BACKGROUND: We describe 2 patients with severe Mooren's ulcer who underwent phacoemulsification and intraocular lens implantation surgery. The clinical features of this disease are highlighted. CASE: A detailed study of the ocular and laboratory findings in these patients, together with a review of the literature, is presented. OBSERVATIONS: There was a visually rewarding outcome after phacoemulsification and intraocular lens implantation were performed, and Mooren's ulcer did not recur. CONCLUSION: We conclude that phacoemulsification-aspiration and intraocular lens implantation surgery with a small incision can be successfully performed in patients with Mooren's ulcer after complete control of inflammation with topical and oral steroid therapy, or with ocular reconstruction surgery when required.

Adult↗

PubMedDate not supplied

Anterior synechiolysis after keratoplasty.

Anterior synechiae that develop following keratoplasty may induce immunological graft rejection or graft failure. Current surgical techniques designed to remove the synechiae early on are quite cumbersome. We describe a simple technique of anterior synechiolysis, performed 1 to 4 weeks postoperatively, using a bent 26-gauge needle, that proved safe and effective in seven cases. The only complication was a hyphema in one case. None of the synechiae had recurred at the final follow up at 3 months.

Adolescent↗

PubMedDate not supplied

Long-term surgical results of combined trabeculotomy ab externo and cataract extraction.

Trabeculotomy ab externo has been demonstrated to be effective in controlling intraocular pressure (IOP) in adult patients with either primary open-angle glaucoma or pseudoexfoliation syndrome. We evaluated the surgical outcome of 60 eyes with either primary open-angle glaucoma or pseudoexfoliation syndrome that underwent combined trabeculotomy ab externo and cataract extraction. All patients were at least 40 years old, and were followed for at least 1 year. At the final examination, IOP was well controlled (21 mm Hg or less) in 54 (90%) of the 60 eyes, with or without medication. Also, "overall success" (ie, stabilization of IOP, visual field, and optic nerve status) was achieved in 49 (81.7%). Complications included fibrin exudation (22%), transient IOP elevation (17%), early perforation of the probe into the anterior chamber (10%), and detachment of Descemet's membrane (5%). We recommend combined trabeculotomy ab externo and cataract extraction in selected cases of glaucoma with coexisting cataract. For cases in which the target IOP level is in the low teens, or for patients who may not tolerate postoperative fluctuations in IOP, we do not recommend trabeculotomy ab externo. Also, in eyes that have normal-tension glaucoma, or that have already sustained severe damage to the optic nerve, visual dysfunction caused by glaucomatous changes may progress even after successful combined trabeculotomy ab externo and cataract extraction.

Aged↗