One hundred consecutive patients who underwent bilateral pan-retinal photocoagulation (PRP) for proliferative diabetic retinopathy were assessed in accordance with the UK Driver and Vehicle Licensing Agency (DVLA) guidelines. Visual acuity was documented, and visual fields were assessed using the Esterman test. Among the 30% of patients who failed to reach the visual standards required for a driving licence, three groups were identified: those who failed to attain either the required binocular visual acuity (n = 4), or visual fields (n = 9), or both (n = 17). Previous studies reveal a large variation in DVLA field test failure following PRP treatment for proliferative diabetic retinopathy. Our results show a 19% failure rate solely attributable to treatment, which is at the lower end of previously reported studies (20-80%). The reasons for this discrepancy are discussed. We conclude that modern treatment procedures for proliferative diabetic retinopathy may be undertaken with the knowledge that in the majority of cases a patient's driving licence is unlikely to be revoked.

We describe the clinical features and management of a 36-year-old man with aniridia and aphakia following blunt ocular trauma. Examination showed partial aniridia and aphakia. We discuss the various options available in the management of this patient and describe the surgical technique involved in the implantation of an iris reconstruction implant.

Topical anesthesia with proparacaine provided similar and reasonable analgesic effects in patients having surgery by a surgeon in the learning curve and those having surgery by an experienced surgeon. The discomfort perceived during surgery performed by an experienced surgeon was less, although not statistically significantly different.

References

Aim: To compare the incidence of various integrin subunits in human cataract anterior lens epithelial cells (A-LEC) and in two mammalian LEC lines. Methods: Circular sections of anterior capsules with attached LEC were obtained during cataract surgery. Integrin subunits were immunolocalised in these anterior LEC and in a human and rabbit LEC line, using four monoclonal antibodies specific for subunits a2, a3, and a5, and b subunit 2. Results: All of these subunits were found in at least a proportion A-LEC samples as follows: a2 71%, a3 92%, a5 62%, and b2 24%. The human LEC line was immunoreactive for a2 and a3 only. The rabbit lens epithelial cell line was immunoreactive for a5 but there was no staining for a2, a3, or b2. Conclusion: The A-LEC and mammalian LEC lines showed a similarity in their pattern of integrin expression. As these integrins are receptors for extracellular matrix (ECM) components, they are likely to be associated with the attachment and migration of LECs that precedes capsular opacification. Therefore these cell lines may be useful in the elucidation of mechanisms involved the pathogenesis of capsule opacification.