SNMMI to watch for job-related health problems
The Society of Nuclear Medicine and Molecular Imaging (SNMMI) and the SNMMI...Read more on AuntMinnie.comRelated Reading: Nuclear medicine techs have higher risk of cataracts Are RTs protected enough during fluoro procedures? Cardiac cath radiation exacts toll on health personnel SIR study eyes whether radiation causes cataracts Higher cataract incidence tied to repeated head CT
Authors: Gupta G, Ram J, Gupta V, Singh R, Bansal R, Gupta PC, Gupta A Abstract PURPOSE: To assess postoperative inflammation using laser flare photometer, following phacoemulsification with or without single intraoperative intravitreal dexamethasone implant in addition to standard of care, in patients of uveitis with cataract. METHODS: Prospectively, 30 eyes with uveitic cataract were randomized into 2 groups (i) standard of care (SOC group) (ii) Dexamethasone implant (DEXA group). Both the groups underwent phacoemulsification with intraocular lens implantation and standard of care treatment for uveitis, but D...
Conclusions: Tumor factors in addition to radiation treatment may contribute to secondary effects. Enhanced clinical optimization should evaluate radiobiological doses delivered to the tumor volume and surrounding normal ocular structures. PMID: 30237818 [PubMed]
The patients in Dallas had all been promised clear eyesight from the medication, designed to be a permanent alternative for eye drops. But now, most of them are blind in at least one eye.
Conclusion: Adjuvant intravitreal dexamethasone implant injections offer promising results in cases of BD with CME. It is effective in preserving the macular anatomy and vision particularly in transition to biological agents.Ophthalmologica
This is a case of high astigmatism in an otherwise healthy and viable 15-year-old PKP graft. The situation is not uncommon, especially as grafts get older. First, I would suggest getting topography to confirm that this is not an occurrence of ectasia in the graft, and to assess whether the astigmatism is regular or irregular.
It is reassuring that the patient has clear grafts with corneal pachymetries that are within normal limits. I would get a corneal topography and evaluate the astigmatism. In addition, I would want to carefully examine the lenses to determine whether there are any cataracts accounting for more myopic shift in the left eye. I assume that there are no sutures in the steep area to remove. If there are sutures, tension can be adjusted with selective suture removal based on topography to decrease astigmatism.
Given the age of the graft, a discussion of a repeat PKP is reasonable; however, with the stated health of the graft, I would prefer to salvage the current graft. I would therefore suggest taking the patient to the operating room and proceeding with a small wedge resection of the graft superotemporally in the left eye. Removing a small crescent of corneal tissue anteriorly and placing some sutures to reapproximate the graft –host junction will strengthen the graft–host junction and adjust the corneal astigmatism.
This patient is experiencing keratoconus progression after successful penetrating keratoplasty (PKP) because the original disease still remains in the host cornea. The patient is unable to tolerate scleral contact lenses, indicating that other contact lens modalities are also unlikely to be successful.
Because the corneal transplant grafts are clear and the patient is not able to tolerate contact lens correction, additional surgical treatment is indicated to further improve his visual function.
A 40-year-old man, with a history of keratoconus and an ocular history of corneal transplants 15 years ago in both eyes, reported a gradual decline in visual acuity in the left eye over the course of the last several years, with increasing magnitude of cylinder in the refractive error. The patient is unable to wear rigid gas-permeable (RGP) contact lenses or scleral lenses, despite multiple trials over the years by numerous physicians. His corrected distance visual acuity (CDVA) was 20/20 and 20/60 in the right eye and left eye, respectively.