Comparison of intraocular lens tilt after capsular sutured scleral fixation with capsular segments versus uneventful cataract surgery.

PURPOSE: To evaluate and compare intraocular lens (IOL) tilt between uneventful phacoemulsification with in-the-bag IOL implantation and sutured scleral fixation (SSF) of the lens bag with a capsular tension segment (type 6 D / Morcher) using a Sheimpflug camera. SETTING: Clinical Practice, Hospital. Barcelona and A Coruña, Spain. DESIGN: Retrospective, comparative multicenter study. METHODS: IOL tilt was compared between patients who underwent sutured scleral fixation with a capsular tension segment in a single eye (SSF group, n = 15) with patients who underwent uneventful IOL implantation (control group, n = 12) that were matched by biometric measurements. Post-operative refractive accuracy of biometric formulas by means of mean absolute error (MAE) was also reported. All patients underwent a general ophthalmic evaluation, anterior segment photography, and postoperative optical biometry (Zeiss IOLMaster® 500). In addition, IOL tilt was measured with a Scheimpflug camera (Pentacam R, Oculus Optikgerate Gmbh). RESULTS: Mean vertical tilt was similar in both groups (2.20+/-2.47° SSF vs 1.97 +/- 1.79° control; p = 0.836) but mean horizontal tilt tended to higher values in the SSF series (2.09 +/- 2.74° vs 0.94 +/- 1.17°; p = 0.139). Considering post-operative refractive error in diopters by MAE calculations, there was an underestimation of IOL power in the SSF group which was only statistically significant for Barrett Universal II (1.07 vs 0.32; p = 0.028) and Hill-RBF (0.95 vs 0.26; p = 0.024) formulas, but not for SRK/T (0.99 vs 0.42; p = 0.285) and Kane (0.96 vs 0.33; p = 0.083). CONCLUSION: Sutured scleral fixation of capsular tension segments in the presence of zonular instability does not seem to induce clinically significant IOL tilt compared to uneventful cataract extraction cases.

Two cases of drug-induced orbital inflammatory disease.

Orbital inflammatory disease (OID) includes all inflammatory processes affecting the orbit. Although several aetiologies are recognised, a cause may not be elucidated. We describe 2 cases in which drugs (hyaluronidase and zoledronic acid) were the cause of OID. In patients with a clinical picture of OID simulating an orbital cellulitis, the recent drug history should be considered as a possible aetiology, and treatment with steroids with or without a biopsy should be considered after an infection has been excluded.

Bilateral Choroidal Osteoma Associated with Optic Neuritis in Behçet's Disease.

Three-dimensional optical coherence tomography (OCT) were founded to be useful to evaluate posterior pole involvement in an unusual concurrence of bilateral choroidal osteoma after optic disk inflammation in a 36-year-old woman in whom optic neuritis was the first symptom of Behçet's disease. Bilateral asymmetric choroidal osteoma was observed after optic disk inflammation following disease recurrence. B-scan ultrasonography and orbital axial CT were essential for the diagnosis. Bilateral full-thickness calcified plaques in juxtapapillary choroids were the main intraocular feature after optic neuritis. The pathogenesis of bone formation in choroidal osteoma remains uncertain and although several etiological factors have been associated with its onset, intraocular inflammation is a very unusual cause.

Explantation of intraocular lenses in children with juvenile idiopathic arthritis-associated uveitis.

We report the outcome in 2 eyes of 2 patients with juvenile idiopathic arthritis-associated uveitis who had intraocular lens (IOL) explantation. The primary reason for explantation was persistent and uncontrolled inflammation with secondary cystoid macular edema.