Purpose: To describe the findings, recurrence rate and complications following therapeutic penetrating keratoplasty (PK) in eyes with Acanthamoeba keratitis (AK). Methods: A retrospective study comparing eyes that underwent surgery in the early stages of the disease versus eyes that had surgery delayed for more than five months of disease. Results: The study analyzed 23 eyes with similar demographic characteristics. Seventeen eyes (73.91%) underwent early surgical procedures within five months (Group 1), and 6 (26.08%) had the late PK after five months (Group 2). The mean clinical treatment time between the first symptoms and surgical procedure was 1.80 + 0.915 months in group 1 and 7.83 + 2.48 months in group 2 (p < 0.001). Patients in Group 1 achieved a final mean Best-corrected visual acuity (BSCVA) of logMar 0.61 + 1.07 versus 0.98 + 0.85 in Group 2 (p =0.416). Recurrence of the AK infection occurred in 11.8% (2/17) of the early PK group and in 50% (3/6) of the eyes that underwent a late therapeutic PK (p = 0.051). Cornea rejection was the most reported complication following PK, and it affected 35.3% (6/17) of the eyes in Group 1 versus 66.7% (4/6) of the eyes in Group 2 (p = 0.183). Secondary glaucoma affected 17.6% (3/17) of patients who have undergone early PK versus 66.7% (4/6) of the eyes where surgery was delayed (p = 0.025). Conclusions: Early therapeutic PK for Acanthamoeba keratitis might have beneficial results concerning the cure of infection, fewer complications, and better visual acuity recovery than a late one.
Introduction: we reported a rare case involving chronic ICL V4c deposits after surgery without any other clinical manifestations. The deposits was found one month after surgery, and last about six weeks. After using topical steroid, the deposits were removed gradually. Patient and Clinical Findings: A 24-year-old female presented with granular opacity of implantable collamer lens (ICL) from one month after surgery (OS). There were no other inflammatory responses in the anterior segment of the eye. Diagnosis, Intervention, and Outcomes: The patient was diagnosed as chronic deposits on implantable collamer lens after surgery. After using 1% Prednisolone Acetate Eye Drop, the deposits were removed gradually. Conclusions: After ICL surgery, it is very uncommon for the chronic deposits to form on the ICL surface. Topical steroids was effective to help eliminate the deposits.
Bilateral retinoblastoma is one of the congenital retinal lesions that is found in the early life and also recognized as one of the reasons of loss of vision.It is an autosomal dominant condition that is mean if any of the biological parents has the condition should do the ophthalmological screen to the new-born baby in his few days of his life.It needs genetic screen.If the disease has been confirmed by either the screen or by the ophthalmology assessment, it needs an operation (surgical removal).
Hyperreflective materials on Spectral-Domain Optical Coherence Tomography (SD-OCT) images of eyes with different retinal disorders may have diverse shapes and origins and are a prognostic marker of disease progression. This study documents using SD-OCT the presence of Curved Hyper Reflective Structures (CHRS) in the outer macula of eyes with different retinal disorders. A retrospective case series of 22 eyes of 21 patients with CHRS is described. In addition, 12 eyes of 12 patients with other kinds of intra retinal hyperreflective structures were investigated. CHRS, which form curved thin lines or broad bands between the outer plexiform layer and external limiting membrane (ELM) in the macula, were found in eyes without edema. Thin CHRS were secondary to dry age-related macular degeneration (AMD; n=10 eyes), glaucoma (n=2), wet AMD, chorioretinitis, macular scarring, anterior ischemic optic neuropathy, proliferative diabetic retinopathy, adult-onset foveomacular vitelliform dystrophy, and ocular ischemia (each n=1), respectively. Broad CHRS were caused by hemorrhages in the inner foveal layers (n=3). CHRS were associated with focal photoreceptor layer defects. The defects were present before the formation of thin CHRS and during or after the formation of broad CHRS. The retina of eyes with edema showed hyper reflective foci and cystoid cavities which contained hypoor medium-reflective fluid and hyper reflective material, but not CHRS. It is concluded that CHRS in the outer macula are found in eyes with different retinal disorders without edema. Thin CHRS likely develop after photoreceptor damage from the ELM. Broad CHRS are caused by hemorrhages within the inner foveal layers.
Current review focus on hidden links between glaucoma, contact lenses and Ocular Surface Disease (OSD), in glaucoma the most important treatment is the control of progression through targeted pharmaceutical protection, keeping low intraocular pressure, by prescribing ophthalmic medications. On the other hand, use of preservatives in glaucoma medications is a common practice in order to maintain their effectiveness for an extended period of time. Anti-glaucoma medications enclose preservatives and the 70% of them contain a very common preserving agent, the Benzalkonium chloride (BAK). In glaucoma medications BAK toxicity includes, loss of tear film stability, direct damages to the cornea and conjunctival epithelium, and possible immune allergic reactions. Other types of preservatives may exhibit less toxicity but are still irritating agents. Of course, concentration and duration of treatment determine the extent of side effects of the preservatives. High content hydrogel contact lenses absorb BAK molecules and release them slowly onto the corneal epithelium over time. So, patients that use contact lenses may wear those better 15 minutes after the medication. The prolonged exposure to BAK is well known to increase symptoms of ocular inflammation. A diminish of patient's life quality is observed and patient compliance to the specific anti-glaucoma medication, is also undermined. Conversely, there are more causes of dry eye in glaucoma patients, as the majority of the glaucomatous patients are elderly. Such factor is the decrease of tear production with increasing of age and numerous changes in the composition of the tear film. At the same time, elderly often suffer from other pathological diseases that encourage the development of dry eye and eye irritations. Adding the anti-glaucoma eye drops containing preservatives along with the constant use of contact lenses, we are led to a serious multifactorial dry eye condition. The last years several antiglaucoma agents have been marketed such as preservative-free or Benzalkonium chloride-free formulations in an attempt to reduce the side effects related to the preservatives.
