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Biomedical subjects

C P Juarez

Publications and source records attributed to C P Juarez.

17 recordsLinked to original sources

Intravitreal triamcinolone acetonide injection in blind painful eyes. Intraocular steroids as a treatment for blind painful red eyes.

PURPOSE: Phthisis bulbi results from different ocular conditions. We evaluated intravitreal triamcinolone acetonide as a treatment option in blind painful eyes. METHODS: Thirty-one patients with unilateral phthisis were randomly divided into two groups. Group A received 0.3 ml (12.5 mg) triamcinolone acetonide intravitreally and Group B 0.3 ml balanced salt solution after retrobulbar anesthesia. Treatment success was assessed by subjective response to pain and clinically by biomicroscopic evaluation of conjunctival congestion. Tonometry was done before and after treatment. Follow-ups were at 24 hours, 3 weeks, 3 and 6 months, and 1 and 2 years. RESULTS: Throughout the two-year follow-up, only two patients in Group A reported pain after the procedure and were retreated, one at week 4 and the other at week 7. Conjunctival congestion was significantly lower in Group A. Two patients with hypotony before treatment had normal tension after triamcinolone. All Group B patients were reinjected with triamcinolone because pain continued after balanced salt solution injection. No severe complications were found. CONCLUSIONS: Intravitreal triamcinolone acetonide may be effective and safe for treating blind painful eyes.

Adolescent↗

Vitreoretinal alterations following laser in situ keratomileusis: clinical and experimental studies.

BACKGROUND: The presence of vitreoretinal changes following laser in situ keratomileusis in myopia is evaluated. METHODS: Clinically, 50 patients (100 eyes) with marked anisometropic myopia, 50 low-myopic eyes (<4.00 D) and 50 high-myopic eyes (>7.00 D) were prospectively evaluated pre- and postoperatively for the presence of newly recognized entoptic phenomena (vitreous floaters, light flashes, or both), and for vitreoretinal changes using indirect depressed fundus examination, a +90 D preset lens, Goldman three-mirror contact lens, and kinetic ultrasound (KU) before and after bilateral LASIK. Patients with previous partial or total posterior vitreous cortex detachment (PVD) were excluded. Experimentally, groups of adult pigs underwent KU, retinal fluorescein angiography (FA), and electroretinography (ERG) before and after applying the microkeratome suction ring for 30 s. RESULTS: Clinically, 8% (4 eyes) had positive perception of postoperative vitreous floaters in the low myopia group, and 32% (16 eyes) in the high myopia group. Postoperative light flashes were noted only in the high myopia group, in 12% of cases. Partial or total posterior vitreous cortex detachment was detected by biomicroscopy in 2% (1 eye) of the low and in 10% (5 eyes) of the high myopia group and by KU in 4% (2 eyes) of the low and in 24% (12 eyes) of the high myopia group. Experimentally, 2 pig eyes out of 12 developed partial PVD by KU, immediately after microkeratome suction ring application. All pig eyes showed significantly diminished ERG amplitudes during and immediately after suction ring application. No FA changes or delays in retinal circulation time were noted during or immediately after removal of the suction ring. CONCLUSIONS: Vitreoretinal alterations after LASIK were demonstrated clinically mainly by KU in high myopes. Experimentally, PVD were also demonstrated. Diminished ERG recordings with normal retinal circulation following suction ring application may suggest some transient choroidal circulation abnormalities.

Adult↗

Small choroidal melanoma with massive extraocular extension: invasion through posterior scleral emissary channels.

Massive orbital extension arising from a small posterior pole uveal melanoma is rare. A 75-year-old male followed for an asymptomatic choroidal nevus developed a two and a half month history of mild decrease in visual acuity. Upon clinical examination minimal enlargement of the tumor with surrounding serous retinal detachment was observed. Pre-operative magnetic resonance imaging disclosed massive extrascleral extension. Histopathology revealed that the tumor was composed of spindle B malignant melanoma cells. Multiple serial sections of the entire tumor area failed to demonstrate permeation through scleral lamellae. Instead, peripapillary perivascular short posterior ciliary vessel invasion was observed. This route of dissemination may explain the rapid growth and clinically undocumented behavior of small malignant melanomas at this location.

