Operated Eyes (operated + eye)

Distribution by Scientific Domains

Selected Abstracts

Anaesthetists should be aware of delayed hypersensitivity to phenylephrine

P. Dewachter
Delayed reactions to phenylephrine, used as a mydriatic agent during ophthalmological surgical procedures, are well known. We diagnosed a delayed hypersensitivity reaction to phenylephrine included in an ophthalmic insert in a woman presenting, 24 h after surgery, with an acute blepharoconjunctivitis associated with eyelid eczema of the operated eye. The diagnosis was supported by the recognition of clinical symptoms associated with a positive patch test to phenylephrine. Patients who present with previous contact eczema to phenylephrine may develop a generalized eczema if phenylephrine is injected intravenously. Intravenous phenylephrine is increasingly being used in the operating room to treat hypotension. This case report confirms the need for systematic allergological investigation of all drugs and substances administered during the peri-operative period in order to avoid a delayed hypersensitivity reaction occurring after the peri-operative period. Anaesthetists should be aware of the possibility of delayed hypersensitivity reactions involving phenylephrine. [source]

2146: Intracorneal lenses for the treatment of presbyopia using femtosecond laser: visual outcomes and safety

Purpose To investigate the visual outcomes and safety of Intracorneal lenses (Flexivue Micro-Lens, Presbia, CA)) for the treatment of presbyopia. Methods This was a prospective clinical study. An intrastromal corneal tunnel was created using femtosecond laser (Intralase 150, AMO , CA). The lens was inserted within the cornea tunnel of the non-dominant eye of 10 presbiopian patients. Mean age was 51,23 years old ± 3,11 (5 males and 5 females). The follow-up was up to 12 months. Results In the operated eye, mean uncorrected visual acuity for distance (UVA-D) preoperatively, one day, one week one month, three months and six months, and 1 year after surgery was 20/20, 20/40, 20/40, 20/32, 20/32, 20/32 and 20/32 respectively, whereas for near (UVA-N) was 20/50, 20/40, 20/30, 20/30, 20/25, 20/25 and 20/30. Binocular far vision was not altered. No tissue alterations of the cornea were found using corneal confocal microscopy. No intra or post-operative complications were demonstrated up to one year after surgery. Conclusion Intracorneal lenses for the correction of presbyopia using femtosecond laser seems to be a safe and effective method to correct presbyopia in patients aged between 45 to 55 years old; a target group which is considered too old for refractive laser surgery and too young for clear lens extraction. Longer follow-up and a larger population are necessary in order to draw more significant results of this new surgical approach for the treatment of presbyopia. Commercial interest [source]

MOOKP clinical results and Indications

Purpose To demonstrate which are the reasons that permit by the modified osteo-odonto-keratoprosthesis (Mookp) technique to obtain in 275 blind eyes,with a basic pathology where 42% of eyes were dry,and 32% had severe physical/chemical burns,excellent anatomical and functional results. Methods Tables are shown which put into evidence the best visual acuity obtained in the 275 eyes affected by corneal blindness,operated by the Mookp technique from 1973 to 2008, with a 36 years causistry,with a very long follow-up. Results 275 blind eyes. Best Visual Acuity recovered, between 10/10 and 5/10 in 80.25% of operated eyes, excellent for any working activity,( best visual acuity recovered), between 10/10 and 2/10 in 91,20%, useful for any activity. Final V.A., between 10/10 and 5/10 in 67,68%, and between 10/10 and 2/10 in 78,11%- Conclusion The reasons for these excellent results are due to the biological properties of this Kpro invented by Strampelli and to the modifications made by Falcinelli. The indications for this technique are all those types of corneal blindness not treatable by penetrating keratoplasty. [source]

