Ocular Tissue Adhesive Application in DSAEK: a Comparative Study - Juniper Publishers - JOJ Ophthalmology

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Ocular Tissue Adhesive Application in DSAEK: a Comparative Study

Authored by AJ Kanellopoulos

Idiopathic hyperammonemia is characterized by increased serum ammonia levels (>200umol/L) and is sometimes associated with normal to slightly elevated liver function tests [1]. These patients often present with encephalopathy, cerebral edema, seizures, and coma. Idiopathic hyperammonemia has been reported after high dose chemotherapy, and organ transplants including Orthotopic lung transplant [2]. Hyperammonemia is a rare, severe, and often fatal complication. There are few cases reported in the literature since 1997, including one retrospective analysis of 807 lung transplants; only 8 patients were diagnosed with hyperammonemia [3]. The exact mechanism of idiopathic hyperammonemiais not fully understood with congenital or acquired defects in ammonia metabolism, as well as bacterial infection having been described.

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Ocular Health Assessment of Basic School Children in the Oforikrom Sub- Metropolis, Kumasi-Ghana - Juniper Publishers - JOJ Ophthalmology

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Ocular Health Assessment of Basic School Children in the Oforikrom Sub- Metropolis, Kumasi-Ghana

Authored by Kumah DB

Background: Vision is critical for daily activities and sight is treasured by all. Eye diseases and disorders such as uncorrected refractive errors, cataract, glaucoma and retinopathies, tend tomar normal vision.

Purpose: To determine the prevalence of ocular conditions, their association with age and gender and the commonest associated symptoms experienced by the basic school children in the Oforikrom sub-metropolis of the Kumasi Metropolis of Ghana.

Design: A descriptive, cross sectional survey was used.

Methods: Out of the ten sub-metros in Kumasi, simple rando
m technique was used to select a sub-metropolis. The multistage sampling technique was then used to select two public primary schools in the selected sub-metropolis as well as to identify a sample of school children aged 5-16 years. The examination procedures adopted included history-taking, visual acuity testing, plus-one blur test, static retinoscopy, subjective refraction and ophthalmoscopy.

Results: A total of 500 children were examined and refractive error was found to be the most prevalent ocular condition occurring among 200 (40.0%) of the school children, followed by allergic conjunctivitis 111 (22.2%) and dry eyes 51(10.2%). The commonest symptoms recorded include itchiness (38.40%), tearing (32.4%), red eyes (30.20%) and headache (26%).

Conclusion: Uncorrected refractive error was the most prevalent ocular condition and this study indicates that the school age is a high risk group for developing refractive errors. Eye screening of school children is recommended and eye care services, especially, refractive error services should be enforced.

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Stromal Rejection after Deep Anterior Lamellar Keratoplasty (DALK) - A Retrospective Study - Juniper Publishers - JOJ Ophthalmology

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Stromal Rejection after Deep Anterior Lamellar Keratoplasty (DALK) - A Retrospective Study

Authored by Vipul Bhandari

Aim: To report and analyse the incidence of stromal rejction, which is a central island of flattening of the graft associated with thinning in patients who underwent DALK for keratoconus.

Materials & Methods: Retrospective review of patients who underwent DALK for progressive keratoconus from 2010 to 2013 was done. Patients who completed 2 years of follow up were included. Slit lamp findings, corneal topography and central corneal thickness were analysed.122 eyes of 71 patients were analysed. Uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) were analysed in each visit

Results: Thirty one eyes of thirty one patients showed topographic evidence of Central Island of flattening which correlated with slit lamp finding of stromal haze of varying density. The pachymetry reading of the central cornea varied from 400 to 479μ and correlated with topographic finding of flattening. The average onset of central stromal haze was at 9 months post DALK. None of the patients had bilateral involvement. The central haze progressed over time and was associated with thinning of the cornea. The onset and progression of central flattening was associated with corresponding decrease in UCVA and BCVA. No epithelial defect was noted.

Conclusion: 25.4% of keratoconus patients who underwent DALK developed a central island of flattening with associated decrease in the visual acuity. The central haze, flattening and thinning may be a chronic stromal rejection or progressive thinning of cornea associated with disease process of keratoconus.

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