Aged↗

Experimental retinal vascular occlusion. II. A clinico-pathologic correlative study of simultaneous occlusion of central retinal vein and artery.

After experimentally occluding the central retinal vein and artery simultaneously at their point of entry into the optic nerve, acute retinal necrosis occurred, but not hemorrhagic retinopathy. In the retinal vasculature, stagnation of blood flow and thrombosis with subsequent recanalization was noted. The necrosis was extensive in the inner retinal layers but focal in the outer retinal layers. The internal limiting membrane was detached and disrupted in every case. Following the post-edematous stage, numerous micro and macroretinal cysts appeared. The peripheral retina showed much less ischemic changes. A clinico-pathologic correlation was made.

Animals↗

Experimental retinal vascular occlusion. III. An ultrastructural study of simultaneous occlusion of central retinal vein and artery.

The retinal changes following the simultaneous occlusion of retinal vessels were examined at an ultrastructural level. The preservation of endothelial cells that prevented leakage of blood and horseradish peroxidase tracer material in the surrounding retinal tissues explained the lack of hemorrhages observed clinically. Mueller cell death resulted in severe structural disorganization of the retina, with disruption of the inner limiting membrane, involvement of the outer retinal layers, and fleurette formation. The retinal macrocysts were derived from ischemic infarction.

Animals↗

Ten years experience with eye wall resection for uveal malignant melanomas.

Thirty-four patients underwent eye wall resection for choroidal malignant melanoma over a period of more than ten years. Of these, 11 eyes were later enucleated for complications. Average mean follow-up has been more than 5.3 years. Postoperative visual acuity ranged from light perception to 20/30. Two patients developed liver metastasis 4 years following eye wall resection and later died. However, no local metastasis has been observed. Two patients died from unrelated causes.

Adult↗

Resection of uveal melanocytoma: clinicopathological correlation.

Four patients had pigmented lesions in the anterior uveal tract and choroid which presented clinically as malignant melanomas. All the lesions were successfully removed by local excision. Histopathological studies showed the tumours to be melanocytomas, indicating that enucleation or irradiation would have been contraindicated. The 3 patients with iris and ciliary body melanocytomas continue to maintain corrected visual acuities of 20/30 or better. In the patient with choroidal melanocytoma central visual acuity was compromised owing to cystoid macular oedema. All 3 melanocytomas involving the anterior segment were located inferiorly. Biomicroscopically, they were chocolate coloured (not black) and resembled malignant melanomas of the same location. The choroidal melanocytoma also resembled a malignant melanoma by ophthalmoscopic and angiographic criteria, and did not have the jet black or homogeneous pigmentation that characterises most melanocytomas of the disc.

Adult↗

Effects of argon and krypton laser on experimentally detached retinas.

Krypton and argon laser photocoagulation on the foveas and blood vessels of experimentally detached monkey retinas were studied clinicopathologically. In this manner heat transmission from the retinal pigment epithelium (RPE) to the overlying sensory retina was avoided. Krypton lesions bypassed the sensory retina on every occasion to produce major photocoagulative effects at the level of the RPE and choroid. Argon laser wavelengths damaged the overlying retina in the foveal areas as well as in perivascular structures. Although the krypton laser appears preferable for treatment of macular diseases, proper parameters should be used to avoid serious complications.

Animals↗

Full-thickness eye-wall biopsy: long-term results in 9 patients.

Nine patients who had an eye-wall biopsy were evaluated for long-term results. The follow-up time ranged from 2 1/2 months to 7 years. Six patients were followed up for more than 2 years. Few operative and postoperative complications were observed. Except for 1 patient with reticulum cell sarcoma, all eyes retained preoperative visual acuity. Tractional retinal detachment occurred only in 1 patient, who had vitreous bands around the biopsy site and did not undergo a simultaneous vitrectomy during the biopsy operation.

