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Anita Lyssek-Boroń,1 Adam Wylęgała,1 Dariusz Dobrowolski,1,2 Ewelina Kowalczyk,1 Katarzyna Polanowska,1 Edward Wylęgała1,2 1Department of Ophthalmology with Pediatric Unit, Trauma Center, Santa Barbara Hospital, Sosnowiec, 2Department of Ophthalmology, Ophthalmology Clinic, Medical University of Silesia, District Railway Hospital, Katowice, Poland Purpose: The most frequent qualifications for pars plana vitrectomy (PPV) in diabetic patients include recurrent hemorrhage into the vitreous body chamber and vitreoretinal proliferation, also with traction retinal detachment. The aim of this study was to evaluate the effectiveness of EX-PRESS implant for the treatment of secondary glaucoma in elderly diabetic patients following PPV 23G with silicon oil or SF6 gas endotamponade.Materials and methods: This retrospective analysis comprised 18 patients (19 eyes). We applied EX-PRESS implants in 9 patients with neovascular glaucoma (NVG) and in 10 patients with non-NVG. All patients had earlier history of diabetes and vitrectomy 23G for diabetic complications. Intraocular pressure (IOP) was measured and compared before; 7 days; 1, 3, 6, and 12 months; and a year after the surgery.Results: Application of the implant exhibited a lowering effect on IOP. After 1 month, 53% of patients had IOP values beyond 22 mmHg, while 86% after 1 year.Conclusion: The implant can be used to treat both NVG and non-NVG in diabetic patients following PPV. Keywords: PPV, glaucoma surgery, DM, IOP

PurposeTo evaluate the clinical outcomes of corneal grafting for severe dry eye complications in bone marrow transplant recipients.MethodsEleven eyes of nine patients with severe corneal complications of chronic graft-versus-host disease were treated from 2000 to 2005. The subjects underwent penetrating keratoplasty (n=9 eyes; seven for perforation and two for leucoma) or deep anterior lamellar keratoplasty (n=2 eyes) for deep postinflammatory stromal scarring without endothelial abnormalities. Patients were observed for graft survival, visual acuity, and postoperative complications.ResultsDuring the follow-up period (mean=21.6 months), nine grafts (82%) remained clear or almost entirely clear and gained more than two logarithmic units of best-corrected visual acuity. Two regrafts were necessary as the primary grafts became cloudy after 9 and 11 months. Persistent epithelial defects occurred in seven eyes (64%), cataract in six (55%), ocular hypertension in five (45%), corneal calcareous degeneration in two (18%), loss of clarity in two (18%), and sterile ulceration in one (9%).ConclusionCorneal grafting was effective for restoring corneal clarity and improving visual function in this series of patients. Although the complication ratio was high and some patients required regrafting, there was a clinical improvement in the majority of patients.Eye (2007) 21, 1493–1500; doi:10.1038/sj.eye.6702589; published online 20 October 2006 [ABSTRACT FROM AUTHOR]

José Manuel Benitez del Castillo,1 Thomas Kaercher,2 Khaled Mansour,3 Edward Wylegala,4 Harminder Dua5 1Universidad Complutense, Madrid, Spain; 2Augenarztpraxis, Heidelberg, Germany; 3Department of Ophthalmology, Tjongerschans Hospital, Heerenveen, the Netherlands; 4Department of Ophthalmology, Medical University of Silesia, District Railway Hospital, Katowice, Poland; 5Division of Ophthalmology and Visual Sciences, Eye ENT Centre, Queens Medical Centre, Nottingham, UKAbstract: Meibomian gland dysfunction (MGD) is widespread and has significant impact on patients’ quality of life. Eyelid hygiene is the mainstay of treatment but is unstandardized and requires commitment from the patient and encouragement from the ophthalmologist. Blephasteam® is an eyelid warming device designed to be an easy-to-use and standardized treatment for MGD. In the present study, 73 patients were treated for 21 days with twice daily Blephasteam® sessions. The primary efficacy variable, a symptomatology visual analog scale score, declined from 63.07±21.23 (mean ± standard deviation) on day 0 to 41.90±25.49 on day 21. There were also improvements in a number of secondary efficacy variables including subjective ocular symptoms and clinical signs and symptoms of MGD and dry eye, though tear film breakup time and tear osmolarity were not improved. Global efficacy was assessed as satisfactory or very satisfactory in 83.8% of cases. Patient-reported subjective ocular symptoms declined during the study, and a majority of patients rated the efficacy of Blephasteam® as satisfactory or very satisfactory. Most patients found the device comfortable and were able to continue with normal activities (reading, watching TV, using a computer) during the Blephasteam® session. No safety or tolerability issues were identified.Keywords: dry eye, Blephasteam®

