JCRS Online Case Reports最新文献_第4页

Macular phototoxicity after corneal crosslinking 角膜交联后黄斑光毒性

JCRS Online Case Reports Pub Date : 2022-03-09 DOI: 10.1097/j.jcro.0000000000000078

Mohammed A. Alfayyadh, Halla A. AlAbdulhadi, Muhammad A. Ahad

{"title":"Macular phototoxicity after corneal crosslinking","authors":"Mohammed A. Alfayyadh, Halla A. AlAbdulhadi, Muhammad A. Ahad","doi":"10.1097/j.jcro.0000000000000078","DOIUrl":"https://doi.org/10.1097/j.jcro.0000000000000078","url":null,"abstract":"Introduction: Keratoconus is a progressive degenerative corneal disease of variable severity. Its management includes medical and surgical treatment. Corneal crosslinking (CXL) is being increasingly used to stabilize the condition. Macular phototoxicity is a well-known side effect of light exposure; however, its incidence after treatment with riboflavin and UV light is unknown. This study reported the clinical features of a patient with macular phototoxicity after UV-A exposure and described the structural and angiographic retinal changes observed in the patient. Patient, Clinical Findings, and Diagnosis: A 37-year-old man with keratoconus underwent corneal refractive surgery (topography-guided custom ablation with accelerated and high-fluence CXL). Postoperatively, he had decreased vision in the operated eye. Ophthalmoscopy, spectral-domain optical coherence tomography, and fluorescein angiography revealed retinal pigment epithelial changes, ellipsoid zone disruption, and window defects, respectively. The patient was diagnosed with macular phototoxicity. The corrected distance visual acuity stabilized at 20/100 after 6 months. Conclusions: Macular phototoxicity may occur after UV-A exposure during CXL. The use of accelerated and high-fluence protocols might have contributed to its occurrence in this patient.","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"10 1","pages":"e00078"},"PeriodicalIF":0.0,"publicationDate":"2022-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46658312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Surgical management of a calzone-like posttraumatic infolding of a 10-year-old LASIK flap 10岁LASIK角膜瓣创伤后凹陷的外科治疗

JCRS Online Case Reports Pub Date : 2022-03-09 DOI: 10.1097/j.jcro.0000000000000074

S. Elahi, A. Mazharian, D. Gatinel

{"title":"Surgical management of a calzone-like posttraumatic infolding of a 10-year-old LASIK flap","authors":"S. Elahi, A. Mazharian, D. Gatinel","doi":"10.1097/j.jcro.0000000000000074","DOIUrl":"https://doi.org/10.1097/j.jcro.0000000000000074","url":null,"abstract":"Introduction: The popularity of femtosecond laser–assisted in situ keratomileusis (LASIK) has increased, but flap-related complications such as trauma and possibility of displacement, even years after surgery with complications such as striae, diffuse lamellar keratitis, and epithelial ingrowth, may still be challenging. Patient and Clinical Findings: A 45-year-old woman was referred a week after trauma and flap displacement on a 10-year-long myopic LASIK correction. Corrected distance visual acuity was 20/30 (0, −2.25 at 35 degrees) due to epithelial ingrowth involving the visual axis. The external third of the flap was rolled inward (calzone-like), exposing the underlying edematous stroma associated with dense fibrosis at the level of the roll. Diagnosis, Intervention and Outcomes: Emergency flap surgical revision was performed using a technique of mechanical debridement and a 20% alcohol-dipped sponge application to help with epithelial cells lysis, and fibrin glue was applied on the flap. Uncorrected distance visual acuity was restored and examination revealed a stable, well-apposed flap, without epithelial cell ingrowth, and an otherwise unremarkable examination. Conclusions: This study showed the 10-month-efficacy of a combined approach of mechanical debridement, ethanol-based cell lysis, and fibrin glue in traumatic 10-year-old-flap management with infolding or invagination and extensive epithelial ingrowth.","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"10 1","pages":"e00074"},"PeriodicalIF":0.0,"publicationDate":"2022-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49609821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anterior segment OCT findings and atypical refractive changes secondary to Epstein-Barr virus–associated nummular keratitis Epstein-Barr病毒相关性努穆拉角膜炎继发的前段OCT表现和非典型屈光变化

