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Principles of management
Whatever section of pathology is to blame and wherever it strikes, the aim of treatment is always the same. Find the cause if you can. Establish the effects of the cause. Halt the pathological process if you can. Reverse its...Vitreomacular traction and full thickness macular hole
Clinical scenario: A 64-year-old lady presented to the clinic with a few weeks history of sudden onset of metamorphopsia, central blur and reduced vision in her right eye. The ocular examination and ocular coherence tomography confirmed right eye focal vitreomacular...
Tacrolimus for endothelial rejection
This double-blinded randomised controlled trial tested the use of adjuvant topical Tacrolimus drops in cases of acute endothelial rejection in penetrating keratoplasty (PK). Patients with typical signs of endothelial rejection were randomised to receive either steroid therapy with topical Tacrolimus...
Femto-DMEK – a solution for high re-bubbling rates?
This retrospective study examined results of patients that underwent femtosecond laser enabled descemet membrane endothelial keratoplasty (DMEK) (FE-DMEK) and manual DMEK (M-DMEK) for Fuch’s endothelial dystrophy. In FE-DMEK femtosecond laser was used to create 8.25mm descemetorhexis, whereas during M-DMEK- descemetorhexis...
Penetrating keratoplasties in infants
This retrospective review looked at endothelial cell counts (ECC) following penetrating keratoplasties (PKP) performed in infants within the first year of their life. One hundred eyes of 71 patients had their first PKP during the study period (1998-2013). In 30%...Burning vision: vision loss from misuse of ‘toy’ laser pens in children
A case series of five children with macular burns due to the misuse of novelty laser products, purchased online or abroad, was undertaken at the Royal Hallamshire Hospital and The Children’s Hospital, Sheffield [1]. All patients were from the Sheffield...
Silicone oil in rhegmatogenous retinal detachment
Silicone oil (SO), used in complicated retinal detachments, is associated with complications such as cataract, increased intraocular pressure (IOP), keratopathy, cystoid macular oedema (CMO), epiretinal membrane (ERM) and loss of vision. Emulsification of oil can also lead to migration of...DMEK vs. UT-DSAEK: has the debate been finally concluded?
In recent years the surgical treatment of corneal endothelial dystrophy has progressed tremendously. Descemet’s membrane endothelial keratoplasty (DMEK) is the newest iteration in the line of rapid surgical advances that has taken place. However, the previously accepted gold standard prior...Bilateral eye pain after contact lens wear: an inadvertent case of chemical eye injury
Introduction There are around 4.1 million contact lens wearers in the UK [1]. While the vast majority of them do not experience any complications, over the past years there have been cases of acanthamoeba keratitis and multiple retained contact lenses...Principles of contact lens fitting in keratoconus
Keratoconus is an ectatic condition of the cornea characterised by progressive conical distortion with irregular astigmatism, myopia and apical protrusion. Most cases progress slowly resulting in varying degrees of myopic astigmatism. Management of keratoconus includes spectacles, soft contact lenses, a...
Is DSAEK or DMEK better for failed penetrating keratoplasty (PKP)?
This retrospective study involved 52 patients with failed penetrating keratoplasty. Twenty-eight eyes underwent Descemet membrane endothelial keratoplasty (DMEK) and 24 eyes underwent Descemet stripping automated endothelial keratoplasty (DSAEK). Data collection included demographic characteristics, number of previous corneal transplants, previous glaucoma...