Abstract Background The available scientific literature contains descriptions of manual, semi-automated and automated methods for analysing angiographic images. The presented algorithms segment vessels calculating their tortuosity or number in a given area. We describe a statistical analysis of the inclination of the vessels in the fundus as related to their distance from the center of the optic disc. Methods The paper presents an automated method for analysing vessels which are found in angiographic images of the eye using a Matlab implemented algorithm. It performs filtration and convolution operations with suggested masks. The result is an image containing information on the location of vessels and their inclination angle in relation to the center of the optic disc. This is a new approach to the analysis of vessels whose usefulness has been confirmed in the diagnosis of hypertension. Results The proposed algorithm analyzed and processed the images of the eye fundus using a classifier in the form of decision trees. It enabled the proper classification of healthy patients and those with hypertension. The result is a very good separation of healthy subjects from the hypertensive ones: sensitivity - 83%, specificity - 100%, accuracy - 96%. This confirms a practical usefulness of the proposed method. Conclusions This paper presents an algorithm for the automatic analysis of morphological parameters of the fundus vessels. Such an analysis is performed during fluorescein angiography of the eye. The presented algorithm automatically calculates the global statistical features connected with both tortuosity of vessels and their total area or their number.

Background/Objectives: The purpose of this study is to evaluate clinical outcomes and early postoperative complications in patients undergoing Boston type I keratoprosthesis (BKPro) implantation, with a specific focus on the onset and nature of ocular surface disorders during the early postoperative period. Methods: This retrospective study included 77 eyes that underwent BKPro implantation between 2019 and March 2022. Patients were treated at the Saint Barbara Hospital, Trauma Centre, Sosnowiec, Poland, and District Railway Hospital, Katowice, Poland. Data were collected from medical records, including patient demographics, medical history, surgical outcomes, postoperative visual acuity, and complications. The analysis incorporated both detailed medical history and direct clinical examination results. Results: The most common early postoperative complication was glaucoma, affecting 32 eyes (42%). Retroprosthetic membrane formation occurred in 20 eyes (26%), while partial extrusion of the BKPro was observed in 10 eyes (13%). Severe corneal surface damage was noted in patients with underlying autoimmune diseases (36%) and after chemical burns (24%). Five patients suffered from transient hypotony resulting from keratoprosthesis extrusion. The results highlight the complex nature of managing ocular surface conditions and the frequent challenges associated with early postoperative complications. Conclusions: BKPro implantation is an effective solution for severe corneal diseases that are resistant to conventional treatments. However, it is associated with a significant risk of early complications, particularly glaucoma and retroprosthetic membrane formation. Early identification and management of these complications are crucial for improving outcomes and maintaining visual function. Further research into optimizing postoperative care is needed to minimize these risks and enhance patient outcomes.

Background: Aniridia is a rare panocular, bilateral, and congenital disease characterized by complete or partial iris hypoplasia and foveal hypoplasia, leading to decreased visual acuity and nystagmus. AAK, also referred to as aniridic keratopathy, manifests as corneal surface damage, epithelial thinning or loss, inflammation with immune cell infiltration, vascularization, and chronic progressive opacification. Methods: Twenty-one eyes in eighteen patients with aniridia underwent the triple procedure for visual rehabilitation. Subjects with stromal scarring with mild limbal deficiency were qualified for surgery. The majority of them developed stage II (15), and a few of them had third-degree (6) aniridic keratopathy. Results: The mean patient age was 38.4 ± 8.8. Visual acuity after one year of observation ranged from 0.4 in two eyes to 0.2 in nine eyes to below 0.1 in ten eyes. In the second year, VA remained at the same level in 13 patients (72.2%). In the third year, four patients (22.2%) experienced recurrence of AAK. Conclusions: A majority of the ARK cases (72.2%) had a graft providing useful vision for the patient 2 years after corneal transplantation, but the visual gain was modest at best. Longer follow-up time is required to evaluate functional graft outcomes.

