Minas Coroneo

UNSW Sydney | UNSW · Ophthalmology

Purpose: To analyse reused Drysdale nucleus manipulator (DNM) instruments associated with intraoperative complications for sharp defects and evaluate their ele- mental composition to determine probable source. Method: This laboratory study utilised scanning electron microscopy to examine six DNMs (5 reused, 1 control) for sharp surface defects (nu...

Glaucoma surgery with implantation of aqueous humor draining microstents may compromise long-term corneal health by disrupting aqueous humor circulation. The effect of stent numbers on this circulation was interrogated to determine the number of stents associated with minimal circulation disruption. An in vitro anterior eye model perfusion system w...

Retinal vessel segmentation is generally grounded in image-based datasets collected with bench-top devices. The static images naturally lose the dynamic characteristics of retina fluctuation, resulting in diminished dataset richness, and the usage of bench-top devices further restricts dataset scalability due to its limited accessibility. Consideri...

Purpose: The aim of this study was to report the recurrence and complication rates of a modified limbal-conjunctival autograft surgical technique for pterygium excision. Methods: This was a retrospective, single-surgeon, single-operating environment, consecutive case series of 176 eyes in 163 patients with a biopsy-proven diagnosis of pterygium....

Title: Dame Ida Mann: The Prototypical Modern Woman. Purpose Dr. Ida Mann (6. February 1893, London (UK) – 18 November 1983, Perth (Australia) was the pre-eminent ophthalmologist of her era. Her career is reviewed in the context of the evolution of attitudes and practices in modern society. Methods Selective literature search in books and journal...

The present article reports on the management of six different and rare cases of fungal keratitides, two of which have never been documented in previous literature. This is a case series of six patients with rare fungal keratitides managed at a quaternary eye referral unit, Sydney Eye Hospital, Australia over a period of 7 months (May to December,...

The purpose of this article was to look at the pathophysiology behind and devise a classification system for the causes of zonular apparatus-capsular bag (ZACB) insufficiency. Also discussed is dystrophic bag syndrome, including clinical cases and addressing where it lies on the ZACB spectrum. There has been interest in the emergence of in-the-bag...

Rho kinase inhibitors (ROCKi) have attracted growing multidisciplinary interest, particularly in Ophthalmology where the question as to how they promote corneal endothelial healing remains unresolved. Concurrently, stem cell biology has rapidly progressed in unravelling drivers of stem cell (SC) proliferation and differentiation, where mechanical n...

Background: Temporal Arteritis is the most common panarteritis in adults and typically affects elderly people, particularly women. This occlusive vasculitis is associated with at least 51 symptoms and signs and can result in bilateral blindness and potentially death from aortic root dilatation and rupture. Case Report: This report demonstrates a ca...

Pterygium pathogenesis is often attributed to a population of altered limbal stem cells, which initiate corneal invasion and drive the hyperproliferation and fibrosis associated with the disease. These cells are thought to undergo epithelial to mesenchymal transition (EMT) and to contribute to subepithelial stromal fibrosis. In this study, the pres...

Purpose : To analyse microtopography of 5 reusable Drysdale nucleus manipulator (DNM) paddled tips for sharp defects and evaluate their elemental composition in order to determine probable source, investigating two instruments (DNM 1 & 4) implicated in causing posterior capsule rupture (PCR) and three instruments with sharp edges identified by fing...

Pterygium is an ultraviolet-related disease characterized by an aberrant, wing-shaped and active wound-healing process. There is nothing quite as disheartening for the surgeon or patient as the recurrence of pterygium and various adjuvants have been studied to ameliorate this. This systematic review provides a comprehensive summary of the efficacy...

The human face/head supports a highly diverse population of microorganisms across a diverse range of microhabitats. This biogeographical diversity has given rise to selection pressure resulting in the formation of distinct bacterial communities between sites. This review investigates the similarity and differences of microbiomes across the differen...

Because little is known about cataract in pilots, we estimated prevalence by anonymously ascertaining all commercial airline pilots diagnosed with cataract 2011-2016 using the electronic Medical Records System of the Australian Civil Aviation Safety Authority. Of 14,163 Australian male commercial pilots licensed in 2011, 1286 aged ≥60 had biennial...

