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Background/Aim. Corneal cross-linking (CXL) treatment shows the best results in stabilizing the cornea and stopping the progress of the ectatic process. The aim of the study was to assess the impact of CXL on the keratoconus regarding higher-order aberrations (HOAs) and potential improvement of visual function. Methods. In 19 patients, a standard epithelium-off CXL was performed with an energy density of three mW/cm2 for half an hour. The cornea was examined by Pentacam topography before CXL and one and six months after CXL. Best-corrected visual acuity (BCVA), topographic data, and aberrations were collected. Results. A significant reduction in vertical coma was observed from preoperative -1.03 ± 1.89 to -0.74 ± 1.73 (p = 0.004) six months after CXL, and in spherical aberration from preoperative -0.22 ± 1.05 to -0.08 ± 1.13 (p = 0.002) six months after CXL. Root mean square (RMS) HOAs six months after CXL also significantly reduced from 2.31 ± 1.82 to 2.26 ± 1.84 six months after CXL (p = 0.001). BCVA improved from preoperative 0.43 ± 0.15 to 0.71 ± 0.19 six months after surgery (p < 0.001). Conclusion. CXL is a very potent treatment method for keratoconus, which significantly reduces certain corneal wavefront aberrations, especially vertical coma, spherical aberration, and RMS, and leads to a significant improvement in visual acuity.

Background: Techniques for the preparation of grafts for Descemet membrane endothelial keratoplasty (DMEK) can be classified into those that involve the manual dissection of the Descemet membrane (DM) and those that use an injection of a liquid or a gas to achieve a separation of the DM from the posterior corneal stroma. The purpose of this study was to evaluate the efficiency of the liquid bubble technique. Methods: The success rate of the technique was calculated retrospectively using the operating reports. Video files for each graft preparation were retrieved and the time, number of injections, and number of injections sites required for the hydrodissection were measured. The number of cases in which a manual dissection of the Descemet membrane was necessary was recorded. Information on donor age and graft preservation time were retrieved from the eye bank file. Results: In 58 cases, the success rate was 98.3%. In the 28 procedures where a video was available, the median time for hydrodissection was 4.4 min. The median number of injection sites was 2, with a median number of injections of 3.5. Manual dissection as a rescue technique was performed in 25% of cases, with one case resulting in graft tears. The mean graft diameter was 7.6 mm. The mean donor age was 66 years, and the mean graft storage time was 22 days. Conclusions: The liquid bubble technique can be a fast and valuable choice for DMEK graft preparation, especially in centers where the tissue is prepared in the operating theater. [ABSTRACT FROM AUTHOR]

(1) Background: Mid-stromal isolated Bowman layer transplantation aims to reduce and stabilize corneal ectasia in patients with advanced, progressive keratoconus. The purpose of this review is to evaluate the effectiveness and safety of this new surgical technique. (2) Methods: Following the PRISMA statement and checklist, we searched Medline, the Cochrane Controlled Trials Register, and Embase and used a broad systematic search strategy according to the Cochrane Collaboration. (3) Results: Eight studies with a total number of 120 eyes of 106 patients met our inclusion criteria. One month after Bowman layer transplantation, patients with keratoconus showed a significant decrease in the measured simulated keratometry (−4.74 D [95% CI −6.79 to −2.69]) and the maximum keratometry (−7.41 D [95% CI −9.64 to −5.19]), which remained significant one year postoperatively (−2.91 D [95% CI −5.29 to −0.53] and −5.80 D [−8.49 to −3.12]). Intra- and postoperative complications were observed in 3% and 9% of the patients, respectively. An estimated success rate of 75% to 85% was achieved by experienced surgeons at 5 to 8 years postoperatively. (4) Conclusions: Bowman layer transplantation may be an effective and safe treatment option in patients with advanced, progressive keratoconus. Additional multicenter prospective interventional studies are needed to confirm these preliminary findings. [ABSTRACT FROM AUTHOR]

Purpose. To evaluate the outcomes and safety of a minimally invasive technique for sutured IOL scleral fixation in case of compromised capsular and iris support. Materials and Methods. In this retrospective study, we explain our mini-invasive technique and assess the outcomes in terms of visual acuity, pre- or postoperative complications, and IOL position (Sensar AR40e, AMO) in a case series of three patients. Results. The expected best corrected visual acuity could be achieved after one month. Surgeries were uneventful with a stable eye. No postoperative complications occurred except for one patient who had a conjunctival disinsertion. Neither postoperative hypotony nor raised IOP was found. Additionally, no patient experienced corneal edema at one week control, IOL dislocation, vitreous hemorrhage, or new pupil's irregularity. Conclusions. In conclusion, each scleral technique has its own advantages and its inherent postoperative complications. To date, there is no evidence of superiority of any single technique. By improving our scleral sutured lens techniques, we could improve peroperative ocular stability, potentially decrease postoperative complication rate, and offer a rapid recovery with a stable visual acuity within a month. [ABSTRACT FROM AUTHOR]

