ABSTRACT
We aimed to describe congenital keratoglobus with blue sclera in two siblings with overlapping Marshall/Stickler phenotype. Two sisters (ages four and six) with bilateral high astigmatism were evaluated by slit-lamp microscopy. Corneal topography and pachymetry maps were also obtained. Slit-lamp examination revealed that both corneas were globular in shape with peripheral corneal thinning. Pachymetry maps showed diffuse corneal thinning. Two siblings had in common the features of keratoglobus, blue sclera, atypical face, hearing loss, and hypermobile joints. We tentatively diagnosed the sisters as having an overlapping Marshall-Stickler phenotype based on clinical and radiological findings. Marshall-Stickler syndrome may exist in the differential diagnosis of keratoglobus with blue sclera.
Subject(s)
Abnormalities, Multiple , Cataract/diagnosis , Collagen Type XI/deficiency , Cornea/abnormalities , Craniofacial Abnormalities/diagnosis , Eye Diseases, Hereditary/diagnosis , Genetic Diseases, X-Linked/diagnosis , Hearing Loss, Sensorineural/diagnosis , Osteochondrodysplasias/diagnosis , Sclera/abnormalities , Siblings , Child , Child, Preschool , Corneal Topography , Female , Humans , Phenotype , Visual AcuityABSTRACT
OBJECTIVE: To analyze the visual results of phacoemulsification in highly myopic eyes, to investigate the risk factors for poor postoperative visual acuity and to assess postoperative complications. METHODS: This retrospective study reviewed the records of 209 eyes of 150 patients with high myopia who underwent phacoemulsification and foldable intraocular lens (IOL) implantation between January 1998 and July 2008 at Beyoglu Education and Research Eye Hospital, Istanbul, Turkey. RESULTS: Postoperative best-corrected visual acuity (BCVA) was 0.5 or better in 63.2% of eyes. One hundred forty-seven (70.3%) eyes were within ±1.0 diopter (D) of the intended target refraction. In multiple regressions, only pre-existing myopic chorioretinal macular degeneration was found to be associated with poor BCVA (p=0.000). Nor patient age nor axial length (AL) had any correlation with postoperative BCVA. Retinal detachment (RD) occurred in one eye (0.5%) during mean follow-up (18.7+/-8.9 months). CONCLUSION: Most of the eyes with high myopia achieved satisfactory improvement in BCVA with few complications. Myopic retinal degenerative changes were the single independent factor limiting visual potential. Our lower incidence of postoperative RD could be attributed partially to our lower neodymium:yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy rates and our surgical modification involving the implementation of primary posterior capsulorhexis in all patients younger than 40.
Subject(s)
Myopia/surgery , Phacoemulsification , Humans , Lens Implantation, Intraocular , Myopia/physiopathology , Retrospective Studies , Visual AcuityABSTRACT
BACKGROUND: To report a case of delayed-onset Streptococcus pyogenes endophthalmitis following implantation of an Ahmed glaucoma valve. CASE: A 10-year-old patient presented with acute endophthalmitis 1 year after Ahmed glaucoma valve implantation. OBSERVATIONS: The conjunctiva and Tenon's capsule over the valve plate had been penetrated by one of the polypropylene fixation sutures. The valve was removed, and pars plana vitrectomy was performed. Vitreous specimens and removal of the discharge over the plate revealed Streptococcus pyogenes. CONCLUSIONS: This is the first documented case of Streptococcus pyogenes endophthalmitis following Ahmed glaucoma valve implantation. We think the conjunctival buttonhole caused by the polypropylene suture provided an entry site for the infection.
