任何破坏角膜上皮屏障的屈光性激光外科操作,都有发生感染性并发症的潜在危险.随着准分子激光角膜层间磨镶术(LASIK)被更广泛地应用,与LASIK有关的感染性角膜炎病例已被报道1～6.我们现在对5人6只眼在接受LASIK术后继发了角膜溃疡进行报道.

Intraocular lens placement in the absence of an intact posterior capsule presents a particular challenge to the surgeon. Many options are available: an open-loop anterior chamber lens can be used or a posterior chamber lens can be placed in the ciliary sulcus over residual capsular material or sutured either in the ciliary sulcus or to the posterior aspect of the iris. In the late 1980s, the method of choice at our institution during penetrating keratoplasty was to suture the lens to the posterior aspect of the iris. To evaluate the long-term stability of lenses that were fixed by this method, we reviewed the records of all of these operations performed in our institution over a 52-month period that were followed for at least 1 year. A 7-mm optic, 3-piece posterior chamber intraocular lens with optic positioning holes was used in all the operations. A double-armed 10-0 polypropylene suture was passed

Acute angle-closure glaucoma is a real ophthalmic emergency that requires prompt therapy. Pupillary block is the most common mechanism leading to acute angle-closure glaucoma, and it occurs when the flow of aqueous humor from the posterior chamber to the anterior chamber is obstructed by a functional block between the pupillary portion of the iris and the lens. The flow of aqueous humor through the pupillary aperture can be impeded in several ways.1We report a unique case of acute pupillary block, angle-closure glaucoma that developed secondary to an air bubble, which was occluding the pupillary aperture. Report of a Case. A 65-year-old Hispanic woman, who had nanophthalmos, underwent cataract extraction via phacoemulsification; the procedure was complicated by a small tear in the Descemet membrane. At the end of the procedure, a large air bubble was infused into the anterior chamber to unfold the tear and prevent its extension. Eight

The purpose of this study was to identify new trends in the changing indications for penetrating keratoplasty. We retrospectively reviewed the clinical and pathologic diagnoses of 1,104 corneal buttons that had been submitted to the Estelle Doheny Eye Pathology Laboratory, Los Angeles, during the 5-year period 1989-1993. The leading indications, in order of decreasing frequency, were pseudophakic corneal edema (24.8%), regrafts (21.3%), scarring with or without chronic inflammation (11.1%), keratoconus (7.1%), aphakic corneal edema (6.4%), and ulcerative conditions (5.8%). The incidence of pseudophakic corneal edema remained stable over the study period and was actually surpassed by regraft in the last year of the study. Although pseudophakic corneal edema remains the predominant indication for penetrating keratoplasty, our findings suggest that its occurrence rate has begun to level off.

The efficacy of corneal transplantation in infants with corneal opacity secondary to congenital glaucoma has not been established. We retrospectively reviewed our results of nine penetrating keratoplasties performed on eight eyes of six infants who had multiple risk factors for poor prognosis: age < 2 years at the time of grafting; uncontrolled glaucoma in four eyes; concurrent lensectomy, retinal, or glaucoma surgery in five eyes; aphakia in five eyes; and an acute perforation in one eye. Six of the nine grafts (67%) remained clear during a mean follow-up of 24 months (30 months in eyes with clear grafts). Development of ambulatory vision or better occurred in six of eight (75%) eyes after corneal transplantation and treatment of refractive errors and amblyopia. Graft failure occurred in three eyes-two from corneal decompensation, and one from homograft rejection. Complications included one total retinal detachment, one case of Streptococcus pneumoniae keratitis, and three cases that lost intraocular pressure control, requiring further glaucoma surgery. We conclude that useful vision can be achieved after penetrating keratoplasty even in some high-risk infants with congenital glaucoma.

Purpose: To determine whether the choice of intraocular lens (IOL) power formula improves IOL power predictions and whether personalized constants within the IOL power formula are critical factors in improving refractive predictions after combined penetrating keratoplasty, cataract extraction, and IOL implantation. Methods: Records of 46 patients who had the triple procedure between January 1988 and December 1992 were evaluated using the SRK II, SRK/T, Holladay, and Hoffer Q formulas to predict the postoperative spherical equivalent refractions for implanted lens power. Calculations were carried out with and without the use of personalized constants. The predictive accuracy of each formula was assessed by comparing the actual postoperative spherical equivalent refractive error with that predicted by the formulas. The predictive error and the distribution of predictive errors were used to assess predictive accuracy. Results: There was no difference in the mean absolute predictive errors and the distribution of predictive errors for the four formulas evaluated (P < .05). The use of personalized formula constants significantly reduced the mean absolute predictive error for the SRK II, SRK/T, and Holladay formulas (P < .05) and approached significance for the Hoffer Q formula. Conclusion: The findings suggest that the choice of IOL power formula does not affect IOL power predictions in the corneal triple procedure; however, personalized constants within a formula appears to be a critical factor in improving postoperative refractive predictions.

During a one-month period, we examined four patients referred for evaluation of probable microbial keratitis after bilateral, simultaneous radial keratotomy. Each patient had midstromal infiltrates compatible with microbial keratitis that involved one or more of the radial incisions. In two patients the keratitis was bilateral. All patients had been treated empirically with antibiotic agents; superficial cultures with cotton-tipped applicators and corneal scraping by inserting a platinum spatula into the radial incisions were negative. Corneal biopsy of one patient disclosed gram-positive rods and culture of the biopsy specimen grew diphtheroids. The infiltrates gradually resolved over a period of several months with intensive antibiotic therapy. Sight-threatening infectious keratitis can occur after radial keratotomy, and we believe that simultaneous bilateral ocular surgery of any kind should be discouraged.

Evaluation of the Rabbit as a Model of Acanthamoeba Keratitis Get access Mary A. Côté, Mary A. Côté Department of Ophthalmology, University of Southern California School of Medicine; and the Doheny Eye Institute, Los Angeles, California Search for other works by this author on: Oxford Academic PubMed Google Scholar John A. Irvine, John A. Irvine Department of Ophthalmology, University of Southern California School of Medicine; and the Doheny Eye Institute, Los Angeles, California Search for other works by this author on: Oxford Academic PubMed Google Scholar Narsing A. Rao, Narsing A. Rao Department of Ophthalmology, University of Southern California School of Medicine; and the Doheny Eye Institute, Los Angeles, California Search for other works by this author on: Oxford Academic PubMed Google Scholar Melvin D. Trousdale Melvin D. Trousdale Department of Ophthalmology, University of Southern California School of Medicine; and the Doheny Eye Institute, Los Angeles, California Reprints and correspondence: Dr. Melvin D. Trousdale, Doheny Eye Institute, 1355 San Pablo Street, Los Angeles, California 90033. Search for other works by this author on: Oxford Academic PubMed Google Scholar Reviews of Infectious Diseases, Volume 13, Issue Supplement_5, March-April 1991, Pages S443–S444, https://doi.org/10.1093/clind/13.Supplement_5.S443 Published: 01 March 1991