{"title":"Superficial anterior lamellar keratoplasty for the treatment of recalcitrant photorefractive keratectomy–associated haze","authors":"Zale Mednick MD, FRCSC, Santaella Gisella MD, Nir Sorking MD, Tanya Trinh MB BS, FRANZCO, Clara Chan MD, FRCSC, David Rootman MD, FRCSC","doi":"10.1016/j.jcro.2018.12.002","DOIUrl":"10.1016/j.jcro.2018.12.002","url":null,"abstract":"<div><p><span>A 36-year-old man with persistent corneal haze had multiple unsuccessful conventional treatments<span> including 8 rounds of phototherapeutic keratectomy<span> with mitomycin-C, several superficial keratectomies, and the use of </span></span></span>thiotepa<span> drops. After 8 years of ineffective treatments, femtosecond laser–assisted superficial anterior lamellar keratoplasty (ALK) was used as a treatment option. More than 6 months postoperatively, the patient’s haze had resolved and showed no signs of recurrence. Superficial ALK is a viable option for patients with persistent corneal haze that has been resistant to and has recurred with conventional therapies.</span></p></div>","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"7 2","pages":"Pages 31-32"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcro.2018.12.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49181132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anders H. Vestergaard MD, PhD , Pernille Rævdal MD , Anders R. Ivarsen MD, PhD , Jesper Ø. Hjortdal MD, PhD, DMSci
{"title":"Corneal biomechanical change assessment using biomechanical waveform analyzer parameters: Contralateral comparison of eyes having femtosecond lenticule extraction and small-incision lenticule extraction for moderate to high myopia","authors":"Anders H. Vestergaard MD, PhD , Pernille Rævdal MD , Anders R. Ivarsen MD, PhD , Jesper Ø. Hjortdal MD, PhD, DMSci","doi":"10.1016/j.jcro.2018.10.002","DOIUrl":"10.1016/j.jcro.2018.10.002","url":null,"abstract":"<div><p>Thirty-four patients were treated with femtosecond lenticule extraction (FLEx) in 1 eye and small-incision lenticule extraction (SMILE) in the other eye for moderate to high myopia. The procedures were performed using the ReLEx VisuMax femtosecond laser system. Patients were examined before and 6 months after surgery. Overall, the 37 corneal waveform parameters from the Ocular Response Analyzer biomechanical waveform analyzer were not able to detect major differences in corneal biomechanical properties between the flap-based FLEx procedure and the cap-based SMILE procedure.</p></div>","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"7 2","pages":"Pages 17-19"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcro.2018.10.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46248241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Late corneal acute hydrops in ineffective accelerated transepithelial corneal crosslinking in a patient with keratoconus","authors":"Shotaro Asano MD , Takashi Miyai MD, PhD , Tetsuya Toyono MD, PhD , Wei Aixinjueluo MD, PhD , Junko Yoshida MD, PhD , Tomohiko Usui MD, PhD","doi":"10.1016/j.jcro.2018.10.001","DOIUrl":"10.1016/j.jcro.2018.10.001","url":null,"abstract":"<div><p><span>A 20-year-old man with a very thin cornea developed acute hydrops with corneal thinning after accelerated transepithelial corneal crosslinking (CXL) for </span>keratoconus<span><span>. Because the corneal thinning and deformation were progressing, accelerated transepithelial CXL was performed in the right eye. However, corneal thinning still progressed after the procedure. After 3.5 years, blurred vision occurred suddenly and acute hydrops was diagnosed. With a pressure eye patch and ofloxacin ointment, the acute hydrops resolved 2 months after the onset. Corneal thickness and topographic change should be monitored carefully after accelerated transepithelial CXL, especially </span>in patients with thin corneas.</span></p></div>","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"7 2","pages":"Pages 20-22"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcro.2018.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49248855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William J. Johnson MD , George N. Magrath MD , Lynn J. Poole Perry MD, PhD
