Sathish Srinivasan

• MBBS, FRCS(Ed), FRCOphth, FACS
• Managing Director at NHS Ayrshire and Arran

To report clinicopathological features and management of a case of extensive fibrovascular proliferation into the anterior segment after acute angle-closure glaucoma (AACG). Interventional case report with pathological correlation. A 61-year-old white woman was referred with persistent corneal opacity in the right eye 3 months after AACG. Slit-lamp...

Purpose: To determine the incidence of endophthalmitis after penetrating keratoplasty (PK) and patient and donor risk factors. Design: Retrospective cohort study using national transplant registry data. Participants: All corneal transplant recipients (n = 11 320) registered on the United Kingdom Transplant Registry undergoing their first PK be...

Objective: To determine the prevalence of corneal astigmatism, changes in astigmatism, and biometry measurements with age and to correlate fellow eye measurements of patients undergoing cataract surgery. Design: Prospective, observational study. Participants: 3498 eyes of 1814 patients undergoing cataract surgery. Methods: Setting was a sing...

A 72-year-old man was referred for cataract surgery in the right eye. On slit-lamp biomicroscopy he was noted to have a vertical split in the Descemet's membrane in the left cornea. Based on the appearance, orientation of the split and medical history of forceps delivery, a forceps injury to the left cornea was diagnosed. The break in Descemet's me...

Congenital iris defects may usually present either as subtotal aniridia or colobomatous iris defects. Acquired iris defects are secondary to penetrating iris injury, iatrogenic after surgical excision of iris tumours, collateral trauma after anterior segment surgery, or can be postinflammatory in nature. These iris defects can cause severe visual d...

To report the ocular features, underlying systemic conditions, and management of diet-induced vitamin A deficiency in Scottish adults. Retrospective case series. Three middle-aged white adults presented with ocular signs of xerophthalmia and keratomalacia that led to the diagnosis of previously undiagnosed vitamin A deficiency. Case 1 presented wit...

To characterize corneal, internal, and total ocular monochromatic higher-order aberration (MHOA) changes that occur in the aging eye. Prospective observational case series including 300 eyes of 167 patients (mean age = 63.8 years) attending the ophthalmology service at University Hospital Ayr, Scotland. Corneal, internal, and total ocular aberratio...

Sebaceous gland carcinoma (SGC) arises from the sebaceous glands of the ocular adnexa. It can present as a yellow nodule that may be ulcerated. It can also appear as a plaque-like lesion or as recurrent eyelid inflammation similar to a chalazion. Its ability to spread within the epidermis simulates chronic blepharoconjunctivitis.(1) We present an u...

A 78-year-old man had uneventful cataract surgery with implantation of a 1-piece plate-haptic intraocular lens in the capsular bag. Seven weeks later, he presented as an emergency with intense fibrinous uveitis and increased intraocular pressure (IOP). Examination revealed an inflammatory capsular block syndrome (CBS) causing fibrinous anterior uve...

PurposeTo report visual and refractive outcomes, and endothelial cell loss following primary and secondary 'piggyback' toric intraocular lens (IOL) implantation in patients with high post-penetrating keratoplasty (PK) astigmatism.Methods Prospective case series. Nine eyes of nine patients with post-PK astigmatism were consecutively recruited for im...

The presence of pre-existing corneal opacities during cataract surgery can cause scattering of light from the operating microscope, limiting the surgeon's view of the anterior chamber (AC). In this context, combined corneal transplantation and cataract surgery may be preferential. However, patients with mild to moderate nebulae may prefer to underg...

Background/aims: To characterise histopathological changes in corneal buttons associated with deep anterior lamellar keratoplasty (DALK). Methods: This was a retrospective, clinical laboratory study. All recipient corneal buttons that underwent DALK in the West of Scotland and were submitted to the regional Ocular Pathology Laboratory (Glasgow,...

To assess the prognostic factors influencing visual prognosis and length of treatment after acanthamoeba keratitis (AK). Forty-two AK eyes of 41 patients treated between 1999 and 2006 were included. A diagnosis of AK was made on the basis of culture results with a corresponding clinical presentation. We calculated the prognostic effect of the vario...

Anterior lamellar keratoplasty (ALK) is indicated in patients with anterior corneal opacities. Benefits over penetrating keratoplasty include quicker visual rehabilitation, less postoperative astigmatism, and preservation of the host endothelium, thus minimizing the chances of graft rejection. A rare complication of lamellar corneal surgery is infe...

Conjunctival lymphangiectasia is an uncommon clinical condition in which there is dilatation of lymphatic channels in the bulbar conjunctiva. Conjunctival lymphangiectasia is a rarely appreciated ocular surface disorder that typically occurs as a secondary phenomenon in response to local lymphatic scarring or distal obstruction. Conjunctival lympha...

To describe a case of peripheral ulcerative keratitis (PUK) that developed in the immediate postoperative period after uncomplicated cataract surgery in a patient with ocular cicatricial pemphigoid. Single interventional case report. An elderly white woman with stable ocular cicatricial pemphigoid underwent an uncomplicated clear corneal phacoemuls...

