Background/aims: Transscleral diode laser cyclophotocoagulation (''cyclodiode'') is widely used to treat refractory glaucoma. The main aims of this study were to investigate the dose-response relation of cyclodiode and to evaluate possible predictive factors that would help establish optimum treatment parameters. Methods: A retrospective analysis of the case notes of 263 eyes of 238 consecutive patients who underwent transscleral diode laser cyclophotocoagulation at two centres was undertaken. Results: Mean intraocular pressure (IOP) decreased significantly from 40.7 mm Hg (SD 13.7) before cyclodiode therapy to 17.7 mm Hg (SD 10.9) post-treatment, a reduction of 52.6% (p = 0.0001). Following cyclodiode, 89% of patients achieved an IOP of less than 22 mm Hg or a greater than 30% drop in IOP. Hypotony occurred in 9.5% of patients, 76% of whom had neovascular glaucoma. A linear dose relation response was found for the 122 eyes with neovascular glaucoma (p = 0.001) but not for the group as a whole. Treatment failure was associated with male sex (multivariate regression analysis, p = 0.008) and low mean energy per treatment session (univariate analysis alone, p = 0.016). High pretreatment IOP (p = 0.031) and high mean energy per treatment episode (p = 0.001) appeared to be associated with the occurrence of hypotony, although multivariate analysis did not support this finding. Conclusion: Cyclodiode therapy is highly effective but there is a significant risk of hypotony, which may be reduced by applying lower energy in cases of very high pretreatment IOP and in neovascular glaucoma. The dose-response association remains unpredictable, although a linear relation was found for neovascular glaucoma.

HISTORICAL AND GLOBAL SIGNIFICANCE OF CORNEAL TRANSPLANTATION AND FACTORS ASSOCIATED WITH HIGH IMMUNOLOGICAL RISK The landmark report by Eduard Zirm in 1905 of a successful full-thickness corneal transplant in a 45-year-old farm laborer with lime burn preceded, by several decades, the subsequent successes of vascularized organ transplants. 1,2 Following the introduction of topical corticosteroid therapies in the 1950s, corneal transplantation (keratoplasty) has become established as the primary sight-restoring procedure for corneal blindness in developed and developing countries. 3 Furthermore, while partial-thickness (lamellar) keratoplasty has now become the preferred transplant procedure for many corneal disorders, 4 fullthickness allograft remains the most frequently utilized treatment worldwide for corneal conditions associated with significant stromal opacity or vascularization such as bacterial, fungal, or viral infections; severe atopic disorders; ocular trauma and prior graft loss. Corneal opacity Review Abstract. Human corneal transplantation (keratoplasty) is typically considered to have superior short-and long-term outcomes and lower requirement for immunosuppression compared to solid organ transplants because of the inherent immune privilege and tolerogenic mechanisms associated with the anterior segment of the eye. However, in a substantial proportion of corneal transplants, the rates of acute rejection and/or graft failure are comparable to or greater than those of the commonly transplanted solid organs. Critically, while registry data and observational studies have helped to identify factors that are associated with increased risk of corneal transplant failure, the extent to which these risk factors operate through enhancing immune-mediated rejection is less clear. In this overview, we summarize a range of important recent clinical and basic insights related to high-risk corneal transplantation, the factors associated with graft failure, and the immunological basis of corneal allograft rejection. We highlight critical research areas from which continued progress is likely to drive improvements in the long-term survival of high-risk corneal transplants. These include further development and clinical testing of predictive risk scores and assays; greater use of multicenter clinical trials to optimize immunosuppressive therapy in high-risk recipients and robust clinical translation of novel, mechanistically-targeted immunomodulatory and regenerative therapies that are emerging from basic science laboratories. We also emphasize the relative lack of knowledge regarding transplant outcomes for infection-related corneal diseases that are common in the developing world and the potential for greater cross-pollination and synergy between corneal and solid organ transplant research communities.

Approximately 40% of patients presenting with idiopathic AAU have undiagnosed SpA. A simple to apply algorithm is described with excellent sensitivity and specificity.

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Based on systemic breakpoint data, resistance to commonly used antimicrobials was apparent. Meropenem is a potentially effective agent for ophthalmic use, with low MICs throughout all the bacterial subgroups. Tigecycline and linezolid showed good activity against particular groups and may be useful for treating bacterial keratitis resistant to current antimicrobials. Of the fluoroquinolones, moxifloxacin showed the lowest MICs and resistance for both Gram-positive and -negative bacteria.

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During retinal degeneration, microglia are activated and express sialoadhesin. The temporal relationship between photoreceptor apoptosis and microglial response suggests that microglia are not responsible for the initial wave of photoreceptor death, and this is corroborated by the absence of iNOS and nitrotyrosine. Expression of sialoadhesin may indicate blood-retinal barrier breakdown, which has immune implications for subretinal gene therapeutic strategies.