Queratitis por Fusarium multirresistente / Multidrug resistant Fusarium keratitis

CASO CLÍNICO: Se presenta un caso de queratitis en una usuaria de lentes de contacto que desarrolló un absceso corneal profundo. En el cultivo de la biopsia corneal creció Fusarium solani multirresistente. La paciente empeoró progresivamente a pesar del tratamiento antifúngico local y sistémico y finalmente hubo que realizar una enucleación. CONCLUSIÓN: La queratitis por Fusarium puede progresar a una endoftalmitis con graves consecuencias. Es importante la sospecha diagnóstica para iniciar el tratamiento sin demora. El tratamiento es complejo dada la elevada resistencia de este hongo a los antifúngicos habituales

CASE REPORT: We report a case of keratitis in a female contact lens wearer, who developed a deep corneal abscess. The culture of a corneal biopsy scraping was positive for multiresistant Fusarium solani. The patient has a complicated clinical course and failed to respond to local and systemic antifungal treatment, requiring eye enucleation. CONCLUSION: Fusarium keratitis may progress to severe endophthalmitis. Clinical suspicion is paramount in order to start antifungal therapy without delay. Therapy is complex due to the high resistance of this organism to usual antifungal drugs

Multidrug resistant Fusarium keratitis.

CASE REPORT: We report a case of keratitis in a female contact lens wearer, who developed a deep corneal abscess. The culture of a corneal biopsy scraping was positive for multiresistant Fusarium solani. The patient has a complicated clinical course and failed to respond to local and systemic antifungal treatment, requiring eye enucleation. CONCLUSION: Fusarium keratitis may progress to severe endophthalmitis. Clinical suspicion is paramount in order to start antifungal therapy without delay. Therapy is complex due to the high resistance of this organism to usual antifungal drugs.

Mejorando la visualización del implante no absorbible T-Flux (R) para esclerectomía profunda. Técnica de tinción / Improving the visualization of non-absorbable T-Flux (R) implants in deep sclerectomy. Colouring technique

OBJETIVO: Describir una técnica de coloración que aumente la visualización del implante no absorbible T-Flux. MÉTODO: La técnica se emplea en el implante no absorbible T-Flux. Este se sumerge en una solución de fluoresceína sódica entre 5 y 10 min, posteriormente se retira y se seca con una hemosteta. DISCUSIÓN: Esta técnica fácil y sencilla que usa una solución común de fluoresceína nos permite aumentar el contraste en el campo quirúrgico entre este y el implante transparente empleado en la esclerectomía profunda. Esta técnica disminuye el riesgo de pérdida del implante

PURPOSE: To describe a staining technique that will enhance the visualization of non-absorbable T-Flux implants. METHODS: The technique was applied to non-absorbable T-Flux implants. The implants were submerged for 5 to 10 minutes in a sodium fluorescein solution, and dried with a sponge when removed from the solution. DISCUSSION: This is a very simple and easy procedure that uses a common fluorescein solution to enhance the contrast between the surgical field and a transparent implant used in deep sclerectomy. This colour technique will decrease the risk of loss of the implant in the surgical field

[Improving the visualization of non-absorbable T-Flux(®) implants in deep sclerectomy. Colouring technique]. / Mejorando la visualización del implante no absorbible T-Flux(®) para esclerectomía profunda. Técnica de tinción.

PURPOSE: To describe a staining technique that will enhance the visualization of non-absorbable T-Flux implants. METHODS: The technique was applied to non-absorbable T-Flux implants. The implants were submerged for 5 to 10 minutes in a sodium fluorescein solution, and dried with a sponge when removed from the solution. DISCUSSION: This is a very simple and easy procedure that uses a common fluorescein solution to enhance the contrast between the surgical field and a transparent implant used in deep sclerectomy. This colour technique will decrease the risk of loss of the implant in the surgical field.

[Retinal nerve fiber layer thickness analysis in children from 6 to 9 years of age]. / Análisis del espesor de la capa de fibras nerviosas en niños de 6 a 9 años.