JCRS Online Case Reports Pub Date : 2022-03-09 DOI: 10.1097/j.jcro.0000000000000077

Asher Khan, D. A. Murphy, Finny T. John, M. Dastjerdi, K. Riaz

{"title":"Anterior segment OCT findings and atypical refractive changes secondary to Epstein-Barr virus–associated nummular keratitis","authors":"Asher Khan, D. A. Murphy, Finny T. John, M. Dastjerdi, K. Riaz","doi":"10.1097/j.jcro.0000000000000077","DOIUrl":"https://doi.org/10.1097/j.jcro.0000000000000077","url":null,"abstract":"Introduction: This case study described refractive changes that can occur in the setting of Epstein-Barr virus (EBV)-associated nummular keratitis (NK) and highlighted the role that anterior segment optical coherence tomography can serve in diagnosis and management of this disease. Patient and Clinical Findings: A 15-year-old girl developed subepithelial and anterior stromal corneal lesions and experienced progressive decline in the corrected distance visual acuity. She also developed a significant myopic shift with increased keratometric and refractive astigmatism. Diagnosis, Intervention, and Outcomes Targeted laboratory testing was performed. A diagnosis of chronic EBV-associated NK was made, and the patient was treated with systemic valacyclovir and topical steroids. Clinical appearance of lesions and corrected distance visual acuity improved, although refractive and keratometric changes persisted. Conclusions: Significant and persistent refractive changes can occur in the setting of EBV-associated NK, similar to those seen after conductive keratoplasty. Anterior segment optical coherence tomography can be a potentially helpful supplementary diagnostic imaging modality to avoid invasive testing in such cases.","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"10 1","pages":"e00077"},"PeriodicalIF":0.0,"publicationDate":"2022-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45091511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Corneal endothelial wound healing after Descemet tear with a rho kinase inhibitor rho激酶抑制剂用于后弹力层撕裂后角膜内皮伤口的愈合

JCRS Online Case Reports Pub Date : 2022-03-09 DOI: 10.1097/j.jcro.0000000000000075

Jamal Azhari, Umangi Patel, M. Vakharia

{"title":"Corneal endothelial wound healing after Descemet tear with a rho kinase inhibitor","authors":"Jamal Azhari, Umangi Patel, M. Vakharia","doi":"10.1097/j.jcro.0000000000000075","DOIUrl":"https://doi.org/10.1097/j.jcro.0000000000000075","url":null,"abstract":"Introduction: To the authors’ knowledge, this is the first report of Descemet tear postcataract surgery that was successfully treated with ripasudil hydrochloride hydrate. Patient and Clinical Findings: An 85-year-old pseudophakic man presented with blurry vision and mild photophobia in the left eye. Slitlamp biomicroscopy showed moderate corneal edema and a central Descemet tear from cataract surgery 7 years earlier. Diagnosis, Intervention, and Outcomes: The patient was treated for 1 month with prednisolone acetate 1% and sodium chloride 5% hyperosmotic ophthalmic solution with no clinical improvement. He declined surgical intervention and opted for medical management with ripasudil 0.4% ophthalmic solution, a rho kinase inhibitor. He applied it topically 4 times daily for 3 months, with improvement of corneal edema and corrected distance visual acuity. After discontinuation of ripasudil, his edema and vision worsened and then improved again after retreatment, showing a strong clinical response. 2 years after starting ripasudil therapy, the patient had continued to use ripasudil 3 times daily and reported worsened vision at lower doses. Conclusions: The use of topical ripasudil may be a viable medical intervention for corneal edema due to Descemet tear instead of surgery, although chronic use may be required.","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"10 1","pages":"e00075"},"PeriodicalIF":0.0,"publicationDate":"2022-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49526057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Traumatic intraocular lens ectopia from a nonadhesive capsule 非粘连性囊性外伤性人工晶状体异位

JCRS Online Case Reports Pub Date : 2022-02-28 DOI: 10.1097/j.jcro.0000000000000076

Zeli Chen, Yan Wu, Mao-sheng Chen, Zhen Liu

引用次数: 0

Myopic outcome after intraocular lens implantation in a patient who previously had small-incision lenticule extraction 一名曾接受小切口晶状体摘除术的患者植入人工晶状体后的近视结果

