The influence of scleral lens parameters and fitting characteristics on corneal oedema under open and closed eye conditions

This is the first documentation of vancomycin precipitation with viscoelastic in the anterior chamber of the eye. A 34-year-old white male underwent uneventful penetrating keratoplasty. Intracameral instillation of 1 mg/0.1 mL of vancomycin followed no attempts of meticulous viscoelastic irrigation. Six hours later thick white material in the anterior chamber was sedimented. The following criteria excluded the diagnosis of endophthalmitis and TASS: clear and transparent anterior chamber and vitreous body, the absence of ciliary injection and corneal oedema, and unremarkable laboratory tests’ results. This iatrogenic complication mimicking endophthalmitis does not require any specific management and should be acknowledged in guidelines for prevention and treatment of endophthalmitis. The objective of this paper is to alert colleagues to this iatrogenic complication of vancomycin mimicking endophthalmitis. Whether this condition should be labelled as positive or negative demands further investigation. As vancomycin is a time-dependent antibiotic, it is possible that this precipitate could serve as a slowly releasing drug depot and viscoelastic as a vehicle for precipitation. This being the case, investigation is needed to analyse its potential to precipitate with another dispersive and cohesive viscoelasticity.

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Interstitial Keratitis, with Marked Radial Deep Corneal Striation (Corneal Œdema)

Proceedings of the Royal Society of Medicine ◽

10.1177/003591572702000473 ◽

1927 ◽

Vol 20 (4) ◽

pp. 430-430

Author(s):

Humphrey Neame

Keyword(s):

Corneal Oedema ◽

Interstitial Keratitis

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Congenital hereditary corneal oedema of Maumenee: its clinical features, management, and pathology.

British Journal of Ophthalmology ◽

10.1136/bjo.71.2.130 ◽

1987 ◽

Vol 71 (2) ◽

pp. 130-144 ◽

Cited By ~ 66

Author(s):

C M Kirkness ◽

A McCartney ◽

N S Rice ◽

A Garner ◽

A D Steele

Keyword(s):

Clinical Features ◽

Corneal Oedema

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Comparison of real-world treatment outcomes of femtosecond laser-assisted cataract surgery and phacoemulsification cataract surgery: A retrospective, observational study from an outpatient clinic in France

European Journal of Ophthalmology ◽

10.1177/1120672120925766 ◽

2020 ◽

pp. 112067212092576

Author(s):

Philippe Charles Crozafon ◽

Christine Bouchet ◽

Monia Zignani ◽

Ray Griner ◽

Samuel D Foster ◽

...

Keyword(s):

Visual Acuity ◽

Femtosecond Laser ◽

Cataract Surgery ◽

Multiple Comparisons ◽

Posterior Capsule Opacification ◽

Dissipated Energy ◽

Corneal Oedema ◽

Corrected Distance Visual Acuity ◽

Cumulative Dissipated Energy ◽

Phacoemulsification Cataract Surgery

Purpose: This study compared real-world safety and efficacy outcomes of cataract surgery performed with LenSx femtosecond laser-assisted cataract surgery or manual phacoemulsification cataract surgery procedures. Methods: A retrospective observational study used data from anonymised electronic medical records to compare mean cumulative dissipated energy, the proportion of eyes reaching emmetropia, mean change in best-corrected distance visual acuity and the proportion of eyes with post-surgical complications, including corneal oedema and posterior capsule opacification. Results were adjusted for multiple comparisons for primary and secondary objectives. Results: Data from 811 phacoemulsification cataract surgery and 496 femtosecond laser-assisted cataract surgery procedures were analysed. Mean cumulative dissipated energy was significantly lower for femtosecond laser-assisted cataract surgery (6.5 percent-seconds) than for phacoemulsification cataract surgery (14.3 percent-seconds; p < 0.0001) procedures. More femtosecond laser-assisted cataract surgery (81.2%) procedures achieved emmetropia (⩽ 0.5 dioptre) than did phacoemulsification cataract surgery (73.5%) procedures, although this difference was not statistically significant. Mean change in best-corrected distance visual acuity and the proportion of eyes with corneal oedema, posterior capsule opacification or other complications were not significantly different between cohorts when adjusted for multiple comparisons. Conclusions: In this single-centre, single-surgeon retrospective electronic medical record database study using divide and conquer technique, femtosecond laser-assisted cataract surgery was associated with significantly lower cumulative dissipated energy when compared to manual phacoemulsification cataract surgery. This supports the hypothesis that femtosecond laser-assisted cataract surgery involves less mechanical trauma, which might lead to more consistent refractive and safety outcomes than manual phacoemulsification cataract surgery, though such outcomes were found to be comparable in this study.

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