Intraocular Eyelash after an Uneventful Cataract Surgery: Case Report and Literature Review.

The presence of an eyelash in the anterior chamber after an uneventful phacoemulsification and intraocular lens implant surgery is exceedingly rare, with 8 cases reported globally. We present a patient in whom an eyelash was found trapped in the main cornea wound at postoperation week 1 after an uneventful surgery and unremarkable postoperation day 1 review. The eyelash was removed immediately. The patient denied rubbing his eye and there is video evidence of an uneventful surgery with no eyelash in the anterior chamber at the end of the surgery. Interestingly, the orientation of the eyelash supports previous reports that the eyelash tends to migrate intraocularly through the cornea wound in one direction (i.e., with proximal end/follicle first), purportedly due to the cellular arrangement of an eyelash. Management of such cases should be undertaken on a case-by-case basis. The treatment strategy includes observation or prompt removal, either at the slit lamp or at the operating theatre, depending on a few factors including extent of ocular inflammation, time of presentation, eyelash contact with the cornea endothelium, and location of the eyelash. Patients should be reminded not to rub their eyes after cataract surgery.

Efficacy of an aspheric treatment algorithm in decreasing induced spherical aberration after laser in situ keratomileusis.

PURPOSE: To determine the effectiveness of an aspheric laser in situ keratomileusis (LASIK) algorithm for myopia with and without astigmatism in minimizing postoperative induction of spherical aberration. SETTING: Four sites in Asia. METHODS: Patients with -1.00 to -10.00 diopters (D) of spherical myopia with -4.00 D or less of astigmatism were recruited. Patients randomly had bilateral Zyoptix aspheric algorithm (aspheric group) or bilateral conventional Zyoptix Tissue Saving algorithm (control group). A Technolas 217z100 excimer system was used for LASIK ablation. Visual effectiveness, safety, higher-order aberrations, and corneal asphericity (Q value) were evaluated postoperatively. RESULTS: The aspheric group comprised 86 eyes and the control group, 84 eyes. At 3 months, the high-contrast uncorrected distance visual acuity was 20/20 or better in 78% of eyes in the aspheric group and 83% of eyes in the control group. The control treatment induced 0.22 microm of spherical aberration, which was significantly higher than the 0.04 microm induced with the aspheric treatment (6.0 mm pupil) (P<.0001). The aspheric treatment induced significantly less vertical coma and trefoil (P = .02). Eyes in the aspheric group had significantly lower Q values (P<.0001). There was no statistically significant difference in the manifest refraction spherical equivalent between the 2 groups (P >.05). Although high- and low-contrast corrected distance visual acuity (CDVA) was similar between the groups, the aspheric group gained more lines of low-contrast CDVA. CONCLUSION: The aspheric algorithm was more effective than the conventional algorithm in reducing induced spherical aberration and maintaining corneal asphericity after myopic LASIK.

Diffuse lamellar keratitis after laser in situ keratomileusis associated with surgical marker pens.

PURPOSE: To describe a series of cases of diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK) associated with intraoperative use of a surgical marker pen. SETTING: Singapore National Eye Centre, Singapore, Singapore. METHODS: A review of all 115 patients (125 eyes) who had myopic LASIK from July 23 to July 26, 2007, was performed to determine whether eyes in which the Codman surgical marker pen (Johnson & Johnson Medical) was used intraoperatively developed postoperative DLK. RESULTS: Nine of 12 eyes that had LASIK or flap relifting with a Codman surgical marker pen developed grade 1 to grade 3 DLK on the first postoperative day. The 113 other eyes that had LASIK in the same week with another brand of surgical marker pen (Securline, Precision Dynamics Corp.) did not develop DLK. All eyes with DLK were treated with intensive topical steroid therapy. The DLK resolved in 2 eyes after the steroid treatment; 7 eyes required flap relifting with interface irrigation. One month postoperatively, 6 eyes with DLK had an uncorrected visual acuity of 6/7.5 or better. Two eyes developed central corneal scarring with consecutive hyperopia with a best corrected visual acuity of 6/12 after 1 month. CONCLUSIONS: There was a strong association between the occurrence of DLK after LASIK with the use of the Codman surgical marker pen. One or more constituents of the ink in the Codman pen may have been responsible for this series of cases.