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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a new surgical procedure, adverse reactions or complications may surface without most ophthalmic surgeons experiencing them or being aware of them. Even those with a large series of cases may never see certain problems. Through a collaborative effort with over 200 radial keratotomy surgeons totaling 63,000 cases nearly every significant complication has been documented. This study of radial keratotomy complications includes the number of patients and percentage of the total of the following: intraoperative occurrences which generally do not affect vision, which include microperforations and macroperforations; postoperative changes which do not affect vision: limbal "peeking" and star pattern with light; transient occurrences which tend to resolve with time: ptosis, recurrent erosions, corneal ulcer, microwound abscess, delayed wound healing, inferior rectus palsy, glare or fluctuating vision after six months, iritis, and stromal keratitis; postoperative changes which can affect vision (correctible): overcorrection more than 1.5 diopters, marked undercorrection more than -2.00 diopters, irregular astigmatism, neovascularization after soft-contact-lens wear, and best-corrected acuity decreased usually only one line; and postoperative changes which can affect vision (uncorrectible): retrobulbar hemorrhage and endophthalmitis, loss of the eye, herpes keratitis, and cataract formation.
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PMID:Radial keratotomy complications. 342 39

Hurricane keratitis is an epithelial disorder of corneal transplants which occurs irrespectively of the type of local postoperative therapy used. The epithelial defects show a vortex-like arrangement resembling satellite photos of whirlwinds. Even before the development of punctate keratitis, fluorescein staining of the corneal surface reveals vortex-like figures corresponding to a varying thickness of the tear film in a vortex-like configuration. The irregularities in the tear film are due to an irregular profile of the corneal surface, the functional result of which is irregular astigmatism. The irregular surface profile in turn is caused by the approximation of incongruent wound edges and by sutures being too tightly drawn. Particularly when Healon is used, there is a tendency to draw the sutures tight, since a postoperative pressure increase with subsequent fistulation must be expected. Hurricane keratitis thus also appears to result indirectly from the use of Healon.
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PMID:[Pathogenesis of hurricane keratitis]. 355 Feb 57

A 55-year-old white female underwent a 7.5 mm penetrating keratoplasty for stromal scarring secondary to herpex simplex keratitis. Postoperatively, stromal vascularization and a prolonged graft rejection forced premature suture removal and a prolonged course of topical and systemic glucocorticoids. A mild anterior wound gape spontaneously closed with reduction of steroid therapy. Eighteen months after the original surgery, the patient underwent a relaxing corneal incision to correct 12 diopters of corneal astigmatism. During an inferior incision a small microperforation was noted and the procedure was terminated. Eleven days after the relaxing incision, the patient returned with a "vitreous wick" syndrome through the superior incision. The wound dehiscence and vitreous wick were repaired without incident and the astigmatism was reduced to 7 diopters. Incisions more than 3/4 depth in aphakic patients, or in patients who have required intense steroid therapy should be monitored closely for several days after surgery for microperforations or a wound dehiscence which may lead to a "vitreous wick" syndrome.
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PMID:Vitreous wick syndrome following a corneal relaxing incision. 705 54

We studied the complications resulting from using running Mersilene suture in 14 patients who underwent penetrating keratoplasty for keratoconus. 11-0 Mersilene running suture and 12 interrupted 10-0 nylon stitches were used in each procedure and the patients were followed for 22 to 48 months. None of the Mersilene sutures broke, but four were removed in two patients: in one, due to astigmatism or loosening of the suture as a result of sterile ulceration, and in the other, due to herpetic keratitis. Marked scarring manifested along the loops of the sutures in 11 of the Mersilene sutures. Despite these problems, we conclude that the use of Mersilene sutures, alone or combined with nylon sutures, in penetrating keratoplasty is sufficiently advantageous to warrant further study.
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PMID:Mersilene sutures for corneal surgery. 759 37

Since the cornea is an avascular tissue, the wound healing process is lengthy, with a need for sutures to stabilize the wound for a long time. Platelet-derived growth factor (PDGF) has been shown to accelerate wound healing in rat dermal models. Accelerated healing, if unaccompanied by side effects may reduce suture related complications such as astigmatism and infectious keratitis. This study evaluated the effect of PDGF on wound strength in corneal laceration and penetrating keratoplasty models using New Zealand white albino rabbits. Twenty-two rabbits were used in the corneal laceration model and sixteen rabbits in the penetrating keratoplasty model. The treated rabbits received 385 picomoles/drop of PDGF-BB dissolved in balanced salt solution six times on day 1 and three times a day for the remainder of the study. The control rabbits received balanced salt solution in the same dosing schedule. The pressure required to rupture the wound was measured using a pressure transducer. In the laceration model the PDGF treated group had mean (+/- standard deviation) average pressures on day 7 of 360 +/- 102 mm Hg for wound rupture compared to 210 +/- 102 mm Hg in the control group. (p = 0.005). The average pressures in the penetrating keratoplasty model on day 17 were 707 +/- 201 mm Hg for the controls and 1042 +/- 292 mm Hg for the PDGF treated group (p = 0.026). Histopathological evaluation of eyes not subjected to bursting showed increased fibroblasts at the wound junction with an increase in types III and type IV collagen production.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of topically administered platelet-derived growth factor on corneal wound strength. 772 Mar 91

