Retrobulbar anesthesia (block) is used for many ocular surgeries, whereas it is well known that this procedure has complications such as for retrobulbar hemorrhage, globe perforation, optic nerve injury and brain stem...Retrobulbar anesthesia (block) is used for many ocular surgeries, whereas it is well known that this procedure has complications such as for retrobulbar hemorrhage, globe perforation, optic nerve injury and brain stem anesthesia. In this report, we present a unique case in the literature of isolated exudative retinal detachment (RD) secondary to iatrogenic retrobulbar hemorrhage. A 73-year-old woman underwent retrobulbar block for combined phaco-vitrectomy. Immediately after the injection, progressive proptosis was recognized. The globe was decompressed and she underwent combined phaco-vitrectomy after stabilization of the eye on the same day. At the be-ginning of the vitrectomy, a dome shaped serous RD was observed in the infero-temporal quadrant. Peripheral exploration was performed, whereas there was no retinal tear or hole. On the first day postoperatively, serous RD was disappeared. In conclusion, this report suggests that increased intraorbital pressure secondary to iatrogenic retrobulbar hemorrhage might lead exudative RD.展开更多
Background:To compare and contrast morpho-volumetric features between Down syndrome(DS)cornea and non-DS keratoconic cornea by three-dimensional(3D)modelling.Methods:Forty-three subjects(43 eyes)with DS and 99 patient...Background:To compare and contrast morpho-volumetric features between Down syndrome(DS)cornea and non-DS keratoconic cornea by three-dimensional(3D)modelling.Methods:Forty-three subjects(43 eyes)with DS and 99 patients matching their age and sex(99 eyes)with keratoconus(KC)were included in this single-center cross-sectional study.Main outcome measures were high-order aberrations(HOA),central corneal thickness(CCT),spherical equivalent refraction,and morpho-volumetric parameters established using a 3D corneal model,such as deviation of anterior and posterior corneal apices(Dapexant/D_(apexpost))and minimum thickness points(D_(mctant)/D_(mctpost))from corneal vertex,areas of the anterior and posterior surfaces(Aant/A_(post)),sagittal area passing through the anterior and posterior corneal apices(Aapexant/Aapexpost)and minimum thickness point(A_(mctpost))and corneal volume of the complete cornea(V_(total)).Results:Age,gender,spherical equivalent refraction,CCT and V_(total)were similar between the net on-DS KC and DS groups(P>0.05),while non-DS KC group had higher HOA than the DS group(P<0.05).Dapexant,Aant,A_(post)and Aapexant showed higher values in the DS group than in the non-DS KC group,whereas D_(apexpost)showed a reduction in the DS group when compared with the non-DS KC group(P<0.05).Conclusions:This study demonstrated that anterior and posterior corneal apex dynamics were specifically different in DS subjects,as the anterior apex tends to displace more prominently when compared to that from the non-DS KC group,while the posterior apex appears to be more stable than that in non-DS KC,which also support the theory that DS patients suffer from a specific keratopathy,distinctively different to KC but strongly related to it,and probably showing a diversity of corneal phenotypes in all cases of DS.展开更多
This short report includes 5 eyes of 5 patients(mean age 63.2±12 years)who underwent a tectonic keratoplasty[deep anterior lamellar keratoplasty(DALK)or penetrating keratoplasty(PK)]in order to rehabilitate the e...This short report includes 5 eyes of 5 patients(mean age 63.2±12 years)who underwent a tectonic keratoplasty[deep anterior lamellar keratoplasty(DALK)or penetrating keratoplasty(PK)]in order to rehabilitate the eye after the extrusion of the non-perforating keratoprosthesis(Kpro)KeraKlear(KeraMed,USA).The non-perforating Kpro was extruded after a mean period of 21.4±21.8 months due to melting.In two cases,the keratoplasty was performed the same day of the non-perforating Kpro removal due to a severe melting,while in the other three cases it was performed 1 to 3 months later.Two eyes received a DALK,but in 3 eyes a macroscopic Descemetzs membrane perforation forced the conversion into a PK.The mean follow-up period after the keratoplasty was 16.8±6.6 months.No cases of rejection were recorded.All the 5 eyes achieved"anatomical success"(transparent graft,with no