bluuebunny/crossref_metadata_2025_split huggingface dataset:
Traumatic Neuroma of the Infraorbital Nerve Subsequent to Inferomedial Orbital Decompression for Graves’ Orbitopathy
Authors: Baldeschi Lelio , Saeed Peerooz , Regensburg Noortje I. , Zacharopoulos Ioannis , Wiersinga Wilmar M. 
Published: January 2018

Purpose. To present and discuss the occurrence of a traumatic neuroma subsequent to inferomedial orbital decompression surgery in Graves’ orbitopathy. Methods. Case report. Results. Approximately 1 month after surgery, a patient who underwent bilateral rehabilitative inferomedial orbital decompression developed a mass with clinical and radiologic characteristics compatible with a traumatic neuroma of the left infraorbital nerve. The lesion, which was thought to be the result of unnoticed nerve trauma at the time of surgical dissection of the infraorbital canal, remained stable in shape and other imaging characteristics during the 39-month follow-up period. Symptoms of trigeminal neuralgia could be only partially controlled with medical therapy (oral pregabalin 75 mg 3 times daily). Conclusions. The second branch of the trigeminal nerve may be damaged in the course of orbital floor removal decompression for Graves’ orbitopathy. This may potentially induce the formation of traumatic or amputation neuromas. Such lesions should be included in the potential complications of decompressions when counseling patients about to undergo this type of surgery, as they are difficult to treat and may cause persistent and disabling pain.
Sutureless Human Sclera Donor Patch Graft for Ahmed Glaucoma Valve
Authors: Zeppa Lucio , Romano Mario R. , Capasso Luigi , Tortori Achille , Majorana Mara A. , Costagliola Ciro 
Published: January 2018

Purpose. To report the safety and effectiveness of a sutureless human sclera donor patch graft covering the subconjunctival portion of glaucoma drainage implant tube to prevent its erosion throughout the overlying conjunctiva. Methods. This was a prospective pilot study. Fifteen eyes of 15 consecutive patients not responsive to medical and to not-implant surgical glaucoma treatment underwent Ahmed glaucoma valve (AGV) implant surgery with sutureless human sclera donor patch graft. The surgical procedure included AVG implant placed 8 mm behind the corneal limbus and fixed to the sclera with two 9–0 black nylon sutures. The tube was passed through the scleral tunnel, parallel to the corneal limbus, and shortened at the desired length. The anterior part of the tube was covered with human donor scleral graft and kept in place with fibrin glue (Tissue Coll®) under the conjunctiva. Examinations were scheduled at baseline and then at 1 week and 1, 3, 6, and 12 months after surgery. Results. At 12-month follow-up, the best-corrected visual acuity did not significantly improve from baseline 0.78±1.2 logMAR, whereas mean intraocular pressure significantly decreased from preoperative values of 29.8 (SD 8.4) mmHg. In all cases, the scleral patch was found in place at each check during the follow-up period. No conjunctival erosion over the AGV tube nor sign of endophthalmitis was recorded at any time during the follow-up period. Conclusions. AVG implant surgery with sutureless human sclera donor patch graft represents an effective and relatively safe surgical procedure for complicated glaucomas, avoiding conjunctival erosions over the AGV tube.
Ocular Morbidity of Traumatic Hyphema in a Jamaican Hospital
Authors: Mowatt Lizette , Chambers Celeste 
Published: January 2018

Purpose. To determine the outcome of patients with hyphema secondary to ocular contusion. Methods. A retrospective review of the ophthalmic records of 44 consecutive patients with traumatic hyphema secondary to ocular trauma presenting to the Eye Clinic of the University Hospital of the West Indies between May 2004 and November 2007. Results. The mean age was 21 years (95% confidence interval [CI] 16.4–25.5 years). Follow-up ranged from 2 weeks to 22 months. The most common mechanism of injury was impact by a missile and 41% occurred at home. The mean visual acuity at presentation was logMAR 1.85 (95% CI 1.4–2.3) and at 3 months improved to logMAR 0.63 (95% CI 0.3–1.0). The presenting intraocular pressure (IOP) ranged from 7–64 mmHg with 45.4% (20/44) having IOP of greater than 21 mmHg; 18% had the sickle cell trait. A total of 72.7% of patients presented with a grade I hyphema. Surgical intervention was indicated in 20.5% (9/44), which included anterior chamber paracentesis/washout and trabeculectomy. The most frequent complications were secondary glaucoma (32.4%), angle recession (23.5%), cataract (20.6%), and commotio retinae (20.6%). In the sickle cell group, 80% presented with elevated IOP (29–64 mmHg) and 70% had complications. A total of 94.7% of patients had an IOP <21 mmHg at 3 months. Conclusions. Traumatic hyphema is a recognized cause of significant visual disability. Improved visual acuity was attained after 3 months. The presenting visual acuity correlated with the visual prognosis. Patients with posterior segment complications tended to have poorer visual outcomes. The presence of the sickle cell gene increased the risk of secondary glaucoma.
Comparison of the Clinical Presentation and Visual Outcome in Open Globe Injuries in Adults and Children over 30 Months
Authors: Gupta Arvind , Srinivasan Renuka , Babu K. Ramesh , Setia Sajita 
Published: January 2018

