Medulloepithelioma Masquerading as Chronic Granulomatous Uveitis

To report a case of ciliary body medulloepithelioma presenting as granulomatous uveitis.A 3-year-old girl presented with chronic granulomatous anterior uveitis in the right eye following unilateral cataract extraction and IOL implantation which was unresponsive to topical steroids and intra-vitreal injection of vancomycin and triamcinolone acetonide. One month later, white masses appeared over the iris surface. Histopathologic examination of the iris biopsy disclosed ciliary body medulloepithelioma. The patient was referred for plaque therapy due to the aggressive behavior of the tumor and finally, the eye was enucleated due to getting blind and painful and high suspicious of malignant behavior of the tumor. Medulloepithelioma is a rare congenital ciliary body tumor that presents with decreased vision, pain, leukocoria, and observation of a mass in the region of the ciliary body, anterior chamber and iris. Secondary glaucoma, cataract, uveitis, rubeosis iridis, retinal detachment, and ectopia lentis may develop later. The tumor may be locally aggressive and rarely metastasize. If extraocular extension does not occur, iridocyclectomy with tumor excision [in small tumors] and enucleation [in large tumors] appears to be the treatment of choice

Ciliochoroidal Melanoma presenting as a Subconjunctival Mass

To report a rare case of ciliochoroidal malignant melanoma presenting as a subconjunctival black-colored mass adjacent to the limbus. A 42-year-old woman presented with a subconjunctival black-colored mass adjacent to the limbus in left eye from 2 years ago. The lesion had increased in size during the previous 2 months. Funduscopic examination with scleral depression disclosed a small mass at the cilioretinal junction. Gonioscopy revealed that the superior portion of the angle was occupied by the mass. Visual acuity and intraocular pressure were normal. Other systemic examinations were unremarkable. Because of extensive extraocular extension of the tumor, the left eye was enucleated and histopathologic examination of the globe disclosed a highly pigmented medium-sized ciliochoroidal malignant melanoma of mixed cell type together with marked anterior extrascleral extension. Results of 6-month follow-up for metastasis were negative.A darkly pigmented epibulbar mass may be the first manifestation of ciliochoroidal malignant melanoma

Recurrent Keratoconus after penetrating Keratoplasty

To report a case of recurrent keratoconus after penetrating keratoplasty [PK].A 31-year-old male patient who had undergone PK in his right eye tor keratoconus 10 years ago presented with gradually decreased vision in the right eye. Clinical, topographic, and histopathologic features of the cornea including irregular myopic astigmatism, central and paracentral corneal thinning, and foci of break and fragmentation in Bowman's layer were in keeping with the diagnosis of keratoconus.Slow recurrence of keratoconus characteristics in the corneal graft after PK may result from graft repopulation by recipient's keratocytes, graft aging or both and may occur along with the process of cellular invasion from the recipient and renewal of resident cells

[Early results of autologous cultivated limbal stem cell transplantaion in total limbal stem cell deficiency]

To report the early results of transplantation of autologous limbal stem cell cultivated on amniotic membrane in total limbal stem cell deficiency. Four eye of 4 patients with total unilateral stem cell deficiency secondary to severe chemical or thermal burn included. Stem cell deficiency was confirmed with impression cytology in all cases. Under topical anesthesia, a small limbal sector [1x1 mm] was removed from the sound eye and cultivated on amniotic membrane. Cell expansions were transplanted to the affected eye 2 weeks later. Patients were regularly followed up. At each follow-up visit, corneal eye examination with special attention recurrence or regression of vascularization, corneal pacification, and healing of epithelial defect was performed. Digital imaging was performed at each follow-up visit. Impression cytology was repeated in all cases after surgery. The patients were followed for 5-13 months. Decrease in corneal opacification and vascularization was obvious in 3 cases, in which the surface of the cornea was covered with corneal epithelium. Sectoral conjunctivalization was evident in these 3 cases, but their corneas were ready for corneal transplantation. The procedure failed in one case with total corneal conjunctivalization. Visual acuity improved in all cases. Autologous cultivated stem cell transplantation on amniotic membrane seems to be an effective way for stem cell transplantation. More definite judgment needs longer follow-up together with long-term results of corneal transplantation in these patients