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Purpose: The aim of the study was to evaluate long-term results of autologous serum treatment for recurrent corneal erosions. Methods: In this prospective single-centre study, 33 eyes of 33 patients (21 male and 12 female) were treated with autologous serum eye drops for recurrent corneal erosions. Mean age of the patients was 49.3 ± 9.8 standard deviation (range 24–73) years. All subjects had failed to respond to other treatments. Autologous serum drops were administered for a 6-month period: six times daily for the first 3 months and four times daily for the remaining 3 months. Detailed informed consent was obtained from the entire patient group before the study. Results: The mean follow-up period was 30 ± 6.3 standard deviation (range 12–48) months. None of the patients experienced a recurrence while under treatment. Twenty-eight patients (85%) had complete healing of erosions with no relapses of the disease over the whole follow-up period. Five patients (15%) presented a single recurrence 3–12 months after the end of the treatment. No sight-threatening complications were reported over the follow up. There was no statistically significant difference in the best spectacle-corrected visual acuity values (tstat = 2.1, F = 0.096, degree of freedom = 40 166, P

Purpose To restore the anophthalmic socket, primarily or secondarily, using a hydroxy-apatite sphere (HA). Methods We used HA in 33 patients (25 male, 8 female), aged from 4 to 68 years (mean 38.1 years) for 19 primary and 14 secondary implantations. HA spheres measured 16 mm in one patient, 18 mm in 21 and 20 mm in 11. The spheres were wrapped in donor sclera preserved in absolute alcohol. All six extraocular muscles were isolated, in the cases where this was possible. Buccal membrane was grafted in three patients to restore the fornices. Drilling was done on four patients using a 3.8 serrated plastic sheath. Results During follow-up of 7 - 69 months we observed no complications except for slight edema in the immediate postoperative period. All patients gained very good to excellent motility of the implant, acceptable symmetric appearance in the case of primary implantation, and a dramatic improvement of facial appearance in the case of secondary implantation. Conclusions HA spheres are an excellent orbital implant for primary and secondary restoration of the anophthalmic socket causing no serious complications

* BACKGROUND AND OBJECTIVE: Restoration of the anophthalmic socket to improve the aesthetic result on the face. * PATIENTS AND METHODS: The authors describe variations in the technique of secondary orbital implantation in 10 patients using the scleralwrapped hydroxyapatite (HA) sphere implant. Secondary implantation was performed in 4 patients without a previously inserted orbital implant, in 4 patients as an exchange procedure with a preexisting orbital implant, and in 2 patients with eviscerated eyes. Two of these patients proceeded with the drilling operation. * RESULTS: All 10 patients achieved a better facial appearance. There were no postoperative complications during the follow-up period of between 6 and 53 months. * CONCLUSION: Based on the authors' experience, secondary implantation of the HA sphere is a procedure of choice with no complications, but requires considerable skill and patience on the part of the surgeon. [Ophthalmic Surg Lasers 1998;29:808-814.]

To assess the visual function of patients with keratoconus who underwent penetrating keratoplasty with the use of the VF-14 questionnaire. Fourteen patients (9 male and 5 female) with a mean age of 38 years (SD 13.59) participated in the study. All patients had keratoconus, confirmed by corneal topography, and all had previously undergone penetrating keratoplasty in one eye. Their mean best-corrected visual acuity (BCVA) binocularly was 0.185 (SD 0.077) LogMAR. None of the grafted eyes had a BCVA