Purpose. To compare the clinical presentation and final visual outcome of open globe injuries in children and adults in a referral hospital over a 30-month period. Methods. This is an institutional-based prospective study of open globe injuries cases presenting in the emergency department between July 2003 and December 2005. Patients were divided in 2 groups: group 1, children (2–15 years), and group 2, adults (>15 years). All the patients were admitted and emergency surgical interventions were undertaken. The clinical features at presentation and the final visual acuity are compared. Chi-square and Fisher exact tests were used for statistical analysis. Results. Ninety and 84 patients were included in group 1 and group 2, respectively. The most common places of injuries were home or while playing outdoor games in group 1 (67%) and workplace in group 2 (53.5%). The presenting features were significantly more grave in group 2. These included poor presenting visual acuity (p=0.012), vitreous prolapse (p=0.002), presence of relative afferent pupillary defect (p=0.001), and incidence of endophthalmitis (p=0.004). Time interval between injury and surgical intervention (p=0.018) was better in group 2. Other features, such as presence of hyphema, uveal tissue prolapse, cataract, intraocular foreign body, and length or location of laceration were similar in both groups. The final visual outcome was similar in the groups (p = 0.21), with approximately half of the patients achieving vision of 20/60 or better in each group. Conclusions. The majority of injuries in children and adults occurred in their homes or workplaces, respectively. Although the clinical presentations of open globe injuries were significantly more grave in adults than in children, the final visual outcomes were similar.
Screening for Ophthalmic Disorders and Visual Impairment in a Nigerian School for the Deaf
Authors: Onakpoya Oluwatoyin Helen , Omotoye Olusola J. 
Published: January 2018

Purpose. To detect the presence of ophthalmic abnormalities and visual impairment in deaf students. Methods. A cross-sectional survey of all students in the school for the deaf was conducted following ethical clearance from the Ministry of Health. Age, sex, and previous eye examination was recorded for each student as well as visual acuity, penlight eye examination, intraocular pressure, dilated funduscopy and refraction (when applicable). Data were analyzed with SPSS version 11 and statistical significance inferred at p<0.05. Results. The 156 (100%) students at the school for the deaf with age range 6–25 years, mean ± standard deviation of 15.6±3.3 years, and modal age of 14 years were studied. A total of 110 (70.5%) had no previous eye examination, 2 (1.3%) students were blind, 5 (3.2%) were visually impaired, 4 (2.6%) had unilateral visual impairment, and 4 (2.6%) had unilateral blindness. Blindness was caused by Usher syndrome in 1 (50%) and bilateral pigmented macular scar in 1 (50%) patient. Uncorrected refractive errors were the leading cause of unilateral visual impairment (75%), visual impairment (60%), and unilateral blindness (50%). Ocular abnormality was present in 53 (34%) students while uncorrected refractive error (18.6%), retina changes (7%), and allergic conjunctivitis (3.8%) were the leading disorders. Previous eye examination was more common among primary school students (p<0.0001) and students with ocular abnormalities (p=0.046). Conclusions. Institutions for deaf children should be aware of the high prevalence of ophthalmic disorders and the importance of vision to development of a deaf child, and conduct an initial and periodic eye examination for every intake.
Spontaneous Dislocation of a Verisyse Phakic Intraocular Lens with Severe Corneal Endothelial Cell Loss
Authors: Wang Kai-Jie , Zhu Si-Quan 
Published: January 2018

