Aim-To test the eYcacy and safety of recombinant human epidermal growth factor (hEGF) on corneal reepithelialisation following penetrating keratoplasty. Methods-A prospective, randomised, placebo controlled study was carried out in which patients were matched for diagnosis and received either hEGF ophthalmic solution (30 µg/ml or 100 µg/ml) or placebo in a double masked fashion. Matched pairs of patients received donor corneas from the same donor and were operated by the same surgeon on the same day. At the end of surgery all donor epithelium was removed mechanically. Patients were examined twice daily and fluorescein stained photographs were taken until the epithelium had closed. The area of the defect was measured by planimetry of the fluorescein stained defect on the photographs. Results-There were no significant diVerences in re-epithelialisation of the donor cornea between the placebo group and the group treated with 30 µg/ml hEGF. Time until complete closure was slightly longer with 100 µg/ml hEGF compared with 30 µg/ml hEGF and with placebo. Mean healing rate of the epithelial defect with 100 µg/ml hEGF was significantly slower than in the other groups. Conclusion-No significant acceleration of corneal re-epithelialisation was demonstrated with the use of recombinant hEGF after penetrating keratoplasty in humans. (Br J Ophthalmol 1997;81:391-395)

BACKGROUND: Intraocular lens implantation in eyes with Pseudophakie or aphakic corneal edema and insufficient posterior capsular support presents a surgical challenge. The iris claw lens has the advantage that it can be fixated to the iris without sutures because the peripheral iris is incarcerated between the claws. METHODS: We present the results of a study with implantation of an iris claw lens in combination with penetrating keratoplasty in 19 eyes of 19 patients with Pseudophakie or aphakic corneal edema which lacked posterior capsular support. The lens was fixated on the anterior iris surface (12 eyes) or posterior iris surface (seven eyes). RESULTS: Mean follow-up time was 1 1 .8 months (7 to 21 months). All grafts remained clear. One patient was lost for follow up after 3 months. Visual acuity improved in 83% of the patients. Twentyeight percent of the patients had a visual acuity of 2^20/40. Complications such as pigment dispersion, glaucoma, peripheral synechiae, and lens decentration were rare. CONCLUSIONS: We feel iris claw lens implantation combined with penetrating keratoplasty is a safe alternative to achieve pseudophakia in eyes with corneal edema and inadequate posterior capsular support. (Refract Corneal Surg. 1994;10:14-19.) RESUME INTRODUCTION: L'implantation ä'une lentille intra-oculaire dans les yeux atteints de la kératopathie bulleuse est difficile s'il n'existe pas assez de la capsule postérieure pour la soutenir. L'avantage de la lentille à griffes sur l'iris est qu'elle s'accroche à l'iris dans la périphérie moyenne sans^nécessiter de sutures. MÉTHODES: Nous présentons les résultats d'une étude d'implantation des lentilles à griffes en combinaison avec la kératopathie bulleuse d'aphakie ou la kératopathie bulleuse de Pseudophakie et l'appui capsulaire insuffisant. La lentille a été attachée sur la surface antérieure (12 patients) ou la surface postérieure (7 patients). RÉSULTATS: Le suivi post-opératoire fut en moyenne de 1 1,8 mois (7-21 mois). Toutes les greffes restaient transparentes. Un patient ne s'est pas présenté à la consultation après 3 mois. L'acuitié visuelle fut amélioré chez 83% des patients. L'acuité visuelle chez 28% des patients fut inférieure à 20/40. Des complications comme la dispersion du pigment, le glaucome, les synechiae périphérique et la décentration de la lentille furent rares. CONCLUSION: L'implantation d'une lentille à griffes sur l'iris apparaît comme une alternative sure pour réaliser une Pseudophakie dans l'oeil atteint de kératopathie bulleuse et dont l'appui capsulaire est insuffisant. (Translated by Rob Mack, MD, Iowa City, la.) SOMMARIO PREMESSA: L'impianto di lenti intraoculari in occhi con edema corneale in pseudofachia o afachia e insufficiente supporto capsulare posteriore rappresenta un problema chirurgico. La lente iridea a chela ha il vantaggio di poter essere fissata all'iride senza suture perchè la parte periferica dell'iride viene incarcerata tra le chele. METODI: Presentiamo i risultati di uno studio con impianto di lenti iridee a chela durante la cheratoplastica in 19 occhi di 19 pazienti con edema corneale in pseudofachia o afachia, che mancavano del supporto capsulare posteriore. La lente è stata fissata alla superficie anteriore (12 casi) o posteriore dell'iride (7 casi).