Purpose: Age-related macular degeneration (AMD) is a complex eye disorder affecting millions worldwide. This article uses deep learning techniques to investigate the relationship between AMD, genetics and optical coherence tomography (OCT) scans., Methods: The cohort consisted of 332 patients, of which 235 were diagnosed with AMD and 97 were controls with no signs of AMD. The genome-wide association studies summary statistics utilized to establish the polygenic risk score (PRS) in relation to AMD were derived from the GERA European study. A PRS estimation based on OCT volumes for both eyes was performed using a proprietary convolutional neural network (CNN) model supported by machine learning models. The method's performance was assessed using numerical evaluation metrics, and the Grad-CAM technique was used to evaluate the results by visualizing the features learned by the model., Results: The best results were obtained with the CNN and the Extra Tree regressor (MAE = 0.55, MSE = 0.49, RMSE = 0.70, R 2  = 0.34). Extending the feature vector with additional information on AMD diagnosis, age and smoking history improved the results slightly, with mainly AMD diagnosis used by the model (MAE = 0.54, MSE = 0.44, RMSE = 0.66, R 2  = 0.42). Grad-CAM heatmap evaluation showed that the model decisions rely on retinal morphology factors relevant to AMD diagnosis., Conclusion: The developed method allows an efficient PRS estimation from OCT images. A new technique for analysing the association of OCT images with PRS of AMD, using a deep learning approach, may provide an opportunity to discover new associations between genotype-based AMD risk and retinal morphology., (© 2024 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Thank you for your thoughtful and insightful commentary on our paper, "Outcomes of Boston Keratoprosthesis Type I Implantation in Poland: A Retrospective Study on 118 Patients" [...].

Introduction: Recent advancements in imaging techniques, particularly optical coherence tomography angiography (OCTA), have transformed our understanding of retinal microvascular changes in various ocular diseases, including dry age-related macular degeneration (AMD). Our literature review summarizes key findings on retinal vascular alterations in dry AMD as observed with OCTA, highlighting their implications for disease progression and management., Areas Covered: Studies reveal significant changes in dry AMD patients, affecting the superficial and deep capillary plexuses as well as the choroid. These alterations include decreased vascular and flow density, variations in the foveal avascular zone, reduced choriocapillaris perfusion, and alterations in choroidal vascularity and thickness. Such changes reflect the complex vascular pathology of dry AMD and serve as potential biomarkers for monitoring disease progression. Variability in study results underscores the importance of considering AMD stage, sample size, follow-up duration, imaging protocols, and standardization., Expert Opinion: OCTA in dry AMD is primarily research-focused due to technical and methodological challenges. Its adoption in clinical practice requires standardized protocols and improved software. With future advancements and a better understanding of disease pathology, OCTA could become a routine part of dry AMD management, especially as new therapies emerge that utilize OCTA for assessing dry AMD progression.

Background/objectives: In this study, we aimed to analyze the changes in the expression profiles of selected messenger RNAs (mRNAs) and their encoded proteins in the tears of patients undergoing photorefractive keratectomy (PRK), femtosecond-assisted laser in situ keratomileusis (FS-LASIK), and small-incision lenticule extraction (SMILE) procedures., Methods: A total of 120 patients were divided into three groups based on the laser vision correction (LVC) procedure: PRK, FS-LASIK, or SMILE. Tear samples were collected preoperatively and at 1, 7, 30, and 180 days postoperatively. The expression levels of selected messenger RNAs (mRNAs) and proteins were analyzed by using reverse transcription quantitative polymerase chain reaction (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA), respectively., Results: PRK and FS-LASIK elicited significantly stronger biological responses than SMILE. Interleukin-15 ( IL-15 ) expression increased notably in the PRK and FS-LASIK groups, with mRNA levels reaching fold changes of 4.65 ± 0.65 and 4.99 ± 0.28, respectively, on day 1, compared with only 2.09 ± 0.23 in the SMILE group. Vascular endothelial growth factor A ( VEGFA ) levels were also elevated in the PRK (2.98 ± 0.23 fold change) and FS-LASIK groups (3.45 ± 1.09 fold change) on day 1, while the SMILE group showed minimal fluctuations. The protein concentration analysis based on the ELISA confirmed these trends, with IL-15 levels peaking at 54.2 ± 2.5 pg/mL in the PRK group and 52.8 ± 3.1 pg/mL in the FS-LASIK group, compared with 32.4 ± 1.9 pg/mL in the SMILE group on day 1. Similarly, VEGFA protein concentrations were the highest in the PRK (72.4 ± 4.1 pg/mL) and FS-LASIK patients (69.5 ± 3.8 pg/mL) on day 1 but remained low in the SMILE patients (45.6 ± 2.3 pg/mL). By day 180, gene expression and protein levels in all groups had stabilized, returning to near-preoperative values., Conclusions: PRK and FS-LASIK induced more pronounced molecular and protein-level changes during corneal wound healing than the less invasive SMILE procedure, indicating stronger biological responses. These findings suggest that tailored postoperative care based on the specific procedure could optimize healing and patient outcomes. However, further research with larger sample sizes and longer follow-ups is needed to confirm these observations and develop personalized treatment strategies.

