RESUMEN
Accidental infection with animal filarial worms in humans is a dilemma for clinicians and parasitologists throughout the world. To date a variety of such rare parasitoses have been reported mostly in tropics and subtropics. Human dirofilariasis is among those unusual zoonotic infections that occasionally have been observed in the eye and in subcutaneous areas exhibiting with nodule formation. Filarial worms are transmitted to humans through invertebrate biological vectors such as certain species of mosquitoes. The present report describes a peculiar case of ocular dirofilariasis in a 49-year-old man resident in Iran.
RESUMEN
PURPOSE: To study a preferred technique of phacoemulsification in eyes with posterior polar cataract and report its outcome. METHODS: Under topical anesthesia, phacoemulsification was carried out after hydrodelination in 23 cases (38 eyes) with ages ranging from 19 to 65 years (mean=33.5 years). Hydrodissection was not performed. RESULTS: Mean duration of follow-up was 9.5 months. None of the eyes developed posterior capsule rupture, but seven eyes (18.4%) revealed posterior capsule plaque postoperatively, which needed neodymium : YAG laser capsulotomy. Mean visual acuity improved significantly after surgery (P=0.0001, paired t-test); In all, 34 eyes achieved a best-corrected visual acuity of 20/40 or more (89.4%). However, the postoperative visual acuity was less than 20/25 in 11 eyes (28.9%). The causes of the low acuity were amblyopia in eight eyes (21.0%) and macular degeneration due to retinitis pigmentosa in two others (5.2%). CONCLUSION: Phacoemulsification is an effective and safe method to treat posterior polar cataract with gentle hydrodelination 'hydrodissection free phacoemulsification technique'. This is especially true when great attention is paid to the 'floppy' posterior capsule. Although previous amblyopia might interfere with excellent surgical outcome in patients with a unilateral or highly asymmetric bilateral cataract, visual acuity improved significantly in most cases.
Asunto(s)
Lesiones Oculares/prevención & control , Complicaciones Intraoperatorias/prevención & control , Cápsula del Cristalino/lesiones , Facoemulsificación/métodos , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Rotura/prevención & control , Resultado del Tratamiento , Agudeza VisualRESUMEN
BACKGROUND/AIMS: To evaluate the efficacy of intracameral recombinant tissue plasminogen activator (r-TPA) in prevention of fibrinous effusion after lensectomy, anterior vitrectomy, and posterior chamber intraocular lens (PCIOL) implantation in patients with congenital cataract. METHODS: The study was done as a double masked randomised clinical trial between April 2002 and November 2003 in Farabi Eye Hospital. 34 eyes of 26 patients with congenital cataract were included in the study and randomised into two groups (18 cases and 16 controls). Mean age was 8.1 years (3--14 years). Each eye underwent lensectomy and anterior vitrectomy with PCIOL implantation. At the end of surgery 20 microg r-TPA was injected intra-camerally in the case group. The control group received only balanced salt solution. All patients received periocular, systemic, and topical steroids after surgery. Patients underwent follow up examinations for 3 months. RESULTS: The incidence of intraocular fibrin membrane formation was significantly lower in the case group on days 1, 3, 7, 14 (p=0.02, p=0.01, p=0.01, and p=0.01, respectively, chi(2) test), but there was no significant difference on days 30 and 90. The frequency of pigmented intraocular lens precipitates was significantly lower in the case group at the end of the third month (p<0.001, chi(2) test). No gross ocular side effects were noted after r-TPA injection. CONCLUSION: It seems that prophylactic intracameral r-TPA is effective in prevention of fibrinous effusion at least in the first 2 weeks after cataract extraction in the paediatric age group and decreases the incidence of pigmented IOL precipitates.