JCRS Online Case Reports Pub Date : 2022-02-23 DOI: 10.1097/j.jcro.0000000000000071

Xinxin Li, Shaowei Li, Luyao Li, Chang Liu, Qiumei Li

{"title":"Myopic outcome after intraocular lens implantation in a patient who previously had small-incision lenticule extraction","authors":"Xinxin Li, Shaowei Li, Luyao Li, Chang Liu, Qiumei Li","doi":"10.1097/j.jcro.0000000000000071","DOIUrl":"https://doi.org/10.1097/j.jcro.0000000000000071","url":null,"abstract":"Introduction: This is a report of cataract surgery in a post–small-incision lenticule extraction (SMILE) patient with low myopia. Patient and clinical findings: A 49-year-old man underwent bilateral SMILE 18 months previously, and the visual acuity of both eyes recovered to 20/20. The patient noticed a gradual reduction in visual acuity in his left eye and blurring for 3 months. The corrected distance visual acuity (CDVA) was 20/67 in his left eye. Diagnosis, intervention, and outcomes: The slitlamp examination revealed an anterior subcapsular cataract. The intraocular lens (IOL) power was calculated by using a multiformula averaging method. A standard femtosecond laser–assisted phacoemulsification cataract surgery was performed and a trifocal IOL implanted. 2 months after IOL implantation, the uncorrected distance visual acuity of the left eye was 20/33, the autorefraction values were −1.37 −0.25 × 146, and the CDVA was 20/20. Conclusions: This case report showed that current postrefractive IOL power calculation formulas or methods may lead to myopic outcomes in patients who previously received SMILE. A standard IOL calculation may be more suitable for such patients. Additional case studies are needed to accurately calculate IOL power after SMILE similar to laser in situ keratomileusis.","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"10 1","pages":"e00071"},"PeriodicalIF":0.0,"publicationDate":"2022-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42733414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Endophthalmitis after corneal suture removal 角膜缝线拆除后眼内炎

JCRS Online Case Reports Pub Date : 2022-02-02 DOI: 10.1097/j.jcro.0000000000000073

P. Staropoli, Nicolas A. Yannuzzi, D. Jacobs, H. Flynn

引用次数: 0

Bilateral corneal opacities and surface irregularity: role of contact lenses in a case of paraproteinemic keratopathy and multiple myeloma 双侧角膜混浊和表面不规则:隐形眼镜在副蛋白血症性角膜病变和多发性骨髓瘤中的作用

JCRS Online Case Reports Pub Date : 2022-01-25 DOI: 10.1097/j.jcro.0000000000000069

Lily T. Nguyen, Ronald J. Smith, Xiao-Xia Yu, P. Ilsen

{"title":"Bilateral corneal opacities and surface irregularity: role of contact lenses in a case of paraproteinemic keratopathy and multiple myeloma","authors":"Lily T. Nguyen, Ronald J. Smith, Xiao-Xia Yu, P. Ilsen","doi":"10.1097/j.jcro.0000000000000069","DOIUrl":"https://doi.org/10.1097/j.jcro.0000000000000069","url":null,"abstract":"Introduction: This report features an interdisciplinary approach to diagnose and manage a case of paraproteinemic keratopathy and multiple myeloma. In addition, it suggests that rigid gas-permeable contact lenses (RGP CLs) may be a viable alternative to corneal surgery to reduce visual symptoms. Patient and clinical findings: A 57-year-old man symptomatic for progressive blur and glare over 2 years presented with an outside diagnosis of corneal dystrophy. An examination revealed bilateral diffuse subepithelial corneal crystals in conjunction with peripheral annular deposits with demarcated ridges. Corneal topography revealed central irregular astigmatism induced by these peripheral corneal opacities. Diagnosis, intervention, and outcomes: A hematological workup confirmed IgG Kappa monoclonal gammopathy and multiple myeloma. Visual rehabilitation for paraproteinemic keratopathy was achieved with RGP CLs, which are expected to maintain stable visual acuity while the patient undergoes systemic chemotherapy. Conclusions: This report emphasizes the value of thoroughly investigating dystrophy-like corneal deposits of unknown etiology as monoclonal gammopathy can have adverse or even fatal systemic implications. To the authors’ knowledge, this is the first study to directly suggest RGP CL as an adaptable and economical means to improve acuity in certain cases of paraproteinemic keratopathy without resorting to surgical intervention.","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"10 1","pages":"e00069"},"PeriodicalIF":0.0,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42666356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recurrent scleral-fixated intraocular lens dislocation with spontaneous repositioning produced by tilting and head movements 复发性巩膜固定型人工晶状体脱位伴倾斜和头部运动引起的自发重新定位