To evaluate the safety and efficacy of using fibrin glue in cases of recurrent pterygium treated with pterygium excision and conjunctival autograft combined with mitomycin C. Retrospective, interventional case series. The charts of 28 patients with recurrent pterygium who had undergone pterygium excision and conjunctival autograft using fibrin glue...

To review the indications and types of keratoplasty performed in the West of Scotland between 2001 and 2010. A retrospective analysis of the histopathological diagnoses of all corneal buttons submitted to the regional Ocular Pathology Laboratory (Glasgow, UK) between January 2001 and December 2010 was performed. Between 2001 and 2010, a total of 92...

A 7-year-old Caucasian girl presented with a pigmented lesion on the left bulbar conjunctiva that increased in size from 1 mm to 4 mm over a 12-month period. She underwent excision biopsy and reconstruction of the ocular surface with amniotic membrane graft. Histopathology showed the naevus was composed of somewhat swollen naevus cells with clear c...

A 56-year-old Caucasian male was referred to the corneal service for the management of post penetrating keratoplasty (PK) astigmatism in his right eye. He had also previously undergone trabeculectomy and cataract surgery in the same eye. Corneal topography showed high postoperative astigmatism of 8.74 dioptres. He was intolerant to contact lens wea...

Fuchs heterochromic uveitis (FHU) in its classic presentation is a unilateral, chronic, low grade, often asymptomatic anterior uveitis. It is characterized by a classic triad of iris heterochromia, cataract and keratic precipitates. Neovascularization of the iris and the anterior chamber (AC) angle (radial and circumferential) occurs in 6-22% of ca...

We describe a novel technique on the use of fibrin glue to seal a longstanding partial thickness corneal laceration. A 67-year-old lady was referred to the corneal service with an asymptomatic, partial thickness corneal laceration in the right eye (RE) that had failed to heal spontaneously over a 12-month period. She had no recollection of any his...

The femtosecond laser is gaining popularity as a safe and effective alternative to the microkeratome for creating corneal flaps during LASIK. Rarely, gas bubble formation in the anterior chamber during laser flap creation can interfere with the eye tracking and iris registration software during the subsequent excimer laser ablation. Surgical steps...

A 67-year-old man with a history of multiple myeloma (treated with chemotherapy) was referred with a left hyperaemic conjunctival lesion covering almost 360° of the limbus and extending onto the corneal surface. Conjunctival biopsy revealed conjunctival intraepithelial neoplasia. Initial treatment consisted of topical and intralesional injections o...

The purpose of this study was to assess the incidence and risk factors of Acanthamoeba keratitis (AK) over an 8-year period in a Canadian tertiary care setting. We retrospectively reviewed the medical records of 41 patients (42 eyes), who were diagnosed as having AK between January 1999 and December 2006 in the cornea clinic at the Toronto Western...

To compare the degree of conjunctival autograft inflammation, subconjunctival haemorrhage (SCH) and graft stability following the use of sutures or fibrin glue (FG) during pterygium surgery. Prospective, observer masked, clinical trial. 40 eyes of 40 patients undergoing primary pterygium surgery with conjunctival autograft were allocated into two g...

To evaluate patients' perspectives on endothelial keratoplasty and to compare the outcomes of deep lamellar endothelial keratoplasty (DLEK) and Descemet stripping automated endothelial keratoplasty (DSAEK), performed in the same patients. A fellow eye, comparative retrospective case series. The records of 14 patients (28 eyes) who underwent DLEK in...

To compare the visual outcomes following deep anterior lamellar keratoplasty (DALK), penetrating keratoplasty (PK), and manual top-hat PK (TH-PK) in subjects undergoing corneal transplantation for keratoconus (KC). A retrospective comparative case series. settings: Cornea clinic at the Toronto Western Hospital. study population: Fifty patients who...

To compare the outcomes of manual top hat penetrating keratoplasty (PK) versus traditional PK. We reviewed the charts of 71 consecutive patients who underwent manual top hat (n = 36) or traditional (n = 35) PK at our institute. Main outcome measures included best-corrected Snellen visual acuity (BCVA), topographic and refractive results, high-order...

To report the initial experience of the use of implantable collamer lens (ICL) in the management of hyperopia after radial keratotomy (RK). Single-center, retrospective chart review. Four eyes of 3 patients with secondary hyperopic shift after myopic RK had a mean spherical equivalent of 5.31 D (range, 3.25-9 D) on presentation. All of them underwe...

Eye is the official journal of the Royal College of Ophthalmologists. It aims to provide the practising ophthalmologist with information on the latest clinical and laboratory-based research.

To evaluate the efficacy and safety of prophylactic mitomycin C (MMC) during photorefractive keratectomy (PRK) over LASIK flaps for the treatment of residual refractive errors following LASIK. In this single center, retrospective clinical study, 30 eyes of 33 patients (mean age 37.2 years) who had MMC (0.02%, 30 to 120 seconds) during PRK for the t...

