Heidelberg retina tomograph II findings of Acanthamoeba keratitis.

PURPOSE: Heidelberg retina tomograph II (HRTII) examination was performed with cornea module in one patient with Acanthamoeba keratitis (AK) to provide images detailing characteristic findings of the disease. METHODS: A 34-year-old woman presented with clinical signs and symptoms of AK. HRTII with cornea module was performed and the patient underwent laboratory investigations. RESULTS: HRTII examination with cornea module revealed numerous 20-26-micro m diameter high-contrast round particles within the corneal epithelium and anterior stroma, resembling Acanthamoeba cysts. Stellate cells as well as ovoid irregular objects, possibly inflammatory cells, trophozoites, altered cysts, or activated keratocytes, were also present in the area of stromal infiltrates. Laboratory investigations confirmed the diagnosis of AK. CONCLUSIONS: HRTII cornea module can be helpful in the diagnosis of AK by identifying acanthamoeba cyst-like structures in the cornea. This technique also has potential uses in monitoring the efficiency of anti-infective treatment.

Retinal detachment after phacoemulsification: a study of 114 cases.

PURPOSE: To analyze the features of retinal detachment (RD) occurring after cataract surgery performed by Kelman phacoemulsification (KPE) and to identify any potential correlations between KPE intraoperative complications and the features of RD (incidence apart) as well as the final visual outcome. DESIGN: Interventional consecutive case series. METHODS: Retrospective review of 114 eyes of 114 consecutive patients with RD occurring after KPE and followed for 6 months or more after surgery. RESULTS: Removal of posteriorly dislocated lens fragments during KPE by pars plana vitrectomy (PPV) was associated with a significantly shorter time interval between KPE and RD (3.89 vs. 15.7 months, P =.0044). Once RD occurred, no other statistically significant correlation between its features or the final visual outcome and KPE intraoperative complications (posterior capsular rupture, vitreous loss, posteriorly dislocated lens fragments) was detected. The overall anatomic reattachment rate was 94%. Only redetachment associated with the development of proliferative vitreoretinopathy (PVR) was significantly correlated with ultimate anatomic failure (P =.0036). A best-corrected visual acuity of 20/60 or better was achieved in 58 out of 114 eyes (51%). Three variables were independently correlated with visual results: more extensive RD (P =.0001), redetachment associated with the development of PVR (P =.0029), and failure to identify retinal breaks (P =.0114). CONCLUSIONS: Posterior capsular rupture and vitreous loss during KPE do not seem to affect the features (incidence apart) or the final visual outcome of RD occurring afterwards, except for a shorter time interval between KPE and RD in eyes that underwent PPV to remove posteriorly dislocated lens fragments.