Hasil untuk "Ophthalmology"

Alon Kahana, Alon Kahana, Raymond I. Cho et al.

Tingyi Wu, Tingyi Wu, Qianqian Ji et al.

PurposeTo investigate the influence of aqueous humor cytokines levels on the failure of illuminated microcatheter-assisted circumferential trabeculotomy (MAT) in open-angle glaucoma (OAG) patients.MethodsThis was a prospective case series with a follow-up period of 24 months. General information and ocular examinations were recorded. Aqueous humor was collected at the time of surgery. Eight aqueous humor cytokines were analyzed: CCL2, VCAM-1, ICAM-1, IL-6, IL-8, IL-10, CXCL10 and G-CSF. Bioinformatics analysis was used to explore the protein network and the possible pathways related to OAG. Surgical failure was defined as a requirement for glaucoma reoperation or intraocular pressure (IOP) greater than 21mmHg with more than 3 topical antiglaucoma medications at 24-month follow-up.ResultsSixty-five eyes were enrolled (58 success and 7 failure). The levels of CCL2, ICAM-1, IL-6 and CXCL10 in aqueous humor were significantly higher in the surgical failure group (P = 0.024, 0.002, 0.022 and 0.008, respectively). A higher percentage of secondary glaucoma (P < 0.001), younger age (P = 0.019), worse preoperative BCVA (P = 0.022), higher preoperative IOP (P = 0.022) and more preoperative topical antiglaucoma medications (P = 0.029) were significantly observed in the surgical failure group. Bioinformatics analysis identified 4 hub proteins, including CCL2, CXCL10, IL-6 and CXCR3, and demonstrated the potential role of chemokine signaling pathway in MAT surgical outcome.ConclusionHigher concentrations of CCL2, ICAM-1, IL-6 and CXCL10 in the aqueous humor were related to the failure of MAT surgery in OAG patients, and chemokine signaling pathway might be associated with the surgical outcome.

Yaohua Zhang, Jing Li, Zhiqing Wu et al.

Small-incision lenticule extraction (SMILE) is a safe and effective procedure to correct myopia and myopic astigmatism. The corneal stromal lenticules extracted from SMILE surgery have good light transmission, mechanical properties, and biocompatibility, which are suitable for the treatment of a variety of corneal diseases and can solve the problem of donor cornea shortage. At present, no single method of preserving corneal stromal lenticules has been universally accepted as ideal, as the preservation of tissue integrity, optical transmittance, cellular viability, and the potential for long-term storage remain key challenges. Current approaches include short-term preservation methods such as the use of dehydrating agents and Optisol GS, and long-term preservation strategies such as cryopreservation, hydrogel nutrient capsules, and silicone oil. Standardized storage methods can improve the use of SMILE-derived lenticules as a substitute for donor corneal tissue in clinical settings. The reuse of corneal stromal lenticules is a highly regarded research area, especially in hyperopia, presbyopia, keratoconus, and some corneal ulcerative diseases, providing new possibilities for addressing corneal tissue shortage and improving surgical outcomes. Here, we review various preservation methods and clinical applications of SMILE-extracted lenticules, highlighting their potential in addressing corneal tissue shortages and the treatment of a variety of corneal diseases.

Jennifer Adeghate, Samantha R. Goldburg, Sherry Bass et al.

Introduction: The intraflagellar transport (IFT) complex plays a key role in protein transport and turnover within photoreceptors. IFT140 and IFT172 gene mutations have been associated with skeletal ciliopathies that occur concurrently with retinal dystrophy. These mutations have also been associated with non-syndromic retinal dystrophies. This phenotypic heterogeneity can make diagnosis challenging. Here, we report novel variants in IFT140 and IFT172 genes in 3 patients with similar retinal dystrophy phenotypes. Case Presentations: Two siblings (a 51-year-old male and 46-year-old male) who presented with a similar retinal dystrophy, skeletal abnormalities, and kidney disease were found to have the same novel variant in the IFT140 gene, along with another, previously reported variant. An unrelated individual with a similar retinal phenotype was found to have a novel variant in the IFT172 gene, although this was noted as a variant of uncertain significance. The patients underwent testing with the Blueprint Genetics (Blueprint Genetics Oy, Keilaranta 16 A-B, 02150 Espoo, Finland) “My Retina Tracker Program Panel Plus” panel. Conclusion: Novel variants in the IFT140 and IFT172 genes encoding the IFT complex may contribute to similar retinal dystrophy phenotypes, as noted in our case series.

