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Eight immunosuppressed homosexual men with cytomegalovirus viremia--seven with serious bilateral retinitis, one with colitis in addition to retinitis, and one with pneumonitis only--were treated with a new acyclovir derivative, 9-(1,3-dihydroxy-2-propoxymethyl) guanine, which has excellent in-vitro activity against cytomegalovirus. All patients had virologic and clinical improvement, but substantial leukopenia developed in three patients. Both clinical relapses and viral relapses occurred frequently, usually within 30 days after cessation of treatment. 9-(1,3-Dihydroxy-2-propoxymethyl) guanine represents the first clinically and virologically effective agent for the treatment of cytomegalovirus disease, but more effective and less toxic therapeutic regimens for both acute and chronic use must be developed.

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<h4>PURPOSE</h4><p>To assess the efficacy, predictability, and safety of LASIK for the surgical correction of low to moderate hyperopia and hyperopic astigmatism using the NIDEK EC-5000 excimer laser.</p> <h4>METHODS</h4><p>In a multicenter United States Food and Drug Administration (FDA) regulated study of LASIK, 7 centers enrolled 293 eyes with manifest refraction sphere that ranged from +0.50 to +6.00 diopters (D) with or without astigmatism up to 3.00 D. The intended outcome was plano in all eyes. Patients were treated bilaterally. One year postoperative outcomes are reported. </p> <h4>RESULTS</h4><p>The mean spherical equivalent refraction (MRSE) for all eyes changed from +2.61±1.19 D (range: +0.50 to +6.63 D) preoperatively to +0.35±0.54 D (range: -1.63 to +2.00 D) 1 year postoperatively. Overall, 61% (170/279) of eyes achieved distance uncorrected visual acuity (UCVA) of 20/20 or better, 82% (228/279) of eyes saw 20/25 or better, and 99% (277/279) of eyes saw 20/40 or better. Refractive accuracy was demonstrated as 63.1% (176/279) of eyes achieved a MRSE within ±0.50 D and 90.3% (252/279) of eyes within ±1.00 D. Less than 2% (4/279) of eyes lost 2 lines of distance best spectacle-corrected visual acuity. Stability of refraction was demonstrated by 6 months, with a mean hyperopic shift of <0.03 D from 3 to 6 months. </p> <h4>CONCLUSIONS</h4><p>The NIDEK EC-5000 corrected hyperopia and hyperopic astigmatism with UCVA, refractive accuracy, 1-year stability, and safety that surpassed all FDA criteria. [<cite>J Refract Surg.</cite> 2008;24:123-136.]</p> <h4>ABOUT THE AUTHORS</h4> <p>From InView, Atlanta, Ga (Waring); Clinical Research Consultants Inc, Cincinnati, Ohio (Fant); Sound Eye and Laser, Seattle, Wash (Phillips); Fischer Laser Eye Center, Willmar, Minn (Fischer); Liberty Laser Eye Center, Vienna, Va (Tanchel); Southern Eye Associates, Memphis, Tenn (Schanzer); the Department of Ophthalmology, Loma Linda University, Loma Linda, Calif (Narvaez); and CODET/Aris Vision Institute, Tijuana, BC, Mexico (Chayet).</p> <p>Dr Waring is a consultant for NIDEK, AMO, Acufocus, Calhoun Vision, and SCHWIND. Dr Chayet is a consultant for NIDEK and Calhoun Vision. Dr Fant is a consultant for NIDEK and has a financial interest in Clinical Research Consultants Inc. The remaining authors have no financial interest in the materials presented herein.</p> <p>Correspondence: George O. Waring III, MD, InView, 301 Perimeter Center North, Ste 600, Atlanta, GA 30346. Tel: 678.222.5102; Fax: 404.250.9006; E-mail: <a href="mailto:drgeorge@georgewaring.com">drgeorge@georgewaring.com</a></p> <p>Received: June 25, 2007</p> <p>Accepted: December 4, 2007</p>

The spongiotic dermatoses including eczema and its clinicopathologic variants are capable of presenting in a variety of clinical guises and are pathologically defined by the presence of epithelial intercellular edema that may rarely form blisters. The mechanisms which underlie there pathogensis has only recently begun to be elucidated. Collectively, these disorders comprise an integral facet of dermatology and are the subject of discussion in this article.

Progressive epithelial ingrowth occurred with a continuous sheet of epithelium to the flap edge. Location of epithelial ingrowth and cytokine epithelial-stromal interaction appear to be important factors in this complication. Histopathological changes in the cornea after LASIK are difficult to detect in areas with normal wound healing.

The Er:YAG laser emulsified the lens nucleus safely and effectively. These early results include a higher than acceptable posterior capsule rupture rate and reflect the surgeon's learning curve with a new technology. Effective power delivery can be achieved with sapphire- and zirconium-fluoride-based fiber optics through a silica tip. The optimal energy delivery system has not been determined.