Complications secondary to cosmetic artificial iris anterior chamber implants: a case report

BACKGROUND: Artificial iris anterior chamber implants were originally developed for therapeutic purposes but have been used recently for the cosmetic alteration of eye colour. There is a growing body of evidence surrounding their associated risks. We report a case presenting with complications secondary to bilateral NewColorIris® implants, including the first report of pressure-induced stromal keratopathy in this context. CASE PRESENTATION: A thirty-eight year old South American man presented as an emergency in the UK with best corrected visual acuities of 1/60 OD and 6/18 OS, bilateral corneal decompensation, lens opacities and raised intraocular pressures 4 years following bilateral NewColorIris® implantation in Panama. Anterior segment optical coherence tomography demonstrated the direct apposition of the implant with the iris and iridocorneal angle, together with pressure-induced stromal keratopathy with a fluid interface between the corneal stroma and previous laser-assisted in situ keratomileusis flaps. We describe the successful combined medical and surgical management in this case to yield a final visual acuity 6/12 in both eyes. CONCLUSION: Artificial iris anterior chamber implants are associated with sight-threatening complications that can present years after their implantation. We caution against their use for the cosmetic alteration of eye colour

Newly diagnosed type II diabetes mellitus presenting with localized itch

Type II diabetes is caused by insulin resistance resulting in high blood sugar levels. Although the typical symptoms of diabetes are described as polyuria, polydipsia and fatigue as many as 60% of newly diagnosed patients with type II diabetes are asymptomatic. Here authors present a case of a 39-year-old male patient who presented with localized pruritus affecting the medial aspects of his forearms and upper legs as the sole symptom of newly diagnosed type II diabetes mellitus. The itch symptom markedly improved on significantly reducing his dietary intake of sugars and with the use of metformin. Authors hope to alert clinicians to consider the possibility of underlying diabetes in such presentations to enable swift diagnosis and consequent treatment. It is unusual to find patients presenting with localized itch without any corresponding cutaneous manifestations as a presentation of type II diabetes

Multicountry clinical outcomes of a new nondiffractive presbyopia-correcting IOL

Implantació de lents intraoculars; Facoemulsificació; Estudis prospectiusImplantación de lentes intraoculares; Facoemulsificación; Estudios prospectivosLens Implantation Intraocular; Phacoemulsification; Prospective StudiesPurpose: To evaluate the effectiveness and safety of a new presbyopia-correcting intraocular lens (IOL) with a nondiffractive design, DFT015, compared with an aspheric monofocal IOL, SN60WF. Setting: 19 investigational sites in 4 countries: Australia, Canada, Spain, and the United Kingdom. Design: Prospective, randomized, parallel-group, controlled, assessor- and patient-masked clinical study. Methods: Participants aged ≥22 years with bilateral cataracts were randomized to DFT015 or SN60WF in a 5:4 ratio and masked until final postoperative follow-up at month 6. The primary effectiveness objective was superiority of DFT015 over SN60WF in mean monocular photopic distance-corrected intermediate visual acuity (DCIVA) at month 3. Secondary effectiveness objectives included noninferiority of DFT015 to SN60WF in mean monocular photopic corrected distance visual acuity (CDVA) and superiority in the mean monocular photopic distance-corrected near visual acuity (DCNVA) at month 3. Visual disturbances were assessed at month 6. Results: 282 patients were randomized to DFT015 (n = 159) or SN60WF (n = 123). All effectiveness objectives were achieved at month 3 in first eyes. For monocular photopic results in first eyes, DFT015 demonstrated superior mean DCIVA (least squares means of -0.139 logMAR in favor of DFT015, P < .001), noninferior mean CDVA (97.5% upper confidence limit [UCL] of the difference was <0.1 logMAR) and superior mean DCNVA (95% UCL of the difference was <0.0 logMAR) compared with SN60WF at month 6. DFT015 exhibited a similar visual disturbance profile to that of SN60WF. Conclusions: DFT015 provided superior intermediate and near vision and a similar visual disturbance profile compared with an aspheric monofocal IOL

Sutureless large incision cataract extraction: Indications and results from two teaching hospital eye departments in the United Kingdom

Objective: To highlight the role of Sutureless Large Incision Cataract Extraction (SLICE) in the United Kingdom for the treatment of cataracts at high risk for intra- or postoperative complications. Setting: Two University Hospitals in the United Kingdom Materials and Methods: Retrospective case note review of planned SLICE performed over a 12-month period. Results: SLICE was performed on 11 eyes of 11 patients (mean age, 79 years) having preoperative vision of hand motions (10 eyes) with very dense or mobile cataracts and high risk for phacoemulsification. Mean follow up was 12 weeks, with no operative or postoperative complications. Nine patients (without ocular or systemic comorbidity) achieved best corrected vision of 0.3 LogMAR (20/40) or better. Conclusions: SLICE is safe and effective for dense or mobile cataracts and can play a role in patients where conventional phacoemulsification carries higher risks of complications