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Some families have more than 1 member with plateau iris syndrome. The pattern of inheritance resembles an autosomal dominant pattern with incomplete penetrance.

Little is known about the effect of keratome type on postoperative wound integrity and architecture. Studies comparing metallic blades and diamond blades show conflicting results in terms of which type creates a less traumatized wound. 1,2 Recently, a new line of surgical blades composed of silicon material was introduced. Studies of the quality of corneal wounds created by silicon blades are needed but difficult to find in the peer-reviewed literature.We compared the postoperative architecture and integrity of corneal wounds created by metallic and silicon keratomes by observation of wound leakage, scanning electron microscopy (SEM) of the wounds and blades, and histopathologic analysis of the wounds in an ex vivo setting. Each of 10 human cadaver eyes (2 groups of 5 eyes) had a 2.8 mm clear corneal incision by a silicon blade (BD Atomic Edge safety slit knife [BD Medical]) or a metallic blade (Sharpoint slit knife [Surgical Specialties Corp.]). Care was taken to ensure that all eyes were of similar firmness before wound creation. A small amount of balanced salt solution was injected into the anterior chamber of softer eyes to prevent bias in wound construction.All incisions were created in a standard biplanar fashion with a length approximately equal to the initial width of 2.8 mm. A new blade was used for each eye.Simulated phacoemulsification was performed for 2 minutes in each eye using the Legacy Everest system (Alcon Laboratories). After phacoemulsification, each wound was examined for evidence of initial leakage. Then, intraocular pressure (IOP) was cycled between 0 mm Hg and 125 mm Hg 3 times in each eye and the wound was again examined for leakage (IOP was cycled and monitored using an arterial line dynamometer connected to an electronic pressure sensor, which was the design used by Berdahl et al. 3 ). In 2 eyes in each group, India ink was placed above the wound prior to IOP cycling. Those eyes were examined for leakage as well as ingress of fluid. Corneas with India ink were sent for histopathologic analysis to determine whether there was evidence of penetration. All other corneas in each group, along with a representative blade from each group, were sent for SEM examination using a Philips XL30 ESEM TMP electron microscope (FEI Co.).No eye had leakage immediately after phacoemulsification. In the metallic blade group, spontaneous leakage during IOP cycling was evident in 3 eyes (60%) and 8 of 15 total cycles (53%). In the silicon blade group, no eye displayed leakage during IOP cycling. India ink penetration was not evident in any eye in either group. On SEM, wounds in the metallic blade group displayed more stromal disruption than wounds in the silicon blade group (Figure 1). Scanning electron microscopy of the blades showed the silicon blade to have a smoother surface texture and sharper point than the metallic blade.As keratome technology advances, the interest in providing alternative blade designs and materials that have the potential to create better wounds will Figure 1. Scanning electron mic...

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We report a case of extrafoveal choroidal neovascularization (CNV) secondary to neovascular age-related macular degeneration treated with photodynamic therapy (PDT) and intravitreal triamcinolone. Nine months following PDT and intravitreal triamcinolone, no ophthalmoscopic or angiographic evidence of recurrent CNV in the left eye was found. The intraocular pressure (IOP) increased from 10 mmHg on presentation to 20 mmHg at 9 months. No IOP-lowering agents were required. The mild nuclear sclerosis remained unchanged.