ABSTRACT
A 96-year-old lady underwent cataract surgery complicated by the loss of a 5.5 mm diameter area of Descemet's membrane (DM) centrally. Postoperatively, severe corneal oedema with folds in the remaining annular ring of DM were observed. The patient was managed conservatively and the corneal oedema gradually resolved over 5 months. Loss of DM can be managed conservatively with good visual outcome without the need for surgical intervention.
Subject(s)
Cataract Extraction/adverse effects , Cataract/complications , Corneal Edema/physiopathology , Descemet Membrane/injuries , Iatrogenic Disease , Aged, 80 and over , Corneal Edema/etiology , Descemet Membrane/pathology , Female , Humans , Intraoperative Complications , Remission, Spontaneous , RuptureABSTRACT
INTRODUCTION: The aim of this case series is to describe the clinical course of 2 patients with Neisseria meningitidis corneal ulcers. CLINICAL PICTURE: A 49-year-old man (Patient 1) and a 22- year-old man (Patient 2) both experienced eye pain and were found to have corneal ulcers with surrounding infiltrate and ground-glass appearance. Gram-negative diplococci were seen in the first case. N. meningitidis was isolated in culture of corneal scrapings from both patients. TREATMENT: Patient 1 was treated with levofloxacin (0.5%) and cefazolin (50 mg/mL) eye drops hourly and intravenous ceftriaxone and oral rifampicin. Patient 2 was treated with cefazolin (50 mg/mL) and gentamicin (14 mg/mL) eye drops hourly, as well as intravenous ceftriaxone. OUTCOME: The corneal ulcers resolved with anterior stromal scarring and no impairment of vision. CONCLUSIONS: Corneal ulcers caused by N. meningitidis may respond well to treatment without permanent visual sequelae. However, in view of the potential ocular and systemic complications, it is important to investigate and treat patients with N. meningitidis infection aggressively.
Subject(s)
Cornea/microbiology , Eye Infections, Bacterial/microbiology , Keratitis/microbiology , Meningococcal Infections/microbiology , Neisseria meningitidis/isolation & purification , Adult , Cornea/pathology , Diagnosis, Differential , Eye Infections, Bacterial/pathology , Humans , Keratitis/pathology , Male , Meningococcal Infections/pathology , Middle AgedABSTRACT
INTRODUCTION: To report the sequential changes in corneal topography and astigmatism following limited macular translocation. CLINICAL PICTURE AND TREATMENT: A 45-year-old-man who underwent limited macular translocation for idiopathic subfoveal choroidal neovascularisation in the right eye was evaluated by corneal topography and manifest refraction preoperatively and serially for 1 year postoperatively. OUTCOME: An increase in astigmatism with corneal steepening along meridians corresponding to the area of chorioscleral infolding was observed and this persisted for 1 year after surgery. Vector-analysed astigmatic change showed significant surgically induced astigmatism of 2.18 dioptres (D) X 52.9 degrees, 2.17 D X 57.8 degrees and 2.56 D X 59.1 degrees at 2, 5 and 12 months after surgery respectively. CONCLUSION: Surgically induced corneal changes are evident after limited macular translocation and may remain up to 1 year after surgery.
Subject(s)
Astigmatism/etiology , Corneal Diseases/etiology , Ophthalmologic Surgical Procedures/adverse effects , Choroidal Neovascularization/surgery , Corneal Topography , Humans , Male , Middle AgedABSTRACT
PURPOSE: To determine the presence of bacterial biofilm on nylon sutures removed from clinically noninfected eyes after cataract surgery. SETTING: The Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore. METHODS: Sutures were removed from 10 eyes after cataract surgery at different time periods. Immediately after removal, the sutures were fixed and dehydrated. All sutures were viewed by scanning electron microscopy, and 6 were also viewed by transmission electron microscopy (TEM). RESULTS: There was no evidence of bacterial biofilm formation on the nylon sutures. Significant cellular debris was seen, mainly at the knots. Clusters of coccoid-shaped structures were visible; however, examination by TEM showed they were not bacteria. CONCLUSION: There was no evidence of biofilm formation on sutures removed after cataract surgery from clinically noninfected eyes.
