RESUMEN
PURPOSE/METHOD: We studied a case of acute retinal necrosis in which a 30-year delay occurred between involvement of the first and fellow eyes. After systemic treatment with acyclovir and prednisolone, the fellow eye developed a retinal detachment requiring vitrectomy and silicone oil tamponade. RESULTS/CONCLUSION: The fellow eye retained a useful Snellen acuity of 20/120. In a patient who has had acute retinal necrosis, any symptoms or signs in the fellow eye, even several decades later, should alert the examining physician to the possibility of delayed involvement of the fellow eye.
Asunto(s)
Síndrome de Necrosis Retiniana Aguda/complicaciones , Aciclovir/uso terapéutico , Infecciones Virales del Ojo/complicaciones , Infecciones Virales del Ojo/tratamiento farmacológico , Enfermedades de los Párpados/complicaciones , Enfermedades de los Párpados/tratamiento farmacológico , Enfermedades de los Párpados/virología , Femenino , Herpes Simple/complicaciones , Herpes Simple/tratamiento farmacológico , Humanos , Persona de Mediana Edad , Prednisolona/uso terapéutico , Desprendimiento de Retina/etiología , Desprendimiento de Retina/cirugía , Síndrome de Necrosis Retiniana Aguda/tratamiento farmacológico , Aceites de Silicona , Factores de Tiempo , Agudeza Visual , VitrectomíaRESUMEN
A prospective, randomised double-masked study was undertaken to compare the effect of pretreatment with acetazolamide or placebo on the immediate intraocular pressure (IOP) rise following argon laser trabeculoplasty. One hundred eyes (100 patients) underwent 180 degree of laser treatment with a mean of 59 spots of 50 microns size and 800 to 1000 mW power. The IOP was measured during the first three hours after laser treatment, at 24 hours, and at two months. Forty-six patients (92%) in the placebo group had an immediate rise of IOP. The mean rise (SD) for these patients was 8.6 (7.1) mmHg. Fifteen patients (30%) in this group had an IOP rise of greater than 10 mmHg. Nine patients (18%) receiving acetazolamide had an immediate rise of IOP. The mean rise for these patients was 4.3 (3.1) mmHg, and no patient had an increase in IOP of greater than 8 mmHg. Acetazolamide appears to be effective in preventing a critical IOP rise after argon laser trabeculoplasty (p less than 0.0001).
Asunto(s)
Acetazolamida/uso terapéutico , Presión Intraocular/efectos de los fármacos , Terapia por Láser , Complicaciones Posoperatorias/prevención & control , Trabeculectomía , Anciano , Ensayos Clínicos como Asunto , Método Doble Ciego , Femenino , Humanos , Masculino , Premedicación , Estudios Prospectivos , Distribución AleatoriaRESUMEN
This case report highlights the successful management, by vitrectomy alone, of a case of chronic phacolytic glaucoma secondary to a dislocated hypermature lens in the vitreous of a patient with ectopia lentis et pupillae (ELP). The features and complications of ELP are discussed.
Asunto(s)
Desplazamiento del Cristalino/complicaciones , Glaucoma de Ángulo Abierto/complicaciones , Vitrectomía , Antagonistas Adrenérgicos beta/uso terapéutico , Terapia Combinada , Desplazamiento del Cristalino/cirugía , Glaucoma de Ángulo Abierto/tratamiento farmacológico , Glaucoma de Ángulo Abierto/cirugía , Humanos , Latanoprost , Masculino , Persona de Mediana Edad , Prostaglandinas F Sintéticas/uso terapéutico , Timolol/uso terapéuticoRESUMEN
The correction of paediatric traumatic aphakia remains a controversial topic. This study examines retrospectively the visual outcome in 32 children with uniocular traumatic cataracts. Fifteen received intraocular lens implants following lensectomy, and 17 received aphakic contact lenses. Age range was 2-14 1/2 years at the time of injury. The maximum follow-up time was 13 years. Twenty-four children obtained a good visual result (6/5 to 6/18). These were equally divided between those receiving intraocular lens implants and those with contact lenses. Factors adversely affecting visual outcome are discussed. These include complex trauma, delay in referral for lensectomy, inadequate postoperative correction of aphakia, contact lens difficulties and problems with occlusion therapy. Although aphakic correction with intraocular lens implants may require several subsequent surgical procedures such as capsulotomy, we advise early lensectomy and intraocular lens implantation where possible, particularly in young children with traumatic cataracts. This eliminates contact-lens-associated problems and maximises the chance of good visual outcome and retention of stereoscopic vision.