Extracapsular cataract extraction in Europe prior to Jacques Daviel.

The first successful planned extracapsular cataract extraction was reported by Jacques Daviel in 1752. The history of European cataract surgery in the first half of the 18th century, immediately preceding Daviel's report, contains interesting information that explains the foundations of this accomplishment. Daviel himself credited the prior work of Francois Pourfour du Petit. Other important advances were reported by Michel Brisseau, Antoine Maitre-Jan, Jean Méry and others. A critical insight during this time period was the realization that the cataract was, in fact, the opacified crystalline lens, rather than a membrane or opacity located anterior to the lens.

Supplementary IOLs: Monofocal and Multifocal, Their Applications and Limitations.

Supplemental intraocular lenses (IOLs) have been developed to replace IOLs designed for in-the-bag placement being used as "piggy-back" IOLs in the sulcus due to unacceptable complications. The new IOLs have unique platform designs to avoid these complications. As a result, a new nomenclature is needed to describe the 4 scenarios when supplemental IOL use is now indicated.

Pros and cons of immediately sequential bilateral cataract surgery (ISBCS).

Immediately sequential bilateral cataract surgery (ISBCS) is currently a "hot topic" in ophthalmology. There are well-documented advantages in terms of quicker visual rehabilitation and reduced costs. The risk of bilateral simultaneous endophthalmitis and bilateral blindness is now recognized to be minuscule with the advent of intracameral antibiotics and modern management of endophthalmitis. Refractive surprises are rare for normal eyes and with the use of optical biometry. Where a general anesthetic is indicated for cataract surgery, the risk of death from a second anesthetic is much higher than the risk of blindness. A widely recognized protocol from the International Society of Bilateral Cataract Surgeons needs to be adhered to if surgeons wish to start practicing ISBCS.

Recurrent presumed herpes simplex keratitis and episcleritis in keratosis follicularis (Darier's disease).

Keratosis follicularis (Darier's disease) is an autosomal dominant dermatological disorder characterised by abnormal epidermal differentiation and loss of normal cell-to-cell adhesion. Cardinal features include diffuse hyperkeratotic warty papules with scaly plaques in seborrhoeic regions with associated mucous membrane changes. Darier's disease is rare (prevalence 2.7 in 100,000), with few ocular sequelae reported: commonly dry eye with or without Sjögren's syndrome. This is the first report, to the best of our knowledge, to describe a case of recurrent herpes simplex virus (HSV) keratitis and episcleritis in a 47-year-old man suffering from Darier's disease. The patient's condition predisposed him towards developing ocular complications due to several factors: impaired desmosome function leading to poor cell-to-cell adhesion in the corneal epithelium, dry eye and HSV invasion of inflamed periocular skin presumably combining to allow viral colonisation of a poorly protected cornea.

Safety and efficacy of an intraocular Fresnel prism intraocular lens in patients with advanced macular disease: initial clinical experience.

PURPOSE: To perform a pilot study of a new in-the-bag Fresnel prism intraocular lens (IOL) designed to deviate the image from diseased to healthy retina in eyes with bilateral age-related macular degeneration (AMD). SETTING: Anterior segment subspeciality practice, Pretoria, South Africa. DESIGN: Prospective nonmasked trial. METHOD: Cataract surgery and unilateral implantation of the prismatic IOL were performed in patients with bilateral AMD and cataract. Outcomes were surgical complications, subjective and objective visual improvement, and undesirable optical effects. RESULTS: Three eyes of 3 patients were evaluated. All patients reported displacement of the scotoma, and no patient reported diplopia. The only complication was posterior capsule opacification (1 eye). CONCLUSIONS: Patients noted improved vision and no diplopia. This pilot was performed using a prototype IOL with single power and single angle of deviation; however, there is scope for individual patient optimization. This new technology merits further research and development because it may benefit large numbers of patients with stable end-stage AMD. FINANCIAL DISCLOSURE: Dr. Claoué has a financial interest in the patent controlling the Fresnel prism IOL. Dr. Potgieter has no financial or proprietary interest in any material or method mentioned.

Transport and interaction of cosmetic product material within the ocular surface: beauty and the beastly symptoms of toxic tears.

Eye cosmetics such as mascara, eye shadow and eyeliner are used extensively to highlight the eyes, and are normally applied external to the ocular surface. Adverse reactions of cosmetics within the ocular surface include mild discomfort, eyelid dermatitis, pre-corneal tear film instability, and keratitis. These are attributed mainly to the preservative (benzalkonium chloride (BAC)) constituent of cosmetic product material (CPM). Transport of CPM from an external environment to any location on the ocular surface, essentially precedes the adverse interactions occurring at the location, and the control of these transport modes is therefore of clinical relevance. The inter-transport of CPM across the TF occurs due to both diffusion and drift processes. Diffusion of neutral species is driven by concentration gradients, and the drift of cationic BAC is influenced by the inherent electric field; determined by the distribution of the various ions secreted into the aqueous layer, and the negative glycocalyx charge at the mucin layer. In the presence of mucin deficiency, the corneal epithelium is exposed to invasion by both incident BAC and lipophilic species. The transport of cationic BAC across the TF may be controlled by regulating the secretion of various electrolytes at the lacrimal gland. This is of clinical significance in reducing corneal epithelial adverse effects. However, the risks of adverse effects at the corneal surface due to invasion by the lipophilic species remain. Patients with mucin deficiency, and especially those on eye ointment/drops medication, should be discouraged from using cosmetics in a way likely to contaminate the TF.