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Biomedical subjects

David Zadok

Publications and source records attributed to David Zadok.

At least 19 recordsLinked to original sources

Comparison of different techniques of anterior chamber depth and keratometric measurements.

PURPOSE: To compare measurements of anterior chamber depth (ACD) and corneal curvature obtained with the Pentacam to other commonly used devices. DESIGN: Prospective, nonrandomized clinical trial. METHODS: Measurements of ACD and keratometry were prospectively obtained in 22 eyes of 11 subjects with the Pentacam compared with measurements of the ultrasound (US) A-scan and IOLMaster (ACD), and with those of automated keratometry (AK) and IOLMaster (keratometry) at the Assaf Harofeh Medical Center. RESULTS: The mean interdevice differences in keratometry for Pentacam vs AK, Pentacam vs IOLMaster, and AK vs IOLMaster were -0.046 diopters, -0.471 diopters, and -0.424 diopters, respectively. Measurements of keratometry by the IOLMaster differed statistically significantly from those of Pentacam (P < .01) and AK (P < .01). For measurement of keratometry, 95% limits of agreement were -1.321 to 1.229 diopters for the Pentacam and AK, -1.478 to 0.536 diopters for the Pentacam and IOLMaster, and -1.026 to 0.178 diopters for the AK and IOLMaster. The mean interdevice differences in ACD for the Pentacam vs US, Pentacam vs IOLMaster, and US vs IOLMaster were 0.103, 0.099, and -0.004 mm, respectively. Measurements of ACD by the Pentacam differed statistically significantly from those of US (P < .05) and IOLMaster (P < .01). For measurement of ACD, 95% limits of agreement were -0.197 to 0.404 mm for the Pentacam and US, -0.169 to 0.367 mm for the Pentacam and IOLMaster, and -0.332 to 0.324 mm for the US and IOLMaster. CONCLUSIONS: For some clinical applications, measurements of ACD and corneal curvature with the tested machines may differ greatly and therefore may not be interchangeable.

Anterior Chamber↗

Intraoperative mitomycin and corneal endothelium after photorefractive keratectomy.

PURPOSE: To determine whether there is an increased risk to the corneal endothelium when mitomycin C (MMC) is administered after photorefractive keratectomy (PRK). DESIGN: Prospective, randomized, double-blind, placebo-controlled crossover trial. METHODS: Corneal endothelium was analyzed preoperatively and postoperatively in 18 eyes of nine patients who were administered either MMC- or balanced salt solution (BSS)-supplemented PRK at Codet Aris Vision, Tijuana, Mexico. After laser ablation, one eye was randomly assigned to intraoperative topical MMC 0.02% treatment for 30 seconds, and the fellow eye (the control eye) was treated in a standard fashion with topical BSS. Preoperative pachymetry and endothelial cell count were performed and compared with postoperative measurements after one month and three months. Main outcome measure studied was endothelial cell loss. RESULTS: There was no significant difference in the preoperative endothelial cell count between the 2 groups: MMC group 2835 +/- 395, control group 2779 +/- 492, P = .62. In the control group, at one month and three months the difference in the endothelial cell count was not statistically significant (P = .27, P = .14, respectively). However, in the MMC group the endothelial cell loss was statistically significant: at one month 14.7 +/- 5.1%, and at three months 18.2 +/- 9.0% (P = .0006, P = .002, respectively). CONCLUSIONS: The use of intraoperative topical MMC 0.02% for 30 seconds after PRK may affect the endothelial cell count.

Administration, Topical↗

Rehabilitation time after simultaneous bilateral photorefractive keratectomy for low to moderate myopia.

PURPOSE: To evaluate the visual acuity rehabilitation time after simultaneous bilateral photorefractive keratectomy (PRK) using a flying small spot laser. SETTING: Eye Tech Medical Laser, Tel Aviv, Israel. METHODS: In this prospective interventional nonrandomized clinical trial, 42 consecutive eyes (21 patients) with myopia ranging from -0.75 to -5.50 diopters (D) (mean -2.75 D +/- 1.18 [SD]) and astigmatism up to -2.75 D (mean -0.64 +/- 0.55 D) were treated with bilateral simultaneous PRK using the ESIRIS excimer laser (Schwind). Main outcome measures were uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and manifest refraction up to 12 weeks after surgery. Both eyes of each patient were examined at the same follow-up after initial treatment. RESULTS: Within 2 weeks and 1 month of the laser procedure, the UCVA was at least 20/40 in 1 eye in 85.7% of patients (18 patients) and 100% of patients (21 patients), respectively. After 2 weeks, UCVA was at least 20/20, 20/25, and 20/40 in 7.1%, 40.5%, and 80.9% of eyes. The final mean manifest spherical equivalent 12 weeks post laser treatment was -0.10 +/- 0.26 D, with a mean sphere of +0.02 +/- 0.22 D and a mean cylinder of -0.24 +/- 0.37 D. No eye had a BCVA loss during the follow-up. CONCLUSION: Simultaneous bilateral PRK using a flying small spot excimer laser for low to moderate myopia allowed most patients to return to most daily tasks in a couple of weeks without compromising safety.

