We report a case of a patient with necrotizing infection of the conjunctiva and Tenon's capsule caused by , a rare and atypical ophthalmologic condition. A 50-years-old male patient with acute red-eye, purulent discharge, and pain diagnosed with post-septal cellulitis presented with a yellowish and dense membrane covering the ocular surface with necrotic Tenon's capsule. Patient was hospitalized, and intravenous antibiotics were initiated (ceftriaxone and clindamycin).
View Article and Find Full Text PDFCoronaviruses gained public attention during the severe acute respiratory syndrome (SARS) outbreak in East Asia in 2003 and spread of Middle Eastern respiratory syndrome (MERS) in 2012. Direct human-to-human contact and droplet are the main methods of transmission. Viral stability in aerosols on different surfaces supports evidence on indirect viral acquisition from fomites through the mucous membranes of the mouth, nose, and eyes.
View Article and Find Full Text PDFPurpose: To compare VA outcomes in patients with advanced keratoconus wearing SCL or after ICRS or DALK. In addition, determine the percentage of complimentary treatments after ICRS and DALK, and which of these was fitting a SCL, and final visual acuity (f-VA) results.
Methods: Retrospective case series analyzed 55 eyes with advanced keratoconus fitted with SCL, or after ICRS or a DALK between 2010 and 2018.
Purpose: To determine visual field findings in Boston type 1-KPro (BI-KPro) patients without glaucoma. Characterize normal threshold values and global indices using standard automated perimetry and characterize visual field amplitude using Goldmann's manual perimetry.
Methods: This cross-sectional prospective noninterventional study included patients (n=6 patients, 6 eyes) with BI-KPro who had normal optical coherence tomography and fundoscopic evaluation of the optic disc and retina.
Purpose: To investigate if a stress event can influence intraocular pressure (IOP) in a group of healthy individuals.
Design: Case-control study.
Participants: A total of 28 healthy subjects were included: 17 in the stress group and 11 in the control group.
Purpose: To present an alternative technique (Pachy-DSEK) for the manual preparation of thin endothelial lamellae in Descemet stripping endothelial keratoplasty (DSEK), as well as to evaluate its visual and anatomic outcomes.
Methods: A retrospective chart review was conducted in 15 cases who underwent DSEK at a private eye clinic in Brazil (INOB, Brasília) from June 2017 to December 2019. All patients had ocular comorbidities and relative contraindications to Descemet membrane endothelial keratoplasty (DMEK).
Objective: To compare the thickness of corneal layers, specifically the Descemet's membrane (DM), in normal corneas and in failed grafts due to rejection (FGRs) using the digital histopathology and to propose a model for the measurement of corneal layers using this method.
Methods: This is a prospective, cross-sectional study performed at the MUHC-McGill University Ocular Pathology & Translational Research Laboratory (McGill University, Montreal, Canada). Histopathological sections of 25 normal human corneas and 40 FGRs were fully digitalized and examined.
Purpose: To compare the outcomes of intracorneal ring segments (ICRS) implantation in keratoconic eyes with a similar tomographic pattern, using two different manufacturers' nomograms for surgical planning.
Methods: ICRS were implanted alternately in patients with the same tomographic pattern of keratoconus divided into two groups according to the surgical planning proposed by the ICRS manufacturers (Keraring, Mediphacos, Belo Horizonte, Brazil, and Ferrara Ring, AJL Ophthalmics, Vitoria, Spain). Visual, refractive, keratometric, corneal aberrometry, and optical quality changes were evaluated during a 6-month follow-up.
Aim: To compare the functional and anatomic results of femtosecond laser (FSL)-assisted deep anterior lamellar keratoplasty (DALK) associated with phototherapeutic keratectomy (PTK) and FSL-assisted DALK performed using the big-bubble technique in keratoconus.
Methods: During the first phase of the study, an electron microscopy histopathology pilot study was conducted that included four unsuitable donor corneas divided into two groups: in FSL group, FSL lamellar cuts were performed on two corneas and in FSL+PTK group, PTK was performed at the stromal beds of two corneas after FSL lamellar cuts were made. During the second phase of the study, a randomized clinical trial was conducted that included two treatment groups of patients with keratoconus: group 1 (=14 eyes) underwent FSL-assisted DALK associated with PTK and group 2 (=12 eyes) underwent FSL-assisted DALK associated with the big-bubble technique.
Purpose: To report the outcomes of implantation of the Boston Type I keratoprosthesis in three patients with Acanthamoeba keratitis (AK), a severe infection that can lead to significant visual loss.
Observations: Case series reporting three patients with difficult cases of AK that needed multiple corneal transplantations and glaucoma surgeries. All patients were implanted with the Boston Type I keratoprosthesis device.
Objectives:: To describe the indications for and visual outcomes of intrastromal corneal ring segment implantation.
Methods:: A large retrospective case-series chart-review study was conducted using Sorocaba Ophthalmological Hospital medical records. This study included 1222 eyes (1196 patients) that were surgically treated between November 2009 and December 2012.
Purpose: To compare the visual outcomes of Descemet membrane (DM)-on and DM-off after deep anterior lamellar keratoplasty (DALK) using the big-bubble (BB) technique in keratoconus patients.