Ueno T, Fujita H, Ikeda A et al.

Tomohiro Ueno, Hideaki Fujita, Aya Ikeda, Kazuhiro Harada, Tomoko Tsukahara-Kawamura, Hiroaki Ozaki, Eiichi Uchio Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, JapanCorrespondence: Eiichi Uchio, Department of Ophthalmology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan, Tel +81 92 801 1011, Fax +81 92 865 4445, Email euchio@fukuoka-u.ac.jpBackground: We studied the kinetic phenomenon of an airbag impact on eyes with different axial lengths using finite element analysis (FEA) to sequentially determine the physical and mechanical responses of intraocular segments at various airbag deployment velocities.Methods: The human eye model we created was used in simulations with the FEA program PAM-GENERISTM. The airbag was set to impact eyes with axial lengths of 21.85 mm (hyperopia), 23.85 mm (emmetropia) and 25.85 mm (myopia), at initial velocities of 20, 30, 40, 50 and 60 m/s. The deformation rate was calculated as the ratio of the length of three segments, anterior chamber, lens and vitreous, to that at the baseline from 0.2 ms to 2.0 ms after the airbag impact.Results: Deformation rate of the anterior chamber was greater than that of other segments, especially in the early phase, 0.2– 0.4 ms after the impact (P < 0.001), and it reached its peak, 80%, at 0.8 ms. A higher deformation rate in the anterior chamber was found in hyperopia compared with other axial length eyes in the first half period, 0.2– 0.8 ms, followed by the rate in emmetropia (P < 0.001). The lens deformation rate was low, its peak ranging from 40% to 75%, and exceeded that of the anterior chamber at 1.4 ms and 1.6 ms after the impact (P < 0.01). The vitreous deformation rate was lower throughout the simulation period than that of the other segments and ranged from a negative value (elongation) in the later phase.Conclusion: Airbag impact on the eyeball causes evident deformation, especially in the anterior chamber. The results obtained in this study, such as the time lag of the peak deformation between the anterior chamber and lens, suggest a clue to the pathophysiological mechanism of airbag ocular injury.Keywords: airbag, ocular trauma, computer simulation, lens, anterior chamber, vitreous body, finite element analysis, deformation

Silvia Diz-de Almeida, Raquel Cruz, Andre D Luchessi et al.

The genetic basis of severe COVID-19 has been thoroughly studied, and many genetic risk factors shared between populations have been identified. However, reduced sample sizes from non-European groups have limited the discovery of population-specific common risk loci. In this second study nested in the SCOURGE consortium, we conducted a genome-wide association study (GWAS) for COVID-19 hospitalization in admixed Americans, comprising a total of 4702 hospitalized cases recruited by SCOURGE and seven other participating studies in the COVID-19 Host Genetic Initiative. We identified four genome-wide significant associations, two of which constitute novel loci and were first discovered in Latin American populations (BAZ2B and DDIAS). A trans-ethnic meta-analysis revealed another novel cross-population risk locus in CREBBP. Finally, we assessed the performance of a cross-ancestry polygenic risk score in the SCOURGE admixed American cohort. This study constitutes the largest GWAS for COVID-19 hospitalization in admixed Latin Americans conducted to date. This allowed to reveal novel risk loci and emphasize the need of considering the diversity of populations in genomic research.

Yuh-Shan Ho, Ali Ouchi, Leila Nemati-Anaraki

AIM: To determine and evaluate the features of highly cited articles (HCAs) in the ophthalmology category in the Science Citation Index Expanded (SCI-EXPANDED) from 1991 to 2020. METHODS: The Web of Science Core Collection documents with at least 100 citations from their publication year until December 31, 2020, were evaluated as highly cited. The examined features were the distribution of yearly output and its average number of per publication, HCAs, authors, institutions, journals, and nations. The publication performance of nations and organizations was assessed using six publication indicators. The Y-index was employed to compare the research outputs of various authors. RESULTS: Publications that had cited the most references were highly published in high-impact factor journals. The United States of America came out on top across all six publication indicators, and it was home to eight of the top 10 most productive institutions. The articles written by Breivik et al (2006) and Farrar et al (2001) were highly cited and had a significant impact in 2020. The authors had a higher number of highly cited articles published as corresponding authors than as first authors. CONCLUSION: The findings of the present study highlight the current scope of global research in ophthalmology. The findings can help policy-makers and advisory groups of research centers to develop future policies. In addition, the findings can guide researchers in this field.

