ABSTRACT
Relato de dois casos de síndrome do bloqueio capsular, de ocorrência tardia, nove e cinco anos após facoemulsificação, respectivamente, em um olho com pseudoexfoliação capsular e outro operado de glaucoma, com bolha funcionante. A condição se constituiu na retenção de grande quantidade de líquido esbranquiçado, atrás da lente intraocular, o que levou à redução da AV, de quatro linhas de Snellen, nos dois casos. Houve pronta resolução do quadro com mínima capsulotomia posterior.
Two cases of late capsular block syndrome are reported. They were observed nine and five years after facoemulsification, in one eye with pseudoexfoliation syndrome and the other operated on for glaucoma with a functioning bleb. There was a large amount of milky material behind the intraocular lens, and reduction of the visual acuity (four lines of the Snellen chart in both cases). The condition was promptly resolved through minimal YAG laser posterior capsulotomy.
Subject(s)
Humans , Male , Female , Aged , Phacoemulsification/adverse effects , Lens Implantation, Intraocular/adverse effects , Lens Capsule, Crystalline/pathology , Lens Diseases/etiology , Lenses, Intraocular/adverse effects , Postoperative Complications , Trabeculectomy , Visual Acuity , Glaucoma/surgery , Capsulorhexis , Posterior Capsulotomy , Intraocular Pressure , Lens Capsule, Crystalline/surgery , Lens Diseases/surgery , Lens Diseases/diagnosisABSTRACT
Relato de caso de um paciente de 18 anos com sindrome de Alport apresentando perda visual progressiva. A biomicroscopia revelou lenticone anterior bilateral. O paciente realizou tomografia de córnea e segmento anterior com o sistema Scheimpflug (Pentacam) e aberrometria e topografia corneana (i-Trace). O paciente foi submetido à facoemulsificação com implante de lente intraocular peça única hidrofóbica (Acrysof® SN60AT). As imagens de Scheimpflug documentaram o lenticone anterior. A aberrometria total mostrou acentuado astigmatismo miópico com acentuada aberração esférica negativa, havendo grande impacto das aberrações de alta ordem (HOA) na conversão da letra E de Snellen. O mapa de integração da aberrometria do olho todo com a topografia corneana mostrou maior semelhança das aberrrações totais com as aberrações intraoculares do que com as aberrações da superfície anterior da córnea. Após a cirurgia, o paciente apresentou acuidade visual corrigida igual a 20/20 em ambos os olhos, as imagens de Scheimpflug revelaram lentes intraoculares tópicas e os mapas diferenciais revelaram resolução da miopia e redução das aberrações da alta ordem (total e interna). Os exames de imagem foram úteis para demonstrar o impacto do lenticone anterior na qualidade visual e a resolução das aberrações ópticas após a cirurgia.
Case report of a 18-year-old male patient with Alport's syndrome, who presented with renal failure and hearing loss reporting a progressive loss of vision acuity. Slitlamp examination revealed bilateral anterior lenticonus. The patient underwent pre and post-operative corneal and anterior segment tomography with a rotating Scheimpflug system (Pentacam), integrated whole eye (individual laser beam ray tracing) and corneal surface (Placido) wavefront aberrometry (i-Trace). Phacoemulsification and single piece hydrophobic IOL implantation (Acrysof® SN60AT) was performed uneventfully in both eyes. Pre op Scheimpflug well decomented the anterior lenticonus. Total aberrometry showed myopic astigmatisms with high negative spherical aberrations OU; higher order aberrations (HOAs) greatly influenced the conversion of Snellen E letters. Total aberrations and corneal topographies integration maps OU demonstrated high levels of intraocular aberrations which had more similarity with whole eye aberrations than anterior corneal aberrations. After surgery, BCVA was 20/20 in both eyes. Scheimpflug images revealed topic intraocular lens and the differential maps showed resolution of myopia and decrease of the total ocular HOAs as well as from the internal optics. Adjunctive advanced diagnostic tools were useful to demonstrate the anterior lenticonus and its optical impact along with the resolution of the aberrations post operatively.