Biosynthetic corneas , evaluation in humans

Collagen-based biosynthetic corneas, designed to mimic the extracellular matrix of the corneal stroma have been developed and extensively evaluated in animal models over the last 7 years. Human recombinant collagen type III (RHC III) was crosslinked with water-soluble carbodiimides and fabricated into optically transparent corneal substitutes for transplantation. Following study approval of the Medical Product Agency, Sweden and the Human Ethics Committee, University of Linköping, Sweden, a Phase I study was initiated. 10 patients who were scheduled for corneal grafting were enrolled into the study. Nine had keratoconus and one had a deep scar following Pseudomonas keratitis. A central 6 mm diameter deep lamellar button was excised and was replaced by a 6.25 mm diameter 500 µm thick construct. Six overlying sutures were used to anchor the graft. Topical 0.1% dexametasone and chloramphenicol was used for the first 1 month postoperatively. The sutures were removed after 5-7 weeks. The patients were followed clinically and evaluated for UCVA, BSCVA and VA with contact lenses. Corneal touch sensitivity (Cochet-Bonnet) and tear production (Schirmer ) were tested. Photography, OCT (Visante), topography (Orbscan II) and in vivo confocal microscopy (Heidelberg) was documented. After 3 months all patients had stably epithelialized and implants were anchored by recipient keratocyte ingrowth. The mean BSCVA at 6 months (20/133) improved slightly at 12 months (20/90). The mean BCLCVA was 20/50 at 12 months and was notably better in younger patients (mean of 20/40 in the 5 youngest). One patient had BCLVA of 20/20 at 12 months. The mean central corneal thickness was stable between 3 and 12 months at about 400µm. The mean 5min Schirmer values were 20 ± 10mm in operated eyes and 17 ± 8 mm in fellow eyes. At 12 months the mean touch sensitivity was 25mm in operated eyes and 60mm in fellow eyes, which was the same as in penetrating grafts. In-vivo confocal microscopy revealed the ingrowth of corneal nerves at the subbasal epithelium. We have shown for the first time that bioengineered collagen-based corneal substitutes are fully compatible and promote regeneration of corneal cells. The 18 months follow-up results will be presented aswell. [source]

Operated and unoperated cataract in Australia

Catherine A McCarty PhD MPH
ABSTRACT Purpose: To quantify the prevalence of cataract, the outcomes of cataract surgery and the factors related to unoperated cataract in Australia. Methods: Participants were recruited from the Visual Impairment Project: a cluster, stratified sample of more than 5000 Victorians aged 40 years and over. At examination sites interviews, clinical examinations and lens photography were performed. Cataract was defined in participants who had: had previous cataract surgery, cortical cataract greater than 4/16, nuclear greater than Wilmer standard 2, or posterior subcapsular greater than 1 mm 2. Results: The participant group comprised 3271 Melbourne residents, 403 Melbourne nursing home residents and 1473 rural residents. The weighted rate of any cataract in Victoria was 21.5%. The overall weighted rate of prior cataract surgery was 3.79%. Two hundred and forty-nine eyes had had prior cataract surgery. Of these 249 procedures, 49 (20%) were aphakic, 6 (2.4%) had anterior chamber intraocular lenses and 194 (78%) had posterior chamber intraocular lenses. Two hundred and eleven of these operated eyes (85%) had best-corrected visual acuity of 6/12 or better, the legal requirement for a driver's license. Twenty-seven (11%) had visual acuity of less than 6/18 (moderate vision impairment). Complications of cataract surgery caused reduced vision in four of the 27 eyes (15%), or 1.9% of operated eyes. Three of these four eyes had undergone intracapsular cataract extraction and the fourth eye had an opaque posterior capsule. No one had bilateral vision impairment as a result of cataract surgery. Surprisingly, no particular demographic factors (such as age, gender, rural residence, occupation, employment status, health insurance status, ethnicity) were related to the presence of unoperated cataract. Conclusions: Although the overall prevalence of cataract is quite high, no particular subgroup is systematically under-serviced in terms of cataract surgery. Overall, the results of cataract surgery are very good, with the majority of eyes achieving driving vision following cataract extraction. [source]