ABSTRACT
To evaluate the results of laser in situ keratomileusis [LASIK] retreatment in patients with postoperative regression. In a retrospective interventional case series, 153 eyes of 113 patients who had undergone LASIK retreatment for postoperative regression were evaluated. Both initial LASIK and retreatment were performed with a Nidek: EC 5000 excimer laser, and flap was made with a Moria microkeratome. Mean age was 29.63 +/- 2.2 yr [range, 20 to 54 yr] and mean follow-up was 11 months [range, 3 to 34 mth] after the initial surgery and 13.1 months [range, 12 to 18 mth] after retreatment. Retreatment was performed 3-34 months after the primary LASIK. Mean spherical equivalent [SE] was -5.39 +/- 2.69 diopters [D] [range, -1.50 to -14.00 D] before initial LASIK and -1.76 +/- 1.08 D [range, -0.50 to -5.00 D] before retreatment. Mean astigmatism was -1.38 +/- 1.07 D [range, -0.50 to -5.00 D] before initial LASIK and -1.12 +/- 0.50 D [range, -0.50 to -2.50 D] before retreatment. One year after retreatment, mean UCVA was 20/25, and mean SE was -0.29 +/- 0.02 D. Best corrected visual acuity [BCVA] improved in all eyes. Two eyes received more than one retreatment. Twenty eyes had flap wrinkling, 2 eyes had diffuse lamellar keratitis [DLK], and 2 eyes had epithelial ingrowth after the initial LASIK. Four eyes had epithelial ingrowth and 2 eyes developed mild keratectasia after retreatment. LASIK retreatment is a safe and effective option with small amounts of myopia and myopic astigmatism regression. The rate of retreatment is higher in patients with myopic astigmatism and in patients with less than 40 years of age, also the risk of complications in retreatment is higher than the initial LASIK. Refractive changes are more stable after retreatment. The risk of keratectasia is higher in final residual stromal bed thickness less than 250 lam after the reoperation
ABSTRACT
To compare the safety, efficacy, and visual results of laser in situ keratomileusis [LASIK] in eyes with and without previous scleral buckling surgery in the same individuals.In a prospective clinical trial, 14 eyes of 7 patients with myopic refractive error and history of sclera] buckling in one eye, underwent LASIK surgery in both eyes according to a standard surgical protocol. Uncorrected visual acuity [UCVA], best corrected visual acuity [BCVA], refraction, Orbscan topography, and pachymetry were recorded 1, 3, 6, and 12 months after LASIK. Eyes with previous scleral buckling were named RD group and the fellow eyes without any previous ocular surgery were named non-RD group. LASIK was performed without any complication. No patient developed a new RD or significant vitreoretinal changes during one year of follow-up. There was no decrease in BCVA in any of the eyes. In the RD group, mean spherical equivalent [MSE] before LASIK was -7.67 D and '.4.-as reduced to -0.17, -0.87, -1.37, and -1.89 D at 1, 3, 6, and 12 months after LASIK, respectively. In the non-RD group, MSE before LASIK was -5.25 D which was reduced to +0.05, -0_17. -0_37. and -0.57 D - at 1. 3, 6, and 12 months after LASIK, respectively. Differences between the two eroups were statistically significant at 3, 6, and, 12 months after operation. Myopic regression between 1 and 12 months after LASIK in the RD group [-1.71 D] was greater than the non-RD group [-0.62 D]. [P=0.019] Mean increase in central corneal thickness during this period had no significant difference between the two groups. Corneal power increase in the RD group [2.44 D] was more than the non-RD group [1.01 D]. [P=0.00I] LASIK may be considered for treatment of myopia in eyes with previous RD surgery. Although it seems to be safe in these eyes, it is not as effective as LASIK in eyes without previous RD surgery. Myopic regression seems to be more pronounced in these eyes
ABSTRACT
