ABSTRACT
To describe the clinical signs, diagnosis and treatment of toxic keratopathy in a patient who abused tetracaine drops. A 32-year-old man was referred to the emergency ward of our center with persistent corneal epithelial defect associated with a ring infiltrate in the corneal stroma, without any history of ocular trauma or contact lens use. The patient was hospitalized and a thorough ocular examination was accomplished. A detailed history in our patient revealed topical anesthetic abuse keratitis. The topical anesthetic was deliberately taken from the pharmacy without a prescription. The hallmark of topical anesthetic abuse keratitis was a persistent corneal epithelial defect and a complete ring infiltration in the corneal stroma in our case. Functional and anatomic results after appropriate treatment were not favorable in this case. Although topical anesthetic abuse keratitis is rare, it should be carefully explained to patients that although topical anesthetics numb the eye, more than a few drops can actually prevent healing and may lead to permanent damage. The unrestricted availability of topically applied ophthalmic anesthetics as over-the-counter medications in Iran must be reevaluated
ABSTRACT
To evaluate the visual outcomes of LASIK in myopic eyes. This interventional case series was performed on records of 345 eyes of 179 patients for correcting myopia with astigmatism < 3.00 diopter [D]. All patients were operated by one surgeon [H.N.] with the NIDEK EC 5000 excimer laser. All patients had at least one year follow up. Based on preoperative refraction, patients were divided into four groups: low [-1.00 to -4.00 D], moderate [-4.00 to -7.00 D], high [-7.00 to -13.00 D], and extremely high myopia [> -13.00 D]. Data including pre- and postoperative refraction, UCVA one year after surgery, pre- and postoperative BCVA, and range of emmetropia were analyzed in each group. Mean preoperative spherical equivalent [SE] was -2.84 +/- 0.73 D in low myopia group, 5.12 +/- 0.84 D in moderate myopia group, -9.53 +/- 1.8 I D in high myopia group, and -16.26 +/- 2.23 D in extremely high myopia group. The value decreased to -0.0845 +/- 0.16 D, -0.143 +/- 0.216 D, 0.467 +/- 0.34 D, and -2.385 +/- 1.49D, respectively at one year. The percentage of eyes according to range of ametropia were as follow: 94%, 83%, 40%, and 0% of eyes were within +/- 0.25 D of emmetropia; 100%, 100%, 73%, and 15% of eyes were within +/- 0.5 D of emmetropoia; and 100%, 100%, 95.5%, and 23% of eyes were within +/- 1.0 D of emmerropia in each group, respectively. Postoperative UCVA of 20/40 or better was achieved in 100%, 100%, 98.4%, and 30.8% of eyes and UCVA of 20/20 or better was obtained in 78.9%, 73.1%, 31%, and 0% of eyes in the four groups, respectively. One year after LASIK, 2.1%, 0%, 6.7%, and 0% of the eyes lost two or more lines of BCVA in each group but 2.1%, 1.4%, 4.4%, and 7.7% of eyes gained more than one line of BCVA. LASIK is an effective and predictable procedure for correcting myopia. The predictability of LASIK decreases with increase in preoperative refractive error
ABSTRACT
To evaluate and compare tear secretion and tear film instability following laser in situ keratomileusis [LASIK] and laser assisted subepithelial keratectomy [LASEK]. In a randomized clinical trial, 30 eyes of 15 patients underwent LASIK and 30 eyes of 15 patients underwent LASEK to correct myopia. Tear secretion and tear film instability were tested preoperatively, 2 and 6 weeks, and 6 month postoperatively, using TBUT [tear break-up time] and Schirmer I and II tests. Six month after surgery, TBUT, Schirmer I, II tests decreased significantly in LASIK group compared with LASEK group. There was no significant difference between LASIK and LASEK groups preoperatively. The decrease in tear secretion was greater after LASIK than LASEK at 6 months' follow up. Proper treatment of dry eye is required after LASIK and LASE, particularly after LASIK surgery
ABSTRACT
Purpose: to evaluate corneal thickness changes after soft contact lens [SCL] removal in LASIK candidates
Methods: fifty LASIK candidates [100 eyes] with history of daily wear SCL for at least 6 months were enrolled in this descriptive study. Central corneal thickness was measured by ultrasonic pachymetry immediately after lens removal and then repeated daily at the same time, until the thickness became stable
Results: subjects were aged between 18 to 40 years [mean, 29.5 years]. Central corneal thickness immediately after lens removal was 557.4 +/- 32 [micro]m and reached 521.8 +/- 25 [micro]m when corneal edema completely resolved. After discontinuation of SCL wear, corneal edema required 2-15 days to resolve. Corneal thickness stabilized in 74% within the 1 st week, in 24% during the 2nd week, and in 2% during the 3rd week. Older patients and more severe primary corneal edema needed longer time to recover. There was no significant correlation between sex and rate of corneal deswelling
Conclusion: it is important to discontinue SCL wear at least 15 days before refractive surgery for corneal thickness stabilization to achieve an accurate pachymetry