A retrospective review of selective laser trabeculoplasty outcomes at Lancashire Teaching Hospitals, UK.

Introduction: Selective laser trabeculoplasty has been carried out at Lancashire Teaching Hospitals over the past seven years. This work aimed to review the use of SLT in this Trust. The primary objectives were to establish the efficacy of SLT in reducing intraocular pressure, to analyse how prior treatment with different topical medications can influence SLT outcomes and to analyse the outcomes in revisionary patients.

Deep sclerectomy after DSAEK: A cautionary tale.

A 78-year-old pseudophakic women with pseudoexfoliation glaucoma and 6-year history of prior Descemet's stripping automated endothelial keratoplasty (DSAEK) underwent deep sclerectomy for a poorly controlled glaucoma. Exposure of the trabeculo-Descemet's window (TDW), showed a very poor drainage. An attempt to dissect the fibrous tissue off the TDW resulted in perforation of the window needing peripheral iridectomy, followed by a white fibrous band which had to be excised to prevent blockade of the filtration channel.

Outcomes of adult aponeurotic ptosis repair under general anaesthesia by a posterior approach white-line levator advancement.

Unlabelled: Aponeurotic ptosis surgery is conventionally performed under local anaesthetic to allow adjustment of eyelid height and contour. This may not be possible where general anaesthesia (GA) is required.

Purpose: We describe our experience using a tranconjunctival posterior approach "white-line" levator advancement (WLA) in patients undergoing aponeurotic ptosis correction under a GA.

Marsupialization for lacrimal ductular cysts (dacryops): a case series.

Purpose: To present the clinicopathological features and treatment outcomes of lacrimal ductular cysts managed with marsupialization.

Methods: Retrospective case review of 13 patients presenting with lacrimal ductular cysts.

Results: Thirteen patients were identified, of which 7 patients with full clinical data were included in the study, 4 female, 3 male, mean age 50 years.

A lateral approach to lower eyelid entropion repair.

The authors describe a simple technique that highlights the use of the sagittal anatomy of the lower eyelid to aid identification of the retractors during involutional entropion repair. This anatomy is exposed following lateral canthotomy and inferior cantholysis. The orbital septum is seen to enclose the fat pad and fuse with the retractors above it prior to insertion into the tarsus.

Treatment of proliferative diabetic retinopathy with anti-VEGF agents.

Proliferative diabetic retinopathy (PDR) is the most common cause of severe visual loss in people with diabetes. Although panretinal photocoagulation (PRP) remains the gold standard of care to date, several combinations of new treatment modalities have emerged. These approaches can be used to increase the extent of treatment, expedite the effect of laser treatment and provide alternate measures when laser delivery is difficult or impossible, especially in patients with vitreous haemorrhage.

Posterior approach white line advancement ptosis repair: the evolving posterior approach to ptosis surgery.

Introduction: We describe a surgical technique for ptosis correction in moderate to good levator function involving advancement of the levator aponeurosis via a transconjunctival posterior approach without resection of Müller's muscle. We present our experience of and the results from this method, and review the evolution of posterior approach ptosis surgery.

Purpose: To assess the efficacy and predictability of posterior approach white line advancement ptosis repair.

Superior oblique myositis as an early feature of orbital Wegener's granulomatosis.

A 66-year-old female presented with a 6-month history of increasing right-sided facial pain and diplopia. Right ocular movements were restricted in adduction and downgaze. Superior oblique (SO) enlargement was seen on an initial MRI scan, and subsequent diffuse infiltration was seen on a repeat scan.

Superior retinal detachment in an oil-filled eye with a colobomatous optic disc.

Background: Optic disk pits are known as congenital cavitary defects associated with serous detachment of the retina; 75% of such cases do not resolve spontaneously, and surgical management is required. The use of gas or oil tamponade in these cases has been associated with detachment of the retina attributed to the passage of intravitreal gas or fluid via the disk pit and into the subretinal space. Prophylactic peripapillary laser retinopexy is therefore recommended peroperatively to create a barrier to fluid flow between the vitreous cavity and the subretinal space.

Orbital cellulitis or lymphoma? A diagnostic challenge.

We present a case report of an aggressive natural killer T cell lymphoma in a police officer who presented with combined features of orbital cellulitis and mid-facial destruction. However, his initial diagnosis was confused with other disease conditions that had overlapping features. This emphasizes the significance of clinical alertness and adequate tissue sampling; this can have a great impact on early diagnosis and treatment.