Corneal staining during cataract surgery: Natural course, ASOCT features, and preventive measures

We report the natural course of the accidental injection of trypan blue into the corneal stroma while performing a routine cataract surgery by a resident during a training session. The corneal staining resolved with conservative medical treatment over 7 weeks. This case describes the anterior segment optical coherence tomography (ASOCT) features of corneal staining. It emphasizes on the relatively benign nature of this dye and the follow-up course. Causes that may be responsible for this untoward complication are highlighted with the necessary preventive measures that need to be taken care are also discussed.

Endoilluminator-assisted pediatric cataract surgery with hazy cornea

The purpose of this study was to demonstrate the usefulness of endoilluminator in pediatric cataract with hazy corneas. We describe a series of three cases of pediatric cataract where visualization of intraocular structures was inadequate under the operating microscope. The endoilluminator was held at the limbus with light directed obliquely to visualize the details of intraocular structures against the hazy cornea using oblique illumination. It allowed structures behind the hazy cornea to be seen with ease. A simple modification in surgical procedure of pediatric cataract using an endoilluminator helps in better visualization of intraocular structures in difficult situations.

Small lens for a big eye: Successful management of anterior megalophthalmos

We report a case of anterior megalophthalmos and complicated cataract, with apparently smaller lens in both eyes. The right eye had spontaneous retinal detachment. The child underwent cataract surgery in both the eyes with retinal detachment surgery in the right eye. Due to small size of the lenticular bag, a downsized customized intraocular lens (IOL) was implanted. Postoperatively, the IOL was well centered with ambulatory vision till 3 years of follow-up. This case describes this rare disorder and its association with apparently small-sized lens and discusses the course of its management, highlighting the visual rehabilitation with customization of IOLs.

Technique of cultivating limbal derived corneal epithelium on human amniotic membrane for clinical transplantation.

BACKGROUND: The technique of transplantation of cultivated limbal epithelium rather than direct limbal tissue isa novel method of "cell therapy" involved in reconstructing the ocular surface in severe limbal stem cell deficiency [LSCD], caused by chemical burns. AIM: To describe a simple feeder-cell free technique of cultivating limbal epithelium on human amniotic membrane[HAM]. MATERIALS AND METHODS: The limbal tissues (2 mm) were harvested from patients with LSCD. These tissues were proliferated in vitro on HAM supplemented by human corneal epithelial cell medium and autologous serum. Cultures covering more > or = 50% area of 2.5 x 5 cm HAM were considered adequate for clinical use. The cultured epithelium was characterized by histopathology and immunophenotyping. RESULTS: A total of 542 cultures out of 250 limbal tissues were cultivated in the laboratory from January 2001 through July 2005. The culture explants showed that clusters of cells emerging from the edge of the explants in one-three days formed a complete monolayer within 10-14 days. In 86% of cultures (464 of 542), the growth was observed within one-two days. Successful explant cultures were observed in 98.5% (534 of 542 cultures) with 91% explant cultures showing an area of > or = 6.25 cm2 (6.25 - 12.5 cm2 range). The cultivated epithelium was terminated between 10-14 days for clinical transplantation. The problems encountered were inadequate growth (2 of 542) and contamination (2 of 542). CONCLUSIONS: We demonstrate a simple technique of generating a sheet of corneal epithelium from a limbal biopsy. This new technique could pave the way for a novel form of cell therapy.

Spontaneous onset corneoscleral hematic cyst.

Corneoscleral cysts are a rare entity. We report a case of spontaneous corneoscleral hematic cyst, which was treated by cyst excision and lamellar corneal patch graft. No recurrence of cyst was noticed during the 6 years of followup.