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Biomedical subjects

Jaime Levy

Publications and source records attributed to Jaime Levy.

At least 37 records · Page 2Linked to original sources

Removal of giant vernal papillae by CO2 laser.

BACKGROUND: We report our experience in removing giant papillae in cases with severe vernal keratoconjunctivitis using CO2 laser. METHODS: Five cases with conjunctival giant papillae due to severe vernal keratoconjunctivitis were treated with CO2 laser. All cases were resistant to conventional treatment. In 4 eyes, there was also an associated corneal shield ulcer. RESULTS: In all 5 cases the procedure was uneventful. Retreatment was performed in only 2 cases because of recurrence of the papillae. No intra- or postoperative complications were observed. INTERPRETATION: CO2 laser seems to be a safe method for removing conjunctival giant papillae in cases with severe vernal keratoconjunctivitis. It is also a repeatable method that enables a rapid conjunctival and corneal recovery.

Adolescent↗

Bilateral consecutive blindness due to sphenoid sinus mucocele with unilateral partial recovery.

BACKGROUND: We present an interventional case report of a rare occurrence of sphenoid sinus mucocele causing bilateral consecutive blindness with unilateral partial recovery after endoscopic surgery. METHODS: A 64-year-old woman with known sphenoid sinus mucocele and right blindness was referred because of an acute drop of vision to hand motion in her only-seeing left eye over 5 days. Imaging revealed a large mucocele enlarging the sphenoid sinus, eroding the base of the skull, protruding into the cranial cavity, and compressing the left optic nerve. RESULTS: Urgent endoscopic sphenoidotomy was performed. Several hours after the procedure, visual acuity was partially recovered in the left eye. INTERPRETATION: Sphenoid sinus mucoceles can cause bilateral blindness. A high index of suspicion and urgent imaging studies are necessary. Because visual recovery depends on prompt diagnosis and surgical intervention, a close collaboration between otolaryngologists and ophthalmologists is crucial.

Blindness↗

Punctate inner choroidopathy: resolution after oral steroid treatment and review of the literature.

CASE REPORT: A case of punctate inner choroidopathy (PIC) that resolved after oral steroid treatment is described. The 25-year-old female patient presented with reduced visual acuity of several days duration. Results of fundus examination, fluorescein angiography, and indocyanine green angiography were consistent with PIC with a small choroidal neovascularization lesion nasal to the fovea. Visual acuity improved significantly after several days on oral steroid treatment. COMMENTS: Although spontaneous resolution of the lesions can occur without any treatment, oral steroids in PIC may help achieve improved vision more rapidly. The clinical manifestations, differential diagnosis, and therapeutic modalities of this rare entity are discussed.

Administration, Oral↗

Eye injuries due to tractor wheel explosion: report of two cases.

CASE REPORT: We describe 2 patients who sustained eye injuries when tractor wheels exploded while being inflated. Descriptions of ocular involvement from such accidents are rare in the literature. One of our patients experienced severe eye trauma requiring enucleation. In the second case, despite trauma to both eyes, 20/20 vision was recovered. COMMENTS: Injuries from exploding tires are compared to those seen in the context of air-bag deployment, and safety recommendations are discussed.

Accidents, Occupational↗

Primary congenital glaucoma presenting within the first three months of life in a Bedouin population: prognostic factors.

OBJECTIVES: To analyze the final outcome of surgery in Arab-Bedouin children with primary congenital glaucoma (PCG) presenting within the first three months of life, and to search for prognostic factors for success. DESIGN: Retrospective study of all cases with follow-up of at least 24 months. PATIENTS: Twenty-five Arab-Bedouin children (45 eyes) with PCG presenting within the first three months of life who underwent surgical procedures at the Soroka University Medical Center from January 1988 to December 1998. METHODS: Patient's age, family history, main presenting features, data from examinations under anesthesia, including intraocular pressure (IOP), horizontal corneal diameter, and cup/disc (c/d) ratio, and the type of surgery performed were reviewed. MAIN OUTCOME MEASURES: Success of the first operation, defined as final IOP < 21 mm Hg achieved after only one surgical procedure without anti-glaucoma medication, and final outcome, defined as good when IOP was < 21 mm Hg and > 5 mm Hg at the end of a 24-month follow-up period without anti-glaucoma medication, irrespective of the number of procedures performed. RESULTS: At presentation mean IOP was 36.2 +/- 8.0 mm Hg, corneal diameter was 12.62 +/- 0.98 mm, and c/d ratio was 0.41 +/- 0.16. The mean age at first operation was 17 +/- 20 days, and median of 5 days. The mean follow-up period was 37.4 +/- 25.4 months. The success of the first operation performed was not related to the type of operation (P = 0.22), gender (P = 0.47), consanguinity (P = 1.0), family history (P = 0.12), clinical presentation (P = 0.81), or age at first operation (P = 0.38). Eyes with high initial IOP and greater c/d ratio were at a significantly higher risk for failure (P = 0.05, P = 0.04, respectively). A final outcome of IOP under 21 mm Hg and above 5 mm Hg was achieved in 39 eyes (86.5%). There was no statistical association between final outcome and the type of first surgical procedure performed, gender, consanguinity, clinical presentation, and age at first operation. Cases with no family history had a significantly better final outcome (P = 0.05). In multivariate analysis only initial IOP showed borderline significance as an independent risk factor for final outcome (P = 0.06). CONCLUSIONS: Initial high IOP and higher c/d ratio were found to be predictive factors for failure of the first procedure. Final outcome was significantly better in cases with no family history, yet initial IOP was the only independent predictive factor for failure at the final outcome in a multivariate model. Findings of this type have not been previously reported, and they may constitute an important tool in predicting the treatment outcome of very young children with PCG.

