Caterpillar setae penetration in an eye: long-term follow-up.

PURPOSE: To report the results of 9 years of follow-up after caterpillar setae penetration into a child's eye. METHODS: The clinical course of caterpillar setae penetrating an eye and their migration will be described. Initially confined to the anterior segment (conjunctiva, cornea), they later migrated to the anterior chamber and iris toward the posterior pole. Management included treatment of the associated recurrent uveitis and repeated surgical interventions including pars plana vitrectomy. PATIENTS: Ten-year-old boy at the time of the initial eye injury. RESULTS: It was not possible to completely remove the caterpillar setae that had penetrated the conjunctiva and cornea. Later attempts to remove the setae from the anterior chamber and the vitreous by pars plana vitrectomy were also unsuccessful. Argon laser photocoagulation was performed around the setae, which later reached the retina, but did not prevent their further migration. CONCLUSION: Management of an eye injury caused by caterpillar setae is problematic because they are almost impossible to remove from eye tissue. Setae have a tendency to migrate in the eye. It requires long-term follow-up, conservative management of recurrent uveitis, as well as repeated surgical interventions.

Analysis of the capsule edge after Fugo plasma blade capsulotomy, continuous curvilinear capsulorhexis, and can-opener capsulotomy.

PURPOSE: To compare the quality of the edges of anterior capsulotomies performed in porcine eyes using 3 different techniques. SETTING: David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, Utah, USA. METHODS: Four porcine eyes were submitted to the center in 10% neutral buffered formalin. The cornea of the eyes had been removed, and a continuous capsulotomy had been performed in each eye using the Fugo plasma blade. To provide morphologic correlation, 4 additional porcine eyes were used in the study. In 2, a manual continuous curvilinear capsulorhexis (CCC) was performed after the cornea or cornea/iris was removed and in the other 2, a can-opener capsulotomy (COC) was performed. The eyes were then placed in 10% neutral buffered formalin. Gross (macroscopic) and microscopic analysis of each eye was performed, and photographs were taken. One eye in each group was also prepared and analyzed under scanning electron microscopy (SEM). RESULTS: The capsulotomy margin in the Fugo blade group presented some regularly spaced tags directed centrally with smooth edges at the base. Such a configuration would not interfere with the dynamics of the capsulorhexis sphincter and would generally not lead to radial tears. The smooth and regular nature of the capsulotomy margin in the CCC group was confirmed by gross and microscopic examinations of the eyes. The capsulotomy margin in the COC group presented some sharp notches directed outward, irregularly spaced, and irregular in shape. These are known to have a tendency to extend and form radial tears. CONCLUSION: Although performance of an anterior capsulotomy with the Fugo blade was associated with some margin irregularities, the geometry of the centrally directed tags prevented them from becoming the site of radial tear formation. The base of the capsulotomy performed with the Fugo blade appeared to be almost as smooth and regular as in the CCC under SEM evaluation.

Management of bipseudophakia with implantation of an iris claw lens.

We discuss a case of bipseudophakia with secondary dislocation of a posterior chamber intraocular lens (IOL) into the anterior chamber that was managed by explantation of the anterior and posterior chamber IOLs and implantation of an iris claw IOL.