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Roberto Pineda

Publications and source records attributed to Roberto Pineda.

12 recordsLinked to original sources
PubMed2006

Corneal ulceration and perforation with ketorolac tromethamine (Acular) use after PRK.

PURPOSE: To report a case of corneal ulceration and perforation after PRK connected with high doses of ketorolac tromethamine (Acula). METHODS: A 31-year-old man presented 5 days after PRK in the left eye with corneal ulceration and perforation requiring penetrating keratoplasty. The patient admitted to using Acular every hour, ciprofloxocin every hour, and prednisolone acetate 1% QID postoperatively. RESULTS: Laboratory tests, including corneal cultures, were normal. A diagnosis of corneal ulceration secondary to incorrect use of high-dose ketorolac tromethamine was made. CONCLUSION: Judicious patient counseling is recommended when using topical NSAIDs in the setting of PRK.

Adult↗
PubMed2005

Discoid lupus erythematosus masquerading as chronic blepharoconjunctivitis.

PURPOSE: To recognize discoid lupus erythematosus (DLE) as a treatable cause of chronic blepharoconjunctivitis. DESIGN: Retrospective observational case series. PARTICIPANTS: Records of 5 patients with biopsy-proven DLE were reviewed. METHODS: Clinical and pathology records were examined. MAIN OUTCOME MEASURES: Patients' clinical and histopathological characteristics and response to treatment were assessed. RESULTS: Clinical features included meibomian gland dysfunction, blepharitis, chalazia, trichiasis, madarosis, conjunctivitis, chronic eyelid edema, and eyelid plaques. Histopathology showed hyperkeratotic epithelium, degeneration of the basal cell layer, and a perivascular lymphocytic infiltrate. There was delayed diagnosis in all cases, ranging from 4 months to 25 years. All of the patients responded to systemic hydroxychloroquine therapy. CONCLUSIONS: Heightened awareness of eyelid DLE may lead to earlier detection and specific therapy for this chronic disorder.

Adult↗
PubMed2002

Epithelial and fibrous downgrowth: mechanisms of disease.

Epithelial downgrowth is a rare, but potentially devastating, complication of intraocular surgery and trauma. It has been suggested that the incidence is declining with modern surgical techniques, but further long-term analysis is needed to determine whether this in fact is true. While clinical observations and experimental studies have helped to elucidate factors involved in the development of this disease, a precise understanding of its pathogenesis is unknown. Given the difficult management and poor prognosis of this disease, further study and heightened clinical awareness are needed to better understand this disease process.

Anterior Eye Segment↗
PubMedDate not supplied

Phacoemulsification and thermal wound injury.

The technique of lens nucleus phacoemulsification has revolutionized cataract surgery. However, the production of ultrasound energy is associated with heat generation that can result in damage to ocular tissue, in particular the corneoscleral wound site. Thermal damage to the corneoscleral wound site may result in difficulty with wound closure and consequent risk of wound leakage, as well as damage to the adjacent corneal stroma and endothelium, fistula formation, and the induction of high degrees of post-operative astigmatism. The loss of adequate flow of irrigation fluid around the phacoemulsification tip is the key factor in the development of phacoemulsification-induced thermal injury. Use of excessive ultrasound power and production of excessive frictional forces generated by contact of the vibrating phacoemulsification needle with the irrigation sleeve are also factors involved. In the event of a "phacoburn," a specialized "gape suture" may help minimize surgically-induced astigmatism. The degree of induced astigmatism tends to wane over time; astigmatic keratotomy is an option in the setting of high degrees of residual astigmatism.

Cornea↗
PubMedDate not supplied

Descemet membrane tear after cataract surgery.

Descemet membrane detachment is a potentially devastating complication of cataract surgery. Small localized detachments are rarely problematic, however persistent extensive detachments can affect visual acuity. In severe cases penetrating keratoplasty may be required for restoration of vision. One case of a persistent descemets membrane tear is presented and the progress after surgical repair via suture and injection of air is described. The patient was followed for 5 months after repair with persistent haze and mild corneal edema, though vision improved to 20/25+.

Aged↗