One-movement insertion of the superior loop into the bag.

An efficient, simple technique for one-movement insertion of the superior intraocular lens loop into the capsular bag is described. This bimanual technique avoids undue stress on the capsular bag and zonules, may be used with all extracapsular techniques, and is suitable for almost all flexible loop intraocular lenses designed for in-the-bag implantation.

YAG laser treatment in a series of failed trabeculectomies.

YAG laser treatment was used in 22 consecutive cases of failed or failing trabeculectomy. Seven treatments were considered to be successful with a mean decrease in intraocular pressure of 9.8 mm Hg (6 to 13 mm Hg) over a mean follow-up period of 10.7 months (two to 18 months). In the successful cases the trabeculectomy was the first intraocular surgery that the eye had undergone and the average time from trabeculectomy to YAG laser treatment was relatively short, 6.7 weeks, compared to 1.1 years for the failures. The major complication was an increase in intraocular pressure of 4 mm Hg or more in nine (60%) of the failed cases two hours after laser treatment.

Use of a pulsed picosecond Nd: YAG laser in 6,664 cases.

We used a modulated picosecond Nd:YAG laser to perform preoperative anterior capsulotomies and posterior capsulotomies in eyes with and without an intraocular lens, and to cut a variety of cyclitic membranes, iridocapsular adhesions, and vitreous traction bands in more than 6,500 cases. The complications were transient bleeding when vascularized tissues were cut because the laser does not coagulate, temporary anterior chamber inflammation, and transient increased intraocular pressure. The last two were caused by released lens material and shock wave side effects.

Methylcellulose instead of Healon in extracapsular surgery with intraocular lens implantation.

Methylcellulose 1% was used in the anterior chamber to facilitate posterior chamber lens implantation at the time of extracapsular cataract extraction. In parallel series with similar preoperative endothelial cell counts, 70 eyes implanted under methylcellulose had a mean central endothelial cell loss of 8 +/- 5.3% at 8 to 12 weeks postoperative, whereas 63 eyes implanted under an air bubble lost a mean 25.3 +/- 14.6% (P less than 0.001). No differences in postoperative visual acuity, intraocular pressure, or inflammation were noted. A YAG laser preoperative anterior capsulotomy was used in all cases, and may have contributed to overall preservation of endothelial cells.

Reopening blocked trabeculectomy sites with the YAG laser.

After unsuccessful attempts to reduce the intraocular pressure of a 70-year-old man with advanced open-angle glaucoma by drugs, trabeculoplasty, and trabeculectomy, we used a mode-locked, pulsed picosecond neodymium YAG laser to cut away an opaque nonpigmented membrane that had occluded the trabeculectomy site. The intraocular pressure decreased immediately from 18 mm Hg to 5 mm Hg and a diffuse conjunctival bleb formed. One month later, the intraocular pressure was 11 mm Hg and the bleb was still present.

Cemento-ossifying fibroma of the ethmoidal sinus manifesting as proptosis.

We report an aggressive cemento-ossifying fibroma of the ethmoidal sinus that initially manifested as proptosis and was misdiagnosed as meningioma after a frozen section was tested. Fibroosseous lesions containing cementum are considered to be of periodontal membrane origin and are most common in the mandible and maxilla. With the exception of the gigantiform cementoma, they are usually small, innocuous lesions following a benign course and are easily removed surgically. On rare occasions, the cemento-ossifying fibroma attains a large size, behaves aggressively, destroys bone, and requires radical surgery for complete excision. Such behavior appears likely when is is located in unusual sites such as the ethmoidal sinus. To our knowledge, our case is the third report of a cemento-ossifying fibroma arising in the ethmoidal sinus. Aggressive behavior has been a feature in all three instances.

Corectopia with nystagmus, absent foveal reflexes and corneal changes.

A family is described with corectopia, nystagmus, absent foveal reflexes, and corneal changes inherited in an autosomal dominant pattern. Other abnormalities found in this family include microcornea, Bitot's spots, and iris colobomas. Faint superficial opacities and fine superficial vessels were found in the peripheral cornea of younger family members. Older family members showed an increase in the density of the superficial opacities and areas of stromal thinning were found in the 60-year-old proband. Corneal vessels and progression centrally. Full-thickness stromal opacities and changes have been associated with familial and sporadic aniridia and iris colobomas. The present report describes similar changes in association with corectopia.