ABSTRACT: To describe characteristic histopathologic markers in deep anterior lamellar keratoplasty (DALK) using pneumatic dissection: Anwar "big-bubble" technique.
Case reports. Deep stromal buttons from 2 patients with keratoconus who had undergone DALK surgery using the "big-bubble" technique were examined by light microscopy.
The histopathology of excised corneal buttons demonstrated multiple intrastromal spaces consistent with air bubbles. Apical stromal thinning seen clinically was not as readily appreciated on histopathology.
Pneumatic dissection in DALK produces diffuse intrastromal air bubbles that may mask the corneal thinning that usually characterizes keratoconus histopathologically. This is a characteristic finding of which ocular pathologists and corneal surgeons should be aware.
Cornea 05/2009; 28(5):579-82. · 1.73 Impact Factor
ABSTRACT: To describe the histopathologic characteristics of a 51-year-old Castroviejo square graft that remained functional for more than 50 years and to describe the wound-healing characteristics over this period of time.
An 80-year-old woman with a history of keratoconus underwent penetrating keratoplasty with square grafts in 1956 and 1957 in the right and left eyes, respectively. The graft from the right eye was replaced in 2007, and the corneal specimen was submitted for histopathologic analysis.
Light microscopy demonstrated a smooth transition between host and donor stroma. Descemet's membrane was markedly thickened (>40 m) and laminated, and a very thin retrocorneal membrane was visible at high magnification.
This case provides an opportunity to observe the histopathology of corneal wound healing over a period of more than half a century.
Cornea 05/2009; 28(3):345-7. · 1.73 Impact Factor
ABSTRACT: To review our experience with triamcinolone-assisted pars plana vitrectomy for internal limiting membrane (ILM) peeling for various retinal diseases.
Twenty-one patients underwent surgery in which intraoperative triamcinolone acetonide (TA) was used. Indications for surgery included epiretinal membrane (3 patients), branch retinal vein occlusion associated with macular edema (2), traction retinal detachment (3), diabetic macular edema (4), vitreous hemorrhage with diabetic macular edema (4), macular hole (4), and cystoid macular edema (1).
TA was useful in the removal of the ILM in all cases. There were no intraoperative complications or toxicity. The mean follow-up was 22 weeks (range, 9-30 weeks). Eleven patients improved by >or=2 Snellen lines, 1 lost >or=2 Snellen lines, and 9 were within 2 Snellen lines of preoperative vision at the last follow-up.
The intraoperative use of TA improves visualization of ILMs associated with a variety of conditions. No intraoperative or postoperative complications were observed. TA-assisted removal of the ILM appears to be safe and cost effective. TA-assisted ILM peeling should be considered as an alternative to the use of intraoperative dyes.
Retina 12/2005; 25(8):972-5. · 2.81 Impact Factor
Archives of Ophthalmology 09/2005; 123(8):1138-41. · 3.71 Impact Factor
ABSTRACT: To report histopathologic confirmation of the internal limiting membrane (ILM) using triamcinolone acetonide (TA).
Interventional case report.
One eye of one patient who underwent macular hole repair using TA suspension to help visualize the internal limiting membrane (ILM). The specimen was sent to pathology.
Triamcinolone acetonide greatly improved the visualization of the ILM; the peeled area was seen as an area lacking white specks. The macular hole closed with an improvement in vision. No adverse effects were observed during the follow-up period. The specimen was identified as ILM by histopathologic examination.
Peeling of the ILM is facilitated by the use of TA. Microscopic confirmation of ILM was made.
American Journal of Ophthalmology 11/2004; 138(4):656-7. · 4.22 Impact Factor