Delayed-onset pseudophakic endophthalmitis.
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Biomedical subjects
Publications and source records attributed to T L Beyer.
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Terminal duct adenocarcinoma, of minor salivary gland origin and arising from the base of the nose, eroded through the lateral nasal bone to present as a medial canthal mass. Although rare, these tumors should be considered in the differential diagnosis of periorbital adnexal masses.
Two patients (3 eyes) had a history and clinical findings typical of acute retinal necrosis syndrome. Ten-day treatment with intravenous acyclovir and topical cycloplegia resulted in rapid resolution of the vitreoretinal findings and a swift return to near normal vision. All three eyes have maintained normal vision, and there have been no retinal detachments over a year after treatment.
After sustaining blunt ocular trauma and total hyphemas, two patients quickly developed corneal blood staining in the absence of elevated intraocular pressure. Corneal blood staining has previously been reported to occur in association with hyphema and raised intraocular pressures. Although several bibliographic references acknowledge that corneal blood staining may occur without raised pressure, a careful review of the literature failed to reveal any well-documented cases.
The posterior capsule has an important effect on the risk of postoperative bacterial endophthalmitis. In order to investigate whether the posterior capsule inhibited the spread of infection into the vitreous we performed extracapsular cataract extraction in both eyes of 10 primates. In one eye of each primate the posterior capsule was left intact and in the other eye a large posterior capsulectomy was performed. When the anterior chambers were challenged with equivalent inocula of Staphylococcus aureus, one of 10 eyes with an intact posterior capsule developed culture-positive vitreous infection. In contrast, nine of 10 eyes with a large posterior capsulectomy developed culture-positive vitreous infection. In a second experiment we investigated the effect of an intraocular lens on the barrier effect. Ten primates received extracapsular cataract extraction in both eyes and pseudophakic implantation. In one eye of each primate the posterior capsule was left intact and a J-loop monoplanar lens was implanted in the ciliary sulcus. In the other eye of each primate a large posterior capsulectomy was followed by implantation of a monoplanar, non-vaulted pseudophakos into the anterior chamber. None of the 10 eyes with a posterior capsule intact and a posterior chamber lens in place developed positive vitreous cultures or histopathological evidence of vitreous infection. Thus the presence of a posterior chamber lens did not appreciably compromise the barrier effect of the intact posterior capsule. 40% of the eyes with a large posterior capsulectomy and a non-vaulted pseudophakos in the anterior chamber developed culture-positive vitreous infection, and 60% of the eyes showed histopathological evidence of vitreous infection.