Adult↗

Outcome of simultaneous phakic implantable contact lens removal with cataract extraction and pseudophakic intraocular lens implantation.

PURPOSE: To assess the outcome of simultaneous implantable contact lens (ICL) removal and cataract extraction with pseudophakic intraocular lens (IOL) implantation. SETTING: CODET Aris Vision Institute, Tijuana, Mexico. METHODS: This retrospective noncomparative interventional case series evaluated 14 eyes of 12 patients with ICL implantations who developed a cataract and simultaneously had ICL removal and cataract extraction with IOL implantation. The follow-up time was at least 6 months (range 6 to 24 months). Visual acuity (logMAR), manifest refraction, intraocular pressure, and adverse events were recorded. RESULTS: Of the 12 patients (14 eyes), 10 patients (12 eyes) had ICL surgery to correct high myopia and 2 patients (2 eyes), to correct hyperopia. The mean uncorrected visual acuity after ICL implantation (before cataract development), before cataract surgery, and after cataract surgery were 0.48 +/- 0.32, 0.83 +/- 0.34, and 0.40 +/- 0.27, respectively. The mean best corrected visual acuity (BCVA) before ICL implantation, after ICL implantation, and after cataract surgery were 0.31 +/- 0.21, 0.28 +/- 0.19, and 0.27 +/- 0.21, respectively. The mean final manifest spherical equivalent was 0.30 diopters (D) +/- 1.07 (SD) (range +2.38 to 2.0 D). Ten eyes (71.4%) were within +/-1.0 D of the calculated target. One eye had a tear in the posterior capsule with vitreous loss during cataract surgery. No other intraoperative, perioperative, or postoperative complications were observed. No loss of BCVA was recorded at the last postoperative visit. CONCLUSIONS: Lens opacities and cataract formation are a potential complication of ICL surgery. The removal of the ICL and the cataract with IOL implantation was found to be safe, with predictable refractive results.

Adult↗

Brief posturographic test as an indicator of fatigue.

The purpose of the present paper was to analyze the efficiency of an abbreviated, albeit objective posturographic test as an indicator of fatigue. Posturography was measured in 10 healthy adults (age 18-33 years, male/female 7/3). Baseline posturographic measurements were taken for each subject. Later, a shorter (3-min) posturographic test was administered 12 times during 25 h of sleep deprivation. This was correlated with subjective assessment of fatigue using a questionnaire and cognitive performance assessed with a reaction time test (Psychomotor Vigilance Test). Although showing significant individual differences, the score of the abbreviated posturographic examination, normalized to each subject's baseline performance ('fatigue index') had a pronounced circadian pattern with a peak of instability in the early morning hours. Fatigue index was highly correlated with the cognitive test (r=0.80-0.90). A substantial, albeit weaker correlation was found between the fatigue index and the subjective fatigue scores (r=0.59-0.75). Fourier spectral analysis showed that low median sway (0.10-0.50 Hz), considered to be an expression of vestibular control, was most affected by fatigue. The study demonstrates that cognitive deterioration caused by fatigue can be objectively predicted by an abbreviated postural test of <or=3 min. This test is promising to be valid, reliable, and practicable, while being significantly correlated with physiological markers and validated cognitive measures of fatigue obtained by substantially more time-consuming and less convenient methods.

Adolescent↗

Ocular higher-order aberrations in eyes with supernormal vision.

