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Biomedical subjects

Y Domniz

Publications and source records attributed to Y Domniz.

8 recordsLinked to original sources

Epithelial ingrowth: causes, prevention, and treatment in 5 cases.

PURPOSE: To examine the clinical course, treatment, and outcome in 5 cases of epithelial ingrowth following laser in situ keratomileusis (LASIK). SETTING: The Eye Institute, Sydney, Australia. METHODS: Five patients with adequate follow-up were selected. Each patient had developed epithelial ingrowth as a consequence of LASIK, and each represented a different clinical course in terms of severity, time, and treatment of the epithelial ingrowth. RESULTS: Treatment ranged from observation, lifting and manual removal, phototherapeutic keratectomy, alcohol application, removal of the corneal cap, and penetrating keratoplasty (PKP). Outcomes ranging from retention of preoperative best corrected visual acuity to the need for PKP reflect the wide disparity in the severity of this complication and the therapeutic interventions required. CONCLUSION: Epithelial ingrowth is a relatively uncommon complication following LASIK. Suggestions for prevention and treatment are made.

Adult↗

Successful treatment of Paecilomyces lilacinus endophthalmitis after foreign body trauma to the cornea.

PURPOSE: To report the successful treatment of a patient with Paecilomyces lilacinus endophthalmitis infection after foreign body (FB) trauma to the cornea. METHODS: A 30-year-old man presented to us with a corneal abscess and iritis 2 months after removal of a metal corneal FB. Initial corneal biopsy culture was negative. Treatment with topical 5% natamycin, 0.9% fortified gentamycin, and 5% cephalothin hourly was commenced. As a result of developing signs of endophthalmitis, two more biopsies were taken, a week apart, from the vitreous and anterior chamber, successively. The last biopsy yielded positive microbiologic results of the specious Paecilomyces lilacinus. Intravitreal injection of 50 microg/0.5 mL of amphotericin was administered during the vitreal biopsy. Soon after isolating the specious Paecilomyces lilacinus, the following treatment was administered: 200 mg of itraconazole bd by mouth, 5% topical natamycin every hour, 2 mg/mL of topical fluconazole every 2 hours, three anterior chamber injections of 0.35 mL of 0.1% fluconazole and two amphotericin B injections to the anterior chamber of 50 microg/0.5 mL each. RESULTS: There appeared to be no sign of infection 6 months after initial treatment. A large, dense scar existed in the medial part of the cornea only. The pupil was secluded. The patient's visual acuity was 6/21. The eye was comfortable and all topical antifungal medication was ceased.

Adult↗

Corneal deposition after high-dose chlorpromazine hydrochloride therapy.

PURPOSE: To report a case of dermal and ocular changes after prolonged use of high-dose chlorpromazine hydrochloride therapy. METHOD: This case report includes clinical history, clinical findings, and photographic images of ocular and dermal changes. RESULTS. Chlorpromazine therapy in a cumulative dosage exceeding 1,100 g resulted in dramatic skin discoloration and multiple crystalline deposits in both corneas. Anterior capsular opacities were binocularly present. These changes were sufficient to cause reduction in visual acuity. CONCLUSIONS: Chlorpromazine deposition at high levels can cause reduction in visual acuity and significant skin discoloration.

Antipsychotic Agents↗

[Corneal infection, cause and effect on vision].

We conducted a retrospective 5-year survey of corneal infections treated in the ophthalmology ward of Hasharon Hospital. The most frequent type of corneal infection was corneal abscess; the most frequent cause was Staphylococcus albus, although this bacterium is not reported as a frequent cause of corneal infections. There was improvement in visual acuity in 69.2% and no change in 15.4%. Corneal infection by Pseudomonas aeruginosa was the most frequent cause of worsening of corneal acuity (23.08%). The greatest improvement of visual acuity was in those with corneal ulcers. The worst visual acuity was in those with corneal abscesses. Pseudomonas aeruginosa was the main cause of infection in contact-lens wearers. In the world medical literature, Staphylococcus albus is considered of very low virulence. This bacterium was the most frequent cause of corneal infections in our study so it may have greater virulence in Israel.

Adolescent↗

[Corneal infection in wearers of contact lenses: causes, effect on visual acuity and prevention].

This is a 5-year retrospective survey of corneal infection in wearers of optical contact lenses (OCL). 23 of the 61 patients (38%; Hasharon Hospital) with positive cultures wore OCL. Visual acuity improved in 15 (65%), no change was noted in 4 (17.5%) and there was deterioration in 4 (17.5%), as compare with status on admission. Pseudomonas aeruginosa was the most common cause of infections among OCL wearers. The improvement in visual acuity expected due to wearing OCL was affected by infections. Those after Staphylococcus albus infections had the highest rate (100%) of improvement in visual acuity and after Ps. aeruginosa the lowest rate (57.2%) of improvement, as well as the highest rate of deterioration (42.8%) found following recovery. OCL wearers are at higher risk for damage to visual acuity following corneal infection, and highly virulent infections in OCL wearers are responsible for a high risk of damage to visual acuity.

Contact Lenses↗

[Laser photorefractive surgery].

As photorefractive keratectomy (PRK) with excimer laser gains world-wide acceptance, more patients are able to discard their spectacles. Our study comprised 611 eyes which underwent PRK and were followed for at least a year. Those with myopia up to -6.00D had better post-operative visual acuity and refraction, than patients with higher grades of myopia. They had less corneal haze and a greater proportion were satisfied with their results. Complaints of halos and glare were similar at all degrees of myopia up to -10.00D.

Follow-Up Studies↗

Recutting the cornea versus lifting the flap: comparison of two enhancement techniques following laser in situ keratomileusis.

PURPOSE: To evaluate enhancement techniques following laser in situ keratomileusis (LASIK). METHODS: Recutting was performed on 263 eyes and the flap was lifted in 55 eyes that had LASIK for simple myopia or myopic astigmatism. The time interval between LASIK and retreatment was 340+/-46 days (range, 270 to 892 days) in the recutting group and 215+/-36 days (range, 53 to 617 days) in the flap lifting group. Mean spherical equivalent refraction, refractive cylinder, uncorrected and best spectacle-corrected visual acuity were examined prior to, and 1, 3, and 6 months after retreatment. RESULTS: Seventeen eyes were lost to follow-up in the lifting group and 53 eyes in the recutting group. In the recutting group, mean spherical equivalent refraction improved from -1.48+/-1.25 D to -0.49+/-0.88 D at 6 months. In the flap lifting group, mean spherical equivalent refraction improved from -1.05+/-1.49 D to -0.45+/-0.39 D at 6 months. Refractive cylinder did not change significantly in either group (P = .2). There was a significant increase in uncorrected visual acuity (UCVA) of 6/6 in each group. In the recutting group, UCVA of 6/6 increased from 3.8% to 65.2% at 6 months, and in the lifting group from 3.6% to 71.1% at 6 months. In the recutting group, seven free flaps and three macerated flaps that required removal occurred. One eye in the recutting group and two in the lifting group developed significant epithelial ingrowth. No patient lost more than one line of best spectacle-corrected visual acuity (BSCVA). CONCLUSION: Both procedures were safe, effective, and highly predictable for enhancements, but flap complications may be more likely with recutting.

Adult↗