Background: To report the results of cryopreserved human amniotic membrane transplantation for the management of symptomatic bullous keratopathy. Methods: Prospective non-comparative interventional case series study. Consecutive cases with symptomatic bullous keratopathy for more than 12 months not amenable to conservative treatment were managed with amniotic membrane transplantation. They were recruited over a 5-year period (September 1999 to November 2004) in one referral centre. Only one eye of each patient (the worse affected eye in bilateral cases) was operated. A 360 degree conjunctival peritomy was followed by removal of the diseased corneal epithelium. Amniotic membrane was transplanted over the cornea as a patch and sutured to the free conjunctival edges. Primary outcome measures were ocular pain and epithelial defects; secondary measures were visual acuity and ocular surface inflammation. Results: Four out of 85 recruited cases did not complete the minimum observation of 12 months and were excluded from the study. The mean follow-up period for the remaining 81 cases was 21 ± 4.2 months (range 14–34 months). Seventy-one (87.6%) eyes became asymptomatic with healed epithelium, seven required repeated amniotic transplantation and three underwent penetrating keratoplasty. Visual acuity improved in 64 (79%) patients and remained unchanged in 14. No complications were recorded. Conclusions: Amniotic membrane transplantation is an efficient and safe treatment for symptomatic bullous kerato pathy, when penetrating keratoplasty is not available. It has been shown to alleviate pain, promote corneal epithelialization and reduce conjunctival inflammation whereas in some cases it may also improve visual acuity.

Purpose: To investigate the role of vision as a prognostic factor of the general developmental process in children with cerebral palsy (CP). Methods: 80 CP children (age range 24-96 months), participated in the study. Anamnestic data was collected, evaluation of Developmental Quotient (DQ), assessment of visual function (VFA-K test), Visual Evoked Potentials (VEPs) and brain magnetic resonance imaging (MRI), were performed in all. VFA-K test assesses the visual function in a global way (sensory, oculomotor, eye body coordination). Results: 53 CP children (66.25%) appeared with affected visual function and reduced DQ. 75.55% of the CP children with moderate to severe PVL and 93.75% with combined brain damage, appeared with affected visual function. Statistical analysis showed a significant relationship between visual function, DQ and the severity of brain damage. (p

The management of Graves' ophthalmopathy is shared between endocrinologists and ophthalmologists. Assessment and treatment of the active inflammatory stage is based on the clinical activity and disease severity scores, often without detailed eye examination by the treating endocrinologist.We report a case of acute viral keratoconjunctivitis occurring during immunosuppressive treatment for Graves' ophthalmopathy which masked the signs, symptoms and response to treatment of the orbitopathy, posing a differential diagnostic challenge.The apparent worsening of the ophthalmopathy and the increased clinical activity score led the treating endocrinologist to alter the management decisions. Ophthalmic examination confirmed the diagnosis of viral keratoconjunctivitis and immunosuppressive treatment was continued with significant final improvement of Graves' ophthalmopathy.Ocular surface conditions, unrecognised by the treating physician, may complicate the assessment of thyroid ophthalmopathy when detailed eye examination is not performed. The diagnostic challenge of Graves' ophthalmopathy requires a combined approach by an endocrinologist and an ophthalmologist working as a team.

Background/aim: Endothelin 1 (ET-1) is considered the most potent vasoconstrictor in the body and the eye. This molecule may play a significant role in the pathobiology of exfoliation syndrome (XFS), a disorder characterised by a progressive iris vasculopathy. The purpose of this study was to investigate the concentration of ET-1 in the aqueous humour of cataract patients with and without XFS. Methods: Aqueous humour samples were obtained from 25 consecutive eyes of 25 cataract patients with XFS and an equal number of age matched controls during phacoemulsification cataract surgery. None of the subjects had elevated intraocular pressure or glaucoma. ET-1 concentration in the aqueous was measured using a specific immunoassay with 100% immunoreactivity for ET-1. Total aqueous humour protein concentration was measured with a microplate Coomassie blue based method and was correlated with ET-1 concentration. Results: Mean ET-1 concentration in the XFS aqueous samples (4.6 (SD 2.3) pg/ml) was significantly higher than that measured in the age matched control samples (2.8 (SD 1.71) pg/ml); (p = 0.006). Although total protein concentration was significantly elevated in the XFS samples (0.380 (SD 0.159) v 0.279 (SD 0.144) mg/ml in the controls); (p = 0.023), no correlation was found between aqueous ET-1 and total protein concentration (p = 0.730). Conclusion: The increased concentration of ET-1 in the aqueous humour of XFS patients suggests that ET-1 may play a role in the pathobiology of XFS.

