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1.
J Cataract Refract Surg ; 26(12): 1722-8, 2000 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-11134870

RESUMEN

PURPOSE: To compare the refractive results of laser astigmatic treatment in eyes in which the astigmatic axes of the eye and laser are aligned by limbal marking at the 6 o'clock position and in eyes that are not marked. SETTING: University Hospital and Clinics, Madison, Wisconsin, USA. METHODS: This retrospective study comprised 143 eyes that had photoastigmatic refractive keratectomy with the VISX Star excimer laser. The eyes were divided into marked (G1) and unmarked (G2) groups. Based on the preoperative astigmatism, each group was subdivided into low astigmatism (/=1.25 D). Early postoperative manifest refractions (1.0 to 2.5 months) were analyzed. The Alpins vector analysis method was used to calculate the target induced astigmatism, surgically induced astigmatism, difference vector (DV), magnitude of error (ME), angle of error (AE), and index of success (IS). RESULTS: There was no significant difference between the groups in DV, ME, and IS. When the subgroups were analyzed, the DV and ME were comparable; the IS in the G1 high astigmatism subgroup was significantly better than that in the G2 high astigmatism subgroup (0.22 +/- 0.08 and 0.29 +/- 0.04, respectively; P <.0001). There was comparable scatter of AE values; 30% and 36% in G1 and G2, respectively, had an AE of 0. Similar scatter was observed in the subgroups. Of the eyes that had an AE of 0, 90% and 43% in the high astigmatism subgroups of G1 and G2, respectively (P <.05), had full correction of astigmatism. CONCLUSION: Limbal marking and subsequent eye and laser astigmatic axis alignment improved the refractive outcome of laser astigmatic treatment of >/=1.25 D. A preliminary report of an ongoing prospective randomized study of eyes that had laser in situ keratomileusis is included.


Asunto(s)
Astigmatismo/cirugía , Córnea/anatomía & histología , Queratectomía Fotorrefractiva , Adulto , Córnea/cirugía , Humanos , Láseres de Excímeros , Persona de Mediana Edad , Miopía/cirugía , Queratectomía Fotorrefractiva/métodos , Refracción Ocular , Estudios Retrospectivos , Resultado del Tratamiento
5.
Arch Ophthalmol ; 105(9): 1248-52, 1987 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-3307723

RESUMEN

Recessive epidermolysis bullosa dystrophica (REBD), a bullous disorder of the skin and mucous membranes, is frequently associated with ocular complications. A 40-year-old woman presented with lid ulcerations, chronic conjunctivitis, diffuse subepithelial corneal scarring, corneal ulceration, and cataracts. Management with intensive lubricant therapy, soft-bandage contact lenses, and cataract extraction successfully restored her sight. Histologic examination via light and electron microscopy revealed blister formation and scarring beneath the epithelial basement membrane of both the skin and cornea, confirming the diagnosis of REBD. The ultrastructure of the skin and cornea and the ocular complications of the major forms of epidermolysis are described herein. To our knowledge, successful ocular management of a confirmed case of REBD with complete ocular histopathologic features has not been documented.


Asunto(s)
Epidermólisis Ampollosa/patología , Genes Recesivos , Adulto , Catarata/complicaciones , Extracción de Catarata , Córnea/patología , Córnea/ultraestructura , Trasplante de Córnea , Epidermólisis Ampollosa/clasificación , Epidermólisis Ampollosa/complicaciones , Epidermólisis Ampollosa/genética , Femenino , Humanos , Microscopía Electrónica , Piel/patología , Piel/ultraestructura
7.
Ophthalmology ; 90(1): 34-7, 1983 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-6338436

RESUMEN

The clinical outcome and final visual acuities of 29 patients with intracapsular lens extraction and keratoplasty to 38 patients having extracapsular cataract extraction and keratoplasty were compared. Grafts remained clear in 89% of the intracapsular group and 82% of the extracapsular group over an average follow-up of 38 months and 21 months, respectively. Ninety-one percent of eyes with intracapsular lens extraction and 70% of eyes in the extracapsular group achieved a final visual acuity of 6/21 (20/70) or better. We found a significantly higher incidence of additional surgery in the extracapsular group and glaucoma in intracapsular combined cases. Late vitreous prolapse with vitreo-endothelial membrane formation and graft decompensation was a discouraging complication in three eyes having intracapsular extractions.


Asunto(s)
Extracción de Catarata/métodos , Enfermedades de la Córnea/cirugía , Trasplante de Córnea , Cristalino/cirugía , Adulto , Anciano , Femenino , Estudios de Seguimiento , Supervivencia de Injerto , Humanos , Presión Intraocular , Cápsula del Cristalino/cirugía , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Factores de Tiempo , Agudeza Visual
9.
Ophthalmology ; 88(1): 46-9, 1981 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-7017532

RESUMEN

We examined the graft clarity and clinical outcome of 130 patients undergoing penetrating keratoplasty with donor preservation in either McCarey-Kaufman (MK) medium or moist chamber. We found comparable results with both methods of preservation in our two best prognostic groups. We feel MK medium is an excellent alternative to moist chamber preservation when used within 48 hours after the donor's death.


