HQ-induced toxicity is mediated through mitochondrial damaging, oxidative stress-related and necrosis-related pathways; Brimonidine significantly prevented the mitochondrial damaging and oxidative stress-related effects but had little effect on blocking the necrosis component of HQ-toxicity. Brimonidine protective effects differ between the different retinal cell types and high concentrations of Brimonidine (10×) have minimal damaging effects on human retinal cells.

Purpose: To evaluate the effect of intravitreal triamcinolone acetonide–moxifloxacin at the time of cataract surgery on central macular edema in patients with preexisting diabetic retinopathy. Setting: Loma Linda University Eye Institute, California, USA. Design: Retrospective observational clinical study. Methods: Retrospective chart review included 75 eyes of 64 patients who had cataract surgery between February 2015 and October 2018 performed by 2 surgeons. Intravitreal injection of triamcinolone–moxifloxacin (15 mg/1 mg/mL, 0.2 mL injection with 3.0 mg triamcinolone acetonide and 0.2 mg moxifloxacin) was given at the time of surgery. Visual acuity and central macular thickness (CMT) with optical coherence tomography were recorded at preoperative and postoperative visits. Results: Mean visual acuity (logarithm of the minimum angle of resolution) at 4 to 6 weeks, 6 to 12 weeks, and 12 weeks or more postoperatively was 0.32, 0.35, and 0.43, respectively. Baseline mean CMT of 75 eyes was 294 μm (SD = 72). Mean CMT 4 to 6 weeks postoperatively for 46 eyes decreased from 299 μm (78) to 297 μm (79), with a mean decrease of 2 μm (50) (P = .97). Mean CMT 6 to 12 weeks postoperatively for 34 eyes increased from 317 μm (88) to 344 μm (111), with a mean increase of 26 μm (98) (P = .021). Mean CMT 12 weeks or more for 60 eyes increased from 295 μm (72) to 328 μm (108), with a mean increase of 33 μm (85) (P = .0023). Conclusions: Triamcinolone acetonide–moxifloxacin maintained stability of postoperative CMT in patients undergoing cataract surgery with preexisting diabetic retinopathy in the short term, with the greatest effect at 4 to 6 weeks postoperatively.

Anterior-Segment OCT to Visualize and Treat Capsular Bag Distension Syndrome An 83-year-old man underwent phacoemulsification and posterior-chamber intraocular lens (PCIOL) placement in the right eye. At 2-year followup, the patient had blurry vision in that eye. Slit-lamp photos and corresponding anterior-segment (AS) OCT showed turbid fluid collection between posterior aspect of PCIOL and anterior aspect of posterior capsule, consistent with Capsular Bag Distension Syndrome (Fig A, C). A YAG laser capsulotomy focused on the IOL anterior surface using AS-OCTederived posterior offset values targeted the otherwise nonvisible posterior capsule. The patient noted subjective visual improvement, and clinical imaging and AS-OCT demonstrated resolution of fluid distension (Fig B, D).

Purpose: To present a case of primary graft failure after penetrating keratoplasty found to have epithelial ingrowth into the host stroma on histopathologic analysis. Methods: This is a single observational case report. Results: We herein describe the clinical course of a case of primary graft failure after penetrating keratoplasty. The corneal button was sent for histopathologic analysis. Analysis of the patient's failed corneal button revealed circumferential epithelial full-thickness wound invasion and stromal epithelial invasion into corneal stroma. Conclusions: Based on histopathologic analysis and this patient's presentation, the stromal ingrowth followed recipient epithelial invasion of the wound and stromal invasion through clefts in the donor corneal edges. Cases of primary graft failure should be assessed for histopathologic evidence of epithelial stromal ingrowth, despite its rarity. To our knowledge, epithelial ingrowth into the corneal donor stroma after penetrating keratoplasty has not been previously reported.