Subject(s)
Humans , Male , Adolescent , Phacoemulsification/methods , Lens, Crystalline/abnormalities , Lens, Crystalline/surgery , Lens Diseases/surgery , Lens Diseases/diagnosis , Nephritis, Hereditary/complications , Photography , Visual Acuity , Lens Implantation, Intraocular , Diagnostic Techniques, Ophthalmological , Renal Insufficiency , Aberrometry , Slit Lamp Microscopy , Hearing Loss , Lens, Crystalline/pathology , Lens Diseases/etiology , Anterior Eye Segment/pathologyABSTRACT
Phacoemulsification with implantation of single-piece acrylic foldable intraocular lens (IOL) in a 19-year-old boy with microspherophakia, high myopia and angle closure glaucoma is described. The associated myopia and angle closure glaucoma was severely compromising the quality of life. Post-surgical visual recovery was 20/20 with sustained normal intraocular pressure. Management of such cases at times calls for innovations in current surgical technique.
Subject(s)
Capsulorhexis/methods , Diagnosis, Differential , Follow-Up Studies , Glaucoma, Angle-Closure/diagnosis , Glaucoma, Angle-Closure/etiology , Glaucoma, Angle-Closure/surgery , Gonioscopy , Humans , Intraocular Pressure , Lens Diseases/congenital , Lens Diseases/diagnosis , Lens Diseases/surgery , Lens Implantation, Intraocular/methods , Lens, Crystalline/abnormalities , Lens, Crystalline/surgery , Male , Phacoemulsification/methods , Visual Acuity , Young AdultABSTRACT
Relatamos dois casos de exfoliação verdadeira da cápsula, acontecendo em pacientes idosos sem história de exposição prolongada a altas temperaturas ou passado de inflamação intra-ocular. Os aspectos biomicroscópicos, anátomo-patológicos e possíveis implicações cirúrgicas são comentados.
We report two cases of true capsular exfoliation occurring in elderly patients with no known history of prolonged heat exposure or intraocular inflammation. The biomicroscopic aspects, histopathologic findings and possible surgical implications are discussed.
Subject(s)
Aged, 80 and over , Female , Humans , Male , Lens Capsule, Crystalline/pathology , Lens Diseases/diagnosis , Capsulorhexis , Lens Capsule, Crystalline/surgery , Lens Diseases/surgery , PhacoemulsificationABSTRACT
A continuación se revisarán de manera muy esquemática las patologías oculares más frecuentes en el preescolar y escolar, y también algunas patologías que si bien no son muy frecuentes, si son importantes diagnosticarlas y tratarlas precozmente, idealmente antes de los 8 años, es decir, antes de la maduración total del sistema visual, de lo contrario el pronóstico de ese niño se empobrece, su visión no alcanza una normalidad y va a terminar con una ambliopía. por lo tanto, es muy importante destacar el rol de la derivación temprana de aquellos pacientes que presentan alguna patología ocular importante como una ptosis palpebral, estrabismo o algún problema refractivo importante, entre otros, para prevenir el compromiso visual posterior.
Subject(s)
Humans , Child, Preschool , Child , Astigmatism , Strabismus/classification , Hyperopia , Eye Injuries/genetics , Myopia , Eye Diseases/diagnosis , Eye Diseases/genetics , Conjunctival Diseases/classification , Corneal Diseases/classification , Retinal Diseases/classification , Retinal Diseases/diagnosis , Retinal Diseases/therapy , Eyelid Diseases/etiology , Eyelid Diseases/drug therapy , Eyelid Diseases/therapy , Lens Diseases/diagnosisABSTRACT
The present report describes a case where HSV was detected by polymerase chain reaction (PCR) in the lens cortical material removed during cataract surgery one year after resolution of retinal inflammation in a patient with ARN.
Subject(s)
Adult , DNA Primers/chemistry , DNA, Viral/analysis , Diagnosis, Differential , Eye Infections, Viral/diagnosis , Herpes Simplex/diagnosis , Herpesvirus 1, Human/genetics , Humans , Lens Diseases/diagnosis , Male , Polymerase Chain Reaction , Retinal Necrosis Syndrome, Acute/diagnosisSubject(s)
Humans , Electrophoresis/methods , Microscopy, Electron/methods , Lens Diseases/diagnosisSubject(s)
Humans , Lens Diseases/diagnosis , Glaucoma/pathology , Amblyopia/etiology , Anisometropia/etiologyABSTRACT
A ecografia ocular, quer do tipo A como do tipo B, é um recurso diagnóstico importante nos casos de opacidades dos meios transparentes, nas medidas do globo ocular, no diagnóstico de descolamento de retina, nas opacidades vitreanas e no estudo dos tumores oculares. Nos casos de catarata congenita a ecografia é fundamental para um prognóstico funcional