Treatment of Limbal Stem Cell Deficiency (LSCD), based on autologous transplantation of the patient's stem cells, is one of the few medical stem cell therapies approved by the European Medicines Agency (EMA). It relies on isolating and culturing in vivo Limbal Epithelial Stem Cells (LESC) and then populating them on the fibrin substrate, creating a scaffold for corneal epithelial regeneration. Such a solution is then implanted into the patient's eye. The epithelial cell culture process is specific, and its results strongly depend on the initial cell seeding density. Achieving control of the density and repeatability of the process is a desirable aim and can contribute to the success of the therapy. The study aimed to test bioprinting as a potential technique to increase the control over LESCs seeding on a scaffold and improve process reproducibility. Cells were applied to 0.5 mm thick, flat, transparent fibrin substrates using extrusion bioprinting; the control was the traditional manual application of cells using a pipette. The use of 3D printer enabled uniform coverage of the scaffold surface, and LESCs density in printed lines was close to the targeted value. Moreover, printed cells had higher cell viability than those seeded traditionally (91.1 ± 8.2% vs 82.6 ± 12.8%). The growth rate of the epithelium was higher in bioprinted samples. In both methods, the epithelium had favorable phenotypic features (p63 + and CK14 +). 3D printing constitutes a promising approach in LSCD therapy. It provides favorable conditions for LESCs growth and process reproducibility. Its application may lead to reduced cell requirements, thereby to using fewer cells on lower passages, which will contribute to preserving LESCs proliferative potential., (© 2024. The Author(s).)

(1) Axenfeld-Rieger syndrome (ARS) is a rare autosomal dominant disorder, the symptoms of which include both ocular and systemic abnormalities. In the studied subjects, the cornea was significantly opacified with peripheral scarring neovascularization, which is not specific to this syndrome. A suspicion of incorrect diagnosis was raised despite an initial diagnosis of a bilateral Chandler syndrome. (2) In order to provide the proper diagnosis, a DNA sequencing genetic test was conducted with three sisters carrying the presence of a genome imbalance in the FOXC1 gene. The aim of this study is to report a case of a Polish family with a novel gene mutation and its relation with ARS. (3) Our findings implicate the novel deletion of the FOXC1 gene in the pathogenesis of ARS in the affected family. The phenotypic variability observed, including differences in corneal and systemic anomalies, underscores the importance of genetic testing and suggests the influence of non-genetic factors on ARS manifestation.

Objective: This study aimed to assess changes in the morphology of the retina and cornea in patients treated and hospitalized during the acute active phase of SARS-CoV-2 infection. Methods: A total of 24 patients with symptomatic early COVID-19 disease and 38 healthy participants from a control group were enrolled in our study. Among them, 20 received oxygen therapy at flow rates ranging from 1-10 L, while four received high-flow intranasal oxygen therapy (HFNOT). Some patients were treated with other types of therapy, such as Remdesivir, COVID-19 convalescent plasma therapy, or Tocilizumab. In the study, we focused on the analysis of optical coherence tomography (OCT) images of the cornea and retina including corneal thickness, central retinal thickness, retinal nerve fiber layer (RNFL), and optic disc parameters. The measurements were acquired using Spectral-domain OCT REVO FC 130. Results: The analysis did not show significant changes between the examined ophthalmological parameters before and after therapy. Furthermore, there were no detected significant differences between the tested parameters of the retina and cornea in COVID-19-positive patients compared to the control group. Conclusions: No ophthalmological manifestations of COVID-19 disease were observed during the study. Taking into account the results of other publications, the lack of an unambiguous position on this topic requires further research.

Background: Age-related macular degeneration (AMD) is a complex eye disorder with an environmental and genetic origin, affecting millions worldwide. The study aims to explore the association between retinal morphology and the polygenic risk score (PRS) for AMD using fundus images and deep learning techniques., Methods: The study used and pre-processed 23,654 fundus images from 332 subjects (235 patients with AMD and 97 controls), ultimately selecting 558 high-quality images for analysis. The fine-tuned DenseNet121 deep learning model was employed to estimate PRS from single fundus images. After training, deep features were extracted, fused, and used in machine learning regression models to estimate PRS for each subject. The Grad-CAM technique was applied to examine the relationship between areas of increased model activity and the retina's morphological features specific to AMD., Results: Using the hybrid approach improved the results obtained by DenseNet121 in 5-fold cross-validation. The final evaluation metrics for all predictions from the best model from each fold are MAE = 0.74, MSE = 0.85, RMSE = 0.92, R 2 = 0.18, MAPE = 2.41. Grad-CAM heatmap evaluation showed that the model decisions rely on lesion area, focusing mostly on the presence of drusen. The proposed approach was also shown to be sensitive to artifacts present in the image., Conclusions: The findings indicate an association between fundus images and AMD PRS, suggesting that deep learning models may effectively estimate genetic risk for AMD from retinal images, potentially aiding in early detection and personalized treatment strategies.

