Clinical results of topography-based customized ablations for myopia and myopic astigmatism.

Purpose: To evaluate clinical outcomes after primary treatments for myopia and myopic astigmatism with topography-based ablation profiles on the Allegretto Wave Eye-Q platform (Alcon Laboratories Inc).

Methods: Records of patients who underwent topography-guided, Q-adjusted LASIK were retrieved and analyzed. Patients with mean refractive spherical equivalent up to -16.

Assessment of fibrin glue in pterygium surgery.

Purpose: To evaluate the efficacy and safety of fibrin glue in pterygium surgery with conjunctival autografting.

Methods: This was a prospective noncomparative case series. Patients were recruited from the general clinics for pterygium surgery.

Comparison of outcomes of lamellar keratoplasty and penetrating keratoplasty in keratoconus.

Purpose: To compare outcomes after penetrating keratoplasty (PK) and two techniques of deep anterior lamellar keratoplasty (DALK) in patients with keratoconus.

Design: Retrospective cohort study.

Methods: One hundred and twenty-five corneal transplantations comprising 100 PK and 25 DALK procedures for keratoconus at the Singapore National Eye Centre from April 1992 through December 2006 were included.

Glaucoma management in patients with osteo-odonto-keratoprosthesis (OOKP): the Singapore OOKP Study.

Purpose: To report diagnostic modalities and treatment options for glaucoma in eyes with osteo-odonto keratoprosthesis (OOKP).

Methods: Eyes that underwent OOKP were evaluated for glaucoma at the time of the first postoperative visit, then at 1 and 3 months after the procedure, and thereafter every 6 months. All eyes underwent stereo-biomicroscopic optic nerve head (ONH) assessment, kinetic (Goldmann perimetry) and automated static visual field testing, ONH photography, Heidelberg retina tomograph, scanning laser polarimetery (GDx), and optical coherence tomography.

Intracameral fibrin tissue sealant as an adjunct in tectonic lamellar keratoplasty for large corneal perforations.

Purpose: To report a technique of intracameral injection of Tisseel fibrin sealant as an adjunct in the performance of tectonic deep anterior lamellar keratoplasty in cases with preexisting or intraoperative macroperforation.

Methods: Patients with corneal perforations up to 4 mm in greatest dimension first had the defect sealed externally with cyanoacrylate adhesive or fibrin sealant. An air bubble was injected into the anterior chamber (AC), followed by intracameral Tisseel fibrin sealant.

Acanthamoeba keratitis associated with contact lens wear in Singapore.

Purpose: To describe an outbreak of Acanthamoeba keratitis (AK) cases among contact lens wearers.

Design: Retrospective cohort study.

Methods: Patients with AK were included.

Femtosecond laser creation of donor cornea buttons for Descemet-stripping endothelial keratoplasty.

Purpose: To evaluate the accuracy of the thickness and diameter of corneal disks obtained with the Femtec femtosecond laser (20/10 Perfect Vision) for Descemet-stripping endothelial keratoplasty (DSEK).

Setting: Singapore National Eye Centre, Singapore.

Methods: A femtosecond laser was used to create posterior stromal ablations at varying depths, producing donor lenticules 150 to 200 microm thick with diameters of 7.

Comparison of donor insertion techniques for descemet stripping automated endothelial keratoplasty.

Objective: To evaluate the difference in endothelial cell damage between 2 donor insertion techniques for Descemet stripping automated endothelial keratoplasty (DSAEK).

Design: Experimental study and prospective case series. Thirty donor corneas and 10 patients undergoing DSAEK with glide insertion were included.

Femtosecond laser-assisted endothelial keratoplasty: a laboratory model.

Purpose: To evaluate the ability of a 40-kHz femtosecond laser in performing posterior stromal ablation for endothelial keratoplasty.

Methods: Human corneoscleral rims were mounted on an artificial anterior chamber. After corneal pachymetry, the femtosecond laser was used to create a donor lenticule by using a variety of diameter ablations, 150 microm from the Descemet membrane.

Keratoprosthesis surgery for end-stage corneal blindness in asian eyes.

