Three cases of Acanthamoeba keratitis diagnosed and treated in the early stage.

Acanthamoeba keratitis (AK) is a severe infectious corneal ulcer that usually occurs in contact lens wearers. Although the number of AK cases in Japan has been increasing, many of these cases are diagnosed in the early stage and are treated adequately. This is probably because of the increased availability of various diagnostic techniques and the ever-increasing knowledge about AK among ophthalmologists. In this article, we described 3 cases of AK that were diagnosed and treated in the early stages of the disease, and we discuss why 1 of the cases had a less favorable prognosis than the other 2 cases, which had excellent prognoses, from an etiological point of view.

Preliminary outcomes of primary phacoemulsification plus intraocular lens implantation for primary angle-closure glaucoma.

PURPOSE: To evaluate effects and safety of primary phacoemulsification plus intraocular lens implantation for controlled chronic angle-closure glaucoma (CACG) or primary angle-closure (PAC). DESIGN: Prospective, non-randomized comparative trial. METHODS: Two treatment groups were used. The IOL group included the use of phacoemulsification plus intraocular lens (IOL) implantation in 27 eyes. The LI group included treatment by laser iridotomy (LI) in 23 eyes. Intraocular pressure (IOP), numbers of anti-glaucoma medications, complications, and corneal endothelial cell counts were examined in each group. RESULTS: In the IOL group, IOP was significantly reduced from a preoperative mean of 14.8 +/- 4.2 mmHg to a 6-month-postoperative mean of 10.8 +/- 1.6 mmHg (P < .05). However, in the LI group, mean preoperative IOP was 15.5 +/- 4.1 mmHg, and the 6-month-postoperative IOP was 14.7 +/- 4.7 mmHg (P = .76). In the IOL group, no patient used anti-glaucoma medications 6-month postoperatively, whereas in the LI group, mean number of anti-glaucoma medications was 0.2 +/- 0.4 (P < .05). There were no significant differences in preoperative and postoperative corneal endothelial cell counts between IOL and LI groups (P = .39). CONCLUSIONS: Primary phacoemulsification plus intraocular lens implantation for controlled CACG or PAC seems to be a safe and effective method in reducing IOP. This procedure might become the first treatment of choice for controlled CACG or PAC with cataract.

Visualization of uveal perfusion by contrast-enhanced harmonic ultrasonography at a low mechanical index: a pilot animal study.

OBJECTIVE: To evaluate contrast-enhanced harmonic ultrasonography at a low mechanical index for its usefulness in visualizing uveal perfusion. METHODS: The study was performed with 9 rabbits, 6 intact and 3 with focal impaired blood flow in the uvea. Ultrasonography was performed by harmonic imaging (transmit, 5 MHz; receive, 10 MHz) with a contrast agent. The agent was administered at a dose of 50 microL/kg. Transmission power was at a mechanical index of 0.2, which is below the US Food and Drug Administration guideline. The images were compared between the impaired and intact eyes. For uveal measurements, video signal intensity-versus-time plots were generated in all cases. The plots were analyzed to obtain the rate of signal intensity increase and peak signal intensity. RESULTS: A clear increase of signal intensity was observed after contrast agent administration. The signal intensity of the uvea was lower in the impaired eye than in the intact eye. In the impaired eye, the intensity was lower on the side with impaired flow than on the other side. The differences were significant. CONCLUSIONS: Our findings suggest that uveal perfusion can be visualized by contrast-enhanced harmonic ultrasonography in the harmonic imaging mode at a low mechanical index.