Arabs↗

The silent sinus syndrome.

Patients with silent sinus syndrome typically present for investigation of facial asymmetry. Unilateral, spontaneous enophthalmos and hypoglobus are the prominent findings at examination. Imaging of the orbit and sinuses characteristically show unilateral maxillary sinus opacification and collapse with inferior bowing of the orbital floor. It has been suggested that SSS is due to hypoventilation of the maxillary sinus secondary to ostial obstruction and sinus atelectasis with chronic negative pressure within the sinus. Treatment involves functional endoscopic sinus surgery for reestablishing a functional drainage passage, and a reconstructive procedure of the floor of the orbit for repairing the hypoglobus and cosmetic deformity. Ophthalmologists, otorhinolaryngologists, and radiologists must be familiarized with this relatively newly reported disease.

Adult↗

[Outcome of combined penetrating keratoplasty with vitreoretinal surgery using temporary Eckardt keratoprosthesis].

BACKGROUND: For the adequate management of vitreoretinal pathology, good visualization through a clear cornea is needed to permit proper surgical repair. However, an opaque cornea, precludes this necessary visualization and makes posterior segment surgery impossible. Temporary keratoprosthesis facilitates visualization of intraocular structures in eyes that might otherwise be inoperable due to corneal opacities. AIM: To report the effectiveness of a combined procedure (pars plana vitrectomy with temporary Eckardt keratoprosthesis, vitreoretinal surgery, and penetrating keratoplasty) and to assess the functional outcome of eyes undergoing these procedures. METHODS: Six eyes from six consecutive patients operated on between 2001 and 2004 at the Department of Ophthalmology, Soroka University Medical Center, Beer Sheva, and followed-up for at least 6 months, were evaluated retrospectively. The evaluation focused on ocular history, visual acuity (VA), anatomical outcome and complications. RESULTS: The average follow-up period was 26 months. Prior to the operation, the most frequent diagnosis in the anterior segment was corneal scar in 4 eyes (67%). In the posterior segment, the most frequent diagnosis was retinal detachment in 5 eyes (83%). Preoperative VA was full light perception or less in all eyes. In five cases (83%), final postoperative VA was 6/240 or better. The corneal graft remained clear in five cases (83%). The retina remained attached in all cases. CONCLUSIONS: Combined corneal and retinal procedures using temporary keratoprosthesis are a safe and efficacious way of managing complicated corneal and retinal disease. These methods can preserve ambulatory vision and improve the quality of life of patients. Visual prognosis is usually limited due to the primary ocular disease.

Adult↗

Rhinolithiasis: a very late complication after dacryocystorhinostomy with rubber-gum and polyethylene stenting.

PURPOSE: To describe a rare case of rhinolith formation 21 years after dacryocystorhinostomy (DCR) with rubber gum and polyethylene tubing surgery. DESIGN: Interventional case report. METHODS: A 23-year-old-woman underwent uneventful left DCR with rubber gum and polyethylene tubing for chronic dacryocystitis. Twenty-one years later, she presented with purulent rhinorrhea, nasal obstruction, and facial pain. Computed tomography revealed a radiopaque density in the left nasal cavity. RESULTS: A rubber gum foreign body embedded with granulation tissue and a huge rhinolith was removed endoscopically through the anterior nares. After surgery, the patient reported immediate and complete relief of symptoms. CONCLUSION: Rhinoliths can develop progressively several years after DCR as a result of foreign body reaction to rubber gum or polyethylene tubing. This rare complication should be ruled out in patients complaining of purulent rhinorrhea who underwent DCR with tubing before the early 1980s.

Adult↗

Artisan aphakic intraocular lens in children with subluxated crystalline lenses.

PURPOSE: To evaluate the results of Artisan (Ophtec) aphakic intraocular lens (IOL) implantation in children with idiopathic subluxated lenses. SETTING: Department of Ophthalmology, Soroka University Medical Center, Beer-Sheva, Israel. METHODS: This retrospective small case series comprised 4 eyes (3 children) with idiopathic essential subluxated lenses that had lens washout, lens capsule removal, Artisan IOL implantation, and peripheral iridectomy. The indications for surgery were reduced visual acuity and monocular diplopia. The main outcome measures were postoperative refraction and change in best corrected visual acuity (BCVA). RESULTS: The postoperative follow-up ranged from 8 to 10 months. After surgery, the BCVA was 6/12 or better in the 3 cases that could be recorded. Visual acuity improved by 2 or more Snellen lines in all 4 eyes. The postoperative spherical equivalent was within +/-1.00 diopter in all cases. No significant postoperative complications were observed. CONCLUSIONS: In 4 eyes with a subluxated crystalline lens, implantation of an Artisan aphakic IOL improved visual acuity. Studies with a larger number of patients and longer follow-up are necessary to confirm these results.

Biocompatible Materials↗