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Matthew Ison,1,2 Jane Scott,3 John Apel,3 Andrew Apel1,3 1Princess Alexandra Hospital, Woolloongabba, QLD, 4102, Australia; 2University of Queensland, St Lucia, QLD, 4072, Australia; 3The Eye Health Centre, Brisbane, QLD, 4000, AustraliaCorrespondence: Matthew IsonPrincess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, AustraliaTel +61 434 946 264Email Matthew.Ison2@health.qld.gov.auPurpose: To report patient expectations, visual performance and satisfaction with AcrySof IQ PanOptix multifocal intraocular lens in a heterogeneous patient group. Additionally, determine if identifiable pre-operative characteristics can predict post-operative satisfaction.Methods: Data were prospectively collected for 67 consecutive patients (134 eyes) who underwent bilateral Panoptix implantation in a private ophthalmology clinic. A pre-operative questionnaire was completed regarding vision satisfaction, visual phenomena and expectations. Routine clinical parameters were collected 1 month and follow-up questionnaire administered 3 months post-operatively.Results: Post-operative unaided distance vision was 20/20 (0.01 ± 0.10) and binocular near vision 20/25-2 (N5; 0.14 ± 0.06). Patients satisfied with vision increased from 6% (n=4) unaided and 48% (n=32) aided pre-operatively to 94% (n=63) unaided post-operatively (p< 0.001). There was marked increase in frequency of halo from 14% (n=9) to 69% (n=46; p< 0.001) but no corresponding increase in how bothersome this symptom was (p=0.193) nor the frequency of other visual phenomena. Worse post-operative vision and fluctuating vision were associated with lower post-operative satisfaction. There was no difference in satisfaction or residual astigmatism in those implanted with toric lenses. A total of 96% (n=64) of patients were spectacle-free at 3-months and would recommend this procedure to others.Conclusion: This study supports the trend towards increased patient expectations of multifocal intraocular lenses, matched

Aim:Guide practitioners’ management of microbial keratitis (MK) by providing epidemiological information to define the disease and trends of MK in Queensland, Australia.Methods:This project studies MK through two databases to define and analyse the disease in Queensland. Databases used were the Queensland microbial keratitis database (QMKD), which is a multi-centre pathology database of all patients with culture positive MK in Queensland, Australia between 2005-2015; and Princess Alexandra Hospital microbial keratitis audit (PAHMK audit) is an single centre medical record review of patients with culture positive MK between 1999-2015.Results:QMKD included 3182 corneal scrapes which yielded 4111 organisms. Estimated incidence of culture positive microbial keratitis was 0.66 cases per 10 000 people (95% CI 0.65-0.67). Pseudomonas aeruginosa was most common single isolate (729, 17.7%), although gram positive organisms were more common overall (2737, 66.6%). Fungal organisms were cultured in 6% of cases, while acanthamoeba comprised only 1% of records. The yearly incidence of MK in children was estimated to be 0.11 cases per 10 000 people 16 years old or younger (95% CI 0.086-0.134). Cultures positive for Streptococcus pneumoniae (17; 13.6%; p<0.001) and bacteria sensitive to all recorded antibiotics (96.8%; p<0.001) were significantly more common in children. Incidence of protozoal isolation decreased over time (p=0.055). Yeasts showed a linear increase in incidence (p=0.045). PAH MK audit included 895 episodes. Most common: risk factor was contact lens wear (324, 36.2%), isolated organism was Pseudomonas aeruginosa (181, 55.9%) and treatment was monotherapy with a fluoroquinolone (172, 53%). CLMK was most common between 2009-2011 (49.5% vs other years 32%, p<0.001). Poisson regression of the interrupted time series showed there was a significant decrease in the rate over time after 2010 (p<0.001). 328 patients’ records were included in the analysis of steroid treatment

Cultured limbal tissue transplants have become widely used over the last decade as a treatment for limbal stem cell deficiency (LSCD). While the number of patients afflicted with LSCD in Australia and New Zealand is considered to be relatively low, the impact of this disease on quality of life is so severe that the potential efficacy of cultured transplants has necessitated investigation. We presently review the basic biology and experimental strategies associated with the use of cultured limbal tissue transplants in Australia and New Zealand. In doing so, we aim to encourage informed discussion on the issues required to advance the use of cultured limbal transplants in Australia and New Zealand. Moreover, we propose that a collaborative network could be established to maintain access to the technology in conjunction with a number of other existing and emerging treatments for eye diseases.

AIM: To investigate the expression of p63 and cytokeratins throughout the course of producing a cultivated autograft of limbal epithelial cells. METHODS: A 75 year old male with a severe alkali burn to his right eye received two cultivated autografts of limbal epithelial cells on amniotic membrane followed by a corneal allograft. Immunostaining for p63 and cytokeratins was performed during ex vivo expansion with 3T3 fibroblasts, following subcultivation on amniotic membrane, and on the excised corneal button. RESULTS: Cultures grown in the presence of 3T3 fibroblasts or on amniotic membrane displayed positive staining for keratins 14 and 19, and p63, but poor staining for keratin 3 (K3). The excised corneal button possessed a stratified epithelium of K3 positive cells residing on amniotic membrane. CONCLUSIONS: Our results document for the first time the co-expression of cytokeratins 14 and 19 with p63 in a cultivated limbal graft. These data support the conclusion that cultivated grafts of limbal epithelium contain predominantly undifferentiated cells with the potential to regenerate a normal corneal epithelium.