Asunto(s)
Córnea , Conservación de Tejido/métodos , Adulto , Anciano , Trasplante de Córnea , Medios de Cultivo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Trasplante Homólogo
11.
Am J Ophthalmol ; 89(5): 744-5, 1980 May.
Artículo en Inglés | MEDLINE | ID: mdl-6990769

RESUMEN

We designed two new instruments to facilitate the handling and cutting of donor corneal buttons: 12-mm media forceps and a varible curved Teflon block with centering targets.


Asunto(s)
Trasplante de Córnea , Instrumentos Quirúrgicos , Córnea/cirugía , Humanos , Trasplante Homólogo
12.
Ophthalmic Surg ; 11(5): 330-2, 1980 May.
Artículo en Inglés | MEDLINE | ID: mdl-6992017

RESUMEN

Forty patients with aphakic bullous keratopathy undergoing combined penetrating keratoplasty and anterior vitrectomy using mechanical vitreous instruments were studied for a mean length of 36 months. Seventy percent of the grafts remained clear and thirty percent failed during the follow-up period. Fifty-three percent of those with clear grafts (15/28) obtained a visual acuity of 20/70 or better. In comparison to older methods of anterior vitrectomy, we have found that removal of vitreous with mechanical vitreous instruments offers more effective removal of solid and liquid vitreous, decreased surgical time, and decreased retinal traction. Further, it is easy to learn to use and handle these instruments.


Asunto(s)
Enfermedades de la Córnea/cirugía , Trasplante de Córnea , Cuerpo Vítreo/cirugía , Rechazo de Injerto , Supervivencia de Injerto , Humanos , Oftalmología/instrumentación , Trasplante Homólogo , Agudeza Visual
13.
Am J Ophthalmol ; 87(4): 497-502, 1979 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-375739

RESUMEN

Nineteen patients with aniridia and one patient with bilateral iris colobomata from eight families were examined for corneal abnormalities. Thirty-six eyes revealed changes that are consistent with a progressive corneal dystrophy. These changes begin in the corneal periphery in the early years of life and progress to the corneal center with increasing age. This dystrophy has been staged into four typical clinical patterns. Central corneal scarring, and in some cases, ulceration may occur, which may be a significant threat to vision.


Asunto(s)
Coloboma/complicaciones , Distrofias Hereditarias de la Córnea/complicaciones , Iris/anomalías , Adolescente , Adulto , Catarata/complicaciones , Niño , Preescolar , Coloboma/genética , Distrofias Hereditarias de la Córnea/diagnóstico , Trasplante de Córnea , Femenino , Fluoresceínas , Humanos , Lactante , Presión Intraocular , Queratitis/complicaciones , Masculino , Linaje
14.
Am J Ophthalmol ; 85(5 Pt 1): 651-5, 1978 May.
Artículo en Inglés | MEDLINE | ID: mdl-655244

RESUMEN

Twenty-six of 75 eyes undergoing pars plana vitrectomy developed significant corneal complications requiring treatment. Slow or nonhealing epithelial abrasions, recurrent corneal erosion, and microcystoid and striate keratitis were among the most frequent problems. Significant predisposing factors included diabetes, surgical trauma such as epithelial debridement and prolonged operative time, aphakia, and postoperative glaucoma or hyphema. Corneal complications may be minimized with careful preoperative and operative precautions.


Asunto(s)
Enfermedades de la Córnea/etiología , Complicaciones Posoperatorias , Cuerpo Vítreo/cirugía , Adulto , Úlcera de la Córnea/etiología , Humanos , Queratitis/etiología , Persona de Mediana Edad , Cuidados Posoperatorios , Complicaciones Posoperatorias/prevención & control
15.
Invest Ophthalmol ; 15(1): 32-4, 1976 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-173668

RESUMEN

This study reviewed the potential for survival of a pathogenic bacteria when inoculated into McCarey-Kaufman modified tissue culture media 199. A clinically isolated specimen of Staphylococcus aureus was selected and rabbit eyes inoculated with 0.1 ml. of the organism in a suspension of 1 to 3 x 10(-5). Upon enucleation 12 hours later no clinical signs of infection were noted. Limbal-conjunctival cultures were obtained on all eyes before and after application of the antibiotic. Corneas were stored in M-K media with standard penicillin-streptomycin added and cultured up to 48 hours. Our studies showed some recovery of the infecting organism from the media with topical antibiotic application but none following complete immersion of eyes in antibiotic. Direct cultures from corneal buttons taken 48 to 72 hours after antibiotic application by either method showed 1 to 3 colonies per plate in 25 per cent of eyes. In this study improperly applied antibiotic allowed some survival of S. aureus in the media.


Asunto(s)
Córnea/microbiología , Medios de Cultivo , Staphylococcus aureus/crecimiento & desarrollo , Conservación de Tejido , Animales , Neomicina/administración & dosificación , Neomicina/farmacología , Polimixinas/administración & dosificación , Polimixinas/farmacología , Conejos , Staphylococcus aureus/efectos de los fármacos
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