Aim: To assess the risk of dysphotopsia after phacoemulsification, with the use of four different intraocular lens (IOL) models. Methods: In this prospective randomized study, 600 patients underwent phacoemulsification surgery. Four study groups were formed, according to the type of the IOL implanted: Meridian HP60M [Bausch & Lomb, hydrogel, 6 mm, three piece (3P), square edge, refraction index (RI): 1.470], Acrysof MA60BM (Alcon, acrylic, 6 mm, 3P, square edge, RI: 1.550), Acrysof MA30BA (Alcon, acrylic, 5.5 mm, 3P, square edge, RI: 1.550) and Clariflex (AMO, silicone, 6 mm, 3P, anterior round and posterior square edge, RI: 1.460). Patients were examined for dysphotopsia symptoms after 1 week, 1, 3 and 6 months. Results: During the first follow-up visit, 117 patients (19.5%) reported dysphotopsia. During the next visits, the actual number of patients still reporting phenomena declined. Optic phenomena occurred less frequently in patients with AMO Clariflex lens, especially when compared to Acrysof (5.5 and 6 mm); IOL odds ratios ranged from 2.27 to 6.7, depending on follow-up time (p value < 0.05). IOL optic diameter was negatively but significantly associated with the risk of dysphotopsia. Conclusions: The design of the optic edge and the optic diameter of the IOL play an important role in the occurrence of dysphotopsia. AMO Clariflex, with round anterior and square posterior edge, overcomes the problem of dysphotopsia to a considerable extent.

Eighty-five patients undergoing cataract surgery were given for prophylaxis of intraocular infection two intravenous doses each of 200 mg, 300 mg or 400 mg ciprofloxacin (35 patients), 400 mg or 800 mg pefloxacin (30 patients), or 400 mg ofloxacin (20 patients). Ciprofloxacin levels in aqueous humour ranged from 0.02 to 0.50 microgram/ml, pefloxacin levels from 1.04 to 7.80 micrograms/ml, and ofloxacin levels from 0.44 to 2.27 micrograms/ml with ratios of aqueous humour to serum levels ranging from 3.8% to 25%, 21% to 48.1% and 44% to 88.4%, respectively. It is concluded that the quinolones studied might be suitable for surgical prophylaxis or treatment of anterior chamber infections due to Enterobacteriaceae, while ciprofloxacin at high doses is preferable for Pseudomonas aeruginosa infections.

Purpose To report a case of a 46‐year‐old man with bilateral neuroretinitis due to tertiary syphilis. Methods The patient presented at the clinic with a history of blurred vision. He was agitated and was looking unwell. Snellen Visual acuity (VA) was 0.2 in the right eye and 0.1 in the left eye. Pupillary reflexes to light were sluggish but normally reactive to accommodation. Fundoscopy showed bilateral optic disc oedema and fluorescein angiography revealed active neuroretinitis. Visual fields (VF) were abnormal in both eyes. Laboratory blood tests, cardiological investigations and a brain MRI were performed. Mantoux test was negative and IV treatment with corticosteroids was initiated. Results Treatment with steroids was discontinued due to the appearance of a maculopapular rash on the head and neck. Laboratory results showed: RPR (Rapid Plasma Reagin)/FTA: positive, TPPA of serum and CSF (IgG, IgM): positive. Virological tests were negative. Based on these findings the diagnosis of neurosyphilis was made. Cardiological investigation was normal and brain MRI did not show any major abnormalities. Patient was started on IV crystalline penicillin, 3‐4 million units q 4h for two weeks. Three months after treatment VA was 0.6 in the right eye and 0.4 in the left. There was an improvement on the VF mainly in the right eye. Electro‐encephalogram showed no significant pathology. ISCEV standard full field and pattern electroretinography were affected bilaterally. Conclusion Bilateral neuroretinitis due to tertiary syphilis affects vision and complete visual recovery may not occur despite adequate treatment.

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