Assuntos
Doenças da Córnea/etiologia , Transplante de Córnea/efeitos adversos , Desbridamento/efeitos adversos , Descolamento Retiniano/cirurgia , Adulto , Córnea/cirurgia , Doenças da Córnea/patologia , Doenças da Córnea/cirurgia , Edema da Córnea/cirurgia , Epitélio/cirurgia , Feminino , Humanos , Hiperopia/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/patologia , Retalhos Cirúrgicos/patologiaRESUMO
PURPOSE: To study the clinical course of accidental, single-focus Nd:YAG laser injuries to the macula. METHODS: We reviewed the clinical course of five eyes (four patients) that sustained macular injuries from a Nd:YAG laser. All patients were examined within 24 hours of injury and were observed without surgical intervention for a mean of 20 months (range, 12 to 32 months). RESULTS: A single full-thickness foveal or parafoveal retinal hole was apparent in all eyes either on initial examination or within two weeks of injury. All macular holes were within 650 microns of the foveal center. The mean final visual acuity was 20/60 (range, 20/25 to 20/400) and was related to the distance between the macular hole and the foveal center. None of the eyes developed either subretinal neovascularization or clinically significant epiretinal membrane formation during the study period. CONCLUSIONS: Despite initial poor visual acuity in patients who had a full-thickness foveal or parafoveal retinal hole, visual acuity improved without treatment when the site of the laser injury was located outside the foveal center.
Assuntos
Lasers/efeitos adversos , Macula Lutea/lesões , Perfurações Retinianas/etiologia , Adulto , Feminino , Seguimentos , Fóvea Central/lesões , Fóvea Central/patologia , Fóvea Central/efeitos da radiação , Fundo de Olho , Humanos , Macula Lutea/patologia , Macula Lutea/efeitos da radiação , Masculino , Perfurações Retinianas/patologia , Acuidade VisualRESUMO
We examined 13 patients referred for management of dislocated lens fragments after phacoemulsification. Ocular findings included corneal decompensation, glaucoma, inflammation, and retinal tears and detachments. Eleven of the 13 patients underwent vitrectomy with removal of lens fragments. Surgical indications included the presence of large lens fragments, uncontrolled glaucoma, persistent and severe inflammation, and retinal detachment. Better visual acuity was observed in patients who had smaller lens fragments or when vitrectomy was delayed to allow medical treatment of intraocular inflammation and glaucoma. The results indicate that nucleus dislocation during phacoemulsification is an important visual complication, with seven of the 13 patients having a final visual acuity of 20/80 or less.
Assuntos
Subluxação do Cristalino/etiologia , Fotocoagulação/efeitos adversos , Corticosteroides/uso terapêutico , Adulto , Idoso , Extração de Catarata/métodos , Feminino , Humanos , Núcleo do Cristalino/cirurgia , Subluxação do Cristalino/terapia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Período Pós-Operatório , Reoperação , Acuidade Visual , VitrectomiaRESUMO
Using immunofluorescence techniques, we analyzed the distribution of glycoproteins in normal and keratoconus corneas of humans. Laminin, bullous pemphigoid antigen, fibronectin, and fibrin/fibrinogen were all found in the epithelial basement membrane of normal corneas. Keratoconus corneas produced similar results, except that staining for fibrin/fibrinogen was weak. Fibrin/fibrinogen was absent from normal corneal basement membrane in animal models studied previously. Keratoconus may be the result of the lysis of fibrin or may involve impeded elaboration of fibrin.
