A 65-year-old male patient received intravitreal bevacizumab for age-related macular degeneration. On the first day, he presented with ocular pain, corneal stromal infiltration and dense vitritis. Prompt intravitreal vancomycin and ceftazidime were injected after sampling. Widespread gram-positive cocci were seen on microscopy after staining the vitreous sample. No significant improvement took place the following day and the cornea was completely opacified. The patient underwent an early vitrectomy combined with penetrating keratoplasty. Culture grew Streptococcus salivarius. Postoperative visual acuity was hand motions and the retina was attached.
Objectives: We present a case of epithelial ingrowth after late onset interface fluid syndrome, a rare complication after laser in situ keratomileusis (LASIK). Methods: This patient presented herself to the emergency department with corneal oedema due to endothelial failure after multiple intraocular surgeries. Anterior segment optical coherence tomography (OCT) showed a fluid filled pocket in the LASIK interface, 20 years after LASIK surgery. Results: As a result, she was diagnosed with late onset interface fluid syndrome which resolved after endothelial transplantation (DMEK). However, 3 months after surgery, epithelial ingrowth in the LASIK interface was noticed. We adopted a conservative approach as there was no progression after 3 weeks. Conclusions: Epithelial ingrowth is a rare complication after DMEK, which might be caused by interface fluid induced flap lifting and further facilitated by intraoperative flap manipulation during graft unfolding.
Objective: To highlight the importance of considering systemic metastatic retinal lymphoma (SMRL) in the differential diagnosis of atypical uveitis and to emphasize the need for a comprehensive diagnostic and treatment approach for optimal patient outcomes. Methods: Medical records and imaging of the patient were retrospectively reviewed. Results: A 61-year-old man presented with blurred vision, initially diagnosed as granulomatous uveitis following cataract surgery. Further ocular examination revealed optic nerve infiltration and retinal white infiltrates, prompting additional systemic evaluation. Imaging and biopsy confirmed a diagnosis of primary adrenal non-Hodgkin lymphoma with ocular involvement. The patient underwent R-CHOP chemotherapy and autologous stem cell transplantation during the COVID-19 pandemic, achieving systemic remission. However, due to pandemic-related logistical challenges, he declined further ocular treatment. At 1.5-year follow-up, his final visual acuity was 20/25 in the right eye and 20/125 in the left eye, with persistent cystoid macular edema in the left eye. Conclusion: This case underscores the importance of recognizing SMRL as a potential cause of atypical uveitis, particularly in the presence of optic nerve and retinal infiltrates. It highlights the need for early diagnosis and a multidisciplinary approach, integrating systemic and ocular management to improve patient outcomes.
An 18-year-old male was discovered with an oval, 1PD-sized, well-defined lesion on the inferonasal fovea of the right eye. Multimodal imaging was carried out. The lesion was diagnosed as torpedo maculopathy (TM). Most TM patients have no visual symptoms, are often detected during routine examination, and are generally stable.
Objective:To report a case with a history of previous radial keratotomy who underwent refractive lens exchange with trifocal intraocular lenses. Methods:Case report. Results:A 69-year-old man underwent bilateral RK to correct myopia in both eyes elsewhere 40 years ago. He was admitted to our hospital due to progressive deterioration of vision. The uncorrected distance visual acuity in both eyes was 20/40, and the uncorrected near visual acuity (40 cm) was J10. On slit-lamp examination, mild cataract and four radial keratotomy incisions were found. The patient underwent bilateral refractive lens exchange with trifocal intraocular lenses one-week interval. We were unable to obtain the preoperative data or details of the patient's prior surgeries. Calculations were run with the American Society of Cataract and Refractive Surgery calculator using the Barret True K formula. Postoperative follow-up was continued for approximately six months. No perioperative complications were noted. Conclusions:Six months after the surgery, the refractive outcomes for both eyes had stabilized, and no other complications had occurred. The patient was satisfied with the result.
