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The retrocorneal fibrous membrane in eight cases of the vitreous touch syndrome was characterized by homogeneous granular material, fine filaments arranged either singly or in bundles, multiple lamellae of basement membrane-like material, and banded figures of similar to 110 nm periodicity. Seven cases demonstrated an intact endothelial monolayer while only one showed cells in a markedly thickened fibrous layer. These findings support the pathogenic mechanism of endothelial fibrous metaplasia and secretory activity as the origin of the retrocorneal fibrous membrane in the vitreous touch syndrome.

Using the Binkhorst four-loop intraocular lens, we began a trial of intraocular lens implantation in 1975. We compared the operative and postoperative complications and the visual results of 100 implant cases during a two-year period to those of 100 age-matched aphakic control cases. Although the additional steps of lens implantation resulted in more operative and postoperative complications in the intraocular lens group, the visual results were good and were the same for both groups at an average follow-up of 12 months. Because the long-term follow-up results of implant cases are unknown, we recommend a conservative approach to selection of patients for intraocular lens implantation.

A 27-year-old white man had endogenous Candida endophthalmitis with fungi in the vitreous cavity, presumably caused by hematogenous spread related to drug abuse, and was treated by pars plana vitrectomy and antifungal medications administered systemically after surgery. There was no evidence of other systemic involvement, and excision of fungi from the vitreous cavity confirmed the clinical diagnosis and determined the sensitivity of this fungus to antifungal medications. The fungus was sensitive to flucytosine (5-FC), which the patient received orally since it was less toxic to body tissues than amphotericin B. The intraocular infection cleared rapidly after vitrectomy, and visual acuity returned to 6/5 (20/15).

A distinctive subepithelial keratopathy developed in four adult patients with Crohn's disease (granulomatous ileocolitis). Small, bilateral, symmetrical subepithelial, and anterior proliferative infiltrates and scarring were present 2 to 3 mm inside the entire corneoscleral limbus. Vision was not affected because the lesions spared the central cornea. The mechanism is not known and the lesion should be regarded as a distinct clinical sign of Crohn's disease.

We developed a reliable method for measuring corneal regeneration in humans with noninvasive, readily available photographic techniques. We then used this method prospectively to compare the rates of primary corneal regeneration after surgery in a series of 27 diabetic and nondiabetic patients. The rates of corneal epithelial regeneration were not significantly different when diabetic patients were compared with nondiabetic patients. A tendency toward recurrent epithelial defects was confirmed in the diabetic patients, however.

We analyzed pre- and postoperative corneal endothelial photographs of 33 intraocular lens patients and found an average endothelial cell density loss of 14%. Twenty-six cataract patients, similarly examined, showed a 13% mean endothelial cell loss. In 14 of the intraocular lens patients, a second postoperative evaluation of the central endothelium, at a later date, revealed a trend toward continuing cell loss. Our results indicate fewer endothelial cells were lost after intraocular lens implantation than has been previously reported. This may be accounted for by our considering only patients with normal corneas for lens implantation, and by our constant maintenance of the anterior chamber with an air bubble during lens implant surgery.