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.