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ABSTRACT: We sought to determine the ideal length of time to use the diagnostic occlusion test (DOT) in the evaluation of patients with intermittent exotropia.
Eighty-two consecutive intermittent exotropia patients were prospectively evaluated. After the routine ophthalmic examination, the DOT was applied for 1, 3, and 24 hours. The mean distance and near deviations, obtained with the DOTs, were compared, and the DOT periods at which deviations were stabilized were determined. The Nonparametric Tukey HSD test was used for statistical analysis.
Before occlusion, the mean distance exotropia was 28.4 +/- 14.5, and the mean near exotropia was 25.7 +/- 15.5. After 1 hour of DOT, the exotropia measured 30.0 +/- 14.8 (p = 0.023) and 31.2 +/- 14.0 (p = 0.000), respectively. A clinically and statistically significant difference was not found after 3-hour and 24-hour DOT at either distance or near.
Although the distance deviation stabilized after the 1-hour DOT and the near deviation was stabilized after the 3-hour DOT in intermittent exotropia cases, the change of mean near deviation between 1 and 3 hours was clinically negligible. The 1 hour DOT was at least as effective as the 3- and 24-hour DOT in most cases. Therefore, we recommend that the 1 hour DOT is sufficient for clinical applications.
Journal of AAPOS: the official publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus 11/2008; 12(5):504-6. · 1.07 Impact Factor
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ABSTRACT: To investigate the conjunctival cytologic changes induced by different contact lens materials and contact lens-wearing periods in asymptomatic contact lens wearers.
Seventy-five patients (150 eyes) who were to wear contact lenses for the first time were evaluated in this study. Forty eyes of 20 soft hydroxyethylmethacrylate (vinyl pyrrolidone copolymer) contact lens wearers, 70 eyes of 35 soft Polymacon contact lens wearers, and 40 eyes of 20 hard gas-permeable contact lens wearers used the lenses on a daily-wear basis. Conjunctival cytologic changes were investigated by using impression cytology. Impression cytologic samples were obtained before contact lens fitting and after contact lens wear (mean evaluation time, 6.9 +/- 2.6 months; range, 4-12 months). The samples were appropriately stained and were assessed by using the Nelson grading system and for the presence of snakelike chromatin. The Kruskal-Wallis test, the Wilcoxon test, and logistic regression were used for statistical analysis.
There were statistically significant differences in impression cytologic findings for all three materials before versus after contact lens wear (P=0.00, P=0.00, P=0.00, Wilcoxon test). The contact lens-wearing period produced a statistically significant effect on conjunctival cytologic changes and snakelike chromatin formation (P=0.00, P=0.00, logistic regression analysis), but the effects of different contact lens materials were insignificant (P=0.88, P=0.62).
Conjunctival cytologic changes occurred in asymptomatic contact lens wearers and were related to the duration of lens wear. For this reason, asymptomatic contact lens wearers may be followed up because of conjunctival cytologic changes.
Eye & Contact Lens Science & Clinical Practice 06/2008; 34(3):166-8. · 1.25 Impact Factor
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ABSTRACT: To report the acute management and clinical findings of a case of corneal bee sting and to report the outcome of corneal endothelial cell analysis 1 year after trauma.
Clinical findings, anterior segment photographs, corneal endothelial images, and medical treatment of a case of right corneal bee sting are presented. Right and left central corneal endothelial cell analysis was performed by noncontact specular microscopy.
The stinger was removed from the cornea. Systemic, subconjunctival, and topical steroids and systemic and topical antibiotics were given. One year later, a corneal scar and anterior capsular opacity of the lens in the right eye were shown by slit-lamp examination. Endothelial cell analysis determined that the endothelial cell density of the right eye was substantially decreased compared with the left eye.
Corneal infiltration gradually decreased, presumably because of the systemic, topical, and subconjunctival steroids. Late complications observed in this case included a substantial decrease in cornea endothelial cell density, a corneal scar, and anterior capsular opacity.
Cornea 10/2006; 25(8):981-3. · 1.73 Impact Factor
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ABSTRACT: To determine if there are any corneal endothelial cell size and shape changes (and the time course of these changes) in subjects wearing rigid high gas-permeable (RGP) contact lenses for daily wear.
Ninety-seven eyes of 57 new wearers were fitted with a fluoroperm contact lens material (Persecon92E, oxygen transmissibility (Dk)= 92 x 10(-11)). Prior to lens wear and after 1 week, 1 month, 3 months, 6 months, and 1 year, noncontact endothelial photographs were taken. Maximum cell size/Minimum cell size (Max/Min) was measured as an index of polymegethism and the relative frequency of 5-, 6-, and 7-sided cells was evaluated.
An increase in the ratio of Max/Min was present 1 week after lens fitting and increased further over the subsequent year. This study showed significant increase in endothelial polymegethism and in the relative frequency of 7-sided cells, but a significant decrease in the relative frequency of 6-sided cells.
Daily-wear high Dk gas-permeable contact lenses can cause endothelial polymegethism and pleomorphism similar to those caused by soft and hard contact lenses.
The CLAO journal: official publication of the Contact Lens Association of Ophthalmologists, Inc 02/2002; 28(1):40-3.
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ABSTRACT: Two cases of Stenotrophomonas maltophilia endophthalmitis, a rare cause of postoperative endophthalmitis, are reported in this study. Both of the patients underwent vitreus tap and intravitreal antibiotic injection. The therapy was augmented with systemic and subconjunctival injections. The response to this therapy protocol was excellent and the final visual acuity in both of the patients was 10/10. The results are discussed and the literature, which consists of only 8 reported cases of Stenotrophomonas maltophilia endophthalmitis, is reviewed. Although endophthalmitis caused by this pathogen is a rare but important cataract surgery complication, with appropriate therapy, this clinical presentation can be cured without risk of reoccurrence.
Ophthalmic surgery and lasers 33(3):253-6.