signs of infection or inflammation).Two eyes showed limited functional success"because the achievement of the best visual potential was prevented by the development of glaucomatous optic atrophy during the follow-up period.In conclusion,this short report presents an unexpected success of a keratoplasty performed with a tectonic purpose after the extrusion of the non-perforating Kpro because the corneal graft remained transparent,without neovascularization or scarring during the follow-up period.This initial evidence shows some encouraging results reg a rd i ng graft survival rate and the achievement of a useful visual rehabilitation with keratoplasty after a nonperforating Kpro failure in stead of repeating the Kpro implantation.展开更多
This short report includes 5 eyes of 5 patients(mean age 63.2±12 years)who underwent a tectonic keratoplasty[deep anterior lamellar keratoplasty(DALK)or penetrating keratoplasty(PK)]in order to rehabilitate the e...This short report includes 5 eyes of 5 patients(mean age 63.2±12 years)who underwent a tectonic keratoplasty[deep anterior lamellar keratoplasty(DALK)or penetrating keratoplasty(PK)]in order to rehabilitate the eye after the extrusion of the non-perforating keratoprosthesis(Kpro)KeraKlear(KeraMed,USA).The non-perforating Kpro was extruded after a mean period of 21.4±21.8 months due to melting.In two cases,the keratoplasty was performed the same day of the non-perforating Kpro removal due to a severe melting,while in the other three cases it was performed one to 3 months later.Two eyes received a DALK,but in 3 eyes a macroscopic Descemet membrane perforation forced the conversion into a PK.The mean follow-up period after the keratoplasty was 16.8±6.6 months.No cases of rejection were recorded.All the 5 eyes achieved“anatomical success”(transparent graft,with no signs of infection or inflammation).Two eyes showed limited“functional success”because the achievement of the best visual potential was prevented by the development of glaucomatous optic atrophy during the follow-up period.In conclusion,this short report presents an unexpected success of a keratoplasty performed with a tectonic purpose after the extrusion of the non-perforating Kpro because the corneal graft remained transparent,without neovascularization or scarring during the follow-up period.This initial evidence shows some encouraging results regarding graft survival rate and the achievement of a useful visual rehabilitation with keratoplasty after a nonperforating Kpro failure instead of repeating the Kpro implantation.展开更多
文摘Retrobulbar anesthesia (block) is used for many ocular surgeries, whereas it is well known that this procedure has complications such as for retrobulbar hemorrhage, globe perforation, optic nerve injury and brain stem anesthesia. In this report, we present a unique case in the literature of isolated exudative retinal detachment (RD) secondary to iatrogenic retrobulbar hemorrhage. A 73-year-old woman underwent retrobulbar block for combined phaco-vitrectomy. Immediately after the injection, progressive proptosis was recognized. The globe was decompressed and she underwent combined phaco-vitrectomy after stabilization of the eye on the same day. At the be-ginning of the vitrectomy, a dome shaped serous RD was observed in the infero-temporal quadrant. Peripheral exploration was performed, whereas there was no retinal tear or hole. On the first day postoperatively, serous RD was disappeared. In conclusion, this report suggests that increased intraorbital pressure secondary to iatrogenic retrobulbar hemorrhage might lead exudative RD.
基金supported in part by the Thematic Network for Co-Operative Research in Health(Red Temática De Investigación Oftalmológica,RETICS)(Reference No.RD16/0008/0012)financed by the Carlos III Health Institute-General Sub-direction of Networks and Cooperative Investigation Centres(R&D&I National Plan 2013–2016)and the European Regional Development Fund(FEDER)+2 种基金carried out within the framework of the project“Desarrollo y validación de un nuevo concepto de caracterización biomecánica-morfofuncional de la córnea”(Reference No.DTS21/00103)funded by Instituto de Salud Carlos III(ISCIII)cofunded by the European Union.This study was also carried out in collaboration with the Association for the Integration of the Disabled in the Comarca del Mar Menor(AIDEMAR,collaboration protocol UPCT-AIDEMAR).
