Corneal and Scleral Problems Caused by Skin-Lightening Creams.

Purpose: To present a case series of patients with corneal and scleral changes associated with the use of skin-lightening creams. This is the first report of corneal changes with these widely available creams.

Methods: Three patients of West African origin presented with strikingly similar skin, corneal, and scleral changes and were found to have all been using skin-lightening creams containing hydroquinone.

Cytomegalovirus infection is not a major cause of corneal graft failure in the United Kingdom.

Background: Cytomegalovirus (CMV) endotheliitis is a significant cause for acute corneal allograft rejection in East Asian populations, where there is a high CMV seroprevalence. To determine how frequently CMV is associated with corneal graft failure in the UK, we looked for the presence of CMV DNA in grafts that had failed and had been removed at repeat keratoplasty. We also looked for CMV DNA in corneal rims discarded after corneal transplantation.

Intraoperative anterior segment optical coherence tomography: a novel assessment tool during deep anterior lamellar keratoplasty.

Purpose: To describe the use of high-resolution anterior segment optical coherence tomography (AS-OCT) during deep anterior lamellar keratoplasty (DALK).

Design: Prospective case series.

Methods: At the Singapore National Eye Centre we performed sequential intraoperative AS-OCT scans using iVue 100-2 (Optovue, Fremont, CA, USA) during various DALK techniques.

Reversible femtosecond laser-assisted myopia correction: a non-human primate study of lenticule re-implantation after refractive lenticule extraction.

LASIK (laser-assisted in situ keratomileusis) is a common laser refractive procedure for myopia and astigmatism, involving permanent removal of anterior corneal stromal tissue by excimer ablation beneath a hinged flap. Correction of refractive error is achieved by the resulting change in the curvature of the cornea and is limited by central corneal thickness, as a thin residual stromal bed may result in biomechanical instability of the cornea. A recently developed alternative to LASIK called Refractive Lenticule Extraction (ReLEx) utilizes solely a femtosecond laser (FSL) to incise an intrastromal refractive lenticule (RL), which results in reshaping the corneal curvature and correcting the myopia and/or astigmatism.

Ex-vivo ocular surface stem cell therapies: current techniques, applications, hurdles and future directions.

Engineered tissue derived from ocular surface stem cells (SCs) are a cutting edge biotechnology for repair and restoration of severely damaged eyes as a result of ocular surface dysfunction because of SC failure. Ex-vivo SC expansion techniques have advanced significantly since the first patients were treated in the late 1990s. The techniques and clinical reports reviewed here highlight the evolution and successes of these techniques, while also revealing gaps in our understanding of ocular surface and SC biology that drives further research and development in this field.

Reproducibility and age-related changes of ocular parametric measurements in rabbits.

Background: The rabbit is a common animal model for ophthalmic research, especially corneal research. Ocular structures grow rapidly during the early stages of life. It is unclear when the rabbit cornea becomes mature and stabilized.

Effect of different femtosecond laser-firing patterns on collagen disruption during refractive lenticule extraction.

Purpose: To evaluate the changes in corneal collagen architecture subjected to different laser-firing patterns during refractive lenticule extraction.

Setting: Singapore Eye Research Institute, Singapore.

Design: Experimental study.

Refractive lenticule re-implantation after myopic ReLEx: a feasibility study of stromal restoration after refractive surgery in a rabbit model.

Purpose: To investigate the potential of refractive lenticule (RL) storage and re-implantation in vivo as a method for reversing RL extraction (ReLEx) and restoring corneal stromal volume.

Methods: ReLEx [-6.00 diopter (D) correction] was performed on six New Zealand White rabbits in one eye.

Theoretical, experimental, and optical coherence tomography (OCT) studies of graft apposition and adhesion in Descemets stripping automated endothelial keratoplasty (DSAEK).

Purpose: To investigate the effects of adhesion promoting surgical adjuncts in Descemets stripping automated endothelial keratoplasty (DSAEK). The effects of air-fill pressure, duration, use of venting incisions and stromal roughening on fluid dispersion, and donor adhesion strength were examined in theoretical, optical coherence tomography (OCT), and strain gauge models of DSAEK.

Methods: OCT analysis: DSAEK modeled using a microkeratome prepared lenticule inserted under a "recipient" corneo-scleral rim mounted on an artificial anterior chamber.

Manual suction versus femtosecond laser trephination for penetrating keratoplasty: intraocular pressure, endothelial cell damage, incision geometry, and wound healing responses.

Purpose: To measure real-time intraocular pressure (IOP) during trephination with a manual suction trephine (MST) and the femtosecond laser (FSL), and to assess endothelial cell damage, incision geometry, and wound healing response with these procedures.

