Autoimmune keratitis in mycobacterium tuberculosis.

PURPOSE: To report a case of autoimmune keratitis in a patient with mycobacterium tuberculosis (MBT). METHODS: An 84-year-old male with pulmonary tuberculosis (TB) was admitted with chronic, non-healing bilateral ulcerations of the inferior peripheral cornea associated with stromal and subconjunctival nodules. RESULTS: Clinical examination revealed circumscribed peripheral corneal ulceration with whitish nodules in adjacent stromal and subconjunctival tissue. Microbiological cultures of the corneal tissue were negative for MBT and other microbial pathogens; however, enzyme-linked immunosorbent assay (ELISA) of blood and corneal samples showed significantly elevated levels of IgM and IgA against MBT. In addition to systemic anti-tuberculosis therapy, the patient was treated topically with Polyspectran® eye drops, Dexamethasone eye drops, and Bepanthen® ointment, for 2 weeks. Both eyes showed dramatic improvement after 2 weeks. CONCLUSION: The present report demonstrates that MBT is able to initiate delayed autoimmune response within the corneal tissue during an intensive phase of anti-tuberculosis treatment.

Management of Interface Fluid Syndrome After LASIK by Descemet Membrane Endothelial Keratoplasty in a Patient With Fuchs' Corneal Endothelial Dystrophy.

PURPOSE: To report a case of interface fluid syndrome after LASIK in a patient with Fuchs' corneal endothelial dystrophy treated with Descemet membrane endothelial keratoplasty (DMEK). METHODS: Case report. RESULTS: A 74-year-old patient presented with interface fluid syndrome and was treated with DMEK. Its complications in the form of partial graft detachment and cystoid macular edema were successfully managed by rebubbling and topical treatment, respectively. The treatment led to amelioration of both visual acuity and patient satisfaction. At the examination 6 months after DMEK, the cornea was clear and corrected distance visual acuity improved to a satisfactory level. CONCLUSIONS: Interface fluid syndrome can develop many years after LASIK as a result of corneal endothelial decompensation and can be effectively treated with DMEK. Close postoperative monitoring of patients is paramount to intervene therapeutically in case of transplant detachment or development of cystoid macular edema requiring further surgical or conservative management. [J Refract Surg. 2017;33(5):347-350.].

The efficacy of photodynamic therapy in treatment of recurrent squamous cell and basal cell carcinoma.

OBJECTIVES: A number of investigations have already been carried out to assess the effect of photodynamic therapy (PDT) on primary basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) lesions, but lack of investigations on recurrent lesions or lesions with treatment failure, prompted the authors to carry out this study. The aim of the present study was to evaluate the efficacy of photodynamic therapy on recurrent BCC and SCC lesions on head and neck skin. PATIENTS AND METHODS: A total of 30 patients, including 16 men and 14 women, were selected from patients with recurrent SCC and BCC who referred to Iran university ENT research center Rasool-e-Akram Hospital, Tehran-Iran, met the criteria and entered the study. This is a longitudinal study of 30 patients with 43 histologically verified head and neck skin tumors, candidate for photodynamic therapy. RESULTS: To cite the results obtained in this study, it is worth mention that five cases expressed disagreement with this treatment modality after the first session of illumination; the treatment was stopped because of pain or burning. In a three-month evaluation, complete treatment response rates were obtained in 72% of patients (18 cases); in SCC cases it was 71.4% (10 cases) and in BCC it was 72.7% (eight cases). The final result of complete response rate in three years of follow up, demonstrated that 16 (64%) patients out of 25 were disease-free from recurrent BCC and SCC (Table 1). In BCC cases the final three-year response rate was seven (63.6%) and in SCC cases it was nine (64.2%). Hence, there was no statistical difference between SCC and BCC cases to treatment (P = 0.34). DISCUSSION: The obtained data from the current study is supportive of the recommended treatment method of PDT as an effective, tolerable and less invasive treatment in patients with recurrent BCC and SCC carcinomas, particularly when cosmetic effects are an important consideration. However, more research is needed to establish this.