Total extrusion of a silicone encircling band through the muscle insertions presenting as orbital cellulitis.

INTRODUCTION: We present an unusual case of anterior migration of a solid silicone encircling band 9 years after scleral buckling surgery. MATERIALS AND METHODS: An 83-year old woman presented with acute onset of pain and discharge in her left eye. She had undergone cataract surgery complicated by endophthalmitis and managed with pars plana vitrectomy nine years earlier. RESULTS: The patient was treated with transection and removal of the extruding encircling band. Pain ceased within two days. Two weeks postoperatively, the conjunctiva was well adapted without any discharge, ocular motility was as preoperatively. DISCUSSION: Anterior migration of an encircling band through all four rectus muscle insertions is a very uncommon late complication following scleral buckling surgery. The remarkably good preservation of ocular motility in our case can be attributed to the slow advancement of the encircling band over nine years, which allowed a gradual reattachment of the rectus muscle insertions to the sclera.

A novel PIKFYVE mutation in fleck corneal dystrophy.

PURPOSE: To report the findings of the clinical and molecular evaluation in a Greek family with fleck corneal dystrophy (CFD). METHODS: A 58-year-old woman was seen on routine ophthalmic examination and diagnosed as having CFD. All available family members were examined to evaluate the clinical findings and inheritance of the disease. Twenty members of the family in five generations underwent slit-lamp examination. Eleven were females and nine males, aged from two years to 85 years old. Blood samples were available from four patients with CFD and seven unaffected relatives, and the DNAs were subjected to molecular screening of the phosphoinositide kinase, five finger-containing (PIKFYVE) gene by direct sequencing or denaturing high performance liquid chromatography (DHPLC). RESULTS: The clinical evaluation revealed six family members (five females and one male) with CFD. In two CFD patients early cataract formation was noticed. All patients affected with the corneal dystrophy were asymptomatic. The molecular analyses demonstrated the existence of a novel c.3060-3063delCCTT (p.P968Vfs23) mutation in PIKFYVE in all CFD patients tested but in none of the six unaffected family members. No molecular screening was performed in the seventh unaffected member as the causative mutation was clearly transmitted from his affected wife to his affected son. CONCLUSIONS: We report on the clinical and molecular findings of a five generation Greek family with CFD and we conclude that the novel c.3060-3063delCCTT (p.P968Vfs23) mutation in PIKFYVE, which segregated with the disease, was the causative mutation in this family.

Comparison of Goldmann applanation tonometry and Pascal dynamic contour tonometry in relation to central corneal thickness and corneal curvature.

PURPOSE: The aim of the study was to assess the influence of central corneal thickness (CCT) and corneal curvature in tonometry measurements taken by Goldmann applanation tonometry (GAT) and Pascal dynamic contour tonometry (DCT). METHODS: This was a prospective study of 185 eyes from 97 subjects, attending outpatient ophthalmology appointments, who underwent intraocular pressure measurements by GAT and Pascal DCT. CCT and corneal curvature were obtained using ultrasound pachymetry and Orbscan topography, respectively. All measurements were carried out among males and females during the period 2009-2012. Apart from the usual descriptive and exploratory data analysis, one-way analysis of variance and agreement analysis were performed, linear as well as intraclass correlation coefficients were estimated, and multiple scatter and Bland-Altman plots were produced. RESULTS: Mean IOP measurements obtained were 17.21±4.10 mmHg by DCT and 13.23±4.07 mmHg by GAT. Mean difference between the GAT and DCT measurements was 3.88±2.8 mmHg. Mean CCT and corneal curvature were 522.78±52 µm and 43.83±2.9823 D, respectively. CONCLUSION: Intraocular pressure measured by GAT was consistently lower when compared with DCT, and this difference was greatest with thinner CCT. Flat corneas seem to influence GAT measurements compared to DCT.