PURPOSE: To quantify ocular higher-order aberrations (HOAs) in eyes with supernormal vision, that is, natural uncorrected visual acuity (UCVA) > or = 20/15, to analyze the correlation between ocular HOAs and age in these eyes, and to investigate the correlation of HOAs between right and left eyes. DESIGN: Observational case series. METHODS: Ocular HOAs were examined across a naturally dilated pupil with a diameter > or = 6.0 mm in 70 eyes of 35 subjects with > or = 20/15 UCVA (mean age 24.3 years +/- 7.7 [SD]) using the Nidek OPD scan wavefront aberrometer. Root-mean-square (RMS) values of HOA, total spherical aberration (TSA), total coma (TC), and total trefoil (TT) were analyzed. Correlation analysis was performed to assess the association between ocular HOAs and age and the correlation of HOAs between right and left eyes. RESULTS: Mean RMS values were 0.334 +/- 0.192 microm for HOA, 0.110 +/- 0.077 microm for TSA, 0.136 +/- 0.081 microm for TC, and 0.268 +/- 0.220 microm for TT. There were no significant differences in the mean values of HOA, TSA, TC, and TT between right and left eyes. The Pearson correlation coefficient between right and left eyes for TSA was 0.764 (P<.0001). No significant correlation was found between right and left eyes for HOA, TC, and TT. No significant correlation was found between each of the ocular aberrations and age. CONCLUSIONS: The amount of ocular HOAs in eyes with natural supernormal vision is not negligible, and is comparable to the reported amount of HOAs in myopic eyes.

Adolescent↗

Ocular higher-order aberrations in myopia and skiascopic wavefront repeatability.

PURPOSE: To study the distribution of ocular higher-order aberrations (HOAs) in a myopic population and to assess the repeatability of HOA measurements determined by a commercially available skiascopic wavefront sensor. SETTING: Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin, Israel. METHODS: Ocular HOAs were examined 3 times across a 6.0 mm naturally dilated pupil in 61 eyes using the Optical Path Difference (OPD)-scan wavefront aberrometer. Root-mean-square (RMS) values of HOAs, total spherical aberration (TSA), total coma (TC), and total trefoil (TT) were analyzed. Correlation analysis was performed to assess the aberration symmetry between right and left eyes. The repeatability of the OPD-scan measurements was assessed by calculating Pearson r correlation coefficients between each pair of measurements and the interclass correlation coefficients between the 3 measurements of each score. RESULTS: The mean RMS values of HOAs, TSA, TC, and TT were 0.347 microm +/- 0.252 (SD), 0.120 +/- 0.174 microm, 0.165 +/- 0.168 microm, and 0.252 +/- 0.157 microm, respectively. The HOAs, TSA, TC, and TT changed slightly and not significantly with increasing refractive error (all P>.05). The RMS level of HOAs and TTR of the 3rd measurement was significantly different from the 1st and 2nd measurements (P<.05), with overall low correlation between the 3 measurements for the HOAs, TSA, TC, and TT. CONCLUSIONS: The ocular wavefront aberrations varied greatly from subject to subject. Ocular HOAs were not correlated with refractive error. The repeatability of HOAs measurements with the OPD-aberrometry was low.

Adolescent↗

Central corneal thickness measurement with the Pentacam Scheimpflug system, optical low-coherence reflectometry pachymeter, and ultrasound pachymetry.

PURPOSE: To assess the intraoperator repeatability and interoperator reproducibility of central corneal thickness measurements by the Pentacam Scheimpflug imaging system (Oculus) and the optical low-coherence reflectometer (OLCR) pachymeter (Haag-Streit) and to compare them with those of ultrasound (US) pachymetry. SETTING: Assaf Harofe Medical Center Ophthalmology Outpatient Clinic, Zerifin, Israel. METHODS: Repeatability was determined from 10 successive measurements in each of 4 healthy patients. Reproducibility for the Pentacam Scheimpflug system was determined from measurements by 2 operators in each of 24 patients; in these 24 patients, central corneal thickness measurements were compared between the Pentacam and US pachymetry. For the OLCR pachymeter, reproducibility was determined from measurements by 2 operators in each of 16 patients, in whom central corneal thickness was also measured with the Pentacam. RESULTS: Mean coefficient of repeatability was 0.84% for the Pentacam Scheimpflug system and 0.33% for the OLCR pachymeter. For the Pentacam, the coefficient of interoperator reproducibility was 1.10% and the 95% limits of agreement were -10.2 microm to +11.9 microm. Mean difference between Pentacam and US was 6.09 microm. For the OLCR pachymeter, the coefficient of interoperator reproducibility was 0.59% and the 95% limits of agreement were -5.4 microm to +7.0 microm. Mean difference between central corneal thickness values obtained with the OLCR pachymeter and Pentacam Scheimpflug system was 1.7 microm. CONCLUSIONS: Objective, noncontact measurement of central corneal thickness with the Pentacam Scheimpflug system and OLCR pachymeter was convenient and yielded excellent intraoperator repeatability and interoperator reproducibility. Central corneal thickness values obtained with the Pentacam were similar to those obtained with both the OLCR pachymeter and an US pachymeter. Further research is needed to corroborate whether central corneal thickness measurements by the Pentacam and OLCR devices can be used interchangeably and are more clinically useful than US pachymetry.