Background : The purpose of this study was to investigate the risk factors for glaucoma in patients with keratoconus following keratoplasty and to identify potential factors that could affect post-transplant complications. Methods : A retrospective analysis was conducted on the medical records of 192 keratoconus patients who underwent keratoplasty. Data on treatment history, perioperative information, tissue bank data, postoperative regimens, complications, and infections were collected and analyzed. Statistical analysis was performed to identify risk factors associated with glaucoma and transplant complications. Results : There was a 41.6% incidence of glaucoma (high IOP) ( p < 0.001), with the median time to glaucoma development being 314 ± 67 days post-transplant. A significant number of patients required surgical intervention, accounting for 48.05%. Our analysis revealed a 14% graft failure rate. On univariable Cox proportional hazard analysis, the following factors demonstrated statistically significant associations with the risk of glaucoma after transplantation: donor endothelial cell density, the use of a single continuous suture type, and the surgeon (performing the surgery). For many variables, the only factor that remained significant was the surgeon. Among the factors analyzed for risks of failure post-transplantation, significant associations were observed for the donor age, the time from harvest to transplant, and the surgeon. In the multivariable analysis, donor age emerged as a significant predictor of post-transplant complications. Conclusions : Risk factors such as donor endothelial cell density, suture type, surgeon, host and donor size, and host gender were found to increase the risk of developing glaucoma post-keratoplasty. Surgeon type was identified as a significant risk factor, while donor age was predictive of post-transplant complications.

Background/Objectives: Keratoconus (KC) is a bilateral eye disease characterized by corneal thinning and cone-like deformation, leading to visual impairment. This study evaluated the radial peripapillary capillaries (RPCs) in keratoconus patients with and without penetrating keratoplasty (PKP) using OCT and angio-OCT, comparing the results to a control group. Methods: This retrospective study included 149 eyes, 97 from patients who underwent PKP between January 2018 and February 2023 and 52 from patients who did not undergo PKP. The control group comprised 72 patients (144 eyes) who were healthy volunteers. Measurements included the best corrected visual acuity (BCVA), the intraocular pressure (IOP), slit-lamp biomicroscopy, a fundus examination, and corneal topography, as well as OCT and angio-OCT assessments of the RPCs, retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), and central retinal thickness (CRT). Statistical analyses were performed using Student's t -test and Pearson's correlation coefficient. Results: The RNFL was significantly thinner in KC eyes after PKP compared to control eyes ( p < 0.001), and the CRT was significantly thicker in KC eyes after PKP compared to control eyes ( p = 0.003). However, the GCC was similar across the groups ( p = 0.0885). Additionally, RPCs inside the disc were significantly reduced in KC eyes after PKP compared to control eyes ( p < 0.0001). A significant positive correlation was found between RPC whole vessel density and RNFL thickness as measured via angio-OCT (r = 0.308, p < 0.0001). Conclusions: This study found that the RPC density inside the disc is significantly reduced in keratoconus patients after penetrating keratoplasty, highlighting RPCs inside the disc as a potential diagnostic tool for further assessment of keratoconus.

We present the results of the first study of a large cohort of patients with inherited retinal dystrophies (IRD) performed for the Polish population using whole-exome sequencing (WES) in the years 2016-2019. Moreover, to facilitate such diagnostic analyses and enable future application of gene therapy and genome editing for IRD patients, a Polish genomic reference database (POLGENOM) was created based on whole-genome sequences of healthy Polish Caucasian nonagenarians and centenarians. The newly constructed database served as a control, providing a comparison for variant frequencies in the Polish population. The diagnostic yield for the selected group of IRD patients reached 64.9%. The study uncovered the most common pathogenic variants in ABCA4 and USH2A in the European population, along with several novel causative variants. A significant frequency of the ABCA4 complex haplotype p.(Leu541Pro; Ala1038Val) was observed, as well as that of the p.Gly1961Glu variant. The first VCAN causative variant NM&#95;004385.5:c.4004-2A>G in Poland was found and described. Moreover, one of the first patients with the RPE65 causative variants was identified, and, in consequence, could receive the dedicated gene therapy. The availability of the reference POLGENOM database enabled comprehensive variant characterisation during the NGS data analysis, confirming the utility of a population-specific genomic database for enhancing diagnostic accuracy. Study findings suggest the significance of genetic testing in elder patients with unclear aetiology of eye diseases. The combined approach of NGS and the reference genomic database can improve the diagnosis, management, and future treatment of IRDs.

