Visual rehabilitation with limbal autologous stem cells transplant and cataract surgery in a patient with ocular surface squamous neoplasia.

PURPOSE: To describe the outcome of simple limbal epithelial transplantation along with Phacoemulsification and IOL implantation for visual rehabilitation in limbal stem cell deficiency due to ocular surface squamous neoplasia. OBSERVATIONS: This case report of a 66-year-old woman clinically diagnosed with OSSN in her right eye involving all cornea and limbus meridians. Topical chemotherapy for tumor treatment was done, followed by SLET and sequential cataract surgery. The entire tumor could be clinically reduced with topical chemotherapy but a LSCD could not be avoided. After SLET, corneal transparency was restored, and anterior segment details could be seen, phacoemulsification was performed uneventfully. After a follow-up period of 18 months, stable ocular surface and visual acuity and no tumor recurrence was observed. CONCLUSIONS: SLET is an option to restore not only corneal epithelium homeostasis but also gain cornea transparency, avoid keratoplasties and allow anterior segment surgeries to be performed. IMPORTANCE: This case report provide evidence of benefits of simple limbal epithelial transplantation in ocular surface squamous neoplasia and shows that cataract surgery could be performed uneventfully after limbal stem cell transplantation.

Thermographic Behavior of the Cornea During Treatment With Two Excimer Laser Platforms.

Purpose: To investigate the temperature of the cornea during treatment with the excimer laser using two platforms, Nidek EC-5000 and Schwind Amaris 750S. Methods: A prospective case series study was conducted in a reference center in Mexico City including patients aged 18 years or older who had any type of ametropia and underwent excimer laser refractive surgery. The patients had measurements of corneal temperature with an infrared camera before, during, and after ablation treatment. Results of prior corneal surface temperature, temperatures during excimer laser surgery, and delta temperature for each platform were analyzed and compared. Results: A total of 107 eyes were analyzed. Mean baseline temperature was 32.7 ± 1.03°C for the Nidek group and 31.5 ± 1.4°C for the Amaris group. Mean maximum temperature was 39.94 ± 1.3°C for the Nidek group and 35.6 ± 1.5 °C for the Amaris group. Delta temperature was higher in the Nidek group than in the Amaris group. There were statistically significant associations between treated micrometers, treated diopters, and time in the Nidek group and no such associations in the Amaris group. Conclusions: The different excimer laser devices used and the variety in the optical design, together with different software ablation algorithms, resulted in different levels of thermal loading; peak temperature rose in all measurements. Eyes treated with Nidek reached temperatures that doubled those found with Amaris. Translational Relevance: The correlation between Delta of temperature with defocus, depth, and treatment time is different regarding excimer laser generation.

Hallazgos oftalmológicos de una fístula carotidocavernosa postraumática en un paciente joven / Ophthalmologic findings of a posttraumatic carotid-cavernous fistula in a young patient

Introducción: Se presenta un caso clínico de un paciente joven con una fístula carotidocavernosa traumática que requirió embolización con coils como manejo definitivo. Objetivo: Dar a conocer la importancia de realizar unos adecuados enfoque, diagnóstico y tratamiento ante una fístula carotidocavernosa que presente compromiso oftalmológico, para disminuir el riesgo de presentar complicaciones oculares que pueden ser devastadoras. Resumen del caso: Varón de 27 años que sufrió un traumatismo craneoencefálico, el cual generó afectación oftalmológica que involucra desde el segmento anterior hasta el segmento posterior, con un leve compromiso de la agudeza visual. Requirió manejo multidisciplinario en conjunto con el servicio de neurocirugía para tratamiento endovascular, con posterior resolución de los signos y síntomas clínicos. Conclusiones: Las fístulas carotidocavernosas de alto flujo son las más frecuentes y suelen ocurrir en pacientes jóvenes con antecedentes de traumatismo craneoencefálico. Estas fístulas presentan múltiples manifestaciones clínicas oculares, por lo que los oftalmólogos deben ser capaces de hacer un adecuado enfoque y solicitar los estudios paraclínicos necesarios para hacer el diagnóstico y el tratamiento oportuno

Introduction: We presents a clinical case of a young patient with traumatic carotid-cavernous fistula who required coil embolization as definitive management. Objective: To make known the importance of carrying out an adequate approach, diagnosis and treatment in the patient with carotid-cavernous fistula that presents an ophthalmological findings in order to reduce the risk of presenting ocular complications that can be devastating. Case summary: A 27-year-old male patient who presented cranioencephalic trauma generating ophthalmological changes that involves from the anterior segment to the posterior segment, with a mild compromise of visual acuity, multidisciplinary management required in conjunction with neurosurgery service for endovascular management with subsequent resolution of the clinical signs and symptoms. Conclusions: Carotid-cavernous high-flow fistulas are the most frequent and they are associated with young patients with a history of head trauma. These fistulas present multiple ocular clinical manifestations, so ophthalmologists must be able to make an adequate approach and request the necessary paraclinical to make the diagnosis and timely treatment