Intraocular pressure after implantation of the Visian Implantable Collamer Lens With CentraFLOW without iridotomy.

PURPOSE: To compare the intraocular pressure (IOP) values during a 3-month period after implantation of the new Visian Implantable Collamer Lens (ICL; STAAR Surgical Company, Nidau, Switzerland) V4c design with CentraFLOW technology without iridotomy using a standard procedure followed by implantation of the conventional ICL V4b model. DESIGN: Retrospective cohort study. METHODS: This study included 17 eyes implanted with the ICL V4b model and 18 eyes implanted with the ICL V4c model. The mean preoperative spherical equivalent refractions were -7.48 ± 5.00 diopters and -8.66 ± 4.2 diopters, respectively. We compared the best-corrected distance visual acuity before surgery with the uncorrected distance visual acuity after surgery. The intraocular pressure (IOP) was measured 1 week, 1 month, and 3 months after surgery. The central vault at 3 months was measured using optical coherence tomography. RESULTS: Three months after surgery, the mean uncorrected distance visual acuities were -0.09 ± 0.12 logarithm of the minimal angle of resolution units with the V4b and -0.07 ± 0.11 logarithm of the minimal angle of resolution units with the V4c. The mean distances between the ICL and the anterior crystalline lens surface were 557 ± 224 µm and 528 ± 268 µm for the V4b and V4c, respectively (P = .73). After 1 week and 1 month, the mean IOPs were 13.7 and 13.3 mm Hg and 14.7 and 15.1 mm Hg, respectively. There were no significant differences in IOP within or between groups during the follow-up period (P > .05, for all comparisons). CONCLUSIONS: The new ICL with the CentraFLOW design seems to provide similar results as its predecessors for the correction of moderate to high myopia and maintenance of safe IOP levels without iridotomy.

Late-onset Candida keratitis after Descemet stripping automated endothelial keratoplasty: clinical and confocal microscopic report.

PURPOSE: To report clinical and confocal microscopy features of late-onset Candida albicans keratitis after Descemet stripping automated keratoplasty (DSAEK). METHODS: We performed clinical and confocal scan on a patient who underwent DSAEK and phacoemulsification for Fuchs endothelial dystrophy and cataract. RESULTS: A 76-year-old woman who underwent uneventful DSAEK and phacoemulsification presented with white to cream deposits 3 months after DSAEK. Confocal microscopy showed a hyperintense deposit at the lenticule and interface. Confocal scan also disclosed intense haze and inflammation at the interface and clusters of hyperreflective round structures resembling epithelial cells within the interface area. No signs of hyphae-like structures were seen. Late-onset symptoms misled us into a bacterial chronic endophthalmitis diagnosis, and the patient was started on topical and systemic antibiotics. Despite intense antibiotic therapy, the patient developed severe endophthalmitis, so we performed anterior vitrectomy and the donor lenticule was removed. Microbiology results from the removed lenticule showed infection by C albicans. Antifungal therapy with systemic and topical voriconazole controlled the infection. CONCLUSIONS: Candida interface keratitis is possible after DSAEK. The posterior location of infected tissue poses diagnostic and therapeutic challenges. In our case, the late onset of the symptoms and not performing corneoscleral rim cultures delayed correct diagnosis. This is the first reported case of post-DSAEK Candida keratitis with confocal microscopy images. A hyperintense granular deposit was seen at the lenticule and interface with confocal microscopy. We also observed intense haze, granular round structures resembling epithelial cells, and hyperreflective needle-shaped material at the interface. No hyphae-like structures were seen with confocal imaging.