Search

The aim of this study is to compare magnetic resonance imaging (MRI) with computed tomography (CT) for visualization of an orbital alloplastic prosthesis made of ultra-high-molecular-weight polyethylene (UHMW-PE) both in vitro and in vivo. A study of 15 test implants from UHMW-PE visualized in vitro in CT and MRI and an in vivo visualization in a patient who suffered from orbital injury and underwent reconstructive surgery is presented. The postsurgery MRI showed the UHMW-PE material clearly, with no significant artifacts. The surrounding tissues could be satisfactorily evaluated. The CT scans did not present the graft material. Both techniques were sufficient tools for in vitro evaluation of the shape and measurement of the prosthesis. [ABSTRACT FROM AUTHOR]

The article features sports activities that can present risks for eye injuries. Eye injuries commonly occur in collision sports including hockey, lacrosse and football as well as in non contact sports such as swimming, tennis and cross country running. It notes the mechanisms of eye injuries that are sports-related, the proper and immediate treatment of eye injuries and reduction of eye injuries through the use of eye protection when participating in sports activities.

Aim of the study: To analyze the reasons for referrals of patients under the age of 15 to the Ophthalmic Emergency Department (ED), to determine the type of services provided and to define the age range of children presenting to the ED most frequently. Material and methods: The retrospective review included 537 patients below 15 years old who presented to the ED of the Ophthalmology Department of Poznan University of Medical Sciences between November 2017 and February 2019. Results: 250 girls and 287 boys aged from 10 days to 15 years old presented to the ED. Children less than 1 year old constituted 13.4% of patients, patients between 1 and 3 years old constituted 21.8%, and those between 4 and 7 constituted 28.7%. The largest group consisted of patients between 8 and 15 years old (36.1%). Injuries constituted 71 of referrals (13.2%). The patients most frequently complained of redness of the eye, discharge and eye pain. The most frequently diagnosed condition was conjunctivitis (218 patients, 40.6%), and the second most common was stye or chalazion (51 pa- tients, 9.5%). Twenty-six patients (4.8%) required hospitalization, 4 in the ophthalmic ward (0.7%). Two hundred seventy patients (50.2%) were advised to visit an ophthalmologist for a check-up or to have a planned refraction examination. Conclusions: Patients under 15 years old reported to the ophthalmic ED most commonly for non-traumatic reasons. The dominant diagnosis was conjunctivitis. The most common recommendation was mandatory control in the outpatient ophthalmic clinic. The most numerous group among the patients was that of children aged 8 to 15 years. [ABSTRACT FROM AUTHOR]

A 25-year-old male patient presented at the clinic with chemical trauma to the left eye. His visual acuity according to Snellen chart measurement was 0.05/10 in the left eye and 10/10 in the right eye. On slit lamp examination, conjunctival hyperemia and limbal ischemia were observed between the 1 o'clock and 6 o'clock hours (approximately 5 clock hours). The cornea was edematous in this area, and a corneal epithelial defect adjacent to the limbal ischemia area was present. The anterior chamber, iris, and lens were normal; the fundus could not be concurrently evaluated. Conjunctivalization and excessive neovascularization were observed in the limbal ischemic area at the end of the fourth week of medical treatment. Visual acuity in the left eye was 0.3 and the epithelial defect had healed. At the end of the sixth week, a conjunctival limbal autograft (CLAU) combined with amniotic membrane (AM) transplantation surgery was performed. Subsequently, the corneal neovascularization was noted to have completely vanished in the ischemic area where the CLAU and AM transplantation were performed. Visual acuity improved to 0.7 and the symptoms of the patient decreased. [ABSTRACT FROM AUTHOR]

Purpose: Visual impairment is responsible for medical, mental, and socio-economic problems. Several studies have investigated the prevalence of blindness and low vision in different parts of Iran. This study aims to estimate the pooled results of these studies to estimate the total prevalence of this problem in Iran. Methods: National and international databases were searched using specific keywords. The selected primary studies were quality assessed using STROBE checklist. According to the results of the heterogeneity tests (Cochrane and I-squared indices), fixed- or random-effect models were applied to estimate the pooled results. The factors responsible for the heterogeneity were investigated using meta-regression models. The point and pooled estimates were presented by forest plots, and the presence of publication bias was assessed based on Egger test. Results: Considering the results of 10 eligible studies showed that the prevalence (95% confidence intervals) of blindness among men, women, urban, and rural population as well as total population was 0.96% (0.60-1.31), 1.00% (0.70-1.31), 0.81% (0.19-1.44), 0.89% (0.45-1.32), and 1.02% (0.71-1.34), respectively. Prevalence (95% confidence intervals) of low vision among men, women, urban, and rural populations and also total populations was estimated at 2.19% (1.60-2.79), 2.60% (2.08-3.12), 2.81% (1.26-4.36), 3.67% (2.17-5.17), and 2.85% (2.12-3.58), respectively. Conclusion: Our meta-analyses showed that more than 3% of Iranian people are suffering from visual problems. In addition, we found that prevalence of blindness and low vision among Iranian women was more common than that of Iranian men and also was higher in rural areas than urban areas. [ABSTRACT FROM AUTHOR]

Purpose: To describe the trends in eye injuries and associated medical costs among children in the United States. Methods: Data were from the 2002-2014 Medical Expenditure Panel Survey (MEPS). Eye injuries in children aged <18 years were identified by the International Classification of Diseases-9 (ICD-9) codes. The trends of cumulative incidence of eye injury, total costs, and average costs were estimated from 2002-2014 MEPS data. All costs were adjusted to 2014 US dollars. Analyses accounted for the complex stratified multistage survey design of the MEPS. We used MarketScan data (2010-2013) to validate outpatient cost estimates. Results: The 3-year average cumulative incidence of eye injuries declined from 0.56% in 2002-2004 to 0.31% in 2012-2014 (Trend p < 0.001). The average annual total costs decreased from $193 million during 2002-2004 to $66 million during 2012-2014 (p < 0.001). Conclusion: The MEPS data showed that among children aged <18 years, the incidence of eye injuries and associated financial burden substantially declined during 2002-2014, highlighting the progress in preventing children eye injuries. Continuing efforts are needed to further reduce the burden in this population. [ABSTRACT FROM AUTHOR]

