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Purpose: To compare the long-term safety, efficacy, and complications of small-incision lenticule extraction (SMILE) and flexible iris-fixated anterior chamber phakic intraocular lens (pIOL) implantation for the treatment of high myopia. Setting: University of Health Science Turkey, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey. Design: Retrospective comparative case series. Methods: Data of patients who underwent SMILE or pIOL (Artiflex) implantation for myopia were retrospectively reviewed. Only patients with preoperative manifest refraction spherical equivalent from -6.00 to -10.00 diopters (D) were included in the study. Results: There were 47 eyes of 32 patients in the SMILE group and 52 eyes of 29 patients in the pIOL group. The mean postoperative follow-up was 63.75 +/- 18.40 months in the SMILE group and 65.38 +/- 16.22 months in the p-IOL group (P =.71). At 6 years postoperatively, refractive predictability was slightly better in the pIOL group, and the percentages of eyes within +/-0.50 D of the attempted correction were 77% and 83% in the SMILE and pIOL groups, respectively. Although mean uncorrected distance visual acuity was comparable (SMILE, 0.12 +/- 0.06 logarithm of the minimum angle of resolution [logMAR]; p-IOL, 0.09 +/- 0.05 logMAR), the safety indices (1.08 +/- 0.22 vs 1.11 +/- 0.20; P =.02) and the efficacy indices (0.92 +/- 0.24 vs 1.11 +/- 0.22; P =.03) were statistically significantly higher after pIOL implantation. Despite a mean of 11.09% of the endothelial cell being lost at 6 years after pIOL implantation, no pIOL was explanted due to endothelial cell loss. Conclusions: In this comparative and long-term study, iris-fixated anterior chamber pIOL implantation for high myopic correction showed slightly better safety and efficacy profiles but with statistically significant endothelial cell loss. [ABSTRACT FROM AUTHOR]

Bullous keratopathy is a result of endothelial loss and the failure of the remaining corneal epithelium to pump leaking water molecules away from the corneal tissue, causing overhydration. In eyes with good visual potential, keratoplasty is the primary treatment. There are also several other approaches to provide temporary improvement until a permanent solution with keratoplasty can be achieved. These alternatives include hypertonic topical sodium chloride (5%) drops, bandage contact lenses, anterior stromal puncture, phototherapeutic keratectomy, amniotic membrane transplantation, conjunctival flaps, and collagen crosslinking. This case report is a description of a different surgical technique using manual lamellar corneal dissection and intrastromal silicone oil insertion to provide symptomatic treatment of bullous keratopathy in an eye with no light perception and significant corneal scarring. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluated anterior segment surgeries performed during the coronavirus 2019 (COVID-19) pandemic. Prevention of virus transmission is a critical consideration for surgeons, and includes assessment of etiology, the referral region, demographic characteristics, and the surgery to be performed., Methods: The data of 144 patients who underwent anterior segment surgery between March 19, 2020 and June 1, 2020 were retrospectively reviewed. The patient demographic data and details of ophthalmological examination findings, the region patients were referred from, and the type of surgery performed were recorded and analyzed., Results: A total of 144 patients, 49 women (34%) and 95 men (66%), were included in this study. The mean age of the patients was 31.30±25.88 years (range: 1-86 years). The presenting complaint was in the right eye in 43.7% of the cases, in the left eye in 52.8%, and in both eyes in 3.5% of the cases. While 94.4% of the applications were from Istanbul, the remaining 5.6% were from outside the province. Though 43.7% of the cases were patients seen previously at the study hospital in Istanbul, 56.3% presented for the first time. This hospital was the first referral center in only 39.6% of the cases. Evaluation of etiology indicated that corneal perforation (18.1%) was the most common, followed by keratitis (13.2%). The most common surgical intervention applied was amnion membrane transplantation (19.4%), followed by perforation repair (16.7%)., Conclusion: Ophthalmological surgeries continue to be performed during the ongoing COVID-19 pandemic, however, special algorithms must be used to reduce the risk of COVID-19 transmission and to ensure continuity of healthcare for ophthalmology patients., (Copyright © 2021 by Beyoglu Eye Training and Research Hospital.)