Table of Contents - WOC 2012

WOC2012 Abstract Book
PO-COR-48
Regeneration of the human cornea endothelial cells
Ramos López Juan F (1) , Pérez Roca Fernando (1) , Rodrigo Morales Esther (1) ,
Medialdea Marcos Santiago (1) , Alaminos Mingorance Miguel (2)
1. Hospital Universitario Virgen de las Nieves
2. Departamento Histologà a e Ingenieria Tisular. Universidad de Granada
Objective/purpose: In this work we have quantified at different time the number
and shape of the corneal endothelial cells of patiens subjected to cataract
surgery in order to determine the in vivo regenerative capabilities of the cornal
endothelium.
Methods: Fifteen patients with unilateral cataract were subjected to
programmed phacoemulsification and intraocular lens implantation following
routinary treatment protocols. The number and size of corneal endothelial cells
per mm2 of cornea were determined by using a specular microscope (Konan,
Japan) just before the surgical procedure and 1 week, 1, 6 and 12 months after
the surgery was performed.
Results: In general, 20% of the cases (3 of 15) showed a positive slope after 6
months of the surgical procedure. Of the 15 corneas subjected to
phacoemulsification, 4 corneas reached more than 95% of the presurgical
endothelial cell count 6 month after the procedure was carried out. A similar
trend was found for the cell size and pleomorphism.
Conclusion: These results suggest that a considerable percentage of corneas
affected by iotrogenic endothelial loss could retain regenerative capabilities.
The idea that endothelial cells are not able to proliferateand regenerative in
vivo should be revised in the future.
PO-COR-49
Critical Evaluation and Management of Epibulbar Dermoids
Gupta Anoop Kishore (1) , Nindra Krishna Sasikala (1) , Panda Anita (1)
1. Dr. R.P.Centre, AIIMS
Purpose:To evaluate the mode of management and outcome in epibulbar
dermoid besides its critical clinical evaluation . Subjects and
Methods:302 consecutive patients with epibulbar dermoid over a period of 3
decades (1977- 2009) were evaluated. Complete ocular and systemic
examination was performed prior to surgery.
Results: Simple excision with direct conjunctival closure was sufficient in 131,
AMG in 44 and LK in 225 with anatomic and visual improvement. Amblyopia
therapy was required in 197 eyes.
Conclusion:To avoid functional damage there is a need to identify these
patients early and should be referred to tertiary hospitals where meticulous
surgical facilities are existing.
PO-COR-50
Secondary glaucoma following Penetrating Keratoplasty : A single
surgeon case series
Rao Lavanya (1) , Bhandary Sulatha (1) , Rao Krishna (1)
1. Kasturba Medical College Manipal University
Objective and Purpose: To evaluate the incidence of secondary glaucoma
following penetrating keratoplasty
Methods: A retrospective study done to analyse the incidence of secondary
glaucoma following penetrating keratoplasty in 18 eyes of 18patients between
July 2007 and Dec 2010.A single surgeon performed all the surgeries. Graft
size and recipient bed size was 7.5 mm and 7 mm in 17 eyes, but in 1 eye it was
8.5 and 8.0mm. Inclusion criterion was IOP >21 mm Hg [Goldmann tonometry]
in immediate or late postoperative period with/without disc changes. Follow up
was after 1 week, 2 weekly for 2 months,monthly for 6 months,2 monthly for
6 months.
Results: 7 eyes had increased IOP- 5 within 2 weeks,1 after 2 months&1 after
3 months [6 phakic and 1 aphakic].3 were steroid responders,2 had
inflammatory reaction,1 had pre-existing mesodermal angle anomaly,1 was
repeat keratoplasty for the third time.3 patients had to undergo trabeculectomy.
Incidence of glaucoma was 38.8%, which correlated with other studies.
Conclusion:IOP assessment during every postoperative visit is very important
to diagnose and manage this complication effectively.
496
PO-COR-51
Disaster due to wrong Donor Tissue Selection
Gupta Anoop Kishore (1) , Nindra Krishna Sasikala (1) , Panda Anita (1)
1. Dr. R.P.Centre, AIIMS
Purpose: This report traces the history and subsequent treatment course of
two patients, one with Keratoconus who underwent a Lamellar Keratoplasty
for corneal opacity for healed hydrops and other with a corneal graft melting.
Inadvertent donor selection resulted in a severe fungal infection mandating
a therapeutic keratoplasty procedure in both. Method: Two cases of donor
related multi organismal infection in recipient is highlighted.
Results: Organism isolated from donor eyes were pseudomonas and
aspergillus flavus and that from the recipient sample with additional coagulase
+ve Staphylococcus. Though response was delayed , finally the eye could be
saved
Conclusions: . Infectious keratitis following keratoplasty is a disaster. The same
transmitted through donor tissue is hazardous and should be critically evaluated
and adequately managed both pre and post operatively.
PO-COR-52
Confocal Scanning Laser Tomography: an Ideal Screening Tool in
Refractive Surgery
Al Kharousi Nadia (1) , Wali Upender (2)
1. SENIOR CONSULTANT DEPARTMENT OF OPHTHALMOLOGY, SULTAN
QABOOS UNIVERSITY HOSPITAL
2. SENIOR REGISTRAR DEPARTMENT OF OPHTHALMOLOGY, SULTAN
QABOOS UNIVERSITY HOSPITAL
Objectives and purpose: Acanthamoeba keratitis (AK) is a rare condition with
an infection rate of 0.2 per 10 000 contact lens wearers per year. This case
series highlights the importance of CSLT as a screening tool in corneal
refractive surgery in the diagnosis of protozoal corneal infections existing prior
to the procedure.
Methods: Confocal Scanning Laser Tomography (CSLT) is an in-vivo
noninvasive diagnostic tool that provides high definition images of corneal
microstructures of four microns. Laser in situ keratomileusis (LASIK) is a very
common refractive procedure undergone by young people for refractive error
correction. All patients had routine psycho-physical tests done.
Results: Confocal Scanning Laser Tomography in both eyes revealed stromal
cyst-like structures suggestive of acanthamoeba keratitis. After a course
of anti-acanthamoeba medication, repeat CSLT at four months showed
disappearance of the acanthameoba cysts.
Conclusion: Confocal Scanning Laser Tomography should not be a substitute
for clinical examination, smear, culture or biopsy procedures in AK, however,
whenever and wherever possible, it should be used as a screening procedure
before any type of corneal refractive surgery is done so that the protozoal
infections can be diagnosed and treated, making surgery safer.
PO-COR-53
Multibacterial Graft Infection Overshadowing The Fungal Infection-
Report of Two Cases and a Brief Review
Gupta Anoop Kishore (1) , Panda Anita (1) , Nindra Krishna Saikala (1) , Satpathy
Geeta (1)
1. Dr. R.P.Centre, AIIMS
Purpose: This report traces the history and subsequent treatment course of
two patients, one with Keratoconus who underwent a Lamellar Keratoplasty
for corneal opacity for healed hydrops and other with a corneal graft melting
. Inadvertent donor selection resulted in a severe fungal infection mandating
a therapeutic keratoplasty procedure in both. Method: Two cases of donor
related multi organismal infection in recipient is highlighted.
Results: Organism isolated from donor eyes were pseudomonas and
aspergillus flavus and that from the recipient sample with additional coagulase
+ve Staphylococcus. Though response was delayed , finally the eye could be
saved
Conclusions: . Infectious keratitis following keratoplasty is a disaster. The same
transmitted through donor tissue is hazardous and should be critically evaluated
and adequately managed both pre and post operatively.