Acute unilateral leukemic hypopyon in an adult with relapsing acute lymphoblastic leukemia.

PURPOSE: To report acute unilateral hypopyon uveitis as an initial presenting feature of relapsing acute lymphoblastic leukemia (ALL) in an adult patient. DESIGN: Observational case report. METHODS: Anterior chamber paracentesis was performed in a 56-year-old male presenting with treatment-resistant unilateral hypopyon while in the remission phase of ALL. RESULTS: Examination of the aqueous humor aspirate revealed presence of malignant cells compatible with the previous bone marrow biopsy and subsequent spinal tap results. CONCLUSIONS: Atypical hypopyon uveitis can be an indication of relapsing ALL, even in adults. Prompt anterior chamber aspiration is required for the correct diagnosis and subsequent treatment.

Phacoemulsification with indocyanine green versus manual expression extracapsular cataract extraction for advanced cataract.

PURPOSE: To compare the outcomes of indocyanine green dye (ICG)-assisted phacoemulsification with manual expression extracapsular cataract extraction (ECCE) in eyes with advanced cataract. SETTING: Parkland Memorial Hospital and Dallas Veterans Affairs Medical Center, Dallas, Texas, USA. METHODS: In this retrospective study, 72 consecutive cases of advanced or mature cataract extractions performed in a 1-year period were reviewed. Fifty-nine eyes met the inclusion and exclusion criteria; 33 had ICG-assisted phacoemulsification and 26, manual expression ECCE. Preoperative and intraoperative findings and the postoperative outcomes up to 6 months were analyzed. RESULTS: Intraoperative complications included posterior capsule tear with vitreous prolapse in 2 eyes (6.6%) and conversion to manual expression ECCE in 1 eye (3.3%) in the ICG phacoemulsification group. There was no intraoperative complication in the manual expression ECCE group. There were significantly more patients with a best corrected visual acuity of 20/30 or better in the ICG phacoemulsification group than in the manual expression ECCE group at all postoperative periods. The mean logMAR visual acuities were significantly better in the ICG phacoemulsification group at all postoperative intervals. The ICG phacoemulsification group had significantly less postoperative astigmatism. There was no significant difference between the groups in the early postoperative intraocular pressure. CONCLUSIONS: Phacoemulsification with ICG led to better postoperative visual acuity and less postoperative astigmatism than manual expression ECCE. Phacoemulsification with ICG was associated with more intraoperative complications than manual expression ECCE; however, the complication rate is comparable to a previously published rate for phacoemulsification performed in a university training program. Phacoemulsification with ICG appears to be a reasonable alternative to manual expression ECCE for advanced cataract.

Corneal edema after cataract surgery: incidence and etiology.

Corneal edema from inadequate endothelial pump function is one of the most common complications of cataract surgery. Various causes for this endothelial dysfunction can be divided into four categories including (a). mechanical injury, (b). inflammation/infection, (c). chemical injury, and (d). concurrent eye disease. This review serves as a basis for the diagnosis and treatment of this complication.