Subject(s)
Descemet Stripping Endothelial Keratoplasty/adverse effects , Endothelium, Corneal/transplantation , Fuchs' Endothelial Dystrophy/surgery , Graft Rejection/diagnostic imaging , Aged, 80 and over , Air , Allografts , Descemet Membrane/pathology , Descemet Membrane/surgery , Female , Graft Rejection/diagnosis , Humans , Postoperative Complications/diagnosis , Postoperative Complications/etiology , Tissue Adhesions/diagnosis , Tissue Adhesions/etiologySubject(s)
Anti-Bacterial Agents/adverse effects , Ciprofloxacin/adverse effects , Cornea/pathology , Keratitis/drug therapy , Pseudomonas Infections/drug therapy , Aged , Anti-Bacterial Agents/analysis , Anti-Bacterial Agents/pharmacokinetics , Chemical Precipitation , Ciprofloxacin/analysis , Ciprofloxacin/pharmacokinetics , Cornea/chemistry , Crystallization , Female , Fuchs' Endothelial Dystrophy/surgery , Herpes Zoster Ophthalmicus/complications , Humans , Hydrogen-Ion Concentration , Keratitis/microbiology , Keratoplasty, Penetrating , Preservatives, Pharmaceutical , Tomography, Optical CoherenceABSTRACT
INTRODUCTION: To determine outcomes of conjunctival autograft attached with fibrin glue (FG) for primary pterygium, and compare these outcomes in expert versus closely supervised trainee ophthalmologists. METHODS: This was a retrospective, comparative, non-randomized, interventional study. Patients were recruited among those with primary nasal pterygium undergoing FG conjunctival autograft. Surgery was performed by expert (136 eyes) or closely supervised trainee (128 eyes) ophthalmologists. Mean follow-up was 7.82±8.23months. Main outcome measures were recurrence rate, reoperation rate and complications. RESULTS: The study sample comprised 264 eyes of 225 patients. Participants were of mean age 47.09±12.89years; 46.7% were male, 28.4% Caucasian and 70.5% Hispanic. Recurrence was recorded in 6.4%: 5.9% in the expert group and 7% in the trainee group (P=0.704) and reoperation in 1.9%: 0.7% and 3.1% (P=0.202), respectively. Both groups showed similar rates of complications such as transient graft edema, graft dehiscence, hematoma or ocular hypertension. Reoperation was slightly more frequent in patients younger than 40years (P=0.064). CONCLUSIONS: Good outcomes were observed for FG conjunctival autografting in primary pterygium surgery, with no differences recorded between supervised trainee and expert surgeons. Our findings suggest the need to supervise pterygium surgeries during training.
Subject(s)
Conjunctiva/transplantation , Fibrin Tissue Adhesive/therapeutic use , Ophthalmologists/education , Pterygium/surgery , Transplantation, Autologous/methods , Adult , Aged, 80 and over , Autografts , Female , Follow-Up Studies , Humans , Learning Curve , Male , Middle Aged , Organization and Administration , Postoperative Complications/epidemiology , Recurrence , Reoperation/statistics & numerical data , Retrospective Studies , Treatment Outcome , Young AdultABSTRACT
CASE REPORT: A 24 year old woman who complained of maculo-papulo rash, genital and bucal aphthous ulcers, abdominal pain, minor dyspnea and visual loss in both eyes. Funduscopy revealed a bilateral occlusive vasculitis including central vessels. Treatment was initiated with a methylprednisolone bolus (1 g/24h) and infliximab 5mg/kg/day (0-2-6 weeks and every 8 weeks). The treatment prescribed induced a fast remission. Visual acuity improved. The patient did not suffer any other relapse after one year of follow-up. DISCUSSION: An initial treatment with Infliximab should be considered in Behçet disease for serious outbreaks, such as macular occlusive vasculitis with ischemia.