{"title":"Rapid anterior capsule contraction after femtosecond laser–assisted cataract surgery in a patient with retinitis pigmentosa","authors":"William J. Johnson MD , George N. Magrath MD , Lynn J. Poole Perry MD, PhD","doi":"10.1016/j.jcro.2018.11.001","DOIUrl":"10.1016/j.jcro.2018.11.001","url":null,"abstract":"<div><p><span><span>We report a case of rapid and extreme capsule contraction after uneventful femtosecond laser–assisted cataract surgery (FLACS) in one eye performed subsequent to uneventful standard </span>phacoemulsification with manual continuous curvilinear </span>capsulorhexis<span><span> (CCC) creation in the fellow eye. In the setting of retinitis pigmentosa, the rapid and extreme anterior capsule contraction in the FLACS eye compared with the manual CCC eye might have been the result of release of </span>inflammatory mediators<span> from cell death<span> during the laser capsulotomy combined with a structurally weaker CCC edge.</span></span></span></p></div>","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"7 2","pages":"Pages 23-25"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcro.2018.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47540540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Blood staining of the posterior capsule caused by Terson syndrome","authors":"Kaori Hanai MD , Masato Hashimoto MD , Masako Sasaki MD , Hirohiko Nakamura MD","doi":"10.1016/j.jcro.2018.11.002","DOIUrl":"10.1016/j.jcro.2018.11.002","url":null,"abstract":"<div><p><span>A 49-year-old man noticed bilateral acute visual loss<span><span><span><span> after a subarachnoid hemorrhage caused by right </span>vertebral artery dissection. Ophthalmologic findings were consistent with a diagnosis of </span>Terson syndrome. A 25-gauge </span>pars plana vitrectomy<span> was performed after phacoemulsification<span> with intraocular lens implantation; all procedures were uneventful. However, the operative field was very hazy. A small transparent circle, presumably the basement of Cloquet canal, was observed in the center of the cloudy operative field. We concluded that the posterior capsule had been stained by the </span></span></span></span>vitreous hemorrhage<span>. Therefore, a posterior capsulotomy was performed around the small circle, resulting in a clear operative field, and the surgery proceeded safely.</span></p></div>","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"7 2","pages":"Pages 26-27"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcro.2018.11.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41456508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marie Verstappen MD, Guillaume Debellemanière MD, PhD, Sarah Moran MD, Damien Gatinel MD, PhD
{"title":"Fibrin glue to manage flap necrosis secondary to late-onset infectious keratitis after laser in situ karatomileusis","authors":"Marie Verstappen MD, Guillaume Debellemanière MD, PhD, Sarah Moran MD, Damien Gatinel MD, PhD","doi":"10.1016/j.jcro.2018.12.001","DOIUrl":"10.1016/j.jcro.2018.12.001","url":null,"abstract":"<div><p><span><span>A 52-year-old man developed flap necrosis secondary to late-onset infectious </span>keratitis<span> after laser in situ keratomileusis. Management involved a flap lift and irrigation of the interface with fortified antibiotics. The flap was then replaced, and fibrin glue<span> was placed at the flap edges and over the necrotic area to seal it completely. Two months after surgery, the corrected distance visual acuity was 20/20 and a slitlamp examination showed no signs of infection. Localized flap necrosis can be adequately managed with fibrin glue, including in cases of </span></span></span>herpes simplex virus keratitis.</p></div>","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"7 2","pages":"Pages 28-30"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcro.2018.12.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44980674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical biomarker in aqueous misdirection syndrome: The pupillary snap sign","authors":"Francesco Stringa MD, Tajwar Iqbal MD, Achini Makuloluwa MD, Vikas Shankar MD","doi":"10.1016/j.jcro.2018.08.004","DOIUrl":"10.1016/j.jcro.2018.08.004","url":null,"abstract":"<div><p><span>Aqueous misdirection syndrome (AMS) is characterized by high intraocular pressure<span><span> and a shallow anterior chamber because of anterior rotation of the </span>ciliary processes, accumulation of aqueous within the anterior vitreous, and forward displacement of the iris–lens diaphragm (ILD). It mainly occurs in eyes with narrow iridocorneal angles, after intraocular surgery, after laser procedures, or after administration of topical </span></span>miotics<span>. There is no standardized therapy; however, zonulectomy–hyaloidectomy–anterior vitrectomy<span> seems to be the most effective treatment<span>. A neodymium:YAG (Nd:YAG) laser capsulotomy–hyaloidotomy is a more conservative approach that can decompress the anterior vitreous, release the aqueous, and promote backward displacement of the ILD. We present a case of AMS initially managed with Nd:YAG laser capsulotomy–hyaloidotomy. During this procedure, constriction and redilation of the pupil (ie, the pupil “snapped”) was observed, along with aqueous and vitreous prolapse in the anterior chamber. This sign might represent the moment of aqueous misdirection reversal and could be interpreted by the ophthalmologist as a useful clinical biomarker.</span></span></span></p></div>","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"7 1","pages":"Pages 6-8"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcro.2018.08.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54450885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Burak Mergen MD , Ahmet M. Sarici MD , Fatih Baltu MD , Hrisi Bahar-Tokman PhD , Guzin Iskeleli MD
