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Fungal infections in KPro eyes have appeared since we introduced broad-spectrum antibiotic prophylaxis and therapeutic contact lenses 5 years ago, but the infection rate remains very low in our mostly New England-based patient population. Cleaning or replacing the contact lens on a regular basis and prescribing a short course of topical amphotericin at the first visible signs of fungal colonization may prevent these infections.

Background/aims To compare the effectiveness and side-effect profile of two doses of interferon alpha2b (IFNa2b) eye-drops (1 million international units (IU)/ml versus 3 million IU/ml) in the treatment of ocular surface squamous neoplasia (OSSN). Methods Retrospective case series. Results Thirty-five eyes were identified over an 11-year period (1996e2007). Twenty-one eyes (19 patients) with conjunctival intraepithelial neoplasia (CIN) were treated with 1 million IU/ml of topical IFN-a2b; 12 eyes (nine patients) with CIN were treated with 3 million IU/ ml. Two patients with squamous cell carcinoma (SCC) were treated with topical interferon, one with 1 million IU/ml and one with 3 million IU/ml. Baseline demographic information was not statistically different between the two groups. In patients with CIN, topical therapy eliminated disease in 81% of eyes in the 1 million IU/ml group versus 92%, in the 3 million IU/ml group, p¼0.41. The median time to OSSN resolution was 2.8 months in the 1 million IU/ml group and 1.9 months in the 3 million IU/ml group, p¼0.55. Neither eye with SCC responded to interferon therapy. Topical therapy was well tolerated. After a median follow-up of 24 months, three recurrences were seen in eyes successfully treated with topical therapy. Conclusion In our study, there were no significant differences between the 1 million IU/ml group and the 3 million IU/ml group for the treatment of CIN.

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Experience has shown us that virtually all patients who are candidates for laser in situ keratomileusis can be candidates for surface ablation, but patients with specific ocular conditions, such as epithelial basement membrane dystrophy, superficial corneal scars, and previous radial keratotomy will have the best outcomes with surface ablation. Surface ablation and laser in situ keratomileusis are comparable in terms of safety and quality of vision. Wavefront-guided photorefractive keratectomy offers better acuity and less induction of higher order aberrations than wavefront-guided laser in situ keratomileusis.

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