Ocular chemical burns are an ophthalmic emergency and are responsible for 11.5%–22.1% of ocular injuries. Immediate copious irrigation is universally recommended in acute ocular burns to remove the offending agent and minimize damage. Conventional medical therapy consists of the use of agents that promote epithelialization, minimize inflammation, and prevent cicatricial complications. Biological fluids such as autologous serum, umbilical cord blood serum, platelet-rich plasma, and amniotic membrane suspension are a rich source of growth factors and promote healing when used as adjuncts to conventional therapy. Surgical treatment of acute ocular burns includes the debridement of the necrotic tissue, application of tissue adhesives, tenoplasty, and tectonic keratoplasty. Amniotic membrane transplantation is a novel surgical treatment that is increasingly being used as an adjunct to conventional treatment to promote epithelial healing, minimize pain, and restore visual acuity. Various experimental treatments that aim to promote wound healing and minimize inflammation are being evaluated such as human mesenchymal and adipose stem cells, beta-1,3 glucan, angiotensin-converting enzyme inhibitors, cultivated fibroblasts, zinc desferrioxamine, antifibrinolytic agents, antioxidants, collagen cross-linking, and inhibitors of corneal neovascularization. [ABSTRACT FROM AUTHOR]

Purpose To determine the current population-based epidemiology, treatment, use of resources and outcomes of children's eye injuries in Finland. Methods The study included all new patients, 16 years of age or under, with ocular or orbital traumas taken into care to the Helsinki University Eye Hospital (population base 1.5 million people) in 1 year. The follow-up period was 3 months. Results Two hundred and two children's eye injuries were treated. The eye injury incidence was 5.2-8.3 per 10 000 per year, including all minor and major eye traumas. Eye injury most likely occurred at the junior high school age (13-16 years). Thirty-three percentage of accidents took place at home and 24% at school or in day care. The most common causes were sports equipment (15%), contact with human body (12%) and superficial foreign bodies (11%). Excluding minor injuries, contusion was the most common diagnosis ( n = 60, 30%). Eighty-seven percentage of contusion patients were estimated to need lifelong follow-up due to elevated glaucoma risk. Nine percentage of all patients had a permanent disability. Guns, fireworks, tools and pellet guns were relatively the most dangerous objects. Pellet guns caused 6% of eye injuries, 36% of them causing permanent impairment. The number of outpatient visits was altogether 443, inpatient days were 49, and 60 children had major surgeries. Conclusions Use of protective eyewear would have prevented or diminished eye traumas caused by pellet gun, floorball, most of the firework and in many superficial foreign body. The use of pellet guns and protective eyewear should be more supervised. Fireworks and tools are not suitable toys for children. [ABSTRACT FROM AUTHOR]

Purpose To describe epidemiology, causes, treatments and outcomes of ocular injuries in adults aged 17 to 60 in southern Finland. Methods All new ocular trauma patients admitted to the Helsinki University Eye Hospital ( HUEH), during 1 year in 2011-2012. The data were from hospital records and prospectively from patient questionnaires. The follow-up time was 3 months. Results The incidence for ocular injury was 88/100 000/year. From 831 trauma patients, 80% were men, 34% were work-related injuries, and 11% were assaults. Most of the injuries were minor traumas (54%). Contusions (22.5%) and chemical injuries and burns (13%) were common. Fractures (5%), lid wounds (3%), open globe injuries ( OGI, 2%) and optic nerve injuries (0.5%) were rare. The main causes of ocular injury were superficial foreign bodies (33%), chemicals (13%), body parts (13%) and sports equipment (10%). The most dangerous objects were needles, stones, pellet guns, tools and guns. No patient with OGI used protective eyewear. All OGI and most of contusions needed a lifelong follow-up. Permanent impairment (73 patients, 9%) was caused most often by body parts, sports equipment and work tools. Conclusion A typical ocular trauma patient was a man aged 31-45 with a minor trauma caused by a foreign body at work and a final visual acuity of 20/20. Most common serious injuries were contusion, OGI or fracture at home or at work and were caused by a body part, sport equipment or work tool. Factors causing common and serious eye injuries provide the targets for protective measures. [ABSTRACT FROM AUTHOR]

Epithelial cells are involved in the regulation of innate and adaptive immunity in response to different stresses. The purpose of this study was to investigate if alkali-injured corneal epithelia activate innate immunity through the nucleotide-binding oligomerization domain-containing protein (NOD)-like receptor family pyrin domain containing 3 (NLRP3) inflammasome pathway. A unilateral alkali burn (AB) was created in the central cornea of C57BL/6 mice. Mice received either no topical treatment or topical treatment with sodium butyrate (NaB), β-hydroxybutyric acid (HBA), dexamethasone (Dex), or vehicle (balanced salt solution, BSS) quater in die (QID) for two or five days (d). We evaluated the expression of inflammasome components including NLRP3, apoptosis-associated speck-like protein (ASC), and caspase-1, as well as the downstream cytokine interleukin (IL)-1β. We found elevation of NLRP3 and IL-1β messenger RNA (mRNA) transcripts, as well as levels of inflammasome component proteins in the alkali-injured corneas compared to naïve corneas. Treatment with NLRP3 inhibitors using NaB and HBA preserved corneal clarity and decreased NLRP3, caspase-1, and IL-1β mRNA transcripts, as well as NLRP3 protein expression on post-injury compared to BSS-treated corneas. These findings identified a novel innate immune signaling pathway activated by AB. Blocking the NLRP3 pathway in AB mouse model decreases inflammation, resulting in greater corneal clarity. These results provide a mechanistic basis for optimizing therapeutic intervention in alkali injured eyes. [ABSTRACT FROM AUTHOR]

