Endothelial Cell Loss Following Cataract Surgery Using Continuous Curvilinear Capsulorhexis or Precision Pulse Capsulotomy.

Purpose: To compare endothelial cell density (ECD), percentage of hexagonal cells (%Hex) and coefficient of variation (CV) in cell size following lens cataract surgery with phacoemulsification performed using Continuous Curvilinear Capsulorhexis (CCC) or Precision Pulse Capsulotomy (PPC). Patients and Methods: Sixty-seven subjects were randomly assigned to undergo lens cataract removal with the capsulotomy step performed using either CCC or PPC. Specular microscopy images were obtained pre-operatively, 1 month and 3 months after surgery. ECD, %Hex and CV were analyzed in a masked fashion by an independent reading center. Results: The mean percentage ECD loss at 1 month was 11.5% in the CCC group and 12.3% in the PPC group (P = 0.818; t-test). At 3 months, the mean percentage ECD loss was 11.7% in the CCC group and 12.4% in the PPC group (P = 0.815; t-test). The mean %Hex at 1 month was 54.3% in the CCC group and 54.7% in the PPC group (P = 0.695; t-test). At 3 months, the mean %Hex was 56.2% in the CCC group and 54.7% in the PPC group (P = 0.278; t-test). The CV at 1 month was 34.4% in the CCC group and 34.3% in the PPC group (P = 0.927; t-test). At 3 months, the CV was 32.7% in the CCC group and 33.4% in the PPC group (P = 0.864; t-test). Conclusion: No differences in ECD loss, %Hex and CV were observed between patients who received CCC or PPC. PPC use during cataract surgery does not result in any increased endothelial cell loss beyond that normally associated with this surgery.

Xylene keratopathy: a case report and review of the literature.

PURPOSE: To report a case of direct contact xylene-related vacuolar keratopathy. METHODS: Interventional case report and review of the literature. RESULTS: Xylene keratopathy is a distinct clinical entity characterized by significantly decreased visual acuity, increased corneal thickness, and the presence of corneal epithelial and stromal vacuoles on a diffuse gray stromal background. The vacuoles are diffusely scattered, subtle, and clear on slit-lamp examination. Occasionally, white, round, denser areas can also be observed. Xylene keratopathy disappeared gradually over 4 weeks with topical steroid treatment and did not cause permanent sequelae. CONCLUSIONS: Xylene exposure should be considered as possible etiologic agent of vacuolar epithelial and stromal keratopathy. Exposure may occur directly as a splash of liquid or through its vapors.

Comparison of scotopic pupil measurement with slitlamp-based cobalt blue light and infrared video-based system.

PURPOSE: To determine the accuracy and reproducibility of scotopic pupil measurements with a slitlamp-based cobalt blue light. SETTING: University of Texas Health Science Center-San Antonio, San Antonio, Texas, USA. METHODS: In a prospective experimental study, 2 independent observers measured 16 subjects' pupils with a standard slitlamp-based cobalt blue light. In the same setting, the accuracy and reproducibility of the measurements were compared with those obtained with an infrared video-based system. RESULTS: Measurements of pupil size using the infrared video-computer system were highly reproducible. With the slitlamp-based cobalt blue light, the 2 measurements obtained by observer 2 (n = 16) were very close to each other (mean difference 0.09 mm +/- 0.23 [SD]; P =.12), whereas those obtained by observer 1 (n = 16) were slightly different from each other (mean difference 0.18 +/- 0.33 mm; P =.043). The mean pupil diameter measured with cobalt blue light was not significantly different between the 2 observers (P >.05), and the measurements were highly correlated with each other (r = 0.96, P <.01). The mean difference between the measurements using cobalt blue light and the infrared video-computer system was 0.21 +/- 0.54 mm for observer 1 (P =.47) and 0.06 +/- 0.47 mm for observer 2 (P =.85). Good correlation was noted between the measurements taken from each measuring device for both observers (r = 0.87 and 0.90, P <.01). CONCLUSIONS: Slitlamp-based cobalt blue light provided a reasonably good measurement of scotopic pupil size. It correlated well with the infrared video system when used at the lowest setting by experienced personnel. However, the observed difference between the measurements obtained by the 2 devices indicates that the cobalt blue light should be used cautiously in the refractive surgery preoperative evaluation of patients with large pupils.

Positive polymerase chain reaction and histology with borderline serology in Parinaud's oculoglandular syndrome.

PURPOSE: To report a case of Parinaud's oculoglandular syndrome (POS) in which, despite a borderline serology, polymerase chain reaction (PCR) testing for a conjunctival biopsy was positive for Bartonella henselae, a source of cat-scratch disease. A Steiner silver stain demonstrated the organism. METHODS: Case Report. RESULTS: A 65-year-old man was seen for a foreign body in his left eye (OS) associated with chemosis and a preauricular node. CONCLUSION: B. henselae is a known cause of POS. This gram-negative pleomorphic rod has been more frequently discovered in connection with this syndrome due to improved diagnostic testing such as indirect immunofluorescence antibody and PCR testing. Frequently, serology is positive if the organism is present. This report describes a patient with clinical findings of POS who, despite borderline serology, had pleomorphic rods on Steiner silver stain and positive PCR testing compatible with Bartonella henselae.