Biometry↗

Penetrating keratoplasty for keratoconus: long-term results.

PURPOSE: To study central corneal endothelial cell density and morphology and corneal topography in transplanted corneas for keratoconus 10 to 17 years postoperatively. METHODS: Retrospective, noncomparative case series including all keratoconus patients who underwent penetrating keratoplasty by one surgeon, at the same center, between January 1986 and December 1994. Seventeen patients (22 eyes) met the criteria. Four patients (5 eyes) with unchanged visual acuity during the follow-up period did not agree to return for the last follow-up examination, 1 patient (1 eye) had graft failure, and 3 patients (4 eyes) were lost to follow-up. We reviewed the charts of 9 patients (12 eyes), and collected data including manifest refraction, best corrected visual acuity (BCVA), endothelial cell density, cell morphology, and corneal topography. RESULTS: The mean follow-up period for all eyes evaluated was 13.3 +/- 2.4 years (range 10-17 years). At the last follow-up, 91.7% of eyes achieved BCVA of 20/40 or better, and mean endothelial cell density was 695 +/- 113.6 cells/mm(2). Pleomorphism was detected in 5 eyes. Keratoconus pattern, by corneal topography, was not detected in any eye at the final examination. CONCLUSION: Endothelial cell count 10-17 years post-PKP for keratoconus is very low with pleomorphism and viable grafts, indicating continued endothelial instability.

Adolescent↗

Reduction of conjunctival bacterial flora by povidone-iodine, ofloxacin and chlorhexidine in an outpatient setting.

PURPOSE: To compare the reduction of conjunctival bacterial flora by povidone-iodine 4%, ofloxacin 0.3%, and chlorhexidine 0.05% for endophthalmitis prophylaxis before corneal suture removal in an outpatient setting. METHODS: In each group of 25 consecutive subjects who presented for outpatient ophthalmic evaluation, one eye was treated with either povidone-iodine 4% (PI), ofloxacin 0.3% (Oflox) or chlorhexidine 0.05% (Chex). The other eye served as a control. Three minutes after treatment, cultures were taken from the inferior conjunctival sac in both eyes. Following incubation at 35 degrees for 48 hours, the numbers of colonies were counted and compared. The difference in the numbers of colonies in each pair of treated and control eyes was assessed for each drug and compared. RESULTS: The reduction in colony-forming units was highly significant for each of the three drugs tested (Wilcoxon signed-ranks test; p < 0.0001). There was no significant difference between percent reduction by the three drugs (Kruskal-Wallis test; p = 0.68). Sterile cultures following preparation by PI, Oflox and Chex were obtained in 52%, 68% and 52%, respectively. CONCLUSIONS: The regimens tested were similarly effective in reducing conjunctival commensals. They may all be considered as options for a quick prophylaxis against infection following suture removal in an outpatient setting.

Anti-Infective Agents, Local↗

The effect of corneal flap on optical aberrations.

PURPOSE: To evaluate the changes in ocular aberrations induced by corneal flap creation. DESIGN: Prospective interventional nonrandomized clinical trial. METHODS: This study included 15 patients who were scheduled for laser in situ keratomileusis. A nasal hinge flap was created, using the Nidek MK-2000 microkeratome and then replaced without performing laser ablation. The ocular aberrations were measured before and after flap creation using the Nidek Optical Path Difference Scanning System ARK-10000. RESULTS: The root mean square wavefront errors of the higher-order optical aberrations (third-, fourth-, fifth-, and sixth-order aberrations) were not significantly altered at 1 week postsurgery compared with the preoperative values (P >.35). CONCLUSIONS: Creating a corneal flap with the Nidek MK-2000 microkeratome did not induce changes in higher-order optical aberrations as measured with the Nidek Optical Path Difference Scanning System ARK-10000 during the early postoperative period.