Background: A foreign body (FB) penetrating intracranially after passing transorbitally or transnasally is a rare occurrence. However, otolaryngologists are increasingly being asked to participate in the care of these patients for both endoscopic removal of the object and repair of any skull base defects. Objective: To assess the presentation, workup, and management of transnasal or transorbital penetrating FB injury. Methods: Systematic review of the presentation, workup, and management of transnasal or transorbital penetrating FB injury; plus, a case report of a 53-year-old woman with a transorbital penetrating rose bush branch. We searched medical literature data bases, which resulted in 215 total titles, which were then narrowed based on inclusion and exclusion criteria. Results: Thirty-five cases of transorbital or transnasal low-velocity trauma that involved the paranasal sinuses were reviewed from 33 articles. The average age was 30 years, 40% of the objects were made of wood. Fifty-seven percent of the cases were transorbital, whereas 43% were transnasal. Forty-six percent of the surgical interventions were completed endoscopically or with endoscopic assistance. Complications of injury were common, with 66% of patients experiencing cerebrospinal fluid leaks; 23%, permanent blindness; 17%, meningitis; 14%, ophthalmoplegia; 9%, decreased visual acuity; and 3%, brain abscess. Our patient presented with a traumatic cerebrospinal fluid leak, and recovered well after transorbital and endoscopic removal of the branch, skull base repair, and a prolonged course of antibiotics and antifungal medications. Conclusions: Transnasal and transorbital penetrating FB injuries are a relatively uncommon occurrence but when they do occur require rapid workup and interdisciplinary management to prevent acute and delayed complications. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the epidemiological characteristics and outcomes of ocular injuries resulting from the use of firecrackers during the Diwali festival in all age groups.Materials and Methods: A single-center, retrospective, hospital-based case series presenting with ocular trauma consequent to fireworks usage in a tertiary eye care center in North India during the 5 days of Diwali festival from 2011 to 2015 was conducted.Results: A total of 53 eyes of 45 patients were included in the study, out of which the vast majority (39/87%) were males. The mean age was 20.55 years. Almost an equal number of bystanders (25/55.5%) were affected as compared to people handling the fireworks (20/44.44%). Five (9.43%) eyes had open-globe injury, whereas 48 (90.56%) eyes had closed-globe injury. Eighteen (33.96%) eyes underwent surgical intervention. Thirty-three (62.26%) eyes had final vision >20/200 with eight (15.09%) eyes being vision <3/60 in the affected eye.Conclusion: Firework-related ocular trauma can lead to serious visual impairment. Mandatory legislative laws pertaining to the manufacture, sale, and use of fireworks and creating public awareness can reduce the incidence of this preventable cause of blindness in the society. Initiating new policies for retailers involved in sale of these firecrackers can also bring in decrease of such morbidities. [ABSTRACT FROM AUTHOR]

Background Restoration of orbital volume after internal orbital fractures can prevent enophthalmos. A variety of allografts are commonly used including titanium mesh with and without porous polyethylene coating. Some controversy exists over the use of uncoated titanium mesh in the orbit. Newer products contoured to the three dimensional orbital anatomy aim to improve reestablishment of the complex orbital shape though studies of outcomes with their use are limited. Methods A retrospective chart review was performed to evaluate surgical outcomes in all patients who underwent orbital fracture repair with DePuy/Synthes titanium MatrixMIDFACE prefabricated implants (PFTi) as compared with porous polyethylene/titanium hybrid implants (PPETi) including Stryker Medpor Titan, MTB, and BTB implants. Incidence of reoperation, diplopia, and movement restriction between PFTi and PPETi groups and the risk ratio of the above outcomes between implant types were compared. Results A total of 464 orbital implants were reviewed. Patients were divided by implant type with 195 patients receiving a PFTi implant and 269 patients receiving PPETi implant. (PFTi) and 269 had placement of a porous polyethylene/titanium hybrid implant. Despite statistically significant increased probability of utilization in more complex and delayed fractures, the PFTi implant showed no significant difference in complication profile or reoperation rate compared to the more commonly used PPETi. Conclusions PFTi implants, designed to replicate the native orbital shape, have similar surgical outcomes and no difference in complication profile compared to standard porous polyethylene/titanium implants hybrid plates. [ABSTRACT FROM AUTHOR]

Ocular injury by lewisite (LEW), a potential chemical warfare and terrorist agent, results in edema of eyelids, inflammation, massive corneal necrosis and blindness. To enable screening of effective therapeutics to treat ocular injury from LEW, useful clinically-relevant endpoints are essential. Hence, we designed an efficient exposure system capable of exposing up to six New-Zealand white rabbits at one time, and assessed LEW vapor-induced progression of clinical ocular lesions mainly in the cornea. The right eye of each rabbit was exposed to LEW (0.2 mg/L) vapor for 2.5, 5.0, 7.5 and 10.0 min and clinical progression of injury was observed for 28 days post-exposure (dose–response study), or exposed to same LEW dose for 2.5 and 7.5 min and clinical progression of injury was observed for up to 56 days post-exposure (time–response study); left eye served as an unexposed control. Increasing LEW exposure caused corneal opacity within 6 h post-exposure, which increased up to 3 days, slightly reduced thereafter till 3 weeks, and again increased thereafter. LEW-induced corneal ulceration peaked at 1 day post-exposure and its increase thereafter was observed in phases. LEW exposure induced neovascularization starting at 7 days which peaked at 22–35 days post-exposure, and remained persistent thereafter. In addition, LEW exposure caused corneal thickness, iris redness, and redness and swelling of the conjunctiva. Together, these findings provide clinical sequelae of ocular injury following LEW exposure and for the first time establish clinically-relevant quantitative endpoints, to enable the further identification of histopathological and molecular events involved in LEW-induced ocular injury. [ABSTRACT FROM AUTHOR]

Purpose: To examine the pharmacokinetic characteristics of sustained-release dexamethasone depots in two separate canine studies.Methods: Dexamethasone depots loaded with a clinically representative (0.4 mg) dose (DEXTENZA™; Ocular Therapeutix) or an elevated (0.7 mg) dose were inserted into the canaliculi of beagle eyes (n = 37 and n = 34, respectively). Tear fluid was collected for pharmacokinetic analysis of dexamethasone in both studies at predetermined time points. Explanted 0.4 mg depots were collected weekly to measure remaining drug level. Clinical observations and ophthalmic examinations were performed in both studies at each visit.Results: The 0.4 mg depots released a median 308 μg by day 15 and tapered to complete drug release by day 28. Median dexamethasone tear fluid concentrations in the 0.4 mg study group decreased from 2,805 ng/mL at day 7 to 0 ng/mL on day 28. Median dexamethasone tear fluid concentrations in the 0.7 mg study group decreased from 4,370 ng/mL at 6 h post insertion to 830 ng/mL on day 35. Mean ± standard deviation intraocular pressures in the 0.4 and 0.7 mg study groups were 20.7 ± 2.8 and 19.0 ± 4.1 mmHg at baseline, respectively, and demonstrated no meaningful change (20.5 ± 3.0 and 20.6 ± 2.9 mmHg, respectively) over the studies' durations. No ocular toxicities were attributed to the dexamethasone depot.Conclusion: Sustained-release dexamethasone produced no identifiable ocular toxicity in this animal model, and pharmacokinetics demonstrated a sustained and tapered drug release over 28 days at a 0.4 mg dose and exceeded 35 days at a 0.7 mg dose. [ABSTRACT FROM AUTHOR]