Introduction: SB11 (Byooviz™; Samsung Bioepis Co., Ltd.) is a ranibizumab (Lucentis ® ; Genentech, Inc.) biosimilar targeting vascular endothelial growth factor A for the treatment of retinal diseases. The pre-filled syringe (PFS) presentation of SB11 offers an alternative administration method to the vial, with the potential for enhanced safety and efficient syringe preparation. The objective of this study was to assess the ability of healthcare professionals (HCPs) to follow the instructions for use to prepare and administer SB11 PFS intravitreal (IVT) injections to patients with neovascular age-related macular degeneration (nAMD) or macular edema secondary to retinal vein occlusion (RVO)., Methods: This study was an open-label, single-arm, single-dose clinical study to evaluate the usability of the SB11 PFS in patients with nAMD or macular edema secondary to RVO. Four HCPs prepared and administered 0.5 mg SB11 PFS IVT injections to 34 patients. Product use task completion (12 tasks in total) was assessed by independent observers. Safety was assessed up to 7 days after injection of the investigational product., Results: A total of 34 patients were enrolled and completed the study. All 12 tasks were successfully completed in 34 (100%) patients without a use-related failure. Most patients (32 patients, 94.1%) experienced no adverse events (AEs), whereas 2 (5.9%) patients experienced three treatment-emergent AEs (TEAEs) which were mild to moderate in severity. There were no severe or serious TEAEs reported during the study., Conclusions: This study showed that HCPs were able to successfully prepare and administer the SB11 PFS via IVT injection. No unexpected safety issues were identified. The SB11 PFS is a promising alternative for therapeutic administration of SB11 in patients with retinal disease., Trial Registration: ClinicalTrials.gov identifier NCT06176963; EudraCT number 2021-003566-12., (© 2024. The Author(s).)

Advances in gene therapy and genome editing give hope that new treatments will soon be available for inherited eye diseases that together affect a significant proportion of the adult population. New solutions are needed to make genetic diagnosis fast and affordable. This is the first study of such a large group of patients with inherited retinal dystrophies (IRD) and inherited optic neuropathies (ION) in the Polish population. It is based on four years of diagnostic analysis using a broad, targeted NGS approach. The results include the most common pathogenic variants, as well as 91 novel causative variants, including frameshifts in the cumbersome RPGR ORF15 region. The high frequency of the ABCA4 complex haplotype p.(Leu541Pro;Ala1038Val) was confirmed. Additionally, a deletion of exons 22-24 in USH2A , probably specific to the Polish population, was uncovered as the most frequent copy number variation. The diagnostic yield of the broad NGS panel reached 64.3% and is comparable to the results reported for genetic studies of IRD and ION performed for other populations with more extensive WES or WGS methods. A combined approach to identify genetic causes of all known diseases manifesting in the posterior eye segment appears to be the optimal choice given the currently available treatment options and advanced clinical trials.

Background : The number of corneal transplants is rising, with the aim to treat a spectrum of diseases ranging from dystrophies to corneal opacities caused by trauma or chemical burns. Refractive outcomes after this procedure are often impossible to predict and associated with high levels of astigmatism. However, there are many techniques that affect the reduction of astigmatism and improve the quality of life of patients. Objectives : The aim was to compare the improvement in postoperative visual acuity (logMAR) and amount of corneal astigmatism (Diopters) after corneal keratoplasty in patients who additionally underwent a surgical procedure, which affects the reduction in postoperative astigmatism, and to determine the most effective method. Search Methods and Selection Criteria: A thorough search was carried out across online electronic databases including PubMed, Embrase, Ovid MEDLINE, Scopus, and Web of Science, using combinations containing the following phrases: postoperative astigmatism, post-keratoplasty astigmatism, anterior lamellar keratoplasty (ALK), deep anterior lamellar keratoplasty (DALK), posterior lamellar keratoplasty, endothelial keratoplasty (EK), penetrating keratoplasty (PK), corneal transplant, keratoplasty, refractive surgery, kerato-refractive surgery, laser in situ keratomileusis (LASIK), and femtosecond LASIK. This was to determine all English-language publications that discuss refractive operations for postoperative or post-keratoplasty astigmatism. These bibliographies were searched for English-language publications published between 2010 and 2023. We proceeded to review each detected record's reference list. Data Extraction: Study characteristics such as study design, sample size, participant information, operations performed, and clinical outcomes were all extracted. Data Statistical Analyses: The Comprehensive Meta-Analysis software (version 3.3.070, 2014) was used to perform the analysis. The threshold of 0.05 for p -values was considered statistically significant. All effect sizes are reported as standardized differences (Std diff) in means with a 95% confidence interval (CI) and visualized graphically as forest plots. Publication bias is presented as a funnel plot of standard error by Std diff in means. Four methods were used to evaluate the heterogeneity among the studies: Q-value, I 2 , chi-square (χ 2 ), and tau-squared. Main Results: We included 21 studies that randomized 1539 eyes that underwent corneal transplantation surgery either by PKP, DALK, or DSEAK techniques. The results showed the most significant improvement in the visual acuity and significant decrease in the corneal astigmatism after laser surgery procedures, like femtosecond-assisted keratotomy after DALK and PKP and LASIK after DSEAK.