Adult↗

Visual field attention is reduced by concomitant hands-free conversation on a cellular telephone.

PURPOSE: To quantify the central attention-diverting effect of hands-free cellular phone conversation on visual field awareness. DESIGN: Experimental study. METHODS: Twenty male and 21 female healthy participants performed a pretest and baseline Esterman visual field examinations with the Humphrey Systems Visual Field Analyzer II. During the consequent third examination, each participant engaged in a hands-free conversation using a cellular phone. The conversation was the same for all participants. Visual field performance parameters were compared between the second (baseline) examination, and the third (test) examination for each eye. RESULTS: During phone conversation, missed points increased from mean 1.0 +/- 1.5 to 2.6 +/- 3.4 (P < or =.001) in the right eye and from 1.1 +/- 1.53 to 3.0 +/- 3.4 (P <.001) in the left eye. Fixation loss increased from mean 7.8% to 27.4% (P <.0001) and from 7.2% to 34.8% (P <.0001) for the right and left eyes, respectively. Test duration increased by a mean of 0.28 seconds (15%) per stimulus (P <.0001). Approximately half of missed points were inside the central 30 degrees. There was no significant difference in the performance of male and female participants. CONCLUSION: We describe a new model for the quantification of the attention-diverting effect of cellular-phone conversation on the visual field. In the current study, cellular hands-free conversation caused some subjects to miss significantly more points, react slower to each stimulus, and perform with reduced precision. Legislative restrictions on concomitant cellular-phone conversation and driving may need to be based on individual performance rather than a general ban on cellular phone usage.

Adult↗

Prediction of visual outcome after penetrating keratoplasty for pseudophakic corneal edema.

OBJECTIVE: To evaluate the ability to predict visual outcome after penetrating keratoplasty (PKP) in patients with pseudophakic corneal edema (PCE) or aphakic corneal edema (ACE) based on preoperative parameters available from the patient history and ocular examination. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Forty-eight patients who underwent 59 PKP procedures for PCE between 1997 and 2000 by two cornea specialists. METHODS: Medical records were retrospectively analyzed for variables in the history and ocular examination before PKP and visual outcome after PKP. Variables included age, gender, presence of diabetes or cardiovascular disease, method of intraocular lens (IOL) implantation during cataract surgery, vitreous loss during cataract surgery, time between cataract and PKP surgery, and maximal visual acuity reached after cataract surgery. The predictive value of each preoperative variable on post-PKP visual outcome was assessed using both univariate and multiple regression analyses. MAIN OUTCOME MEASURES: Statistical significance for the predictive value of each preoperative variable on post-PKP visual outcome. RESULTS: Best-corrected visual acuity (BCVA) of 20/40 or better was achieved in 13 patients (27%). The strongest predictor of this outcome was implantation of a bag-fixated or sulcus-fixated IOL at the time of cataract surgery (P = 0.007; odds ratio, 15.8; 95% confidence interval, 1.2-208). Less significant variables included BCVA after cataract surgery, time between cataract surgery and PKP, and gender. CONCLUSIONS: In planning and advising patients with pseudophakic or aphakic corneal edema who are candidates for PKP, the method of IOL implantation during the cataract surgery is the single most significant predictor of visual acuity after corneal transplantation. Bag-fixated or sulcus-fixated posterior chamber IOL was associated with a better visual outcome than anterior chamber IOL, scleral-fixated posterior chamber IOL, or aphakia.

Aged↗

Laser in situ keratomileusis in a combat jet aircraft pilot.

Pilots who have had laser in situ keratomileusis (LASIK) surgery are disqualified from flying status in a combat jet aircraft in the United States Navy and Air Force. We report the case of a jet aircraft pilot who had LASIK for myopia. The pilot resumed flights 2 weeks after the procedure and has performed several dozen uneventful daylight flights in a combat jet aircraft. We recommend a clinical study to reevaluate the appropriateness of LASIK in military jet aircraft aviation.

Adult↗

Long-term evaluation of hyperopic laser in situ keratomileusis.

