Maya Eibschitz-Tsimhoni

Incidence and management of encapsulated cysts following Ahmed glaucoma valve insertion.

Purpose:Encapsulated cysts have been inconsistently reported to occur following Ahmed glaucoma valve implant insertion. We are unaware of previous reports reviewing their management. The objective of this study was to evaluate the occurrence and management of encapsulated cyst formation following Ahmed glaucoma valve implant insertion. Patients and Methods:Consecutive glaucoma patients who underwent Ahmed glaucoma valve implant insertion were studied retrospectively. Inclusion criteria included a minimum of 12 months of follow-up. Results:Fifty-seven patients met inclusion criteria for analysis. Following Ahmed glaucoma valve implant insertion, 13 patients (23%) developed an encapsulated cyst. After failing medical therapy and needling with 5-fluorouracil, 11 of these patients underwent surgical excision to control intraocular pressure. Eight of the eleven patients achieved adequate control of intraocular pressure with a mean follow-up time post excision of 330 ± 120 days. Conclusion:Encapsulated cysts associated with elevated intraocular pressure were commonly seen after Ahmed glaucoma valve implant insertion. Failing medical therapy, surgical excision of the cyst is effective in lowering intraocular pressure.

Effect of axial length and keratometry measurement error on intraocular lens implant power prediction formulas in pediatric patients.

PURPOSE To examine the relationship between axial length and keratometry measurement errors and intraocular lens (IOL) power calculations for pediatric eyes. METHODS The sensitivity of IOL power calculation to errors in axial length and keratometry measurements was computed as a function of axial length and keratometry for the SRK II, Hoffer Q, Holladay I, SRK/T, and Haigis formulas. RESULTS The sensitivity of the IOL power calculation to an axial length measurement error is increased at 4 to 14 D/mm error in axial length in children compared with 3 to 4 D/mm error in axial length in adults. The error in calculation is 0.8 to 1.3 D/D error in keratometry measurement for both children and adults. CONCLUSIONS Axial length measurement errors in pediatric eyes may lead to large errors in IOL power calculations.

A Locus for Posterior Polymorphous Corneal Dystrophy (PPCD3) Maps to Chromosome 10

Posterior polymorphous corneal dystrophy (PPCD) is an autosomal dominant disorder characterized by corneal endothelial abnormalities, which can lead to blindness due to loss of corneal transparency and sometimes glaucoma. We mapped a new locus responsible for PPCD in a family in which we excluded the previously reported PPCD locus on 20q11, and the region containing COL8A2 on chromosome 1. Results of a 317‐marker genome scan provided significant evidence of linkage of PPCD to markers on chromosome 10, with single‐point LOD scores of 2.63, 1.63, and 3.19 for markers D10S208 (at

Assessing the need for posterior sclerotomy at the time of filtering surgery in patients with Sturge-Weber syndrome

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Early screening for amblyogenic risk factors lowers the prevalence and severity of amblyopia

), D10S1780 (at

Intraocular Lens Power Calculation in Children

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Discrepancies between intraocular lens implant power prediction formulas in pediatric patients

), and D10S578 (at

Retinal and intracranial arteriovenous malformations: Wyburn-Mason syndrome

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Instrument and method for creating an intraocular incision

). A maximum multi‐point LOD score of 4.35 was found at marker D10S1780. Affected family members shared a haplotype in an 8.55 cM critical interval that was bounded by markers D10S213 and D10S578. Our finding of another PPCD locus, PPCD3, on chromosome 10 indicates that PPCD is genetically heterogeneous. Guttae, a common corneal finding sometimes observed along with PPCD, were found among both affected and unaffected members of the probands sib ship, but were absent in the younger generations of the family. Evaluation of phenotypic differences between family members sharing the same affected haplotype raises questions about whether differences in disease severity, including differences in response to surgical interventions, could be due to genetic background or other factors independent of the PPCD3 locus.

Corrective Lens Wear Among Adolescents: Findings From the National Health and Nutrition Examination Survey

PURPOSE Posterior sclerotomy has been recommended for prevention of intraoperative choroidal hemorrhages and choroidal effusions in patients with Sturge-Weber syndrome (SWS) or Klippel-Trenaunay-Weber (KTW) syndrome undergoing glaucoma filtering surgery. In this study, we evaluated this unproven clinical perception. DESIGN A retrospective, noncomparative, case series. PARTICIPANTS Seventeen consecutive patients with SWS or KTW syndrome who underwent glaucoma filtering surgery without prophylactic posterior sclerotomy or other prophylactic measures between January 1973 and March 1997 at a university-based practice. INTERVENTION Glaucoma filtering surgery without prophylactic posterior sclerotomy. MAIN OUTCOME MEASURES Incidence of intraoperative and postoperative choroidal effusion, choroidal detachment, or choroidal hemorrhage. RESULTS No intraoperative choroidal effusion, choroidal detachment, or choroidal hemorrhage occurred in this series. After surgery, 6 patients had a transient choroidal effusion. Surgical drainage was not required in any of them. No suprachoroidal hemorrhages occurred after surgery. CONCLUSIONS We did not encounter significant intraoperative suprachoroidal hemorrhage, choroidal effusions, or a combination requiring therapeutic intervention in our series. This finding leads us to question the necessity for prophylactic posterior sclerotomy to prevent the occurrence of these complications in patients with SWS and KTW syndrome undergoing glaucoma filtering surgery.