PURPOSE: To establish a database of scanning laser polarimetry (GDx) parameters for children between 6 and 9 years of age and compare the results at each age. METHODS: The retinal nerve layer thickness of 116 children from one school was evaluated with GDx and the results were analyzed for each age and for the entire group to determinate the normal range for that population. RESULTS: In the global analysis of the software-derived GDx parameters, we obtained a TSNIT average of 59.43 (IC95% 58.41-60.45), a superior average of 71.35 (IC95% 69.99-72.70), an inferior average of 70.08 (IC95% 68.71-71.45), and a TSNIT Std. Deviation of 25.11 (IC95% 24.36-25.86). The results from the analysis for age were similar to the global results. CONCLUSIONS: Given the low level of cooperation required, GDx can be used without problem to study the retinal nerve fiber layer in 6-9-year-old children. GDx could provide objective information about the state of development of the retinal nerve fiber layer during this period of life.

Análisis del espesor de la capa de fibras nerviosas en niños de 6 a 9 años / Retinal nerve fiber layer thickness analysis in children from 6 to 9 years of age

Objetivo: Establecer una base de datos para el GDx-VCC representativa para nuestra población de entre 6 a 9 años y analizar los datos obtenidos por rango de edades. Método: Se analizó la densidad de la CFN mediante oftalmoscopía de barrido con láser (GDx) a 116 niños procedentes de un único colegio y los resultados fueron sometidos a estudio estadístico por edades y en global a fin de determinar el rango de valores considerable como la normalidad para esa población y las posibles diferencias entre ellos. Resultados: En el análisis global por cuadrantes de los datos estudiados por el GDx se encontró un promedio TSNIT de 59,43 (IC95% 58,41-60,45); superior de 71,35 (IC95% 69,99-72,70); inferior de 70,08 (IC95% 68,71-71,45) y una desviación estándar TSNIT de 25,11 (IC95% 24,36-25,86). En el análisis por edades se observan valores medios por cuadrantes comparables a los del global. Conclusiones: El estudio de la CFN mediante GDx se puede realizar sin problema en la población infantil de 6 a 9 años dada la mínima colaboración requerida, obteniendo así datos objetivos sobre su estado y desarrollo durante estas edades

Purpose: To establish a database of scanning laser polarimetry (GDx) parameters for children between 6 and 9 years of age and compare the results at each age. Methods: The retinal nerve layer thickness of 116 children from one school was evaluated with GDx and the results were analyzed for each age and for the entire group to determinate the normal range for that population. Results: In the global analysis of the software-derived GDx parameters, we obtained a TSNIT average of 59.43 (IC95% 58.41-60.45), a superior average of 71.35 (IC95% 69.99-72.70), an inferior average of 70.08 (IC95% 68.71-71.45), and a TSNIT Std. Deviation of 25.11 (IC95% 24.36-25.86). The results from the analysis for age were similar to the global results. Conclusions: Given the low level of cooperation required, GDx can be used without problem to study the retinal nerve fiber layer in 6-9-year-old children. GDx could provide objective information about the state of development of the retinal nerve fiber layer during this period of life

[Simultaneous botulism in two brothers addicted to cocaine]. / Botulismo simultáneo en dos hermanos cocainómanos.

INTRODUCTION: Botulism is currently an uncommon disease in which the botulinum toxin causes a progressive muscular paralysis that can lead to the death due to a failure of respiratory muscles. CLINICAL CASE: Two brothers, both addicted to cocaine, came to the casualty department because of a decrease of near visual acuity and bilateral mydriasis. Two days later, they developed eyelid ptosis, asymmetric dysfunction of the extraocular muscles and vomiting. DISCUSSION: The presence of a paralysis of accommodation, with bilateral mydriasis that reacts to pilocarpine, makes it necessary to consider botulism as a possible cause.

