Pilot Safety Study of a Microfabricated Device for Anterior Stromal Puncture to Treat Corneal Epithelial Disease in the Optical Axis.

Purpose: Anterior stromal puncture is an inexpensive and widely used technique at the slit lamp to treat recurrent corneal erosions (RCE), common sequelae of corneal abrasions, trauma, and epithelial basement membrane dystrophies (EBMDs). The purpose of this study was to determine safety of a novel anterior stromal micropuncture device (termed a "plexitome") for use in the optical axis of the cornea.

Methods: We performed an IRB-approved clinical pilot study on 45 patients with diverse corneal pathologies to determine the safety of the plexitome device and examined corneal healing responses clinically for a minimum of 30 days after treatment.

Late iris cerclage suture cheese-wiring.

Purpose: To describe a case series of cerclage failures due to cheese-wiring; iris repair can develop late cheese-wiring of cerclage sutures with resultant loss of benefits.

Setting: Cincinnati Eye Institute, Cincinnati, Ohio.

Design: Retrospective single-surgeon case series.

Microscopic analysis of preinsertion cutting modalities on custom, flexible iris prostheses.

Purpose: To determine the induced edge effects of different clinically used device postmanufacture modification styles and modalities on custom iris implants.

Settings: An academically affiliated multispecialty private practice group and an academic medical center.

Design: Laboratory study.

Structural effects on custom, flexible iris prostheses passing through injector systems.

Purpose: To determine the suitability of various commercially available intraocular lens injection systems for the implantation of custom, flexible artificial irides of various sizes, both with and without fiber meshwork.

Setting: Cincinnati Eye Institute, Blue Ash, Ohio.

Design: Laboratory study.

A peculiar case of aqueous misdirection from a pseudophakic secluded pupil in a patient with chronic angle closure glaucoma.

Purpose: To explore the course of a pseudophakic and pseudoiridic 61-year-old man with a history of open angle glaucoma in his right eye who developed a sub-totally secluded pupil then later presented with angle closure, a significant pressure spike, and a marked myopic refractive shift, consistent with aqueous misdirection.

Observations: Goniosynechialysis, surgical removal of much of the native peripheral iris, and zonulohyaloidectomy led to a return to his prior refraction and improve intraocular pressure (IOP) control.

Conclusions And Importance: This case demonstrates that a diagnosis of aqueous misdirection should not be disregarded in the presence of a prior vitrectomy and that aqueous misdirection should be strongly considered in cases of elevated IOP with a patent peripheral iridotomy, myopic shift and angle narrowing.

Scleral suture fixation of a custom, flexible iris prosthesis.

Introduction: Iris prostheses are an integral tool for the management of symptoms in the setting of damaged, insufficient, or absent irides. Fixation of a custom iris prosthesis in the absence of capsular support raises similar challenges to the fixation of an intraocular lens (IOLs) without capsular support. Centration and planar orientation of these larger iris devices are perhaps even more important than with IOLs.

Intraocular methotrexate for epithelial downgrowth: long-term outcomes in a multicentre case series.

Background/aims: Sheet-like type of epithelial downgrowth (EDG) is not easily amenable to surgical excision. We describe long-term outcomes in patients with EDG treated with intraocular methotrexate (MTX).

Methods: This is a retrospective, multicentric case series including 10 eyes (nine patients) treated with intraocular MTX for sheet-like EDG.

In-the-bag injection and overfold technique for custom flexible prosthetic iris prostheses.

In-the-bag placement is the ideal location for an anterior segment implant, including the custom flexible artificial iris prosthesis (CUSTOMFLEX ARTIFICIALIRIS). Yet, an injection of a bag-filling iris device through a reasonably sized capsulorhexis creates a geometric challenge. First, the device must be placed into an injection cartridge.

Results of the United States Food and Drug Administration Clinical Trial of the CustomFlex Artificial Iris.

Purpose: To evaluate safety and efficacy of a custom-manufactured artificial iris device (CustomFlex Artificial Iris; HumanOptics AG) for the treatment of congenital and acquired iris defects.

Design: Multicenter, prospective, unmasked, nonrandomized, interventional clinical trial.

Participants: Patients with photophobia, sensitivity secondary to partial or complete congenital or acquired iris defects, or both.

Lamellar Dissection Technique for Traumatic Cataract With Corneal Incarceration.

Purpose: To describe a technique for traumatic cataract management for cases in which part of the anterior capsule has been incarcerated into a healed corneal laceration.

Methods: This is a single-center retrospective chart review of 3 patients with capsular/corneal incarceration after penetrating injury. Each patient underwent primary globe repair, followed by subsequent cataract surgery with intraocular lens (IOL) and iris prosthesis placement.

Management of common iatrogenic iris defects induced by cataract surgery.

The proximity of the iris to the instruments and currents of cataract surgery makes iatrogenic damage to the iris a common complication of cataract surgery. This article discusses techniques to prevent or minimize this damage. When damage does occur, the surgeon must decide if, when, and how to repair the damage.

Long-term follow-up of a custom-made prosthetic iris device in patients with congenital aniridia.

Purpose: To investigate the effectiveness and safety of a custom-made iris prosthetic device used to reduce photic symptoms in patients with congenital aniridia.

Setting: Cincinnati Eye Institute, Cincinnati, Ohio, USA.

Design: Retrospective single-surgeon case series.

Partial-thickness scleral tethering suture for optimum fixation and centration of transscleral-sutured intraocular lens-capsule complex.

We describe a surgical technique for fine-tuning the centration of a transscleral-sutured modified capsular tension ring (CTR)-intraocular lens-capsular bag complex using a partial-thickness scleral tethering suture placed posterior to the external episcleral portion of a transscleral suture loop. The technique can be used for adjusting the centration of any intraocular supporting or prosthetic device that is transsclerally sutured in a "hanging" technique, such as capsular tension segments, modified CTRs, capsular anchoring devices, or iris prostheses.

Short-term outcomes of combined pars plana vitrectomy for epiretinal membrane and phacoemulsification surgery with multifocal intraocular lens implantation.

Purpose: The purpose of this study was to evaluate the functional and anatomical outcomes of combined phacovitrectomy with multifocal intraocular lens (mfIOL) implantation.

Methods: Retrospective, interventional, non-comparative case series of six eyes that received a combined phacoemulsification surgery with apodized, diffractive mfIOL implantation for cataract and pars plana vitrectomy (PPV) with membrane peeling for epiretinal membrane (ERM). Outcome measures included distance and near visual acuities (DVA and NVA), central macular thickness (CMT), intraocular pressure (IOP), and disruption of external limiting membrane (ELM) or inner-segment outer-segment (IS/OS) junction.

COMBINED PHACOEMULSIFICATION SURGERY WITH MULTIFOCAL INTRAOCULAR LENS IMPLANTATION AND PARS PLANA VITRECTOMY FOR SYMPTOMATIC VITREOUS OPACITIES.

Purpose: To report surgical outcomes of combined vitrectomy for vitreous floaters and phacoemulsification surgery with multifocal intraocular lens implantation.

Methods: Retrospective, interventional, noncomparative case series of five eyes from five patients who underwent same-day combined phacoemulsification surgeries with apodized, diffractive multifocal intraocular lens implantation for cataract and pars plana vitrectomy for symptomatic vitreous opacities, that is, floaters. Primary outcomes were distance and near visual acuities, and resolution of symptoms.