Efficacy of Retrobulbar Filler Injections for Correcting Enophthalmos Associated with Phthisis Bulbi or Anophthalmos

Purpose@#To describe the clinical outcome of retrobulbar injection of synthetic fillers to correct enophthalmos associated with phthisis bulbi or anophthalmos. @*Methods@#We retrospectively reviewed the medical records of patients who underwent enophthalmos correction using retrobulbar filler injections at Asan Medical Center between January 2015 and October 2019, and who were followed for at least 6 months. We evaluated the number of injections and amount of filler injected, improvement in enophthalmos, interval between injections, and adverse effects of filler injection. @*Results@#The study enrolled five patients (four females and one male). Two patients had anophthalmos after evisceration and three had phthisis bulbi. Two patients received hyaluronic acid (HA) filler only, one had collagen-polymethylmethacrylate (PMMA) filler only, and two had both fillers. The HA and collagen-PMMA filler volumes per injection were 1.0–1.4 and 0.75–1.0 mL, respectively. The average degree of enophthalmos, compared to the contralateral eye, was 1.8 mm; the amount of enophthalmos correction per 1 mL of filler injection was 1.5 mm for HA filler and 1.4 mm for collagen-PMMA filler. The longest duration of enophthalmos correction was 15 months for HA filler and 25 months for collagen-PMMA filler. There were no significant adverse effects, but anterior migration of HA filler was observed in one case that resolved with hyaluronidase injection. @*Conclusions@#Retrobulbar filler injection is a safe, effective, minimally invasive procedure for correcting enophthalmos in patients with anophthalmos or phthisis bulbi. If HA filler injection shows good outcomes without adverse effects, semi-permanent fillers can be used for long-term maintenance of enophthalmos correction. Further studies with more patients and long-term follow-up are needed to compare the effectiveness of various fillers.

Comparison of Long-Term Clinical Results after Implantation of Hydrophilic and Hydrophobic Acrylic Intraocular Lens

PURPOSE: To assess long-term clinical outcomes and factors influencing refractive change after implantation of hydrophilic (Akreos AO) and hydrophobic (Acrysof IQ) acrylic intraocular lens. METHODS: After phacoemulsification, intraocular lens was inserted in the bag (Akreos AO for 84 eyes and Acrysof IQ for 19 eyes). Uncorrected visual acuities (UCVA), refraction in both spherical equivalent (SE) and astigmatism were compared longitudinally in more than 2 years follow-up. Factors associated with SE change > or =0.5 diopter (D) after Akreos AO implantation were analyzed with logistic regression. RESULTS: Although Akreos AO showed hyperopic change mainly within 6 months, UCVA and astigmatism change were not statistically significant during follow up (+0.15 +/- 0.43 D, p = 0.027). UCVA, SE, astigmatism were not changed after Acrysof IQ implantation and not significantly different between two groups during follow up. Preoperative anterior chamber depth was a sole factor associated with SE change > or =0.5 D after Akreos AO implantation (p = 0.006). CONCLUSIONS: Possible hyperopic shift after Akreos AO implantation should be considered in setting target diopter, especially in eye with shallow anterior chamber.

Amniotic Membrane Transplantation for Repair of a Large Intraoperative Conjunctival Defect during Trabeculectomy

No abstract available.

Clinicopathological Report of Squamous Cell Carcinoma of Conjunctiva and Cornea in a Patient with AIDS

PURPOSE: To describe the clinical and histopathological findings of corneal and conjunctival squamous cell carcinoma (SCC) in a patient with acquired immune deficiency syndrome (AIDS). CASE SUMMARY: A 45-year-old Korean male who had been diagnosed of AIDS 20 years before presented with vascularized mass in the inferotemporal conjunctiva and in the cornea. The patient underwent an en bloc excisional biopsy of the mass, application of mitomycin C, and repeated cycles of freeze-thaw. Histopathology revealed dysplastic squamous epithelium in the full thickness of epithelial layer. Immunohistochemical staining for proliferation markers showed that the tumor had a high proliferation index: Ki-67 was positive throughout the full epithelial layer, and both p53 and p16 were positive. The patient had an adjuvant chemotherapy with topical interferon alpha 2b (IFNalpha 2b) for 8 months after surgery. CONCLUSIONS: Given the high proliferation index of the tumor in this patient, close observation and combined adjuvant chemotherapy will be required to prevent recurrence in a patient with AIDS.