Purpose. To report a case of spontaneous dislocation of a Verisyse phakic intraocular lens (PIOL) with severe corneal endothelial cell loss. Methods. A 29-year-old woman with no history of trauma presented with complaint of blurred vision in the right eye of 5 months’ duration. History included uneventful implantation of a PIOL bilaterally to correct high myopia in January 2007. Results. Visual acuity was 20/100, central endothelial cell density had decreased to 592/mm2 central corneal pachymetry was 634 μm. The PIOL dislocated temporally and was removed without any lens implanted again. Three months postoperatively, her best-corrected visual acuity was 20/60. Conclusions. A correct fixation with sufficient folded iris inside the claw and long-term follow-up are important for patients with implanted PIOL, and the long-term effects on endothelial cell density in this patient remain to be seen.
Epidemiology and Etiologic Diagnosis of Infectious Keratitis in Uberlandia, Brazil
Authors: Furlanetto Rafael Lacerda , Andreo Eduardo G. V. , Finotti Loná G.A. , Arcieri Enyr S. , Ferreira Magno A. , Rocha Flavio J. 
Published: January 2018

Purpose. To study risk factors, microbiological characteristics, and clinical course of nonviral infectious keratitis diagnosed in a referral service of ophthalmology. Methods. A total of 65 charts of patients with microbial keratitis were retrospectively reviewed at the Clinical Hospital of Federal University of Uberlandia, Brazil, from July 2001 through August 2004. All cases were submitted to microbiological tests and treated according to local protocol. Risk factors, clinical course, therapeutic keratoplasty, and visual outcomes were analyzed. Results. The mean age of patients was 45.9 years (2–83 years) and male to female ratio 2.6:1. Symptoms at presentation ranged from 1–3 days in 16 patients out of 65 (24.61%), 4–7 days in 19 cases (19/65; 29.23%), and more than 7 days in 27 patients (27/65; 41.53%). The major risk factor was trauma (28/65; 40%), predominantly by organic material. A total of 32 eyes out of 65 (49.23%) were culture positive. Fungi were the most common isolates (18/32; 56.25%), being headed by Fusarium sp (11/65; 16.92%), and the most common bacteria was Streptococcus pneumoniae (7/65; 10.77%). Final visual acuity was equal to or better than 20/60 in 20 patients out of 65 (30.77%), between 20/60 and 20/400 in 7 patients (7/65; 10.77%), and worse than 20/400 in 35 patients out of 65 (53.85%). A total of 48 eyes out of 65 (73.84%) presented corneal scar, 12 eyes (12/65; 18.46%) needed therapeutic penetrating keratoplasty, and 2 eyes (2/65; 3.08%) were eviscerated. Conclusions. The high incidence of fungal keratitis in the studied population shows their vulnerability to such infections, which may result in devastating visual outcomes.
Acute Postoperative Endophthalmitis Caused by Gemella Morbillorum
Authors: Ascaso Francisco J. , Cardeñosa Eugenia , Cascante José M. , Lario Bianca , Pérez Diana , Cristóbal José A. 
Published: January 2018

Purpose. We present a case of Gemella morbillorum endophthalmitis after uneventful cataract surgery. Methods. A 78-year-old woman developed progressive blurring of vision, hypopyon, and vitritis in the precocious postoperatory following cataract surgery. Pars plana vitrectomy and intraocular lens explantation were performed followed by intravitreal injection of vancomycin and ceftazidime. Postoperatively, the patient was given hourly topical fortified vancomycin according to antimicrobial susceptibility testing. At the final follow-up visit 6 months after the initial procedure, visual acuity was 20/50 and no signs or symptoms of endophthalmitis were observed. Results. The undiluted vitreous samples and explanted lens were analyzed. Cultures revealed the growth of G morbillorum, an infrequent opportunistic pathogen. Conclusions. To date, this is the second reported case of postoperative endophthalmitis by this species. Although endophthalmitis is rare, ophthalmologists should be alert to the possibility of patients having endophthalmitis caused by G morbillorum. Especially, it is necessary to be cautious with surgery in patients with recent infections. A review of the medical literature of this rare ocular infection is presented.
Vitreous and Retinal Metastasis from Gastric Cancer
Authors: Kim Chang Yeom , Ha Chang Won , Lee Sung Chul 
Published: January 2018

Purpose. Intraocular metastasis from gastric cancer is not common and metastatic carcinoma to the vitreous or retina is exceedingly rare. We describe a case of gastric cancer metastatic to the vitreous and retina. Methods. Retrospective, single-center case report. Results. A 64-year-old woman with advanced gastric cancer with multiorgan metastatic disease presented with decreased visual acuity. Ophthalmoscopy revealed extensive overlying vitreous seeds and macular infiltrations in both eyes. Fine-needle aspiration cytology from the vitreous confirmed the diagnosis of metastatic carcinoma. Conclusions. We report an extremely rare case of vitreous and retinal metastasis from gastric cancer. Ophthalmologists and oncologists should be aware that gastrointestinal cancer can cause intraocular metastasis in the form of vitreous seeds and retinal infiltration.
Retinal Mass in a Case of Pediatric Myelodysplastic Syndrome (Refractory Anemia with Excess of Blasts)
Authors: Basu Biswanath 
Published: January 2018

