Purpose: To compare the accuracy of biometry using conventional A-scan ultras onography and partial coherence interferometry, and to improve the accuracy of b iometry by sequential audit of postoperative refractive er...Purpose: To compare the accuracy of biometry using conventional A-scan ultras onography and partial coherence interferometry, and to improve the accuracy of b iometry by sequential audit of postoperative refractive error. Methods: The stud y was performed in three phases. In phase 1, 20 consecutive patients undergoing routine phacoemulsification underwent biometry using bothA-scan ultrasonography and the Zeiss IOLMaster (ZIOLM).Asingle experienced optometrist refracted all p atients 2 weeks after surgery. The errors between expected and achieved refracti on were calculated and compared between the two methods. In phases 2 and 3, a fu rther 22 and 20 patients, respectively, were recruited and only the ZIOLM was us ed for biometry. The manufacturer’s suggested A-constant was refined and the e rror between expected and achieved refraction was calculated. Results: In phase 1, the median unexpected error for the ZIOLM was +0.63 (interquartile range +0 .368 to +1.015) and for A-scan biometry was 0.24 (interqu artile range-1.335 to +0.802). In phase 1 65%of patients’- postoperative refractions were found to be within 1.0 D of emmetropia using th e ZIOLM (55%using A-scan biometry). Refinements to the A-constant improved th is to 95%by phase 3. Conclusion: An error was identified in IOL power estimatio n with the ZIOLM, when using the manufacturer’s recommended A-constant (recomm ended and previously optimized ultrasound A-constant 118.0; ZIOLMoptimized A-c onstant 118.6). Serial modifications to the A-constant were successful in reduc ing the unexpected error towellwithin the tolerance limits of published internat ional standards.展开更多
Background: The mechanism responsible for optic disc pit maculopathy is unclea r, but abnormal vitreous structures, including the anomalous Cloquet’s canal at the optic disc pit, have been suggested as important fact...Background: The mechanism responsible for optic disc pit maculopathy is unclea r, but abnormal vitreous structures, including the anomalous Cloquet’s canal at the optic disc pit, have been suggested as important factors. Case: We report t he intraoperative and ultrastructual findings of an unusual posterior vitreous s trand in the eye of an 8-year-old girl with optic disc pit maculopathy. Observ ations: The patient presented with decreased vision in the left eye. Examination of the left eye revealed a best-corrected visual acuity (VA) of 0.08 and a mac ular detachment associated with an optic disc pit. Vitrectomy was performed with the adjunctive use of triamcinolone acetonide intraoperatively. The presence of an unusual posterior hyaloid strand tightly attached to the margin of the optic disc pit was noted. An unusual movement of this strand was observed during the surgery. The strand was excised, and fluid-gas exchange was performed using gas tamponade with 20%SF6. After 12 months, a complete macular reattachment was ob tained, with the VA improving to 1.2. Electron microscopic examination of the re moved strand revealed abundant thick collagen fibrils with a frame of fine fibri ls. Conclusion: The unusual posterior vitreous strand connected to the optic dis c pit may have contributed to the pathogenesis of maculopathy in this young chil d.展开更多
PURPOSE: To report the efficacy of electrolysis as a treatment of corneal opac ities in a young patient with the superficial variant of granular corneal dystro phy. DESIGN: Interventional case report. METHODS: An 11-y...PURPOSE: To report the efficacy of electrolysis as a treatment of corneal opac ities in a young patient with the superficial variant of granular corneal dystro phy. DESIGN: Interventional case report. METHODS: An 11-year-old boy presented with subepithelial opacities in both eyes. His visual acuity was 0.2 in the lef t eye; he received corneal electrolysis under topical anesthesia. RESULTS: The e lectrolysis, which required only 5 minutes, resulted in the disappearance of the subepithelial opacities. His visual acuity improved to 0.4 on the next day and was 1.0 eight months later. The corneal curvature and thickness were not altered by the electrolysis. CONCLUSIONS: Corneal electrolysis proved to be an effectiv e treatment for subepithelial opacities, and we recommend electrolysis as an eff ective and simple treatment for young patients with SGCD.展开更多
Background: Patients with severe unilateral ocular surface disease require rec onstruction of the damaged ocular surface. We succeeded in culturing primary cor neal limbal epithelial cells taken from minimal biopsy an...Background: Patients with severe unilateral ocular surface disease require rec onstruction of the damaged ocular surface. We succeeded in culturing primary cor neal limbal epithelial cells taken from minimal biopsy and,once grown, transplan ting them on denuded amniotic membrane (AM). Methods: Autologous corneal limbal epithelial cells from a 3 mm2 biopsy of the uninjured eye were grown for 3weeks on a denuded AM carrier. The resultant sheet was then transplanted onto the unil ateral severely chemically injured eye. Results: Minimal biopsy showed the autol ogous cultivated corneal epithelial cells to have 4-5 layers of sufficient stra tification and to be well differentiated. At 19 months post-transplantation, th e ocular surface epithelium was stable and there were no epithelial defects. Con clusion: We document that it is possible to produce sufficiently stratified, wel l differentiated, autologous cultivated corneal limbal epithelium on AM from a m inimal biopsy of the donor eye and to transplant it onto the injured eye.展开更多