Botulismo simultáneo en dos hermanos cocainómanos / Simultaneous botulism in two brothers addicted to cocaine

Introducción: El botulismo es poco frecuente en la actualidad. La toxina botulínica produce una parálisis muscular progresiva que puede producir la muerte del paciente por parada de los músculos respiratorios. Caso clínico: Dos pacientes hermanos, adictos a la cocaína, acudieron al Servicio de Urgencias por disminución de la agudeza visual cercana, con midriasis bilateral. A los dos días presentaban, además, ptosis palpebral, disfunción asimétrica de la motilidad ocular extrínseca, y vómito. Discusión: Ante la presencia de una parálisis de la acomodación con una midriasis bilateral que responde a pilocarpina, se debe considerar el botulismo como una posible etiología

Introduction: Botulism is currently an uncommon disease in which the botulinum toxin causes a progressive muscular paralysis that can lead to the death due to a failure of respiratory muscles. Clinical case: Two brothers, both addicted to cocaine, came to the casualty department because of a decrease of near visual acuity and bilateral mydriasis. Two days later, they developed eyelid ptosis, asymmetric dysfunction of the extraocular muscles and vomiting. Discussion: The presence of a paralysis of accommodation, with bilateral mydriasis that reacts to pilocarpine, makes it necessary to consider botulism as a possible cause

Modificación de la flora conjuntival por el empleo de soluciones de higiene palpebral / Modification of the conjuntival flora with cleaning papebral solutions

Objetivo: El objetivo del presente trabajo consiste en valorar la efectividad de una solución de higiene palpebral en el preoperatorio de cirugía de cataratas así como las modificaciones en la flora conjuntival. Material y métodos: Estudiamos 286 pacientes divididos en 5 grupos. Un grupo control que no utilizó el producto y los 4 restantes que emplearon el producto durante 3, 4, 5 y 6 días respectivamente. El diseño del estudio fue prospectivo, randomizado y enmascarado. Se tomó una muestra de fondo de saco conjuntival en la mañana del día de la cirugía, previa a la instilación de colirios. Las muestras fueron sembradas y analizadas según las técnicas microbiológicas. Resultados: El tiempo óptimo de utilización de las soluciones de higiene palpebral en el preoperatorio de cirugía de cataratas es de 4 a 5 días. Si se usan menos de tres días no se reduce la tasa de cultivos positivos y si se aplican más de seis se aíslan microorganismos que no forman parte de la flora conjuntival habitual. Conclusión: En caso de utilizar productos de higiene palpebral no deben prolongarse más de cinco días consecutivos previo a la cirugía de cataratas(AU)

Objective: The aim of the present study is to evaluate the effectiveness of a solution of palpebral hygiene during the preoperative stageof cataract surgery. Materials and methods: We studied 286 patients divided in 5 groups. One control group that did not use the product, and the remaining 4, that used the product during 3, 4, 5 and 6 days. The design of the study was prospective, randomize and masked. We took a sample of the conjunctival fundus in the morning of the day of the surgery, before commencing treatment with eye drops. This sample was sown according to microbiological techniques and analyzed by the microbiology department. Results: The best time for using palpebral hygiene solutions prior to cataract surgery is four to five days. If it is used at less than three days, it does not decrease the rate of positive cultures and if the solution is applied more than six days, microorganisms that are not part of the common conjunctival flora may appear. Conclusions: Palpebral hygiene products should not be used more than five consecutive days previous to surgery(AU)

[Modification of the conjuntival flora with cleaning palpebral solutions]. / Modificación de la flora conjuntival por el empleo de soluciones de higiene palpebral.

OBJECTIVE: The aim of the present study is to evaluate the effectiveness of a solution of palpebral hygiene during the preoperative stage of cataract surgery. MATERIALS AND METHODS: We studied 286 patients divided in 5 groups. One control group that did not use the product, and the remaining 4, that used the product during 3, 4, 5 and 6 days. The design of the study was prospective, randomize and masked. We took a sample of the conjunctival fundus in the morning of the day of the surgery, before commencing treatment with eye drops. This sample was sown according to microbiological techniques and analyzed by the microbiology department. RESULTS: The best time for using palpebral hygiene solutions prior to cataract surgery is four to five days. If it is used at less than three days, it does not decrease the rate of positive cultures and if the solution is applied more than six days, microorganisms that are not part of the common conjunctival flora may appear. CONCLUSIONS: Palpebral hygiene products should not be used more than five consecutive days previous to surgery.