Scleral burn and perforation following transscleral cyclophotocoagulation.

Purpose: This case report highlights scleral perforation as a complication of diode laser transscleral cyclophotocoagulation in the treatment of refractory primary open-angle glaucoma, as well as the management of this complication. Observations: A 78-year-old woman with primary open-angle glaucoma refractory to medication had transscleral cyclophotocoagulation performed in her left eye. During the procedure, it was noted that conjunctival burns and scleral perforation had occurred, at which point the procedure was aborted. Limited peritomy and patch graft with split-thickness donor cornea was done in the area of the scleral thinning and perforation. The patient had a good outcome with an intraocular pressure of 8 mm Hg, appropriate integration of the patch graft, and no significant conjunctival inflammation at the 2-month post-operative visit. Conclusions and importance: This patient, without any known risk factors for scleral thinning or necrosis, experienced conjunctival burn as well as scleral perforation during transscleral cyclophotocoagulation, underscoring this possible complication of the procedure. Additionally, split-thickness donor cornea was used to patch graft the area of scleral thinning and perforation, which is a method of managing this complication that had not been previously reported.

Emergence of ocular toxicities associated with novel anticancer therapeutics: What the oncologist needs to know.

As cancer treatment evolves in the era of precision oncology, molecularly targeted agents (MTAs) have become frontline therapy for many cancers. MTAs are biologically targeted and thought to have less off-target toxicity; however, the eye is particularly susceptible to off-target toxicities given its unique microenvironment. In this review, we present commonly used FDA-approved MTAs, any associated ocular toxicities and review the mechanisms, frequency, severity, and management. Increased awareness and communication between clinicians caring for cancer patients is needed for individualized risk assessment, earlier diagnosis, and mitigation of ocular toxicities.

Running Mechanics and Metabolic Responses With Water Bottles and Bottle Belt Holders.

PURPOSE: To determine whether differential kinematics, kinetics, rates of energy use, and cardiopulmonary responses occur during running with water bottles and bottle belt holders compared with running only. METHODS: Trained runners (N = 42; age 27.2 [6.4] y) ran on an instrumented treadmill for 4 conditions in a randomized order: control run (CON), handheld full water bottle (FULL; 16.9 fluid oz; 454 g), handheld half-full water bottle (HALF; 8.4 fluid oz; 227 g), and waist-worn bottle belt holder (BELT; hydration belt; 676 g). Gas exchange was measured using a portable gas analyzer. Kinetic and kinematic responses were determined by standard 3-dimensional videographic techniques. Interactions of limb side (right and left) by study condition (CON, FULL, HALF, and BELT) were tested for rates of oxygen use and energy expenditure and kinematic and kinetic parameters. RESULTS: No significant limb-side × condition interactions existed for rates of oxygen use or energy expenditure. A significant interaction occurred with sagittal elbow flexion (P < .001). Transverse pelvic-rotation excursions differed on average 3.8° across conditions. The minimum sagittal hip-flexion moment was higher in the right leg in the HALF and BELT conditions compared with CON (P < .001). CONCLUSIONS: Carrying water by hand or on the waist does not significantly change the kinematics of running motion, rates of oxygen use and energy expenditure, or cardiopulmonary measures over short durations. Runners likely make adjustments to joint moments and powers that preserve balance and protect the lower-extremity joints while maintaining rates of oxygen use and energy expenditure.