Case Report: Snake Venom Ophthalmia Caused by Cobra Exposure: A Report of 26 Cases.

We report 26 cases of eye injuries resulting from cobra venom sprayed by Naja atra. This accounts for 14.5% of patients (26/173) treated for cobra injuries who presented to the emergency department of a snakebite treatment center in Guangzhou, South China. Pain, blurred vision, lacrimation, photophobia, and foreign body sensation were the most common symptoms, found in 24 patients. Ophthalmic examination revealed eyelid swelling and conjunctival congestion. Eye slit lamp examination showed obvious punctate corneal epithelial defects in four patients. Five patients received an intravenous infusion of antivenom. All patients' eyes were rinsed completely with normal saline after their arrival at the hospital. Prophylactic topical antibiotics were given to all patients. All eyes were cured without long-term sequelae.

Correlation between ocular Demodex infestation and serum immunoreactivity to Bacillus proteins in patients with Facial rosacea.

PURPOSE: To investigate correlation between ocular Demodex infestation and serum. DESIGN: A prospective study to correlate clinical findings with laboratory data. PARTICIPANTS: We consecutively enrolled 59 patients: 34 men and 25 women with a mean age of 60.4+/-17.6 years (range, 17-93). METHODS: Demodex counting was performed based on lash sampling. Serum immunoreactivity to two 62-kDa and 83-kDa proteins derived from B oleronius was determined by Western blot analysis. Facial rosacea, lid margin, and ocular surface inflammation were documented by photography and graded in a masked fashion. MAIN OUTCOME MEASURES: Statistical significance based on correlative analyses of clinical and laboratory data. RESULTS: These 59 patients were age matched, but not gender matched, regarding serum immunoreactivity, ocular Demodex infestation, or facial rosacea. There was a significant correlation between serum immunoreactivity and facial rosacea (P = 0.009), lid margin inflammation (P = 0.040), and ocular Demodex infestation (P = 0.048), but not inferior bulbar conjunctival inflammation (P = 0.573). The Demodex count was significantly higher in patients with positive facial rosacea (6.6+/-9.0 vs. 1.9+/-2.2; P = 0.014). There was a significant correlation of facial rosacea with lid margin inflammation (P = 0.016), but not with inferior bulbar conjunctival inflammation (P = 0.728). Ocular Demodex infestation was less prevalent in patients with aqueous tear-deficiency dry eye than those without (7/38 vs. 12/21; P = 0.002). CONCLUSIONS: The strong correlation provides a better understanding of comorbidity between Demodex mites and their symbiotic B oleronius in facial rosacea and blepharitis. Treatments directed to both warrant future investigation.

Sutureless amniotic membrane transplantation for severe bacterial keratitis.

PURPOSE: To evaluate the efficacy of early sutureless amniotic membrane transplantation in the management of severe bacterial keratitis to reduce pain, inflammation, and haze, and to promote healing. METHOD: A noncomparative case series including 3 eyes of 3 consecutive patients with severe bacterial keratitis exhibiting persistent epithelial defect/ulcer, more than 5 mm in diameter, located within 3mm from the visual axis with infiltration occupying more than 50% of the corneal thickness. They were retrospectively reviewed following early (ie, within 96 hours) sutureless amniotic membrane transplantation via ProKera together with selective topical antibiotics and preservative-free steroid. Pain relief, inflammation, haze, and corneal epithelial healing were monitored. RESULTS: ProKera was inserted once in 1 eye and twice in the other 2 eyes. Pain was significantly relieved and inflammation was markedly reduced in all cases. The corneal epithelial defect and stromal ulceration rapidly healed while visual acuity improved in 2 of the 3 eyes. CONCLUSION: Temporary sutureless amniotic membrane transplantation via ProKera allows easy insertion and replacement of the membrane in the office, as well as early intervention to promote epithelialization, reduce pain, haze and inflammation in cases with severe bacterial keratitis. This result justifies large series controlled studies in the future.

