Nongnart R. Chan

Epiretinal membrane formation with internal limiting membrane wrinkling after Nd:YAG laser membranotomy in valsalva retinopathy

PURPOSE To report the location of premacular hemorrhage in Valsalva retinopathy and epiretinal membrane formation with internal limiting membrane (ILM) wrinkling after neodymium;yttrium-aluminum-garnet (Nd:YAG) laser membranotomy. DESIGN Interventional case report. METHODS A 35-year-old man with a massive premacular hemorrhage due to Valsalva retinopathy underwent Nd:YAG laser membranotomy. After membranotomy, his visual acuity improved from 20/200 to 20/25. Ten months later, he developed metamorphopsia with visual acuity of 20/30. A semiopacified membrane with radiating striae was found, and pars plana vitrectomy was performed for membrane removal. RESULTS Histologic examination of the membrane showed hemosiderin deposits within macrophages on the retinal side of the ILM. One year later, the patient was asymptomatic with visual acuity of 20/20. CONCLUSIONS To our knowledge, histopathologic confirmation of the sub-ILM hemorrhage in Valsalva retinopathy and epiretinal membrane formation with ILM wrinkling as a complication after Nd:YAG laser membranotomy have not been previously reported.

The use of postoperative topical mitomycin C in the treatment of recurrent conjunctival papilloma.

Purpose. To describe the use of postoperative topical mitomycin C (MMC) in the treatment of recurrent conjunctival papilloma. Methods. Case report. Results. We report a 26-year-old man with recurrent conjunctival papilloma despite repeated surgical excision, cauterization, and cryotherapy. He was then treated with excision by cryotherapy, followed by a 2-week course of topical MMC eyedrops prescribed at postoperative day 7 (0.02 mg/mL, four times daily). No recurrence was observed 24 months postoperatively, and no complication was observed during the follow-up period. Conclusion. Postoperative topical MMC may be a useful adjunct in the management of recurrent conjunctival papilloma.

Encapsulated triamcinolone cyst after subtenon injection

The authors report the formation of a subtenon cyst following subtenon triamcinolone injection for chronic recurrent uveitis in Behçet’s disease. The steroid was inadvertently placed superficially in the anterior subtenon space and was encapsulated eventually to present as a subtenon cyst. The episode of uveitis recurrence, which did not regress, required treatment with a repeat posterior subtenon injection 2 months later. The cyst was removed 4.5 months after the initial subtenon injection, when the patient underwent a trabeculectomy for refractory glaucoma. Histological examination of the cyst revealed a fibrous encapsulated cavity filled with small birefringent crystals, consistent with an encapsulated triamcinolone collection. Fibrous encapsulation of triamcinolone crystals can arise after a superficially placed anterior subtenon injection and this may impede the absorption of the corticosteroid and hamper its effectiveness in treating ocular inflammatory diseases.

Isolated microspherophakia with optic disc colobomata

We describe a case of isolated bilateral microspherophakia with optic disc colobomata. A satisfactory outcome was achieved following uneventful lensectomy and scleral fixation of an intraocular lens.

Confirmation of bilateral corneal intraepithelial cystic lesions by confocal microscopy previously treated for meibomian gland dysfunction

Extraction of IOFB using an intraocular magnet offsets these complications by providing greater control. 3 Intraocular magnets used for such a controlled removal are made of rare earth elements or electromagnets. Being relatively more expensive, such magnets may not be available in all vitreoretinal centres. We describe a new technique that can be used as an alternative to the intraocular magnet in situations where an intraocular magnet is not freely available. The basic principle of our technique is to magnetize commonly used intraocular instruments such as the microvitreoretinal (MVR) knife by the application of an external magnet to its shaft. The magnetized MVR knife itself can then be used to lift the IOFB lying on the retinal surface.

Ocular Manifestations and Surgical Management of Lid Coloboma in a Chinese Infant With Linear Nevus Sebaceous Syndrome

An 8-month-old Chinese girl with linear nevus sebaceous syndrome had a right upper lid coloboma and right superior scleral ectasia. At 20 months old, successful surgical repair of the lid coloboma was performed with particular attention paid to the sclera ectasia.