In this study, differentiation of pterygium vs. ocular surface squamous neoplasia based on multispectral autofluorescence imaging technique was investigated. Fifty (N = 50) patients with histopathological diagnosis of pterygium (PTG) and/or ocular surface squamous neoplasia (OSSN) were recruited. Fixed unstained biopsy specimens were imaged by mult...

Purpose: Certain peripheral retinal degenerations pose a significant risk to vision and require prompt detection and management. Other historically "benign" peripheral lesions are being recognised as clinically significant due to their associations with ocular and systemic disorders. Assessment and documentation of these entities however can be di...

Marjolin ulcer is a term used to describe malignancy that originates from chronically inflamed, ulcerated, or scarred tissue. The potential for malignant transformation of ocular surface chemical injuries to a Marjolin ulcer is not well recognised. In fact, this progression may be accelerated by the immunosuppressive treatments often utilised to co...

Purpose: To review the literature on crystalline lens epithelial cell (LEC) removal in routine phacoemulsification and determine whether it should be incorporated as part of a surgeon's standard technique. Design: Perspective. Methods: Expert commentary with video demonstrations on techniques of removal of LEC's and associated potential compli...

Background Conjunctival ultraviolet autofluorescence (CUVAF) is a method of detecting conjunctival damage related to ultraviolet radiation exposure. In cross-sectional studies, CUVAF area is positively associated with self-reported time spent outdoors and pterygium and negatively associated with myopia; however, longitudinal studies are scarce. Ai...

Dr. Ida Mann (6. February 1893, London, UK – 18. November 1983, Perth, Australia) was the pre-eminent ophthalmologist of her era. She is regarded as one of the intellectual giants of 20th century ophthalmology and was a leader in the development of ophthalmology in Australia. Ida Mann´s career is reviewed in the context of the evolution of attitude...

Purpose: To determine the effect of atropine on pupillary diameter, accommodative amplitude as well as myopia progression. Methods: Medical databases and Cochrane Library were systematically searched for studies from 1980 until June 2020. The primary and secondary outcomes were: a) change in pupillary diameter (PD) and accommodative amplitude (A...

As techniques for modern cataract surgery have expanded and premium intraocular lens (IOL) use is now widespread, patient expectations are high. The need for IOL explantation, whilst still low, remains an ongoing issue. Intraocular lens explantation can be challenging for a number of reasons and as such we have introduced an additional technique to...

Significance: Assessment of treatment efficacy via comparison with a target IOP is fundamental in monitoring patients with open-angle glaucoma and ocular hypertension. This article highlights that diurnal IOP fluctuations obtained using self-tonometry may more accurately reflect IOP responses to therapy. Purpose: This study aimed to investigate...

Objective: Irritable bowel syndrome (IBS) is a chronic disorder associated with an abnormal gastrointestinal microbiome. Microbiome-host interactions are known to influence organ function including in the central nervous system; thus, we sought to identify whether IBS may be a risk factor for the development of glaucoma. Design: Two prospective...

Purpose: The purpose of this study is to report a case of corneal epithelial defects resulting from topical treatment of blepharitis with tea tree oil (TTO). Methods: A 44-year-old man with a 1 year history of blepharitis non-responsive to eyelid hygiene was found to have signs of Demodex infestation. He was treated with a topical, off-label 50%...

Wide availability and uptake of contact lenses came with the development of the first polymethyl methacrylate corneal lenses during the late 1940s. It is less well known that colored contact lenses were developed simultaneously. These innovations allowed both a degree of spectacle independence for ametropes and an ability to vary eye color. The imp...

The COVID-19 pandemic has compelled a review of possible routes of microbial infection, of particular importance since the ocular surface is a likely portal of human Coronavirus invasion. As hand contamination is considered an important and potentially preventable factor for transmission, we have reviewed face touching in the context of a group of...

Purpose: The aim of this study is to describe the technique of subpalpebral antibiotic lavage (SAL), which is a highly therapeutic, efficient, and cost-effective method for managing severe bacterial keratitis. Methods: This case report describes a 26-year-old woman with severe bacterial keratitis in the right eye due to contact lens overwear, wi...

Animal models are a critical element of ocular surface research for investigating therapeutic drops, surgical implants, and infection research. This study was a comparative analysis of the microbial communities on conjunctival tissue samples from humans compared to several commonly used laboratory animals (BALB/c mice, New Zealand white rabbits and...

Myopia (near-sightedness) is an important public health issue. Spending more time outdoors can prevent myopia but the long-term association between this exposure and myopia has not been well characterised. We investigated the relationship between time spent outdoors in childhood, adolescence and young adulthood and risk of myopia in young adulthood...