Background and Objectives: Evaporative dry eye disease is frequently associated with meibomian gland dysfunction. Patients are often unhappy because of daily drops, care burden, and suboptimal conventional treatments. In this study, we assessed the efficacy of a novel device, the Eye-light®, a combination of intense pulsed light therapy and low-level light therapy, as a novel treatment for meibomian gland dysfunction and dry eye disease. Materials and Methods: This was a retrospective, single-center study carried out over a 6-week period, in which 22 eyes from 11 patients were included. Each patient received four combined light therapy treatment sessions, once weekly over 4 weeks. Patients underwent a clinical examination and filled out a standardized questionnaire to evaluate symptoms one week prior to treatment, and one week after the fourth session. Results: Combined light therapy improved several ocular surface outcome measures in our patients. This study demonstrates that this adjunctive treatment significantly improves the ocular surface and quality of life of patients with dry eye disease and meibomian gland dysfunction. Conclusions: Combined light therapy may be included in meibomian gland dysfunction treatment protocols as an adjunctive rescue treatment. [ABSTRACT FROM AUTHOR]

A study to compare femto-presbyLASIK to standard myopia femto-LASIK refractive surgical correction with a total of 45 candidates was performed. The goal was to identify a more specific set of indications for presbyopia LASIK treatments. The results showed thoroughly good uncorrected visual acuity for myopia (decimal: 1.01 ± 0.15) as well as for presbyLASIK (decimal: 0.78 ± 0.17) corrections. Astigmatism was comparable in both groups and did not change significantly from preoperative (0.98D ± 0.53 SD) to postoperative (1.01D ± 0.50 SD). Our study results suggest, that presbyLASIK treatment is as safe and effective as regular LASIK myopia correction and can hence be recommended to treat presbyopia. [ABSTRACT FROM AUTHOR]

Macular edema (ME) is the most common sight-threatening complication in uveitis. The diagnostic and therapeutic management of the uveitic macular edema (UME) might be challenging due to the complex diagnostic workup and the difficulties physicians face to find the underlying cause, and due to its usually recurrent nature and the fact that it can be refractory to conventional treatment. Some of the mild cases can be treated with topical steroids, which can be combined with non-steroid anti-inflammatory drugs. However, immunomodulators such as methotrexate, tacrolimus, azathioprine, cyclosporine and mycophenolate mofetil together with anti-tumor necrosis factor-α (anti-TNF alpha) monoclonal antibodies such as adalimumab and infliximab, may be required to control the inflammation and the associated ME in refractory cases, or when an underlying disease is present. This review of the literature will focus mostly on the non-infectious UME. [ABSTRACT FROM AUTHOR]

Purpose: Capsular bag distension syndrome or capsular block syndrome is a rare complication of cataract surgery characterized by accumulation of fluid between the intraocular lens and the posterior lens capsule, leading to visual deterioration. A small continuous curvilinear capsulorhexis, residual cortical lens material, as well as residual viscoelastic material behind the intraocular lens are associated with increased risk of fluid entrapment. Capsular bag syndrome usually occurs in the early postoperative period, but it has also been described as late as 14 years after cataract surgery. Nd‐YAG laser posterior capsulotomy is the treatment of choice in most cases, facilitating the drainage of the fluid in the vitreous cavity. Late‐onset capsular block syndrome is often associated with Propionibacterium acnes, requiring surgical management. Methods: Hereby we report a case of a 72‐year‐old female patient with Fuchs corneal endothelial dystrophy, who developed a capsular block syndrome after an uneventful endothelial keratoplasty (DMEK). Results: In the early postoperative period after the DMEK, we observed the development of capsular block syndrome OS. The patient was subjected to bilateral cataract surgery 6 years ago. After intensive follow‐up examination for excluding Propionibacterium acnes‐related endophthalmitis, we proceeded with Nd‐YAG capsulotomy, which resulted in drainage of the fluid in the vitreous cavity and immediate visual recovery. Conclusions: To our knowledge this is the first report of capsular bag syndrome after DMEK and therefore anterior segment surgeons should be aware of this rare complication. [ABSTRACT FROM AUTHOR]

Degenerative ocular conditions, such as age-related macular degeneration, diabetic retinopathy, retinal vein occlusions, and myopic degeneration, have become a major public health problem and a leading cause of blindness in developed countries. Anti-vascular endothelial growth factor (VEGF) drugs seem to be an effective and safe treatment for these conditions. Ranibizumab, a humanized monoclonal antibody antigen-binding fragment, which inhibits all biologically active isoforms of VEGF-A, is still the gold standard treatment for the majority of these pathological entities. In this review, we present the results of the most important clinical trials concerning the efficacy and safety of ranibizumab for the treatment of degenerative ocular conditions. [ABSTRACT FROM AUTHOR]

