• Title/Summary/Keyword: keratopathy

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Successful Surgical Treatment of Feline Acute Bullous Keratopathy and Corneal Perforation with a Conjunctival Hood Graft

  • Kim, Joon Young;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.34 no.3
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    • pp.204-207
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    • 2017
  • We report the successful treatment of feline acute bullous keratopathy (FABK) and corneal perforation with a conjunctival hood graft. Two cats with FABK and corneal perforation had severe corneal edema with large central bullae. Their corneas were thinned and perforated. Conjunctival hood grafts were performed. All corneas recovered after 3-4 weeks. The grafts were then removed from the cornea using superficial keratectomy and no ocular irritation was observed. One month later, the corneas had recovered, although there was very mild fibrosis. The cats had normal vision without any corneal problems at this time. Conjunctival hood graft was thus useful for the treatment of severe FABK and allowed the cats to maintain vision.

Autologous Lamellar Keratoplasty for the Treatment of Feline Acute Bullous Keratopathy: A Case Report

  • Manbok Jeong
    • Journal of Veterinary Clinics
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    • v.40 no.4
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    • pp.303-307
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    • 2023
  • A 4-year-old female Munchkin cat presented with a 2-day history of a large mass in the left eye. On the first presentation, slit lamp biomicroscopy revealed a large corneal bulla occupying around 40% of the corneal surface along the visual axis. Based on the results, a diagnosis of feline acute bullous keratopathy was made. Due to the location of the extensive corneal bulla, autologous lamellar keratoplasty was performed based on prior studies, to both minimize postoperative complications that may affect axial vision and address any cosmetic concerns the owner had. The autologous lamellar keratoplasty successfully resolved the corneal bulla with no signs of corneal opacities postoperatively. Therefore, autologous lamellar keratoplasty may be a useful surgical treatment for feline acute bullous keratopathy from both the tectonic and optical points of view.

Study to the Effect of Involutional Blepharoptosis Surgery Using Objective and Subjective Parameters

  • Asamura, Shinichi;Wada, Yoshitaka;Tanaka, Saiichi;Saika, Shizuya
    • Archives of Plastic Surgery
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    • v.49 no.4
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    • pp.473-478
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    • 2022
  • Background We investigate the effect of involutional blepharoptosis (IB) surgery based on dry eye symptoms by analysis using objective and subjective measures. Methods We recorded various parameters from patients that underwent levator advancement surgery for IB, totaling 125 eyes (total 65 patients, 5 unilateral, 60 bilateral). Subjective assessment comprised a questionnaire on dry eye-related quality of life score (DEQS), a summary score calculated from DEQS, and six-grade evaluation, the patient's own measure of eye comfort. Objective assessment comprised marginal-reflex distance-1 (MRD-1), measurement of tear film breakup time, and superficial keratopathy (SPK) existence by slit lamp microscope. Results Subjective assessments showed that IB patients had improvement of dry eye symptoms and eye comfort when surgery increased MRD-1. On the other hand, objective assessments showed that the presence of SPK is suspected when the postoperative MRD-1 level is 3 mm or higher. Conclusion IB surgery must not only increase MRD-1 value, but also to perform maintenance of the appropriate ocular surface condition. From our parameters, we suggest postoperative MRD-1 value should be maintained at < 3 mm to safe and effective of IB surgery.

