A technique for treating positive vitreous pressure during intraocular lens implantation in intracapsular surgery.

Positive vitreous pressure during intraocular lens implantation is treated by early recognition and instillation of an air bubble to deepen the anterior chamber, and subsequently to prevent contact between the intraocular lens and the corneal endothelium. A technique is presented which has proven successful in 20 cases.     

Titanium back plate for a PMMA keratoprosthesis: clinical outcomes

Background/Purpose  

To compare the rate of retroprosthetic membrane (RPM) formation in Boston Keratoprosthesis (BKPro) with polymethyl methacrylate (PMMA) versus titanium backplates.     

Novel formulation of glycerin 1% artificial tears extends tear film break-up time compared with systane lubricant eye drops

Abstract Purpose: To evaluate the effectiveness of glycerin 1% formulated with the novel and proprietary ophthalmic excipient poly(l-lysine)-graft-poly(ethylene glycol) (PLL-g-PEG) (Eyeon Particle Sciences LLC) in extending tear film break-up time (TFBUT) compared with a market-leading artificial tear formulation of propylene glycol (0.3%) and polyethylene glycol (0.4%) (Systane(?) Lubricant Eye Drops; Alcon, Fort Worth, TX). Methods: This prospective single-center, single visit, randomized, double-masked exploratory trial compared the new formulation and Systane using TFBUT. Noninvasive break-up time (NIBUT) was measured in subjects with asymptomatic to mild (n=5), mild to moderate (n=5), and moderate to severe (n=6) dry eye disease using the TearscopePlus? at pre-instillation and again at 15, 30, 60, and 120?min after instillation. Fluorescein break-up time (FBUT) was measured at 120?min after instillation. Results: At 15?min (N=16), the new formulation extended mean NIBUT by 14.67?s (P=0.05) compared with 7.40?s (P=0.34) by Systane. The new formulation had a mean FBUT of 4.92?s longer than Systane at 120?min (P=0.12). With outliers removed (N=13), the difference between the mean NIBUT change from baseline for the new formulation and Systane at 120?min was statistically significant (P=0.03). Conclusions: This study demonstrates that PLL-g-PEG as a polymer excipient in artificial tears is effective in improving the performance of demulcents to significantly prolong NIBUT at 15?min, and that protective activity from this artificial tear product for 2 or more hours after eye drop instillation is possible.     

Corneal and conjunctival changes in congenital erythropoietic porphyria

Penetrating keratoplasty and conjunctival resection were performed on a 53-year-old woman with confirmed congenital erythropoietic porphyria. Corneal and conjunctival tissue samples, studied by light and electron microscopy, revealed inflammatory cells and a reduced keratocyte population. Vessels within the conjunctival and corneal stroma displayed a thickened basement membrane. Microfibrillar material was seen in the extracellular spaces of the conjunctival stroma. These changes are similar to those reported for ultraviolet light-exposed skin of porphyria patients. The Descemet's membrane lacked the normal fetal and postnatal banding. It presented as a homogeneous layer, consisting of uniform, densely packed collagen fibers, which suggests endothelial damage in utero. The corneal endothelium was severely damaged.     

Renal stone disease treated with extracorporeal shock wave lithotripsy: short-term observations in 100 patients

The immediate posttreatment findings are described for 100 patients who underwent extracorporeal shock wave lithotripsy (ESWL) for renal stone disease. Excretory urography was performed both before and 24-72 hours after ESWL. In 21 patients, stones were completely disintegrated, and stone fragments were passed rapidly. Stones were fragmented but not passed entirely within 24-72 hours in 76 patients. There was no appreciable effect on stones in three patients. In nine of 27 patients who had mild to severe ureteral obstruction caused by stone fragments, relief procedures (retrograde ureteral manipulation or percutaneous stone extraction) were necessary. Overall, 70 patients experienced successful stone disintegration without complications. Continued investigation is needed to determine prevalence of residual calculi, reversibility of acute effects of ESWL on the kidney, and possible development of late hypertension.