JCRS Online Case Reports Pub Date : 2022-01-25 DOI: 10.1097/j.jcro.0000000000000070

Matthew O'Riordan, V. Raman

{"title":"Recurrent scleral-fixated intraocular lens dislocation with spontaneous repositioning produced by tilting and head movements","authors":"Matthew O'Riordan, V. Raman","doi":"10.1097/j.jcro.0000000000000070","DOIUrl":"https://doi.org/10.1097/j.jcro.0000000000000070","url":null,"abstract":"Introduction: An unusual case of a patient who could repeatedly reposition his dislocated sulcus poly(methyl methacrylate) intraocular lens (IOL) by head movements and tilting his body is reported. Patient and clinical findings: An 86-year-old man presented with a 3-year history of recurrent episodes of transient blurred vision and monocular diplopia in his left eye. 20 years previously, he had phacoemulsification cataract surgery complicated by posterior capsule tear, which was treated with anterior vitrectomy and a secondary scleral-fixated IOL. Over the previous 3 years, he had recurrent episodes of IOL dislocation. He could regain normal vision by tilting his head and trunk. The dislocated IOL was maneuvered into position by capturing the haptic into the residual capsular remnant by appropriate head movements. On examination, his corrected distance visual acuity (CDVA) was counting fingers, and the posterior chamber IOL was subluxated inferiorly. During presentation, he could not reposition it himself, warranting a surgical intervention. Diagnosis, intervention and outcomes: He underwent suturing of the IOL in the sulcus. The IOL was well-centered with a CDVA of 6/9. Conclusions: To the authors’ knowledge, this is the first case report of a patient who could repeatedly reposition a dislocated IOL through tilting and head movements.","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"10 1","pages":"e00070"},"PeriodicalIF":0.0,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48197958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of late in-the-bag IOL dislocation with exchange and scleral fixation of IOL with the transfixion technique 人工晶状体置换巩膜固定术治疗晚期囊内人工晶状体脱位

JCRS Online Case Reports Pub Date : 2021-11-24 DOI: 10.1097/j.jcro.0000000000000068

A. Pineda-Fernández, Yan Chen

{"title":"Management of late in-the-bag IOL dislocation with exchange and scleral fixation of IOL with the transfixion technique","authors":"A. Pineda-Fernández, Yan Chen","doi":"10.1097/j.jcro.0000000000000068","DOIUrl":"https://doi.org/10.1097/j.jcro.0000000000000068","url":null,"abstract":"Introduction: Late in-the-bag intraocular lens (IOL) dislocation is a serious complication of cataract surgery. Patient and clinical findings: A 70-year-old woman with a history of left eye cataract surgery presented with progressively decreasing vision that had worsened over the past 6 months. In the left eye, the uncorrected distance visual acuity (UDVA) was counting fingers at 5 m, the corrected distance visual acuity (CDVA) was 20/25 (+12.25 −1.25 × 180), and the intraocular pressure was normal. An anterior segment examination revealed severe inferior dislocation of the IOL-capsular bag complex. Diagnosis, intervention, and outcomes: The patient was diagnosed with late in-the-bag IOL dislocation and underwent IOL–capsular bag complex explantation with sulcus-sutured IOL implantation using a new scleral fixation technique that included transfixion of a foldable acrylic IOL with polytetrafluoroethylene suture. The postoperative outcome was good; the UDVA was 20/70, and the CDVA was 20/25, and there were no postoperative complications such as infection, suture erosion, iritis, uveitis, vitreous hemorrhage, or retinal detachment. Conclusions: Late in-the-bag IOL dislocation was safely managed with IOL–capsular bag complex explantation and scleral fixation of a foldable posterior chamber IOL. This transfixion technique can be used for scleral fixation in patients with late in-the-bag IOL dislocation.","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"10 1","pages":"e00068"},"PeriodicalIF":0.0,"publicationDate":"2021-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45014000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0