ABSTRACT
Several techniques have been described to localize and repair cyclodialysis clefts. We describe a technique that may be used to easily and accurately localize a cyclodialysis cleft using scleral transillumination. We have verified the accuracy of this technique using high frequency ultrasound biomicroscopy. The location of the cleft was verified using high frequency ultrasound biomicroscopy. Scleral transillumination may facilitate the accurate location of cyclodialysis and may be a useful adjunct in planning the surgical repair of a cyclodialysis cleft.
Subject(s)
Ciliary Body/injuries , Diagnostic Techniques, Ophthalmological , Eye Injuries/diagnosis , Sclera/injuries , Tennis/injuries , Wounds, Nonpenetrating/diagnosis , Adolescent , Ciliary Body/diagnostic imaging , Ciliary Body/surgery , Eye Injuries/etiology , Eye Injuries/surgery , Humans , Light , Male , Sclera/diagnostic imaging , Sclera/surgery , Ultrasonography , Wounds, Nonpenetrating/etiology , Wounds, Nonpenetrating/surgeryABSTRACT
BACKGROUND: An investigation was carried out to compare post-operative inflammation following deep sclerectomy with collagen implant (DSCI) versus standard trabeculectomy. METHODS: In this prospective randomized study, 46 eyes of 46 Caucasian patients with medically uncontrolled chronic open-angle glaucoma and without previous glaucoma surgery underwent filtering surgery. Twenty-four eyes underwent DSCI. Twenty-two eyes underwent standard trabeculectomy. Pre- and post-operative flare, measured using laser flare photometry, were compared between the two groups. RESULTS: In both groups, the mean anterior chamber flare increased on the first post-operative day, then decreased progressively. DSCI was associated with lower flare measurements post-operatively. The difference was statistically significant up to 1 month post-operatively: 16.3 +/- 7.8 vs 72.5 +/- 38.9 (P < 0.001) at 1 day, 7.8 +/- 4.6 vs 44.7 +/- 29.2 (P < 0.001) at 1 week, 5.9 +/- 1.6 vs 7.0 +/- 2.8 (P = 0.012) at 1 month, 6.4 +/- 1.8 vs 6.5 +/- 1.9 (P = 0.77) at 2 months, 5.9 +/- 1.8 vs 6.1 +/- 1.6 (P = 0.65) at 3 months. CONCLUSION: Surgically induced inflammation can be reduced with DSCI. This may be due to the lack of iridectomy, irrigation, and penetration of the anterior chamber. Eyes at increased risk of post-operative inflammation, such as those with uveitic or traumatic glaucoma, may benefit from this procedure. Further studies are needed to evaluate the long-term functional and anatomical outcomes of DSCI.
Subject(s)
Collagen , Glaucoma, Open-Angle/surgery , Prostheses and Implants , Sclerostomy/adverse effects , Trabeculectomy/adverse effects , Uveitis, Anterior/etiology , Aged , Chronic Disease , Female , Fluorophotometry , Glaucoma, Open-Angle/physiopathology , Humans , Intraocular Pressure , Male , Prospective Studies , Sclerostomy/methods , Trabeculectomy/methods , Uveitis, Anterior/prevention & controlABSTRACT
PURPOSE: To describe a case of bilateral, symptomatic rifabutin-associated uveitis with hypopyon and vitreal opacities in an immunosuppressed pediatric patient without acquired immunodeficiency syndrome (AIDS). METHOD: Case report. An 8-year-old boy presented with bilateral uveitis 24 months after a bilateral lung transplant. RESULTS: Our patient, whose medications included rifabutin, clarithromycin, and immunosuppressive agents, responded to discontinuation of the rifabutin and initiation of intensive topical corticosteroid therapy with complete resolution of the uveitis. CONCLUSION: Rifabutin-associated uveitis may occur in a non-AIDS pediatric patient.
Subject(s)
Antibiotics, Antitubercular/adverse effects , Immunosuppression Therapy , Lung Transplantation , Rifabutin/adverse effects , Uveitis/chemically induced , Vitreous Body/drug effects , Acquired Immunodeficiency Syndrome/complications , Antibiotics, Antitubercular/therapeutic use , Child , Eye Diseases/chemically induced , Humans , Immunosuppressive Agents/administration & dosage , Lung Diseases/drug therapy , Lung Diseases/microbiology , Male , Mycobacterium avium-intracellulare Infection/drug therapy , Mycobacterium avium-intracellulare Infection/microbiology , Rifabutin/therapeutic useABSTRACT
PURPOSE: We quantitatively recorded and evaluated night vision disturbances with physiologically dilated pupils. We compared the amount of image degradation experienced in eyes wearing spherical soft contact lenses with the amount of image degradation experienced by subjects wearing spectacles. METHODS: We prospectively evaluated 69 eyes from 35 myopic subjects with no ocular pathology. The subjects ranged in age from 22 to 35 years. We designed a test to quantitatively record image degradation with physiologically dilated pupils in scotopic conditions of dim ambient light. Previously, we have shown that this test accurately measures image degradation. We used this test to compare image degradation between new spherical soft contact lens and spectacle correction. Hyperopes and eyes with greater than 1.50 D of astigmatism were excluded. RESULTS: Adequately correcting myopic refractive error decreased recorded image degradation (P < or = 0.0001). There was no significant difference in the amount of image degradation between spectacle trial frames and new spherical soft contact lenses (P < or = 0.2885). CONCLUSIONS: Our test offers an objective method of assessing night vision disturbances in contact lens wearers. Our results suggest that image degradation, which may contribute to the sensation of glare experienced by some patients, is influenced equally by contact lens and spectacle correction.
Subject(s)
Contact Lenses, Hydrophilic , Myopia/physiopathology , Myopia/therapy , Night Blindness/physiopathology , Adult , Eyeglasses , Glare , Humans , Prospective Studies , Pupil/physiologyABSTRACT
BACKGROUND: We previously described a simple test which evaluates image degradation in post-excimer laser (PRK) patients under scotopic conditions. After refractive surgery, corneal haze, ablation zone decentration, ablation zone/pupillary diameter disparity, and under-correction each result in a characteristic pattern on the Night Vision Recording Chart. METHODS: Using the same method, further studies evaluated night vision image degradation in 118 un-operated emmetropic, myopic, hyperopic, and astigmatic eyes and in 26 contact lens wearers. RESULTS: Scotopic image degradation increases with myopic refractive error, image displacement increases with astigmatism, and contact lens wearers have more image degradation that with spectacle correction. CONCLUSION: Our Night Vision Recording Chart offers a simple, reproducible method to characterize image degradation under scotopic conditions.
Subject(s)
Contact Lenses , Night Blindness/diagnosis , Refractive Errors/diagnosis , Humans , Reproducibility of Results , Vision Tests , Visual Acuity/physiologyABSTRACT
BACKGROUND: Evaluation of night vision disturbances has relied on subjective responses. We designed a test to more objectively measure night vision disturbances. METHODS: The test consisted of projecting a small circle onto a visual acuity screen. The patient is asked to draw exactly what he sees on an Amsler grid. We evaluated 118 eyes in photopic and scotopic conditions and under different conditions of refractive correction. RESULTS: Image degradation increased in scotopic conditions for myopes (p = .0001), hyperopes (p = .005), and emmetropes (p = .01). Myopic refractive error correlated with size of glare response (p = .001). Astigmatism correlated with decentration of glare response (p = .0001). Decentration increased in scotopic compared to photopic conditions (p = .002). CONCLUSION: Our test offers a simple, convenient way to evaluate night vision disturbances and may offer a means of assessing night vision disturbances in patients considering refractive surgery.
