visual acuity was 20/30, with 1.37D of corneal astigmatism. There were no significant operative or postoperative complications.
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keywords = aphakia
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10/18. Cyclic esotropia in a patient with unilateral traumatic aphakia: case report.

    Cyclic esotropia is a rare and poorly understood condition normally treated by correcting the deviation measured on the squinting day. Control in some patients with this condition can be gained by correcting their refractive errors, thereby improving acuity. We report on an adult patient who developed cyclic esotropia after unilateral traumatic aphakia with failed contact lens wear whose squint was corrected by secondary intraocular lens implantation. This may be explained by the reduction in the degree of aneisokonia which subsequently improved steropsis.
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keywords = aphakia
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