ABSTRACT
A 42-year-old man was admitted to our clinic complaining of visual distortion in his left eye two months after bilateral myopic photorefractive keratectomy (PRK). Macular optical coherence tomography (OCT) showed a stage II macular hole in the left eye. Simultaneous OCT in the right eye showed vitreous traction and distortion of the outer retina. One month later, the patient underwent vitrectomy for the left eye, and the macular hole was closed. Two months after that, the patient complained of visual distortion in the right eye, and OCT revealed increased traction and accentuated outer retinal distortion indicating a stage IB macular hole. Traction attenuated later without any intervention. The short interval between PRK and hole formation, bilateral involvement, and the moderate refractive error in this case highlight the possible role of PRK in aggravating vitreoretinal interface abnormalities. We recommend the addition of PRK to the list of procedures that may be associated with the formation of a macular hole.
Subject(s)
Adult , Humans , Male , Myopia/surgery , Photorefractive Keratectomy/adverse effects , Retina/pathology , Retinal Perforations/diagnosis , Tomography, Optical Coherence , Visual AcuityABSTRACT
To evaluate the clinical features, and visual outcomes of sterile uveitis after iris-fixated phakic intraocular lens implantation [pIOLs] [Artisan-Artiflex and Verisyse-Veriflex]. Material and Methods: In this retrospective non-comparative case series, the medical records of 117 eyes implanted with Artisan-Artiflex [Ophtec BV, Groningen, Netherlands] and Verisyse-Veriflex [AMO, Santa Ana, CA] iris claw phakic IOLs were analyzed for postimplantation sterile uveitis. The mean age of the 87 patients included in the study was 27.2 +/- 7.4 years. Of these patients, 56 [64.3%] were men and 31 [35.6%] were women. Patient age, gender, IOL brand type, refractive error, optic diameter, unilateral vs bilateral implantation, and anterior chamber depth were analyzed. Features of uveitis, uncorrected and best corrected visual acuity [VA] at presentation and at follow-up visits were examined. The mean follow-up time was 14.6 months [range: 6-37 months]. Clinically significant uveitis was observed in 12 of 117 eyes [10.3%] in a total of ten patients. Of these ten patients, four [40%] were women and six [60%] were men, and the mean age was 25.1 +/- 5.3 years [range: 18-36 years]. Among those with bilateral implantation, 6.9% of patients developed bilateral uveitis, while 13.8% [4 of the 29 implanted bilaterally] developed unilateral uveitis. Foldable pIOL implantation was the only variable associated with the development of uveitis [P=.03]. Although the prognosis is usually benign, sterile uveitis occurred in 10.3% of patients after iris-fixated pIOL implantation. The implantation of a foldable pIOL was the only variable associated with sterile uveitis. Appropriate medical management can be effective treatment, without the need for pIOL replacement
ABSTRACT
To evaluate the effectiveness of corneal cross-linking in improving the signs and symptoms of bullous keratopathy. This prospective non-randomized case series evaluated 20 eyes with bullous ketratopathy that underwent corneal cross-linking [C3R] with riboflavin and ultraviolet-A [UVA, 370 nm, 3 mW/cm 2]. C3R was performed for 30 min in a routine procedure after removal of epithelium. Central corneal thickness [CCT], corneal haze, visual acuity [VA], and the presence of irritating symptoms were recorded before the procedure, and at 1 week, 1 month, 3 months, and 6 months after the procedure. The mean CCT was 872 +/- 162 micro m [range: 665-1180 micro m] before the procedure. Following the procedure, CCT was 855 +/- 175 micro m after 1 week, 839 +/- 210 micro m after 1 month, 866 +/- 185 micro m after 3 months, and 863 +/- 177 micro m after 6 months [P>0.05, all visits]. There was no significant improvement in VA or corneal clarity after 6 months. Improvement of the following symptoms: burning, pain, and foreign body sensation were reported after 6 months by 83.3%, 75.0%, and 66.7% of patients, respectively. Persistent epithelial defect occurred in five patients [25%] resolved with frequent lubrication and bandage contact lenses. The outcomes of this study indicate corneal cross-linking is not an effective treatment for bullous keratopathy with respect to VA and CCT, although it can improve irritation and discomfort