Search

This study aims to present the use of Restylane Sub-Q for orbital volume augmentation in patients with secondary volume deficiency either postenucleation or postevisceration or those with phthisical eyes.This prospective case series reviews clinical, photographic, and radiologic records of 16 patients with anophthalmic or enophthalmic orbits who underwent volume augmentation by injection with hyaluronic acid gel in the intraconal and extraconal posterior orbit. The technique is discussed in detail.The volume of hyaluronic acid gel injected ranged from 2 to 4 ml (mean volume, 2.3 ml) per orbit, with a mean reduction of enophthalmos of 3.7 mm (71.4%) at 1 week, 2.8 mm (59.9%) at 6 months, and 2.5 (51.3%) at 12 months, with follow-up of 94.1%, 68.8%, and 50% of the patient group, respectively. Follow-up after 12 months consisted of subjective feedback from the patient. With the exception of one patient, the mean subjective follow-up period was 14.7 months (maximum, 22.4 months; minimum, 1.6 months). The procedure was well tolerated by 15 of the 16 patients who all experienced an improvement in cosmetic appearance. There was one possible complication of orbital cellulitis (although not examined by our clinic); this patient did not attend further follow-ups. One patient had full correction of her enophthalmos, which was maintained over 12 months.Hyaluronic acid gel injections in patients with enophthalmic sockets appear to be a safe, tolerable, and minimally invasive alternative for orbital volume augmentation in the outpatient setting. However, as predicted, its affects are temporary, and volume does begin to decrease within 12 months of injection.

To evaluate intraindividual differences in posterior capsule opacification (PCO) and visual performance of AcrySof SN60AT (Alcon Laboratories) and AF-1 YA-60BB (Hoya Corp.) intraocular lenses (IOLs).Ophthalmology Department, St. Thomas' Hospital, London, United Kingdom.In this prospective single-surgeon standardized-surgical-procedure fellow-eye comparison, an AcrySof SN60AT or an AF-1 YA-60BB IOL was randomized to the first eye of 36 patients and fellow-eye surgery was performed within 4 to 6 weeks. Follow-up was at 1, 3, 6, 12, and 24 months. Best distance- corrected logMAR visual acuity was measured at 100% and 9% contrast. Contrast sensitivity was measured using the Functional Acuity Contrast Test (FACT) on the Optec 3500 instrument (Stereo Optical Company, Inc.). Color vision was assessed with the Farnsworth Munsell 100-hue test. After pupil dilation, digital retroillumination photographs were taken and the percentage area of PCO was calculated using POCO software.Posterior capsule opacification was significantly greater in the AF-1 YA-60BB group than in the AcrySof SN60AT group at all time points (P.0001), with the difference greatest at 24 months. At 24 months, 100% contrast visual acuity was significantly better in the AcrySof SN60AT group than in the AF-1 YA-60BB group (P = .0313); 9% contrast visual acuity was significantly better in the AcrySof SN60AT group from 6 months onward. There was no significant difference between groups in color vision or contrast sensitivity. Electron microscopy showed the AcrySof SN60AT IOL has a much sharper posterior edge profile.The AcrySof SN60AT IOL had better PCO performance and thus visual performance than the AF-1 YA-60BB IOL. This is attributable to the differences in optic edge design.

The results of a prospective study examining the effect of refractive blur on colour vision performance in normal subjects measured with three different colour vision tests are reported. The Farnsworth Munsell 100 Hue (FM100) and Cambridge Colour Test (CCT) results were significantly affected at +6 D of spherical refractive blur, whereas those from the Ishihara Pseudoisochromatic Plate (IPP) test were not. In a clinical setting, correction of refractive error up to 3 D for colour vision testing with these tests may not be required. Poor colour vision should not be attributed solely to refractive causes of poor visual acuity (Snellen equivalent: >6/36). Fastest test times were achieved using IPP, followed by CCT.

Purpose: To present a case of inadvertently retained Descemet Membrane (DM). Methods: Case report. Results: A 41-year-old male with previous history of retinal detachment surgery underwent a repeat penetrating keratoplasty; the first graft decompensated secondary to silicone oil. Postoperatively, an inadvertently retained DM was observed forming a physical barrier to the silicone oil. Conclusion: Retained DM is a rare complication of penetrating keratoplasty, with only a few cases reported in the literature. This membrane served a protective role from the effects of silicone oil on the donor cornea but later opacified and required surgical intervention.