Purpose. Myelodysplastic syndrome is a rare childhood clonal hematologic disorder characterized by dysplastic hematopoiesis and progression to leukemia. Methods. Case report. Results. An 8-year-old boy with low-grade fever, easy fatigability, and pallor of 3 months duration showed pancytopenia with 9% circulating blast cells. The bone marrow aspirate revealed striking trilineage dysplasia with 13% of blast cells. Cytogenetic analysis revealed 46, XY, del (20) (q11;q13). The findings were diagnostic of myelodysplastic syndrome with refractory anemia with excess of blasts in accordance with the World Health Organization criteria modified for pediatric age group. Fundus examination revealed a sickle-shaped hanging retinal mass of right eye. Biopsy/aspiration cytology of the retinal mass was not done in this case owing to risk of severe bleeding, a common feature in any hematologic malignancy. The child had been included in pediatric acute myeloid leukemia trials as the parents were not ready for stem cell transplantation, but he died after 3 months due to overwhelming infection. Conclusions. Myelodysplastic syndrome of childhood may present with retinal mass along with other hematologic features. Biopsy/aspiration cytology of the mass should not be attempted as it may cause intraocular hemorrhage.
Refractive lens exchange with the Acri. Twin asymmetric diffractive bifocal intraocular lens system
Authors: Alfonso José F. , Fernández-Vega Luis , Ortí Susana , Montés-Micó Robert 
Published: January 2018

Purpose. To evaluate efficacy, safety, and predictability after refractive lens exchange (RLE) in patients who had implantation of asymmetric Acri. Twin bifocal diffractive intraocular lenses. Methods. The study comprised 130 eyes of 65 consecutive patients after RLE who had bilateral implantation of the Acri. Twin system. Eyes were divided into myopic and hyperopic groups. Binocular uncorrected distance visual acuity, best-corrected distance visual acuity (BCVA), uncorrected distance near visual acuity, and best distance-corrected near visual acuity (BCNVA) were recorded preoperatively and 6 months after surgery. Results. Efficacy indexes were 0.99 for myopic and 0.93 for hyperopic patients at 6 months postoperatively. No patients lost >2 lines of BCVA. For the myopic group, 6 patients gained 1 line, and 10 patients gained ≥2 lines; for the hyperopic group, 5 patients gained 1 line, and 6 patients gained ≥2 lines. Safety indexes were 1.13 and 1.03 for myopic and hyperopic patients, respectively. No patients lost ≥2 lines of BCNVA; for the myopic group, only 2 patients lost 1; for the hyperopic group there was no change after surgery. Safety indexes at near were 0.99 for myopic and 1.00 for hyperopic patients. Efficacy indexes at near were 1.05 for myopic and 1.07 for hyperopic patients. Conclusions. RLE with asymmetric bilateral implantation of the Acri. Twin bifocal IOL is an effective procedure for correcting ametropia and presbyopia. Results obtained were safe and effective at distance and near for both myopic and hyperopic patients.
Anesthesiologist Intervention during Cataract Surgery under Topical or Peribulbar Anesthesia: A Propensity Model Comparison
Authors: Gemma Marco , Gioia Luigi , Dedola Elisa , Basta Benedetta , Blanchi Ingrid , Fasce Francesco , Beretta Luigi 
Published: January 2018

Purpose. To compare the incidence and type of anesthesiologist intervention during cataract surgery under peribulbar (PA) or topical (TA) anesthesia in a day-surgery monitored anesthesia care setting (monitoring provided by nurses with the anesthesiologist available on an on-call basis). Methods. From a prospective database of all phacoemulsifications performed in our hospital (January 2008-January 2009), 97 patients submitted to cataract surgery under PA were matched with 97 patients submitted to the same surgery under TA by a propensity model. The resulting groups were homogeneous as to history of antihypertensive therapy administered on the day of surgery and not administered on the day of surgery, cardiologic history, neurologic history, psychiatric history, anxiolytic assumption, and history of diabetes mellitus. We compared the incidence of intervention of the anesthesiologist between groups and the type of adverse event triggering such interventions. Results. The anesthesiologist was called in 37 (38.14%) cases in the PA group and in 27 (27.84%) cases in the TA group (37 [38.14%]) (p=0.123). Only the occurrence of agitation differed significantly between groups (9 [9.28%] patients in the TA group vs 24 [24.74%] patients in the PA group; p=0.004). Conclusions. Monitored anesthesia care is feasible for cataract surgery both under PA or TA. PA still remains an appealing alternative to TA during cataract surgery for patients incapable of keeping the operating eye in the primary position or with incoercible blinking, photophobia, or phacodonesis. A greater incidence of agitation is to be expected and adequate premedication with anxiolytics should be considered if PA is chosen.
Long-Term Visual Acuity and its Predictors after Cataract Surgery in Patients with Uveitis
Authors: Yoeruek Efdal , Deuter Christoph , Gieselmann Sylvia , Saygili Oguzhan , Spitzer Martin S. , Tatar Olcay , Bartz-Schmidt Karl U. , Szurman Peter 
Published: January 2018

