Biomedical subjects

Shui-Mei Lee

Publications and source records attributed to Shui-Mei Lee.

10 recordsLinked to original sources

PubMed2006

Propionibacterium acnes DNA from an explanted intraocular lens detected by polymerase chain reaction in a case of chronic pseudophakic endophthalmitis.

We report a case of Propionibacterium acnes DNA from the explanted intraocular lens (IOL) a 76-year-old man with delayed-onset chronic endophthalmitis. The detection was by polymerase chain reaction (PCR). Slitlamp microscopic examination showed cells and flare in the anterior chamber, keratic precipitates on the endothelium, and multiple white plaques on both surfaces of the IOL. Propionibacterium acnes DNA was found in both the aqueous humor and the explanted IOL by PCR. Scanning electron microscopy showed diphtheroid particles, a coating of biofilm-like deposits, as well as scattered crystals on the surface of the explanted IOL and supported the possibility of P acne colonies on the IOL.

Aged↗

PubMed2006

Corneal lesion as the initial manifestation of tyrosinemia type II.

Tyrosinemia type II (Richner-Hanhart syndrome) is a rare autosomal recessive disease with deficiency of tyrosine aminotransferase and subsequently increasing level of serum tyrosine. We report the case of a 2-year-old girl who was referred due to bilateral corneal lesions. Slit-lamp examination showed small granular white deposits arranged in a dendritic pattern in the superficial central cornea of both eyes. Physical examination revealed painful, non-pruritic, hyperkeratotic plaques on the soles, palms and fingertips. Mental evaluation demonstrated developmental delay for her age. Blood examination revealed serum tyrosine level to be 1868 microM (normal range, 30-110 microM), which decreased to 838 microM with 2-month diet on tyrosine and phenylalanine restriction. The corneal and skin lesions resolved completely. However, the corneal deposits recurred a month later as her mother failed to strictly control the diet because the little girl was losing weight and activity. With specific formula and adjusted diet regimen, the corneal lesions decreased again. Corneal pseudodendritic deposits may be the initial manifestation in patients with tyrosinemia type II. Early diagnosis and intervention with diet control are crucial for preventing permanent visual and developmental deficits. Corneal deposits can be one of the parameters in monitoring the efficacy of diet control.

Child, Preschool↗

PubMed2006

Herpes simplex keratitis following excimer laser application.

PURPOSE: To report two cases of herpes simplex keratitis following excimer laser application. METHODS: Two immunocompetent patients with no history of ocular viral infection developed ulcers after LASIK and phototherapeutic keratectomy (PTK), respectively. RESULTS: Antiviral treatment was administered, and the lesions healed within 14 days. CONCLUSIONS: These two cases suggest that herpes simplex virus was associated with the use of the excimer laser.

Adult↗

PubMed2005

Laser-assisted subepithelial keratectomy for dry eye associated with soft contact lenses.

PURPOSE: To evaluate the efficacy and safety of laser-assisted subepithelial keratectomy (LASEK) in myopic patients with preoperative dry eye associated with extended soft contact lens use. SETTING: Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan. METHODS: This nonrandomized prospective interventional case series study comprised 9 patients (18 eyes) with dry eye and keratoconjunctivitis associated with long-term complicated soft contact lens use. Prior to LASEK surgery and for 1 year following surgery, measurements and comparisons were made of uncorrected visual acuity, best corrected visual acuity (BCVA), manifest refraction, symptoms, tear function, ocular surface abnormality, and corneal sensitivity. RESULTS: No significant differences (P > .05) in the mean results of the Schirmer test with anesthesia and tear breakup times before and after LASEK were evident. Corneal sensitivity recovered within 1 month after LASEK. No complications occurred during or after LASEK. Subepithelial haze and superficial punctate epithelial defects occurred in 1 eye, representing a loss of 1 Snellen line of BCVA. CONCLUSION: Laser-assisted subepithelial keratomileusis in dry eyes and keratoconjunctivitis associated with complicated soft contact lens wearing was safe and efficacious.

Adult↗

PubMed2005

Central corneal mosaic opacities in Schnyder's crystalline dystrophy.