Jitendra Kumar , Naveen Sirohi , Apurva Jain

Background: Corneal blindness is a major public health problem worldwide and preventable cause of blindness in India. Corneal blindness is the second most common cause of blindness, after cataract, in developing countries. Aims and Objectives: A clinical study of keratomycosis to compare the efficacy of topical 10% NaCl with 5% natamycin (Group A) versus topical 5% natamycin (Group B) alone as a treatment strategy. Materials and Methods: This prospective, randomized, interventional, and comparative study with parallel design enrolled 100 cases diagnosed with unilateral keratomycosis and fulfilling the inclusion criteria, who presented to the outpatient department of Ophthalmology, Maharani Laxmi Bai Medical College and Hospital, Jhansi, Uttar Pradesh, between April 2021 and June 2022 (15 months). Results: Maximum patients in both the study groups belonged to the age group of 41–50 years showed male preponderance and belonged to the low socioeconomic status. Maximum patients in both the study groups had shown total regression in 66 cases with 41 cases from Group A and 25 cases from Group B, respectively. Regression was not seen in 34 cases with 9 cases belonging to Group A and 25 cases belonging to Group B. Maximum patients in study Group A had shown ulcer regression in 3.56 average weeks duration, while it was in 4.50 average weeks duration in Group B. Conclusion: This comparative and interventional study demonstrates that the study Group A receiving 10% sodium chloride solution with 5% natamycin helps in faster healing of corneal ulcer, rate of progression of ulcer is slowed down, and complications are less in comparison to Group B receiving 5% Natamycin alone owning to the anti-edema property of hypertonic saline. Hence, topical 10% NaCl solution can be used with 5% natamycin, as a cost-effective adjunct in the management of fungal keratitis.

Svenja Rebecca Sonntag, Stefanie Gniesmer, Anna Gapeeva et al.

In our previous study we were able to show that zinc oxide (ZnO) tetrapods inhibit wound healing processes. Therefore, the aim of this study was to test the antiproliferative effect of two types of porous polydimethylsiloxane (PDMS)/ tetrapodal zinc oxide (ZnO-T) materials, as well as their usability for glaucoma implants. To find the best implant material, two different porous PDMS/ZnO-T materials were examined. One consisted of 3D interconnected PDMS coarse-pored foams with protruding ZnO-T particles; the other consisted of fine-pored 3D interconnected ZnO-T networks homogeneously coated by a thin PDMS film in the nanometer range. Fibroblast cell viability was investigated for both materials via MTT dye, and some implant material samples were further processed for electron microscopy. Both PDMS/ZnO-T materials showed reduced cell viability in the MTT staining. Furthermore, the electron microscopy revealed barely any fibroblasts growing on the implant materials. At the surface of the fine-pored implant material, however, fibroblasts could not be observed in the etched control samples without ZnO-T. It was found that post-processing of the material to the final stent diameter was highly challenging and that the fabrication method, therefore, had to be adapted. In conclusion, we were able to demonstrate the antiproliferative potential of the two different PDMS/ZnO-T materials. Furthermore, smaller pore size (in the range of tens of micrometers) in the implant material seems to be preferable.

Ethan Zhao, Xinyi Wang, Huiyan Zhang et al.

Xiao Yang, Yuanzhi Chen, Guangwei Yu et al.

Purpose: We report a rare case of recurrent Descemet's membrane detachment (DMD) post-trabeculectomy which was resolved spontaneously without surgical intervention. Observations: A 66-year-old patient with a history of acute angle closure glaucoma in his right eye presented to our hospital. The intraocular pressure (IOP) of his right was 40 mm Hg, and the visual acuity was10/20. After trabeculectomy of the affected eye, a severe Descemet's membrane detachment was found by AS-OCT. Part of Descemet's membrane was lying in front of the iris and lens. Surgical repair was performed, and viscoelastics and sterile air were injected into the anterior chamber to return the detached Descemet's membrane. AS-OCT showed that the DMD was successfully resolved. However, on the 7th day of follow-up, the DMD was detached again as seen on AS-OCT images. The patient refused reoperation to repair the DMD. Six months later, the patient visited our hospital again, and, interestingly, the DMD was completely resolved spontaneously without reoperation. Conclusions and importance: Descemet's membrane is the basement membrane that lies between the stroma and the endothelial layer of the cornea. Minor DMD may be resolved spontaneously within a period of time without surgery, but large DMD is difficult to recover spontaneously. We believe that this is a rare case with spontaneous recovery of extensive DMD after trabeculectomy. But, despite all this, we still remain of the view that DMD should be treated immediately once it occurs.

