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Biomedical subjects

Dany M Najjar

Publications and source records attributed to Dany M Najjar.

15 recordsLinked to original sources
PubMed2006

Strabismus and amblyopia in bilateral Peters anomaly.

BACKGROUND: Peters anomaly is a rare form of anterior segment dysgenesis in which abnormal cleavage of the anterior chamber occurs at the end of the third week of gestation. We examined the prevalence of strabismus and amblyopia and analyzed predictive factors for their development, as well as the visual outcome and associated anomalies in patients with bilateral Peters anomaly. METHODS: Using a retrospective review, we identified 25 consecutive patients with bilateral Peters anomaly who were observed between August 1995 and February 2005. Ocular structural and systemic anomalies, amblyopia therapy, visual acuity, and binocular alignment at last visit were recorded. Fisher's exact test was used to identify any association between defined predictive factors and the development of strabismus. RESULTS: Mean follow-up time was 5.1 year (range, 0.5-21 years). Median age at presentation was 2.5 months (range, 1 day to 13 years). Penetrating keratoplasties were performed on 34 eyes in 20 patients. Final best-corrected visual acuity ranged from 20/25 to no light perception. Thirteen of 18 patients with recorded motility (72%) developed strabismus: esotropia (n = 7), exotropia (n = 5), and variable (n = 1); one also had dissociated vertical deviation. Patients with equal vision were either orthophoric (n = 4) or had intermittent esotropia (n = 1), whereas strabismus occurred in 100% of patients whose vision was asymmetric by more than 1.5 octaves. Asymmetric vision was the only statistically significant predictive factor for the development of strabismus (P = 0.002). Amblyopia treatment resulted in improved vision in 3 of 5 patients. CONCLUSION: Strabismus occurs frequently in bilateral Peters anomaly. Asymmetric vision, (because of ocular structural anomalies) postoperative complications, and amblyopia may predispose to strabismus. Despite ocular structural limitations, amblyopia therapy is recommended in the aggressive rehabilitation of these eyes.

Amblyopia↗
PubMed2006

Assessment of the corneal endothelium in acute ultraviolet keratitis.

BACKGROUND: The purpose of this prospective case-control study was to investigate whether exposure to ultraviolet (UV) light produces detectable damage to the corneal endothelium in patients presenting with acute UV keratitis. MATERIAL/METHODS: Non-contact specular microscopy was performed on 20 consecutive patients who presented to our clinic from July 2000 to July 2002 with acute UV keratitis and similarly on 20 age-matched healthy controls. Both the coefficient of variation in mean cell size (CV) and the mean cell density (CD) were compared in these two groups using the Student t-test. RESULTS: Mean age was 28.6 years in the study group and 28.4 years in the control group. The mean CD in the patient group was 2609.6 (SD = 103.47) and in the control group 2632.87 (SD = 117.05). No statistically significant difference was found between the mean CDs in these two groups (p = 0.93). The mean CV in the patient group was 46.7 (SD = 4.40) and in the control group 45.4 (SD = 5.60). Similarly, there was no statistically significant difference between the mean CVs in these two groups (p = 0.85). CONCLUSIONS: UV light exposure does not seem to have a direct immediate effect on the corneal endothelium in humans with acute UV keratitis. Whether UV light produces cumulative and/or longer-term damage requires further studies with a larger number of patients and a longer follow-up time.

Acute Disease↗
PubMed2005

Trends in contact lens-related corneal ulcers.

PURPOSE: To analyze the frequency of contact lens-related corneal ulcers and its relationship to the type of contact lens and care. METHODS: Charts of 376 patients with corneal ulcers seen at the Cornea Service of Wills Eye Hospital from July 1, 1999 to December 31, 2002 were retrospectively reviewed. All patients with contact lens-related corneal ulcers were identified, and information regarding cultures, lens type, usage, and cleaning was obtained. RESULTS: Of the 376 cases, 113 (30%) were related to contact lens use. The contact lens history was recorded in 83 of 113 cases (73%). The soft daily wear frequent replacement lens was the most common lens type associated with corneal ulcers (n = 36/83, 43%). Corneal cultures were performed in 71 of 113 cases (63%) and were positive in 51 of 71 cases (72%). The most common microorganism involved was Pseudomonas aeruginosa (n = 17/51, 33%). The frequency of contact lens-related corneal ulcers from 1999-2002 (n = 113/376, 30%) was significantly greater than that from years 1996-1999 (n = 37/299, 12%) at our institution (P < 0.05). CONCLUSION: There was a significant increase in the number of contact lens-related corneal ulcers between 1999 and 2002 compared with previous years (P < 0.05). The contact lens type most frequently associated with corneal ulcers was the soft daily-wear frequent-replacement contact lens (43%). Contact lens-related corneal ulcers continue to be a serious problem despite a shift in the market to the use of frequent-replacement daily-wear contact lenses and advances in contact lens technology.

Adolescent↗
PubMed2005

Serratia corneal ulcers: a retrospective clinical study.

