ABSTRACT
The purpose of this case report is to describe a new surgical method for sutureless placement of the amniotic membrane with a symblepharon ring in a pediatric patient with acute toxic epidermal necrolysis (TEN). A 1-year-old girl developed severe ocular surface inflammation with large corneal and conjunctival epithelial defects secondary to TEN. She was treated by applying a large (4 cm x 4 cm) amniotic membrane graft and non-sterile symblepharon ring under sedoanalgesia at bedside in the intensive care unit. The ocular surface was completely epithelized by post-treatment week 6 in the right and week 8 in the left eye. Two years after amniotic membrane transplantation, both eyes were quiet with no symblepharon, scar formation, or limbal stem cell deficiency. Performing bilateral amniotic membrane transplantation under a symblepharon ring at bedside provided sufficient acute coverage of the ocular surface and led to excellent clinical outcomes by reducing inflammation and protecting the ocular surface.
Subject(s)
Amnion/transplantation , Conjunctival Diseases/surgery , Corneal Diseases/surgery , Stevens-Johnson Syndrome/surgery , Acute Disease , Conjunctival Diseases/physiopathology , Corneal Diseases/physiopathology , Epithelial Cells/physiology , Female , Humans , Infant , Stevens-Johnson Syndrome/physiopathology , Sutureless Surgical ProceduresABSTRACT
OBJECTIVES: In this case report, we present a patient with ocular tuberculosis presenting with progressive unilateral corneal melting. PATIENT: A 47-year-old female was admitted with melting at the inferior half of the peripheral cornea and inferior subconjunctival nodules. Biopsy material of the nodules was negative for tuberculosis bacillus. However, polymerase chain reaction of the biopsy sample revealed the DNA of the bacillus, and the diagnosis was confirmed. CONCLUSION: In endemic areas, ocular tuberculosis should be kept in mind in the differential diagnosis of patients with chronic and atypical corneal involvement.
ABSTRACT
PURPOSE: To evaluate the refractive and corneal topographical changes of overnight orthokeratology in myopia with two brands of contact lenses. METHODS: Fourty-four eyes of 22 myopic patients with manifest refraction spherical equivalent (MRSE) of -1.00 to -5.00 D (cylinder≤-1.0) were fitted with either DreamLens (Hanita Lenses Investments, Hanita, Israel) (group A) or Rinehart-Reeves (R&R; Danker Laboratories, Sarasota, FL) (group B) reverse-geometry lenses. Each subject eye was evaluated in regards to the uncorrected and corrected distance visual acuities, manifest refraction, slit lamp biomicroscopy, and corneal topography at each follow-up examination. RESULTS: The follow-up was 1 year. For groups A and B, the mean uncorrected distance visual acuity was -0.02±0.10 logMAR (20/20) and -0.08±0.12 logMAR (20/20) respectively at year-1 examination. The mean MRSE decreased from -2.70±0.9D to -0.50±0.08D in group A and -3.1±1.1 to -0.62±0.18D in group B at week-1; and remained stable thereafter in each group. For both groups, starting with week-1, the mean anterior best-fit sphere (ABFS) was statistically significantly flatter from baseline. A high correlation was found between the change in apical corneal power (ACP) and MRSE (r1=0.79, r2=0.71), and there was a good correlation between the change in ABFS and MRSE (r1=0.67, r2=0.64) in both groups. No significant ocular adverse events were observed during study. CONCLUSIONS: Both types of contact lenses safely and effectively decreased the myopic refractive error at 1 year follow-up. The refractive effect was mainly induced by the changes in the anterior corneal shape and the ACP.
Subject(s)
Contact Lenses , Myopia/diagnosis , Myopia/rehabilitation , Orthokeratologic Procedures/instrumentation , Orthokeratologic Procedures/methods , Visual Acuity , Adolescent , Adult , Equipment Failure Analysis , Female , Humans , Male , Prosthesis Design , Treatment Outcome , Young AdultABSTRACT
OBJECTIVES: We report three cases of corneal melanoma: two without conjunctival primary acquired melanosis or melanoma and one with a history of conjunctival melanoma. METHODS: Report of 3 cases with corneal melanoma and literature review. RESULTS: Medical records of three patients with the diagnosis of corneal melanoma were reviewed. Total excisional biopsy with corneal epitheliectomy using 20% ethanol was performed. Postoperative topical chemotherapy with 0.04% mitomycin-C was used for 4 weeks as adjunctive therapy. The follow-up ranged from 13 months to 7 years. Each of the two patients experienced two recurrences. One was treated in a fashion similar to that of the initial tumor, and the other was treated by enucleation. None of the patients developed regional or distant metastasis. CONCLUSIONS: Malignant melanoma can rarely occur on the cornea with no contiguous conjunctival component. Eye-conserving treatment should be attempted first. Recurrences may occur, and a close follow-up is necessary.
Subject(s)
Corneal Diseases/therapy , Eye Neoplasms/therapy , Melanoma/therapy , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Neoplasm Recurrence, Local , Treatment OutcomeABSTRACT
PURPOSE: To evaluate the results of ruthenium-106 (Ru-106) plaque radiotherapy alone (group A) or in combination with transpupillary thermotherapy (TTT) (group B) in the management of choroidal melanoma with tumor thickness (height) <8 mm. The tumors in each group were subclassified as those with thickness