Pituitary adenylate cyclase-activating polypeptide (PACAP) is a 27- or 38-amino acid neuropeptide, which belongs to the vasoactive intestinal polypeptide/glucagon/secretin family. PACAP and its three receptor subtypes are expressed in neural tissues of the eye, including the retina, cornea and lacrimal gland, and PACAP is known to exert pleiotropic effects throughout the central nervous system. This review provides an overview of current knowledge regarding the cell protective effects, mechanisms of action and therapeutic potential of PACAP in response to several types of eye injury. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to identify the risk factors that are predictive of poor outcomes in penetrating globe trauma. Patients and methods: This retrospective case series evaluated 103 eyes that had been surgically treated for an open-globe injury from 2007 to 2010 at the eye clinic of the University of Virginia. A total of 64 eyes with complete medical records and at least 6 months of follow-up were included in the study. Four risk factors (preoperative best-corrected visual acuity [pre-op BCVA], ocular trauma score [OTS], zone of injury [ZOI], and time lapse [TL] between injury and primary repair) and three outcomes (final BCVA, monthly rate of additional surgeries [MRAS], and enucleation) were identified for analysis. Results: Pre-op BCVA was positively associated with MRAS, final BCVA, and enucleation. Calculated OTS was negatively associated with the outcome variables. No association was found between TL and ZOI with the outcome variables. Further, age and predictor variable-adjusted analyses showed pre-op BCVA to be independently positively associated with MRAS (P=0.008) and with final BCVA (P<0.001), while the calculated OTS was independently negatively associated with final BCVA (P<0.001), but not uniquely associated with MRAS (P=0.530). Conclusion: Pre-op BCVA and OTS are best correlated with prognosis in open-globe injuries. However, no conventional features reliably predict the outcome of traumatized eyes. [ABSTRACT FROM AUTHOR]

Purpose: To elucidate the Chinese practice of intraocular antibiotics administration for prophylaxis after open globe injury. Methods: A cross-sectional questionnaire survey was performed online by scanning a Quickmark (QR) code with smartphones at the 20th Chinese National Conference of Ocular Trauma in November 2014. Results: A total of 153 (30.6%) of all participators at the conference responded. Of the respondents, 20.9% were routinely administered with prophylactic intraocular injection of antibiotics at the conclusion of the primary eye repair, and 56.9% were used only in cases with high risk of endophthalmitis development. The intraocular route of delivery was mainly included with intracameral injection (47.9%) and intravitreal injection (42.0%). Cephalosporins (53.8%) and vancomycin (42.0%) were the main choices of antibiotic agents, followed by fluoroquinolones (24.3%), and aminoglycosides (13.4%). Only 21.9% preferred a combination of two or more two drugs routinely. In addition, significantly more respondents from the referral eye hospital (92.7%) replied using intraocular antibiotics injection for prophylaxis compared to those respondents from the primary hospital (69.4%) (p = 0.001, Fisher’s exact test). Conclusions: Intraocular antibiotics injection for post-traumatic endophthalmitis prophylaxis is widely used in China. However, the choice of antibiotic agents and the intraocular route of delivery vary. A well-designed clinical trial is needed to establish a standardized protocol of intraocular antibiotics administration for post-traumatic endophthalmitis prophylaxis. [ABSTRACT FROM AUTHOR]

Purpose: Characterization of the response of the Balb/c mouse to an eye-directed overpressure airwave, with the hypothesis that this mouse strain and model is useful for testing potential therapeutics for the treatment of traumatic eye injury.Methods: The left eyes of adult Balb/c mice were exposed to an eye-directed overpressure airwave. Intraocular pressure (IOP) was measured and eyes were inspected for gross pathology changes. Optical coherence tomography and histology were used to examine the structural integrity of the retina and optic nerve. Immunohistochemistry, in vivo molecular fluorophores, and a multiplex enzyme-linked immunosorbent assay were utilized to identify changes in cell death, neuroinflammation, and oxidative stress.Results: This model induced a transient increase in IOP, corneal injuries, infrequent large retinal detachments, retinal pigment epithelium (RPE) vacuolization, glial reactivity, and retinal cell death. Both the corneal damage and RPE vacuolization persisted with time. Optic nerve degeneration occurred as early as 7 days postinjury and persisted out to 60 days. Retinal cell death, increased levels of reactive oxygen species, and neuroinflammation were detected at 7 days postinjury.Conclusions: The injury profile of the Balb/c mouse is consistent with commonly observed pathologies in blast-exposed patients. The damage is throughout the eye and persistent, making this mouse model useful for testing cell-based therapies. [ABSTRACT FROM AUTHOR]

So far in Poland, the vast majority of patients with ocular problems have been diagnosed and treated immediately by an ophthalmologist, acting in our country as a "GP". Due to the introduced by the national Health Fund a change in the organization of the home health care system, involving the re-introduction of the need for a referral to an ophthalmologist, family doctors are likely to involve in the diagnosis and treatment of eye diseases. this reform can reduce patient wait time in the ophthalmology office, because family doctors are trained to treat some patients with ocular symptoms. the most serious challenge that can stand in front of them is to distinguish those patients who require urgent ophthalmological consultation and to provide adequate medical care until it was provided by an ophthalmologist. among these so-called "acute conditions in ophthalmology," the most important are the central retinal artery blockage, retinal detachment, iritis, a base or acid burns and acute attack of glaucoma. they represent a direct threat to loss of function of the eye, and quick implementation of appropriate prehospital treatment and rapid transport to a specialized center has a significant impact on the future vision of the patient after completion of the treatment process. therefore, it is important for the family doctor to know right workflow for both initial diagnosis and treatment of patients with eye's acute condtions. [ABSTRACT FROM AUTHOR]

Prompt emergency treatment for ocular injury, particularly in a battlefield setting, is essential to preserve vision, reduce pain, and prevent secondary infection. A bandage contact lens that could be applied in the field, at the time of injury, would protect the injured ocular surface until hospital treatment is available. Cellulose, a natural polymer, is widely used in biomedical applications including bandage materials. Hydrogels synthesized from different cellulose sources, such as plants, cotton, and bacteria, can have the optical transparency and mechanical strength of contact lenses, by tailoring synthesis parameters. Thus, we optimized the fabrication of cellulose-based hydrogels and evaluated their in vivo biocompatibility and related physical properties. Our data demonstrate that along with tailorable physical properties, our novel cellulose-based hydrogels could be made with contact lens geometry, exhibit no significant signs of material toxicity after 22 days of in vivo testing, and show significant promise for use as a corneal bandage immediately following ocular trauma. [ABSTRACT FROM AUTHOR]