Safety and Pitfalls of Blepharoptosis Surgery in Elderly People

  • Yuji Shirakawa;Kazuhisa Uemura;Shinji Kumegawa;Kazuki Ueno;Hiroki Iwanishi;Shizuya Saika;Shinichi Asamura
    • Archives of Plastic Surgery
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    • v.50 no.5
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    • pp.446-451
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    • 2023
  • Background Elderly patients often have complications of blepharoptosis surgery that can result in the appearance or exacerbation of superficial punctate keratopathy (SPK). However, postoperative changes to SPK status have not been previously reported. We used subjective assessment of symptoms and measurement of SPK scale classification to investigate the safety and efficacy of blepharoptosis surgery in elderly patients. Methods Included in this prospective study were 22 patients (44 eyes) with bilateral blepharoptosis that underwent surgery. Patients comprised 8 males and 14 females with a mean (±standard deviation) age of 75.7 ± 8.2 years (range: 61-89). Blepharoptosis surgery consisted of transcutaneous levator advancement and blepharoplasty including resection of soft tissue (skin, subcutaneous tissue, and the orbicularis oculi muscle). Margin reflex distance-1 (MRD-1) measurement, a questionnaire survey of symptoms and SPK scale classification, was administered preoperatively and 3 months postoperatively for evaluation. Results The median MRD-1 was 1 mm preoperatively and 2.5 mm postoperatively, representing a significant postoperative improvement. SPK area and density scores were found to increase when the MRD-1 increase was more than 2.5 mm with surgery. All 10 items on the questionnaire tended have increased scores after surgery, and significant differences were observed in 7 items (poor visibility, ocular fatigue, heavy eyelid, foreign body sensation, difficulty in focusing, headaches, and stiff shoulders). Conclusion Blepharoptosis surgery was found to be a safe and effective way to maintain the increase in MRD-1 within 2.0 mm. Despite the benefits, surgeons must nonetheless be aware that blepharoptosis surgery is a delicate procedure in elderly people.

Thymol Ameliorates Aspergillus fumigatus Keratitis by Downregulating the TLR4/ MyD88/ NF-kB/ IL-1β Signal Expression and Reducing Necroptosis and Pyroptosis

  • Limei Wang;Haijing Yan;Xiaomeng Chen;Lin Han;Guibo Liu;Hua Yang;Danli Lu;Wenting Liu;Chengye Che
    • Journal of Microbiology and Biotechnology
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    • v.33 no.1
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    • pp.43-50
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    • 2023
  • Fungal keratitis is a refractory kind of keratopathy. We attempted to investigate the antiinflammatory role of thymol on Aspergillus fumigatus (A. fumigatus) keratitis. Wound healing and fluorescein staining of the cornea were applied to verify thymol's safety. Mice models of A. fumigatus keratitis underwent subconjunctival injection of thymol. The anti-inflammatory roles of thymol were verified by hematoxylin-eosin (HE) staining, slit lamp observation, quantitative real-time polymerase chain reaction (qRT-PCR), and Western blotting. In contrast with the DMSO group, more transparent corneas and less inflammatory cells infiltration were detected in mice treated with 50 ㎍/ml thymol. Thymol downregulated the synthesis of TLR4, MyD88, NF-kB, IL-1β, NLRP3, caspase 1, caspase 8, GSDMD, RIPK3 and MLKL. In summary, we proved that thymol played a protective part in A. fumigatus keratitis by cutting down inflammatory cells aggregation, downregulating the TLR4/ MyD88/ NF-kB/ IL-1β signal expression and reducing necroptosis and pyroptosis.

Treatment of immune-mediated keratitis (IMMK) in dogs with immunosuppressants observed with spectral domain optical coherence tomography (SD-OCT)

  • Hyelin Kim ;Youngseok Jeong ;Eunji Lee;Kangmoon Seo ;Seonmi Kang
    • Journal of Veterinary Science
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    • v.24 no.5
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    • pp.66.1-66.7
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    • 2023
  • Two dogs presented with bilateral pattern-forming corneal opacity. Treatment with topical immunosuppressants was initiated after a complete ophthalmic examination. The response to treatment was assessed by analyzing serial images using slit-lamp biomicroscopy and spectral domain optical coherence tomography (SD-OCT). Both dogs responded to topical immunosuppressants; however, the lesions recurred once the treatment was abated or withdrawn. The most effective immunosuppressant in both dogs was 0.03% tacrolimus ointment. Early and continuous treatment with topical immunosuppressants may be necessary to improve corneal clarity and prevent scarring. SD-OCT could provide useful structural information regarding presumed immune-mediated keratitis and aid in monitoring treatment response.