Approximately 15% of radial keratotomy procedures result in a residual refractive error of at least 1.00 D. Contact lenses may be used in these cases to optimize visual acuity. Patients who have undergone radial keratotomy present unique physiological challenges because of the corneal incisions; wear of lenses can produce epithelial erosion, infiltrative keratitis, neovascularization, and chronic edema. The corneal topography is altered by the surgery, with the central cornea flattened and the midperiphery steepened; these changes influence contact lens design. The lens of choice is a large, thin, rigid gas-permeable lens with a fairly small optic zone. Hydrogel lenses can also be used, but complications of wear can include neovascularization and corneal edema. Toric hydrogel lenses can be used to minimize residual astigmatism.
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PMID:The role of contact lenses in the management of the radial keratotomy patient. 781 64

Ophthalmic findings are reported in 31 eyes of 28 children with herpes simplex keratitis. Twenty two had dendritic ulcers, and nine had geographic ulcers or disciform stromal keratitis. After resolution of keratitis, 80% (19/22) of children with dendritic ulcers achieved corrected visual acuity of 6/9 or better, 50% (11/22) had induced astigmatism, 45% (9/22) had one to five recurrences. In the group with geographic or disciform lesions, 89% (8/9) had reduced corrected vision, 78% (7/9) had induced astigmatism which was predominantly against the rule, and 87% (7/9) had one to six recurrences.
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PMID:Herpes simplex keratitis in children. 806 Sep 29

We examined 15 eyes of ten patients with complications of hexagonal keratotomy, which included glare, photophobia, polyopia, fluctuation in vision, overcorrection, irregular astigmatism, corneal edema, corneal perforation, bacterial keratitis, cataract, and endophthalmitis. Wound healing abnormalities and anterior displacement of the central cornea adjacent to the incisions were common. Eight eyes lost best-corrected visual acuity of two or more Snellen lines. Three eyes required penetrating keratoplasty for visual rehabilitation. Histologic analysis of two of these corneas disclosed variations in wound depth and abnormalities of wound configuration, including considerable wound gaping. Hexagonal keratotomy appears to be an unpredictable, unsafe surgical procedure with a high complication rate, and it should be abandoned until well-controlled experimental trials establish its safety and efficacy.
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PMID:Complications of hexagonal keratotomy. 829 91

Surgical alteration of the focusing or refractive properties of the eye has been performed on millions of patients. An array of procedures to correct myopia, hyperopia, astigmatism, and presbyopia have been introduced over the past 25 years with varying degrees of success. Improved technology has increased patient and physician satisfaction and enthusiasm. Currently available surgical procedures can be categorized as incisional, surface-altering, lamellar, and intraocular. The choice of procedure depends on individual patient indications and contraindications based on results of ocular examinations, eg, corneal pachymetry to measure corneal thickness, keratometry to measure the corneal curvature, basal tear secretory rate, and dark-adapted pupil size. The postoperative uncorrected visual acuity depends, in large part, on the quality of the preoperative evaluation and refraction. Before scheduling a patient for surgery, the ophthalmologist must ensure that the patient understands the potential risks of the procedure and has realistic expectations for the postoperative level and quality of uncorrected visual acuity. Postoperative complications include corneal flap displacement, undercorrection and overcorrection, and epithelial ingrowth under the corneal flap and inflammatory keratitis. Postoperative dry eye, infection, and inflammation are usually treated medically. Ongoing technological innovations to customize the surgical approach to an individual patient's eye continue to improve outcomes.
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PMID:Making sense of refractive surgery in 2001: why, when, for whom, and by whom? 1149 22

Laser in situ keratomileusis (LASIK) is a rapidly evolving ophthalmic surgical procedure. Several anatomic and refractive complications have been identified. Anatomic complications include corneal flap abnormalities, epithelial ingrowth, and corneal ectasia. Refractive complications include unexpected refractive outcomes, irregular astigmatism, decentration, visual aberrations, and loss of vision. Infectious keratitis, dry eyes, and diffuse lamellar keratitis may also occur following LASIK. By examining the etiology, management, and prevention of these complications, the refractive surgeon may be able to improve visual outcomes and prevent vision-threatening problems. Reporting outcomes and mishaps of LASIK surgery will help refine our approach to the management of emerging complications.
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PMID:LASIK complications: etiology, management, and prevention. 1157 45


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