Chemical and thermal ocular burns are among the most urgent ophthalmic emergencies, often resulting in permanent damage, and in some cases, blindness. These burns are the result of exposure to chemicals or radiant energy (thermal or ultraviolet). The most serious injuries are due to chemical burns by strong acid or bases. The purpose of managing these burns is to eliminate or limit the causative agent from penetrating the ocular structures by irrigation; and, promoting ocular surface healing through medical and surgical intervention. This review presents a current update on the causes of chemical and thermal ocular burns, their clinical features and the importance of appropriate and prompt treatment. [ABSTRACT FROM AUTHOR]

Purpose To quantify the end-of-day silicone-hydrogel daily disposable contact lens fit and its influence of on ocular comfort, physiology and lens wettability. Methods Thirty-nine subjects (22.1 ± 3.5 years) were randomised to wear each of 3 silicone-hydrogel daily-disposable contact lenses (narafilcon A, delefilcon A and filcon II 3), bilaterally, for one week. Lens fit was assessed objectively using a digital video slit-lamp at 8, 12 and 16 h after lens insertion. Hyperaemia, non-invasive tear break-up time, tear meniscus height and comfort were also evaluated at these timepoints, while corneal and conjunctival staining were assessed on lens removal. Results Lens fit assessments were not different between brands ( P > 0.05), with the exception of the movement at blink where narafilcon A was more mobile. Overall, lag reduced but push-up speed increased from 8 to 12 h ( P < 0.05), but remained stable from 12 to 16 h ( P > 0.05). Movement-on-blink was unaffected by wear-time ( F = 0.403, P = 0.670). A more mobile lens fit with one brand did not indicate that person would have a more mobile fit with another brand ( r = −0.06 to 0.63). Lens fit was not correlated with comfort, ocular physiology or lens wettability ( P > 0.01). Conclusions Among the lenses tested, objective lens fit changed between 8 h and 12 h of lens wear. The weak correlation in individual lens fit between brands indicates that fit is dependent on more than ocular shape. Consequently, substitution of a different lens brand with similar parameters will not necessarily provide comparable lens fit. [ABSTRACT FROM AUTHOR]

Background Many approaches were recommended for surgical treatment of orbital lesions via either transorbital or transcranial routes. The frontolateral craniotomy through eyebrow skin incision (lateral supraorbital approach) is a combined cranio-orbital approach that could be used in different orbital lesions. Objectives To evaluate the efficacy and safety of the lateral supraorbital approach for resection of orbital lesions. Patients and Methods Ten patients with different orbital lesions were treated by this minimally invasive technique. The technique is described in details. The postoperative outcome was evaluated with casting light on the specific parameters related to this approach. Results This study included 6 females and 4 males, ranging in age from 2 years to 65 years with mean age of 37.3 years. Proptosis was the most common presenting complaint. Six patients were operated on via the right supraorbital approach, and 4 patients via the left supraorbital approach. Various pathological lesions were treated. The excision was total in 7 patients, subtotal in 1 patient, and partial in 2 patients. Two patients suffered transient supraorbital hypothesia, 1 patient showed temporary superficial wound infection with CSF leak and 1 patient died within 6 months. Conclusion The lateral supraorbital approach is a minimally invasive approach that provides excellent exposure of the superior, lateral, and medial orbit, as well as the orbital apex. [ABSTRACT FROM AUTHOR]

Injuries to the eye and its adnexa are common in head and neck trauma centers. An ophthalmologist experienced in ocular traumatology is not always available. Therefore, every emergency physician should be familiar with the basic evaluation, triage, and management of ocular trauma. Above all, the identification of a need for immediate treatment should be implemented in the algorithm of an emergency room, especially in a head and neck trauma center, to reduce the risk of a devastating loss of vision. This article formulates the different types of ocular trauma and their required first-line therapy. [ABSTRACT FROM AUTHOR]

Eye exposure to the extremely toxic organophosphorus sarin results in long-term miosis and visual impairment. As current treatment using atropine or homatropine eye drops may lead to considerable visual side effects, alternative combined treatments of intramuscular (im) oximes (16.8 mmol/kg, im) with atropine (0.5 mg/kg, im) or with the short acting antimuscarinic tropicamide (0.5%; w/v) eye drops were thus evaluated. The combined treatments efficacy following topical exposure to sarin (1 mg) was assessed by measuring pupil width and light reflex using an infra-red based digital photographic system. Results showed that the combined treatment of various oximes with atropine or with topical tropicamide eye drops rapidly reversed the sarin-induced miosis and presented a long-termimprovement of 67-98% (oximeþtropicamide) or 84-109% (oximeþatropine) in pupil widening as early as 10-min following treatment. This recovery was shown to persist for at least 8-h following exposure. All combined treatments facilitated the ability of the iris to contract following sarin insult as tested by a light reflex response. Our findings emphasize the high efficacy of im oxime treatment combined with either atropine im or tropicamide eye drops in counteracting sarin-induced ocular insult. Therefore, in a mass casualty scenario the systemic combined treatment may be sufficient to ameliorate sarin-induced ocular insult with no need for additional, topical anticholinergic treatment at least in the initial stage of intoxication. For very mild casualties, who are unlikely to receive im treatment, the combined oxime (im) with topical tropicamide treatment may be sufficient in ameliorating the ocular insult. [ABSTRACT FROM AUTHOR]

The incidence and range of spontaneous pathology findings were determined in the eyes of male and female control Crl:CD-1(ICR)BR mice. Data were collected from 250, 430, 510, and 2,266 mice from control dose groups of 4-, 13-, 80- and 104-week studies, respectively, carried out between 2005 and 2013. Lesions of the eye were very rare in 4- and 13-week studies, uncommon in 80-week studies, and were of relatively higher incidence in 104-week studies. No sex predilection in the incidence of eye lesions was apparent. No neoplastic lesions were observed, and congenital lesions were very rare. The most common findings were cataracts, retinal degeneration, mineral deposits in the iris, keratitis, anterior uveitis, and mineral deposits in the corneal stroma. These lesions were observed only in animals from 80- and 104-week studies, except retinal degeneration which was observed in animals from all age-groups. There are no previous reports of mineral deposits in the iris in this strain of mice. It is hoped that reference to the incidences reported here will facilitate the differentiation of spontaneous lesions from compound-induced lesions in toxicology studies in this strain of mouse. [ABSTRACT FROM PUBLISHER]