Clinical Results of Silicone Oil Injection following Vitrectomy as a Primary Procedure in Retinal Detachment (망막박리에서 일차수술로 유리체절제술과 실리콘 주입술에 대한 임상결과 분석)

  • Gyeong, Gil-Hyeon;Lee, Moo-Sik;Hwang, Hye-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.12
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    • pp.3919-3924
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    • 2009
  • To evaluate clinical results of silicone oil injection for retinal detachment. The 45 eyes of 44 patients underwent vitrectomy and silicone oil injection from 1999 to 2002. 1.There were no history of previous retinal surgery and ocular trauma. In 24 of the 45 eyes(53%) visual acuity increased and stabilized in 18 of the 45 eyes(40%). 2. 1 of 16 eyes(6.3%) had recurred retinal detachment after silicone oil removal. 3. Final retinal reattachment was achieved in 44 eyes(97%). Postoperative complications were cataract(16 eyes), glaucoma(10 eyes), emulsification of silicone oil(5 eyes), keratopathy(2 eyes) and recurrent retinal detachment(1 eye). These results show that silicone oil injection for primary retinal detachment yields a high rate of anatomic success and the good visual outcome

A Case of Choroidal Melanocytoma with Optic Nerve Involvement in a Dog

  • Jinseon Chang;Dajeong Jeong;Seonmi Kang;Kangmoon Seo
    • Journal of Veterinary Clinics
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    • v.40 no.4
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    • pp.283-287
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    • 2023
  • A 10-year-old spayed female beagle dog presented with a 2-month history of third-eyelid elevation in the left eye (OS). Ophthalmic examination revealed slightly diminished corneal and palpebral reflexes along with exophthalmos in the OS. Schirmer's tear test and intraocular pressure values were within the normal range for the OS. Slit-lamp biomicroscopy revealed protrusion of the third eyelid and corneal opacity in the OS. Fundoscopy revealed a prominent black mass in the OS covering the optic nerve. Tapetal hyper-reflectivity was also observed around the mass. Ocular ultrasonography showed a 0.74 × 0.67 cm echogenic posterior segment mass around the optic nerve protruding into the retrobulbar space. Computed tomography revealed a contrast-enhanced soft tissue lesion in the posteromedial aspect of the left eyeball protruding into the retrobulbar region, and the optic nerve was suspected to be involved. No evidence of osteolytic changes in the adjacent bone or distant metastasis was observed. Enucleation was performed to prevent potential metastasis or local invasion of the mass and to relieve discomfort due to exposure to keratopathy resulting from lagophthalmos. Histopathological examination revealed a central choroidal melanocytoma extending into the optic nerve. No local recurrence was detected until 16 months postoperatively.

Clinical Experiences of Trabeculectomy with Mitomycin C (Mitomycin C를 사용한 섬유주절제술의 임상경험)

  • Cha, Soon-Cheol
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.55-62
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    • 1994
  • The use of intraoperative application of Mitomycin C at the filtration site has been known to improve the surgical outcome in glaucomatous eyes with high risk for failure of trabeculectomy. The author performed trabeculectomies with intraoperative Mitomycin C on 25 eyes of 20 patients with poor surgical prognosis to study the efficacy and safety of this technique in glaucomatous patients with high risk for failure of trabeculectomy. After the preparation of a scleral flap, 0.2mg/ml solution of Mitomycin C was applied between Tenon's capsule and the sclera for 2 minutes. The exposed area was then irrigated with 200 ml of balanced salt solution. The follow-up period was from 1 to 7 months (mean 3.8 months). The mean preoperative intraocular pressure (IOP) was $38.6{\pm}6.6mmHg$. The mean final postoperative IOP was $11.7{\pm}3.8mmHg$. Twenty three (88%) of the 25 eyes were successfully controlled with the IOP of less than or equal to 20 mmHg without glaucoma medication. There were early postoperative complications of hyphema in 5 eyes (20%), shallow anterior chamber in 4 eyes(16%), punctate keratopathy in 3 eyes (12%), aqueous leaking from conjunctival wound in 2 eyes (8%), encapsulated bleb in 1 eye (4%) and choroidal detachment in 1 eye (4%), and 4 eyes had long term hypotony lasting more than 2 months. Although Mitomycin C is simple to use and effective adjunct to trabeculectomy, further study will be needed to determine the mechanism of action, indication, dosage and optimal exposure time of Mitomycin C.

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