1/13. Postoperative mycobacterium chelonae endophthalmitis after extracapsular cataract extraction and posterior chamber intraocular lens implantation.OBJECTIVE: To describe a case of postoperative endophthalmitis caused by mycobacterium chelonae after extracapsular cataract extraction with posterior chamber intraocular lens implantation. DESIGN: Interventional case report. methods: The history and clinical presentation of a 66-year-old female patient, in whom a low-grade delayed-onset endophthalmitis and keratitis developed after extracapsular cataract extraction with posterior chamber intraocular lens implantation, is described. Microbiologic investigations of the scrapings of corneal infiltrate at the cataract incision site, aqueous humor and eviscerated material, and histopathologic study of eviscerated material and an enlarged cervical lymph node were performed. MAIN OUTCOME MEASURES: The clinical, histopathologic, and microbiologic findings in a case of low-grade delayed-onset endophthalmitis. RESULTS: Analysis of the direct smear of both the corneal infiltrate as well as the eviscerated material revealed acid-fast bacilli. M. chelonae was isolated from these specimens. Direct smear and culture of the aqueous humor were negative for bacteria (including mycobacteria) and fungus. Histopathologic examination of the eviscerated material showed a dense infiltration of polymorphonuclear leukocytes in the uveal tissue, extensive necrosis and hemorrhage, and exudates with hemorrhage in the vitreous cavity. Histopathologic examination of the lymph node revealed granulomatous inflammation with caseation necrosis, but did not reveal acid-fast bacilli. CONCLUSIONS: M. chelonae, although infrequent, should be considered an etiologic agent of delayed-onset, postoperative endophthalmitis and early bacterial diagnosis should help in institution of appropriate therapy.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/13. Postoperative necrotizing sclerokeratitis.The postoperative necrotizing sclerokeratitis is a rare condition occurring shortly after surgical procedures, mainly following cataract extractions. After several exacerbations and remissions spontaneous scleral perforation may occur. In the described case the conservative treatment/topical antibiotics, corticosteroids/failed, therefore the damaged scleral surface was covered with lyophilized dura and the condition came to a standstill.- - - - - - - - - - ranking = 0.16666666666667keywords = extraction (Clic here for more details about this article) |
3/13. pseudallescheria boydii keratitis.We treated a case of post-traumatic keratitis caused by the soil saprophyte, pseudallescheria boydii. The injury was caused by a wood splinter which produced a perforating corneal laceration that was primarily repaired. Signs of corneal infection were not evident until the fourth postoperative week. The organism was eradicated by topical miconazole and natamycin. Subsequent penetrating keratoplasty combined with cataract extraction and intraocular lens implantation has achieved a good visual outcome.- - - - - - - - - - ranking = 0.16666666666667keywords = extraction (Clic here for more details about this article) |
4/13. Subpalpebral lavage antibiotic treatment for severe infectious scleritis and keratitis.OBJECTIVE: To report the subpalpebral lavage therapy for the treatment of infectious scleritis and keratitis. METHOD: Six patients were admitted for treatment of severe infectious scleritis and keratitis and were initiated on the subpalpebral lavage system after showing no improvement with topical fortified antibiotics. A continuous antibiotic lavage was applied until clinical sterility was achieved and topical steroids were gradually added to control concomitant inflammation. RESULTS: All 6 patients had resolution of their infections and achieved a stable ocular surface with no inflammation. One patient required a corneal transplant for active inflammation and corneal thinning, 1 had a transplant for a dense central corneal scar, and 1 patient underwent corneal transplant and cataract extraction. One case was a pseudomonas keratitis in a blind eye, which rapidly resolved and has remained stable. Four patients required additional surgeries, which included 3 corneal transplants, 2 cataract extractions, and 1 glaucoma aqueous shunt. CONCLUSION: Continuous irrigation of the eye can improve scleral penetration of antibiotics. Subpalpebral lavage provides continuous irrigation and may be effective in the treatment of infectious scleritis of a variety of etiologies.- - - - - - - - - - ranking = 0.33333333333333keywords = extraction (Clic here for more details about this article) |
5/13. Mycobacterium chelonei keratopathy with visual rehabilitation by a triple procedure.We report a chronic keratouveitis following an eye injury, the etiology of which remained obscure despite repeated corneal scrapings and cultures. Eventually, the diagnosis was established by culturing Mycobacterium chelonei from a corneal biopsy specimen. Topical amikacin resolved active inflammation, but dense corneal scarring and a cataract remained. Visual rehabilitation was achieved through a combined penetrating keratoplasty, extracapsular cataract extraction, and intraocular lens implantation. This case illustrates that there should be a high index of suspicion of atypical mycobacteria when faced with any unusual keratitis, particularly following penetrating injuries and corneal grafts.- - - - - - - - - - ranking = 0.16666666666667keywords = extraction (Clic here for more details about this article) |
