Faculty Bibliography

Diagnosis and management of Acanthamoeba chronic ulcerative keratitis is difficult. Two cases of Acanthamoeba keratitis at Wills Eye Hospital were diagnosed within several months of each other during 1983. Corneal transplantation was necessary for diagnosis and therapy in these cases. Another two cases were diagnosed when histopathologic specimens from penetrating keratoplasties done between 1974 and 1983 were reviewed retrospectively. There has been no evidence of recurrent disease in any of our cases during follow-up periods averaging two years (range, 12 to 40 months). The diagnosis of Acanthamoeba keratitis must be considered in cases of chronic progressive corneal ulceration unresponsive to medical therapy

A child with a history of a monocular congenital cataract, cataract surgery and intraocular lens implantation at age three developed pseudophakic bullous keratopathy which persisted following intraocular lens removal and vitrectomy two years later. At age nine she presented to the Cornea Service at Wills Eye Hospital with painful bullous keratopathy and underwent a penetrating keratoplasty and anterior vitrectomy. The case is presented to bring attention to potential long-term corneal complications of pediatric cataract surgery with intraocular lens implantation

Between Sept. 1, 1981, and Jan. 31, 1984, 74 eyes (70 patients) were fitted with gas-permeable Polycon contact lenses and monitored for at least six months (range, six to 33 months; mean, 14 months). The major indications for hard contact lens fitting were astigmatism and anisometropia. Astigmatism in this series ranged from 0 to 17.50 diopters (mean, 7.7 diopters). Most patients achieved visual acuities of 20/40 or better (67 of 74, 90%) with contact lenses. Contact lenses were discontinued in 18% (13 of 74), because of graft rejection in four cases and because of contact lens intolerance in nine cases. Our results demonstrated that gas-permeable hard lenses can be fitted successfully in most patients unable to achieve optimal vision with spectacle correction after penetrating keratoplasty

Thirty-four patients with herpes simplex dendritic keratitis were randomized into three treatment categories: Group A had debridement alone; group B, trifluridine (trifluorothymidine) alone; and group C, debridement and trifluridine. Patients treated with debridement alone had a statistically higher failure rate than did the other two groups. No statistically significant difference was observed between trifluridine treatment alone and debridement combined with trifluridine treatment, with regard to healing time. Our results suggest that debridement alone is suboptimal therapy for herpes simplex dendritic keratitis and that debridement combined with trifluridine appears to offer no advantage over trifluridine alone