Purpose To evaluate any correlation between pterygium laterality and patient handedness. Methods Our study represents a retrospective observational study of a series of consecutive pterygium patients recruited from two centres. Each patient was assessed for their handedness which was compared to the laterality of their presenting pterygium. Patien...

Glaucoma-related ocular surface disease (G-OSD) is a significant, yet often underdiagnosed, ocular co-morbidity affecting 40% to 59% of glaucoma patients worldwide. Although the use of topical glaucoma medications represents a proven strategy to control the untoward effects of high intraocular pressure, this treatment can profoundly disrupt the hom...

Management of multiple exposed eyelid concretions can be performed successfully in an anesthetized eyelid with gentle curettage of the concretions using a small chalazion curette. It has the advantage of managing the patient supine, providing better eyelid stability and visibility, and minimizing risk in the event of patient movement. This curettag...

Insertion of the optimal intraocular lens prior to retinal surgery is a topic of interest to both anterior and posterior segment surgeons. There are a number of factors that must be considered prior to intraocular lens selection when a secondary surgery is planned. The areas of intraocular lens opacification post-gas tamponade or use of silicone oi...

Purpose To compare the efficacy and safety of an artificial tear combining the polymers carboxymethylcellulose (CMC) and hyaluronic acid (HA), to a formulation of CMC alone in subjects with dry eye. Methods A preservative-free artificial tear (CMC-HA) was compared with an existing artificial tear (CMC). Subjects with mild-to-severe signs and sympt...

Clinical relevance: Diagnosis and monitoring of keratoconus is increasingly being conducted with the aid of imaging equipment such as corneal aberrometry. There is a need to also know the confidence with which ocular aberration measurements can be made. Background: To assess the repeatability of lower- and higher-order aberration measurements in...

Purpose The ocular surface microbiota are recognised as one of causative microorganisms in post-procedural endophthalmitis but in many cases the vitreous tap is culture negative. This study investigated bacterial contamination of intravitreal (IVT) needles using multiple approaches covering culturing, 16S rRNA gene sequencing, fluorescent in situ h...

Purpose To describe one of the largest case series of children whose ocular surface disease was strongly suspicious for nonaccidental injury (NAI). Methods This multicenter retrospective case series includes 4 patients whose presentations were concerning for anterior segment NAI. The history, examination, treatment, and outcomes of these patients...

Oculo-centric factors may provide a key to understanding invasion success by SARS-CoV-2, a highly contagious, potentially lethal, virus with ocular tropism. Respiratory infection transmission via the eye and lacrimal-nasal pathway elucidated during the 1918 influenza pandemic, remains to be explored in this crisis. The eye and its adnexae represent...

Purpose To evaluate the long-term follow-up of recurrent conjunctival and corneal intraepithelial neoplasia (CCIN) treated with combination topical interferon alfa-2b and retinoic acid (I/RA). Methods Our study represents a retrospective observational interventional series of 82 eyes from 82 patients from a single institution, reviewed for CCIN. A...

Introduction Eye diseases and visual impairment more commonly affect elderly adults, thus, the majority of ophthalmic cohort studies have focused on older adults. Cohort studies on the ocular health of younger adults, on the other hand, have been few. The Raine Study is a longitudinal study that has been following a cohort since their birth in 1989...

Purpose: A clinical examination technique to detect pathology within the anterior eye is known as "sclerotic scatter" (SS). Its propagation pathway has not been thoroughly investigated. Although conventionally theorized to occur by "total internal reflection" (TIR) within the cornea, existing data suggest that this may be an incomplete explanation...

Light-induced amaurosis (LIA) is a rare presentation of internal carotid artery (ICA) stenosis. This report documents a 74-year-old Caucasian male who presented with profound right monocular vision loss, occurring on every occasion upon entering brightly lit environments. This was managed successfully with a right carotid endarterectomy. This case...

Objectives Occupational exposure to cosmic and ultraviolet radiation may increase airline pilots’ risk of cutaneous melanoma. Meta-analyses of available data show a higher than average incidence of melanoma in airline pilots, but the most recent systematic review revealed that few contemporary data are available. Moreover, all relevant studies have...