Purpose To investigate the efficacy of tissue plasminogen activator (tPA) in the treatment of severe fibrinous anterior chamber reactions after intraocular surgery. Setting Ophthalmology Department, AHEPA University Hospital, Thessaloniki, Greece. Methods The study comprised routine surgical and postoperative cases selected in a nonrandomized fashion. Low-dose tPA infusion (0.2 mL of 125 μg/mL) was administered through a side-port in the anterior chamber in 25 patients with recent or long-standing fibrin formation after cataract extraction (n = 13), trabeculectomy (n = 5), combined procedure (n = 5), or penetrating keratoplasty (n = 2). Patients were treated 4 to 25 days postoperatively (mean 7 days). Results Fibrin lysis was observed 2 to 12 hours after tPA infusion. No hemorrhage or other complications occurred, and no further treatment was necessary in any patient. Three cases of delayed partial fibrin lysis resolved with intense topical steroid treatment. There were no recurrences over the 3-month follow-up. Conclusions Low-dose tPA was an effective and safe method for the management of anterior chamber fibrin formation. Treatment was well tolerated and gave excellent results with no complications.

Purpose. To present our experience with the use of preserved human amniotic membrane on patients with epiphora caused by conjunctivochalasis. Methods. Twelve patients, seven women and five men, ages ranging from 56 to 72 years (mean, 61 years) were referred to our Cornea Service with chronic epiphora. In all patients, no punctal ectropion was present, the lacrimal pathway was patent, and the dye disappearance test was abnormal. All patients had already undergone various therapies including multiple irrigations of the lacrimal system, antibiotic drops, steroid drops, and artificial tear drops. In all patients, conjunctivochalasis, which was not previously diagnosed, was evident on slit-lamp examination. After surgical removal of the excess conjunctiva, preserved human amniotic membrane was placed over and sutured with 10-0 nylon continuous suture to the free conjunctival edges. During the postoperative period, artificial tear drops and steroid/antibiotic drops were applied. Results. Improvement of the epiphora was evident from the first postoperative day. After removal of the suture 10 to 15 days (mean, 12 days) after surgery, no patient complained of epiphora. The dye disappearance test was normal. During the follow-up period, which ranged from 6 to 11 months (mean, 8 months), no patient complained of epiphora and no conjunctivochalasis was detected in the area in which human amniotic membrane was transplanted. Conclusion. In our experience, transplantation of preserved human amniotic membrane greatly improved symptoms of epiphora caused by conjunctivochalasis. Continued education of the general ophthalmologists concerning this condition is required.

Restoration of the anophthalmic socket to improve the aesthetic result on the face.The authors describe variations in the technique of secondary orbital implantation in 10 patients using the scleral-wrapped hydroxyapatite (HA) sphere implant. Secondary implantation was performed in 4 patients without a previously inserted orbital implant, in 4 patients as an exchange procedure with a preexisting orbital implant, and in 2 patients with eviscerated eyes. Two of these patients proceeded with the drilling operation.All 10 patients achieved a better facial appearance. There were no postoperative complications during the follow-up period of between 6 and 53 months.Based on the authors' experience, secondary implantation of the HA sphere is a procedure of choice with no complications, but requires considerable skill and patience on the part of the surgeon.

Purpose To report a case of bilateral endogenous endophthalmitis due to group G Streptococcus after a dental procedure. METHODS Case report of a 69-year-old woman who presented with pain, decreased vision, bilateral uveitis, and a unilateral hypopyon 1 week after treatment for an abscessed tooth. Results Bilateral endophthalmitis was diagnosed, and group G Streptococcus was cultured from the vitreous samples. CONCLUSIONS To our knowledge, this is the second reported case of endogenous endophthalmitis following a dental procedure. Furthermore, it was due to group G Streptococcus, which is a rare cause of this condition.