PURPOSE: To study the clinical and microbiological profile of Serratia corneal ulcers at the Cornea Service of the Wills Eye Hospital. METHODS: This was a retrospective, observational case series. The clinical records of patients with Serratia marcescens corneal ulcers seen at the Cornea Service of the Wills Eye Hospital between January 1, 1998 and December 31, 2002 were reviewed. RESULTS: Twenty-four cases of Serratia keratitis were identified in 21 patients. Two patients (9.5%) had recurrent keratitis, 1 of which recurred twice. Both had corneal graft edema and were on topical steroids and antiglaucoma drops. The Serratia infection in 15 patients (71%) was associated with an abnormal corneal surface. Twelve of these patients (57%) had the ulcer in a corneal graft, 4 (19%) of which were associated with suture infiltrates. Fifteen patients (71%) were on topical medications-15 used corticosteroids and 13 used antiglaucoma drops. Six patients (29%) were contact lens wearers-1 had a concomitant suture infiltrate associated with a corneal graft, and 5 had otherwise healthy corneas. One isolate lacked in vitro susceptibility to ciprofloxacin and ofloxacin but was susceptible to gentamicin and tobramycin. Nineteen patients had a favorable response to medical therapy. Two patients with poor outcome had large corneal ulcers with severe necrosis and thinning associated with delay in treatment. CONCLUSIONS: Serratia marcescens keratitis is associated with the presence of an abnormal corneal surface, use of topical medications, and contact lens wear. Prompt medical therapy results in a good clinical response in the majority of cases.

Adolescent↗
PubMed2004

EDTA chelation for calcific band keratopathy: results and long-term follow-up.

PURPOSE: To determine the etiologies and management of calcific band keratopathy (CBK), and assess the results and long-term follow-up after ethylenediamine-tetraacetic acid (EDTA) chelation. DESIGN: Retrospective interventional case series. METHODS: Two hundred thirty patients with clinically significant CBK were included from January 1996 to July 2002. Among these, 54 patients (65 eyes) underwent EDTA chelation. Outcome measures included symptomatic relief, visual improvement, and recurrences. The improvement or worsening of the number of lines of Snellen best-corrected visual acuity was determined at 1 month and at last follow-up visit. RESULTS: The most common causes of CBK were chronic corneal edema in 80 eyes (28%) and idiopathic in 74 eyes (25.9%). The mean follow-up time after EDTA chelation was 36.6 months (range, 1 month to 29.6 years). Forty-four of 45 patients (98%) reported partial or complete symptomatic relief. Seventeen eyes (33.3%) improved 2 or more lines at 1 month and 18 eyes (35.2%) at last follow-up visit (P =.0001). In patients with an initial visual acuity between 20/50 and 20/400, 15 eyes (47%) improved 2 or more lines at 1 month and 16 eyes (50%) at last follow-up visit. Ten of 56 eyes (17.8%) had a recurrence at a mean time of 17.7 years (range, 1 month to 26 years). The highest number of recurrences was in three of five eyes with uveitis (60%; P =.03). CONCLUSION: Chelation with EDTA is an effective treatment of CBK. Visual acuity improves most in eyes with acuity between 20/50 and 20/400. This treatment can be used as the initial surgical intervention after conservative measures fail.

Adolescent↗
PubMed2004

Contact lens-related corneal ulcers in compliant patients.

PURPOSE: To report a case series of contact lens-related corneal ulcers in compliant patients with no apparent predisposing factors. DESIGN: Retrospective case series. METHODS: Charts of 70 patients with contact lens-related corneal ulcers from July 1999 to June 2002 were reviewed. Lens care hygiene and method of disinfection, as well as frequency of lens replacement, were recorded. Only patients who followed recommended guidelines for contact lens wear were included in the study. RESULTS: Of the 70 patients, 21 (30%) developed corneal ulcers despite being compliant with the guidelines for contact lens wear. All patients used multipurpose solutions for cleaning, disinfecting, and storing daily wear soft contact lenses. CONCLUSION: Standard lens care hygiene does not seem to be sufficient in preventing the development of corneal ulcers in patients using conventional and frequent replacement daily wear soft contact lenses.

Adolescent↗
PubMed2004

Descemet membrane detachment with hemorrhage after alkali burn to the cornea.

PURPOSE: To report two cases of Descemet membrane detachment associated with hemorrhage after alkali burn to the cornea. DESIGN: Observational case reports. METHODS: We describe two patients with detachment of Descemet membrane associated with hemorrhage after alkali burns to the cornea. RESULTS: Patient 1 received a splash of caustic soda to the face. Descemet membrane detachment with hemorrhage was present. An attempt at reattachment using intraocular gases failed. Patient 2 sustained a chemical burn secondary to an airbag injury. A thickened, detached Descemet membrane associated with a hyphema was evident. CONCLUSIONS: Detachments of Descemet membrane associated with alkali burns are often accompanied by irreversible endothelial cell damage.

Burns, Chemical↗
PubMedDate not supplied

Vernal keratoconjunctivitis presenting unilaterally.

A 7-year-old boy had itching, foreign body sensation, and redness in his right eye. Unilateral cobblestone papillae and a shield ulcer were found. Topical antihistamines, mast cell stabilizers, and steroids led to marked improvement. Unilateral vernal keratoconjunctivitis should be included in the differential diagnosis of unilateral giant papillary conjunctivitis.

Child↗
PubMedDate not supplied

LASIK risk score: an easy method to predict postoperative outcome.

PURPOSE: To present a simple model for assessing the risk score of laser in situ keratomileusis (LASIK). METHODS: The LASIK surgery risk score is a number attributed to every LASIK procedure and depends on the presence of individual variables that might add difficulty and increase the risk of the surgical procedure. RESULTS: The score can vary from 1 to 14 with values between 1 and 4 considered low risk for complications, values between 5 and 9 moderate risk, and values above 10 high risk. CONCLUSIONS: This scale gives a gross estimate of the surgical risk of the LASIK procedure and adds valuable information to the preoperative assessment.

Adult↗