Importance Floppy Eyelid Syndrome ‘plasty’ (FESplasty) is a surgical technique that addresses underlying superior tarsal plate and lateral canthal instability in FES and aims to restore normal anatomical and physiological function to the upper eyelid. Background To describe the use of FESplasty in the surgical management of FES, and to report outc...

Purpose To assess which factors in the lives and disease of patients with glaucoma affect their adherence to topical glaucoma therapy and the quantitative significance of this effect. To assess qualitatively the most influential barriers to adherence from the perspective of the patient. Design Multicenter, prospective, cross-sectional pilot study....

Purpose: We assess the safety and effectiveness of intranasal neurostimulation to promote tear production via the nasolacrimal pathway in subjects with dry eye disease. Methods: A multicenter, randomized, controlled, double-masked pilot study was conducted in adults with dry eye diagnosis and at least one eye with corneal fluorescein staining ≥2...

Purpose: The human eye is composed of numerous microhabitats. The aim of this study was to understand the communality and differences in the microbiomes of various regions of the eye. Methods: Four ocular sites from different subject groups were assessed including the eyelid margin tissue from patients with lid abnormalities (n = 20), fornix and...

Purpose: The aim of this paper was to investigate the degree of inflammation and dry-eye disease (DED) in recurrent pterygium. Methods: Fifty-five patients with a history of pterygium excision were divided into 3 groups - Group 1: no recurrence after the first excision; Group 2: recurrence after the first excision; Group 3: no recurrence after t...

Importance Excessive ocular sun exposure is linked to various eye pathologies. Conjunctival ultraviolet autofluorescence (CUVAF) is a method of detecting sun‐related conjunctival damage; however, the custom‐built camera system required is not readily available. Background We investigate whether blue laser autofluorescence (BAF) on a commonly used...

Purpose: Knowledge of whether microorganisms reside in protected niches of the conjunctiva is potentially significant in terms of minimizing risks of contact lens inflammation/infection and endophthalmitis. We define if and how microbial communities from limbal and forniceal conjunctival tissue differ from those on the conjunctival surface. Metho...

Podium presentation - Session: "Cornea Unplugged: Cornea and its Diseases for the Comprehensive Ophthalmologist"

Importance Worldwide, ophthalmology teaching is being reduced or eliminated from medical school curricula. The current state of ophthalmic teaching in Australia is unknown. Background To evaluate the perceptions of Junior Medical Officers (JMOs) and medical students on ophthalmology teaching in Australian medical schools. Design Survey‐based cros...

Aim: To describe 4 cases of conjunctival squamous cell carcinoma (SCC) with corneal stromal invasion. Methods: Retrospective, clinicopathologic case series. Results: All patients had prior resections of presumed pterygia. The degree of corneal involvement dictated the extent of surgical management. One eye with localized invasion was treated w...

Podium presentation - Session: "Translational Research"

Podium presentation - Session: "Paediatric Symposium"

The cornea is a clear structure, void of blood, and lymphatic vessels, functioning as our window to the world. Limbal epithelial stem cells, occupying the area between avascular cornea and vascularized conjunctiva, have been implicated in tissue border maintenance, preventing conjunctivalisation and propagation of blood and lymphatic vessels into t...

Myopia is a global public health issue with a worldwide prevalence of ∼30% and is estimated to rise to 50% by 2050. In addition to the burden associated with routine management of the condition, high myopia predisposes the eye to sight-threatening complications such as myopic maculopathy and glaucoma in adult life. Controlling onset and progression...

Background: Epidermolysis bullosa (EB) and autoimmune blistering diseases (AIBD) describe a group of rare chronic dermatoses characterized by cutaneous fragility and blistering. Although uncommon, significant ocular surface disease (OSD) may occur in both and require ophthalmological assessment. Disease scoring systems have a critical role in provi...

Purpose: To prospectively study the range, frequency, and severity of ocular manifestations in an Australasian cohort of patients with epidermolysis bullosa (EB), a disease that presents with severe muco‐cutaneous lesions in early age. Previous reports of ocular involvement in EB have been limited to case reports or retrospective studies. Method:...

Purpose To prospectively study the range, frequency, and severity of ocular manifestations in an Australasian cohort of patients with pemphigus, pemphigoid and epidermolysis bullosa acquisita. Method A total of 28 patients; pemphigus vulgaris (n = 9), pemphigus foliaceus (n = 1), bullous pemphigoid (n = 13), mucous membrane pemphigoid (n = 2), pem...