文摘Background:To compare and contrast morpho-volumetric features between Down syndrome(DS)cornea and non-DS keratoconic cornea by three-dimensional(3D)modelling.Methods:Forty-three subjects(43 eyes)with DS and 99 patients matching their age and sex(99 eyes)with keratoconus(KC)were included in this single-center cross-sectional study.Main outcome measures were high-order aberrations(HOA),central corneal thickness(CCT),spherical equivalent refraction,and morpho-volumetric parameters established using a 3D corneal model,such as deviation of anterior and posterior corneal apices(Dapexant/D_(apexpost))and minimum thickness points(D_(mctant)/D_(mctpost))from corneal vertex,areas of the anterior and posterior surfaces(Aant/A_(post)),sagittal area passing through the anterior and posterior corneal apices(Aapexant/Aapexpost)and minimum thickness point(A_(mctpost))and corneal volume of the complete cornea(V_(total)).Results:Age,gender,spherical equivalent refraction,CCT and V_(total)were similar between the net on-DS KC and DS groups(P>0.05),while non-DS KC group had higher HOA than the DS group(P<0.05).Dapexant,Aant,A_(post)and Aapexant showed higher values in the DS group than in the non-DS KC group,whereas D_(apexpost)showed a reduction in the DS group when compared with the non-DS KC group(P<0.05).Conclusions:This study demonstrated that anterior and posterior corneal apex dynamics were specifically different in DS subjects,as the anterior apex tends to displace more prominently when compared to that from the non-DS KC group,while the posterior apex appears to be more stable than that in non-DS KC,which also support the theory that DS patients suffer from a specific keratopathy,distinctively different to KC but strongly related to it,and probably showing a diversity of corneal phenotypes in all cases of DS.
基金This publication has been carried out in the framework of the Red Tematica de Investigacion Cooperativa en Salud(RETICS),referenee number RD 16/0008/0012,financed by the Instituto Carlos Ⅲ-General Subdirection of Networks and Cooperative Investigation Centers(R&D&I National Plan 2008-2011)and the Euro pea n Regional Developme nt Fund(Fondo Europeo de Desarrollo Regional FEDER).
文摘This short report includes 5 eyes of 5 patients(mean age 63.2±12 years)who underwent a tectonic keratoplasty[deep anterior lamellar keratoplasty(DALK)or penetrating keratoplasty(PK)]in order to rehabilitate the eye after the extrusion of the non-perforating keratoprosthesis(Kpro)KeraKlear(KeraMed,USA).The non-perforating Kpro was extruded after a mean period of 21.4±21.8 months due to melting.In two cases,the keratoplasty was performed the same day of the non-perforating Kpro removal due to a severe melting,while in the other three cases it was performed 1 to 3 months later.Two eyes received a DALK,but in 3 eyes a macroscopic Descemetzs membrane perforation forced the conversion into a PK.The mean follow-up period after the keratoplasty was 16.8±6.6 months.No cases of rejection were recorded.All the 5 eyes achieved"anatomical success"(transparent graft,with no signs of infection or inflammation).Two eyes showed limited functional success"because the achievement of the best visual potential was prevented by the development of glaucomatous optic atrophy during the follow-up period.In conclusion,this short report presents an unexpected success of a keratoplasty performed with a tectonic purpose after the extrusion of the non-perforating Kpro because the corneal graft remained transparent,without neovascularization or scarring during the follow-up period.This initial evidence shows some encouraging results reg a rd i ng graft survival rate and the achievement of a useful visual rehabilitation with keratoplasty after a nonperforating Kpro failure in stead of repeating the Kpro implantation.
基金This publication has been carried out in the framework of the Red Temática de Investigación Cooperativa en Salud(RETICS),reference number RD16/0008/0012financed by the Instituto Carlos III–General Subdirection of Networks and Cooperative Investigation Centers(R&D&I National Plan 2008–2011)the European Regional Development Fund(Fondo Europeo de Desarrollo Regional FEDER).
文摘This short report includes 5 eyes of 5 patients(mean age 63.2±12 years)who underwent a tectonic keratoplasty[deep anterior lamellar keratoplasty(DALK)or penetrating keratoplasty(PK)]in order to rehabilitate the eye after the extrusion of the non-perforating keratoprosthesis(Kpro)KeraKlear(KeraMed,USA).The non-perforating Kpro was extruded after a mean period of 21.4±21.8 months due to melting.In two cases,the keratoplasty was performed the same day of the non-perforating Kpro removal due to a severe melting,while in the other three cases it was performed one to 3 months later.Two eyes received a DALK,but in 3 eyes a macroscopic Descemet membrane perforation forced the conversion into a PK.The mean follow-up period after the keratoplasty was 16.8±6.6 months.No cases of rejection were recorded.All the 5 eyes achieved“anatomical success”(transparent graft,with no signs of infection or inflammation).Two eyes showed limited“functional success”because the achievement of the best visual potential was prevented by the development of glaucomatous optic atrophy during the follow-up period.In conclusion,this short report presents an unexpected success of a keratoplasty performed with a tectonic purpose after the extrusion of the non-perforating Kpro because the corneal graft remained transparent,without neovascularization or scarring during the follow-up period.This initial evidence shows some encouraging results regarding graft survival rate and the achievement of a useful visual rehabilitation with keratoplasty after a nonperforating Kpro failure instead of repeating the Kpro implantation.