PURPOSE: To report an unusual presentation of Schnyder's corneal crystalline dystrophy (SCCD), sharing the feature of central corneal mosaic opacities. DESIGN: Observational case report. METHODS: A 51-year-old man and his family members were examined. Investigations included slit-lamp biomicroscopy, radiography of knee joint, plasma lipid level, and genotyping of the SCCD candidate region in chromosome 1p34.1-1p36. RESULTS: A symmetric, central, disciform, full-thickness opacity was seen in both corneas of the patient. The opacities appeared in a mosaic pattern, instead of collections of crystals or a diffuse haze as typically detected in SCCD. Small clumps of crystalline deposits and arcus lipoides were also observed. Systemically, hyperlipidemia and bilateral genu valgus were identified. He had 2 daughters, and both of them had bilateral corneal crystalline deposits and genu valgus. No other family members had findings suggesting SCCD. The genetic study demonstrated that all of the affected individuals shared a common haplotype within the region of previously reported SCCD locus. However, 1 unaffected sibling of the proband also had the same haplotype. CONCLUSIONS: Central corneal mosaic opacities may be another variant of SCCD.

Adolescent↗

PubMed2004

Linear-long incisions with a small optical zone for the correction of astigmatism in older patients.

PURPOSE: To evaluate the efficacy of astigmatic keratotomy (AK) by paired linear (transverse)-long incisions within a small optical zone in older patients with 3.00 diopters (D) or more of astigmatism who are intolerant of contact lenses, spectacles, or both. DESIGN: Prospective, noncomparative case series. PARTICIPANTS: Twenty-one eyes (20 patients; age range, 58-87 years) treated at clinics of the Taipei Veterans General Hospital were included in this study. METHODS: Paired linear incisions (90 degrees in length) with a central optical zone (OZ) of 4.5 mm were made to correct high astigmatism in older patients. The incisions were 80% of the corneal thickness and parallel to the axis of the steepest cylinder. MAIN OUTCOME MEASURES: Refraction, keratometry, corneal topography, and visual acuity with and without correction were measured as the outcome indicators. RESULTS: The mean course of the stabilization of corneal curvature was 1.8 months. Significant improvement from a preoperative corneal astigmatism of 4.52+/-1.39 D to a postoperative value of 1.82+/-0.88 D (P<0.0001) was shown. Marked axis deviations of more than 30 degrees were observed in 5 cases and corneal perforation was observed in 1 case. When the corneal curvature stabilized, uncorrected visual acuity was improved by 2 lines or more in 15 eyes (71.4%). Spherical equivalents and best-corrected visual acuity did not change significantly. Postoperative glare was absent in all patients. CONCLUSIONS: We conclude that AK by linear-long incisions extending from a small OZ is effective and safe for correcting astigmatism.

Aged↗

PubMed2004

Ocular injuries from plant sap of genera Euphorbia and Dieffenbachia.

Clinical findings in 3 cases of ocular injuries caused by the milky latex from Euphorbia tirucalli and Dieffenbachia sequine were reported. The initial symptoms of all patients were burning pain with subsequently blurred vision. Visual acuity was reduced between 6/30 and 6/20. Euphorbia sap caused punctate erosion, microbullae and Descemet's folds; while Dieffenbachia sap induced conjunctival chemosis and fine blue crystals in the stroma. Ocular symptoms developed in 5 to 18 hours despite immediately copious irrigation. Supportive treatment resulted in a full recovery without sequalae over 1 week. Wearing eye protection and washing the exposed areas with soap and water are advised while handling such plants.

Adult↗

PubMed2003

Pseudomonas corneal ulcer related to overnight orthokeratology.

