Amyloidosis of the orbit and adnexae.

Purpose: To present a series of patients with orbital and adnexal amyloidosis and illustrate the diversity of disease and the challenges of managing such cases.

Methods: Descriptive case series of ten patients with biopsy proven amyloidosis involving the orbit, conjunctiva and eyelids. The presentation, clinical findings and management are discussed for each case.

Spontaneous perforation of the cornea in mild keratoconus.

Purpose: Spontaneous corneal perforation during acute hydrops in keratoconus is a very rare complication and has only been described in patients with advanced keratoconus. We describe a case of spontaneous corneal perforation in mild keratoconus in a patient with no identifiable risk factors.

Methods: We report retrospectively on a 34-year-old woman with mild keratoconus (Krumeich stage II) who presented with the spontaneous perforation of the cornea.

A modified technique for descemet membrane stripping automated endothelial keratoplasty to minimize endothelial cell loss.

In an attempt to enhance postoperative survival of donor endothelium, the conventional technique for Descemet membrane stripping automated endothelial keratoplasty (DSAEK) was modified using the prototype of a glide specially designed to facilitate graft delivery and minimize surgical trauma. Instead of using the so-called taco technique, the Busin glide is loaded with the donor lamella, and a microincision forceps is inserted into a temporal side entry and passed across the anterior chamber, exiting through a nasal clear cornea tunnel to grab the graft and drag it into the eye. In 10 patients who underwent DSAEK, mean (SD) postoperative endothelial cell loss was 20.

Late detachment of donor graft after Descemet stripping automated endothelial keratoplasty.

We describe the case of an 85-year-old man with pseudophakic bullous keratopathy. Descemet stripping automated endothelial keratoplasty (DSAEK) was performed, and 6 weeks postoperatively, subtle separation of the 2 corneal layers was noted. To our knowledge, this case of post-DSAEK graft detachment involves the longest interval between surgery and successful reattachment.

Peripheral ulcerative keratitis due to a 'long lost' hard contact lens.

Peripheral ulcerative keratitis (PUK) is a disorder consisting of a crescent-shaped destructive inflammation of the perilimbal corneal stroma. PUK can occur in a variety of ocular and systemic conditions including infections, lid abnormalities, dermatological disorders and connective tissue disorders. We present a case of PUK associated with a hard contact lens (CL) retained in the superior fornix for over 16 years.

A simple correction for congenital tarsal kink associated with distichiasis.

Congenital tarsal kink is a rare condition. The folded edge of the upper tarsus, or the inturned lashes, may traumatize the cornea causing ulceration. We describe a case of unilateral upper eyelid horizontal tarsal kink associated with distichiasis and congenital corneal ulceration.