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Purpose Iris intraocular implants were developed to manage congenital or traumatic iris defects. However, they are also used to change the color of patient eyes. The aim of this retrospective series was to report complications in patients managed in France after cosmetic implantation. Setting Ophthalmological institutions and private ophthalmologists in France. Design Multicenter retrospective observational study. Methods Questionnaires were sent to all ophthalmology departments in university hospitals and to private ophthalmologists. This questionnaire listed demographic and clinical data for each implanted eye with a focus on safety, the description of ocular complications (corneal edema, endothelial cell loss, increased intraocular pressure, and intraocular inflammation), and the therapeutic management implemented. Results Forty-four questionnaires (87 eyes) were collected, and ultimately, 33 questionnaires (65 eyes) were considered complete and analyzed. Two types of implants were identified. Of the 65 eyes analyzed, only 5 eyes (7.7%) did not experience any complication and 60 eyes (92.3%) had at least 1 complication. The most commonly reported complication was corneal decompensation (78.5%). The diagnosis of glaucoma was made in over half (52.3%) of the cases. Explantation was needed in 81.5% of cases. The mean final visual acuity was 0.45 ± 0.08 logarithm of the minimum angle of resolution (logMAR) (0 to 2 logMAR). Conclusions Several ocular complications with a decreased mean visual acuity were described in a young healthy population. In addition, patient information on the safety of this procedure appeared insufficient.

International audience; We report here a case of an immunocompetent patient suffering from recurrent epithelial herpetic keratitis associated with the emergence of antiviral resistance. Indeed, the not previously described amino acid change L340R within herpes simplex virus thymidine kinase, was shown to confer acyclovir-resistance by recombinant phenotyping using bacmid technology.

Keratoconus (KC) is a complex disease whose pathophysiology is only partially understood. The priority in management is to halt the progression of corneal deformation as soon as possible in the course of KC disease. Corneal cross-linking (CXL) is at present the only dedicated treatment for this purpose. Its biochemical mechanism of action leads to changes in the viscoelastic properties of the cornea induced by matrix bonding and renewal of keratocytes. The effect of CXL is difficult to quantify when measured in in-vivo conditions because of a lack of consistent tools adapted for clinical practice. Nevertheless, a large amount of evidence has been collected so far confirming the positive action of CXL on corneal structural reinforcement, and numerous studies have demonstrated significant efficacy in halting progression of KC with long-term follow-up. Published studies, however, are of relatively low scientific power given the great heterogeneity of the disease and the numerous associated biases in evaluation. The purpose of this paper is to summarize the consistent evidence of efficacy of CXL and to justify its role in our therapeutic armamentarium for management of progressive KC.

To assess the reproducibility of single-pass cutting for preparation of ultra-thin (≤120μm) donor cornea grafts in Descemet stripping automated endothelial keratoplasty (DSAEK).All consecutive patients of DSAEK performed using the MORIA One Use microkeratome (MORIA, Antony, France) in between June 2014 and August 2015. Patient and donor central corneal thickness (CTT), microkeratome head, remaining stromal bed thickness (RSBT), number of cut and graft thickness at 1 month and 6 months postoperatively were recorded in this single-center prospective study.The mean preoperative donor graft CCT was 569.0±45.1μm and the mean donor endothelial graft CCT immediately after the cut was 116.5±28.7μm. At 1 month postoperatively, the mean CCT was 102.8±35.9μm. At 6 months, the mean CCT was 89.4±26.2μm. In all eyes, the mean CCT decreased from the post-cut (116.5±28.7μm) to the last visit (89.4±26.2μm) (P0.01) due to in vivo deturgesence of the graft. We obtained 77.5% ultra-thin DSAEK immediately after the cut, 77.5% at 1 month and 89.8% after 6 months.Single-pass technique with the MORIA One Use microkeratome offers safe and reproducible DSAEK tissue preparation and allows achieving ultra-thin DSAEK in 89.8% of cases.