Mendicute J, Bascarán L, Pablo L et al.

Javier Mendicute,1 Lucia Bascar&aacute;n,1 Luis Pablo,2 C&eacute;dric Schweitzer,3 Laurent Velasque,4 Christine Bouchet,5 Aldo A Martinez5 1Department of Ophthalmology, Hospital Universitario Donostia, San Sebasti&aacute;n, Spain; 2Department of Ophthalmology, Hospital Universitario Miguel Servet, Zaragoza, Spain; 3Department of Ophthalmology, Bordeaux University Hospital, Bordeaux, France; 4Centre Retine Gallien, Bordeaux, France; 5Alcon Research LLC, Fort Worth, TX, USACorrespondence: Javier MendicuteDepartment of Ophthalmology, Hospital Universitario Donostia, Paseo Dr. Beguirist&aacute;in, 115, San Sebasti&aacute;n, 20014, SpainTel +34-943322233Email mendicutejavier@gmail.comPurpose: To evaluate intraoperative intraocular lens (IOL) delivery time and total surgical case time using the UltraSert preloaded delivery system (System U) during routine cataract surgeries and to compare with the manually loaded Monarch delivery system (System M). Physician satisfaction with System U was also assessed.Patients and Methods: In this prospective observational study, subjects &ge; 18 years old underwent cataract surgery in 1 eye and received the AcrySof IQ IOL via the manually loaded System M (n=103) or the AcrySof IQ IOL model AU00T0 via the preloaded System U (n=93). Procedures were digitally recorded by an external camera or by a camera within the operating microscope. Device preparation, IOL delivery, and IOL positioning times were evaluated by 2 independent graders. Pearson &chi;2 test or Fisher exact test was used for categorical variables and Student&rsquo;s t-test or Wilcoxon rank-sum test for continuous variables (all tests were 2-sided and performed at a 5% &alpha;-level). Physician satisfaction levels were assessed using questionnaires.Results: Lens delivery time was similar for System U and System M (12.9&plusmn; 5.1 and 12.2&plusmn; 6.3 s; P=0.412). Mean device preparation time for System U was significantly shorter compared with System M (30.3&plusmn; 6.6 versus 59.8&plusmn; 31.0 s; P&lt; 0.05). This resulted in a significantly shorter total intraoperative time (device preparation + lens delivery) with System U versus System M (43.0&plusmn; 8.6 versus 72.0&plusmn; 32.5 s; P&lt; 0.05). Total surgical case time (device preparation + lens delivery + lens positioning and unfolding) was shorter for System U versus System M (56.6&plusmn; 12.6 versus 89.6&plusmn; 34.6 s; P&lt; 0.05). Physicians reported greater satisfaction levels with System U compared with other devices.Conclusion: Use of the preloaded delivery system (System U) resulted in faster device preparation and reduced total surgical time compared with the manually loaded system (System M). System U was intuitive to use, and physicians preferred it to other devices.Keywords: cataract surgery, intraocular lens delivery time, Monarch, UltraSert

Emanuel R. de Carvalho, Richelle J. M. Hoveling, Cornelis J. F. van Noorden et al.

Application of functional imaging in ophthalmology requires efficient imaging techniques that can detect and quantify chromophores to visualise processes in vivo. The aim of the present study was to develop and evaluate a fast and affordable imaging system. We describe an eight-band retinal multispectral imaging (MSI) system and compare it with a hyperspectral imaging (HSI) device. Determination of blood oxygen saturation was studied as proof of principle. Reflectance of incident light is measured as 1/absorbance at different wavelengths between 440 nm and 580 nm. Both devices have incorporated optical bandpass filters in a mydriatic fundus camera. The MSI system scans the retina at eight pre-defined wavelengths specific for the spectrum of haemoglobin. The HSI system acquires a full scan from 480 to 720 nm in 5 nm steps. A simple assessment of the ratio between the absorbance peaks of oxygenated haemoglobin (HbO₂) and reduced haemoglobin (HbR) was not suitable for generating validated oxygenation maps of the retina. However, a correction algorithm that compares the measured reflectance with reflectance spectra of fully oxygenated and fully deoxygenated blood allowed our MSI setup to estimate relative oxygen saturation at higher levels, but underestimated relative oxygen saturation at lower levels. The MSI device generated better quality images than the HSI device. It allows customisation with filter sets optimised for other chromophores of interest, and augmented with extrinsic contrast imaging agents, it has the potential for a wider range of ophthalmic molecular imaging applications.

