[Recalcitrant cicatrizing conjunctivitis. Treatment of nine patients with rituximab].

Cicatrizing conjunctivitis is the final consequence of several diseases. The most severe among them are cicatricial pemphigoid and chronic Stevens-Johnson syndrome. Systemic immunosuppressive drugs and steroids are usually an effective approach to these diseases.

Peripheral Reconstructive Lamellar Keratoplasty for Late Ectasia After Penetrating Keratoplasty in Keratoconus Eyes.

Purpose: To describe outcomes of customized peripheral anterior lamellar keratoplasty (PALK) for late ectasia of the donor-recipient junction after penetrating keratoplasty (PK) for keratoconus.

Methods: This was a single-center, retrospective review of 33 eyes (28 patients) that developed ectasia restricted to the graft-host junction; 17 eyes underwent PALK using lamellar resections of 8- to 11-mm width starting at the external margin of the previous PK and suturing a same-size donor graft (annular or segmental). Five eyes were excluded from analysis because of postoperative complications unrelated to the technique.

[Anaphylaxis and allergic reactions during surgery and medical procedures].

Anaphylaxis during anesthesia is an unpredictable, severe, and rare reaction. It has an incidence of 1/10 000 to 1/20 000 surgeries. In most series, the responsible drugs include neuromuscular blocking agents, latex, or antibiotics.

Treatment of hereditary angioedema due to C1 inhibitor deficiency in Argentina.

The benefits of the worldwide approval of new drugs for the treatment of acute C1-INH-HAE attacks may still not reach all patients. Identifying the current barriers in the access to medication, as well as conducting a detailed assessment of the progress in this area, is essential to achieve universal treatment. Two hundred and twenty five patients registered in the Argentina Hereditary Angioedema Patient Association (AHAEPA) were randomly selected and invited to participate in a web based questionnaire on accessibility to icatibant and pdC1-INH, self-treatment, delay to treatment, and coverage.

[Allergy to drugs. Experience in 771 procedures].

Drug hypersensitivity reactions (RHD) are those that present clinically as allergic. They can or cannot involve an immunologic mechanism of lesion. They are frequent and, occasionally, life threatening.

[Rituximab and hypogammaglobulinemia].

Rituximab, a chimeric monoclonal antibody against CD20, induces the depletion of B lymphocytes. It is used for the treatment of lymphoproliferative and autoimmune diseases. Antibody immunodeficiency associated to RTX treatment is a new motif for consultation to our service.

Epidemiology of angioedema without wheals in an allergy and immunology center.

We describe the diagnostic epidemiology, the clinical course, the family history and the response to treatment of patients with angioedema without wheals (AWW) at an Allergy and Immunology Clinical Center. We reviewed the case records of all patients at our office from January 1997 to April 2013. We recorded sex, age, age at onset of symptoms, family history of angioedema, number of visits to the office, type of angioedema, and response to treatment from those patients with angioedema without wheals.

[Hereditary angioedema. Treatment of acute attacks in Argentina].

In the world, hereditary angioedema (HAE) affects 1 every 50000 persons. It is characterized by highly disabling and recurrent episodes of cutaneous, abdominal and laryngeal episodes of angioedema. Asphyxia related mortality ranges from 15 to 50%.

Case report: diffuse plane xanthoma with low C4 and systemic inflammatory symptoms.

A normolipemic patient with diffuse plane xanthomas, IgG monoclonal gammopathy of unknown significance, low levels of C4, and systemic inflammatory symptoms is presented. Delay from disease onset to diagnosis is discussed.

Asthma in a primary health care center serving a poor population: a descriptive and interventional study.

Asthma is a common chronic disease. Due to difficulties in accessibility to the health care system, asthma affects severely to minorities. This study's objective is to describe the morbidity of asthma on a poor population and its modification after abolishing assistance barriers.

[Indications and techniques for scleral fixation and suturing of intraocular lenses to the posterior surface of the iris].

The concept of suturing posterior chamber lenses to the ciliary body and sclera as the preferred method for a primary or secondary implantation when there is no capsular or even iris support, particularly at the time of penetrating keratoplasty, was pioneered by Enrique Malbran, M.D., Director of the Malbran Ophthalmology Center in Buenos Aires, Argentina (the current President of the Pan American Association of Ophthalmology).

[Retinopathy associated with acute pancreatitis].

Purtscher's retinopathy is a retinal lesion associated with different diseases such as cardiac aneurism, thoracic compression, bone fractures, post-trauma, pancreatitis and eclampsia. It consists in the appearance of white patches and retinal hemorrhage encircling an apparently normal optic disk. There is some controversy about its pathogenesis, but a probable cause for the development of this affection might be leukocyte emboli activated by complement.

Closed-system phacoemulsification and posterior chamber implant combined with penetrating keratoplasty.

The main intraoperative difficulties of performing a procedure combining open-sky extracapsular cataract extraction, implantation of posterior chamber intraocular lens (PC-IOL), and penetrating keratoplasty ("triple procedure"), most frequently caused by the uncompensated posterior pressure created when the cornea is open, include incomplete capsulorhexis, incomplete aspiration-irrigation of the cortex, uncertain placing of the IOL, posterior capsule rupture, choroidal effusion, and even expulsive hemorrhage. We recommend a two-step procedure that eliminates these problems: The first step begins with removal of epithelium, half-thickness trephining of the cornea, and capsulorhexis; proceeds through phacoemulsification and aspiration-irrigation; and ends with implantation of the PC-IOL, using a pressurized system. The second step is penetrating keratoplasty.

Vitreoretinal surgery performed through a 60-diopter lens.

For vitreoretinal surgery, we recommend using a 60-diopter lens for indirect ophthalmoscopy through the operating microscope without internal illumination. This device has undergone extensive clinical testing since 1986 with excellent results.

Retinal break type and proliferative vitreoretinopathy in nontraumatic retinal detachment.

In a retrospective study of 1180 consecutive eyes operated for retinal detachment, vitreous traction on the rent was the determining factor for the development of proliferative vitreoretinopathy (PVR). Round, multiple, small holes in equatorial degeneration (retinogenic) and macular holes in which no vitreous traction on the rent was found did not complicate with PVR. Retinal detachment caused by horseshoe or crescent-shaped tears with evidence of vitreous traction (vitreogenic) developed PVR to a variable degree: in 171 (25.

Myopic and nonmyopic aphakic retinal detachment: time interval and location of breaks.

Of 471 retinal detachments occurring in aphakic patients after undergoing intracapsular cataract extraction, we reviewed 318 eyes with uncomplicated aphakia (no vitreous loss). Myopic eyes had equatorial breaks 38% of the time versus 19% for nonmyopic eyes. The time interval between aphakia and detachment was shorter for myopic than for nonmyopic eyes.