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PURPOSE The purpose of this study was to evaluate the efficacy and predictability of cataract extraction with toric intraocular lens (IOL) implantation following deep anterior lamellar keratoplasty (DALK) or mushroom penetrating keratoplasty (PK). SETTING "Villa Igea" Hospital, Forli, Italy. DESIGN Prospective case series. METHODS Toric IOL implantation was offered to patients with cataract, corneal astigmatism > 1.5D and regular central corneal topography after complete suture removal. Phacoemulsification was performed through a 2.4-mm scleral tunnel and an enVista monofocal toric MX60T (Bausch & Lomb, Rochester, NY) or Eyecryl monofocal toric IOL (Biotech Vision Care, Ahmedabad, India) was inserted in the capsular bag. Main outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, total prediction error and IOL misalignment. RESULTS 37 consecutive patients that had previously undergone either DALK (n= 27, 73%) or two-piece mushroom PK (n = 10, 27%) were included. All patients completed the 6-months follow-up. The mean toric IOL power was 5.3±1.1 D. Both UDVA and CDVA significantly improved (respectively, from 1.02±0.27 to 0.46±0.31 logMAR, from 0.65±0.27 to 0.11±0.12 logMAR; p

We report our experience during COVID-19 outbreak for intravitreal injections in patients with maculopathy. We proposed a treatment priority levels and timings; the “High” priority level includes all monocular patients; the “Moderate” is assigned to all patients with an active macular neovascularization; the patients affected by diabetic macular edema or retinal vein occlusion belong to the “Low” class. This organization allowed us to treat the most urgent patients although the injections performed had a 91.7% drop compared to the same period of 2019.

Keratoconus (KC) is the most common corneal ectasia characterized by progressive corneal thinning, protrusion, and irregular astigmatism. The Amsler–Krumeich classification based on the analysis of corneal topography, corneal thickness, refraction and biomicroscopy is the most commonly used, recently, a new classification based on anterior segment Optical Coherence Tomography was introduced by Sandali and colleagues. Since there is no information about the possible agreement between these two classifications, the aim of this study is to compare the stratification of consecutive KC patients using the Amsler–Krumeich and Sandali classifications, and to further ascertain KC cases in which one classification is preferred over the other. Overall, 252 eyes of 137 patients (41.45 ± 16.93 years) were analyzed: in 156 eyes (61.9%), the Amsler and Sandali staging differed in one stage while in 75 cases (29.8%) it differed in two or more stages. In 222 eyes (88.1%), the Sandali staging was higher compared to the Amsler one. These results show that the two classifications are not fully interchangeable: the Amsler–Krumeich classification is more appropriate in identifying and longitudinally monitoring patients with early stages of KC, while the Sandali classification for the diagnosis and follow-up of patients with more advanced stages, particularly when a surgical planning has to be chosen.