Aims-To evaluate the therapeutic eVects of excimer laser phototherapeutic keratectomy (PTK) combined with therapeutic contact lens for painful recurrent corneal erosions (RCE) secondary to bullous keratopathy (BK) not suitable for penetrating keratoplasty. Methods-Excimer laser PTK was performed prospectively in eight eyes with painful RCE due to BK visually expecting no benefit from penetrating keratoplasty. After mechanical removal of the epithelium, the corneas were ablated with 50 pulses in the central 6.5 mm zone (ablation rate 0.25 µm per pulse) and another 200 pulses for polishing the periphery. After PTK, therapeutic contact lenses were applied for 3 months. The mean follow up period after PTK was 10.9 months (ranging from 6 to 15 months). Results-All patients experienced relief of their pain symptoms after the epithelium healed. Only one patient complained of occasional stinging pain with intermittent recurrence of small bullae. He refused a second treatment because the pain was much less than that before the surgery and quite tolerable. No infection or other complications were noted. Conclusion-PTK with deeper ablation and adjunctive therapeutic contact lens is an easy to perform and eVective treatment with less recurrence rate for patients with BK and poor visual potential. (Br J Ophthalmol 2001;85:908-911)

To clarify the role of the lens capsule in cataract formation, changes in the protein conformational structure of immature cataractous lens capsules from patients with systemic hypertension or glaucoma have been investigated, as compared to normal lens capsules. The protein secondary structure and composition of these capsular samples were determined using Fourier transform infrared microspectroscopy with second-derivative, deconvolution and curve-fitting methods. We found that the composition of both random coil and β-type (β-sheet and β-turn) structures in the immature cataractous human lens capsules was increasingly induced by systemic hypertension or glaucoma, but α-helix content clearly decreased, leading to the alteration of protein conformational structures in lens capsules. A possible pathway of cataract formation exacerbated by systemic hypertension or glaucoma is discussed. According to the results, we propose that systemic hypertension or glaucoma induce changes in the protein conformational structures of the lens capsule, then cause alteration of membrane transport and permeability for ions, and finally increase intraocular pressure, resulting in the exacerbation of cataract formation. The effect on the conformational structure of cataractous human lens capsules is more pronounced for systemic hypertension than for glaucoma. The present study implies that systemic hypertension or glaucoma can exacerbate cataract formation in senile patients by modifying the protein secondary structures in the lens capsule.

Eye rubbing should be avoided before measurements of corneal biomechanical properties and IOPg. In contrast, breath holding during measurements is not likely to cause a significant change in IOPg and IOPcc or corneal biomechanical properties.