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Biomedical subjects

C Diane Song

Publications and source records attributed to C Diane Song.

6 recordsLinked to original sources

Intracorneal injection of amphothericin B for recurrent fungal keratitis and endophthalmitis.

Penetrating keratoplasty carries an infectious risk. Its requirement for topical corticosteroid therapy facilitates fungal growth with resulting keratitis. Although progression of fungal keratitis to intraocular infection is uncommon, endophthalmitis resulting from keratitis usually has a poor visual prognosis. Fungal infection under these circumstances remains a diagnostic and therapeutic challenge. We report a complicated case of recurrent fungal keratitis with endophthalmitis following a contaminated penetrating keratoplasty that ultimately was controlled with a new treatment modality. Intrastromal corneal injections combined with intravitreal injection of amphotericin B led to the eradication of the corneal fungal plaques and the intraocular infection. Intrastromal corneal injections of amphotericin B may offer a less invasive, in-office alternative to repeat penetrating keratoplasty.

Aged, 80 and over↗

Corneal perforation with secondary congenital aphakia in Peters anomaly.

PURPOSE: To describe two cases of secondary congenital aphakia in association with Peters anomaly. METHODS: Two infants were noted to have corneal opacification at birth. Each child was found to have Peters anomaly requiring corneal transplantation in 1 or both eyes. RESULTS: Each child underwent penetrating keratoplasty, revealing absence of the crystalline lens in 1 eye. Histopathologic evaluation of the corneal buttons was performed. Each specimen showed full-thickness corneal defects with lens remnants. CONCLUSIONS: Secondary congenital aphakia from corneal perforation should be considered in the presentation of severe Peters anomaly.

Aphakia↗

Corneal and conjunctival changes after posterior segment surgery.

Significant corneal compromise can occur subsequent to vitreoretinal surgery, especially in diabetic corneas. Associated factors include the operating lens systems used, irrigating solutions, preoperative lens and anterior capsule status, and the use of adjunctive agents such as intraocular gasses or silicone oil. Corneal, conjunctival, and ocular surface complications can also occur after scleral buckling procedures, often related to buckle extrusion or infection.

Conjunctival Diseases↗

Indications for and outcomes of penetrating keratoplasty performed by resident surgeons.

PURPOSE: To analyze the indications for and outcomes of penetrating keratoplasty (PKP) performed by resident surgeons at both county hospital and Veterans Affairs facilities. DESIGN: Observational case series. METHODS: Retrospective review of 79 eyes from 61 patients undergoing PKP from January 1, 1997, through December 31, 2001, to determine indications for surgery and outcomes, including graft clarity and final visual acuity. RESULTS: There were 52 (65.8%) primary and 27 (34.2%) repeat transplants performed. Follow-up after surgery averaged 21.9 months. Indications for PKP included failed graft, 23 (29.1%), bullous keratopathy, 17 (21.5%), keratoconus, 16 (20.3%), corneal scar, 15 (19.0%), corneal perforation from infection, 5 (6.3%), and Fuchs endothelial dystrophy, 3 (3.8%). Twenty-one eyes had pre-existing ocular disease limiting final acuity. Overall, 51 grafts (64.6%) remained clear. More primary than repeat grafts remained clear (75% vs 44.4%, P =.012) and achieved 20/40 or better final acuity (30.8% vs 11.8%, P =.05). Excluding failed grafts or eyes with limited visual potential, final acuities achieved were: 19 (47.5%) 20/40 or better, 18 (45%) 20/50 to 20/150, 3 (7.5%) 20/200 or worse. Grafts remaining clear by indication were: failed graft, 9 (39.1%); keratoconus, 14 (87.5%); bullous keratopathy, 13 (76.5%); corneal scar, 10 (66.7%); corneal perforation, 2 (40%); Fuchs, 3 (100%). Eyes achieving final acuity of 20/40 or better by indication were: keratoconus, 9 (56.2%); failed graft, 3 (13%); bullous keratopathy, 3 (17.7%); corneal scar, 2 (13.3%); corneal perforation, 0 (0%); Fuchs, 2 (66.7%). CONCLUSIONS: County hospital and Veterans Affairs facilities provide a challenging subset of patients for penetrating keratoplasty. Failed graft was the leading indication for transplantation for our population. Graft clarity and final visual acuity varied by indication for transplantation. Resident surgeons can achieve favorable results for penetrating keratoplasty performed at these venues, especially for primary transplants.

Adolescent↗

Intraocular lens power calculations after laser in situ keratomileusis.

PURPOSE: To compare the accuracy of several techniques for calculating intraocular lens (IOL) power after laser in situ keratomileusis (LASIK). METHODS: Retrospective review of 10 eyes from nine patients undergoing phacoemulsification after LASIK. Corneal power (K) was measured by manual keratometry (MK), refractive history (RH), contact lens overrefraction (CTL), videokeratography (VK), and an average of the refractive history and contact lens methods (AVG 2). Results were compared with the back-calculated K value generated by the Holladay IOL Consultant program. Age-matched patients undergoing phacoemulsification without previous refractive surgery served as controls. RESULTS: Mean spherical equivalent postoperative refraction was +0.21 diopter (D) (SD, 1.54; range, -2.25 to +2.25 D) for patients undergoing cataract extraction after LASIK versus -0.56 D (SD, 0.66; range, -2.375 to +0.5 D; p= 0.16) for controls. Thirty percent of cases versus 90% of controls were within 1 D ( p= 0.002) of emmetropia. Forty percent of cases versus no controls were more than 1 D hyperopic ( p= 0.08). The mean differences for each method compared with the back-calculated K values were MK, +0.82 D; VK, +1.24 D; RH, -0.76 D; CTL, +0.91 D; AVG 2, +0.08 D. The mean absolute deviations from the back-calculated K values were MK, 1.91 D; VK, 2.01 D; RH, 1.68 D; CTL, 1.62 D; AVG 2, 1.42 D. CONCLUSION: Significant refractive errors occurred with each of the methods investigated for determining IOL power after LASIK. RH, CL, or AVG 2 provided the most accurate results.

Adult↗