Corneal calcification and phosphates: do you need to prescribe phosphate free?

Purpose: Both superficial band keratopathy and deeper calcareous calcification have been linked to the presence of phosphate excipients in topical ophthalmic medicines. (1-3) The European Medicines Agency (EMA) has concluded that patients with ocular surface disease are at greatest risk. This potential side effect should be highlighted to both prescribers and patients.

Ulcerative keratitis following particulate elemental gold deposition.

Purpose: To describe a case of 68-year-old male industrial chemist who received a chemical injury after a gold/amine compound exploded causing bilateral eye injuries. No apparent long-term problems were anticipated. After cataract extraction 40 years later, he developed a localized ulcerative keratitis adjacent to embedded gold in the cornea.

Riboflavin/UVA collagen cross-linking-induced changes in normal and keratoconus corneal stroma.

Purpose: To determine the effect of Ultraviolet-A collagen cross-linking with hypo-osmolar and iso-osmolar riboflavin solutions on stromal collagen ultrastructure in normal and keratoconus ex vivo human corneas.

Methods: Using small-angle X-ray scattering, measurements of collagen D-periodicity, fibril diameter and interfibrillar spacing were made at 1 mm intervals across six normal post-mortem corneas (two above physiological hydration (swollen) and four below (unswollen)) and two post-transplant keratoconus corneal buttons (one swollen; one unswollen), before and after hypo-osmolar cross-linking. The same parameters were measured in three other unswollen normal corneas before and after iso-osmolar cross-linking and in three pairs of swollen normal corneas, in which only the left was cross-linked (with iso-osmolar riboflavin).

Pseudophakic pseudoexfoliation of an AkreosFit intraocular lens.

Purpose: To describe a case of intraocular lens opacification resembling pseudophakic pseudoexfoliation affecting an AkreosFit intraocular lens (IOL).

Methods: Single case analysis.

Results: A patient had IOL opacification resembling pseudophakic pseudoexfoliation.

A structural investigation of corneal graft failure in suspected recurrent keratoconus.

Purpose: Penetrating keratoplasty was performed on the right eye of a 51-year-old patient diagnosed with advanced bilateral keratoconus. Thirteen years later, an 8.5 mm regraft was required as a result of gross vascularisation, a poor epithelium, and suspected recurrent keratoconus.

Ultrastructural analysis of collagen fibrils and proteoglycans in keratoconus.

Purpose: To investigate ultrastructural alterations in the distribution of collagen fibrils (CFs) and proteoglycans (PGs) in the keratoconus cornea.

Methods: Four normal corneas (donor age 24-75 years) and four severe and one mild keratoconus corneas (donor age 24-47 years) were fixed in 2.5% glutaraldehyde containing 0.

Central corneal thickness changes after phacoemulsification cataract surgery.

Purpose: To evaluate changes occurring in central corneal thickness (CCT) immediately after uneventful cataract surgery.

Methods: Thirteen consecutive patients who had uneventful phacoemulsification surgery by the same experienced surgeon were prospectively evaluated for CCT measurements 1 hour preoperatively and 1 hour, 1 day, and 1 week postoperatively. The unoperated eye also had CCT measurements simultaneously on all occasions and served as a control.

Outcomes of corneal transplantation: a corneal surgeon vs the general ophthalmologist.

Aims: The aim of this study was to examine the outcomes of corneal transplantation in cases performed by a group of general ophthalmologists and those performed by an ophthalmologist with a subspecialist interest in corneal surgery.

Methods: A retrospective analysis of the outcomes in corneal transplantation was carried out for a 4-year period in three separate units in South Wales. In addition to patient demographic details, the primary diagnosis, type of keratoplasty performed, and outcome of surgery were noted.

Delayed hypersensitivity to brimonidine tartrate 0.2% associated with high intraocular pressure.

Purpose: To report the late presentation of an allergic reaction to brimonidine tartrate 0.2% associated with an elevation of intraocular pressure.

Methods: During a 6-month period six Caucasian patients (three were male), with primary open angle glaucoma (POAG) or ocular hypertension, with an allergic reaction to brimonidine tartrate eye drops were identified.

Progressive ulcerative keratitis related to the use of topical chlorhexidine gluconate (0.02%).

Purpose: To report a case of progressive ulcerative keratitis related to the use of topical chlorhexidine gluconate 0.02%.

Methods: A 45-year-old woman was treated for presumed Acanthamoeba keratitis with chlorhexidine gluconate 0.

Asymmetric pigment dispersion in a patient with the unilateral Adie pupil.

Purpose: Pigmentary glaucoma is a bilateral disorder. When it occurs asymmetrically or unilaterally, a cause should be sought because it may help us to understand the pathophysiology of this condition better. We describe a patient with unilateral pigmentary glaucoma and the Adie pupil in the same eye and discuss the possible role of the Adie pupil in the development of the pigmentary glaucoma.

Ultrastructural morphology and expression of proteoglycans, betaig-h3, tenascin-C, fibrillin-1, and fibronectin in bullous keratopathy.

Aims: To investigate the ultrastructural localisation of proteoglycans (PG), betaig-h3 (keratoepithelin), tenascin-C (TN-C)), fibrillin, and fibronectin in bullous keratopathy (BK) corneas.

Methods: Five corneas from cases of pseudophakic bullous keratopathy (BK) were examined by electron microscopy. PG were demonstrated using cuprolinic blue, and the proteins betaig-h3, TN-C, fibrillin, and fibronectin were immunolocalised with rabbit anti-betaig-h3, mouse anti-TN-C (BC10 and TN2), mouse anti-fibrillin-1 (MAB2502), mouse anti-fibrillin (MAB1919), and rabbit anti-fibronectin by using a standard immunogold technique.

Tarantula keratouveitis.

Purpose: To report a case of chronic bilateral keratouveitis, which was initiated after contact with a pet tarantula.

Methods: A 16-year-old male presented with a photophobia and redness of his eyes two days after handling a tarantula. He was found to have a number of linear corneal foreign bodies with subepithelial infiltrates.

Aland island eye disease: clinical and electrophysiological studies of a Welsh family.

Clinical and molecular genetic studies were performed on a single, large, white family, in which congenital nystagmus and moderate to high refractive error segregated as a sex linked trait with manifestation in some female carriers. In this family, affected males demonstrate myopia, but a high proportion of female carriers, and some of the possibly affected males, show hypermetropia. Clinical ophthalmic examination and electrodiagnostic studies of retinal function were fully compatible with a diagnosis of either incomplete congenital stationary night blindness or of Aland island eye disease.