In vivo confocal microscopic characteristics of crystalline keratopathy in patients with monoclonal gammopathy: Report of two cases.

In this paper, we report two cases of a 62‑year‑old patient presented with blurred vision and a 45‑year‑old male diagnosed with multiple myeloma who was referred from the Department of Oncology. Slit‑lamp examination, in vivo confocal microscopy (IVCM), systemic work‑up and serum protein electrophoresis were obtained. In both patients, slit‑lamp findings revealed bilateral diffuse subepithelial and anterior stromal crystals and IVCM showed highly reflective deposits in the corneal epithelium and stroma. The first patient was eventually diagnosed with monoclonal gammopathy of undetermined significance following bone marrow biopsy and systemic evaluation. Unusual corneal deposits may constitute the first sign of monoclonal gammopathies. IVCM may be helpful in showing the crystalline nature of the corneal deposits and guiding the clinician to the diagnosis of gammopathies. Both ophthalmologists and oncologists should be aware that corneal deposits may herald a life‑threatening hematologic disease.

Bleeding due to slippage of elastic band during variceal ligation: successful use of Ankaferd blood stopper.

Ankaferd blood stopper (ABS) is a hemostatic agent that induces clot formation by a special protein network which mainly causes powerful erythrocyte aggregation. The use of topical ABS as a hemostatic agent has been approved in Turkey for the management of dermal, external post-surgical and postdental surgery bleeding. ABS has been successfully used in Dieulafoy lesion and bleeding from gastrointestinal neoplasms. We present a patient with alcoholic cirrhosis who developed severe bleeding during an elective endoscopic variceal ligation (EVL) session due to immediate band slippage, in whom endoscopic topical application of ABS was associated with cessation of bleeding. The major advantages of ABS appear to be ease of use and lack of side effect.