To describe the findings of a recently described syndrome, the dead bag syndrome, in which the capsular bag appears to be clear many years postoperatively, becoming diaphanous and floppy and unable to support the intraocular lens (IOL) within it.
A study using live rabbits, with subsequent analysis of excised corneas stained with trypan blue/alizarin red, showed that torsional ultrasound led to less corneal endothelial cell damage than classical longitudinal ultrasound.
Autoimmune Polyendocrinopathy Syndrome (APS) is a rare condition caused by an autoimmune failure of two or more endocrine glands. In this case, we report the ocular findings and correlated histopathology from a human eye donor with a prior clinical history of Type 1 APS.
The 23 year-old patient originally presented with blurred vision at the 20/125 level caused by papilledema of the right eye. Bilateral pigmentary changes in the peripheral retinal were also noted. The patient passed away due to electrolyte abnormalities related to autoimmune illness. Histopathology of the posterior segments documents that these pigmentary changes were caused by pigment deposition around inner retinal vessels with corresponding outer retina atrophy. Postmortem genetic sequence analyses revealed a homozygous R257X (C to T substitution) mutation within exon 6 of the
Conclusions and importance
The retinal findings in Type 1 Autoimmune Polyendocrinopathy Syndrome resemble those observed in individuals with retinitis pigmentosa, suggesting that similar pathological processes occur in both.
fibroblasts and causing fibrotic changes in the bag. There is no evidence, of which we are aware, that removing LECs leads to an underlying capsular abnormality. It is our view that the risks for adverse events from not performing LEC removal far outweigh the potential benefits in capsular bag maintenance. 5 In the dead bag condition, we believe a capsular abnormality or some trophic process occurs in the presence of remaining LECs and precludes their growth and long-term survival.It is still not clear where the defect lies in these dead or dystrophic bags. Any entity that affects the long-term stability/integrity of the intraocular lens support structure deserves our attention.
INTRODUCTION AND OBJECTIVE: Urethroplasty for female urethral stricture (FUS) is becoming increasingly popular however there is little to guide choice of technique as all series to date contain small numbers with limited follow-up. We report the medium to long-term outcomes of ventral-onlay buccal mucosa graft substitution urethroplasty (VOBMGSU) in treating FUS.METHODS: A retrospective review of a prospectively acquired database of 46 consecutive women (median age 51.5 years, range 31-71) with urethral stricture having VOBMGSU under the care of a single surgeon since June 2012 and a minimum follow up of 6 months (median 25 months, range 6-96). Data was analysed for stricture recurrence, change in median peak free flow rate (Qmax), median post-void residuals (PVR) and Patient Global Impression of Improvement (PGII) using a 7-point Likert scale where 1 [ very much better and 7 [ very much worse. Short and longer-term complications of surgery were noted. Persistent or de-novo lower urinary tract symptoms (LUTS) were investigated to delineate their cause e and this is detailed.Statistical analysis was performed with the Wilcoxon signed rank test, Students T Test and Mann-Whitney U Test. Statistical significance was taken as P<0.05.RESULTS: At last follow-up 42/46 (91.3%) of women were stricture free. Mean Qmax significantly improved from 5.7 ml/s (range 0-13) to 15.5 ml/s (range 4-38) (p < 0.05). Mean PVR significantly reduced from 147mls (range 0-609) to 24 mls (range 0-245) (p < 0.05). Short and longer-term complication rates were low. 4 patients had pre-existing stress urinary incontinence (SUI). 2/42 (4.7%) patients developed mild de novo SUI, which settled with conservative measures by 6 months post urethroplasty. Frequency persisted in 4/ 46 (8.7%) and was managed with intravesical Botox in 2 and Sacral Neuromodulation in 1. Stricture recurrence was managed by meatotomy in 1, meatal dilatation in 1 and redo-VOBMG urethroplasty in 1 with resolution of stricture. A further patient had their recurrent stricture managed with redo VOBMG but suffered a further recurrence which was managed with a meatotomy. Median PGII at 12 months post VOBMG urethroplasty was 1.5 (1-4) and this was maintained at 36 months post-surgery.CONCLUSIONS: Medium to long term results in the largest series of VOBMG female urethroplasty in the world to date are excellent with stricture free rates of 91.3%, median PGII of 1.5 and significantly improved Qmax and PVRs.
Siponimod is a sphingosine-1-phosphate receptor modulator used as disease-modifying therapy for relapsing-remitting multiple sclerosis similar to Fingolimod which has been known to cause dose dependent fingolimod associated macular oedema (FAME). We report a case of delayed onset bilateral cystoid macular oedema in a patient with stable proliferative diabetic retinopathy who developed cystoid macular oedema in the setting of siponimod (Mayzent; Novartis Pharmaceuticals; Cambridge, Massachusetts, USA) use. As with FAME, cystoid macular oedema resolved in the patient’s eyes with drug cessation and adjunctive topical anti-inflammatory therapy. We highlight unique fluorescein angiographic findings within this class of drugs as well as the clinical challenge posed by comorbid diabetic and inflammatory ophthalmic pathology.
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