To report on an epithelial inclusion cyst of the iris that was successfully treated with needle aspiration and Ab externo laser photocoagulation. A 6-year-old boy was treated for a 6.0 mm fluid-filled cyst in the anterior chamber of the right eye. Thirteen months previously, he had undergone primary closure of a 6 mm full-thickness corneal laceration. The subsequent cyst was diagnosed as an epithelial inclusion cyst of the iris. His vision decreased to finger-count at 30 cm as the cyst grew over the pupil. We performed needle aspiration of the cyst and Ab externo laser photocoagulation of the cyst wall. The treated lesion was completely removed. The patient's visual acuity recovered to 20/40 without complications. There was no recurrence as determined by slit lamp examination up to 6 months after treatment. Needle aspiration and Ab externo laser photocoagulation can be used to effectively treat epithelial inclusion cysts of the iris.
Biopsy, Fine-Needle ; Child ; Cornea/injuries ; Cysts/etiology/*pathology/surgery ; Epithelial Cells/*pathology ; Eye Injuries, Penetrating/complications/surgery ; Humans ; Iris Diseases/etiology/*pathology/surgery ; Lacerations/complications/surgery ; Laser Coagulation ; Male ; Play and Playthings/injuries

In the process of closing scleral wounds caused by various conditions, incarceration of conjunctiva, Tenon's capsule, or vitreous in the wound can occur unexpectedly. We created such conditions experimentally in order to discover their intraocular complications. The experimental materials consisted of 12 albino rabbits (24 eyes) divided into two groups (Groups I & II). Vitrectomy was performed in the Group I rabbits (12 eyes) but not in the Group II rabbits (12 eyes). Flaps of conjunctiva and Tenon's capsule were made and inserted into the vitreous cavity through the sclerotomy site, which was soon closed. Fundal examination of the rabbits was carried out using an indirect ophthalmoscope at intervals after the procedure; first at 3 days, then at 1, 3, and 6 weeks, and then at 3 months and 6 months, respectively. Enucleation of the rabbits' eyes 4 from two different rabbits at each of these intervals was carried out, and the extracted eyes were examined under a light microscope at each interval. The results are summarized as follows: 1. All rabbit eyes studied showed intraocular fibrovascular proliferation. 2. The extent of tissue proliferation, which was proportional to the amount of vitreous hemorrhage, was greater in Group II than in Group I. 3. The proliferated tissue developed to "band" by three weeks postexperiment, after which it gradually regressed. 4. The fibrovascular band was made of fibroblasts, stromal matrix, and capillaries.
Animals ; Cell Division ; Conjunctiva/pathology ; Eye Injuries/surgery ; Fundus Oculi ; Postoperative Complications ; Rabbits ; Retinal Diseases/pathology ; Retinal Vessels/*pathology ; Sclera/*surgery ; Vitrectomy ; Vitreous Hemorrhage/pathology

We report a case of a retained graphite anterior chamber foreign body that was masquerading as stromal keratitis. A 28-year-old male visited with complaints of visual disturbance and hyperemia in his right eye for four weeks. On initial examination, he presented with a stromal edema involving the inferior half of the cornea, epithelial microcysts, and moderate chamber inflammation. Suspecting herpetic stromal keratitis, he was treated with anti-viral and anti-inflammatory agents. One month after the initial visit, anterior chamber inflammation was improved and his visual acuity recovered to 20/20, but subtle corneal edema still remained. On tapering the medication, after three months, a foreign body was incidentally identified in the inferior chamber angle and was surgically removed resulting in complete resolution of corneal edema. The removed foreign body was a fragment of graphite and he subsequently disclosed a trauma with mechanical pencil 12 years earlier. This case showed that the presence of an anterior chamber foreign body should always be considered in the differential diagnosis of idiopathic localized corneal edema.
Adult ; Anterior Chamber/*injuries/pathology ; Corneal Stroma/*pathology ; Diagnosis, Differential ; Eye Foreign Bodies/*diagnosis/physiopathology/surgery ; Eye Injuries, Penetrating/*diagnosis/physiopathology/surgery ; *Graphite ; Humans ; Keratitis/*diagnosis ; Male ; Ophthalmologic Surgical Procedures ; Visual Acuity

