Plateau iris in Asian subjects with primary angle closure glaucoma.

OBJECTIVE: To determine the prevalence of plateau iris in Asian eyes with primary angle closure glaucoma (PACG) using ultrasound biomicroscopy (UBM). METHODS: In this cross-sectional observational study, subjects older than 40 years with PACG who had a patent laser peripheral iridotomy underwent UBM in 1 eye. Ultrasound biomicroscopy images were qualitatively analyzed using standardized criteria. Plateau iris in a quadrant was defined by anteriorly directed ciliary body, absent ciliary sulcus, steep iris root from its point of insertion followed by a downward angulation, flat iris plane, and irido-angle contact. At least 2 quadrants had to fulfill these UBM criteria for an eye to be classified as having plateau iris. RESULTS: One hundred eleven subjects (70 from Singapore, 41 from Thailand) with PACG were recruited. The mean (SD) age was 65.6 (8.1) years, and 63.9% were female. Based on standardized UBM criteria, plateau iris was found in 36 of 111 eyes (32.4%; 95% confidence interval, 24.4%-41.6%). In these 36 eyes, quadrant-wise analysis showed 66.7% had plateau iris in 2 quadrants; 22.2%, in 3 quadrants; and 11.1%, in all quadrants. CONCLUSIONS: About 30% of PACG eyes with a patent laser peripheral iridotomy were found to have plateau iris on UBM, highlighting the importance of non-pupil block mechanisms in Asian individuals.

The results of amniotic membrane transplantation for symptomatic bullous keratopathy.

OBJECTIVES: To evaluate the outcomes of amniotic membrane transplantation for symptomatic relief in patients with bullous keratopathy. MATERIAL AND METHOD: This retrospective study included 17 eyes (17 patients) with bullous keratopathy presenting with intractable pain or discomfort. The patients were enrolled from January 2000 to December 2004. Amniotic membrane transplantation was performed. Symptomatic relief epithelial healing, and visual changes were analyzed. RESULTS: During the follow up period of 14.1 +/- 11.9 months (range 1-36 months) after amniotic membrane transplantation, 14 eyes of 17 eyes (82.4%) with intolerable pain preoperatively had pain relief postoperatively. Corneal epithelial healing was complete in all except 2 eyes one of which had evisceration because of severe corneal ulcer, and the other underwent penetrating keratoplasty soon after amniotic membrane transplantation. CONCLUSION: Amniotic membrane transplantation is a safe and effective treatment modality for pain relief associated with chronic bullous keratopathy. It can be an alternative to conjunctival flap, with better cosmetic appearance for the management of patients with bullous keratopathy.

Isolated corneal intraepithelial neoplasia.

OBJECTIVES: To report two cases of isolated corneal intraepithelial neoplasia. MATERIAL AND METHOD: The present study included 2 cases presenting with isolated corneal intraepithelial neoplasia. Both patients were treated by corneal epithelial scraping. RESULTS: The authors present the clinical picture and histopathological findings of 2 patients suffering from corneal intraepithelial neoplasia that did not arise from the corneoscleral limbus. Both patients showed no recurrence after treatment for a period of time. CONCLUSION: Isolated corneal intraepithelial neoplasia is rare. Corneal scraping may be an effective treatment.