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1.
Ophthalmic Surg Lasers Imaging ; 37(6): 508-10, 2006.
Article in English | MEDLINE | ID: mdl-17152550

ABSTRACT

A technique for repair of traumatic iridodialysis that avoids the need for iris sutures is described. Following a limbal peritomy, sclerostomy sites level with the iris base are created at each clock hour of the iridodialysis using a microvitreoretinal blade. Vitreoretinal forceps passed through these ports are used to incarcerate the peripheral iris. No suture material is used to secure the iris. The conjunctiva is closed with absorbable sutures. The technique is suitable for use in simple iridodialysis repair and in conjunction with intraocular procedures.


Subject(s)
Eye Injuries/surgery , Iris/injuries , Sclerostomy/methods , Suture Techniques , Eye Injuries/pathology , Humans , Rupture , Treatment Outcome
2.
J Cataract Refract Surg ; 29(8): 1630-1, 2003 Aug.
Article in English | MEDLINE | ID: mdl-12954318

ABSTRACT

Extension of the capsulotomy into the periphery is a well-known complication of cataract surgery in young patients with intumescent cataracts. We report such a case successfully treated preoperatively with a neodymium:YAG laser anterior capsulotomy.


Subject(s)
Capsulorhexis/methods , Cataract/therapy , Intraoperative Complications/prevention & control , Laser Therapy/methods , Lens Capsule, Crystalline/surgery , Phacoemulsification/methods , Adult , Humans , Lens Capsule, Crystalline/injuries , Male , Preoperative Care
4.
Clin Exp Ophthalmol ; 33(2): 137-41, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15807820

ABSTRACT

BACKGROUND: Previous management of optic nerve sheath meningioma included conservative observation, surgery, radiosurgery and conventional radiotherapy. All carried significant risk, either of visual loss or damage to adjacent structures. Fractionated stereotactic radiotherapy appears to have few side-effects and may preserve or improve vision. To date only three groups have published their experience with this modality. METHODS: A retrospective review of patients with optic nerve sheath meningioma treated with stereotactic radiotherapy in an academic complex was conducted. Patients with greater than 18 months follow up and no previous related surgery were eligible for inclusion. Patients received an average of 43.5 Gy to the tumour in 26 fractions. Case records from the treating institutions as well as those of the referring ophthalmologist were analysed. The limited literature on the subject was reviewed in order to draw conclusions relevant to contemporary patient management. RESULTS: Four patients had undergone follow up for over 18 months. Prior to treatment all had exhibited progressive loss of visual function. In all cases visual function remained stable or improved at the last assessment. Side-effects included radiologically detected cerebral changes in one patient and transient hair loss in one patient. CONCLUSIONS: This treatment modality represents a promising refinement of previous treatment options. It may be offered to patients who demonstrate progressive loss of visual function caused by optic nerve sheath meningioma. It offers significant advantages over other currently available therapeutic options but its use should be tempered by the knowledge that long-term side-effects are yet to be determined.


Subject(s)
Meningioma/radiotherapy , Optic Nerve Neoplasms/radiotherapy , Stereotaxic Techniques , Adult , Dose Fractionation, Radiation , Female , Humans , Magnetic Resonance Imaging , Male , Meningioma/complications , Meningioma/pathology , Middle Aged , Optic Nerve Neoplasms/complications , Optic Nerve Neoplasms/pathology , Retrospective Studies , Vision Disorders/etiology , Visual Acuity , Visual Fields
5.
Clin Exp Ophthalmol ; 33(5): 461-8, 2005 Oct.
Article in English | MEDLINE | ID: mdl-16181269

ABSTRACT

BACKGROUND: Infliximab is a murine-human recombinant antitumour necrosis factor monoclonal antibody recently introduced for the treatment of autoimmune diseases in which tumour necrosis factor is thought to be a key mediator. Its role in the treatment of juvenile idiopathic arthritis-associated uveitis is as yet undefined. METHODS: Six children with juvenile idiopathic arthritis-associated uveitis, inadequately controlled on currently available therapy, were treated with infliximab between September 2002 and November 2004. All children were required to remain on low-dose immunomodulatory treatment in conjunction with the infliximab. A retrospective review of two electronic databases containing details of ophthalmology and rheumatology visits was conducted. RESULTS: In all six children, institution of infliximab therapy was associated with increased ease of management. Ocular inflammation and intraocular pressure control improved in all. It was also possible to reduce the dose or withdraw some glaucoma, steroid and other immunomodulatory drugs. Two children underwent intraocular surgery without noticeable flare of intraocular inflammation. No patient developed any serious systemic complications attributable to infliximab. CONCLUSION: Infliximab may be a useful adjunct to the management of refractory juvenile idiopathic arthritis-associated uveitis. In our series it was associated with improved uveitis control and simplification of drug use as well as possibly improving safety of surgical intervention. This study suggests that its role is likely to be in conjunction with maintenance immunomodulatory treatment to provide more optimal disease control. Controlled studies are required to confirm its efficacy and safety, and the potential breadth of its use in uveitis and related disorders.


Subject(s)
Antibodies, Monoclonal/therapeutic use , Arthritis, Juvenile/drug therapy , Uveitis/drug therapy , Adolescent , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Antibodies, Monoclonal/administration & dosage , Antirheumatic Agents/administration & dosage , Antirheumatic Agents/therapeutic use , Arthritis, Juvenile/complications , Arthritis, Juvenile/diagnosis , Child , Female , Humans , Infliximab , Infusions, Intravenous , Male , Tumor Necrosis Factor-alpha/immunology , Uveitis/diagnosis , Uveitis/etiology
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