Eye injuries are common in warfare with an incidence of approximately 10%. They carry a high morbidity, as they can determine an injured person’s future independence and employability. The majority are a combination of primary and secondary blast mechanisms, though tertiary and quaternary types are common. There is some evidence of quinary types from toxic elements from the explosion. Eye protection significantly reduces the incidence and severity of ballistic eye injury but does not eliminate it. Thermal ocular burns are relatively common in warfare. The treatment goal is to minimise limbal stem cell damage. Human amniotic membrane can be used to promote this. Retinal and optic nerve injury following closed eye trauma are currently untreatable, but neuroprotective and neuroregenerative agents are being developed to improve outcomes. Sensory substitution of the sense of touch for sight can help orientate blinded individual in their surroundings. Ophthalmology has a major impact on the lives of the war wounded. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the frequency of retinal redetachment after silicone oil removal (SOR) in cases of severe eye injuries operated during the 25th of January Egyptian Revolution; we also attempted to evaluate the causes behind the redetachment. Patients and methods: This retrospective, noncomparative, interventional case series included patients who had undergone both vitrectomy and SOR. The cause for the primary intervention was penetrating posterior segment trauma with and without intraocular foreign body (IOFB). Indications for performing SOR were classified as increased intraocular pressure, decreasing best-corrected visual acuity because of incorrectable refractive error, and oil emulsification changes with a preceding adequate duration of silicone oil tamponade (at least 4 months) in the absence of any complication. After SOR, patients were followed up for a minimum duration of 3 months. Retinal redetachment was managed with a repeat vitrectomy and silicone oil infusion. Preoperative and intraoperative factors that might be related to the recurrent detachment were identified. We attempted to relate these factors to the redetachment. Results: The age of the patients ranged from 15 to 46 years, with a mean age of 31.07 ± 8.3 years. The sample studied included 21 (70%) males. Preoperative retinal detachment (RD) was recorded before the first intervention in 17 (56.7%) eyes. IOFBs were found in 13 (43.3%) eyes. In nine (30%) cases, intraoperative retinotomy or retinectomy was performed to successfully flatten the retina. In the eyes with preoperative RD (17 eyes, 56.7%), an encircling band was fixed. The cause of SOR was found to be increased intraocular pressure in six (20%) eyes, decreasing best-corrected visual acuity because of incorrectable refractive error in 16 (53.3%) eyes, and oil emulsification changes in eight (26.7%) eyes. Before SOR all eyes showed an attached stable retina for a least 4 months. After 3 months of follow-up, seven (23.3%) eyes were found to have a recurrent RD. The cause for this recurrence was surmised to be because of proliferative vitreoretinopathy in two (6.7%) cases, reopening of an old break in another two (6.7%) eyes, and new breaks created because of aggressive proliferative vitreoretinopathy in three (10%) eyes. The recurrence of RD was not affected by the duration of silicone oil tamponade, preoperative RD, intraoperative retinotomy, an IOFB, the presence of vitreous remnants, and C3F8 fill with endolaser barrage at the conclusion of surgery (P = 0.76, 0.07, 0.64, 0.66, 0.54, 0.113, respectively). The only statistically significant correlation that we found was between the fixing of a tamponade and the rate of recurrence (P = 0.01). Conclusion: The routine use of silicone tamponade in complicated cases such as those with penetrating trauma, even if RD was not identified beforehand and the usage of an encircling bands in difficult cases with RD, may increase the success rate after SOR. [ABSTRACT FROM AUTHOR]

Purpose To describe presentation, treatment, and follow-up after unilateral alkaline injuries to the eye in four dogs. Material and method The case notes of four patients that suffered from alkaline injuries to the eye were included in this series. Results Acute clinical signs included blepharospasm and edema of the eyelids, chemosis and conjunctival hyperemia, conjunctival ischemia, destruction of the corneal epithelium, a whitish haze of the corneal stroma, mild corneal edema, and uveitis. Two patients showed depigmentation of the eyelids. Presumed endothelial cell damage resulted in severe corneal edema in two dogs. Long-term complications included phthisis bulbi, scarring of the eyelids and damage to the meibomian glands, symblepharon formation, conjunctivalization of the cornea, corneal vascularization, pigmentation, and fibrosis. Persisting corneal edema was seen in the dogs with presumed endothelial cell damage. One dog developed a mild bullous keratopathy with superficial corneal ulcerations 4½ years after the injury and had a reduced anterior chamber depth on ultrasound. Conclusion The damage to the ocular structures described here mainly affects the ocular surface. One patient presumably suffered an injury to the ciliary body epithelium resulting in a phthisical globe. Chronic corneal edema, conjunctivalization, and scarring can result in permanent visual impairment. Healing of the ocular surface can take weeks and is associated with a dramatic vascular response. However, a severely vascularized cornea has the potential to clear and allow a good visual outcome long term. Ongoing discomfort was only seen in one case with persistent corneal edema and a secondary bullous keratopathy. [ABSTRACT FROM AUTHOR]

The article discusses the method of repairing fractures in the orbital medial wall with the help of the endoscopic endonasal repair technique by using polyethylene implants. A detailed description of the process and patient considerations is presented, which include head and neck examination, conduction of standard radical anteroposterior ethmoidectomy and removal of the fractured lamina papyracea. A detailed discussion on the matter is also presented.

Background: Ocular injury is the most common cause for visual morbidity and blindness and should not be neglected at all. Materials and methods: A retrospective study was conducted at GMERS Medical College, Valsad on patients who came to Ophthalmology Department from January 2015 to December 2016 for period of 2 years. Outdoor as well as indoor patients were included in the study with history of ocular injury. Data were collected from clinical records and analyzed to study pattern of ocular injuries. Results: Total 100 cases were studied, out of which 74 were male and 26 were female with history of ocular injury. Maximum numbers of patients were in age group of 21 to 30 years. Road traffic accidents were the most common cause of ocular trauma among all patients. Conjunctival hemorrhage and scleral hemorrhage were more common among all. Conclusion: This study showed that road traffic accidents were the commonest causes of ocular injuries and conjunctival hemorrhage was the most common type of ocular injury. [ABSTRACT FROM AUTHOR]

Using implants of a porous titanium nickelid at traumatic lesions of the midface allows you to restore the bone structure of the lower edge and the bottom of the eye socket, avoid or significantly reduce the number of complications such as deformation, enophthalmos. [ABSTRACT FROM AUTHOR]