A 38-year-old woman developed diffusely distributed opacities with crystalline materials in the laser in situ keratomileusis (LASIK) interface of her eye after she was scratched by a sprig during mountain climbing. No sign of flap displacement was noted. Despite two days of topical and systemic antibiotics therapy, the corneal infiltration with interface opacities persisted. The following day, the distribution of the crystalline materials had rotated in a counterclockwise direction. Flap lifting and foreign body removal using sufficient irrigation were performed. One month after surgery, the patient's postoperative uncorrected visual acuity was 0.8 with cleared interface. No signs of epithelial ingrowth or flap striae were noted. Mild traumatic corneal scratching without flap displacement may threaten the integrity of the LASIK interface. If foreign bodies are suspected to be the cause of inflammation, early flap lifting with irrigation is imperative for successful treatment.
Adult ; Cornea/*injuries/pathology/surgery ; Eye Injuries/*complications/diagnosis/surgery ; Female ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ/*methods ; Myopia/surgery ; *Surgical Flaps ; Surgical Wound Dehiscence/diagnosis/*etiology/surgery ; Wounds, Nonpenetrating/*complications/diagnosis/surgery

We report a case of tectonic corneal transplantation for impending corneal perforation to preserve anatomic integrity using cryopreserved donor tissue. An 82-year-old woman exhibiting impending corneal perforation suffered from moderate ocular pain in the left eye for one week. After abnormal tissues around the impending perforation area were carefully peeled away using a Crescent blade and Vannas scissors, the patient received tectonic deep anterior lamellar keratoplasty using a cryopreserved cornea stored in Optisol GS(R) solution at -70degrees C for four weeks. At six months after surgery, the cornea remained transparent and restored the normal corneal thickness. There were no complications such as corneal haze or scars, graft rejection, recurrent corneal ulcer, and postoperative rise of intraocular pressure. Cryopreserved donor lamellar tissue is an effective substitute in emergency tectonic lamellar keratoplasty, such as impending corneal perforation and severe necrotic corneal keratitis.
Aged, 80 and over ; Cornea/injuries/*surgery ; Corneal Perforation/pathology/physiopathology/*surgery ; Corneal Transplantation/*methods ; *Cryopreservation ; Eye Injuries, Penetrating/pathology/physiopathology/*surgery ; Female ; Follow-Up Studies ; Humans ; *Tissue Donors ; Visual Acuity

PURPOSE: To evaluate whether systemically injected bone marrow-derived mesenchymal stem cells (MSCs) can be incorporated into neuroretinal tissues and play an important role in retinal wound healing in the laser-induced retinal trauma model. METHODS: Retinotomies were made by applying an Nd:YAG laser to rat retina. On the first day after the injuries, cell suspensions that were obtained from the same line of rat (containing 1 x 10(6) green fluorescence protein [GFP]-marked bone marrow-derived MSCs) were injected through a tail vein in the experimental group and phosphate buffer solution (PBS) was injected in the same way in the control group. Fundus photographs were taken serially for fundus examination and eyeballs were enucleated for histological studies that were conducted at five and seven weeks after MSC and PBS injection. After the tissues were prepared, the retinotomy sites were observed with routine histological staining and confocal microscopy. RESULTS: Retinal detachment resolved in the experimental group, whereas it progressed in the control group. The retinotomy sites closed partially with identifiable GFP positive cells 5 weeks after MSC injection. At 7 weeks after MSC injection, complete healing without retinal detachment and plentiful GFP positive cells were observed at the transitional zone between damaged and normal retina. CONCLUSIONS: Systemically administered GFP-marked MSCs may be incorporated into the neuroretinal tissues and play an important role in the wound modulation of physically damaged retinal tissues.
Animals ; *Bone Marrow Transplantation ; Disease Models, Animal ; Eye Injuries/pathology/*surgery ; Mesenchymal Stem Cell Transplantation/*methods ; Microscopy, Confocal ; Prognosis ; Rats ; Rats, Sprague-Dawley ; Retina/injuries/pathology/*surgery ; *Wound Healing

