RESUMO
A case is presented in which an alternative surgical method for managing poorly dilating pupils preoperatively or intraoperatively was employed. The technique uses iris sutures, is simple, safe, easily reproducible, and reversible, and does not require new devices for pupil enlargement. This new surgical method is appropriate for extracapsular cataract extraction and phacoemulsification or posterior segment surgeries, and maintains pupillary appearance and function postoperatively. Although other techniques are generally available, this technique may be useful in unique situations where other pupil devices or methods are not available.
Assuntos
Iris/cirurgia , Miose , Facoemulsificação/métodos , Suturas , Idoso , Humanos , MasculinoRESUMO
PURPOSE: To report risk factors, clinical course, and outcome in patients with infectious keratitis following implantation of intracorneal ring segments (ICRS). METHODS: The records of 8 patients with culture-proven infectious keratitis after ICRS (Ferrara or Intacs) implantation were retrospectively reviewed. Age, gender, corneal findings, ocular abnormalities, the condition that led to ICRS implantation, immediate prior use of a contact lens, elapsed time between implantation and the onset of symptoms, previous medications, and systemic disorders were noted. RESULTS: Culture-positive infectious keratitis developed in 7 eyes of 7 patients (2 men and 5 women) with a mean age of 35 years who underwent Ferrara implantation for the treatment of keratoconus and in a 29-year-old man who underwent Intacs implantation for correction of low myopia. Contact lens use, diabetes, and trauma were factors possibly associated with the risk of infection in three cases. Microorganisms, identified in all cases, included Staphylococcus aureus, Streptococcus viridans, Streptococcus pneumoniae, Pseudomonas sp, Nocardia sp, Klebsiella sp, and Paecylomices sp. Onset of symptoms of infection varied from less than 1 week to 22 months postoperatively, depending on the infecting organism. CONCLUSIONS: Infectious keratitis following ICRS implantation is a sight-threatening complication for which early recognition and rapid institution of appropriate treatment may result in a better visual outcome.