{"title":"Mixed keratitis caused by Trichoderma and methicillin-resistant Staphylococcus aureus after uneventful laser in situ keratomileusis","authors":"Burak Mergen MD , Ahmet M. Sarici MD , Fatih Baltu MD , Hrisi Bahar-Tokman PhD , Guzin Iskeleli MD","doi":"10.1016/j.jcro.2018.09.001","DOIUrl":"10.1016/j.jcro.2018.09.001","url":null,"abstract":"<div><p>A 41-year-old man presented with simultaneous bacterial and fungal keratitis in the left eye after uneventful laser in situ keratomileusis (LASIK). Three months after surgery, the bacterial and fungal cultures of the corneal scrapings identified <span><em>Staphylococcus aureus</em></span> and <em>Trichoderma</em><span><span> species. After treatment with topical antibacterial and </span>antifungal agents, the infection resolved; however, a complicated cataract developed in the left eye. Complications after LASIK are rare but can be devastating and vision threatening.</span></p></div>","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"7 1","pages":"Pages 14-16"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcro.2018.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44155122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unilateral bilateral acute iris transillumination-like syndrome after intracameral moxifloxacin injection for intraoperative endophthalmitis prophylaxis","authors":"Jacob G. Light MD, Suzanne M. Falkenberry MD","doi":"10.1016/j.jcro.2018.08.001","DOIUrl":"10.1016/j.jcro.2018.08.001","url":null,"abstract":"<div><p><span>In recent years, the use of intracameral moxifloxacin for intraoperative </span>endophthalmitis<span> prophylaxis has gained wide acceptance. Overall, moxifloxacin has been demonstrated to have excellent ocular safety with minimum toxicity. However, some ocular adverse effects have been postulated to be associated with systemic moxifloxacin use. One such possible association identified in recent years is bilateral acute iris transillumination<span> (BAIT), in which sudden pigment dispersion, variable pupillary abnormalities, and diffuse iris transillumination defects are seen in the absence of known infectious or uveitic processes. Until now, such findings have only been reported in the setting of systemic moxifloxacin exposure and never with topical or local exposure. Herein we present the first known case of a BAIT-like syndrome in a single eye after unilateral intracameral injection of moxifloxacin for endophthalmitis prophylaxis.</span></span></p></div>","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"7 1","pages":"Pages 3-5"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcro.2018.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47658564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gitansha Shreyas Sachdev MS, FICO , Shilpi Diwan MS , Mahipal S. Sachdev MD
{"title":"Unilateral fungal keratitis after small-incision lenticule extraction","authors":"Gitansha Shreyas Sachdev MS, FICO , Shilpi Diwan MS , Mahipal S. Sachdev MD","doi":"10.1016/j.jcro.2018.08.003","DOIUrl":"10.1016/j.jcro.2018.08.003","url":null,"abstract":"<div><p><span>A 20-year-old woman developed unilateral fungal keratitis after small-incision lenticule extraction (SMILE). The clinical presentation and subsequent management of the case is presented. The management of infectious keratitis after small-incision lenticule extraction could be challenging because performing an adequate scraping is difficult and </span>topical medication<span><span> penetration is limited in deep-seated infiltrates. An interface wash afforded deeper penetration of antifungal agents, resulting in gradual clinical improvement. A high degree of clinical suspicion for fungal etiology is necessary even with early onset of presentation, and corticosteroid administration should be withdrawn until confirmed microbiological diagnosis. In addition, an interface wash during small-incision lenticule extraction could serve as a source of direct microbiological inoculation into the </span>stroma<span> and might be avoided. Prompt scraping for microbiological analysis and subsequent interface irrigation helped limit disease severity and significant visual loss<span>. To our knowledge, this is the first reported case of fungal keratitis after small-incision lenticule extraction.</span></span></span></p></div>","PeriodicalId":14598,"journal":{"name":"JCRS Online Case Reports","volume":"7 1","pages":"Pages 11-13"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcro.2018.08.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54450851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}