ABSTRACT
PURPOSE: To report the clinical course, microbiologic findings, treatment, and outcomes of overnight orthokeratology associated microbial keratitis. METHODS: Four cases of overnight orthokeratology associated microbial keratitis are reported. RESULTS: Four patients aged 14-23 years (mean 18 years) who had central or paracentral corneal ulcers were included. Visual acuity at presentation ranged from 20/30 to hand motion. In all cases Pseudomonas aeruginosa was cultured from corneal scrapings or storage solution. In all patients the infection resolved with intensive topical antimicrobial treatment. Final best-corrected visual acuity ranged from 20/25 to 20/200 according to the location, size, and density of the corneal scar, which complicated all cases. CONCLUSIONS: Infectious keratitis is a significant, visual threatening complication of overnight orthokeratology. Eye care practitioners should be aware of this complication and educate their patients of the importance of lens hygiene and prompt medical care when symptoms or signs of keratitis appear.
Subject(s)
Corneal Ulcer/microbiology , Eye Infections, Bacterial/microbiology , Klebsiella Infections/microbiology , Orthokeratologic Procedures/adverse effects , Pseudomonas Infections/microbiology , Adolescent , Anti-Bacterial Agents/therapeutic use , Corneal Ulcer/diagnosis , Corneal Ulcer/drug therapy , Drug Therapy, Combination , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/drug therapy , Female , Humans , Klebsiella Infections/diagnosis , Klebsiella Infections/drug therapy , Male , Pseudomonas Infections/diagnosis , Pseudomonas Infections/drug therapy , Visual Acuity , Young AdultABSTRACT
PURPOSE: To study the molecular characteristics of lens epithelial cells from patients with senile cataract by cDNA microarray technique. METHODS: Lens epithelial cells adhering to anterior capsules taken during cataract surgery collected from 108 patients, aged 56-92 years (senile cataract group), were pooled. Pooled epithelial cells of normal, noncataractous lenses from one patient with ocular trauma, one patient with lens subluxation, and 25 cadaveric eyes, all under the age of 55 years, served as a control. Total RNA was extracted by conventional methods from the two groups of cells, and a fluorescent probe was prepared for each group. The probes were hybridized on 9700 known human cDNA clones. Hybridized clones were analysed using a scanning laser and the results were processed by GEMTools (Incyte Genomics) software. RESULTS: A total of 1827 clones hybridized with the two probes. Of these, 400 showed differences of more than two-fold in gene expression between the two probes. Relative to controls, gene expression in the senile cataract lenses was upregulated in 318 clones and downregulated in 82. Three genes-filensin, inwardly rectifying potassium channel (IRPC), and pigment epithelium-derived factor (PEDF) were strongly downregulated (by 41.3-, 6.8-, and 5.9-fold, respectively) in senile cataract. CONCLUSIONS: Cataractogenesis is associated with numerous changes in the genetic profile of the lens epithelial cells. Since filensin, IRPC, and PEDF genes are known to have important roles in the physiology and morphology of the transparent lens, substantial downregulation of their expression might contribute to the formation of senile cataract.
Subject(s)
Aging/genetics , Cataract/genetics , Eye Proteins/genetics , Gene Expression Regulation/genetics , Lens, Crystalline , Aged , Aged, 80 and over , DNA Probes/genetics , DNA, Complementary/genetics , Down-Regulation/genetics , Epithelial Cells , Humans , Intermediate Filament Proteins/genetics , Lens, Crystalline/pathology , Middle Aged , Nerve Growth Factors/genetics , Oligonucleotide Array Sequence Analysis/methods , Potassium Channels, Inwardly Rectifying/genetics , RNA/analysis , RNA, Messenger/analysis , Serpins/geneticsABSTRACT
PURPOSE: To analyze the postoperative outcome and complication rate after cataract extraction or lensectomy with primary intraocular lens (IOL) implantation for penetrating traumatic cataract. DESIGN: Retrospective, nonconsecutive, noncomparative case series. METHODS: We retrospectively reviewed the files of 21 patients who were admitted to our departments because of traumatic cataract with corneal or scleral laceration caused by penetrating trauma with or without intraocular foreign body (IOFB) from 1992 through 1997. Lens aspiration or manual extracapsular cataract extraction with primary IOL implantation was performed in all patients. Removal of an IOFB was performed in eight patients. MAIN OUTCOME MEASURES: Final visual acuity and deviation of actual refraction from emmetropia and from expected postoperative refraction. RESULTS: The mean follow-up was 20.4 months. Fourteen eyes (67%) achieved final visual acuity of 20/40 or better, 95% obtained 20/60 or better final visual acuity, and all eyes achieved 20/100 or better final visual acuity. Major causes of limited visual acuity were central corneal scar and central retinal injury. Eleven eyes (57%) experienced secondary cataract and underwent neodymium:yytrium-aluminum-garnet capsulotomy. CONCLUSIONS: Primary implantation of posterior chamber lenses after penetrating ocular trauma is associated with favorable visual outcome and a low rate of postoperative complications.
Subject(s)
Cataract Extraction , Corneal Injuries , Eye Foreign Bodies/surgery , Eye Injuries, Penetrating/surgery , Lens Implantation, Intraocular , Lens, Crystalline/injuries , Sclera/injuries , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Postoperative Complications , Retrospective Studies , Treatment Outcome , Visual AcuityABSTRACT
A 23-year-old male presented with renal failure, cholestatic liver enzyme elevation and uveitis. Percutaneous renal biopsy revealed marked eosinophilic infiltration of the renal interstitium, which made the diagnosis of TINU syndrome (Tubulo-Interstitial Nephritis and Uveitis). Percutaneous liver biopsy showed granulomatous hepatitis, which was not described as a part of TINU syndrome. The diagnostic dilemma and the literature are discussed.
Subject(s)
Eosinophilia/complications , Hepatitis/complications , Nephritis, Interstitial/complications , Uveitis/complications , Acute Disease , Adult , Granuloma/complications , Humans , Male , SyndromeABSTRACT
PURPOSE: To study the association between chronic intake of aspirin and intraoperative bleeding during cataract surgery and the effect of discontinuing the medication before surgery. SETTING: Department of Ophthalmology, Meir Hospital, Sapir Medical Center, Kfar-Saba, Israel. METHODS: Sixty-one patients having cataract surgery and receiving aspirin to prevent thromboembolic events were divided into 3 groups: Group A, continuation of the medication; Group B, cessation of aspirin intake for 2 to 5 days before surgery; Group C, cessation of medication for 7 to 10 days before surgery. Blood tests of coagulation parameters, a detailed questionnaire, and 1 day and 1 week follow-up were evaluated. RESULTS: There were no significant differences in blood tests and the amount and incidence of intraoperative bleeding among the 3 groups. Diathermy was used somewhat more in Group A; however, there was no difficulty stopping the bleeding in any case and discontinuation of the medication had no effect on the intraoperative course or postoperative outcome. CONCLUSIONS: Aspirin intake was not associated with significant intraoperative bleeding; thus, discontinuation of aspirin is usually not indicated. Clear corneal phacoemulsification is advantageous in patients receiving antiplatelet therapy.
