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C N Anastas

Publications and source records attributed to C N Anastas.

5 recordsLinked to original sources
PubMed1996

Corneal topographic lagoons: a potential new marker for post-traumatic recurrent corneal erosion syndrome.

BACKGROUND: Post-traumatic recurrent corneal erosion syndrome is a common clinical problem in which a definitive diagnosis is not always possible based solely upon biomicroscopic corneal signs. Indeed, in some cases archetypical symptoms or a preceding history of epithelial trauma cannot always be elucidated. METHODS: Four groups of patients underwent corneal analysis using computer videokeratography. Group 1 (n = 11), subjects who presented with simple corneal epithelial trauma approximately three months before the study. Group 2 (n = 11), prospective analysis of subjects presenting with simple corneal epithelial trauma. Group 3 (n = 12), prospective analysis subjects with an established diagnosis of post-traumatic recurrent erosion syndrome. Group 4 (n = 135), prospective analysis of healthy control subjects. RESULTS: Small, well delineated areas (1.0 to 1.5 mm in diameter) of markedly reduced corneal dioptric power (greater than 2 dioptres), which we have termed 'corneal topographic lagoons', were identified more commonly in eyes with recurrent corneal erosion syndrome and in eyes that had recently sustained corneal epithelial trauma; being found in 18.2% of Group 1, 9.1% of Group 2, 58.3% of Group 3 but only 1.5% of Group 4 (control). CONCLUSIONS: The identification of areas of focal abnormality in the corneas of patients with post-traumatic recurrent corneal erosion syndrome remains a significant clinical problem. Corneal topographic analysis has demonstrated a focal abnormality, the 'corneal topographic lagoon', which is much more prevalent in cases of recent corneal trauma and recurrent corneal erosion syndrome than in the 'normal' population. Computerised videokeratography therefore adds a new tool to the armamentarium of the clinician seeking to identify and locate abnormalities in these difficult cases.

Adolescent↗
PubMed1996

Psychological aspects of excimer laser surgery for myopia: reasons for seeking treatment and patient satisfaction.

AIMS: To determine the reasons patients seek excimer laser treatment for myopia and to measure levels of patient satisfaction with each phase of this relatively new treatment. METHODS: A unique 38 item visual analogue questionnaire was developed and applied to 100 consecutive patients (n = 100) who had undergone excimer laser photorefractive keratectomy for myopia or myopic astigmatism at a single centre. All subjects underwent extensive ophthalmic assessment and patient education before treatment. RESULTS: A 90% response rate was achieved (n = 90). Improved unaided vision (85.6%), freedom from spectacles (83.3%), and difficulties with contact lens wear (72.7%) were the most common reasons for seeking treatment. The majority of patients felt that the quality of their life had improved (85.5%) and 82% felt that the quality of their unaided vision was as good as they had anticipated. overall, 95.5% of patients were pleased that they had undergone this procedure. The vast majority (98.9%) of patients felt that they fully understood the operation pretreatment but almost one quarter (23.9%) found the actual operation distressing. Only 15.7% found postoperative pain did not respond adequately to prescribed analgesia. CONCLUSIONS: This study demonstrates a very high level of patient satisfaction after excimer laser treatment for myopia and myopic astigmatism. It suggests that most patients seek treatment to enjoy better vision free from optical aids and that a high level of patient education preoperatively may establish realistic expectations and satisfaction with overall outcome.

Adult↗
PubMed1996

Widespread ocular use of topical chloramphenicol: is there justifiable concern regarding idiosyncratic aplastic anaemia?

A theoretical but as yet not conclusively proved risk of chloramphenicol induced idiosyncratic aplastic anaemia exists with topical ophthalmic therapy, with the absolute, but highly improbable, maximum risk of death (equalling that of systemic therapy) being 1 in 50,000 to 90,000. To put this in realistic perspective, one must note that the comparable risk of fatal anaphylaxis resulting from penicillin therapy, from any route, is similar at 1 in 100,000. Indeed, it has been noted recently that with more than 200 million ocular chloramphenicol products dispensed in the UK in the past 10 years, only 11 reports (all non-fatal) of suspected topical chloramphenicol induced blood dyscrasia have been reported to the Committee on the Safety of Medicines since 1966. One also has to consider that inadvertent exposure to minute quantities of chloramphenicol (ng/ml) may occur through consumption of livestock that have been treated with chloramphenicol. Broad statements condemning topical chloramphenicol need to be tempered with its proved safety, tolerance, cost, and efficacy while acknowledging an extremely remote risk of the very serious adverse effect of drug induced aplastic anaemia. Risk-benefit assessment is the duty of all prescribing physicians and a decision to prescribe or not prescribe must be made on the basis of personal judgment and an awareness of the statistics in perspective. The only known factor to be associated with vulnerability in the case of topical chloramphenicol is family history. There is no evidence to date that suggests children are any more susceptible than adults.

Administration, Topical↗
PubMed1995

Corneal tattooing revisited: excimer laser in the treatment of unsightly leucomata.

BACKGROUND: Corneal tattooing, a procedure first used by Galen in the treatment of unsightly leucomata, has in recent times received relatively little attention due to major advances in intraocular and corneal surgery. Resurrection of the technique, however, may be reasonably considered in 'high risk' cases of leucomata or leucocoria where corneal transplantation would lead to rejection and failure, or, in eyes with no visual potential, where removal of cosmetically unacceptable dense, white cataracts carries an unreasonable risk of phthisis bulbi or sympathetic ophthalmitis. METHODS: Corneal tattooing requires the accurate and limited removal of corneal epithelium to act as the tattoo bed and unfortunately, if removal of the epithelium exceeds, or goes beyond the circumference of, the chosen area, a ragged cosmetically less pleasing 'pupil' is created. The excimer laser appears to be an ideal tool to create a perfectly circular corneal bed to improve upon older techniques. CONCLUSION: We report, for the first time, an updated, simple and improved technique for successful corneal tattooing using excimer laser technology.

Adult↗