One-third of IU patients achieved a remission of their intraocular inflammation for longer than 1 year and had a mean time-to-remission of 8.6 years. Patients who were younger at onset of IU were more likely to achieve remission than those who were older at onset.
PurposeThe aim of this study was to assess signs and symptoms of ocular surface disease (OSD) and the cytomorphological changes of ocular surface in glaucoma patients using preserved antiglaucoma drops.MethodsIn this cross-sectional study, 109 participants (79 patients with topical medication and 30 untreated controls) completed the Ocular Surface Diseases Index (OSDI) questionnaire and underwent an ophthalmic examination, including Schirmer test, tear film breakup time (TBUT), and fluorescein staining. Conjunctival specimens were collected by impression cytology and analyzed by light microscopy using Nelson’s grading scheme (grades 0–3). This classification is based on the nucleus-to-cytoplasm ratios of epithelial cells and the numbers of goblet cells, with grade 2 considered abnormal.ResultsThe medication group had significantly shorter TBUT (median [interquartile range]: 6.0 seconds [5.0–8.0 seconds] vs 9.5 seconds [6.0–12.3 seconds]; P<0.03), greater fluorescein staining (1.0 [0.75–1.25] vs 0 [0–0.25]; P<0.001), and higher impression cytology grade than the control group (median [range]: 1.0 [1:2 to 1:6] vs 0.6 [1:2 to 1:4]; P<0.001). The increasing number of drops instilled per day was associated with an increase in fluorescein staining (Spearman’s rho r=0.475; P<0.001) and shorter TBUT (r=−0.278; P=0.014). The OSDI did not discriminate between the two groups.ConclusionClinical tests and impression cytology showed ocular surface damage in patients using preserved antiglaucoma medications. However, there was no statistically and clinically significant difference in symptoms measured by OSDI score between the medication and control groups.
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Purpose: To analyse the anterior lens capsule thickness and ultrastructure changes of intumescent white cataracts in comparison with nuclear cataracts to prove possible structural reasons for surgical difficulties with the intumescent white cataract.
Methods: Anterior lens capsules from 35 eyes with intumescent white and 35 eyes with nuclear cataracts were analysed for their thickness by semithin sections technique and for morphological characteristics by transmission electron microscopy.
Results: Capsule thickness was not significantly different in intumescent white compared to nuclear cataracts (mean values 17.5 and 18.5 μm, respectively, p = 0.369). The main morphological features of capsules were extrusions of capsule at the basement membrane‐epithelial border embedding cellular material which were significantly more frequent in intumescent cataracts. Filaments in the basement membrane as well as rarefication of its structure and lamellae were often concomitant with the extrusions.
Conclusions: Anterior capsules of white intumescent cataracts do not differ in thickness but have different ultrastructure morphology compared to nuclear cataracts. The extrusions of basement membrane at the basement membrane‐epithelial border towards epithelium, the filamentary inclusions within basement membrane and its rarefication could be the structural causes of tensile weakness and hence additional reason to surgical problems.
Aims: To study the ultrastructure of the anterior lens capsule and epithelium, and capsular thickness in uveitic cataracts. Methods: Capsulorhexis samples from 20 uveitic cataracts were compared to 20 nuclear cataracts using the semi- and ultra-thin techniques. Results: Extensive epithelial and capsular-epithelial border changes and epithelial-mesenchymal transition in some fibrotic capsules were found only in the uveitic group. All these changes were observed predominately in white uveitic cataracts. Mild and moderate ultrastructural changes were seen in both groups. Surface deposition of amorphous material was also found only in uveitic cataracts. Capsular thickness was not different between the two groups. Conclusions: Uveitic capsules showed more extensive and different ultrastructural changes that probably occurred because of inflammation in the eye and epithelial-mesenchymal transition. These changes might be an additional reason for altered behavior of the lens capsule at capsulorhexis.
This study included 1,305 HBsAg-positive serum samples obtained from the same number of patients randomly selected from all 2,337 patients with chronic hepatitis B referred to the Slovenian national reference laboratory for viral hepatitis at the
Pre-existing scleral pathology is an important risk factor for globe rupture during scleral buckling procedures. We report here, the surgical management of an unexpected scleral pathology found at the scleral buckling procedure in a retinal detachment patient. A 77-year-old white female with retinal detachment underwent a scleral buckling procedure. The surgery was converted into a scleral graft procedure, as extreme scleral thinning was found intraoperatively. An alcohol-preserved donor sclera graft was used. The second surgery for definitive retinal alignment was performed two weeks later. The presented case of an unexpected scleral pathology in a retinal detachment patient was managed with a combination of scleral grafting and pars plana vitrectomy, without any major complications. The anatomical outcome was excellent and the scleral rupture was prevented; the visual outcome was satisfactory. A conversion of the scleral buckling procedure into a scleral graft procedure has proved to be safe and effective for unexpected scleral pathology.
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