Digital journal of ophthalmology : DJO最新文献

We report a case of late breakage of a 9-0 polypropylene transscleral suture used for fixation of a dislocated capsular bag-intraocular lens-modified capsular tension ring complex in a 52-year-old woman with Marfan syndrome. Breakage occurred despite use of a cow-hitch technique for external and internal fixation. We believe breakage was caused by the suture chafing on the sharp edges of the modified capsular tension ring eyelet. Cross-sectional analysis of Malyugin-modified capsular tension rings from two different manufacturers revealed a difference with respect to radius of curvature. Suturing intraocular implants with relatively sharp edges may cause suture breakage; further studies are needed to identify the critical parameters for the surface quality of sutured intraocular implants.

We report the case of an 84-year-old man who presented with decreased vision in his left eye. Ocular history included bilateral pseudoexfoliative glaucoma and vitelliform macular dystrophy. He had undergone intraocular lens placement in both eyes 6 years before presenting at our institution. Over follow-up of 4 years, he experienced recurrent spontaneous hyphema and continued residual intracapsular hemorrhage. He was eventually diagnosed with uveitis-glaucoma-hyphema syndrome in the setting of pseudoexfoliation.

Type 1 extrafoveal choroidal neovascularization (CNV) secondary to neovascular age-related macular degeneration was diagnosed in a 68-year-old woman using optical coherence tomography angiography (OCT-A) alone. The entire network of vessels was clearly visible on a 12 × 12 mm OCT-A scan segmented below the retinal pigment epithelium. The patient was initially treated with intravitreal ranibizumab followed by photodynamic therapy (PDT) guided by OCT-A. Complete resolution of subretinal fluid with shrinkage of the neovascular complex was noted 1 month after PDT.

Spheroidal degeneration, involving the cornea and/or the conjunctiva, is characterized by amber-colored homogeneous, translucent spherules in the corneal stroma, Bowman's membrane, and subepithelium. The condition has a higher prevalence in areas with extreme temperatures, low humidity, high wind, and presence of sand. We report the case of a 46-year-old man with a 10-year history of gradual progressive diminution of vision, severe blepharospasm, and photophobia. Examination revealed bilateral plaques of amber-colored nodules covering about half of the cornea. Superficial keratectomy was performed for the lesions in both eyes, leaving an epithelial defect overlying a plane of opaque cornea. Histopathology showed amorphous protein in the anterior stroma, confirming the clinical diagnosis of advanced grade 4 spheroidal degeneration. Visual acuity and other symptoms dramatically improved, and the patient was scheduled for keratoplasty.

We report the case of a 26-year-old man under treatment with the antidepressant drugs olanzapine and buspirone, which are associated with anticholinergic effects, in whom an implantable collamer lens (ICL) became spontaneously dislocated. ICL dislocation and pupil capture occurred 10 months postoperatively. The lens was successfully repositioned. The possible role of these drugs in the dislocation of the ICL is discussed.

A 4-year-old girl with a history of Pearson marrow-pancreas syndrome presenting with severe, progressive photophobia was found to have bilateral, diffuse corneal thickening and peripheral pigmentary retinopathy. She underwent Descemet stripping automated endothelial keratoplasty (DSAEK) surgery in both eyes using a modified suture pull-through technique. Postoperatively there was no evidence of cataract formation or graft detachment; her corneas thinned, and her photophobia improved dramatically.