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Purpose: To report the long-term visual outcomes and biocompatibility of a single-piece hydrophilic acrylic intraocular lens (IOL) in patients with uveitis having cataract surgery. Setting: Tertiary referral center, Birmingham, United Kingdom. Design: Retrospective case review. Methods: The review included consecutive uveitis patients in whom phacoemulsification and acrylic IOL implantation was performed by the same surgeon. Outcomes measures are reported as rate/eye-year and included visual acuity and signs of bioincompatibility. Results: The review identified 171 eyes (140 patients; mean age 51 years [range 16 to 85 years]) with uveitis. The mean follow-up was 3.8 years (range 0.9 to 10.3 years). Signs of uveal bioincompatibility were found in 31 eyes, with visually insignificant deposits on the IOL in 17 eyes. The rate of uveal bioincompatibility was 0.06/eye-year. Signs of capsule bioincompatibility were found in 107 (63%) of 171 eyes (0.31/eye-year). Posterior capsule opacification was documented in 102 eyes (0.29/eye-year); neodymium:YAG laser capsulotomy was required in 31 eyes (0.05/eye-year). The rate of failure to maintain a 3 logMAR line improvement in corrected distance visual acuity (CDVA) was 0.08/eye-year; to maintain better than 0.3 logMAR, 0.15/eye-year; and to maintain either, 0.04/eye-year. At 1 year, 85% of eyes had a CDVA of better than 0.3 logMAR or maintained a 3 logMAR–line improvement. Eyes with preexisting macular or optic nerve disease had significantly worse visual outcomes. Conclusions: The long-term safety profile of the hydrophilic acrylic IOL was good in uveitis cases, leading to good visual outcomes and a low rate of vision-impairing uveal and capsule complications. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. [ABSTRACT FROM AUTHOR]

Background: Oxane HD is a mixture of 5700 cs silicone oil and RMN-3 (a partly fluorinated olefin), which has a specific gravity greater than water, thereby enabling endotamponade of inferior retinal breaks. Droplets of emulsified oil were found in the anterior chamber of two patients with complex retinal detachments who had been treated with Oxane HD. Samples removed from these two eyes were analysed in order to investigate the nature of the emulsified substance. Methods: Samples were dissolved in CDCI3 and, if necessary, dried using magnesium sulphate. Nuclear magnetic resonance (NMR) was used to compare these samples with the unused commercial product. Results: NMR analysis of the samples removed from the anterior segment of both eyes were mainly silicone oil with only trace amounts of RMN-3. Samples taken from different areas of an unused syringe of Oxane HD demonstrated varying concentrations of the RMN-3 compound within the silicone oil. Conclusion: First, the mixture of RMN-3 and silicone oil is not homogenous either in vitro or in vivo. Second, emulsified oil found in the anterior chamber is composed almost entirely of silicone oil, containing only trace amounts of RMN-3. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article by Kaushal on the treatment of acute corneal hydrops that was published in the previous issue.

We present a case of epithelial ingrowth that progressed despite repeated intracameral injections of fluorouracil (5-FU). Six months after cataract surgery, a retrocorneal membrane was found advancing from the corneal section. At 1 year, 0.5 mg of 5-FU in 0.1 mL of balanced salt solution was exchanged for 0.1 mL of aqueous. Ingrowth initially stopped, but progressed 6 months later. Two further injections of 0.5 mg of 5-FU were given at 1-month intervals, followed by 1 mg of 5-FU 3 and 6 months later. Each injection initially halted progression of the ingrowth, but then it recurred. Ultimately, the treatment failed to prevent progression of the disease and angle-closure glaucoma ensued. Resolution of epithelial ingrowth with intracameral 5-FU has been reported twice. We found no reports of such treatment following clear corneal cataract surgery or with eventual epithelial ingrowth progression. Epithelial ingrowth remains a relentless and challenging condition to treat. [Copyright &y& Elsevier]