Methods: In this prospective trial, keratoconic eyes undergoing DALK procedures with the BB technique were randomized into 2 groups: a donor cornea without DM (group 1; 29 eyes) or with DM (group 2; 30 eyes). These groups were compared with respect to best-corrected visual acuity and contrast sensitivity while wearing gas permeable contact lenses and also endothelial cell counts.
Purpose: The aim of this study was to compare the use of multilayer amniotic membrane transplantation (AMT) with lamellar corneal transplantation (LCT) and lamellar scleral transplantation (LST) for the treatment of scleral thinning after pterygium surgery associated with beta therapy.
Methods: Twenty-six eyes from 26 different patients with scleral thinning as a consequence of beta therapy after pterygium surgery were evaluated at the Federal University of São Paulo, Brazil. Ophthalmologic examination and ultrasound biomicroscopy were performed to assess scleral thinning before the transplant surgery and then repeated at 30, 90, and 180 days after surgery.
Objective: To report the experience of the Federal University of São Paulo, Brazil, in performing Boston keratoprosthesis type 1 implantation in the developing world.
Methods: We analyzed 30 eyes of 30 patients who underwent Boston type 1 keratoprosthesis surgery between 2008 and 2012 in a prospective interventional study. Preoperative, perioperative, and postoperative parameters were analyzed, including visual acuity (VA), keratoprosthesis stability, and postoperative complications.
Purpose: To report the outcomes of Boston type I keratoprosthesis (BKPro) in the management of ocular burn injuries.
Methods: This was a prospective study including all cases of BKPro implantation for ocular burns at the External Diseases and Cornea Service of the Federal University of São Paulo, between February 2008 and February 2010. Ten patients (10 eyes) were enrolled.
Purpose: To evaluate the efficacy of a prophylactic regimen of daily topical 0.5% moxifloxacin and 5% povidone-iodine (PI) in patients with Boston type I keratoprosthesis (KPro) and to assess the applicability of a novel molecular diagnostic technique to analyze the ocular surface microbiota in these patients.
Methods: Ten patients had their inferior conjunctival fornix sampled for standard culture methods before the addition of topical 5% PI to the prophylactic regimen and were considered the control group (group 1).
Purpose: To evaluate different methods of oxacillin susceptibility testing of ocular isolates, considering polymerase chain reaction (PCR) as the 'gold standard', and to compare the in vitro susceptibility to oxacillin with that of other antimicrobials used in ophthalmologic practice.
Methods: The Vitek gram-positive identification card was used to identify ocular coagulase negative Staphylococcus species. The presence of the mecA gene was determined by the polymerase chain reaction assay with a combination of two primer sets (mecA and 16S rRNA) in a single region.
Purpose: Refractive and visual analysis in corneal transplantations performed for keratoconus by two groups of surgeons.
Methods: Seventy eyes of seventy patients, which had been submitted to penetrating keratoplasty (PK) for keratoconus, were examined and their charts were reviewed retrospectively for long-term results after all sutures had been removed. The patients were divided into two groups, Group I had surgery performed by skillful surgeons and Group II by surgeons in training.
Purpose: To compare the outcomes of two surgical techniques of penetrating keratoplasty with different surgical time, regarding the crystalline and the intraocular lens.
Methods: This retrospective study included 37 patients' eyes divided into 2 groups: extracapsular cataract extraction, posterior chamber intraocular lens implantation and penetrating keratoplasty (Group 1, G1) and transscleral fixation of posterior chamber lens and penetrating keratoplasty (Group 2, G2). The following parameters were recorded: visual acuity, intraocular pressure, refractive astigmatism, complication and keratometric astigmatism.
Purpose: To determine the prevalence of conjunctivochalasis in patients with immune thyroid diseases, to determine whether there is any association between the 2 diseases, and to determine cytologic study of conjunctivochalasis through the cytology impression test.
Methods: A clinical prospective cohort study carried out by the External Diseases Department in the Ophthalmology Sector and the Thyroid Department in the Endocrinology Sector at Federal University of Sao Paulo (UNIFESP). The patients included were divided into 2 groups following these inclusion criteria: a control group of 25 patients without thyroid diseases, confirmed after clinical and laboratory examinations (thyroid hormones), or any other ocular diseases.
A 64-year-old woman with a diagnosis of rheumatoid arthritis developed painless bilateral episcleral rheumatoid nodules without any flare-up of her associated disease. Biopsy of the lesions disclosed a lymphocytic and plasmacytic infiltration within the conjunctiva, overlying palisading granulomas with multinucleated giant cells, and central necrobiotic degeneration of the collagen of the episclera and superficial sclera. The rheumatologic designation for the development of groups of nodules in inactive rheumatoid arthritis is rheumatoid nodulosis.
View Article and Find Full Text PDFPurpose: To evaluate the surgical outcome of preserved amniotic membrane transplantation (AMT) for ocular surface reconstruction in chemical burn with limbal stem cell deficiency.
Design: Prospective, noncomparative, interventional case series.
Participants: Twenty eyes of 20 consecutive patients with limbal stem cell deficiency secondary to ocular chemical injury.