Background: The aim of the study is to investigate whether the circadian IOP rhythm can be influenced by combined cataract surgery with high frequency deep sclerotomy (HFDS) and whether intraocular pressure (IOP) can be significantly reduced by HFDS. Methods: In our study 10 patients were included, in whom 24 h IOP monitoring was installed before and after HFDS/cataract surgery using a Triggerfish. HFDS is a minimally invasive glaucoma surgery (MIGS). Results: After performed HFDS combined with cataract surgery, the IOP was reduced from 27.7 ± 2.11 mmHg to 14.4 ± 2.59 mmHg, which is highly significant (p < 0.001). The contact lens sensor (CLS) cosinor analysis pre- and postoperatively showed that the circadian rhythm is not influenced by the surgery, i.e., the circadian IOP rhythm did not show significant differences before and after surgery. Conclusions: HFDS combined with cataract surgery is a potent surgical method that can significantly reduce the IOP. However, the circadian rhythm cannot be changed by the surgery. The acrophase remained during the night in all patients. [ABSTRACT FROM AUTHOR]

Background: Presbyopia treatment in pseudophakic patients with a monofocal IOL is challenging. This study investigates the refractive results of femto-PresbyLASIK and analyzes presbyopia treatment in pseudophakic eyes. Methods: 14 patients with 28 pseudophakic eyes were treated with femto-PresbyLASIK. The dominant eye was targeted at a distance and the non-dominant eye at −0.5 D. The presbyopic algorithm creates a steepness in the cornea center by using an excimer laser that leads to corneal multifocality. Results: 6 months after surgery a refraction of −0.11 ± 0.13 D (p = 0.001), an uncorrected distance visual acuity of 0.05 ± 1.0 logMAR (p < 0.001) and an uncorrected near visual acuity of 0.15 ± 0.89 logMAR (p = 0.001) were achieved in the dominant eye. For the non-dominant eye, the refraction was −0.28 ± 0.22 D (p = 0.002), the uncorrected distance of visual acuity was 0.1 ± 1.49 logMAR, and the uncorrected near visual acuity was 0.11 ± 0.80 logMAR (p < 0.001). Spherical aberrations (Z400) were reduced by 0.21–0.3 µm in 32% of eyes, and by 0.31–0.4 µm in 26% of eyes. Conclusion: By steepening the central cornea while maintaining spherical aberrations within acceptable limits, PresbyLASIK created a corneal multifocality that safely improved near vision in both eyes. Thus, femto-PresbyLASIK can be used to treat presbyopia in pseudophakic eyes without performing intraocular surgery. [ABSTRACT FROM AUTHOR]

Introduction: Conjunctival cysts are usually asymptomatic but they can cause foreign body sensation and contribute to dry eye disease. The purpose of this case report is to describe the presentation and treatment of an infected inclusion cyst of a conjunctival nevus in a healthy 36-year-old patient., Case Presentation: A healthy 36-year-old man presented to the emergency department for redness and pain in his left eye for 1 day. Slit-lamp examination revealed a conjunctival hyperemia and a conjunctival nevus with 4 inclusion cysts, one of which was filled with purulent material. Fluorescein staining of the conjunctival epithelium was negative. Α mini-incision of the white cyst was performed using a 30 G needle, followed by bimanual drainage and topical treatment with tobramycin and moxifloxacin drops every 3 h for a week. A swab of the purulent drainage was positive for gram-positive flora. One week after the drainage of the cyst, the patient was asymptomatic and on slit-lamp examination, the 4 inclusion cysts were filled with a transparent liquid, there was not any vessel dilation and fluorescein staining was negative., Conclusion: Conjunctival inclusion cysts, although considered benign, can become infected and form a conjunctival abscess. A mini-incision on the slit lamp combined with bimanual drainage and followed by topical antibiotic drops seems to be a safe and effective treatment., Competing Interests: The authors have no conflicts of interest to declare., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Macular edema (ME) is the leading cause of visual loss in uveitis and may persist long after ocular inflammation has been resolved. Local steroids are the first line treatment for uveitis and uveitic ME. Dexamethasone intravitreal implant (OZURDEX ® ; Allergan, Inc., CA, USA) has been used to treat diabetic ME and ME secondary to retinal vein occlusion. Recent studies have also demonstrated that Ozurdex may be effective treatment for patients with persistent uveitic ME. In this review, we present the results of the real word studies concerning the efficacy and safety of Ozurdex for the treatment of uveitic ME.

Today there are different options for correcting presbyopia by corneal laser procedure, but all of them have their benefits and compromises. The Monovision is a pseudoaccommodation procedure which works with an anisometropy of up to 2 D. The smaller the anisometropy is the faster a neuroadaptation will be achieved. There could be a decrease of binocularity. The monovision is not well supported by all patients, thus it is important to simulate this correction by contact lenses before surgery. The PresbyLASIK is a corneal multifocal solution for presbyopia correction for emmetropic, myopic and hyperopic eyes. It is a true presbyopia procedure where both eyes will be treated for far, intermediate and near. The disadvantage and compromise is that in some cases there could be a loss of uncorrected visual acuity. The corneal inlay is a solution for emmetropic, presbyopic patients who have a strong intention to read without glasses. The disadvantages could be some side effects as halo, glare, decrease of contrast and far vision. All procedures are potentially reversible in case the patient does not support the correction. An enhancement is possible for Monovision and PresbyLASIK., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (Georg Thieme Verlag KG Stuttgart · New York.)