Han Wu, Jing-Yi Wang, Xin-Cao Zhong et al.

AIM: To investigate the risk factors for eye removal following ocular trauma at a major ophthalmology department in China. METHODS: A retrospective study of patients who underwent eye removal surgery following ocular trauma was completed. Clinical outcomes were consulted in detail through the hospital’s computed medical data system. Patients’ information including age, gender, cause of ocular trauma, affected eye, and education level was collected and recorded in a standardized database. Chi-squared test, Student’s t-test, Fisher’s exact test, and bivariate correlation analysis were used for statistical comparisons. RESULTS: The present study included 1675 removal eyes from 1674 patients over the 20-year period. Patients included 80.5% males and 19.5% females, with mean age of 38y. The majority of the patients (70.7%) were blue-collar workers (physical laborers), and 1098 patients (65.6%) did not receive high school education. Work-related injuries were the most common reason for eye removal (n=739, 44.1%), of which 441 cases (59.7%) were related to metal/nail wounds. The most frequent injury type in males was work-related injuries (49.7%), whereas the most frequent injury type in females was home-related injuries (25.8%). CONCLUSION: Work-related injuries are a leading cause of severe ocular injury resulting in eye removal. In addition, men and undereducated patients are more likely to undergo eye removal surgery following ocular trauma. This study identified multiple high-risk factors leading to eye removal following ocular trauma, which is of great importance for preventing severe eye injuries.

Eriko Sugano, Genea Edwards, Saikat Saha et al.

Over 11 million people in the United States alone have some form of age-related macular degeneration (AMD). Oxidative stress, cell death, and the degeneration of retinal pigment epithelial (RPE) cells contribute to AMD pathology. Recent evidence suggests that ceramide (Cer), a cellular sphingolipid mediator that acts as a second messenger to induce apoptosis, might play a role in RPE cell death. The lysosomal breakdown of Cer by acid ceramidase [N-acylsphingosine amidohydrolase (ASAH)1] into sphingosine (Sph) is the major source for Sph 1-phosphate production, which has an opposing role to Cer and provides cytoprotection. Here, we investigated the role of Cer in human RPE-derived ARPE19 cells under hydrogen peroxide-induced oxidative stress, and show that Cer and hexosyl-Cer levels increase in the oxidatively stressed ARPE19 cells, which can be prevented by overexpression of lysosomal ASAH1. This study demonstrates that oxidative stress generates sphingolipid death mediators in retinal cells and that induction of ASAH1 could rescue retinal cells from oxidative stress by hydrolyzing excess Cers.

Hui Wang, Zhao-yang Meng, Song-guo Li et al.

Abstract Background This study aimes to characterize the fundus structural changes in patients with nonarteritic anterior ischemic optic neuropathy (NAION) and the correlation between macular vessel density, retinal nerve fibre layer (RNFL) parameters and visual field sensitivity (VFS) in NAION patients. Methods A retrospective case control study was performed using 37 eyes with NAION, 30 uninvolved contralateral eyes, and 27 eyes of healthy age-matched subjects. Data on the retinas and choroidal vessel densities and VFS were compared among the three groups. Results The NAION group exhibited significantly lower RNFL thicknesses, lower ganglion cell complexes (GCC), larger global loss volume (GLV) values and focal loss volume (FLV) values when compared with both uninvolved eyes and healthy eyes (p < 0.01 for all comparisons). The superficial vessel density (SVD) valus (whole, parafovea, superior-hemi and inferior-hemi) were significantly lower in NAION eyes, followed by uninvolved eyes and healthy eyes (p < 0.01; LSD, p < 0.05 for all comparisons). The deep vessel density (DVD) values (parafovea, superior-hemi and inferior-hemi) were the lowest by a significant value in NAION eyes, followed by uninvolved eyes and healthy eyes (p < 0.01; LSD, p < 0.05 for all comparisons). However, DVD value measurements (whole and fovea) of healthy and uninvolved eyes were not significantly different. The average threshold deviation (TD) was − 11.02 ± 3.75 dB for the overall field region, − 6.01 ± 2.21 dB for the affected superior field region and − 9.98 ± 3.34 dB for the affected inferior field region in NAION eyes. A statistically significant correlation was found between the RNFL thickness and visual field(VF) loss (r = − 0.788, p < 0.001). Conclusion In addition to peripapillary vascular changes occurring in NAION eyes, macular vessel density is also involved. Furthermore, NAION-uninvolved eyes exhibited abnormalities compared with healthy eyes. This indicates that vascular changes may occur before changes in retinal thickness at the early stages of NAION.

