Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0851184 (thinning)
 11,252 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present a case of unilateral iatrogenic keratectasia developing 10 months after bilateral laser in situ keratomileusis (LASIK) involving enhancement surgery using a broad-beam excimer laser (Summit Apex) to treat 6.6 diopters (D) of myopia. The ectasia progressed rapidly over the subsequent 12 months. The surgeon did not measure preoperative pachymetry, but preoperative topography and corneal measurements did not reveal underlying keratoconus or forme fruste keratoconus. Corneal transplantation was required for final visual rehabilitation. Light microscopy of the button revealed no underlying inflammation, which suggests biomechanical corneal weakening as the cause of the ectasia. Scanning electron microscopy showed the dramatic thinning seen clinically. latrogenic keratectasia appears to be a possible complication of LASIK.
J Cataract Refract Surg 1999 Apr
PMID:Delayed onset keratectasia following laser in situ keratomileusis. 1044 82

A 5-wk-old female dromedary camel (Camelus dromedarius) was clinically diagnosed with bilateral corneal dermoids, incomplete congenital cataracts, a left persistent hyaloid artery (PHA), and a ventricular septal defect (VSD). The corneal dermoids were removed by lamellar keratectomy, and vision improved in the left eye. Thirteen months after dermoid surgery, the calf was presented for enlargement of the right eye. Glaucoma was confirmed in the right eye, and corneal fibrosis and cataract were noted in the left eye. Persistence of the VSD was confirmed by cardiac ultrasonography. The calf was euthanized, and necropsy findings confirmed VSD. Histopathologic examination revealed bilateral corneal thinning and fibrosis, cataracts with retrolental fibroplasia, and retinal dysplasia. Additional changes in the right globe were anterior segment dysgenesis, ruptured lens capsule, chronic phacoclastic uveitis, and retinal separation. The PHA was confirmed in the left eye.
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PMID:Congenital ocular anomalies and ventricular septal defect in a dromedary camel (Camelus dromedarius). 1057 69

Lenses from patients with glaucoma and senile cataract (control) were examined under electron microscope. Ultrastructural changes in the lenses of glaucoma patients differ from changes in senile cataract by a more pronounced thinning of the capsule and development of microdefects in it and in many cases by accumulation of amorphous material on the surface of the posterior capsule adjacent to the vitreous body. This material may be pseudo-exfoliate or a manifestation of stratification of the posterior capsule proper. Development of a pseudomembrane on the surface of posterior capsule is a manifestation of proliferative processes in glaucoma. These features in a certain measure reflect the mechanism of cataract development in glaucoma, which helps plan the measures for preventing it. The status of posterior lenticular capsule in glaucoma is to be taken into consideration when implanting intraocular lenses.
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PMID:[The pathomorphological characteristics of the cataractous lens in glaucoma patients]. 1105 15

We screened family members of monozygotic twins with keratoconus to search for a corneal thinning disorder using clinical, videokeratographic, and pachymetric analyses. The parents had bilateral astigmatism of a symmetric bow-tie pattern with normal videokeratographic and pachymetric indices. The 8-year-old sister had slightly asymmetric astigmatism in both eyes with normal pachymetry values. No family member was suspected of a corneal thinning disorder. We discuss the mode of inheritance of keratoconus in this family.
J Cataract Refract Surg 2000 Dec
PMID:Keratographic analysis of a family with keratoconus in identical twins. 1113 87

The incidence of drug-induced adverse effects is likely to increase as a result of advanced age and exposure of elderly patients to polypharmacy. Therefore, pharmacological therapy of asthma and chronic obstructive pulmonary disease (COPD) in the elderly patient can be potentially hazardous. beta(2)-agonists, administered as therapy for asthma and COPD, have recognised systemic sequelae, such as hypokalaemia and chronotropic effects, which may be life-threatening in susceptible patients. Adverse effects such as hypokalaemia can be aggravated by concomitant treatment with other drugs promoting potassium loss including diuretics, corticosteroids and theophyllines. In addition, relatively minor adverse events associated with the administration of beta(2)-agonists, such as tremor and blood pressure changes, may be of significance to the elderly patient leading to impairment in the quality of life. However, long-term treatment with beta(2)-agonists may reduce the incidence of drug-induced adverse effects as a result of beta-receptor subsensitivity. Oral and inhaled corticosteroids have been used for the treatment of acute asthma and COPD in the elderly patient. Long-term treatment with oral corticosteroids can result in serious systemic adverse effects such as suppressed adrenal function, bone loss, skin thinning and cataract formation. In contrast to beta(2)-agonists, oral corticosteroids can upregulate beta(2)-adrenoceptors and thereby potentiate the systemic sequelae of beta(2)-agonists. Hence, oral corticosteroids should be administered with caution for as short a duration as possible. Inhaled corticosteroids appear to be relatively well tolerated when administered at doses below approximately 1000 microg. However, larger doses of inhaled corticosteroids may affect hypothalamic-pituitary-adrenal function and bone turnover. In the case of inhaled corticosteroids, spacer devices, often used in older patients who cannot operate metered dose inhalers, can potentiate the systemic sequelae of both corticosteroids and beta(2)-agonists. The use of theophyllines in the treatment of COPD or chronic asthma is controversial. Theophyllines have a wide adverse effect profile and are prone to drug-drug interactions. The adverse effects may be mild or life threatening and include nausea and vomiting or sinus and supraventricular tachycardias. Therefore, theophyllines should be prescribed with extreme caution to elderly patients with asthma or COPD. In contrast, inhaled anticholinergic drugs such as ipratropium bromide and oxitropium bromide are generally safe in elderly patients and have useful bronchodilator function. Commonly reported adverse effects are an unpleasant taste and dryness of the mouth. When used as first-line therapy, anticholinergic drugs may optimise the bronchodilator effects of low-dose inhaled beta(2)-agonists in patients with chronic airflow obstruction, and hence obviate the need for higher doses.
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PMID:Asthma medications and their potential adverse effects in the elderly: recommendations for prescribing. 1173 62