6/13. Spherophakia: a case report.A case of spherophakia with unilateral traumatic phacometecesis is presented and the treatment of the postextraction sequelae by contact-lens therapy is described.- - - - - - - - - - ranking = 0.16666666666667keywords = extraction (Clic here for more details about this article) |
7/13. Changes in nuclear dna content and cell size of injured human corneal endothelium.To understand how human corneal endothelium compensates for cell loss, nuclear dna-cytofluorometry and cell morphometry were carried out on injured corneal endothelium. The examined corneas included two cases of keratoconus complicated with acute hydrops and one without acute hydrops, two cases of herpetic keratitis, one case of post-intracapsular cataract extraction (post-ICCE) and one case of luetic keratitis. The endothelial cell layer was separated from Descemet's membrane and double-stained with Rhodamine-labeled wheat germ agglutinin-lectin (WGA) and 4',6-diamidino-2-phenylindole dihydrochloride (DAPI). The area of each cell was measured with a color image analyser and compared with its cytofluorometric nuclear dna content. The endothelium in apparently intact regions of the diseased corneas showed the same dna-ploidy pattern and cell area as the physiological corneas. However, endothelial cells in injured regions had greater area, even in diploidy, than in presumably normal ones and showed a larger number of hyperploid cells ranging from 4C to 36C. Hyperploid cells consisted of many multinucleates and few polyploidies and had extremely large and bizarre cytoplasm. All injured corneas were accompanied by cells with numerous micronuclei. A few asymmetrical 4C-binucleates (with dna values such as 1.3 plus 2.6C) appeared in the case of the post-ICCE. It is concluded that damage to human corneal endothelial cells in vivo results in cell enlargement with or without dna synthesis. Those changes appear more severe in diseased corneas than in the situation of physiological aging which we have reported previously. In severe cases, micronuclei, polyploid cells and multinucleated giant cells are frequent, thereby suggesting a possible long-persistent metabolic impairment of the endothelium after severe damage to the cornea.- - - - - - - - - - ranking = 0.16666666666667keywords = extraction (Clic here for more details about this article) |
8/13. Extended-wear aphakic soft contact lenses after penetrating keratoplasty.Seven patients undergoing aphakic keratoplasty or combined keratoplasty and cataract extraction were fitted with a single type of high-water-content, extended-wear, aphakic soft contact lens (Permalens). Six patients were fitted early after keratoplasty, ie, before the removal of the sutures and while they were still receiving corticosteroid drops (1% prednisolone acetate). The patients were followed up at close intervals with high-magnification serial corneal photography. Complications of extended wear included superficial neovascularization, punctate epithelial keratitis, and variable visual acuity. Our results suggest that although extended-wear aphakic soft contact lenses may be an acceptance form of visual rehabilitation in selected patients who undergo transplantation, they are frequently problematic. In addition, fitting of these lenses should be withheld until after the removal of the sutures, and patients should be followed up at closer intervals than the patients with extended-wear aphakic soft contact lenses who have not undergone keratoplasty.- - - - - - - - - - ranking = 0.16666666666667keywords = extraction (Clic here for more details about this article) |
9/13. Scrolls of Descemet's membrane in healed syphilitic interstitial keratitis.A 45-year-old woman with healed syphilitic interstitial keratitis presented with decreased vision, foreign-body sensation of the right eye, and bilateral conjunctival injection. Examination disclosed a network of tissue on the posterior corneal surface, with extension into the anterior chamber. Bullous keratopathy developed after intracapsular cataract extraction, and a keratoplasty was performed. Pathologic examination of the corneal button disclosed corneal edema, posterior stromal vascularization, much thickening of Descemet's membrane, and concentrically laminated scrolls of Descemet's membrane-like tissue that extended from the posterior corneal surface into the anterior chamber. endothelium was attenuated considerably throughout and in one area was replaced by a single layer of iris melanocytes.- - - - - - - - - - ranking = 0.16666666666667keywords = extraction (Clic here for more details about this article) |
10/13. Linear endotheliitis.We treated six eyes of five patients with linear endotheliitis. This entity appears clinically as a line of keratic precipitates on the corneal endothelium that progresses centrally and is accompanied by peripheral stromal and epithelial edema. All five patients had ocular pain, redness, and photophobia. One eye had an episode of a dendritic lesion typical of herpes simplex. Two eyes had a history of cataract extraction before developing linear endotheliitis. We treated all patients aggressively with a combination of corticosteroids and antiviral agents. Complete resolution of inflammation and edema occurred in all cases. Four patients required the use of oral acyclovir to control the inflammation and prevent recurrence of the disease. Linear endothelitis is a distinct form of endotheliitis that may be associated with herpes simplex virus, and treatment included corticosteroid and antiviral therapy.- - - - - - - - - - ranking = 0.16666666666667keywords = extraction (Clic here for more details about this article) |
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