RESUMO
PURPOSE: To analyze clinical outcomes and intraocular pressure control following scleral-glued intraocular lens (IOL) fixation in eyes with pseudoexfoliation (PXF). METHODS: A retrospective chart review and outcome analysis was performed on a series of eyes undergoing glue-assisted, scleral-fixated (scleral-glued) IOL insertion in the setting of PXF and poor or absent capsular support. RESULTS: In total, 28 eyes were included in the study. The indications for scleral-glued IOL fixation included late endocapsular IOL dislocation (21/28, 75%), exchange for iris-fixated IOL due to complication (4/28, 14%), subluxed crystalline lens (2/28, 7%), and aphakia after complicated cataract surgery (1/28, 4%). In total, 15/28 (54%) eyes had diagnosed preexisting glaucoma at the time of scleral-glued surgery. The most common postoperative complication was ocular hypertension requiring escalation of medical management, which occurred in 8/28 (29%) eyes. At final follow-up, corrected distance visual acuity was equivalent to or improved from preoperative measurements in 25/28 (89%) eyes. CONCLUSIONS: The scleral-glued surgery is a good option for fixating an IOL in eyes with PXF and poor zonular integrity or absent capsular support. Special attention should be placed on intraocular pressure control following surgery, which can be less predictable in PXF eyes with or without preexisting glaucoma.
Assuntos
Síndrome de Exfoliação/complicações , Pressão Intraocular/fisiologia , Implante de Lente Intraocular/métodos , Lentes Intraoculares , Esclera/efeitos dos fármacos , Adesivos Teciduais/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Síndrome de Exfoliação/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Tonometria Ocular , Resultado do Tratamento , Acuidade Visual/fisiologiaRESUMO
PURPOSE: To describe the outcomes of concurrent Ozurdex implantation during anterior segment surgery in patients with chronic recurrent uveitis. METHODS: Retrospective chart review. Data recorded from preoperative and 1-, 3-, and 6-month postoperative visits included visual acuity, intraocular pressure (IOP), medications, and clinical examination findings of inflammation. RESULTS: Twelve patients (12 eyes) with chronic, recurrent noninfectious uveitis undergoing cataract extraction (n=9) or intraocular lens (IOL) explantation (n=3) were included. Mean duration of follow-up after Ozurdex implantation was 12.9 months. There was a significant reduction (n=10, P=0.02) in the average number of inflammation recurrences 6 months before surgery compared to 6 months after surgery with Ozurdex in affected eyes. IOP remained stable in the postoperative period. One patient undergoing anterior chamber IOL (ACIOL) explantation experienced migration of Ozurdex into the anterior chamber resulting in corneal edema that resolved after 1 month. CONCLUSIONS: Ozurdex safely and effectively controlled postoperative inflammation in eyes with chronic recurrent uveitis when concurrently implanted during anterior segment surgery in our patients. Caution should be exercised in cases of IOL explantation, as Ozurdex use is now contraindicated in eyes with posterior capsule rupture and ACIOLs.
Assuntos
Câmara Anterior/cirurgia , Dexametasona/administração & dosagem , Glucocorticoides/administração & dosagem , Injeções Intravítreas/métodos , Implante de Lente Intraocular/métodos , Uveíte/terapia , Adulto , Extração de Catarata/métodos , Doença Crônica , Implantes de Medicamento , Feminino , Humanos , Pressão Intraocular/fisiologia , Lentes Intraoculares , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Recidiva , Estudos Retrospectivos , Resultado do Tratamento , Uveíte/tratamento farmacológico , Uveíte/fisiopatologia , Uveíte/cirurgia , Acuidade Visual/efeitos dos fármacosRESUMO
We report a case of an orbital hemangiopericytoma (HPC) in a female infant diagnosed at 7 weeks of age. Cytogenetic analysis of the tumor revealed trisomy 15. To the authors' knowledge, this is only the second reported case of this chromosomal aberration being associated with HPC, both cases occurring in infants.
Assuntos
Cromossomos Humanos Par 15/genética , Hemangiopericitoma/genética , Neoplasias Orbitárias/genética , Trissomia/genética , Feminino , Idade Gestacional , Hemangiopericitoma/patologia , Hemangiopericitoma/cirurgia , Humanos , Lactente , Imageamento por Ressonância Magnética , Procedimentos Cirúrgicos Oftalmológicos , Neoplasias Orbitárias/patologia , Neoplasias Orbitárias/cirurgia , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: To evaluate the use of TNF-alpha inhibitors for non-infectious, non-necrotizing scleritis. METHODS: We conducted a retrospective chart review of patients with non-infectious, non-necrotizing scleritis treated at our institutions from 2002 to 2012. RESULTS: Seventeen patients (26 eyes) were included. Ten patients were started on infliximab and seven on adalimumab; five patients were treated with both TNF-alpha inhibitors on separate occasions. All patients had an associated autoimmune disease. Control of active inflammation for at least 2 months was achieved in 15 (88%) of 17 patients. Seven out of eight patients successfully tapered concurrent corticosteroid use. Only one patient discontinued TNF-alpha inhibitor use due to an allergic reaction. CONCLUSIONS: TNF-alpha inhibitors appear to have a role in managing non-infectious, non-necrotizing scleritis refractory to initial therapy, mainly by reducing inflammation and decreasing concurrent CS use.