To report anterior chamber gas bubble formation during corneal flap creation in a myopic patient who underwent LASIK using a femtosecond laser (IntraLase). A 30-year-old man underwent customized wavefront-guided LASIK for myopia. The IntraLase FS15 was used to create the corneal flap. During flap creation, gas bubble formation was noted in the ante...

The femtosecond laser produces photodisruption at the molecular level to generate plasma, displacing the surrounding tissue resulting in the formation of cavitation bubbles. We report a case of myopic LASIK in which a vertical gas break through the surface occurred during IntraLase femtosecond flap creation. A 30 year-old patient underwent bilatera...

To describe a new slit-lamp technique for draining interface fluid to manage complete donor disc detachments following Descemet's stripping (automated) endothelial keratoplasty (DSEK/DSAEK). Interventional case series. Five DSEK/DSAEK patients presented on the first postoperative day with complete detachment of the donor lenticule. Slit-lamp biomic...

To report the clinical efficacy, safety, and long-term follow-up data on the use of endocapsular iris reconstruction implants (IRIs) during cataract surgery in patients with acquired iris defects. Single centre, retrospective, noncomparative, interventional case series. Five eyes of four patients with acquired iris defects and visually significant...

To report a case of unilateral total limbal stem cell (LSC) failure and corneal opacification secondary to thimerosal- and contact lens-induced ocular surface toxicity. Interventional case report and review of the literature on thimerosal-induced ocular surface changes. A 49-year-old woman with a 2-year history of long-term soft contact lens wear d...

Sjögren syndrome is a chronic autoimmune disorder of the exocrine glands with associated lymphocytic infiltration of the affected glands. The exocrinopathy can be encountered alone (primary Sjögren syndrome or in association with other autoimmune disorders, the three most common ones being rheumatoid arthritis, systemic lupus erythematosus, and pro...

To report a case of unilateral lacrimal gland atrophy in a patient with hereditary angioedema (HAE). Observational case report with literature review. A 32-year-old woman with HAE presented with dryness and irritation of the left eye (OS). Investigations revealed features of unilateral severe dry OS with atrophy of the ipsilateral lacrimal gland co...

We report a case of severe bilateral simultaneous Achromobacter xylosoxidans keratitis following penetrating keratoplasty (PKP) in a patient with graft-versus-host disease. The predisposing factors, clinical features, treatment options, and final visual outcome are reviewed. To our knowledge, this is the first report of bilateral A xylosoxidans ker...

To report spontaneous corneal perforation as a presenting sign of unilateral Terrien marginal degeneration in a young adult. A 19-year-old woman presented with sudden loss of vision in her left eye of 1-day duration. Examination revealed superior corneal thinning with superficial vascularization and secondary lipid keratopathy. There was an area of...

To show that a pledget soaked in mydriatics and placed in the lower conjunctival fornix is as effective as drops in providing mydriasis for cataract surgery. A randomized, masked, controlled trial of 56 patients assigned to either a pledget group (n=25) or a control eye drops group (n=31) was carried out. Controls had the routine practice of repeat...

To characterize the corneal topographic features in a family with nanophthalmos. Two observational case reports and a review of the literature. Corneal shape was analyzed using a topographic modeling system (TMS) and an Orbscan topographic system, with further analysis based on Fourier series and Zernicke polynomials. A control group was used for c...

To report a case of localized conjunctival necrosis following intravitreal injection of triamcinolone acetonide (TA). Single observational case report. A 63-year- old man presented with inferotemporal branch retinal vein occlusion and macular edema in his left eye (OS). He underwent pars plana vitrectomy combined with arteriovenous sheathotomy. Pos...

To report a case of localized bullous keratopathy and total corneal decompensation secondary to iridocorneal touch in iridoschisis. Single interventional case report with pathologic correlation. An 80-year-old man with bilateral iridoschisis presented with loss of vision in the left eye (OS). Examination of the OS showed shallow anterior chamber (A...

To describe bilateral corneal endothelial abnormalities associated with thalidomide toxicity. Observational case report. A 30-year-old man, born with bilateral hypoplastic upper limb defects (phocomelia) caused by thalidomide toxicity, presented with bilateral symmetrical corneal endothelial changes resembling guttata without corneal edema. Pachyme...

Several local anaesthetic techniques are available for cataract surgery. Recently, topical anaesthesia has gained in popularity. A randomized trial was designed to compare patient discomfort and intraoperative complications following routine cataract surgery under topical or sub-Tenon's anaesthesia. A randomized double-blinded placebo-controlled cl...

A man presents with defective central vision in his right eye. A 38-year-old man presented to the ophthalmology department with a four-week history of defective central vision in his right eye. Examination of the fundus of the right eye showed two discrete, yellowish-orange subretinal masses, each measuring about 2.5 mm in diameter, occupying the p...

To report two patients with lipid granulomas of the episclera complicating vitrectomy and silicone oil tamponade. Two observational case reports. Patient 1, a 41-year-old woman, underwent vitrectomy with silicone oil tamponade for proliferative diabetic retinopathy. Four weeks later, she sought treatment for inflamed episcleral nodules adjacent to...