We describe herein a case of an impending corneal perforation with a large descemetocele in a patient with previous penetrating keratoplasty (PKP) that subsequently was treated with an emergent lamellar keratoplasty using frozen preserved cornea. A 76-year-old male patient, who had a PKP, presented with a completely whitish and edematous graft accompanied by large epithelial defects. Although antibiotics and antiviral agents were tried for three days, the corneal stroma abruptly melted, except for the Descemet's membrane and endothelium. Cryopreserved corneal tissue that was kept at -80degrees C was thawed and sutured on top of the remaining Descemet's membrane and endothelium. Pathological and microbiological tests were conducted using the remaining donor and recipient corneal tissues. After tectonic corneal transplantation on top of a large descemetocele, a healthy graft and relatively clear interfaces between graft-host junctions were maintained without serious adverse reactions throughout 6 month follow-up period. Microbiological evaluations of donor tissue at the time of thawing and tissue preparation were done, and the results were all negative. Tissue that was taken intraoperatively from the recipient cornea also showed negative microbiological results. In conclusion, tectonic lamellar keratoplasty, using cryopreserved corneal tissue, only onto the remaining Descemet's membrane and endothelium in an emergent condition, was a safe and effective treatment.
Cornea/*surgery ; Corneal Perforation/pathology/physiopathology/*surgery ; Corneal Transplantation/*methods ; *Cryopreservation ; Eye Injuries, Penetrating/pathology/physiopathology/*surgery ; Female ; Humans ; Keratoplasty, Penetrating ; Male ; Middle Aged ; *Tissue Donors ; Treatment Outcome ; Visual Acuity

PURPOSE: To evaluate the effect of transposition procedures on the vertical rectus muscle (VRM) in the patients who underwent a medial rectus muscle (MR) transection after endoscopic sinus surgery (ESS). METHODS: In 4 patients with exotropia (XT) and a lack of adduction after ESS, orbital CT or MRI revealed a complete transection of the midportion of the MR. Full-tendon VRM transposition was performed within 3 months after injury (early surgery) in 2 patients with 40delta XT. Two patients with 70delta and 85delta XT underwent an X-type augmented Hummelsheim procedure, which involved pulling each half-tendon and crossing it through the undersurface of the severed MR to the other end of the MR insertion, concurrently with an ipsilateral lateral rectus (LR) recession 11 months and 36 months after ESS, respectively. The adduction deficits were divided into -1 through to -8. The patients were followed up for more than than 1.5 years. RESULTS: Postoperatively, 3 patients showed orthophoria and no diplopia in the primary position. The adduction deficits improved to -3.5 or -4. One patient who underwent an X-type augmented Hummelsheim procedure showed a residual XT of 25delta. CONCLUSIONS: VRM transposition is effective in correcting a large XT secondary to a MR transection after ESS. When a longstanding large-angle XT with severe contracture of the ipsilateral LR and massive scarring of the adjacent tissues is present, the X-type augmented Hummelsheim procedure coupled with an ipsilateral LR recession had an augmenting effect.
Adult ; Aged ; Endoscopy/*adverse effects ; Exotropia/diagnosis/etiology/*surgery ; Eye Movements ; Female ; Humans ; *Iatrogenic Disease ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Oculomotor Muscles/injuries/pathology/*surgery ; Paranasal Sinus Diseases/*surgery ; Tendon Transfer/*methods ; Tomography, X-Ray Computed ; Vision, Binocular