Australasian ophthalmology: trans-Tasman ties.

Links between Australian and New Zealand ophthalmology began with peripatetic surgeons who worked in both countries. Links continued with the Intercolonial Medical Congresses which began in 1887. Ophthalmologists from both countries were involved in the founding of the Royal Australian College of Surgeons in 1927. There were combined meetings of the Ophthalmological Societies of Australia and New Zealand from 1962. Common training and qualification programs evolved. The culmination of ties occurred in 1997 when the Ophthalmological Society of New Zealand merged with the Royal Australian College of Ophthalmologists to form the Royal Australian and New Zealand College of Ophthalmologists.

Presumed late diffuse lamellar keratitis progressing to interface fluid syndrome.

We report an unusual case of presumed late-onset unilateral diffuse lamellar keratitis of uncertain etiology in a 23-year-old man who presented with elevated intraocular pressure following uneventful laser in situ keratomileusis (LASIK). After treatment with topical corticosteroid therapy, the condition progressed to interface fluid syndrome. Isolated pockets of fluid were clearly demonstrated at the level of the LASIK flap interface on slitlamp biomicroscopy and in Pentacam Scheimpflug images.

Assessing the accuracy of Orbscan II post-LASIK: apparent keratectasia is paradoxically associated with anterior chamber depth reduction in successful procedures.

PURPOSE: To establish a relationship between the forward protrusion of the cornea (keratectasia), following successful LASIK, and anterior chamber depth. METHODS: One hundred and fifteen eyes of 59 patients who had undergone Zyoptix LASIK and 39 eyes of 21 patients who had undergone PlanoScan LASIK at the Eye Institute, Centre for Refractive Surgery, Remuera, Auckland, New Zealand, were included in the study. The results of Orbscan II acquisitions, taken before and 8.3 weeks +/- 4.0 (mean +/- standard deviation) following the procedure, were analysed to determine the amount of forward protrusion of the central 2 mm diameter of the posterior surface. The apparent keratectasia was then related to the Orbscan II anterior chamber depth (ACD) measurement in a linear mixed model analysis that included 'right or left eye', 'sex', 'type of LASIK procedure', 'change in pachymetry', 'postoperative pachymetry', 'change in anterior corneal curvature', 'postoperative anterior corneal curvature', 'planned ablation depth' and 'time until follow-up' as factors and covariates. RESULTS: The mean +/- SD amount of keratectasia determined by Orbscan II was 22.8 +/- 26.8 microm for the Zyoptix group and 16.9 +/- 24.6 microm for the PlanoScan group. The reduction in depth of the anterior chamber was 14.7 +/- 79.3 microm for the Zyoptix group and 18.2 +/- 68.8 microm for the PlanoScan group. The mixed model analysis demonstrated strong relationships with postoperative pachymetry and change in anterior corneal curvature (P < 0.001 and P < 0.001, respectively). Furthermore, the statistical model showed a marked significant difference in the Orbscan II assessment of keratectasia and change in ACD (P < 0.001). CONCLUSION: Using the Orbscan II device, the forward protrusion of the posterior corneal surface appears to coincide with a paradoxical reduction in depth of the anterior chamber. Although the keratectasia found in this study is accompanied by thin postoperative corneas and larger central pachymetry change, the contradictory decrease in anterior chamber depth creates uncertainty of measurement, and of ectasia as a mechanism of regression.