The use of fibrin glue to seal Descemet membrane microperforations occurring during deep anterior lamellar keratoplasty.

PURPOSE: To report the use of fibrin glue to seal microperforations in Descemet membrane (DM) during deep anterior lamellar keratoplasty (DALK). METHODS: Two patients with keratoconus underwent DALK complicated by DM microperforation. Fibrin glue was successfully used to seal the microperforation in both cases. RESULTS: DM remained attached postoperatively in both cases, with no opacification, increased inflammation, or vascularization of the corneal stroma. CONCLUSIONS: The use of fibrin glue for managing microperforations in DALK may be a viable option.

Axis alignment and rotational stability after implantation of the toric implantable collamer lens for myopic astigmatism.

PURPOSE: To assess axis alignment and stability of the Toric Implantable Collamer Lens (TICL; STAAR Surgical Co) over time. METHODS: Thirty-five consecutive eyes of 19 patients received the TICL for treatment of myopic astigmatism. Manifest refraction spherical equivalent (MRSE) and manifest refractive cylinder were measured preoperatively and at 3 months postoperatively. The axis alignment of the TICL was measured using the internal OPD map obtained with the OPD-Scan II (NIDEK Co Ltd). RESULTS: Mean refractive cylinder was reduced from 2.80+/-1.45 diopters (D) preoperatively to 0.63+/-0.75 D at 3 months postoperatively; MRSE was -7.61+/-4.02 D preoperatively and -0.14+/-0.38 D at 3 months. Mean absolute value of the measured axis misalignment from baseline (day 1) to 1 month was 2.90+/-2.11 degrees and from 1 month to 3 months was 4.6+/-11.2 degrees. Mean absolute value of the measured changes in axis misalignment from baseline to 3 months was 2.68+/-2.11 degrees (after excluding one eye that required repositioning due to TICL rotation). At 3 months postoperatively, 96.8% (30/31) eyes had