Distrofia de Fuchs asociada a queratotomía radial: ¿queratoplastia penetrante o lamelar? / Fuchs' dystrophy associated with radial keratotomy: Lamellar or perforating keratoplasty?

CASO CLINICO: Paciente de 70 años que acude con queratotomía radial, signos de distrofia de Fuchs con edema central y catarata. Se realiza cirugía en 2 tiempos: facoemulsificación e implante de lente intraocular y 4 meses después DSAEK (descemet stripping automatized endothelial keratoplasty) en ambos ojos sucesivamente sin complicaciones, salvo edema macular cistoide recurrente en ambos ojos. La agudeza visual corregida final es 20/40 en ambos ojos y el paciente se encuentra satisfecho. DISCUSIÓN: Ante coexistencia de queratotomía radial y disfunción endotelial, la DSAEK constituye una alternativa a la queratoplastia penetrante si no se detecta ectasia corneal ni opacidad estromal significativa

CASE REPORT: A 70 year-old male patient with a history of radial keratotomy suffering from Fuchs' dystrophy and a cataract. The patient received a two-step surgery: lens phacoemulsification and intraocular lens implant, followed by descemet stripping automated endothelial keratoplasty in both eyes, four months later. There were no complications apart from a recurrent cystoid macular oedema in both eyes. The best corrected visual acuity was 20/40 both eyes, and the patient was satisfied. DISCUSSION: Descemet stripping automated endothelial keratoplasty may be considered as an alternative to penetrating keratoplasty in the case of endothelial dysfunction and radial keratotomy in patients with no corneal ectasia or significant stromal opacity

Fuchs' dystrophy associated with radial keratotomy: Lamellar or perforating keratoplasty? / Distrofia de Fuchs asociada a queratotomía radial: ¿queratoplastia penetrante o lamelar?

CASE REPORT: A 70 year-old male patient with a history of radial keratotomy suffering from Fuchs' dystrophy and a cataract. The patient received a two-step surgery: lens phacoemulsification and intraocular lens implant, followed by descemet stripping automated endothelial keratoplasty in both eyes, four months later. There were no complications apart from a recurrent cystoid macular oedema in both eyes. The best corrected visual acuity was 20/40 both eyes, and the patient was satisfied. DISCUSSION: Descemet stripping automated endothelial keratoplasty may be considered as an alternative to penetrating keratoplasty in the case of endothelial dysfunction and radial keratotomy in patients with no corneal ectasia or significant stromal opacity.

Tacrolimus tópico al 0, 03% en el tratamiento de la psoriasis ocular / Topical tacrolimus 0.03% for the treatment of ocular psoriasis

OBJETIVO/MÉTODO: Presentamos una serie de 4 pacientes afectos de psoriasis ocular con sintomatología severa, a los que se indicó tratamiento off label con tacrolimus tópico al 0,03% una vez al día. Resultados/conclusión: La blefaritis mixta y queratitis es común a los 4, y en 3 casos hay seudopterigión y opacidades corneales. Se apreció mejoría subjetiva del prurito en 2 semanas, y al mes mejoría de la superficie. Todos manifiestan mejoría significativa de su calidad de vida tras un rango de seguimiento de 6 meses a 2 años. El tacrolimus tópico puede ser considerado una opción en el tratamiento de la psoriasis ocular

OBJECTIVE/METHODS: Cases are presented of 4 patients suffering from severe symptoms due to ocular psoriasis and who were treated with off-label 0.03% tacrolimus once a day. Results/conclusions: All four patients had a mixed blepharitis and keratitis. Pseudopterygium and corneal opacities were present in three of them. All of them experienced an improvement of their itching and ocular surface. They all referred to a marked improvement of their quality of life in a follow-up period ranging from six months to two years. Therefore, topical tacrolimus could be considered an option in the treatment of ocular psoriasis

Topical tacrolimus 0.03% for the treatment of ocular psoriasis. / Tacrolimus tópico al 0,03% en el tratamiento de la psoriasis ocular.

OBJECTIVE/METHODS: Cases are presented of 4 patients suffering from severe symptoms due to ocular psoriasis and who were treated with off-label 0.03% tacrolimus once a day. RESULTS/CONCLUSIONS: All four patients had a mixed blepharitis and keratitis. Pseudopterygium and corneal opacities were present in three of them. All of them experienced an improvement of their itching and ocular surface. They all referred to a marked improvement of their quality of life in a follow-up period ranging from six months to two years. Therefore, topical tacrolimus could be considered an option in the treatment of ocular psoriasis.

Carcinoma de células escamosas en la córnea: un nuevo signo de invasión corneal en la tomografía de coherencia óptica / A new oct sign of invasive squamous cell carcinoma of the cornea

CASO CLÍNICO: Presentamos un caso de inusual opacificación corneal y neovascularización progresiva, causada por un carcinoma de células escamosas (CCE). El infiltrado estromal blanquecino sugestivo de queratitis estromal herpética, mostró una imagen en la tomografía de coherencia óptica (OCT) semejante a una "lengua de lava" deslizándose entre las lamelas corneales. El análisis histopatológico confirmó que se trataba de un CCE. DISCUSIÓN: A nuestro conocimiento, es la primera descripción en la literatura de esta peculiar imagen. El CCE es una causa extremadamente infrecuente de opacificación corneal progresiva y neovascularización, y el retraso en el diagnóstico y tratamiento puede conducir a fracaso del tratamiento y pérdida del globo ocular

CASE REPORT: A case is reported of an unusual progressive corneal opacification and neovascularization caused by a squamous cell carcinoma (SCC) of the cornea. A patient with a white stromal infiltrate, consistent with herpetic stromal keratitis, showed a very particular image in optical coherence tomography (OCT), resembling a "tongue of lava" sliding between corneal lamellae. Histopathological analysis confirmed the diagnosis of SCC. DISCUSSION: To our knowledge this is the first report in the literature of this peculiar image with OCT. Squamous Cell Carcinoma is an extremely rare cause of progressive corneal opacification and neovascularization, and a delayed diagnosis may lead to unsuccessful treatment and loss of the eyeball

A new oct sign of invasive squamous cell carcinoma of the cornea.

CASE REPORT: A case is reported of an unusual progressive corneal opacification and neovascularization caused by a squamous cell carcinoma (SCC) of the cornea. A patient with a white stromal infiltrate, consistent with herpetic stromal keratitis, showed a very particular image in optical coherence tomography (OCT), resembling a "tongue of lava" sliding between corneal lamellae. Histopathological analysis confirmed the diagnosis of SCC. DISCUSSION: To our knowledge this is the first report in the literature of this peculiar image with OCT. Squamous Cell Carcinoma is an extremely rare cause of progressive corneal opacification and neovascularization, and a delayed diagnosis may lead to unsuccessful treatment and loss of the eyeball.