Purpose: To present a unique case of a 65-year-old man using warfarin who presented with acute unilateral loss of vision due to hemorrhagic Descemet membrane detachment (DMD) with pupillary block and elevated intraocular pressure and its subsequent treatment and challenges.
Method: Case report.
Results: Clinical examination showed a visual acuity of finger counting, central DMD with near contact to the iris and premembrane hemorrhage, an intraocular pressure (IOP) of 19 mmHg, and normal pupillary reaction. An International Normalized Ratio (INR) of 4.9 was treated with dose reduction and vitamin K. Twelve hours later the patient re-presented with an acute increase in pain and an IOP of 78 mmHg with pupillary block and iris bombé. YAG-laser membranotomy, anterior chamber paracentesis, and maximal topical and systemic therapy were unsuccessful in reducing the IOP. Surgical management, including irrigation and aspiration of blood, led to a normalization of the IOP. Descemet stripping automated endothelial keratoplasty (DSAEK) resulted in a visual acuity of 0.3. Deep stromal/pre-Descemet membrane neovascularization was found bilaterally, suspicious for a previous interstitial keratitis.
Conclusions: The previously unreported complication of pupillary block following a pre-Descemet membrane hemorrhage was treated successfully for the first reported time, in a 2-step DSAEK. This indicates that DSAEK could be considered as a treatment option for DMD, especially in traumatic circumstances.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.5301/ejo.5000164 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Purpose: To identify areas of consensus among experts on the performance of endothelial keratoplasty by using a modified Delphi approach, to help create a framework for novice surgeons to adopt these procedures.
Methods: Thirty-one international experts in endothelial keratoplasty participated. Two rounds of electronic survey were followed by a hybrid, virtual meeting.
A Case of Acute Angle Closure Secondary to Pupillary Block Caused by a Dislocated Intraocular Lens-Capsular Tension Ring Complex.
Cureus
November 2024
Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, JPN.
We report a case of acute angle closure secondary to pupillary block caused by a dislocated intraocular lens (IOL)-capsular tension ring (CTR) complex. A 68-year-old woman, who had undergone cataract surgery 28 months earlier, presented with acute right eye pain and blurred vision. Examination revealed elevated intraocular pressure (IOP) of 80 mmHg, corneal edema, and anterior chamber shallowing, with anterior displacement of the IOL-CTR complex observed on anterior-segment optical coherence tomography.
View Article and Find Full Text PDFTwo cases of type I sialidosis and a literature review.
Orphanet J Rare Dis
November 2024
Department of Endocrinology, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Genetics, Metabolism, Beijing, 100045, China.
Article Synopsis
- The study compares clinical and genetic features of two Chinese children with type I sialidosis to previously reported cases, aiming to gather more insights into the disorder.
- The first patient, an 11-year-old girl, presented with short stature and vision problems linked to genetic mutations in the NEU1 gene, while the second patient, a 10-year-old boy, showed rapid weight gain and distinct visual impairments.
- Upon analyzing a total of 71 cases from the literature, common symptoms identified include muscle spasms and ataxia, highlighting the diverse manifestations of this genetic condition.
Process Evaluation of a Secondary School-Based Digital Behaviour Change Intervention to Improve Toothbrushing: The BRIGHT Randomised Controlled Trial.
Community Dent Oral Epidemiol
November 2024
School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
Article Synopsis
- - The study evaluated a behavior change intervention aimed at reducing dental caries in secondary school children in the UK, involving 4680 participants from 42 schools over 2.5 years, with a focus on schools with higher free school meal eligibility to address low household income.
- - Data collection included mixed methods such as self-reported questionnaires, staff feedback, and interviews to assess implementation fidelity, acceptability, and contextual factors surrounding the intervention.
- - While the intervention was mostly implemented as planned, challenges included inconsistent delivery of classroom sessions and technical issues with text messages; despite this, the intervention was generally deemed acceptable by participants.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!