Adult↗

Secondary pupillary membranes treated by the pars plana/pars plicata approach: long-term results of 108 cases.

One hundred and eight pupillary membranes treated with the vitrophage through a pars plicata or pars plana approach were evaluated for long-term results. The average follow-up was 3.86 years, with a range of 1 to 7 years. No major operative complications were encountered. Anatomical success was achieved in all cases. Vision improved in 67.5% of eyes. In 4 cases (3.7%) postoperative visual acuity was worse, because of glaucoma secondary to previous blunt ocular trauma. Six cases showed delay rhegmatogenous retinal detachment postoperatively. These could not be attributed to the surgical procedure per se.

Adult↗

An ultrastructural study of melanocytomas (magnocellular nevi) of the optic disk and uvea.

We examined by light and electron microscopy five melanocytomas from four patients. Two types of cells were observed in each tumor. The predominant cell type in most of the tumors studied consisted of plump polyhedral nevus cells that contained numerous giant melanosomes. These cells showed advanced differentiation. They appeared to be metabolically inactive and to have been the cause of the heavy pigmentation and benign nature of these tumors. The second variant of melanocytoma cells were smaller spindle-shaped cells that were lightly pigmented. Other morphologic features of these cells such as high nucleus-cytoplasm ratio, prominent nucleolus, nuclear membrane infolding, numerous mitochondria, prominent rough endoplasmic reticulum, and free ribosomes, indicated a metabolically active cell, which may explain the infiltrating behavior of these tumors.

Adult↗

Laser in situ keratomileusis for myopia and hyperopia using the Lasersight 200 laser in 300 consecutive eyes.

PURPOSE: To evaluate effectiveness, safety, predictability, and short-term stability of laser in situ keratomileusis (LASIK) using the LaserSight Compac-200 Mini excimer laser with software version 9.0, for all refractive errors. METHODS: One hundred fifty consecutive patients (300 eyes) that received bilateral LASIK for myopia, hyperopia, and astigmatism were studied prospectively. A new 9.0 software version applying a modified nomogram that takes advantage of bilateral surgery was used. Follow-up at 6 months was available for 267 eyes (89%). RESULTS: Six months postoperatively, 131 eyes (96.32%) in the low to moderate myopia group (-1.00 to -5.99 D; n=136) had a spherical equivalent refraction within +/-1.00 D, and 123 eyes (90.44%) were within +/-0.50 D of emmetropia. In the high to extreme myopia group (-6.00 to -25.00 D; n=114), 97 eyes (87.08%) had a spherical equivalent refraction within +/-1.00 D and 78 eyes (68.42%) were within +/-0.50 D of emmetropia. In the hyperopia group (+1.00 to +6.00 D; n=50), 44 eyes (88%) had a postoperative spherical equivalent refraction within +/-1.00 D, and 31 eyes (62%) were within +/-0.50 D of emmetropia. Mean change in spherical equivalent refraction at 6 months was less than -0.50 D in the low to high myopia groups and -1.16 +/- 0.55 D in the extreme myopia group. At 6 months follow-up, uncorrected visual acuity was 20/20 or better in 73 eyes (54%) in the low to moderate myopia groups and 21 eyes (18%) in the high to extreme myopia groups. In the hyperopia group at 6 months follow-up, uncorrected visual acuity was 20/20 or better in 31 eyes (62%) and 20/40 or better in 41 eyes (82%). Only two eyes had a temporary loss of two or more lines of spectacle-corrected visual acuity due to corneal folds that were surgically treated. Six months after LASIK, no eye had lost any lines of best spectacle-corrected visual acuity in this series. CONCLUSIONS: Our modified LASIK nomogram with the 9.0 software of the LaserSight 200 excimer laser (with a larger and smoother ablation pattern) resulted in safe and effective outcomes for the treatment of low to high myopia, astigmatism, and hyperopia.

Adult↗