Purpose. To analyze the outcomes of phacoemulsification and posterior intraocular lens (IOL) implantation in patients with uveitis and to determine factors responsible for poor visual outcome. Methods. The records of 155 patients (180 eyes) with uveitis who had phacoemulsification and IOL implantation between August 2001 and March 2008 were examined retrospectively. Best-corrected visual acuity (BCVA) was recorded at the immediate preoperative visit and at follow-up examinations every 3 months. At each postoperative visit, a complete ophthalmologic examination was performed. The postoperative visual outcomes and complications were analyzed. Univariate regression analysis was done to determine risk factors for poor visual acuity during follow-up. Results. The mean follow-up was 31.4 months (range 3–78 months). An underlying systemic disease was present in 70 (45.2%) patients (82 eyes, 45.6%). The mean preoperative logMAR BCVA was 1.13±0.62 (95% CI: 0.85–1.02) and increased to 0.42±0.57 (95% CI: 0.32–0.59) at last medical visit (p<0.001). A total of 107 eyes (59.4%) had postoperative complications including posterior capsular opacification, newly developed macular edema, recurrence of uveitis, macular epiretinal membrane, and deposits on the IOL surface. Preoperatively observed macular lesions was the factor most strongly associated with poor visual outcome after cataract surgery (odds ratio: 5.43; 95% CI: 3.41–7.34; p<0.001). Anterior segment pathologies, age at surgery, etiology of uveitis (idiopathic, uveitis associated systemic disease), and gender did not influence visual rehabilitation after surgery (p>0.05). Conclusions. The outcomes of phacoemulsification and IOL implantation in patients with uveitis were satisfactory. Patients with observed preoperative macular lesions are at risk for poor visual outcome.
Quantitative Assessment of Anterior Chamber Parameters in Pigmentary Glaucoma Using Slit-Lamp Optical Coherence Tomography
Authors: Dine Umut A. , Kulacoglu Destan N. , Oncel Banu , Yalvac Llgaz Sagdic 
Published: January 2018

Purpose. To quantitatively assess the parameters of anterior chamber and angle dimensions by slit-lamp optical coherence tomography (SL-OCT) in eyes with pigmentary glaucoma (PG). Methods. A total of 18 eyes of 11 patients with PG and 18 eyes of 11 healthy volunteers were included in the study. Anterior chamber depth (ACD), anterior chamber volume (ACV), spur distance (internal horizontal anterior chamber diameter), central corneal thickness (CCT), angle opening distance at 500 urn from the scleral spur (AOD 500), and trabecular iris space area at 500 μm from the scleral spur (TISA 500) parameters were detected by SL-OCT. The differences of anterior chamber parameters between patients with PG and the control group were analyzed by Mann-Whitney U test. Results. Mean ACD and ACV were measured as 3.28±0.38 mm and 191.6±39.7 mm3 respectively in the PG group. Mean AOD 500 and TISA 500 were 0.88±0.47 mm and 0.29±0.15 mm2 at the nasal angle and 1.14±0.67 mm and 0.41 ±0.23 mm2 at the temporal angle, respectively. Nasal and temporal angles were 49.83±11.1° and 53.83±10.46°. In eyes with PG, the midperipheral iris configuration was found to be considerably concave in 15 eyes (83.3%). Except CCT and spur distance, all anterior chamber dimension and angle parameters detected by SL-OCT were found to be significantly higher in the eyes with PG (Mann-Whitney U test, p<0.05). Conclusions. SL-OCT provided highly quantitative data on the parameters of anterior chamber and angle dimensions in PG. The evaluation of the anterior segment anatomy using SL-OCT revealed increased anterior chamber dimensions and posterior bowing of the iris consistent with the increase in angle parameters in patients with PG.