Quistes secundarios de iris / Secondary Iris Cysts

Los quistes epiteliales del iris o de cámara anterior son una rara y grave complicación tras la cirugía o traumatismos penetrantes del segmento anterior del ojo. Son secundarios a la invasión epitelial de la cámara anterior. Se ha descrito una incidencia de 0,09-0,12 por ciento, aunque estudios histopatológicos en ojos enucleados, tras cirugía de cataratas señalan una incidencia del 16 por ciento. Frecuentemente evolucionan hacia un aumento progresivo de tamaño y la producción de complicaciones visuales como glaucoma (de ángulo abierto por liberación de contenido mucoso del quiste, o cerrado), uveítis, descompensación corneal y membranas retrocorneales. Se presenta el caso de un paciente masculino de 61 años de edad, que acude a consulta tras una cirugía de dos meses de evolución, en la que se le realizó una cirugía combinada de catarata y glaucoma Al examen en lámpara de hendidura le son detectados varios quistes retroiridianos(AU)

Iris epithelial or anterior chamber cysts are a rare and serious complication following surgery or penetrating trauma to the anterior segment of the eye. They are secondary to epithelial invasion of the anterior chamber. An incidence of 0.09-0.12 percent has been described, although histopathological studies in enucleated eyes after cataract surgery indicate an incidence of 16 percent. They frequently evolve towards a progressive increase in size and the production of visual complications such as glaucoma (open angle due to the release of mucous content of the cyst, or closed), uveitis, corneal decompensation and retrocorneal membranes. We present the case of a 61-year-old male patient, who came to the clinic after a two-month surgery, in which he underwent a combined cataract and glaucoma surgery(AU)

Degeneración nodular de Salzmann / Salzmann's nodular degeneration

La degeneración nodular de Von Salzmann constituye una entidad clínico-patológica en la que aparecen nódulos lisos y opacos, blanco grisáceos o algo azulados en las capas anteriores de la córnea. La afectación suele ser bilateral y los nódulos tienden a disponerse en anillo sobre la media periferia corneal. Pueden estar relacionados o no con un proceso inflamatorio previo y su tratamiento puede ser sintomático o quirúrgico si compromete el área pupilar y con ella la visión del paciente.Se presenta un paciente masculino, de 57 años de edad, coloración de la piel blanca, quien acudió a la consulta y refirió enrojecimiento de ambos ojos (predominio del ojo derecho), con picor, escozor y lagrimeo, de más de 6 meses de evolución. Asociado a esto notó una zona de color blanquecina en ambos ojos. En la exploración oftalmológica se observaron lesiones blanquecinas sobrelevadas de aspecto hialino, en el tercio inferior de la córnea en el ojo derecho y en el ojo izquierdo hacia la región nasal. Se concluye que el caso presenta una degeneración nodular de Salzmann(AU)

Von Salzmann nodular degeneration constitutes a clinical pathological condition in which flat and opaque, white-grayish or bluish nodules appear in the anterior layers of the cornea. The effect is usually bilateral and the nodules tend to spread in a ring form upon the corneal peripheral media. It can be related or not with previous inflammatory process and its treatment can be symptomatic or surgical if the papillary area and the patient's vision are compromised. Here is the case of a 57 years-old male Caucasian patient, who went to the doctor´s and complained of reddened eyes (mainly the right eye), itching and tearing for more than six months. In addition to this, he observed a whitish area in both eyes. The eye screening showed overelevated whitish lesions of hyaline aspect in the lower third of the right eye cornea and in the left eye towards the nasal region. It was concluded that this is a case of Von Salzmann nodular degeneration(AU)

Comparison of immersion ultrasonography, ultrasound biomicroscopy and anterior segment optical coherence tomography in the evaluation of traumatic phacoceles.

Blunt ocular trauma in the elderly can result in anterior dislocation of the crystalline lens into the subconjunctival space (phacocele). Although rare, this presentation can be missed, especially if the patient presents several days after the injury and if the lid is not everted on examination. While a careful clinical examination is adequate in the diagnosis, imaging techniques can be put to use for the accurate location of the associated sclera rupture. We report three cases of post-traumatic phacocele wherein ultrasound biomicroscopy (UBM) was compared to the anterior segment optical coherence tomography (AS-OCT) and B-scan ultrasonography (B-scan), in order to establish the best imaging tool for this condition. We concluded, based on image quality, that UBM could be the imaging modality of choice to aid in the diagnosis of phacocele.

Unilateral Scleral Fixation of Posterior Chamber Intraocular Lenses in Pediatric Complicated Traumatic Cataracts

PURPOSE: The purpose of this study was to evaluate the visual outcomes and complications of unilateral scleral fixation of posterior chamber intraocular lenses (SF-PCIOLs) in pediatric complicated traumatic cataracts without capsular support. METHODS: This study involved five eyes of five children who underwent unilateral SF-PCIOL. All patients had a unilateral complicated traumatic cataract associated with anterior or posterior segment injury. Visual acuity (VA), IOL position, and postoperative complications were assessed during follow-up. RESULTS: The mean age of patients at the time of SF-PCIOL was 90 months (range, 66-115). The mean duration of follow-up time after surgery was 22 months (range, 5-55). In all patients, the best-corrected VA was either improved or was stable at last follow-up following SF-PCIOL implantation. There were no serious complications. CONCLUSIONS: Unilateral scleral fixation of PCIOL can be a safe and effective procedure for pediatric, unilateral, complicated traumatic cataracts without capsular support in selected cases.

Intraocular cilia associated with perforating injury.

PURPOSE: To report a case series of penetrating injury complicated by occurrence of intraocular cilia. METHODS: Retrospective analysis of charts of 11 eyes of 11 patients with penetrating injury and intraocular cilia, presenting between September 1978 and November 1998. Ten eyes underwent surgery for trauma-related problems such as cataract, vitritis, retinal detachment etc., at which time intraocular cilia were removed. One eye did not have surgery and continues to harbour cilia at the posterior perforation site. RESULTS: Metallic wire was responsible for injury in 6 of 11 eyes with intraocular cilia. Five eyes had significant intraocular inflammation. The cilia were located in the anterior segment in 4 eyes; in the posterior segment in 6 eyes and in both in one eye. At the last follow up, 72.7% had 6/18 or better vision. Poor vision in the rest was due to recurrent retinal detachment (2 eyes) and macular scarring (1 eye). CONCLUSION: Intraocular cilia are more commonly associated with injury by a metallic wire. The presentation and management of an injured eye does not seem to be influenced by the presence of cilia in the eye.

Anterior segment reconstruction following trauma.

In summary, this discussion reiterates the basic principles and techniques of reconstructive surgery following severe anterior segment trauma. Clearly, visual rehabilitation is a direct concomitant of anatomical restoration. Thus, definitive efforts to remove and replace damaged ocular surface tissue, as by conjunctival transplantation or pannus stripping, followed by penetrating keratoplasty with particular attention to restoration of iris and angle structures are well within the capability of anterior segment surgeons. Given the remarkable plasticity of ocular anterior segment tissues, particularly conjunctiva and iris, the straight forward application of these techniques can frequently yield both aesthetically satisfying and visually satisfactory results.