Surgically-induced corneal changes following macular translocation with punctate retinotomies and chorioscleral infolding (limited macular translocation)

<p><b>INTRODUCTION</b>To report the sequential changes in corneal topography and astigmatism following limited macular translocation. CLINICAL PICTURE AND TREATMENT: A 45-year-old-man who underwent limited macular translocation for idiopathic subfoveal choroidal neovascularisation in the right eye was evaluated by corneal topography and manifest refraction preoperatively and serially for 1 year postoperatively.</p><p><b>OUTCOME</b>An increase in astigmatism with corneal steepening along meridians corresponding to the area of chorioscleral infolding was observed and this persisted for 1 year after surgery. Vector-analysed astigmatic change showed significant surgically induced astigmatism of 2.18 dioptres (D) X 52.9 degrees, 2.17 D X 57.8 degrees and 2.56 D X 59.1 degrees at 2, 5 and 12 months after surgery respectively.</p><p><b>CONCLUSION</b>Surgically induced corneal changes are evident after limited macular translocation and may remain up to 1 year after surgery.</p>

Neisseria meningitidis keratitis in adults: a case series

<p><b>INTRODUCTION</b>The aim of this case series is to describe the clinical course of 2 patients with Neisseria meningitidis corneal ulcers.</p><p><b>CLINICAL PICTURE</b>A 49-year-old man (Patient 1) and a 22- year-old man (Patient 2) both experienced eye pain and were found to have corneal ulcers with surrounding infiltrate and ground-glass appearance. Gram-negative diplococci were seen in the first case. N. meningitidis was isolated in culture of corneal scrapings from both patients.</p><p><b>TREATMENT</b>Patient 1 was treated with levofloxacin (0.5%) and cefazolin (50 mg/mL) eye drops hourly and intravenous ceftriaxone and oral rifampicin. Patient 2 was treated with cefazolin (50 mg/mL) and gentamicin (14 mg/mL) eye drops hourly, as well as intravenous ceftriaxone.</p><p><b>OUTCOME</b>The corneal ulcers resolved with anterior stromal scarring and no impairment of vision.</p><p><b>CONCLUSIONS</b>Corneal ulcers caused by N. meningitidis may respond well to treatment without permanent visual sequelae. However, in view of the potential ocular and systemic complications, it is important to investigate and treat patients with N. meningitidis infection aggressively.</p>