Intracameral bleeding during femtolaser assisted cataract surgery: A case report.

Purpose: To report a case of anterior chamber bleeding that was noted post completion of laser during femtosecond laser assisted cataract surgery (FLACS). Observations: A 54 yr old woman with no ocular and systemic morbidity underwent Right Eye FLACS.Vacum loss was noted due to patient's eye movements. Suction and Docking was achieved at the 2nd attempt, following which laser treatment was uneventful. An intracameral bleed was noted superiorly extending towards center of the anterior chamber. Cataract surgery with IOL implantation was uneventful. Post-operative course was uneventful. Conclusions and importance: This is the first report in literature of intracameral bleeding during FLACS. It is essential to proceed with caution in patients with repeated vacuum loss due to a higher risk of developing intraocular bleeds.

Topical 5% Natamycin With Oral Ketoconazole in Filamentous Fungal Keratitis: A Randomized Controlled Trial.

PURPOSE: To assess the role of additive oral antifungal therapy in deep keratitis caused by filamentous fungi. DESIGN: A randomized, masked, double-blind clinical trial. METHODS: All patients presenting with culture-positive fungal keratitis with a size measuring 2 to 60 mm2 and involving more than 50% of stromal depth were enrolled in 1 of the 2 treatment arms. Group A received 5% natamycin, whereas Group B was given 200mg of oral ketoconazole twice a day in addition to 5% natamycin. Patients were followed up for 4 weeks. Liver function was assessed at baseline and at exit. Tests for significance included t test to compare the means of continuous variables, chi-square and Fisher's exact tests for comparing categorical variables and Kaplan-Meier procedure to estimate the survival rate. RESULTS: Of the 115 patients enrolled, 108 completed the study. Fifty-eight patients were in group A and 57 in group B. There was no significant difference in baseline characteristics or in ulcer characteristics between the 2 groups. In group A, 68.5% of the patients responded favorably to medical therapy, whereas in group B, 72.2% responded favorably. There was no statistically significant difference in healing between the 2 groups (P = -0.618). All patients had normal liver functions during the study. CONCLUSIONS: Although safe, oral ketoconazole did not add significant benefit to topical natamycin therapy in treating deep fungal keratitis. The efficacy of newer antifungal agents and drug delivery routes needs to be explored.

Risk factors for intraocular penetration of caterpillar hair in Ophthalmia Nodosa: a retrospective analysis.

We report risk factors associated with intraocular penetration of caterpillar hair seen at our institute from January 2005 to December 2007. Records of all patients with caterpillar hair induced ophthalmitis (CHIO) were retrospectively reviewed for clinical characteristics, anatomic location of lodgment of the caterpillar hair, treatment methods, and outcomes. Out of a total of 544 cases of CHIO, 19 eyes (seven in the anterior chamber and 12 in the posterior segment) experienced intraocular penetration (3.5%). The presence of deep intracorneal hair (80 cases, 14.7%) was found to be the only risk factor for intraocular penetration ( P < 0.001). The removal of intracorneal hair was possible in only 29 out of 80 eyes (36%) and this was associated with a significantly reduced risk of intraocular penetration ( P = 0.022). Patients with retained intracorneal hairs should be counseled regarding risk of intraocular penetration and closely followed up for at least six months.