Methods: IOP was monitored with an intracameral sensor. Eight rabbits underwent manual suction trephination.

Femtosecond lenticule extraction (FLEx): clinical results, interface evaluation, and intraocular pressure variation.

Purpose: To characterize the clinical profile of femtosecond lenticule extraction (FLEx) correlated with ultrastructural analysis of the corneal interface and in vivo real-time intraocular pressure (IOP).

Methods: Prospective clinical case series with experimental studies; consecutive patients underwent FLEx at a single tertiary center over 10 months with postsurgical follow-up of 3 months. The patients were divided into three groups according to spherical equivalence (SE) (A, < -5.

Optimization of Fibrin Glue Spray Systems for Ophthalmic Surgery.

Purpose: To optimize fibrin glue (FG) spray for ophthalmic surgery using two spray applicators, EasySpray and DuploSpray systems, by varying the distance from point of application and the pressure/flow rate, and to compare the adhesive strength of sutured and sutureless (FG sprayed) conjunctival graft surgery in a rabbit model.

Methods: FG was sprayed on a 0.2 mm-thick sheet of paper using EasySpray by variously combining application distances of 2.

Early corneal wound healing and inflammatory responses after refractive lenticule extraction (ReLEx).

Purpose: To compare the early corneal wound repair and inflammatory responses after refractive lenticule extraction (ReLEx) and LASIK.

Methods: Eighteen rabbits underwent ReLEx and another 18 underwent LASIK. Each group was divided into three subgroups of six rabbits each and these were subjected to refractive corrections of -3.

Intraocular fluid dynamics and retinal shear stress after vitrectomy and gas tamponade.

Purpose: To evaluate fluid dynamics and fluid shear stress on the retinal wall in a model eye after vitrectomy and gas tamponade in relation to saccadic eye movements and sudden head movements and to correlate the results with gas fill fraction (GF). Methods. Analyses was undertaken using high-resolution computational fluid dynamic software.

The 2-dot technique: minimalist donor lenticule marking in endothelial keratoplasty.

Correct orientation of the donor lenticule within the anterior chamber is essential for the success of Descemet stripping automated endothelial keratoplasty. We describe a 2-dot pattern for gentian violet marking of the donor lenticule that confirms correct graft positioning while minimizing associated endothelial toxicity. The 2-dot pattern is the smallest pattern possible with no axis of rotational symmetry about any diameter across the lenticule.

Live or Let Die: Epithelial Flap Vitality and Keratocyte Proliferation Following LASEK and Epi-LASIK in Human Donor and Porcine Eyes.

Purpose: To determine the relationship between epithelial flap vitality and stromal keratocyte proliferation following two epithelial refractive techniques: epi-LASIK and laser epithelial keratomileusis (LASEK).

Methods: Human corneas were maintained in organ culture and underwent standard -6.00-diopter ablation.

Use of low-cost video recording device in reflective practice in cataract surgery.

Reflective surgical practice is invaluable for surgeons at all levels of experience. For trainees in particular, every surgical opportunity must be optimized for its learning potential. Recording and reviewing cataract surgery is an invaluable tool.

Inhibition of transforming growth factor-beta1 and its effects on human corneal fibroblasts by mannose-6-phosphate Potential for preventing haze after refractive surgery.

Purpose: To evaluate the action of mannose-6-phosphate (M6P) as an inhibitor of transforming growth factor-beta1 (TGF-beta1) and its effects on human corneal fibroblasts.

Setting: Department of Academic Ophthalmology, Rayne Institute, St. Thomas' Hospital, London, United Kingdom.

A theoretical model for predicting interfacial relationships of retinal tamponades.

Purpose. To establish a theoretical model to determine the relationship between retinal coverage and tamponade shape in relation to tamponade volume, for a variety of tamponades, and to test these relationships with a physical analogue of the human eye. Methods.

Anterior chamber instability caused by incisional leakage in coaxial phacoemulsification.

Purpose: To establish the percentage of fluid loss through incisions during coaxial phacoemulsification and analyze whether simple measures can reduce it.

Setting: Department of Ophthalmology, Royal Free Hospital, London, United Kingdom.

Methods: This prospective study comprised consecutive patients having routine uneventful cataract surgery.

United Kingdom survey of antibiotic prophylaxis practice after publication of the ESCRS Endophthalmitis Study.

The European Society of Cataract & Refractive Surgeons Endophthalmitis Study published preliminary results in 2006 showing a near 5-fold decrease in the rates of postoperative endophthalmitis with the use of intracameral cefuroxime. The study findings have generated considerable controversy, and 1 year later its recommendations had been heeded by only 6% of American Society of Cataract and Refractive Surgery (ASCRS) members. This poll sought to gauge the uptake among surgeons in the United Kingdom and survey their response to its findings.