Efficacy of Electrical Stimulation on Nerve Fiber Growth in Small Fiber Neuropathy.

OBJECTIVES: To define whether electrical nerve stimulation (ENS) therapy would promote intraepidermal nerve growth and nerve regeneration in patients with small fiber neuropathy (SFN). METHODS: This was a prospective study conducted on 8 subjects with previously diagnosed SFN. Nerve conduction testing, punch biopsies, and clinical examinations with a calculation of revised total neuropathy score were conducted on subjects before beginning ENS therapy and at 30 and 60 days after the start of ENS therapy. RESULTS: Clinical examination findings and intraepidermal nerve fiber density measurements on day 30 and day 60 did not show statistically significant changes in the treated group compared with the untreated group. CONCLUSIONS: Despite the success of previous animal studies, no meaningful nerve growth and regeneration in SFN was demonstrated with ENS therapy in this study. Studies of larger subject larger populations with longer duration of ENS treatment are warranted to confirm our findings.

Long-term complications of iris-claw phakic intraocular lens implantation in Weill-Marchesani syndrome.

PURPOSE: This study was designed to report the long-term complications of iris-claw phakic intraocular lens implantation in a patient with Weill-Marchesani syndrome. METHODS: Case report and literature review. RESULTS: A 26-year-old man with a history of glaucoma had bilateral phakic lens implantation for high myopia 10 years previously. Two years later, the left implant dislocated and was repositioned. Slit-lamp examination of both eyes revealed phakic implants of the iris-claw variety. There were moderate iridocorneal adhesions in the areas in which the lens haptics pinched the iris in both eyes and moderate epithelial and stromal edema over the temporal one-third of the left cornea. The crystalline lenses were clear with 3+phacodonesis OU. Dilated fundus examinations revealed bilateral severe optic nerve cupping. Crystalline lens diameters were measured at 7.5mm in the right eye and 8 mm in the left. Anterior chamber depths were 2.63 mm OD and 2.40 mm OS. Specular microscopy revealed central endothelial cell counts of 1133 and 587 cells/mm OD and OS, respectively. Axial lengths were 23.3 mm OD and 25 mm OS. Gonioscopic examination revealed bilateral angle closure with marked peripheral anterior synechiae. Based on our findings of short stature, shortened and thickened fingers, relatively normal axial length, microspherophakia, high myopia, and glaucoma, we diagnosed the patient with Weill-Marchesani syndrome. CONCLUSION: Iris claw-lens phakic lenses may be an effective surgical alternative to correct high myopia in select patients; however, it may produce long-term complications in eyes with specific features.