Mae Lynn Catherine Bastion

Study of the factors associated with the presence of white dots in the corneas of regular soft contact lens users from an Asian country.

Purpose. To investigate factors associated with the presence of microdot deposits or white dots (WDs) on confocal microscopy in regular soft contact lens (SCL) users. Methods. This cross-sectional observational study investigated changes in the cornea in regular SCL users by using an in vivo slit-scanning microscope (ConfoScan 3). Images were analyzed by noting the presence of highly reflective WDs. Factors associated with WDs were analyzed by using an unpaired t test with Welch correction. Results. There were 56 SCL wearers. Of these, a group of 10 had WDs (GWD) in various parts of the cornea. They had worn SCLs for 7 to 20 years and had a mean total duration of SCL wear of 13.6 ± 4.4 years. Their mean age was 35.8 ± 10.4 years. They were compared with a group of SCL wearers with no evidence of WDs (GNWD). The mean age of GNWD was 29.1 ± 7.2 years, with a mean duration of SCL use of 8.17 ± 5.1 years. The two groups were compared in terms of age, total duration of SCL wear (years), duration in hours per week, SCL water content (%), mean cell density in the endothelium and stroma, endothelial cell coefficient of cell size variation, and percentage of hexagonal cells. Only the duration of SCL wear was significantly associated with the presence of WDs (p=0.0042). WDs were most commonly found in the posterior stroma (n = 9). Two patients had WDs in the epithelium, with one of these having WDs in the endothelium. All patients except one with a hazy left eye scan had WDs bilaterally and symmetrically. Conclusions. Confocal microscopy allows visualization of WDs in the corneas of Asian regular SCL users. Patients with WDs have a longer history of SCL wear. WDs may represent an early stage of corneal disease or degeneration associated with alterations in cell behavior.

Evaluation of Corneal Endothelial Cell Loss After Uncomplicated Phacoemulsification Cataract Surgery With Intracameral Phenylephrine

Purpose: To study the effects of intracameral phenylephrine 1.5% on corneal endothelial cell loss and morphological changes in patients who had uneventful phacoemulsification surgery. Design: A double‐blind randomized controlled trial. Methods: This study comprised 295 patients who were randomized into the intracameral (ICM) mydriatic group or topical mydriatic group. Central corneal endothelial cell density (ECD), coefficient of variation (CV), and percentage of hexagonal cells were measured preoperatively and postoperatively at 1 week, 6 weeks, and 3 months with specular microscope. Results: There was no significant difference in endothelial cell density and endothelial cell loss between the topical and ICM mydriatic groups. At 3 months, the mean endothelial cell density in the ICM group was 2129.76 ± 423.53 cells/mm2 and 2100.54 ± 393.00 cells/mm2 in the topical group (P = 0.539). The endothelial cell loss was 18.60 ± 12.79% in the ICM group and 19.44 ± 11.24% in the topical group (P = 0.550). No significant difference was seen in the percentage of hexagonal cells and coefficient of variation of patients between the 2 groups. Conclusions: Intracameral phenylephrine was not associated with increased risk of postoperative endothelial cell loss or morphological changes. It can be safely injected into the anterior chamber for pupil dilatation before phacoemulsification cataract surgery.

Front to back ocular injury from a vaping-related explosion.

We describe a case of extensive ocular injury secondary to an electronic cigarette (e-cigarette)-related explosion. The explosion was the result of modifications made to a heating element of the e-cigarette device by a non-professional. Extensive ocular injuries that result from an explosion of an e-cigarette device can potentially cause significant and permanent visual impairment.

Unilateral visual loss after spine surgery in the prone position for extradural haematoma in a healthy young man

This case reports a patient who developed central retinal artery occlusion following spinal surgery in the prone position. When placed in this position, especially as a result of malposition of the head, the patient may develop external compression of the eye which leads to central retinal artery occlusion. Therefore, a special precaution must be given for adequate eye protection during prolonged prone-positioned spine surgery.

Surgical management of unilateral rhegmatogenous retinal detachment associated with ocular coloboma in a 7-year-old child with Noonan syndrome.

The authors would like to present an unusual case of unilateral retinal detachment, phacodonesis, dense cataract and ocular coloboma in a 7-year-old Indian Muslim boy with Noonan syndrome. He underwent lensectomy, 23G pars planar vitrectomy, air fluid exchange, endolaser and silicone oil injection which successfully reattached the retina. His best corrected visual acuity was 6/24 6 months after the surgery and oil removal.

Randomized controlled trial of topical insulin for healing corneal epithelial defects induced during vitreoretinal surgery in diabetics

Purpose: To determine the effect of topical insulin of 3 concentrations [0.5, 1, and 2 units per drop 4 times per day (QID)] on postoperative corneal epithelial wound healing in diabetic patients. Design: A double blind randomized controlled hospital‐based study involving diabetic patients with postoperative corneal epithelial defect after vitreoretinal surgery. Methods: Diabetic patients were randomized to 3 different concentrations of topical insulin (DTI 0.5, DTI 1, and DTI 2) or placebo in the control group (DNS). Primary outcome measure was the rate of corneal epithelial wound healing (mm2 per hour) over pre‐set interval and time from baseline to minimum size of epithelial defect on fluorescein stained anterior segment digital camera photography. Secondary outcome measure was any adverse effect of topical insulin. Follow‐up was 1 month. Results: Thirty‐two eyes of 32 patients undergoing intraoperative corneal debridement with resultant epithelial defect (8 eyes per group) were analyzed. DTI 0.5 was superior to other concentrations achieving 100% healing rate within 72 hours of treatment compared with 62.5% in DNS, 75% in DTI 1, and 62.5% in DTI 2. Statistically, DTI 0.5 achieved significant results (P = 0.036) compared with the diabetic control group (DNS) in terms of mean rate of corneal epithelial wound healing from maximum to minimum defect size. No adverse effect of topical insulin was reported. Conclusions: Topical insulin 0.5 units QID is most effective for healing corneal epithelial defect in diabetic patients after vitrectomy surgery compared with placebo and higher concentrations. Topical insulin is safe for human ocular usage.

Familial exudative vitreoretinopathy presenting with unilateral rhegmatogenous retinal detachment in a Malay teenager.

To describe a case of familial exudative vitreoretinopathy presenting with unilateral rhegmatogenous retinal detachment in a Malay teenager.

Intravitreal ranibizumab in the management of stage 2B Coats disease in a young adult Malay man.

This paper describes a rare case of Coats disease with late presentation in a young adult. The condition improved with a combination of focal photocoagulation, cryotherapy and intravitreal ranibizumab.

Brilliant crystallisation in the anterior chamber and subretinal space following adjunctive intravitreal ranibizumab for diabetic vitrectomy.

To report a unique case of crystallisation in the anterior chamber and subretinal space in a Malay lady following inadvertent subretinal injection of ranibizumab prior to vitrectomy for proliferative diabetic retinopathy.

Pneumatic retinopexy for treatment of posterior pole detachment following vitreoretinal surgery for diabetic tractional retinal detachment threatening the fovea.

To describe the usage of 100% perfluoropropane and subsequent laser retinopexy for the repair of posterior pole retinal detachment in a previously vitrectomised patient with diabetic tractional detachment.