[Wavefront analysis in pseudophakic eyes by using allegretto wave analyzer].

PURPOSE: To analyze the wavefront aberrations of pseudophakic eyes. METHODS: Seventy-eight patients (84 eyes) who have undergone phacoemulsification and Alcon Acrysof SA60AT intraocular lens were divided into 3 groups by the stage of post-operation. Allegretto Wave Analyzer (Wavelight Laser Technologie AG, Germany) implanted into the eyes was applied to analyze the wavefront aberrations. Twenty-three healthy normal eyes were involved in the control group. RESULTS: The higher order aberrations were detected in all the eyes (100%) of Group 1-3. The higher order aberration of Group 1 (the first week of post-operation) was RMSh (0.3774 +/- 0.2311) microm, which of Group 2 (the first month of post-operation) was RMSh (0.4782 +/- 0.395 2) microm, which of Group 3 (the third month of post-operation) was RMSh (0.2880 +/- 0.1522) microm. The higher order aberration of the control group was RMSh (0.3412 +/- 0.2048) microm. The difference of higher order aberration root mean square (RMSh) values between Group 3 and Group 2 has statistical significance (P < 0.05). But the differences of RMsh between the control group and Group 1, 2, 3 apart were no significant (P > 0.05). CONCLUSION: The higher order aberrations of pseudophakic eyes may be a reason why the visual qualities of phakic eyes are not better than those of normal human eyes statistically when their vision acuity is alike. The IOLs which can reduce higher order aberrations will improve the visual qualities of pseudophakic eyes. Ophthalmologists are looking forward to optimizing and designing individual intraocular lens.

[The clinical study of stereopsis after bilateral intraocular lens implantation].

PURPOSE: To observe the stereopsis of senile cataract patients after bilateral intraocular lens (IOL) implantation. METHOD: Subjects were divided into two groups: IOL group and normal group. Near stereoacuity with distance and near correction was checked with Randot steretests respectively. Near vision acuity was recorded with Logmar. RESULT: Near stereoacuity with distance correction was (101 +/- 59)" and (112 +/- 55)" respectively, the responding near vision acuity was 0.51 +/- 0.15 and 0.52 +/- 0.17. Near stereoacuity with near correction was (33 +/- 11)" and (34 +/- l0)", the responding near vision acuity was 0.09 +/- 0.10 and 0.11 +/- 0.11. There was no significant difference in near stereoauity and near vision acuity between two groups (P > 0.05). Stereoauity and near vision acuity with near correction was significantly improved in both groups (P < 0.01). CONCLUSION: Stereopsis after bilateral intraocular lens implantation was improved.

Quantitative measurements of the decentration distance of four kinds of intraocular lens.

PURPOSE: To investigate a quantitative method to measure decentration distance(DD) and analyze the DD of four kinds of intraocular lenses (IOLs). METHODS: The pseudophakic eye photos were taken under the slit lamp after the IOLs were implanted a year or longer. Then the images were inputted into a computer and the Photoshop software was applied to analyze the DD. Four kinds of IOLs were analyzed, including AcrySof MA60BM (11 eyes), Allergan SA40N (11 eyes), AcrySof SA60AT/SA30AL (5 eyes), Corneal Quattro (4 eyes). RESULTS: The mean value of DD was (0.2643 +/- 0.1574) mm in the AcrySof MA60BM group, (0.3536 +/- 0.1719) mm in the Array SA40N group, (0.3099 +/- 0.1529) mm in the SA60AT/SA30AL group, and (0.3261 +/- 0.1877) mm in the Quattro group. The difference of the DD values among these 4 kinds of IOLs had no statistic significance (F = 0.506, P = 0.681) and the values were not equal to zero (t = 10.508, P < 0.001). CONCLUSION: The Photoshop method is a simple and efficient way for DD analysis. The modern foldable posterior-chamber-IOLs have good centration performances when implanted into the capsular bags.