We describe a technique for suture-guided sulcus implantation of a foldable acrylic posterior chamber IOL (PC IOL). A 10-0 monofilament nylon suture is used to control insertion of the PC IOL over the ciliary sulcus and enable safe retrieval if the PC IOL drops during insertion, stabilization, or centration. In this technique, the 10-0 monofilament nylon suture acts as a guy rope to hold onto the PC IOL, enabling the surgeon to inject the IOL into the sulcus, unfold it in the iris plane, dial it in the appropriate meridian, and stabilize it. [ABSTRACT FROM AUTHOR]

Objective: The aim was to compare the corneal topography and tomography parameters of macular corneal dystrophy (MCD), granular corneal dystrophy (GCD) and lattice corneal dystrophy (LCD) patients obtained by Scheimpflug imaging system. Methods: The charts, photographs and topography images of patients were reviewed retrospectively. This study included 73 eyes of 73 patients (28 MCD, 20 GCG and 25 LCD patients). Topography images were obtained by Pentacam (Oculus Optikgerate, Wetzlar, Germany). The densitometry readings at the corneal apex were used for the statistics. Results: The female to male ratio was 13/15 in MCD group, 12/8 in GCD group and 13/12 in LCD group. The mean age median age was 32, 45 and 53 years in MCD, GCD and LCD groups respectively. The groups were similar regarding the gender (p=0.861). The MCD group was significantly younger than the other two groups (p<0.001). The median (minmum-maximum) corneal densities were 100 (100-100), 68 (17-100) and 97 (34- 100) Pentacam densitometry units in MCD, GCD and LCD groups respectively. The corneal density at the corneal apex was significantly higher in MCD group than in the other groups (p<0.001). The GCD and LCD groups were statistically similar in terms of density of the corneal apex (p=0.079). In MCD group, corneal thickness at the apex and at the thinnest location was significantly thinner, than in the other groups (p=.002 for thickness at apex between MCD and LCD, and p<.001 for all the remaining comparisons). In MCD group corneal volume was significantly smaller than in the other groups (p<.001 for all comparisons). Conclusion: Densitometry on Scheimpflug imaging system gives information on the density of corneal opacities. [ABSTRACT FROM AUTHOR]

The vestibulo-ocular reflex (VOR) shows frequency-dependent behavior. This study investigated whether the characteristics of the electrically evoked VOR (eVOR) elicited by a vestibular implant, showed the same frequency-dependency. Twelve vestibular electrodes implanted in seven patients with bilateral vestibular hypofunction (BVH) were tested. Stimuli consisted of amplitude-modulated electrical stimulation with a sinusoidal profile at frequencies of 0.5, 1, and 2 Hz. The main characteristics of the eVOR were evaluated and compared to the "natural" VOR characteristics measured in a group of age-matched healthy volunteers who were subjected to horizontal whole body rotations with equivalent sinusoidal velocity profiles at the same frequencies. A strong and significant effect of frequency was observed in the total peak eye velocity of the eVOR. This effect was similar to that observed in the "natural" VOR. Other characteristics of the (e)VOR (angle, habituation-index, and asymmetry) showed no significant frequency-dependent effect. In conclusion, this study demonstrates that, at least at the specific (limited) frequency range tested, responses elicited by a vestibular implant closely mimic the frequency-dependency of the "normal" vestibular system. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To Study The Incidence Of CVS In Computer Users And To Evaluate The Efficacy Of Tear Substitutes & Role Of Ergonomics In The Management Of CVS. Materials and Method: 100 subjects in age group 10-60 yrs., who have been using computer for minimum of 2hrs/day for at least 5-6 days/week, were chosen. Each subject underwent for Visual Acuity examination, Slit Lamp Examination, CVS Scoring & following tests. (1) Schirmer Test (2) Tear Film Break up Time (Tbut) Results: Out of 76 subjects having CVS score >6, 52 used the computer for 4 - 8 hrs. & 4 used for <4hrs. Thus, more is the exposure time more is the chances of CVS. Conclusion: There was more improvement after 4 weeks and 8 weeks in the group taking lubricants and ergonomics into consideration than lubricants alone. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the epidemiology and outcomes of all pediatric canalicular lacerations at a high-volume urban tertiary eye care center. Variables of repair were evaluated in relation to age and success of repair. Methods: A retrospective review over a 10-year span of all primary pediatric canalicular laceration repairs was performed. Variables included patient demographics, repair setting, mechanism of injury, associated injuries, type of stent used, and success of repair. Results: Of 137 canalicular lacerations evaluated, 27.7% occurred in patients younger than 18 years. The majority of the children were male (73.7%) and white (68.4%), with a mean age of 10.8 years (range: 1.1 to 17.9 years). The mechanism of injury was significantly more likely to be due to dog bites in children when compared to adults (Of 137 canalicular lacerations evaluated, 27.7% occurred in patients younger than 18 years. The majority of the children were male (73.7%) and white (68.4%), with a mean age of 10.8 years (range: 1.1 to 17.9 years). The mechanism of injury was significantly more likely to be due to dog bites in children when compared to adults (P < .0001), particularly those younger than 10 years (P = .0068). Repair was significantly more successful in the operating room than the minor procedure room, regardless of type of stent used (P = .0247). The majority of children did not have other injuries (60.5%). However, of the other injuries sustained, 52.6% required further monitoring or repair. Conclusions: Pediatric canalicular lacerations are most common in young boys and dog bites are the most common etiology. Although many children may not have other injuries, full examination is warranted because other injuries may require intervention or more frequent monitoring. [ABSTRACT FROM AUTHOR]

About 8% of all major trauma patients have eye injuries, which can have serious implications for the patients and their families. This article outlines a practical approach to the recognition, assessment and management in emergency departments of common ocular traumatic injuries. It also provides an overview of the applied anatomy, and discusses common complications. [ABSTRACT FROM AUTHOR]

Ocular trauma is an important cause of unilateral blindness and visual impairment across the world. Most injuries are accidental, work-related injuries in developed countries, while assaults predominate as a cause in developing countries. Trauma may result in various forms of ocular injuries, ranging from minor insult to major functional impairment. Any ocular structure may be involved, and a careful, systematic approach to the examination of a patient is essential to avoid missing occult injury and resultant visual impairment. This paper highlights key points regarding the clinical evaluation of patients with ocular trauma and covers the presentation and primary care management of the more common ocular injuries. [ABSTRACT FROM AUTHOR]

A 47-year-old man and 14-year-old boy presented with a persistent redness and pain in their eyes. The diagnosis was keratitis. Aspergillus fumigatus was isolated from their corneas. Fungal keratitis occurs very rarely without trauma and shows persistency if not treated properly. The resistance to antibiotic treatment should be noticed and the diagnosis of fungal keratitis considers. Here we present two consecutive cases of Aspergillus fumigatus keratitis that developed without any trauma and their treatment. 1% voriconazole should be considered as the first-line medication in spontaneous Aspergillus fumigatus keratitis. [ABSTRACT FROM AUTHOR]

