Traumatic wound dehiscence following corneal transplantation

To investigate the incidence, mechanisms, characteristics, and visual outcomes of traumatic wound dehiscence following keratoplasty. Medical records of 32 consecutive patients with traumatic globe rupture following keratoplasty who had been treated at our center from 2001 to 2009 were retrospectively reviewed. The study population consisted of 32 eyes of 32 patients including 25 men and 7 women with history of corneal transplantation who had sustained eye trauma leading to globe rupture. Mean patient age was 38.1 [range, 8 to 87] years and median interval between keratoplasty and the traumatic event was 9 months [range, 30 days to 20 years]. Associated anterior segment findings included iris prolapse in 71.9%, lens extrusion in 34.4%, and hyphema in 40.6% of eyes. Posterior segment complications included vitreous prolapse [56%], vitreous hemorrhage [28%] and retinal detachment [18%]. Eyes which had undergone deep anterior lamellar keratoplasty [DALK; 5 cases, 15.6%] tended to have less severe presentation and better final visual acuity. There was no correlation between the time interval from keratoplasty to the traumatic event, and final visual outcomes. The host-graft interface demonstrates decreased stability long after surgery and the visual prognosis of traumatic wound dehiscence is poor in many cases. An intact Descemet's membrane in DALK may mitigate the severity of ocular injuries, but even in these cases, the visual outcome of globe rupture is not good and prevention of ocular trauma should be emphasized to all patients undergoing any kind of keratoplasty.

Immunologic corneal graft rejection after administration of topical latanoprost: a report of two patients

To report endothelial corneal graft rejection after administration of topical latanoprost eye drops. Two eyes of two patients with a history of multiple intraocular procedures prior to penetrating keratoplasty developed endothelial graft rejection one month after administration of topical latanoprost. Cystoid macular edema developed simultaneously in one patient. Latanoprost may trigger endothelial graft rejection in susceptible eyes

Visual outcomes of two aspheric PCIOLs: Tecnis Z9000 versus akreos AO

To compare spherical aberration and contrast sensitivity with two different types of aspheric posterior chamber intraocular lenses [PCIOLs]: Tecnis Z9000 versus Akreos AO. Thirty-four eyes of 34 patients undergoing phacoemulsification for senile cataracts were randomly assigned to implantation of Tecnis Z9000 or Akreos AO PCIOLs. Outcome measures included best-corrected visual acuity [BCVA], spherical aberration [SA] with 4 and 6 mm pupil diameters and contrast sensitivity under photopic and mesopic conditions at spatial frequencies of 1, 2, 5, 10 and 20 cycles per degree [cpd] three months postoperatively. Mean BCVA was 0.08 +/- 0.08 logMAR in the Tecnis Z9000 group and 0.11 +/- 0.09 logMAR in the Akreos AO group [P=0.33]. SA was less with Tecnis than Akreos AO with 4 and 6 mm pupil diameter [0.14 +/- 0.10 micro m vs 0.28 +/- 0.09 micro m, P < 0.001 and 0.30 +/- 0.18 micro m vs 0.33 +/- 0.08 micro m, P=0.4, respectively]. Contrast sensitivity was significantly higher in the Tecnis Z9000 group at 1, 2, 5 and 10 cpd under photopic and at 1, 2 and 10 cpd under mesopic conditions. Tecnis Z9000 IOL seems to entail better visual outcomes in terms of spherical aberration and contrast sensitivity as compared to Akreos AO

Lensectomy and PCIOL implantation with versus without posterior capsulotomy and anterior vitrectomy for pediatric cataracts

To compare the visual outcomes and complications of lensectomy and posterior chamber intraocular lens [PCIOL] implantation with or without posterior capsulotomy and anterior vitrectomy in older subjects with pediatric cataracts. Seventeen eyes of 12 children aged 10 to 15 years with congenital or developmental cataracts were randomly divided to two groups. Lensectomy and PCIOL [Alcon Acrysof MA60 AC] implantation was performed with [8 eyes] or without [9 eyes] posterior capsulotomy and anterior vitrectomy. Mean age at the time of surgery was 12.3 +/- 1.5 [range 10-15] years and mean follow-up period was 18.7 +/- 11.2 [range 6-36] months. Posterior capsule opacification developed in three eyes in the non-vitrectomy group; however, media opacification was mild and capsulotomy was not required in any case. All eyes in the vitrectomy group had a clear visual axis at final follow-up [P=0.2]. No significant difference was observed between the two groups in term of visual acuity [P = 0.3] or complications. Although posterior capsulotomy and anterior vitrectomy seems to be safe in pediatric cataract surgery, it may not be necessary as a routine procedure in older children