文摘Purpose: To compare the accuracy of biometry using conventional A-scan ultras onography and partial coherence interferometry, and to improve the accuracy of b iometry by sequential audit of postoperative refractive error. Methods: The stud y was performed in three phases. In phase 1, 20 consecutive patients undergoing routine phacoemulsification underwent biometry using bothA-scan ultrasonography and the Zeiss IOLMaster (ZIOLM).Asingle experienced optometrist refracted all p atients 2 weeks after surgery. The errors between expected and achieved refracti on were calculated and compared between the two methods. In phases 2 and 3, a fu rther 22 and 20 patients, respectively, were recruited and only the ZIOLM was us ed for biometry. The manufacturer’s suggested A-constant was refined and the e rror between expected and achieved refraction was calculated. Results: In phase 1, the median unexpected error for the ZIOLM was +0.63 (interquartile range +0 .368 to +1.015) and for A-scan biometry was 0.24 (interqu artile range-1.335 to +0.802). In phase 1 65%of patients’- postoperative refractions were found to be within 1.0 D of emmetropia using th e ZIOLM (55%using A-scan biometry). Refinements to the A-constant improved th is to 95%by phase 3. Conclusion: An error was identified in IOL power estimatio n with the ZIOLM, when using the manufacturer’s recommended A-constant (recomm ended and previously optimized ultrasound A-constant 118.0; ZIOLMoptimized A-c onstant 118.6). Serial modifications to the A-constant were successful in reduc ing the unexpected error towellwithin the tolerance limits of published internat ional standards.
文摘Background: The mechanism responsible for optic disc pit maculopathy is unclea r, but abnormal vitreous structures, including the anomalous Cloquet’s canal at the optic disc pit, have been suggested as important factors. Case: We report t he intraoperative and ultrastructual findings of an unusual posterior vitreous s trand in the eye of an 8-year-old girl with optic disc pit maculopathy. Observ ations: The patient presented with decreased vision in the left eye. Examination of the left eye revealed a best-corrected visual acuity (VA) of 0.08 and a mac ular detachment associated with an optic disc pit. Vitrectomy was performed with the adjunctive use of triamcinolone acetonide intraoperatively. The presence of an unusual posterior hyaloid strand tightly attached to the margin of the optic disc pit was noted. An unusual movement of this strand was observed during the surgery. The strand was excised, and fluid-gas exchange was performed using gas tamponade with 20%SF6. After 12 months, a complete macular reattachment was ob tained, with the VA improving to 1.2. Electron microscopic examination of the re moved strand revealed abundant thick collagen fibrils with a frame of fine fibri ls. Conclusion: The unusual posterior vitreous strand connected to the optic dis c pit may have contributed to the pathogenesis of maculopathy in this young chil d.
文摘PURPOSE: To report the efficacy of electrolysis as a treatment of corneal opac ities in a young patient with the superficial variant of granular corneal dystro phy. DESIGN: Interventional case report. METHODS: An 11-year-old boy presented with subepithelial opacities in both eyes. His visual acuity was 0.2 in the lef t eye; he received corneal electrolysis under topical anesthesia. RESULTS: The e lectrolysis, which required only 5 minutes, resulted in the disappearance of the subepithelial opacities. His visual acuity improved to 0.4 on the next day and was 1.0 eight months later. The corneal curvature and thickness were not altered by the electrolysis. CONCLUSIONS: Corneal electrolysis proved to be an effectiv e treatment for subepithelial opacities, and we recommend electrolysis as an eff ective and simple treatment for young patients with SGCD.
文摘Background: Patients with severe unilateral ocular surface disease require rec onstruction of the damaged ocular surface. We succeeded in culturing primary cor neal limbal epithelial cells taken from minimal biopsy and,once grown, transplan ting them on denuded amniotic membrane (AM). Methods: Autologous corneal limbal epithelial cells from a 3 mm2 biopsy of the uninjured eye were grown for 3weeks on a denuded AM carrier. The resultant sheet was then transplanted onto the unil ateral severely chemically injured eye. Results: Minimal biopsy showed the autol ogous cultivated corneal epithelial cells to have 4-5 layers of sufficient stra tification and to be well differentiated. At 19 months post-transplantation, th e ocular surface epithelium was stable and there were no epithelial defects. Con clusion: We document that it is possible to produce sufficiently stratified, wel l differentiated, autologous cultivated corneal limbal epithelium on AM from a m inimal biopsy of the donor eye and to transplant it onto the injured eye.
