Cases reported "Scleral Diseases"

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1/7. Acquired anterior ocular melanocytosis following cataract extraction.

    The right eye of a 59-year-old man was the subject of extracapsular cataract extraction and posterior chamber lens implantation. He gradually developed superior sectoral scleral and diffuse iris hyperpigmentation within 7 years postoperatively. The iris was also uniformly thickened. He sustained 20/20 visual acuity in the pseudophakic eye. Despite marked pigmentation of the angle, his right intraocular pressure remained within normal limits. We use the term acquired anterior ocular melanocytosis because the pigmentary changes were confined to the anterior segment and the choroid was not involved. We conclude that surgical injury in the form of cataract extraction can induce episcleral/scleral hyperpigmentation and iris hyperchromia.
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keywords = extraction
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2/7. Episcleral pseudomelanoma: late complication of scleral tunnel incision.

    PURPOSE: To describe two patients who developed scleral thinning as a late complication of scleral tunnel incision for cataract extraction. DESIGN: Observational case report and interventional case report. methods: A 75-year-old man had an asymptomatic gray-brown subconjunctival nodule in the location of the healed scleral tunnel incision for cataract surgery. A 62-year-old man had a biopsy of a brown conjunctival nodule at the site of a scleral tunnel incision for cataract surgery. RESULTS: The 75-year-old patient with prolapsed uveal tissue was followed up for 4 years without change in the wound defect. The 62-year-old patient had a biopsy because the exposed ciliary body mimicked a melanoma. CONCLUSIONS: Scleral defects with herniated uveal tissue as a late sequela of scleral tunnel incision for cataract surgery should be differentiated from melanoma and can be safely observed for years when covered by conjunctiva.
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keywords = extraction
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3/7. Recurrent scleral abscess after uncomplicated cataract extraction.

    PURPOSE: To report the unusual occurrence of a recurrent scleral abscess after uncomplicated cataract extraction. methods: Case report of a 77-year-old healthy woman. RESULTS: Multiple cultures and antibiotic treatments failed to resolve presenting symptoms. Gram stain, Gomori methenamine silver (GMS) stain, and all cultures were negative. After drainage of the abscess, the patient's symptoms cleared briefly, then returned 6 months later showing a positive GMS stain consistent with candida. The patient was treated with amphotericin, natamycin, and fluconazole at this time, and a return in visual acuity occurred along with a resolution of symptoms. No re-occurrence has been noted with 2.5 years of follow-up. CONCLUSIONS: cataract extraction, although generally a safe procedure, can still result in unusual complications such as scleral abscesses. Excellent outcomes are possible once the infections are identified and treated.
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keywords = extraction
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4/7. Scleral cyst formation following extracapsular cataract extraction.

    Two patients who underwent extracapsular cataract surgery through corneal incisions developed scleral cysts 2 and 6 years later, respectively. The cysts involved the sclera without extension into the cornea or anterior chamber. To prevent further thinning of the sclera, only the anterior walls were excised and the posterior walls were mechanically debrided using alcohol and sponges. Histopathologic examination supported the clinical diagnosis of scleral cysts. No recurrence was seen. Scleral cyst formation may be encountered as a late complication of cataract surgery. Excision of the anterior wall coupled with removal of the epithelial lining of the posterior wall with alcohol may considerably lessen the likelihood of recurrence.
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keywords = extraction
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5/7. Sterile corneal ulceration after cataract extraction in patients with collagen vascular disease.

    We report the occurrence of sterile corneal ulceration in 11 eyes of eight patients with collagen vascular diseases and dry eyes after cataract extraction with intraocular lens implantation. Keratolysis occurred after both extracapsular and intracapsular cataract extraction and appeared unrelated to the type of intraocular lens. Despite aggressive lubrication and other medical treatment, including systemic immunosuppressive agents, penetrating keratoplasty was often required. Although all eyes were saved, visual outcome was usually poor. The histopathologic finding of polymorphonuclear leukocytes localized near the areas of corneal dissolution provides evidence for the role of polymorphonuclear leukocyte-derived collagenase as a contributing factor in the pathogenesis of sterile corneal ulceration in these patients.
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keywords = extraction
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6/7. Multiple scleral abscesses with recurrent bacterial endophthalmitis eight months following cataract surgery.

    Scleral involvement in association with endophthalmitis is unusual. We report a case of recurrent bacterial endophthalmitis and multiple scleral abscesses occurring 8 months following cataract extraction. culture of pus from scleral abscesses first grew pseudomonas aeruginosa; and klebsiella pneumoniae on recurrence. The patient responded to intensive topical and systemic antibiotic therapy and recovered visual acuity of 20/60.
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keywords = extraction
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7/7. Late hypotony after cataract extraction due to a scleral fistula: a technique for surgical correction.

    The authors report the use of a surgical procedure for the correction of a scleral fistula in a patient with late hypotony after cataract surgery. Trephination of necrotic tissue lining the scleral fistula with a double scleral patch technique was performed. Four months later, the patient's vision had improved to 20/40, with improvement of the macular folds and an intraocular pressure of 10 mm Hg. The authors conclude that the use of a double-patching technique is effective in the repair of scleral fistulas. The technique allows one to avoid more risky repair procedures that involve a greater area of tissue excision.
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keywords = extraction
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