Introduction: A novel research objective is to identify new molecules in more readily accessible biological fluids that could be used in the diagnosis of multiple sclerosis (MS) and other demyelinating disorders., Aim: To compare the level of selected cytokines in tears between patients with MS or other demyelinating disorder and healthy controls., Material and Methods: 84 patients with diagnosed MS during remission or with other demyelinating disease of the CNS and 70 healthy controls were enrolled in the study. Tears were collected without any stimulation and stored till the day of assessment. The concentration of selected cytokines was measured by the Bio-Plex Pro Human cytokine screening panel 27 cytokines assay according to the manufacturer's instructions. Statistical analysis was performed with Statistica 13., Results: IL-1b level was significantly lower in the study group compared to the control group [3,6 vs 8.71, p  < 0.001]. The same pattern was observed for IL-6 [3,1 vs 5.26, p  = 0.027] and IL-10 [1,7 vs 10.92, p  < 0.001] (Table 1). In the study group, IL-1RA ( p  = 0.015), IL-5 ( p  = 0.04), IL-9 ( p = 0.014), and IL-15 ( p  = 0.037) showed significant correlations with age. In the total sample, IL-1Ra ( p  = 0.016) and IFN-g ( p  = 0.041) were significantly correlated with age, while in the control group, IL-8 ( p  = 0.09), MIP-1a ( p  = 0.009), and RANTES ( p  = 0.031) showed significant correlations., Conclusions: Our results show that MS and other demyelination diseases lead to decrease in the overall level of cytokines in tears. Further research is needed to determine the role of tear fluid in the assessment of demyelinating disorders like MS.

Background/Objectives : Aniridia-associated keratopathy (AAK) is a potentially vision-threatening pathology in congenital aniridia, for which both the underlying etiopathogenesis and effective treatment remain unclear. Methods :This prospective study was conducted to assess and compare the short-term outcome after superficial keratectomy (SK) alone or in a combination with an amniotic membrane transplantation (AMT). Here, 76 eyes were enrolled in 76 patients with grade 4 AAK. In all eyes, in order to assess preoperatively the efficiency of the limbal epithelial stem cells (LESC), the presence of corneal epithelial cells in confocal microscopy was established. The analyses included: best corrected visual acuity (BCVA), the stage of AAK and the number of corneal quadrants involved in corneal neovascularization (CNV). Results : Six months after surgery, the mean BCVA was 0.05 and ranged from 0.002 up to 0.1 in both groups. Improvement in BCVA occurred in 94.29% patients when *SK alone* was performed, and in 92.68% when in combination with AMT. There were no statistically significant differences in the effect of therapy depending on the type of surgery, regarding BCVA, stage of AAK and the number of quadrants with CNV. Conclusions : SK alone is an effective procedure in short outcomes limited to six months for advanced AAK in association with LESC partial efficiency.