A 79-year-old patient was referred for cataract and high myopia. His optometrist noted difficult refraction. Biometry predicted an emmetropic intraocular lens power of +22.0 diopters. During cataract extraction, the typical features of posterior lenticonus were noted. A careful look for posterior lenticonus is suggested in cases in which there is a discrepancy between the biometry and refraction and no significant nuclear sclerosis to account for the high myopia. Surgeons should be aware of dehiscence or thinning of the posterior capsule while doing cataract extraction in these patients.
J Cataract Refract Surg 2002 Jun
PMID:Surgical identification of posterior lenticonus. 1203 57

The RecQ family of DNA helicases have potential roles in DNA repair, replication and/or recombination pathways. In humans, a defect in the RecQ family helicases encoded by the BLM, WRN and RECQ4 genes gives rise to Bloom's (BS), Werner's (WS) and Rothmund-Thomson (RTS) syndromes, respectively. These disorders are associated with cancer predisposition and/or premature aging. In Bloom's syndrome, affected individuals are predisposed to many types of cancer at an early age. Werner's syndrome is a premature aging disorder with a complex phenotype, which includes many age-related disorders that develop from puberty, including greying and thinning of the hair, bilateral cataract formation, type II diabetes mellitus, osteoporosis and atherosclerosis. The phenotype of Rothmund-Thomson syndrome patients also consists of some features associated with premature aging, as well as predispositon to certain cancers. Here, we discuss the molecular basis of these RecQ helicase-deficient disorders.
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PMID:Premature aging in RecQ helicase-deficient human syndromes. 1220 42

We report 2 patients who experienced progressive blurring of vision following myopic laser in situ keratomileusis (LASIK) in 1 eye (Case 1) and bilaterally (Case 2). High against-the-rule astigmatism, associated with perilimbal thinning inferiorly, was seen on refraction in all eyes. Regional corneal pachymetry confirmed the peripheral corneal thinning inferiorly. Corneal topography revealed the typical features of pellucid marginal corneal degeneration (PMCD) in the untreated eye of Case 1. Advanced changes were noted in the fellow eye. The corneal topography findings in Case 2 were similar to those seen in PMCD. Patients with early PMCD may present to the refractive surgeon with a stable refraction, normal corrected visual acuity, and adequate central corneal thickness. Corneal topography data along with regional corneal pachymetry must be interpreted carefully to detect these cases. Laser in situ keratomileusis can lead to a rapid progression of PMCD.
J Cataract Refract Surg 2003 Apr
PMID:Keratectasia in 2 cases with pellucid marginal corneal degeneration after laser in situ keratomileusis. 1268 50

We report a patient with a sufficiently thick cornea (593 microm) and no topographic signs of keratoconus preoperatively who developed iatrogenic keratoconus 2 months after repeat laser in situ keratomileusis (-4.00 -1.00 x 20) performed 5 months after the primary procedure (-10.50 -1.00 x 55). After penetrating keratoplasty, macrophotography showed severe multidirectional "macrostriae" of the stromal bed. On histologic evaluation, excessive thinning of the residual stromal bed to a minimum of 75 microm in the valleys and a maximum of 200 microm at the peaks of the macrostriae were documented. The flap thickness was 225 microm in the center. The thicker-than-intended flap (160 microm) is thought to be the cause of the severe complication of the LASIK procedure.
J Cataract Refract Surg 2003 Nov
PMID:Penetrating keratoplasty for iatrogenic keratoconus after repeat myopic laser in situ keratomileusis: histologic findings and literature review. 1467 Apr 35

We report a case that demonstrates a difference in wound healing after laser in situ keratomileusis using microkeratomes with both superior and nasal hinges in a patient with bilateral superior corneal vascularization. Subsequently, the patient experienced lamellar keratitis, epithelial defects, and peripheral thinning in both eyes. These postoperative conditions were more extensive and required more time to resolve in the eye with a nasal hinge flap. Creating a superiorly hinged flap decreases the likelihood of transecting extensive corneal pannus and may reduce the degree of postoperative complications.
J Cataract Refract Surg 2003 Dec
PMID:Effect of flap hinge placement on post-laser in situ keratomileusis wound healing in the presence of superior corneal vascularization. 1470 12


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