PubMed Health⌕ Search

Biomedical subjects

J I Luchs

Publications and source records attributed to J I Luchs.

5 recordsLinked to original sources
PubMed2001

Keratitis, ulceration, and perforation associated with topical nonsteroidal anti-inflammatory drugs.

PURPOSE: To report corneal complications associated with topical nonsteroidal anti-inflammatory drugs (NSAIDs). DESIGN: Retrospective, noncomparative interventional case series. PARTICIPANTS: Eighteen eyes of 16 patients with adverse corneal events associated with NSAID use. METHODS: Evaluation of 16 patients referred for management of corneal complications during use of topical NSAIDs (ketorolac tromethamine [Acular], diclofenac sodium [Voltaren], diclofenac sodium [Falcon DSOS]). MAIN OUTCOME MEASURES: Type and severity of corneal complications. RESULTS: Of the 16 patients, two experienced severe keratopathy, three experienced ulceration, six experienced corneal or scleral melts, and five experienced perforations. Eleven patients had recent cataract surgery; nine of these were on concurrent topical steroids and antibiotics. Another patient who did not have recent surgery was using concurrent topical steroids without antibiotics for sarcoid uveitis. Systemic associations included two patients with rheumatoid arthritis, one patient with asymptomatic Sjogren's syndrome, and two with rosacea. CONCLUSIONS: Topical NSAIDs were associated with corneal complications in 18 eyes of 16 patients. Potential risk factors include conditions that predispose the patient to corneal melting, concurrent topical steroids, and epithelial keratopathy in the early postoperative period.

Administration, Topical↗
PubMed1997

Ulcerative keratitis in bullous keratopathy.

PURPOSE: The authors review a large series of patients with bullous keratopathy (BK) to analyze the frequency of ulcerative keratitis, and determine the contributory roles of bullae, bandage soft contact lenses, steroids, and prophylactic antibiotics. METHODS: A retrospective review of all cases of pseudophakic or aphakic bullous keratopathy presenting to the cornea service between January 1, 1986 and September 1, 1995 was performed. The influence of time, bullae, bandage contact lenses, steroids, and prophylactic antibiotics was evaluated by actuarial methods and multivariate analysis. RESULTS: Nine hundred eighteen patients were included in this study, 44 (4.7%) of whom had infectious or inflammatory complications; 813 cases were available for statistical analysis. Steroids (P < 0.0001), bandage soft contact lens use (P = 0.004), and bullae (P = 0.01) had statistically significant independent effect on the risk of developing ulcerative keratitis, and the combination of steroids and bandage lenses yielded the highest risk (P < 0.001). Propylactic antibiotic use paradoxically had a statistically significant association with ulcerative keratitis in these patients (P = 0.01). Increasing BK time was also associated with ulcer development, and the risk remained relatively constant over the 60 months of the study. Streptococcus was the most frequent organism cultured. CONCLUSIONS: Ulcerative keratitis developed in 4.7% of patients with bullous keratopathy. Prolonged BK time alone was a risk factor for infection. The strongest single additional risk factor for ulcer development was steroid use, followed by bandage soft contact lens use, and their simultaneous use had the greatest effect. The presence of bullae was also a risk factor for infection, and prophylactic antibiotic use did not prevent ulcer development.

Aged↗
PubMed1997

Comparison of keratometric values of healthy and diseased eyes measured by Javal keratometer, EyeSys, and PAR.

PURPOSE: To compare the simulated keratometric results of the PAR CTS and the EyeSys corneal imaging systems with Javal keratometer readings in keratoconus eyes, in eyes after corneal grafting, and in healthy eyes. SETTING: Cornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA. METHODS: This prospective study evaluated 69 patients divided into three groups (keratoconus; 6 to 12 months postkeratoplasty; normal corneas) treated at the cornea service. The eyes were measured with each of the three instruments. Keratometry results and number of attempts needed to obtain the results were collected. RESULTS: Thirty keratoconus, 18 transplanted, and 21 normal corneas were examined. The PAR CTS Imaged all corneas and the EyeSys, 86% (P = .000627). The PAR CTS and Javal flat and steep K-readings in all three groups were the same. The EyeSys simulated keratometry results were lower than those of Javal keratometer in the flat K (P < .00001) and steep K (P < .00001) in the normal group and in the steep K in the transplanted cornea group (P = .00823). The EyeSys also measured less astigmatism than the Javal in the normal (P = .00124) and transplanted cornea groups (P = .00376). CONCLUSION: The PAR CTS was better able than the EyeSys to provide keratometric values that agreed with those obtained with the Javal keratometer.

Adolescent↗
PubMed1997

Infantile ulcerative keratitis secondary to congenital entropion.

Congenital entropion is a rare eyelid anomaly that can cause chronic corneal erosions or ulceration. The diagnosis may be easily overlooked by both the pediatrician and the ophthalmologist, particularly when the lids are tightly closed in the crying child. We present three cases of congenital entropion associated with corneal ulceration. Each patient underwent a complete ophthalmologic examination. Examination under anesthesia, including corneal scrapings for culture and photography, was performed before surgical repair of the entropion. There were two cases of lower lid entropion and one case of upper lid entropion. In all three cases symptoms were present since birth, and the diagnosis was overlooked by the treating pediatrician. Corneal ulceration ultimately developed in all three cases. Cultures revealed Staphylococcus aureus in one case, and coagulase negative Staphylococcus in another case. Cultures were negative in one case. In all three patients the ulcers healed rapidly after surgical entropion repair. Congenital upper or lower lid entropion is an uncommon condition that does not spontaneously improve and is an important cause of corneal ulceration in infants. Recognition of this condition is often difficult, and early surgical intervention to repair the lid deformity may help to avoid permanent corneal scarring and visual loss.

Cornea↗