Measurement Comparison of Anterior Segment Parameters between AL-Scan(R) and Pentacam(R)

PURPOSE: To investigate the clinical availability of AL-Scan(R) (Nidek, GAMAGORI, Japan) by comparing anterior segment parameters measured with AL-Scan(R) and Pentacam(R) (Oculus, Wetzlar, Germany). METHODS: Seventy-three patients (117 eyes) who received refractive surgery at our hospital were tested with AL-Scan(R) and Pentacam(R). We compared measurements including anterior chamber depth, central corneal thickness, white-to-white, and corneal curvature. RESULTS: When comparing measurements obtained with AL-Scan(R) and Pentacam(R), the anterior chamber depth (p < 0.001), central corneal thickness (p < 0.001) and 2.4 mm zone K value (p = 0.038) showed significant differences; the white-to-white (p = 0.348) and 3.3 mm zone K value (p = 0.429) showed no significant differences. All AL-Scan(R) and Pentacam(R) parameters had a strong positive linear correlation (p < 0.001). The Bland-Altman plots showed a high degree of agreement between AL-Scan(R) and Pentacam(R) in all parameters except for anterior chamber depth. CONCLUSIONS: AL-Scan(R) is convenient to use clinically because simultaneous measurements of ocular biometry including axial length, intraocular lens power, and topography are possible. However, because differences in some anterior segment parameters exist when compared with Pentacam(R), measurements with AL-Scan(R) may require comparisons with other instruments.

A Case of Dexamethasone Intravitreal Implant Fragmentation During the Injection Procedure in Central Retinal Vein Occlusion

PURPOSE: We report a case of dexamethasone intravitreal implant (Ozurdex(R); Allergan, Inc.) fragmentation during the injection procedure in macular edema due to central retinal vein occlusion. CASE SUMMARY: A 57-year-old man visited our hospital for visual disturbance in his right eye. The patient's best-corrected visual acuity was 0.02 in the right eye and 1.2 in the left eye. After fundus examination, the patient was diagnosed with central retinal vein occlusion with macular edema, thus bevacizumab was injected in the right eye. However, the macular edema did not improve, and a dexamethasone intravitreal implant was injected in the right eye. Immediately after the dexamethasone intravitreal implant injection, on fundus exam, the drug was observed to be fragmented into 3 pieces without any additional treatment. After 2 months, the patient's best-corrected visual acuity was 0.4 in the right eye and 1.2 in the left eye. Macular edema decreased according to optical coherence tomography. CONCLUSIONS: A case of dexamethasone intravitreal implant fragmentation during an injection procedure has not been previously reported in Korea. Although the drug fragmented, the treatment was effective without complications.

A Case of Bilateral Septic Cavernous Sinus Thrombosis after Facial Trauma

PURPOSE: We report a case of a patient with ptosis, lid swelling, limitation of ocular movement, and visual disturbance after a trauma. The patient was diagnosed with unilateral orbital cellulitis, ophthalmic vein thrombosis and bilateral septic cavernous thrombosis and treated. CASE SUMMARY: After head and facial area trauma that occurred 1 month earlier, a 56-year-old man suffered from ongoing visual loss, limitation of ocular movement in all directions, proptosis in the left eye and abduction limitation of the right eye. A week before admission, mild fever and chills were also present. At admission, visual acuity of the left eye was no light perception and pupil reflex was lost. Brain MRA and MRI indicated dilation and thrombosis of the left superior ophthalmic vein, left orbital cellulitis and inflammation in bilateral cavernous sinuses. The patient was immediately treated with systemic antibiotics and steroid injection. Coagulase negative staphylococci were detected in blood culture. CONCLUSIONS: Infection caused by facial trauma spread through the facial area's venous plexus and caused orbital cellulitis. As a result, septic cavernous sinus thrombosis and ophthalmic vein thrombophlebitis occurred. Serious complications can occur after facial trauma, thus rapid differential diagnosis and appropriate treatment are important in determining prognosis.