Purpose: To establish a multidisciplinary surgical program for osteo-odonto-keratoprosthesis (OOKP) surgery in Asia and to evaluate efficacy and preliminary safety of this keratoprosthesis in end-stage corneal and ocular surface disease.

Design: Prospective noncomparative case series.

Participants: Sixteen adults of Asian ethnic origin, bilaterally blind with end-stage corneal blindness from Stevens-Johnson syndrome, or severe chemical or thermal burns.

Using a "small bubble technique" to aid in success in Anwar's "big bubble technique" of deep lamellar keratoplasty with complete baring of Descemet's membrane.

Aim: To describe the "small bubble" technique to immediately determine the success of attaining complete Descemet's membrane (DM) separation from corneal stroma via Anwar's "big bubble" technique of deep anterior lamellar keratoplasty (DALK).

Methods: A partial trephination was followed by a lamellar dissection of the anterior stroma. Deep stromal air injection was then attempted to achieve the big bubble to help separate the stroma from the DM.

Glide insertion technique for donor cornea lenticule during Descemet's stripping automated endothelial keratoplasty.

We describe a simple technique for inserting the donor corneal lenticule in Descemet's stripping automated endothelial keratoplasty. Unlike the standard insertion method, which requires folding the donor lenticule, this technique uses a modified intraocular lens (IOL) glide to guide the unfolded donor lenticule through the small incision with an intraocular forceps. This prevents significant endothelial trauma and surgical difficulties when the lenticule is unfolded.

Use of a "small-bubble technique" to increase the success of Anwar's "big-bubble technique" for deep lamellar keratoplasty with complete baring of Descemet's membrane.

Purpose: To describe a quick and simple "small-bubble" technique to immediately determine the success of attaining complete Descemet's membrane (DM) separation from corneal stroma through Anwar's "big-bubble" technique of deep anterior lamellar keratoplasty (DALK) for complete stromal removal.

Methods: A partial trephination was followed by a lamellar dissection of the anterior stroma. Deep stromal air injection was then attempted to achieve the big bubble to help separate the stroma from the DM.

Trisection technique: a 2-snip approach to intraocular lens explantation.

We describe a new explantation technique that allows an intraocular lens (IOL) to be removed through the small incisions used in modern cataract surgery. After the IOL optic is freed from the capsular bag, a Vannas scissors is used to cut it into 3 pieces via a temporal clear corneal incision. A Sinskey hook inserted via a paracentesis located 90 degrees away provides a stabilizing counterforce, preventing optic slippage as the blades of the scissors close.

Current treatment options for corneal ectasia.

Purpose Of Review: The approach to the management of various forms of corneal ectasia is changing, with the advent of new surgical and nonsurgical options. The purpose of this review is to summarize and evaluate relevant studies on new treatments for keratoconus, postrefractive surgery keratectasia, and peripheral ectatic corneal disorders.

Recent Findings: Various alternatives to corneal transplantation for the management of keratoconus aim to enhance corneal rigidity by means of nonsurgical collagen cross-linking, or with the use of intrastromal corneal ring segments, and studies suggest that these treatments may reduce astigmatism or ectatic progression to varying degrees.

Posterior-assisted levitation: outcomes in the retrieval of nuclear fragments and subluxated intraocular lenses.

Purpose: To report the outcomes of posterior-assisted levitation (PAL) to retrieve nuclear fragments and subluxated intraocular lenses (IOLs).

Setting: Singapore National Eye Centre, Singapore, Singapore.

Methods: In a retrospective series, the case notes of consecutive surgeries performed by a single surgeon between 1999 and 2006 were reviewed.

Spontaneous disinsertion of a multipiece foldable acrylic intraocular lens haptic 3 and 12 months after implantation.

We report 2 cases of spontaneous postoperative haptic disinsertion with the Alcon AcrySof MA60BM posterior chamber intraocular lens (PC IOL). A 14-year-old girl with a history of acute retinal necrosis and pars plana vitrectomy with lensectomy for retinal detachment repair had secondary implantation of a PC IOL in the ciliary sulcus. Three months later, the superior haptic disinserted from the optic and dislocated into the anterior chamber.