PURPOSE: To report two cases of Pseudomonas aeruginosa corneal ulcers as a complication of overnight orthokeratology lens wear. METHODS: Case report. RESULTS: Two 11-year-old girls with acute central corneal ulcers were referred to our hospital. In both cases, the ulcers were about 2 mm in diameter, located centrally, contained dense cellular infiltration, and discharged purulent material. Intensive topical ceftazidime was applied to treat the ulcers. Cultures of the scraped corneal tissues and the contact lens storage solutions in both cases grew P. aeruginosa, which was sensitive to the antibiotic. The presenting best-corrected visual acuity was hand motion at 20 cm in one patient and 6/20 in the other. Both patients had received several months of overnight orthokeratology treatment with rigid gas permeable contact lenses to correct myopia (-4.25 D and -4.75 D in the two affected eyes). The final best-corrected visual acuity was 6/60 in one patient and 6/7.5 in the other. CONCLUSIONS: Overnight orthokeratology contact lens wear carries a potential risk of corneal ulcer and may cause significant visual impairment in children.

Anti-Bacterial Agents↗

PubMed2003

Localized amyloidosis of the cornea secondary to trichiasis: clinical course and pathogenesis.

PURPOSE: To present four cases of localized corneal amyloidosis secondary to trichiasis and to discuss its pathogenesis. METHODS: Medical and pathologic records of four patients with corneal amyloidosis secondary to trichiasis were reviewed retrospectively. Two patients underwent trichiasis surgery and then lamellar keratectomy. One patient underwent trichiasis surgery only, and one patient received keratectomy only. The excised specimens were examined by light and electron microscopy. In two cases, they were stained with antibodies against kappa and lambda immunoglobulin light chains. All patients were followed for evidence of progression or recurrence of the lesions. RESULTS: Three cases presented with blurring of vision and a progressively enlarging vascularized unilateral corneal mass. One case had normal vision and a smaller, nonvascularized mass. All four cases had a history of trichiasis. After trichiasis surgery but before corneal surgery, two patients were followed for 24 and 18 months, respectively, and showed no progression of the corneal lesions. The patient who did not undergo trichiasis surgery had a recurrence of the corneal lesion after lamellar keratectomy. Pathologic examination confirmed amyloid deposition in all three excised specimens with almost no inflammatory cells. Immunohistochemical stains were negative. CONCLUSION: The close correlation between trichiasis surgery and the clinical course of corneal amyloidosis provides further evidence for their association. The pathologic findings in this study do not confirm that the amyloid deposits are light chain proteins (AL).

Adolescent↗

PubMedDate not supplied

Transplantation of the autologous submandibular gland to the lacrimal basin in rats.

PURPOSE: In this study, we designed an animal experiment in which we transferred a part of the autologous submandibular gland without performing a microvascular anastomosis. We studied histological changes and functional effects in the transfer glands. METHOD: Thirty male adult Sprague-Dawley rats were divided into three groups. In each animal of the three groups, the right eye was the control eye and the left eye the experimental eye. Surgical removal of the extraorbital lacrimal gland from the control eyes was performed to create a condition simulating keratoconjunctivitis sicca. In the experimental eyes of group 1, in addition to the removal of the extraorbital lacrimal gland, a part of the autologous submandibular gland was transferred to the orbit and fixed to the intraorbital lacrimal gland. In the experimental eyes of group 2, in addition to the removal of the extraorbital lacrimal gland, an aseptic silicon rubber was transferred to the orbit and fixed to the intraorbital lacrimal gland. In the experimental eyes of group 3, there was no removal of the extraorbital lacrimal gland but instead a sham operation was performed. The histological changes and innervation pattern in the transferred submandibular gland of group 1 were observed. Tear secretion of each group was measured to study the functional effect. RESULTS: Three months after the transplantation, the transferred submandibular glands were similar to the unoperated submandibular glands both in histology and innervation pattern. In group 1, the tear secretion in the experimental eyes was significantly greater than that of the control eyes at 2 and 3 months following transfer. In group 2, no significant difference was noted between the experimental eyes and control eyes. In group 3, the difference in tear secretion between the experimental eyes and control eyes was significant. CONCLUSION: The result of this study revealed that although the procedure did not involve vascular anastomosis, the transfer gland showed a normal histological appearance and good reinnervation, even 3 months after the transfer. These transferred submandibular glands continued to secrete tears. This secretion continued to increase up until the end of the experimental period.

Anastomosis, Surgical↗