PURPOSE: To evaluate the efficacy, safety, and predictability of hyperopic laser in situ keratomileusis (H-LASIK). SETTING: Departments of Ophthalmology, Hadassah University Hospital, Jerusalem, and Assaf Harofeh Medical Center, Zerifin, Israel. METHODS: This prospective noncomparative case series studied the results of H-LASIK in the first 92 consecutive eyes of 50 patients with up to +10.25 diopters (D) of hyperopia. For analysis, the patients were divided into 3 groups based on preoperative hyperopia: low hyperopia (< +3.00 D), moderate hyperopia (> or = +3.00 to 6.00 D), and high hyperopia (> or = +6.00 D). RESULTS: Forty-two patients, 77 eyes (83.7%), were followed for at least 12 months. At 12 months, the mean manifest spherical equivalent was +0.33 +/- 0.65 D (93.1% of eyes within +/-1.0 D of the intended correction) in the low myopia group, +0.21 +/- 0.60 D (92.3% within +/-1.0 D of the intended correction) in the moderate hyperopia group, and +1.62 +/- 1.50 D (36.4% within +/-1.0 D of the intended correction) in the high hyperopia group. The uncorrected visual acuity (UCVA) was 20/40 or better in all eyes (100%), 24 eyes (92.3%), and 13 eyes (59.1%) in the low, moderate, and high hyperopia groups, respectively. Comparing the UCVA at the last examination with the best corrected visual acuity (BCVA) before surgery in all patients showed that 59 eyes (76.6%) were within +/-1 line and 18 eyes (23.4%) were within +/-2 or more lines of the preoperative BCVA. Three eyes (3.9%) in the high hyperopia group lost 2 or more lines of BCVA. Three eyes (3.9%) had flap- related complications. Eight patients (15 eyes) with a follow-up less than 12 months did not have intraoperative or postoperative complications. CONCLUSION: Laser in situ keratomileusis was a safe, effective, and predictable procedure for hyperopia up to +6.0 D and less predictable for higher hyperopia.

Adult↗

Scleral contact lenses may help where other modalities fail.

PURPOSE: To describe the vision-correcting and therapeutic benefits of gas-permeable scleral contact lenses (GP-ScCL) in the management of irregular corneal surface disorders and ocular surface diseases. METHODS: The charts of 48 consecutive patients (66 eyes) whose management included the use of GP-ScCL were reviewed. RESULTS: The most common indication for fitting the lenses was keratoconus in patients who had to stop wearing other types of corneal lenses (44 eyes, 74.6%). Other indications included extreme corneal irregularity after penetrating keratoplasty, nonhealing corneal ulcer, postoperative dry eye syndrome following laser in situ keratomileusis (LASIK), severe exposure keratitis and acid burn. Mean follow-up was 17 months (range, 2-96). Mean wearing time of the GP-ScCL was 16.2 hours per day (range, 3-18). Visual acuity of 20/40 or better was achieved in 90.9% of keratoconus patients and in 81.8% of postkeratoplasty patients. A gain of two or more Snellen lines was observed in 94.5% of eyes treated for improving vision. Marked subjective improvement in quality of life was reported by 86% of the patients, mainly as a result of improvement in their visual function and reduction in discomfort. Five patients (seven eyes) failed to wear GP-ScCL. CONCLUSION: GP-ScCL can provide successful and safe visual and therapeutic solutions for ocular conditions when conventional contact lenses and medical treatment have failed and where surgery is undesirable or contraindicated.

Adolescent↗

Encephalocraniocutaneous lipomatosis: case report and review of the literature.

PURPOSE: Encephalocraniocutaneous lipomatosis is a congenital neurocutaneous syndrome characterized by lipomatous craniofacial hamartomas. The most common ocular manifestation is epibulbar choristoma, but many additional eye anomalies may be present. METHODS: To our knowledge, this is the first reported case with bilateral aniridia. We report a case of a boy affected by this syndrome and review the literature. CONCLUSION: Regarding this case, we suggest adding aniridia to the possible ocular anomalies in this syndrome.

Brain Diseases↗

Refractory intraocular pressure increase after phakic posterior chamber intraocular lens implantation.

PURPOSE: To describe a complication resulting from the implantation of a posterior chamber intraocular lens in a phakic eye. DESIGN: Interventional case report. METHODS: We examined a 37-year-old woman with severe myopia who had implantation of a phakic posterior chamber intraocular lens. RESULTS: The patient developed pigmentary glaucoma with refractory increase in intraocular pressure, despitemedical therapy and intraocular lens removal. Trabeculectomy was required to reduce the pressure. CONCLUSION: This case demonstrates that pigmentary glaucoma secondary to implantation of a phakic posterior chamber intraocular lens can lead to filtering surgery to decrease intraocular pressure.

Adult↗