INTRODUCTIONTo report the sequential changes in corneal topography and astigmatism following limited macular translocation. CLINICAL PICTURE AND TREATMENT: A 45-year-old-man who underwent limited macular translocation for idiopathic subfoveal choroidal neovascularisation in the right eye was evaluated by corneal topography and manifest refraction preoperatively and serially for 1 year postoperatively.

OUTCOMEAn increase in astigmatism with corneal steepening along meridians corresponding to the area of chorioscleral infolding was observed and this persisted for 1 year after surgery. Vector-analysed astigmatic change showed significant surgically induced astigmatism of 2.18 dioptres (D) X 52.9 degrees, 2.17 D X 57.8 degrees and 2.56 D X 59.1 degrees at 2, 5 and 12 months after surgery respectively.

CONCLUSIONSurgically induced corneal changes are evident after limited macular translocation and may remain up to 1 year after surgery.

Astigmatism ; etiology ; Choroidal Neovascularization ; surgery ; Corneal Diseases ; etiology ; Corneal Topography ; Humans ; Male ; Middle Aged ; Ophthalmologic Surgical Procedures ; adverse effects

To evaluate the efficacy of amniotic membrane in the management of painful bullous keratopathy secondary to the intractable glaucoma and in preventing exposure of drainage devices, we inserted Ahmed valve with amniotic membrane patch graft over the implant itself, and debrided corneal epithelium with amniotic membrane graft over the exposed stroma as a single operation. During the follow-up periods, we monitored vision, intraocular pressure (IOP), presence of ocular pain, and postoperative complications associated with the implants. The mean follow up period was 8.4+/-3.2 months. IOP was well controlled after the intervention. The preoperative mean IOP was measured as 43.9+/-9.0 mmHg and lowered to 16.1+/-1.8 mmHg at the last visit and no complications associated with the implants were noted. Even though the improvement in vision was not prominent, the ocular surface stabilized rapidly and ocular pain associated with bullous keratopathy disappeared soon after surgery. Conclusively the use of amniotic membrane in conjunction with Ahmed valve implantation is an effective way to relieve ocular pain and lessen the chances of complications associated with the implant in patients with intractable glaucoma and bullous keratopathy.
Retrospective Studies ; Middle Aged ; Male ; Humans ; *Glaucoma Drainage Implants ; Glaucoma/complications/surgery ; Female ; Epithelium, Corneal/pathology/surgery ; Corneal Transplantation/*methods ; Corneal Diseases/etiology/pathology/*surgery ; Amnion/*transplantation ; Aged

PURPOSE: To evaluate the change of axial length (AL), intraocular pressure (IOP), and corneal astigmatism after scleral shortening with scleral invagination in the rabbit eye. METHODS: The authors performed scleral shortening (3 mm) with scleral invagination in two groups of 6 eyes each: 180 degrees (group 1) and 360 degrees (group 2). RESULTS: Average AL shortening was more prominent in group 2 (0.5 +/- 0.17 mm) than in group 1 (0.37 +/- 0.29 mm), but the difference was not statistically significant. IOP increased immediately after the procedure and was maintained at a high level through 2 months postoperatively. Induced corneal astigmatism was more prominent in group 1 than in group 2. The difference was statistically significant in group 1 (p< 0.05) but not in group 2. CONCLUSIONS: In the scleral shortening with scleral invagination procedure, a large amount of scleral invagination resulted in more shortening of axial length, but there was more corneal astigmatism in 180-degree invagination of the sclera than in 360-degree. Further research is required to determine the effect of the extent of scleral invagination on the change of these values.
Animals ; Astigmatism/*etiology ; Corneal Diseases/*etiology ; Eye/*pathology ; *Intraocular Pressure ; Postoperative Period ; Rabbits ; Sclera/*surgery

Biomedical Research ; Blindness ; etiology ; prevention & control ; surgery ; Corneal Diseases ; complications ; prevention & control ; surgery ; Corneal Transplantation ; education ; methods ; Education, Medical, Graduate ; Health Promotion ; Humans ; Ophthalmology ; education ; Singapore

The purpose of this study was to compare the effects on astigmatism after penetrating keratoplasty with three different suture techniques. In this prospective study, 38 eyes of 38 patients underwent penetrating keratoplasty with three suturing techniques: interrupted, single running, and double running. Topographic astigmatism was measured at 2, 6, 12, and 18 months after keratoplasty. During 18 months after surgery, the interrupted suture group had higher astigmatism than the double running suture group. There was no significant difference in the amounts of astigmatism during the first year after keratoplasty between the single running and the double running suture group. However, at 18 months after surgery, when all sutures were out, the double running suture group (3.60+/-1.58 diopters) showed significantly less astigmatism than the single running group (5.65+/-1.61 diopters). In conclusion, post-keratoplasty astigmatism was the least in the double running suture group of the three suturing techniques at 18 months after penetrating keratoplasty.
Adult ; Astigmatism/etiology/*prevention & control ; Corneal Diseases/surgery ; Corneal Topography ; Female ; Humans ; *Keratoplasty, Penetrating ; Male ; Middle Aged ; Postoperative Complications ; Prospective Studies ; *Suture Techniques ; Time Factors ; Visual Acuity