To investigate the effects of drainage of premacular subhyaloid hemorrhage into the vitreous with Nd: YAG laser in 13 eyes of 12 patients in a 3 months followup period. This study was conducted from January 2001 to December 2001. Thirteen eyes of 12 patients had a circumscribed premacular hemorrhage and were treated with Nd: YAG laser to drain the blood into the vitreous cavity. The hemorrhage originated from diabetic retinopathy [8 eyes], retinal macroaneurysm [2 eyes], AML [2 eyes] and branch retinal vein occlusion [1 eye]. The size of the hemorrhage was expressed in disc diameters. Success of laser application was defined as clearing of premacular hemorrhage within 3 months. By this definition drainage of premacular subhyaloid hemorrhage into the vitreous with Nd: YAG laser succeeded within three months is eleven, out of thirteen eyes treated without requiring further membranotomy. One eye had persistent, dense nonclearing vitreous opacity for at least 3 months. One clotted hemorrhage did not drain into the vitreous. Overall visual improvement was best in eyes with AML and macroaneurysm. During the follow-up, neither macular epiretinal membranes nor tractional retinal detachments occurred in any eye. Drainage of premacular subhyaloid hemorrhage into the vitreous with Nd: YAG laser is a viable alternative treatment alternative for eyes with recent bleeding. However, to establish Nd: YAG laser treatment as a routine procedure, the risk and benefits have to be weighed in randomized trials and compared with those deferral of treatment or primary vitrectomy
Subject(s)
Humans , Male , Female , Hemorrhage/radiotherapy , Retinal Hemorrhage , Lasers , Retinal DiseasesABSTRACT
Purpose: to determine tear secretion changes after prescribing cyclosporine as an immunosuppressive agent in patients receiving allograft kidney transplantation
Methods: patients with end stage renal failure who underwent kidney transplantation at Namazi Hospital, Shiraz, from September 2000 to January 2001were included in the study. Shirmer II test [4 minutes] using local anesthesia was performed in both eyes before and 3 times after receiving cyclosporine
Results: fifteen patients [8 males and 7 females] with mean age of 32.2k2.96 years were evaluated. Tear secretion increased from 18.8350.953 md4 min [measured 1-7 days before prescribing cyclosporine] to 28.433 +/- 1.564,28.633 +/- 1.267, and 28.467 +/- 1.369 mm/4min at 1, 3, and 5 months after prescribing cyclosporine, respectively [P<0.001]
Conclusion: there was a statistically significant increase in tear secretion of patients receiving kidney transplantation and systemic cyclosporine as an immunosuppressive agent. Increased tear secretion continued during 6 months follow up and can be considered as a favorable side effect of cyclosporine. The increased tear secretion was also observed in patients with normal levels of tear secretion
ABSTRACT
Purpose: to compare the anatomical results of scleral buckling with or without retinopexy and to assess the effect of retinopexy on outcomes of the operation
Methods: this interventional case series was performed on 22 patients undergoing scleral buckling [segmental or encircling] with or without subretinal fluid drainage and without any type of retinopexy and 33 patients who received transscleral retinal cryopexy around retinal break[s] in addition to above procedure. The two groups were matched regarding age, sex, myopia, aphakia, and number, size, and location of the break[s] and also stage of proliferative vitreoretinopathy [PVR]
Results: in the non-retinopexy group, 19 patients [86.4%] had complete and 1 patient had partial retinal attachment after 10-24 months of follow up. The cause of failure in two cases was missed breaks out of the buckle area in one and PVR in the other patient. Overall success rate was 90.9% [20 of 22] in this group. In the retinal cryopexy group, 26 patients [78.9%] had complete and 2 had partial attachment after 11-32 months of follow up. Attachment was not achieved in 3 patients and 2 patients developed redetachment 1 and 3 months later because of PVR. Overall success rate was 84.8% [28 of 33]. The anatomical results in this two groups were comparable statistically [P=0.9]
Conclusion: with permanent scleral buckling technique, retinal cryopexy does not seem to increase success rate defined as short term anatomical retinal reattachment
ABSTRACT
Herein we describe a case of intraocular melanoma in a17-year old leukemic patient. The history, histological findings of the enucleated eye, blood and bone marrow of the patient were investigated. The enucleated eye contained epitheloid cell type melanoma instead of leukemic cell infiltration. We conclude that intraocular malignant melanoma can occur in acute lymphoblastic leukemia