Cornea
-
We present the clinicopathologic correlations of two case and two other clinical cases of topical anesthetic abuse keratopathy that were originally diagnosed as Acanthamoeba keratitis because of ring keratitis presentation and characteristic history. ⋯ Topical anesthetic abuse resulting in sight-threatening keratitis may be seen as a masquerade syndrome in many cases. Because of the often poor outcome, we must be aware of this entity, prevent abuse, and be vigilant in our prohibition of topical anesthetic for any therapeutic use.
-
Extensive corneal disease secondary to microbial keratitis can result in frank or impending corneal perforation requiring a large penetrating keratoplasty. In an 8-year period, 26 penetrating keratoplasties with recipient beds of > or = 9.5 mm were performed on 22 eyes: 11 for bacterial keratitis, 10 for fungal keratitis, and one for a mixed bacterial and fungal keratitis. ⋯ The remainder became phthisical or required enucleation. With preservation of the structural integrity of the globe, a subsequent smaller optical penetrating keratoplasty is an option in some of these eyes.
-
We present a case of a patient with scleritis and the fibromyalgia syndrome. Scleritis and the fibromyalgia syndrome are both thought to be caused by an immunological process. This is the first report of a possible association of scleritis and the fibromyalgia syndrome. Additional cases might suggest that the fibromyalgia syndrome be added to the list of etiologies of scleritis.
-
Comparative Study
Prospective study of corneal topographic changes produced by extracapsular cataract surgery.
Cataract surgery is known to induce refractive and corneal astigmatism, but little is known regarding the specific corneal topographic alterations produced by this surgery. We evaluated the corneal topographic effects of extracapsular cataract extraction (ECCE) performed with an 8- to 11-mm posterior limbal incision closed with interrupted sutures and subsequent selective suture removal. Corneal topography was analyzed in 15 eyes with the TMS-1 videokeratoscope preoperatively, before selective suture removal 4-6 weeks after surgery, 2-5 weeks after selective removal of sutures, and at 5 1/2-8 months after surgery. ⋯ A few patients developed against-the-rule astigmatism ranging from 0.6 to 2.2 diopters. ECCE significantly altered corneal tomography compared with the preoperative contour in all patients. In those patients in whom surgically induced nonspherical and noncylindrical distortions occur (radially asymmetrical power distribution, lack of central corneal smoothness), corneal topography may provide information that is useful for management.
-
Case Reports
Iris ischaemia following penetrating keratoplasty for keratoconus (Urrets-Zavalia syndrome)
A fixed and dilated pupil is an uncommon postoperative complication after penetrating keratoplasty (PK) for keratoconus. Although the clinical features have been well described, the precise aetiology is uncertain. ⋯ All of the eyes had severe iris ischaemia. A possible role for a postoperative rise in intraocular pressure in the aetiology of this syndrome is discussed.