Punctate inner choroidopathy: resolution after oral steroid treatment and review of the literature

CASE REPORT: A case of punctate inner choroidopathy (PIC) that resolved after oral steroid treatment is described. The 25-year-old female patient presented with reduced visual acuity of several days duration. Results of fundus examination, fluorescein angiography, and indocyanine green angiography were consistent with PIC with a small choroidal neovascularization lesion nasal to the fovea. Visual acuity improved significantly after several days on oral steroid treatment. COMMENTS: Although spontaneous resolution of the lesions can occur without any treatment, oral steroids in PIC may help achieve improved vision more rapidly. The clinical manifestations, differential diagnosis, and therapeutic modalities of this rare entity are discussed.     

Anterior chamber gas bubbles after corneal flap creation with a femtosecond laser

A 48-year-old woman had bilateral wavefront-guided laser in situ keratomileusis for myopia with IntraLase corneal flap creation. In the right eye the cavitation bubbles were observed not only in the interface between the flap and the corneal bed but also in the anterior chamber disappearing after 30 minutes. After the procedure, uncorrected visual acuity is 20/25 in both eyes; and specular microscopy shows normal hexagonal cells and density. Although no postoperative complications were observed in our case, further follow-up is needed to examine the long-term effect of this phenomenon of IntraLase.     

Two cases of pneumococcal keratitis following myopic LASIK

PURPOSE: To report two cases of pneumococcal keratitis after LASIK. METHODS: Retrospective interventional small case series of two patients who underwent bilateral LASIK for myopia and developed pneumococcal keratitis after surgery. This complication was encountered 2 days after surgery in one eye in both cases. The corneal flap was lifted, and irrigation and cultures from the stromal bed performed. Topical and subconjunctival antibiotics were started. RESULTS: Culture revealed Streptococcus pneumoniae in both cases. The infiltrates responded well to treatment. One year after the procedure, uncorrected visual acuity is > 20/40 in both cases. CONCLUSIONS: Pneumococcal keratitis can complicate LASIK. Patients should be informed of this potential complication, as prompt treatment is crucial.     

Asymmetry in angular rigidity of hydrogen-bonded complexes

The asymmetry in angular rigidity of the proton donor and proton acceptor of hydrogen-bonded hydrogen fluoride binary complexes is investigated. The intermolecular bending frequency of HF, as the proton donor, is linearly proportional to the square root of the dissociation energy, whereas that of the proton acceptor is always much lower. The asymmetry, measured by the ratio of bending elastic constants of HF to that of the proton acceptor, is generally >2, and varies pronouncedly with the acceptors reaching values >20. Molecules with nitrogen as the bridged acceptor atom show an angular rigidity nearly one order of magnitude greater than the group with oxygen as the proton acceptor.     

Artisan Phakic Intraocular Lens for Correcting High Myopia

Objectives: To evaluate the safety indexes and efficacy of Artisan phakic intraocular lens (IOL) for the correction of high myopia. Methods: Retrospective interventional case series reports. Thirty-one eyes (22 patients) with myopia from −5.25 to −19.00 diopters underwent implantation of an Artisan phakic IOL. Follow-up examinations were performed at 1 day, 1 week, 1 month, and 3 months. The following parameters were recorded: manifest refraction, slit-lamp examination, applanation tonometry, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), complications or adverse reactions. The primary variable was the refractive outcome at 3 months. Secondary variables were change in BSCVA, and efficacy and safety indexes. Results: At 3 months, mean spherical equivalent was −0.50 ± 0.36 diopters (range, −1.25 – plano). In 29 eyes (93.5%) UCVA was 6/12 or better; the other three eyes had UCVA of 6/15. The difference between preoperative and 1 week postoperative BSCVA was not statistically significant (p=0.25). Comparison of BSCVA at 1 week and at 1 month was statistically significant (p=0.05); this difference was even more significant at 3 months (p=0.01). The BSCVA remained the same or improved for all the eyes. BSCVA for 20 eyes (64.5%) had improved one or more lines in visual acuity. Mean endothelial cell loss at 3 months was 3.96%. Conclusion: The Artisan lens is a safe, predictable, and efficacious method to correct high myopia. Postoperative gain in BSCVA was achieved for the majority of eyes. Future study to assess safety indexes and risk of complications is required with long-term follow-up.     

Artisan aphakic intraocular lens in children with subluxated crystalline lenses

PURPOSE: To evaluate the results of Artisan (Ophtec) aphakic intraocular lens (IOL) implantation in children with idiopathic subluxated lenses. SETTING: Department of Ophthalmology, Soroka University Medical Center, Beer-Sheva, Israel. METHODS: This retrospective small case series comprised 4 eyes (3 children) with idiopathic essential subluxated lenses that had lens washout, lens capsule removal, Artisan IOL implantation, and peripheral iridectomy. The indications for surgery were reduced visual acuity and monocular diplopia. The main outcome measures were postoperative refraction and change in best corrected visual acuity (BCVA). RESULTS: The postoperative follow-up ranged from 8 to 10 months. After surgery, the BCVA was 6/12 or better in the 3 cases that could be recorded. Visual acuity improved by 2 or more Snellen lines in all 4 eyes. The postoperative spherical equivalent was within +/-1.00 diopter in all cases. No significant postoperative complications were observed. CONCLUSIONS: In 4 eyes with a subluxated crystalline lens, implantation of an Artisan aphakic IOL improved visual acuity. Studies with a larger number of patients and longer follow-up are necessary to confirm these results.