Faculty Bibliography

Osteoma cutis is a term applied to bone formation in the dermis or subcutaneous tissue. It is deemed primary when occurring de novo without prior disease or secondary when associated with pre-existing inflammation, neoplasia or trauma. The authors describe a longstanding focal calcified and ossified lesion of the upper eyelid in a healthy 10-year-old girl along with a sterile corneal ulcer. The lesion most likely represented an ossified tarsal cyst or chalazion.

PURPOSE OF REVIEW:Improve outcomes from an elective procedure by preventing a rare but sight-threatening complication. RECENT FINDINGS:Advancement in anti-infective prophylaxis, and therefore shift in the causative organism permits better diagnostic and empiric management. SUMMARY:Infectious keratitis presents in different patterns depending on the refractive procedure. Atypical causative organisms may respond poorly to empiric therapy and impair vision. Therefore, microbial identification is of utmost importance and therapy is adjusted accordingly.

Purpose of Review: Justify universal adoption of intracameral antibiotic for prophylaxis against postcataract endophthalmitis. Recent Findings: Review of both placebo-controlled randomized clinical trials for intracameral cefuroxime and moxifloxacin as well as large retrospective studies demonstrate efficacy in reducing the risk of postcataract endophthalmitis when the intracameral antibiotic choice is targeted to the causative pathogens of the demographic studied. Summary: Clinical evidence demonstrates the benefit of intracameral antibiotic use from statistical, clinical, and cost-effective analyses. Cases with higher risk for endophthalmitis such as posterior capsule rupture, manual extracapsular cataract extraction, immunocompromised patients, and age > 85, warrant special attention and greater consideration for intracameral antibiotic use. Further research to identify the optimal drug, formulation, and concentration can improve patient outcomes.

Whereas retinoic acids control nuclear events, a second class of retinol metabolites, that is, the hydroxylated forms exemplified by 14-hydroxy-retro-retinol (HRR), operate primarily in the cytoplasm. They function as regulatory cofactors for cell survival/cell death decisions. In accordance with these biological aspects, we demonstrate that these retinoids bound protein kinase C (PKC) alpha with nanomolar affinity and markedly enhance the activation of PKC alpha and the entire downstream MAP kinase pathway by reactive oxygen species. HRR was 10 times more efficient than retinol, and the optimum doses are 10-7 and 10-6 M, respectively. PKC alpha activation was reversed rapidly by imposition of reducing conditions. The retinoid binding site was mapped to the first cysteine-rich region in the regulatory domain, C1A, yet was distinct from the binding sites of diacylglycerol and phorbol esters. The C1B domain bound retinoids poorly. The emerging theme is that retinoids serve as redox regulators of protein kinase C.