Background/aims-Simultaneous pancreas and kidney transplantation (SPK) has become an important option in selected IDDM patients with end stage renal disease (ESRD). Successful SPK transplants are associated with long term normoglycaemic control and improved quality of life. However, debate still continues on the benefit to patients in terms of stabilisation or amelioration of diabetic retinopathy. The progression of diabetic retinopathy (DR) in a cohort of 20 SPK transplant patients is reported. Methods-All patients were reviewed postoperatively with corrected visual acuity, slit lamp examination, and fundal biomicroscopy. Preoperative data were collected retrospectively and DR was considered unstable if there had been a drop in Snellen acuity greater than three lines or a need for laser photocoagulation or vitrectomy in the 2 years preoperatively. Results-20 patients who received SPK transplants between March 1983 and April 1994 were reviewed (mean age 35.1 years; mean duration of IDDM = 24.6 years). 17 patients still had functioning grafts at a mean follow up of 5.1 years. Nine of these patients had unstable DR before transplantation. Of these, 89% (8/9) had stabilised DR following transplantation with only a single case requiring laser photocoagulation. Of the eight patients that had stable DR before transplantation all had stable DR following transplantation. 41% of cases (7/17) required cataract surgery during the follow up period. Conclusions-Advanced diabetic retinopathy is present in a high proportion of cases managed with SPK transplant as a consequence of the duration of IDDM and the presence of ESRD. More than 90% of cases have stable DR following transplant. (Br J Ophthalmol 2000;84:736-740)

Purpose Accurate measurement of ocular axial length is essential for accurate intraocular lens Conclusion The use of a single high-quality axia.1length measurement was as accurate as the mean of three acceptable axial length measurements in the calculation of IOL power.

<H4>PURPOSE</H4> <p>To assess the comparability and intra-/ interobsever reliability of central anterior chamber depth measurements obtained using the Pentacam and IOLMaster.</p> <H4>METHODS</H4> <p>Anterior chamber depth was measured in 50 eyes (25 healthy volunteers)—three times on each eye by two independent observers with each method. A total of 12 measurements were performed on each eye. Analysis of variance was used to analyze the data. Mean values, standard deviations, and confidence limits (95% confidence interval) of the two modalities, two observers, and every observer/modality interaction were calculated.</p> <H4>RESULTS</H4> <p>The mean anterior chamber depth values were 3.23±0.031 mm for the IOLMaster and 3.21±0.033 mm for the Pentacam. No statistically significant difference was noted in measurements between the two modalities (<i>P</i>=.291) or between the two observers (<i>P</i>=.903). Observer/modality interaction was not significant (<i>P</i>=.643). The confi dence limits for observer 1 were 3.223±0.03 mm and 3.226±0.03 mm for observer 2. The confidence limits were: observer 1/IOLMaster, 3.23±0.04 mm; observer 2/IOLMaster, 3.24±0.04 mm; observer 1/Pentacam, 3.21±0.04 mm; and observer 2/Pentacam, 3.20±0.04 mm. The differences in measurements ranged from -0.14 to +0.10 mm for the IOLMaster and from -0.08 to +0.12 mm for the Pentacam. The worst deviation from the average eye reading of 3.23 mm was only 0.14 (4.3%).</p> <H4>CONCLUSIONS</H4> <p>Good agreement exists between anterior chamber depth measurements by the IOLMaster and Pentacam in the assessment of normal eyes, and they offer observer-independent results. Therefore, the modalities are interchangeable. [<cite>J Refract Surg</cite>. 2008;24:615-618.]</p> <h4>ABOUT THE AUTHORS</h4> <p>From Birmingham and Midland Eye Centre, Birmingham (Savant); and Wolverhampton & Midland Counties Eye Infirmary, Wolverhampton (Chavan, Pushpoth, Ilango), United Kingdom.</p> <p>The authors have no financial or proprietary interest in the materials presented herein.</p> <p>This study was presented as an E-paper at the International Society of Refractive Surgery of the American Academy of Ophthalmology Annual Regional Meeting; May 26-28, 2006; Istanbul, Turkey.</p> <p>Correspondence: Vijay Savant, FRCS(Ed), MRCOphth, Birmingham and Midland Eye Centre, Dudley Road, Birmingham B18 7QH, United Kingdom. Tel: 44 1215 543801; Fax: 44 1902 645018; E-mail: <a href="mailto:vijaysavant@hotmail.com">vijaysavant@hotmail.com</a></p> <p>Received: December 25, 2006</p> <p>Accepted: July 10, 2007</p> <p><b>Posted online: January 15, 2008</b></p>

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Silicone punctal plugs are effective and relatively safe method of managing keratoconjunctivitis sicca. We present a case where a silicone punctal plug migrated to cause aseptic necrosis of the surrounding tissue leading to a lid ulcer.