Hypopyon Uveitis Following LASIK in a Patient With Ulcerative Colitis

Liu, Margaret P.; Hwang, Frank S.; Dunn, James P.; Stark, Walter J.; Bower, Kraig S.

doi:10.3928/1081597x-20120722-02

Cited by 9 publications

(2 citation statements)

References 14 publications

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“…Even attempting surgery in patients with inactive disease can be dangerous, as the body’s heightened immune response can result in excessive inflammation. In rare cases, ocular surgery has led to disastrous complications including necrotizing keratitis, corneal melt, and hypopyon uveitis [ 4 , 5 , 6 , 7 ]. IBD has also been demonstrated to have a strong association with keratoconus [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Bowel Disease Guidelines for Corneal Refractive Surgery Evaluation

Moshirfar

Fuhriman

Ali

et al. 2022

JCM

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Inflammatory bowel disease (IBD) is a chronic systemic inflammatory condition that can potentially adversely affect surgical outcomes in patients receiving elective ophthalmic procedures. In this case series, 21 eyes of 11 patients with ulcerative colitis or Crohn’s disease underwent laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), or small incision lenticule extraction (SMILE). Their surgical outcomes were followed up for an average of 8.9 ± 4.6 months. All the patients in this study did well, with 100% of eyes corrected for distance vision achieving uncorrected distance visual acuity 20/20 by postoperative month three. Common symptoms noted during the postoperative period included dry eyes, irritation, foreign body sensation, and blurry vision, all of which improved in prevalence and severity over the follow-up period, and none of the patients experienced a flare-up of their disease. Despite the successful outcomes in these patients, the authors recognize the inherent risks of operating on patients with IBD. Currently, there are no consensus guidelines for clinicians to follow to ensure that they are adequately screening these patients for eligibility, so the authors are suggesting a relevant, focused review of systems, a brief IBD history-related questionnaire, and a preliminary surgical decision-making flowchart for use in surgical evaluation.

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Section: Discussionmentioning

confidence: 99%

Inflammatory Bowel Disease Guidelines for Corneal Refractive Surgery Evaluation

Moshirfar

Fuhriman

Ali

et al. 2022

JCM

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“…The patient's systemic disease was severe enough to necessitate total colectomy for recurrent ulcerative colitis prior to the LRS 23. Liu et al ., reported another case of ulcerative colitis that developed severe anterior uveitis with hypopyon 15 days after LASIK 24. Aman-Ullah et al ., reported two cases of necrotizing keratitis after LRS in patients with controlled Crohn's disease.…”

Section: Collagen Vascular Diseasesmentioning

confidence: 99%

Refractive surgery in systemic and autoimmune disease

Alkharashi

Bower

Stark

et al. 2014

Middle East Afr J Ophthalmol

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Patients with underlying systemic disease represent challenging treatment dilemma to the refractive surgeon. The refractive error in this patient population is accompanied by a systemic disease that may have an ocular or even a corneal component. The literature is rather sparse about the use of laser refractive surgery (LRS) and such procedure is not approved by the United States Food and Drug Administration (FDA) in this patient population. Patients with collagen vascular disease, diabetes mellitus (DM), allergic and atopic disease, or human immunodeficiency virus (HIV) are never ideal for LRS. Patients with uncontrolled systemic disease or ocular involvement of the disease should not undergo LRS. However, a patient with well-controlled and mild disease, no ocular involvement, and not on multidrug regimen may be a suitable candidate if they meet stringent criteria. There is a need for a large, multicenter, controlled trial to address the safety and efficacy of LRS in patients with systemic disease before such technology can be widely adopted by the refractive surgery community.

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Inflammatory Bowel Disease

Borkar¹,

Butler²

2017

Uveitis

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In the US, H. pylori vacA shows allelic variation in the signal sequence (which may be type sla, slb or s2) and the mid-region (type ml or m2). Previous PCR-based vacA mid-region typing classified most, but not all, Asian and South American strains tested as ml or m2. We now sought to investigate vacA mid-region diversity further.MotlmodL We studied 13 Japanese, 6 Chinese, 9 Thai, and 8 Peruvian H. pylori isolates. cagA was identified by colony hybridisation (CH), vacA signal sequence was typed by PCR, and vacA mid-region was typed proximally by CH and distally by PCR. Sections of the vacA mid-region from 8 strains were PCR-amplified, sequenced, and compared with known sequences from 8 other strains.Rcuts Of the 36 Asian and South American strains studied, 35 were cagA+ (the cagA-was Peruvian) and 35 were vacA sla (1 cagA + Peruvian was slb). vacA mid-regions from the 13 Japanese strains were not PCR-amplified by ml or m2-specific primers, but hybridised weakly with an ml probe. Sequence analysis of vacA from 1 Japanese strain revealed 91% nucleotide identity with the ml probe but only 71% identity with the m2 probe. The previously equivocal Thai and Peruvian strains also had ml-like mid-region sequences. A Chinese strain was ml in the proximal mid-region and m2 distally, showing a clear crossover site. Final mid-region types were: Japanese, all 13 ml; Chinese, 1 ml, 1 ml/m2, 4 m2; Thai, 3 ml, 6 m2; Peruvian 4 ml, 4 m2. Distal mid-region sequences of 16 strains, compared over 294 bp, clustered into 2 groups, ml and m2. Nucleotide identity between ml and m2 strains ranged from 73-78%. Within groups, m2 strains were less diverse than ml strains (m2 range 94-99.7%, ml 88-99.3%, p<0.001). Sequence analysis of 7 ml and 3 m2 strains over 1.1kb proximally showed maintenance of clustering outside the 294bp region C duions These Asian and South American strains are similar in terms of cagA status and vacA sla genotype, but fall into 2 vacA midregion groups. ml sequences are more diverse than m2, and thus may be phylogenetically older. The vacA sequence of 1 Chinese strain suggests recombination in vivo between ml and m2 alleles. Introduction: H.pylori antimicrobial susceptibility is an important determinant ofthe efficacy of eradication therapies'. The prevalence of antimicrobial resistance varies within the UK and may increase given the increased use of eradication therapy. This multicentre study assesses the prevalence and possible associations ofH.pylon antimicrobial resistance. Methods: H.pylon was isolated from antral biopsies of patients undergoing routine endoscopy and cultured according to standard microbiological methods. Antimicrobial resistance was determined using "E-tests" or disc tests (tinidazole only) with breakpoints defined by previous studies. Results: H.pyloni was isolated from 32% (1222/3823) of patients and antimicrobial susceptibility determined in 90% (1077/1222) Previous case-control studies of IBD have used hospital or community derived controls. There are obvious inherent biases in both metho...

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Hypopyon Uveitis Following LASIK in a Patient With Ulcerative Colitis

Cited by 9 publications

References 14 publications

Inflammatory Bowel Disease Guidelines for Corneal Refractive Surgery Evaluation

Inflammatory Bowel Disease Guidelines for Corneal Refractive Surgery Evaluation

Refractive surgery in systemic and autoimmune disease

Inflammatory Bowel Disease

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