Showing papers by "Edward J. Holland published in 1993"
TL;DR: Topical cyclosporin A was used in the management of 43 patients with a variety of anterior segment inflammatory disorders that had failed corticosteroid treatment, and thirty-five patients with disorders including highrisk keratoplasty, atopic and vernal keratoconjunctvitis, ligneous conjunctivitis, ulcerative keratitis, and Mooren's ulcer had a beneficial result.
Abstract: Topical cyclosporin A was used in the management of 43 patients with a variety of anterior segment inflammatory disorders that had failed corticosteroid treatment. Treatment with topical cyclosporin A ranged from 1 week to 43 months, with a mean treatment period of 13 months. Thirty-five patients (81%) with disorders including high-risk keratoplasty, atopic and vernal keratoconjunctivitis, ligneous conjunctivitis, ulcerative keratitis, and Mooren's ulcer had a beneficial result, with resolution, reduction, or prevention of inflammation. Six patients (14%) with scleritis, ocular cicatricial pemphigoid, or endothelitis showed no clinical improvement. Two patients (5%) had significant ocular discomfort, and the drug had to be discontinued in them. None of the other patients developed local side effects. Twenty-seven of these patients were followed with serial cyclosporin A blood levels and serum creatinine. None of these patients developed measurable drug blood levels or renal toxicity.
137 citations
TL;DR: Two eyes developed Brown-McLean syndrome after phacoemulsification and one eye developed peripheral edema after pars plana vitrectomy and lensectomy, and severe, infectious keratitis occurred after rupture of peripheral bullae in two eyes.
32 citations
TL;DR: Treatment with cyclophosphamide, systemic corticosteroids and trimethoprim/sulfamethoxazole resulted in resolution of the sclerokeratitis and remission of the disease.
15 citations
TL;DR: It appears that the TSPCLs may have an effect on early postkeratoplasty astigmatism by distorting the corneal wound at the time of ker atoplasty.
Abstract: We reviewed the pattern of astigmatism after penetrating keratoplasty and transsclerally sutured posterior chamber lens (TSPCL) placement in 73 patients. Thirty-five patients (48%) had an axis of astigmatism oriented perpendicularly to the haptics of the TSPCL. Twenty-seven patients (37%) had an orientation of astigmatism that was in the same meridian of the haptics of the TSPCL. Eleven patients (15%) had an axis of astigmatism oriented obliquely to the meridian of the haptics of the TSPCL. The distance the haptic fixation sutures were placed behind the limbus appeared to be correlated with the orientation of astigmatism. Patients having the lens fixated within 0.75 mm of the limbus were more likely to have astigmatism oriented perpendicular to the meridian of the haptics of the posterior chamber lens in the early postoperative period. Patients having the lens fixated 2-3 mm posterior to the limbus were more likely to have astigmatism oriented in the same meridian as the haptics of the posterior chamber lens in the early postoperative period. In an eye bank model of TSPCLs during penetrating keratoplasty, the placement of a posterior chamber lens with haptics fixated within 0.75 mm of the limbus significantly widens the recipient bed an average of 0.3 mm in the meridian of the haptics of lens placement (p = 0.02). When the posterior chamber lens haptics were fixated 3 mm posterior to the limbus, the recipient bed was significantly narrowed in the meridian of lens placement an average of 0.2 mm (p = 0.02). It appears that the TSPCLs may have an effect on early postkeratoplasty astigmatism by distorting the corneal wound at the time of keratoplasty.
2 citations