Simultaneous bilateral cataract extraction.

PURPOSE: To evaluate the visual outcome and safety of simultaneous bilateral cataract extraction. SETTING: Stobhill Hospital NHS Trust, Glasgow, United Kingdom. METHODS: This retrospective case review comprised 259 consecutive patients (518 eyes) who had simultaneous bilateral cataract surgery. Surgeries included bilateral extracapsular procedures, uniocular extracapsular procedures performed simultaneously with a different type of intraocular lens surgery in the other eye, and 1 bilateral intracapsular procedure. Outcome measures were postoperative best spectacle-corrected visual acuity (BSCVA), intraoperative and postoperative complication rates, and conjunctival swab culture results. RESULTS: Eighty-three percent of patients (75% of eyes) with measured preoperative and postoperative BSCVA achieved an acuity of 6/12 or better. Intraoperative and postoperative complication rates were similar to those in previous reports of unilateral extracapsular surgery and simultaneous bilateral cataract surgery. Endophthalmitis occurred in 1 eye (0.19%). There were no bilateral complications that resulted in visual loss. Cultures were positive from 42% of conjunctival swabs; 81% of positive cultures were coagulase-negative Staphylococcus and 10% were Staphylococcus aureus. CONCLUSIONS: Simultaneous bilateral cataract surgery did not lead to an increased incidence of serious intraoperative or postoperative complications, and visual acuity results were good.

Neodymium: YAG laser discission of postoperative pupillary membrane: peripheral photodisruption.

Eight eyes in six consecutive Caucasian women who developed postoperative pupillary membrane in the visual axis were treated with a neodymium:YAG (Nd:YAG) laser using a peripheral quadrantic disruption technique. All patients had outpatient cataract extraction with or without trabeculectomy under local anesthesia. One patient had penetrating keratoplasty. In all cases, the pupillary membrane disappeared. Visual acuity improved to 6/6 except in two eyes, one in a patient with Down's syndrome, making it difficult to assess best corrected visual acuity, and the other in a patient with myopic macular changes. No significant complications occurred.

Autofluorescence in a patient with adult vitelliform degeneration.

The case of an 83 year-old woman is presented in whom bilateral vitelliform macular cysts were observed to fluoresce during the pre-injection phase of intravenous fluorescein angiography. This suggests that the vitelliform response is a non-specific event occurring in retinal pigment epithelial disease in which lipofuscin may or may not be manufactured.

Ultrastructural study of the corneal epithelium in the recurrent erosion syndrome.

BACKGROUND: This study describes the adhesion systems in the corneal epithelium in the recurrent erosion syndrome and the mechanisms by which binucleate and multinucleate cells are formed within the epithelium. METHODS: Twenty five samples of sliding epithelium were obtained from 23 patients and were examined by conventional light and transmission electron microscopy. RESULTS: The separation of the anchoring system occurred either below the level of the anchoring plaques or at the level of the epithelial cell membrane. Normal and degenerate polymorphonuclear leucocytes were found within and between the epithelial cells and within the anchoring layer. Binucleate and multinucleate cells were found within all the layers of the epithelium as were cysts containing degenerate cellular material. CONCLUSION: The presence of leucocytes and degenerate epithelial cells within the sliding epithelium suggests that these are the source of the metalloproteinases which cleave Bowman's layer below the anchoring system. The formation of binucleate and multinucleate giant cells does not appear to occur by fusion of adjacent cells, but rather by nuclear indentation and cleaving due to an abnormal microtubular system in the cytoskeleton.