Rose-K versus Soper contact lens in keratoconus: a randomized comparative trial

To perform a comparative evaluation of the efficacy and acceptability of Rose-K and Soper contact lenses in Keratoconus. Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi. A randomized comparative clinical trial was performed in keratoconic eyes fitted with Rose-K [Rose-K group] and Soper [Soper group] contact lenses. Patients data were evaluated for best spectacle corrected visual acuity, best contact lens corrected visual acuity [BCLCVA], corneal topography, glare acuity, contrast sensitivity, tear function tests and specular microscopy. Patients were also asked to complete a self-reported comfort questionnaire at each visit. Sixty eyes were randomized to the Rose-K and Soper groups. The two groups were comparable in all the baseline parameters. There was a statistically significant improvement in BCLCVA in both groups at 3 months [P < 0.01, both groups]. The difference between in BCLCVA in both groups was not statistically significant. In both groups, there was a significant improvement in the comfort score at 3 months compared to baseline [P< 0.05, both group]. The Rose-K group had statistically significantly better scores at 1 and 3 months compared with the Soper group [P- 0.006 and P< 0.001 respectively]. Both groups were associated with a significant [P< 0.0l], but comparable improvement in glare acuity at 3 months. There was a significant improvement in contrast sensitivity at 3 months in both groups [P< 0.0l]? the Rose-K group was significantly better than the Soper group at 1 and 3 months [P= 0.001 and 0.002 respectively]. The mean number of trial lenses required for fitting Rose-K lens [2.00 +/- 0.59] was significantly lower than the Soper lens [3.43 +/- 0.82; P< 0.00l]. Both the contact lens designs provide an equal improvement in visual acuity in patients with Keratoconus. However, Rose-K contact lens provides greater comfort, better quality of vision and requires less chair time compared with the Soper lens and hence may possibly have a greater acceptability

Results of cataract surgery and plasma ablation posterior capsulotomy in anterior persistent hyperplastic primary vitreous

To report the feasibility and outcome of lens aspiration, and Fugo blade-assisted capsulotomy and anterior vitrectomy in eyes with anterior persistent hyperplastic primary vitreous [PHPV]. In this case series, 10 eyes of 10 patients with anterior PHPV underwent lens aspiration. The vascularized posterior capsule was cut with a Fugo blade [plasma knife] and removed with a vitrector. A foldable posterior chamber intraocular lens [IOL] was implanted in eight eyes and the outcomes were evaluated. The mean age of patients was 16.8 +/- 6.37 months [range: 5 to 28 months]. The surgery was completed successfully in all eyes. There were no cases of intraocular hemorrhage intraoperatively. Foldable acrylic IOL was implanted in the bag in 3 eyes and in the sulcus in 5 eyes. Two eyes were microphthalmic and did no undergo IOL implantation [aphakic]. None of the eyes had a significant reaction or elevated intraocular pressure postoperatively. The follow-up ranged from 4 to 21 months. All the pseudophakic eyes achieved a best corrected visual acuity of >/= 20/200 with 50% [4/8] of these eyes with >/= 20/60 vision. Lens aspiration followed by posterior capsulotomy with Fugo blade-assisted plasma ablation is a feasible technique for performing successful lens surgery in cases with florid anterior PHPV

Terbinafine-induced taste impairment - report of two cases

Terbinafine is an oral antimycotic agent that belongs to the allylamine class. It was introduced in 1991 and is being widely used, both topically and systemically, to treat fungal infections. Nowadays oral terbinafine has become a commonly prescribed drug to treat finger- and toenail fungal infections because of relatively short duration of treatment compared to other oral antifungals like griseofulvin and fluconazole. The common side effects of this drug include nausea, abdominal pain, elevated transaminases and allergic reactions. Loss of taste sensation is a rare side effect occurring in patient taking oral form of this drug. PubMed search showed that very few cases of terbinafineinduced taste loss have been reported worldwide. We report a case series of two patients who complained of taste loss after taking terbinafine

Herpes zoster ophthalmicus: disease spectrum in young adults

To establish the clinical profile of herpes zoster ophthalmicus [HZO] in adults younger than 40 years and correlate the clinical manifestation with their immune status. A retrospective chart review was performed of patients younger than 40 years who presented with HZO. Data were collected on demographics, medical history, clinical presentation, results of serological investigations, and visual outcome. The study cohort comprised 18 subjects with a mean age of 29.7 +/- 6.2 years. Ophthalmic features included lid edema, ptosis, cicatricial lid deformities, sclerokeratitis, peripheral ulcerative keratitis, neuroparalytic keratitis, keratouveitis with concomitant glaucoma, secondary bacterial keratitis and superficial punctate keratitis with dry eye, optic neuritis, and trochlear nerve palsy. Eight of 18 [44.4%] subjects were found to be positive for Human Immunodeficiency Virus [HIV]. Disseminated herpetic lesions were seen present in 5 [63%] of these 8 subjects. Postherpetic neuralgia was noted in 6 [75%] of 8 HIV-positive subjects and in 1 HIV-negative patient. Final visual acuity was 20/40 or better in 90% of the immunocompetent subjects and 20/200 or worse in 100% of the HIV-positive subjects. Immunocompetent young adults do present with features of HZO. However, the disease spectrum in HIV-negative patients is localized, less severe, and more amenable to therapy as compared with young adults with HIV

Scrofuloderma and bilateral anterior staphyloma of eye: an unusual association

We report a patient with bilaterally symmetrical perforated corneal ulcers with formation of anterior staphyloma associated with scrofuloderma. A 22-year-old female in her third month postpartum presented with multiple perforated corneal ulcers bilaterally. There was a presence of a skin lesion that was consistent with scrofuloderma. Fine needle aspiration cytology of preauricular lymph nodes showed evidence of granulomatous inflammation consistent with tuberculosis. Corneal scraping revealed the presence of coagulase-negative Staphylococcus. She was treated with topical fortified combination antibiotics [cefazolin and tobramycin]. The corneal ulcer resolved with formation of anterior staphyloma in both eyes. The patient underwent anterior staphylectomy and tectonic keratoplasty in both eyes. Eight weeks postoperatively, her visual acuity improved to 20/200 in both eyes with clear grafts. Scrofuloderma may be associated with recurrent phlyctenulosis. Multiple corneal ulcerations coupled with use of topical steroids may result in corneal perforation and formation of anterior staphyloma