ABSTRACT
ABSTRACT We report a case of keratis infection after cataract phacoemulsification with intraocular lens implantation in a 65-year-old female patient. The patient initially underwent cataract surgery on the right eye. Intraocular inflammation appeared on the second post-operative day and was initially treated as Toxic Anterior Segment Syndrome (TASS). The inflammation was reduced and vision improved initially but very aggressive and progressive keratitis destroyed the cornea due to the delay in correct diagnosis. Aspergillus flavus was isolated from a biopsy.The infection was treated with antifungal agents and loss of the eye was avoided by total corneal transplantation associated with Gundersen conjunctiva cover. To restore the lost vision, a second penetrating corneal graft with removal of the conjunctiva cover was performed 17 months later. The final best-corrected vision was 20/40 but prognosis for long-term graft survival is poor.
RESUMO Nós relatamos um caso de ceratite após facoemulsificação de catarata com implantação de lente intraocular em uma paciente de 65 anos. A paciente inicialmente passou cirurgia para catarata no olho direito. A inflamação apareceu no segundo dia pós-cirurgia, inicialmente tratada como Toxic Anterior Segment Syndrome (TASS). A inflamação foi reduzida e a visão melhorou, porém uma ceratite progressiva e agressivo destruiu a córnea devido à demora do diagnóstico correto. O fungo Aspergillus flavus foi isolado de uma biópsia. A infecção foi tratada com agentes antifúngicos e a perda do olho foi evitada por transplantação da córnea associada com cobertura da conjuntiva tipo Gunderson. Para recuperar a visão, um segundo enxerto corneal penetrante com remoção da cobertura conjuntival foi realizado após 17 meses. A qualidade visual final era 20/40, porém o prognóstico para sobrevivência do enxerto no longo prazo é negativo.
Subject(s)
Humans , Female , Aged , Aspergillosis/etiology , Aspergillus flavus , Cataract Extraction , Keratitis/complications , Lens Implantation, Intraocular , PhacoemulsificationABSTRACT
PURPOSE: To evaluate light scattering and light transmittance of Ioflex hydrophilic acrylic intraocular lenses (IOLs) explanted because of clinically significant opacification secondary to calcification. SETTING: John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. DESIGN: Experimental study. METHODS: Seven explanted and 8 control Ioflex IOLs were studied. Gross and light microscopy of all the IOLs were performed. Light scattering was measured with a Scheimpflug camera, and light transmittance was assessed with a spectrophotometer. Analyses were performed at room temperature in the hydrated state, and findings of the explanted and control IOLs were compared. RESULTS: Light scattering was 219.71 computer compatible tape (CCT) ± 2.62 (SD) for explanted IOLs and 4.75 ± 2.50 CCT for controls. The mean light transmittance in the visible light spectrum was 75.94% to 87.25% for explanted IOLs and 97.54% to 98.97% for controls. The most striking finding was variable degrees of light transmittance between 290 nm and 350 nm (ultraviolet-A and B radiation) in the explanted and control IOLs with expiration dates in 2009/2010 but 0% transmittance in this region in all controls with expiration dates in 2011/2012. CONCLUSIONS: Light scattering was extremely high and transmittance was significantly reduced in calcified IOLs. Differences in transmittance observed in the 290 to 350 nm region between IOLs with different expiration dates were related to use of different hydrophilic acrylic raw material suppliers in the manufacture of the IOLs, highlighting the complexity of IOL calcification investigations.
Subject(s)
Calcinosis/etiology , Lenses, Intraocular , Optics and Photonics , Scattering, Radiation , Acrylic Resins , Aged , Aged, 80 and over , Biocompatible Materials , Device Removal , Humans , Hydrophobic and Hydrophilic Interactions , Light , Middle Aged , Prosthesis Design , Prosthesis Failure , Tomography, Optical CoherenceABSTRACT
OBJETIVO: Relatar um caso de um acidente perfurante por arame que fixava material de propaganda política exposto nas ruas do DF. MÉTODO: Relato de caso de um adolescente, sexo masculino, 16 anos, vítima de traumatismo perfurante no olho esquerdo por arame exposto que fixava propaganda eleitoral. RESULTADO: Acuidade visual de 20/25 foi obtida por implante secundário no sulco ciliar e capsulotomia posterior cirúrgica 90 dias após a perfuração ocular. CONCLUSAO: Atentamos para a gravidade e o risco a que os cidadãos estão expostos em período de eleições devido à má fiscalização da propaganda política no Distrito Federal e a importância de leis mais rígidas na prevenção destes acidentes.
