Light-scattering characteristics of explanted opacified Aquasense intraocular lenses.

AIM: To study forward light-scattering characteristics of calcified explanted intraocular lenses (IOLs) (Aquasense, Ophthalmic Innovation International Ontario). METHODS: The amount of light scattered by the opacified IOLs was measured using a validated in vitro set-up for angles from 1.7 degrees to 22 degrees . This set-up gives results directly comparable with straylight values as valid for the in vivo situation. RESULTS: Straylight is highest at large angles and declines steeply approaching 0 degrees angle. This corresponds to the in vivo findings that opacified IOLs cause important visual complaints but have little effect on visual acuity. At 7.5 degrees , log (s) is around 1.8 and 2.9 for the two lenses respectively. This corresponds to 8 x and 100 x increases in straylight values compared with values in young, normal eyes. CONCLUSION: High straylight values caused by opacified IOLs can explain subjective complaints of reduced quality of vision in patients with opacified implants, despite good visual acuity.

[The practice guideline 'The red eye' (first revision) of the Dutch College of General Practitioners; a response from the perspective ofthe ophthalmologist]. / De standaard 'Het rode oog' (eerste herziening) van het Nederlands Huisartsen Genootschap; reactie vanuit de oogheelkunde.

The revised guideline 'The red eye' of the Dutch College of General Practitioners contains adequate and scientifically well-supported recommendations for the diagnosis and management of patients with minor ocular trauma and red eyes. Unfortunately the guideline lacks a roadmap for implementation of these recommendations, as well as a definition of indicators for the measurement of implementation. This is important in the light of the limited implementation of the previous guideline 'The red eye' published in 1996.

[Corneal melting after ocular surgery in patients with auto-immune disorders]. / Immuunstromale corneale ulceratie na een oogoperatie bij patiënten met collageen-vasculaire auto-immuunaandoeningen.

Two women aged 78 and 74 years respectively, both with dry eyes due to underlying auto-immune disorders, presented after uncomplicated cataract surgery with immunostromal corneal ulceration. Intensive topical lubrication combined with systemic immunosuppressants were necessary to control the corneal melt. Dry eyes are a frequently-encountered problem among patients with rheumatoid disorders and increase the risk of corneal melting. Auto-immune related corneal melting can occur spontaneously or after ocular surgery, it threatens visual acuity and ocular integrity and may be associated with systemic vasculitis. When treating patients with rheumatoid disorders, the presence of dry eyes and the accompanying risk of serious complications need to be ascertained. In patients at risk, pre-operative preventive measures to suppress any underlying systemic disorders and improve the ocular environment are necessary. When corneal melting is diagnosed, aggressive topical therapy combined with systemic immunosuppressants is indicated.

A successful alternative: repair of a penetrating limbal wound by lamellar keratoplasty.

PURPOSE: To report repair of a penetrating limbal wound by lamellar keratoplasty 1 year post-traumatically. METHOD: Interventional case report. RESULTS: A 5-year-old boy had a self-inflicted injury leading to a limbal penetrating wound. The wound closed spontaneously by prolapsed subconjunctival uveal tissue and no intervention was planned. One year later surgical closure of the defect was necessary, as the amount of prolapsed tissue had increased. After excising the prolapsed tissue the wound was closed with a lamellar corneal graft, resulting in a quiet and stable anterior segment and a best-corrected visual acuity of 20/16. CONCLUSIONS: Lamellar keratoplasty can be a useful technique to repair a limbal penetrating wound. Corneal allografts have adequate tensile strength, low immunogenicity, and are easy to obtain.