Purpose: To evaluate the impact of Optive (Allergan, Irvine, CA) and Optive Advanced (Allergan, Irvine, CA) on tear film stability and quality during a one-hour observation period when compared to saline (Pfizer, Perth, WA). Methods: This was a double-masked, cross-over study. Twenty participants attended three visits, randomly receiving either Opt...

Purpose: To explore the effectiveness of "off-the-shelf" dipotassium-ethylenediaminetetraacetic acid (K2-EDTA) as an alternative to sodium EDTA as chelation therapy in removal of calcific band keratopathy (CBK). Methods: This study was a retrospective case series involving 4 patients with CBK who underwent superficial keratectomy and subsequent...

To determine if there is a core ocular surface microbiome and whether there are microbial community changes over time, the conjunctiva of 45 healthy subjects were sampled at three time points over three months and processed using culture-dependent and -independent methods. Contaminant taxa were removed using a linear regression model using taxa abu...

Defending vision, our highest bandwidth sense, challenges human ingenuity. Replacing or repairing highly specialized but scarce tissue within constraints of transparency, tissue shape and alignment, tissue borders and pressure maintenance, presents special challenges. Many, mostly destructive surgical procedures, were developed prior to an understa...

Purpose: Pterygium is a prevalent ocular surface disorder. Conjunctival autografting (CAG) after pterygium resection is the gold standard treatment. Thinner CAGs without Tenon tissue provide better results but are technically difficult to achieve. We report on the first femtosecond laser (FSL)-assisted pterygium surgery (FLAPS) in humans. Methods...

Background: Conjunctival ultraviolet autofluorescence (CUVAF) area detected from UVAF photographs is a recently developed potential marker for past sun exposure but its relationship with sun-related factors have not been fully investigated. Methods: The study included 339 ethnically diverse and healthy children aged 5-15 years in Melbourne, Aust...

Treating ocular surface squamous neoplasia (OSSN) typically involves surgery, adjuvant cryotherapy, and/or topical chemotherapy. Recurrence is common and the potential sight-damaging effects from repeated surgery and 5-fluorouracil or mitomycin C application warrant concern.¹ Human papilloma virus (HPV) has been implicated as an etiological agent i...

Background: Retinal hemorrhages (RH) in babies in the absence of severe trauma or a medical cause have been strongly associated with abusive head trauma (AHT). We examined the pattern of RH in accidental head injury and AHT objectively using widefield retinal imaging. Methods: A total of 118 infants and children 1-36 months of age admitted with...

Purpose: Pterygium is a common ocular surface disorder. Conjunctival autografting (CAG) following pterygium resection is the gold standard treatment. CAGs without Tenon's tissue provide better results but are more technically difficult to achieve. In this study, we evaluated the feasibility and reproducibility of femtosecond laser (FSL)-assisted C...

Purpose: To report on a case of autoconjunctival graft compromise after pterygium surgery in a patient on long-term anti-vascular endothelial growth factor (anti-VEGF) therapy, due to the deleterious effects of anti-VEGF agents on ocular wound healing. Methods: A white female in her early eighties presented with large right nasal pterygium, firs...

Purpose: To report a novel intervention for the treatment of conjunctival lymphangiectasia-subconjunctival injection of bevacizumab. Methods: A 53-year-old white male presented with a 3-month history of right ocular discomfort and redness unresponsive to conventional topical treatment of lubricants and steroids. A clinical diagnosis of conjuncti...

Purpose : To describe five cases of conjunctival squamous cell carcinoma (SCC) with corneal invasion. Methods : Five cases of corneal invasion of conjunctival squamous cell carcinoma were identified in the L.F. Montgomery laboratory database. Patients were identified and their demographic data, clinical appearance, history, pathologic findings and...

Abstract Purpose : Despite the success of topical medical treatments, particularly with Interferon alpha-2b in treatment of OSSN, there is a failure rate of ~2%. A previous study2 showed OSSN responds to cidofovir (CDV), although our data showed no herpes viruses present in OSSN1. We have previously demonstrated that 6.5% of OSSN specimens are HPV-...

Background: The combination of topical interferon α-2b (IFN α-2b) and all-trans retinoic acid (ATRA) 0.01% has previously been shown to be effective in conjunctival and corneal intraepithelial neoplasia. This combination was incidentally found to be effective in a patient with partial limbal stem cell deficiency (LSCD), a condition which can be ch...