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Transplantation of autologous limbal epithelial cells cultured on amniotic membrane is a simple and effective method of reconstructing the corneal surface and restoring useful vision in patients with unilateral deficiency of limbal epithelial cells.

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Aim-To study the eYcacy and safety of amniotic membrane graft as an adjunctive therapy after removal of primary pterygium, and to compare the clinical outcome with conjunctival autograft and topical mitomycin C. Methods-80 eyes of 71 patients with primary pterygia were treated with excision followed by amniotic membrane graft. The result was compared retrospectively with 56 eyes of 50 patients receiving conjunctival autograft, and 54 eyes of 46 patients receiving topical mitomycin C. Patients were followed for at least 6 months, and the averaged follow up periods for the three groups were 13.8, 22.8, and 18.4 months, respectively. Results-There were three recurrences (3.8%) in the amniotic membrane graft group, three recurrences (5.4%) in the conjunctival autograft group, and two recurrences (3.7%) in the topical mitomycin C group. There was no significant difference in recurrence rate among the three groups (p = 0.879). No major complications occurred in the amniotic membrane graft group or the conjunctival autograft group. One case of infectious scleritis due to scleral ischaemia occurred in the topical mitomycin C group. Conclusion-This study showed that amniotic membrane graft was as eVective as conjunctival autograft and mitomycin C in preventing pterygium recurrence, and can be considered as a preferred grafting procedure for primary pterygium. (Br J Ophthalmol 2000;84:973-978)

Using the Pentacam-derived keratometric index improved the prediction accuracies of total and posterior corneal powers.

Aims-To assess the clinical pictures, possible pathogenesis, management, and therapy of patients with infectious scleritis associated with multifocal scleral abscesses following pterygium excision. Methods-The records of patients with infectious scleritis after pterygium excision who developed multifocal scleral abscesses presenting from 1988 to the end of 1995 were reviewed. Early culture of abscesses was performed, and topical, systemic antimicrobials, or both were given to all patients. Fourteen eyes were operated on in addition to antimicrobial treatment. Results-The initial culture reports of scleral ulcers identified Pseudomonas species in 12 of these 18 patients, Aspergillus in one, Mycobacterium fortuitum in one, and mixed organisms in four. Subsequent abscess cultures were taken from 15 of the infected eyes, and revealed the same organism as the initial culture in 12. Associated complications included four serous retinal detachments, three choroidal detachments, two double detachments, five complicated cataracts, and four recurrences of the initial infection. Four eyes required eventual enucleation and 11 eyes regained useful vision. Conclusions-With subsequent abscess cultures proving to be the same organism as found in the initial ulcer, the abscess formation appears to represent intrascleral dissemination. Early diagnosis and appropriate, prolonged topical plus systemic antimicrobial treatment are essential to halt the progression of such severe infections. (Br J Ophthalmol 1998;82:29-34) Pterygium excision is thought to be a simple and safe surgical procedure, but may be complicated by infectious scleritis that can be destructive and visually disabling.1-7 When we treated the patients with infectious scleritis following pterygium excision, we found that some had multiple scleral nodules which had the potential to increase in size and number, and even perforate with purulent discharge. Previous reports regarding infectious scleritis following pterygium excision emphasised management and prognosis, but multifocal scleral nodules have received little attention.6 Whether these nodules are the result of an infectious process or an immune response, they may complicate the management of infectious scleritis. To try to ascertain the relation of multiple scleral abscesses to infectious scleritis, we focused on these cases of infectious scleritis in association with multiple scleral abscesses following pterygium excision and took cultures from the scleral nodules to study the possible pathogenesis. We also discuss the clinical features and management of this potentially devastating condition. Patients and methodsWe reviewed the medical records of patients who developed multiple scleral nodules associated with infectious scleritis following pterygium excision and were treated at our hospital from 1988 to the end of 1995. That is, the patients presented with culture proved infectious scleritis at the bare sclera of pterygium excision and then multiple sclera nodules appeared. Twenty three patients me...

There were age-related shifts toward against-the-rule and with-the-rule astigmatisms for the anterior and posterior corneal surfaces, respectively. The compensating effects of the posterior corneal surface on anterior corneal astigmatism decreased with advancing age.