Cataract related to a corneal bee sting is an uncommon environmental eye injury that can result in various complications due to the penetrating, immunologic and toxic effects of the stinger and its injected venom. A 52-year-old woman presented at our clinic complaining of a bee sting in her right eye that had occurred a few years earlier and progressively decreasing vision. Upon examination, her best-corrected visual acuity was 0.05 in the right eye and 1.0 in the left eye. There was a paracentral corneal opacity, capsular opacification and pigmentation, and localized lens opacification in her right eye. We performed uncomplicated phacoemulsification surgery with foldable intra-ocular lens implantation to the right eye. Her postoperative best-corrected visual acuity in the right eye was 0.4 during follow-up. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to evaluate the management of limbal stem cell deficiency (LSCD) secondary to chemical ocular burns. Materials and methods: The charts of 48 eyes of 40 patients with grade 2 or higher chemical injury were evaluated retrospectively. Subjects with follow-up longer than 1 year were included. Medical treatment, surgical correction of abnormalities of ocular adnexial structures, limbal stem cell transplantation from patient's fellow eye, from living relatives or from cadaveric donor, amniotic membrane transplantation, conjunctival epitheliectomy, chelation with ethylenediaminetetraacetic acid and penetrating keratoplasty were the treatment modalities. Outcome measures were ocular surface stability and corrected distance visual acuity (CDVA). Failure was defined as the appearance of persistent epithelial defect (nonhealing epithelial defect for more than 2 weeks) with progressive corneal conjunctivalization/vascularization and thinning, and also progression of conjunctivalization to the central 6 mm of the cornea in eyes with subsequent keratoplasty. Results: The mean age of 31 male and 9 female patients were 32.32 ± 12.6 years. LSCD was bilateral in 8 cases. The mean follow-up was 77.2 ± 35.1 months. The presentations were in acute phase in 37.5%, in subacute phase in 32.5% and in chronic phase in 30% of the patients. Only 13 of 48 (27.1%) eyes obtained sufficient ocular surface stability through medical treatment; however, only 5 of these eyes achieved CDVA of less than 0.7 logMAR. Limbal stem cell transplantation was performed in 26 eyes as conjunctival limbal autograft, living-related conjunctival limbal allograft and keratolimbal allograft or as a combination of these transplantations. At the last visit, 30 eyes (62.5%) had an intact and stable ocular surface. Clear cornea was achieved in 11 (78.6%) of 14 eyes with grade 2 injury, in 9 (60%) of 15 eyes with grade 3 injury, in 5 (50%) of 10 eyes with grade 4 injury, in 1 (16.6%) of 6 eyes with grade 5 injury and in 1 (33.3%) of 3 eyes with grade 6 injury. The CDVA that was 1.66 ± 0.99 logMAR initially improved to 0.87 ± 0.85 logMAR at the last visit ( p < 0.001). Conclusion: While patients with low-grade chemical injury seem to benefit quite well from the medical treatment, amniotic membrane transplantation, limbal graft transplantation and subsequent keratoplasty; patients with severe injuries seem to be more prone to failure after all of the available treatment modalities. [ABSTRACT FROM AUTHOR]

Ocular chemical burns are common and serious ocular emergencies that require immediate and intensive evaluation and care. The victims of such incidents are usually young, and therefore loss of vision and disfigurement could dramatically affect their lives. The clinical course can be divided into immediate, acute, early, and late reparative phases. The degree of limbal, corneal, and conjunctival involvement at the time of injury is critically associated with prognosis. The treatment starts with simple but vision saving steps and is continued with complicated surgical procedures later in the course of the disease. The goal of treatment is to restore the normal ocular surface anatomy and function. Limbal stem cell transplantation, amniotic membrane transplantation, and ultimately keratoprosthesis may be indicated depending on the patients' needs. [ABSTRACT FROM AUTHOR]

Purpose. To present the success of posaconazole in two cases with recalcitrant fugal keratitis that were resistant to conventional antifungal drugs. Method. We presented two cases that were treated with posaconazole after the failure of fluconazole or voriconazole, amphotericin B, and natamycin therapy. Case 1 was a 62-year-old man with a history of ocular trauma. He had been using topical fluorometholone and tobramycin. His best corrected visual acuity (BCVA) was hand motion. He had 5.0 x 4.5 mm area of deep corneal ulcer with stromal infiltration. Case 2 was a 14-year-old contact lens user. He had been using topical moxifloxacin, tobramycin, and cyclopentolate. His BCVA was 20/200. He had a 4.0 x 3.0 mm area of pericentral corneal ulcer with deep corneal stromal infiltration and 2 mm hypopyon. Results. Both patients initially received systemic and topical fluconazole or voriconazole and amphotericin B and topical natamycin that were all ineffective. But the response of posaconazole was significant. After posaconazole, progressive improvement was seen in clinical appearance. BCVA improved to 20/100 in case 1 and 20/40 in case 2. Conclusion. Posaconazole might be an effective treatment option for recalcitrant fusarium keratitis and/or endophthalmitis resistant to conventional antifungal drugs. [ABSTRACT FROM AUTHOR]

The article focuses on the management of corneal lacerations and perforations or corneal injuries. It states that management of those injuries needed rapid diagnosis and relied on the size of the wound, wither surgical or medical treatment. It mentions that corneal injury can be treated through medicines like cyanoaerylate, surgeries like amniotic membrane transplantation, and visual rehabilitation like the use of contact lenses.

Osteo-Odonto-Keratoprosthesis (OOKP) is a preferred technique of vision restoration surgery in eyes with end stage ocular surface disorders such as Steven-Johnson syndrome, ocular circatricial pemphigoid and dry keratinized eyes following severe chemical burns. The conventional corneal transplant surgery has much poorer prognosis in these disorders due to intense vasculari-sation of cornea. OOKP uses an acrylic optical cylinder which replaces the diseased cornea and gives excellent image resolution and quality. Although the possibility of immune mediated rejections is less than conventional grafts, the technique is associated with inherent complications such as resorption of bone lamina which can lead to extrusion of the graft and retroprosthetic membrane formation. This makes the technique not only surgically difficult but also demands long term follow-up of the patient. In spite of this being a tedious procedure, it definitely has promising visual outcomes. [ABSTRACT FROM AUTHOR]