Vijay B Wagh

Management of acute corneal hydrops secondary to keratoconus with intracameral injection of sulfur hexafluoride (SF6).

Purpose: To report the use of sulfur hexafluoride (SF6) gas in the management of corneal edema caused by acute corneal hydrops secondary to keratoconus. Methods: Nine eyes with acute hydrops secondary to keratoconus managed by SF6 gas injected into the anterior chamber (group 1) were compared to another 9 eyes that were managed conservatively with conventional medical therapy (group 2). Results: Of 9 eyes in group 1, 3 had 1 injection, 4 had 2 injections, and the remaining 2 had 3 injections into the anterior chamber. All the eyes in group 1 showed an early resolution of corneal edema at 4 weeks. The same was achieved in group 2 at 12 weeks. The central corneal thickness (CCT) in group 1 and group 2 was >1.0 mm at presentation. The CCT at 3 and 12 weeks in group 1 was 0.99 and 0.65 mm, respectively, whereas CCT in group 2 at 3 weeks was >1.0 mm and at 12 weeks was 0.991 mm (P = 0.001). The mean best spectacle-corrected visual acuity (BSCVA) at 12 weeks in group 1 and group 2 was 0.39 and 0.24, respectively (P = 0.016). The results were significant in favor of group 1 over group 2 both in CCT and BSCVA. Conclusion: Early intervention with intracameral SF6 injection is a safe and effective therapy for early reduction of corneal edema in eyes with keratoconus and acute hydrops.

Glial heterotopia of the orbit and extranasal region: an unusual entity

Glial heterotopia or the occurrence of isolated non‐teratomatous extracranial glial tissue is rare. Most of the reported cases of this entity arise in the nose. Herein a rare case of heterotopic glial tissue in the orbit and extranasal region without bony defect is described.

Visual outcome and electron microscopic features of indocyanine green-assisted internal limiting membrane peeling from macular hole of various aetiologies

PURPOSE To describe the visual outcome of internal limiting membrane (ILM) peeling for macular hole of various aetiologies and ultrastructural features of the ILM. MATERIALS AND METHODS The study was conducted on 40 eyes of 38 patients. Thirty eyes with full thickness macular hole were treated with vitrectomy and removal of ILM. Ten eyes with retinal detachment served as negative controls and these patients underwent vitrectomy and ILM removal. The surgical specimens were examined by transmission electron microscopy. RESULTS The anatomical success rate of the first operation was 90% in idiopathic and myopic groups, whereas it was 100% in traumatic macular hole group. Visual improvement of (3) two lines was noted in 80% of the cases. Electron microscopy revealed the presence of ILM in all surgical specimens. Proliferation of astrocytes and synthesis of new collagen along the inner surface of ILM was noted in the surgical specimens. CONCLUSION Our findings suggest that the ILM removal helps in closure of the macular hole and retinal reattachment. Vitrectomy with ILM peeling is a reasonable surgical approach to treat macular holes of idiopathic, myopic and traumatic aetiology.

Hyperplastic persistent pupillary membrane associated with subacute angle-closure glaucoma

We describe a case of hyperplastic persistent pupillary membrane (HPPM) with good visual acuity associated with angle-closure glaucoma. Both gonioscopy and Ultrasound biomicroscopy showed a narrow, occludable angle. A diagnosis of subacute angle closure was made and Nd: YAG iridotomy was undertaken in both eyes. Patients with HPPM may be at an increased risk of angle-closure glaucoma.