Comparison of surgical outcomes of Carlevale sutureless scleral fixation and Artisan Aphakia intraocular lens.

PURPOSE: To compare intra- and postoperative results of sutureless scleral fixated Carlevale intraocular lens (IOL) with iris fixated Artisan IOL. METHODS: Monocentre, retrospective analysis of refractive outcomes and intra- and postoperative complications of patients who received a Carlevale or Artisan IOL between January 2019 and March 2022. RESULTS: 178 eyes of 169 patients were included (101 Carlevale and 77 Artisan IOLs). The standard follow-up time was 1 month. Two statistically significant differences were found: in the deviation of the postoperative spherical equivalent of the refraction from the preoperative chosen IOL target (p = 0.019; mean deviation was -0.46 in the Carlevale and 0.08 in the Artisan group), and the number of eyes with complications between the Carlevale and Artisan groups (p = 0.003; 33 in the Carlevale and 42 in the Artisan group). CONCLUSION: The current study is the largest so far comparing both refractive outcomes and complications after implantation of Carlevale and Artisan IOL. The Carlevale IOL does not carry a greater complication risk on the short-term follow-up. This provides additional evidence that the Carlevale IOL has to be added to the armamentarium of the ophthalmic surgeon.

Surgical treatment of congenital nasolacrimal duct obstructions in Italy.

AIM: The aim of this study to present the surgical treatments performed in Italy for congenital nasolacrimal duct obstruction. METHODS: This was a retrospective review of the Ministry of Health database for groups aged 0-1 and 1-4 years from 1999 through 2005. RESULTS: During the study period, a total of 9081 surgical procedures was performed on children 0-4 years of age, 2739 of which on infants under 1 year of age and 6342 on children 1-4 year-old; 8067 (88.8%) of these interventions were represented by nasolacrimal duct probing, 2556 of which in infants under one year of age and 5511 in the 1-4 year age group. Total number of the other surgical techniques was 984, 183 of which among infants younger than one year of age and 801 among children aged 1-4 years. The seven-year mean number of surgical treatments corresponds to a rate of 7.3/10000 live births for infants <1 year old and 4.3/10000 for children aged 1-4 years. CONCLUSION: When congenital nasolacrimal duct obstructions do not improve spontaneously, probing resulted the more common surgical treatment performed. Our data are related exclusively to infantile inpatients and cases managed on an office basis are not included. Consequently, our figures cannot be considered indicative of the incidence of this pathology in Italy. However, the mean number per 10000 of surgical procedures may represent, in our opinion, a useful indicator for the more severe forms of congenital lacrimal drainage system pathologies.

Resolution of juvenile idiopathic arthritis-associated uveitis after development of common variable immunodeficiency.

PURPOSE: To describe the occurrence of common variable immunodeficiency (CVID) in a patient with juvenile idiopathic arthritis (JIA) and JIA-associated uveitis. METHODS/RESULTS: Case report. A 29-year-old woman was followed-up since the age of 10 years because of right eye JIA-associated recurrent anterior uveitis. She was treated with steroids and immunosuppressants with good control of uveitis and arthritis. At the age of 17 years, she did not experience any further relapse of uveitis or arthritis and both diseases were considered to be in remission. Concomitantly, she started to have recurrent infections and later she underwent splenectomy because of autoimmune hemolytic anemia and thrombocytopenia. Liver biopsy disclosed granulomatous hepatitis. She was ultimately diagnosed with CVID at the age of 23 years when her blood tests revealed neutropenia and severe panhypogammaglobulinemia. She has been treated since then with intravenous immunoglobulins with good control of the disease. Since the development of CVID, she has had no relapses of uveitis or arthritis during a follow-up period of 12 years. CONCLUSIONS: Common variable immunodeficiency (CVID) is the most common primary immunodeficiency where defective antibody formation is the most common feature with B-cell differentiation failure. Ocular complications have been rarely documented and included bacterial conjunctivitis, retinal vasculitis and multifocal choroiditis. We herein report on the occurrence of JIA-associated uveitis as a comorbid manifestation of CVID. We speculate a role for B cells in the pathogenesis of JIA and JIA-associated uveitis here, as this patient had total remission of both conditions with the onset of CVID.

Optical coherence tomography and focal electroretinogram evaluation of cystoid macular edema secondary to retinitis pigmentosa treated with intravitreal triamcinolone: case report.

PURPOSE: To assess macular structure and function by optical coherence tomography (OCT) and focal electroretinogram (FERG) before and after intravitreal triamcinolone acetonide (IVTA) administration for cystoid macular edema (CME) in a patient with retinitis pigmentosa (RP). METHODS: A 33-year-old man with RP and refractory bilateral macular edema was treated with IVTA in his left eye and evaluated with visual acuity, OCT, and FERG for 6 months. RESULTS. Compared to the fellow eye, after IVTA mean retinal thickness significantly decreased, while FERG amplitude and phase did not show significant changes at the end of follow-up. Visual acuity showed a significant tendency to improve. CONCLUSIONS: In this case report, IVTA improved macular anatomy and visual acuity; this result, however, was not associated with a similar electrophysiologic response.

Cataracts associated with inborn errors of metabolism: a diagnostic aid.

Inborn errors of metabolism are a substantial field of medicine. Although genetic syndromes associated with cataracts are rare, they are important since early detection and effective treatment of visual handicaps is one of the most urgent duties of any practitioner and pediatrician. Cooperation among pediatricians, ophthalmologists, orthoptists and geneticists, as well as the institution of a high-risk registry for visual handicaps appears to be of paramount importance.

Epidemiology of ocular complications of childhood head trauma.

Head trauma is a frequent cause of childhood morbidity and mortality. We have studied 293 children aged zero to 18 years who suffered from head trauma, in order to assess the importance and frequency of ocular complications of head trauma. Very significant statistical differences show that children aged zero to 12 years are at risk for ocular complications more frequently than older children. The prompt diagnosis of ocular symptoms and signs and their differentiation can be of value in the early and correct diagnosis of head trauma, thus insuring effective treatment. These data emphasize the importance and prevention of head trauma in children. A pediatric victim of head trauma can surely benefit from the strict cooperation among emergency specialists, pediatricians, ophthalmologists, and neurologists.

Mental retardation and EEG abnormalities in Waardenburg's syndrome: two case reports (EEG anomalies in Waardenburg's syndrome).

Waardenburg's Syndrome (WS), a rare disorder inherited as an autosomal dominant trait with variable penetrance, is characterized by white forelock, eye-ear symptoms and signs, and dysmorphic features. The authors describe two cases of WS with mental retardation and developmental and EEG anomalies. Therefore they suggest to perform an EEG in all suspected cases of WS.

Familial juvenile nephronophthisis. A review and differential diagnosis.

Familial juvenile nephronophthisis (FJN) is a frequent cause of chronic renal failure in children and adolescents. Typically it presents after 6 years of age through adolescence, but may become apparent in early childhood. The clinical presentation is insidious, and the early symptoms of polyuria and polydipsia are often overlooked in the presence of a relatively normal urinalysis and in the absence of proteinuria, azotemia, and hypertension. Thus most patients are not diagnosed until after the onset of renal failure. These children are excellent candidates for properly selected transplantation.

Seven hereditary syndromes with pigmentary retinopathy. A review and differential diagnosis.

This article reviews several autosomal recessive syndromes characterized by pigmentary retinopathy and, in many, combined with deafness, hypogonadism, and/or mental retardation. These syndromes are manifested in infancy and childhood. Although no specific treatment is available, an early diagnosis can be the first step in initiating symptomative management and preventive measures for the patient and family.