We report four cases in which a pericardium (Tutoplast(R)) plug was used to repair a corneoscleral fistula after Ahmed Glaucoma Valve (AGV) explantation. In four cases in which the AGV tube had been exposed, AGV explantation was performed using a pericardium (Tutoplast(R)) plug to seal the defect previously occupied by the tube. After debridement of the fistula, a piece of processed pericardium (Tutoplast(R)), measured 1 mm in width, was plugged into the fistula and secured with two interrupted 10-0 nylon sutures. To control intraocular pressure, a new AGV was implanted elsewhere in case 1, phaco-trabeculectomy was performed concurrently in case 2, cyclophotocoagulation was performed postoperatively in case 3 and anti-glaucomatous medication was added in case 4. No complication related to the fistula developed at the latest follow-up (range: 12~26 months). The pericardium (Tutoplast(R)) plug seems to be an effective method in the repair of corneoscleral fistulas resulting from explantation of glaucoma drainage implants.
Adolescent ; Corneal Diseases/etiology/*surgery ; Device Removal/adverse effects ; Fistula/etiology/*surgery ; *Glaucoma Drainage Implants ; Glaucoma, Neovascular/*surgery ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Pericardium/*transplantation ; *Postoperative Complications ; Reoperation ; Scleral Diseases/etiology/*surgery ; Suture Techniques

A 60-year-old man with bilateral corneal opacity underwent cataract extraction surgery involving the use of a limbal relaxing incision in his left eye. He had lower lid ectropion and lagophthalmos in both eyes. Eleven days after the surgery, a slit-lamp examination revealed a neurotrophic corneal ulcer with a punch-out epithelial defect and rolled edges at the center of the pre-existing corneal opacity. The patient was treated with sodium hyaluronate, autologous serum, and oral doxycycline. Six weeks after the surgery an improvement in corneal sensation was observed and the neurotrophic corneal ulcer subsequently healed over the course of one year. In this report, we present a case of neurotrophic keratitis that occurred after performing cataract surgery concurrent with a limbal relaxing incision. As such, we suggest that limbal relaxing incisions should be performed cautiously in patients with causative risk factors for corneal hypesthesia.
Cataract Extraction/*adverse effects/*methods ; Corneal Diseases/etiology ; Corneal Ulcer/*etiology/*pathology/physiopathology ; Humans ; Hypesthesia/etiology ; Limbus Corneae/*surgery ; Male ; Middle Aged ; Ophthalmologic Surgical Procedures/*adverse effects ; Phacoemulsification ; Wound Healing

We report our experience with corneal epithelium, grown in vivo, transplantation in three patients with persistent epithelial defect (PED). The three patients had ocular surface disease unresponsive to standard treatments and were therefore chosen for transplantation. They underwent transplantation of epithelial sheets, grown in vivo, to the most affected eye. In vivo cultivation was carried out in the cornea of a living related donor. After epithelialization was completed, the epithelium grown on an amniotic membrane was harvested gently; it was then transplanted into the patient's eye after debridement of fibrovascular tissue. The cultivated epithelium was completely epithelialized by 2 weeks; it was well-differentiated with well-formed hemidesmosome. On immunohistochemical staining, p63, connexin 43, and Integrin beta4 were expressed in the cells on the epithelial sheet. The PED was covered completely and maintained for 4 weeks in all cases. However, corneal erosion recurred after 5 weeks in two cases. This novel technique demonstrates the corneal epithelial cells can be expanded in vivo successfully on denuded amniotic membrane of a healthy cornea and harvested safely. A corneal epithelial sheet, grown in vivo, can be transplanted to treat eye with a severe ocular surface disease, such as total limbal deficiency.
Adult ; Cell Culture Techniques ; Cells, Cultured ; Corneal Diseases/etiology/pathology/*surgery ; Corneal Transplantation/*methods ; Epithelial Cells/cytology/*transplantation ; Epithelium, Corneal/cytology/*transplantation ; Eye Burns/complications ; Humans ; Limbus Corneae/*pathology ; Male ; Middle Aged ; Stem Cells/*pathology ; Stevens-Johnson Syndrome/complications

We report a case of Descemet's membrane detachment, a rare complication of viscocanalostomy. During the operation, the injection cannula was directed slightly oblique to the Schlemm's canal rather than parallel to it. Localized corneal whitening developed adjacent to the injection site during viscoelastic injection. One week postoperatively, corneal edema decreased and Descemet's membrane detachment was noted. Nine months after surgery, the cornea was clear while the Descemet's membrane detachment remained. And IOP was 19 mmHg without any medications. We think that improper cannula positioning during viscoelastic injection may cause Descemet's membrane detachment, a rare complication of viscocanalostomy.
Aged ; Case Report ; Corneal Diseases/*etiology ; *Descemet's Membrane ; Human ; Hyaluronic Acid/administration & dosage ; Injections/adverse effects ; Intraoperative Complications ; Male ; Ocular Hypertension/*surgery

No abstract available.
*Biological Dressings ; Calcinosis/complications/*drug therapy ; Chelating Agents/*therapeutic use ; Chelation Therapy/*methods ; Child ; Child, Preschool ; Clinical Trials ; Combined Modality Therapy ; Corneal Diseases/*drug therapy/etiology/*surgery ; Edetic Acid/*therapeutic use ; Humans ; Keratectomy, Laser/*methods