INTRODUCTION : Depuis le début des années 2000, le cross-linking du collagène cornéen (CXL) s'est imposé comme le traitement de référence pour stabiliser le kératocône évolutif. Ses modalités techniques ont vu naître une version « accélérée » permettant une durée de procédure plus courte pour des irradiance plus élevées. L'efficacité de cette dernière modalité est encore peu documentée à long terme en comparaison au protocole de Dresde validé pour le CXL conventionnel. Ce travail se propose de comparer avec un recul prolongé le devenir clinique des patients kératoconiques traités par CXL accéléré (A-CXL) versus CXL conventionnel (C-CXL). MÉTHODES : Ce travail monocentrique rétrospectif a recueilli les données cliniques, topographiques (kératométries maximale Kmax et minimale Kmin, cylindre cornéen, indice d'asymétrie de surface SAI), et pachymétriques des patients traités par C-CXL ou A-CXL pour kératocône évolutif dans le service d'ophtalmologie du CHU de Bordeaux, en préopératoire puis tous les 6 mois jusqu'au dernier suivi. Les énergies délivrées étaient respectivement pour les groupes A-CXL et C-CXL de 3 mW/cm2, 30 min et 30 mW/cm2, 3 min, pour une fluence identique de 5.4 J/cm2, après imprégnation stromale de riboflavine sur cornée désepithélialisée. Les variations moyennes (Δ = postop - préop) des paramètres étudiés étaient calculées à chaque recul et comparées entre les groupes C-CXL et A-CXL. Le critère de jugement principal était la variation comparée du ΔKmax. La variation moyenne de Kmax au cours du suivi était également analysée par sous-groupe de sévérité initiale, selon la classification de Krumeich. La répartition des profils évolutifs après CXL était comparée entre les deux groupes à chaque recul : un patient était identifié « progresseur » pour un ΔKmax ≥ 1 dioptrie, « stable » pour un ΔKmax compris entre 1 dioptrie et -1 dioptrie (bornes exclues), et « régresseur » pour un ΔKmax ≤ -1 dioptrie. Enfin, la tolérance était comparée sur la base de la prévalence des effets indésirables dans chaque groupe. RÉSULTATS : 195 yeux étaient inclus dans le groupe A-CXL et 232 yeux dans le groupe C-CXL entre 2012 et 2015. Les groupes étaient comparables en préopératoire (tous p>0,05) sur les 7 paramètres étudiés ainsi que sur le sexe, l'âge moyen et la distribution des stades de sévérité de Krumeich. La proportion de patients stabilisés ou en régression était comparable dans les deux groupes, évaluée de 80,77 à 96,77% dans le groupe accéléré (A-CXL) versus 86 à 94,12% dans le groupe conventionnel (C-CXL) (p>0,05). Cependant, il existait à chaque recul post-opératoire une baisse plus prononcée de Kmax dans le groupe C-CXL que dans le groupe A-CXL, avec une différence significative à 12 mois (ΔKmax de -0,62 ± 1,55 vs 0,23 ± 0,88 ; p

Keratoconus (KC) is a complex disease whose pathophysiology is only partially understood. The priority in management is to halt the progression of corneal deformation as soon as possible in the course of KC disease. Corneal cross-linking (CXL) is at present the only dedicated treatment for this purpose. Its biochemical mechanism of action leads to changes in the viscoelastic properties of the cornea induced by matrix bonding and renewal of keratocytes. The effect of CXL is difficult to quantify when measured in in-vivo conditions because of a lack of consistent tools adapted for clinical practice. Nevertheless, a large amount of evidence has been collected so far confirming the positive action of CXL on corneal structural reinforcement, and numerous studies have demonstrated significant efficacy in halting progression of KC with long-term follow-up. Published studies, however, are of relatively low scientific power given the great heterogeneity of the disease and the numerous associated biases in evaluation. The purpose of this paper is to summarize the consistent evidence of efficacy of CXL and to justify its role in our therapeutic armamentarium for management of progressive KC.