Jared S. Fredrickson, Jennifer Holmes, Jennifer N. Cathcart et al.

Abstract Background Syphilis and toxoplasmosis are two infectious conditions that can occur during pregnancy. Both these diseases can have ocular manifestations and thus are treated by ophthalmologists and obstetricians. We hypothesized that specialty training would affect the way physicians selected therapy. Results A total of 209 uveitis specialists and approximately 2500 obstetricians across the USA were surveyed using an online questionnaire distributed via listserv and social media posts. Survey respondents were given a series of clinical vignettes containing case examples of a female patient who was either contemplating pregnancy or in the first trimester and was diagnosed with either syphilis or toxoplasmosis. The questionnaire included a total of four case scenarios with questions relating to the management of these diseases, as well as pregnancy counseling. For the syphilis vignette, a total of 97 physicians responded to the survey questions. Choices of therapy between physician specialty differed significantly (p = 0.0001); however, pregnancy status did not seem to affect therapy choice in syphilis. A total of 96 physicians responded to the survey questions pertaining to the toxoplasmosis vignette. For a non-pregnant patient diagnosed with toxoplasmosis, the differences in therapy choice between specialties were not significant; however, when the patient was pregnant, therapy choice was significantly different between specialties (p = 0.0001). Conclusions Differences exist between ophthalmologists and obstetricians concerning the therapy for syphilis and toxoplasmosis during pregnancy. Inter-specialty collaboration is needed to develop consistent criteria to improve the management of these patients.

Syed Abdul Wadud, Muntasir Bin Shahid, Sumon Afroz

Stargardt disease is the most common form of juvenile macular degeneration. Clinically, it is characterized by pisciform flecks at lhe level of the retinal pigment epithelium and a bull's-eye maculopathy. Inheritance is usually autosomal recessive, although dominantly inherited case have been described. Both sexes are affected equally. We reported here three cases of Stargardt's macular dystrophy, who are siblings and daughters of non consanguineous parents. In case-1,2 and 3 we found the typical presentation with almost same findings.

Fabrizio Zeri, Mario De Cusatis, Luigi Lupelli et al.

Purpose: To investigate if the accuracy of intraocular pressure (IOP) measurements using rebound tonometry over disposable hydrogel (etafilcon A) contact lenses (CL) is affected by the positive power of the CLs. Methods: The experimental group comprised 26 subjects, (8 male, 18 female). IOP measurements were undertaken on the subjects’ right eyes in random order using a Rebound Tonometer (ICare). The CLs had powers of +2.00 D and +6.00 D. Measurements were taken over each contact lens and also before and after the CLs had been worn. Results: The IOP measure obtained with both CLs was significantly lower compared to the value without CLs (t test; p < 0.001) but no significant difference was found between the two powers of CLs. Conclusions: Rebound tonometry over positive hydrogel CLs leads to a certain degree of IOP underestimation. This result did not change for the two positive lenses used in the experiment, despite their large difference in power and therefore in lens thickness. Optometrists should bear this in mind when measuring IOP with the rebound tonometer over plus power contact lenses.

Gabriel van Rij, Robert J. Wijdh, Peter G. J. Nikkels

<p>Background. A six-year-old boy presented with a large progressive intracorneal and scleral cyst. Two years before, bilateral cataract surgery through a 6.5-mm corneal incision was performed elsewhere.</p><p>Methods. The posterior wall of the cyst could be excised, as well as the anterior wall in the sclera. Upon histo-pathology the cyst wall was lined by epithelium. The epithelial cells of the anterior side in the cornea were removed with a curette and a corpus alienum drill. Three and a half years after removal of the cyst, there was no recurrence. Visual acuity was 0.8. </p><p>Conclusions. An intracorneal and scleral inclusion cyst was successfully removed by surgical excision and the removal of epithelial cells by a curette and a corpus alienum drill.<br /><br /></p>