Dr. Michael  Insler  Md image

Dr. Michael Insler Md

1340 Poydras St Suite 1640
New Orleans LA 70112
504 121-1860
Medical School: Other - Unknown
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: 014061
NPI: 1023192481
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Fungal scleral keratitis and endophthalmitis following pterygium excision. - European journal of ophthalmology
The authors report a case of fungal scleral keratitis and endophthalmitis as a complication of pterygium surgery.Case presentation.A 46-year old woman underwent pterygium excision with topical use of intraoperative mitomycin C. By day 21 after excision, scleral melting was followed by fungal keratitis. Endophthalmitis ensued, which rapidly progressed, despite surgical and medical interventions. The eye was finally enucleated to prevent fungaemia. Pathology revealed a highly disorganized eye with disruption of scleral collagen in the area of scleral melting.Fungal keratitis and scleral melting are rare but devastating complications of pterygium surgery with adjuvant use of mitomycin C.
Topical tacrolimus ointment for treatment of refractory anterior segment inflammatory disorders. - Cornea
To report 4 cases of patients treated with topical tacrolimus ointment 0.03% for ocular inflammatory conditions refractory to traditional treatment.Four patients were treated topically with tacrolimus 0.03% ointment twice daily: 2 patients with blepharokeratoconjunctivitis, 1 patient with severe atopic keratoconjunctivitis, and 1 patient with chronic follicular conjunctivitis.Three patients had a dramatic improvement of their ocular condition as early as 2 weeks after starting tacrolimus ointment. One patient developed a herpes simplex virus dendrite after 1 week of tacrolimus use.Tacrolimus ointment appears to be an effective alternative for certain ocular inflammatory conditions refractory to traditional treatments. There may be an increased risk of herpes simplex virus keratitis associated with topical use. Our results support previous literature of patients benefiting from topical tacrolimus use.
Human fibrin tissue adhesive for sutureless lamellar keratoplasty and scleral patch adhesion: a pilot study. - Ophthalmology
To determine whether a fibrin adhesive can facilitate the performance of sutureless lamellar keratoplasty and attachment of amnion to bare sclera.Prospective, noncomparative case series.Six patients, 5 of whom underwent lamellar keratoplasty and 1 who received an amniotic patch of the sclera and cornea. Institutional review board approval was not required for these therapeutic treatments.In 5 patients, the epithelium was removed from the corneal surface, a free cap, 200- micro m thick, was cut with a microkeratome, and a human fibrin tissue adhesive (Tisseel VH Fibrin Sealant; Baxter Healthcare Corporation, Glendale, CA) was applied to the cut surface of the corneal stroma. A 200- micro m thick, microkeratome-cut lamellar graft was placed in the stromal bed without sutures, and a bandage soft contact lens was applied. The lens was left in place for 1 week and then removed. In 1 patient, the adhesive was applied to bare sclera for attachment of amniotic membrane after removal of a conjunctival melanosis. All patients were followed up for 3 months after surgery.Tissue adhesion, corneal clarity, and visual acuity.All 5 lamellar grafts healed and remained clear, although final visual acuity varied with visual potential and astigmatism. The amniotic membrane graft also adhered well to the bare sclera.The fibrin adhesive provided satisfactory attachment without sutures for lamellar keratoplasty and amniotic patching. It should be effective for sealing of clear cornea incisions, LASIK flaps, and conjunctival and skin grafts. An adhesive that has been designed specifically for ophthalmic applications and is more convenient to use would be desirable.

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1340 Poydras St Suite 1640 New Orleans, LA 70112
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