Background: The availability of donated eye tissue saves and enhances vision in transplant recipients; however, the current demand for tissue surpasses the available supply. Corneal donor shortages lead to increased wait times, delayed surgeries, prolonged visual impairment, and increased inconvenience to patients requiring eye tissue transplantation. A web-based application was previously developed to facilitate easy and intuitive submission of potential donor information., Objective: The primary objectives of this study were to assess health care professionals' attitudes toward the potential application and evaluate its effectiveness based on user feedback and donor registrations through the application., Methods: Researchers used a mixed methods approach, commencing with a literature review to identify challenges associated with donor procurement. Stakeholder interviews were conducted to gauge health care professionals' perspectives regarding the application. User feedback was collected through questionnaires, surveys, and interviews to assess the application's usability and impact. An assessment of the reported potential donors and questionnaire responses were analyzed., Results: The final version of the application successfully reported 24 real cornea donors. Among 64 health care providers who used the application to communicate about potential donors, 32 of them submitted trial entries exclusively for testing purposes. The remaining 8 health care professionals reported potential donors; however, these individuals did not meet the donor qualification criteria. The majority of participants found the application user-friendly and expressed their readiness to use it in the future. Positive ratings were assigned to the layout, appearance, purpose, and specific features of the application. Respondents highlighted the automatic sending of notifications via SMS text messages and the integration of all necessary documents for donor qualification and tissue collection as the most valuable functions of the application., Conclusions: The study indicates that donor reporting applications offer promising solutions to enhance tissue donor procurement. This application streamlined the reporting process, reduced paperwork, facilitated communication, and collected valuable data for analysis., (©Dominika Szkodny, Ewa Wróblewska-Czajka, Mikołaj Stryja, Filip Gara, Edward Wylęgała. Originally published in JMIR Formative Research (https://formative.jmir.org), 15.05.2024.)

(1) Background : Patients with Fuchs' endothelial corneal dystrophy (FECD) may have coexisting cataracts and, therefore, may require a cataract surgery, which poses challenges due to potential endothelial cell damage. FECD is a degenerative eye disease of unclear etiology, with inflammatory cytokines maybe playing an important role in its development and progression. The present study aimed to investigate the cytokine profile in the aqueous humor of FECD eyes with cataract. (2) Methods : Fifty-two patients were included in the study, 26 with FECD + cataract and 26 with cataract as a control group. Samples of the aqueous humor were analyzed for pro- and anti-inflammatory cytokines using a Bio-Plex 200 system. (3) Results : Interleukin 1 receptor antagonist (IL-1Ra) and interleukin IL-8 levels were significantly higher in the aqueous humor of FECD + cataract patients compared to the control/cataract group. Moreover, the levels of anti-inflammatory IL-10 showed a strong trend to be higher in the FECD + cataract group compared to the control group. In contrast, there were no statistically significant differences in IL-1β, IL-6, IL-4, IL-10, IL-13, IL-17A, and tumor necrosis factor TNF-α between the groups. (4) Conclusions : Presented research contributes to a better understanding of FECD pathogenesis. Elevated levels of IL-1Ra and IL-8 may serve as a defense mechanism in people with FECD and coexisting cataract.

Background : In this study, the changes in corneal cap and residual stromal thickness (RST) values during a 180-day observation period after refractive lenticule extraction small incision lenticule extraction (ReLEx SMILE) were assessed. Methods: Fifty patients underwent ReLEx SMILE using the VisuMax 500 femtosecond laser, with corneal imaging conducted pre and post procedure via anterior segment optical coherence tomography (AS-OCT). Cap thickness in the center and 1.5 mm from the center in four meridians was measured at various intervals. Results: The results showed a significant decrease in cap thickness 180 days post procedure compared to earlier intervals ( p < 0.05). Similarly, RST decreased gradually and significantly post procedure ( p < 0.05). Notably, changes in cap thickness within the central 1.5 mm area were more dynamic than RST changes during the 6-month observation period following SMILE. Conclusions : The corneal cap thickness measured with swept-source AS-OCT within the central 1.5 mm area underwent more dynamic changes than the residual stromal thickness during the 6-month observation following SMILE.

Background: Age-related macular degeneration (AMD) is a multifactorial disease encompassing a complex interaction between aging, environmental risk factors, and genetic susceptibility. The study aimed to determine whether there is a relationship between the polygenic risk score (PRS) in patients with AMD and the characteristics of the retinal vascular network visualized by optical coherence tomography angiography (OCTA)., Methods: 235 patients with AMD and 97 healthy controls were included. We used data from a previous AMD PRS study with the same group. The vascular features from different retina layers were compared between the control group and the patients with AMD. The association between features and PRS was then analyzed using univariate and multivariate approaches., Results: Significant differences between the control group and AMD patients were found in the vessel diameter distribution (variance: p = 0.0193, skewness: p = 0.0457) and fractal dimension distribution (mean: p = 0.0024, variance: p = 0.0123). Both univariate and multivariate analyses showed no direct and significant association between the characteristics of the vascular network and AMD PRS., Conclusions: The vascular features of the retina do not constitute a biomarker of the risk of AMD. We have not identified a genotype-phenotype relationship, and the expression of AMD-related genes is perhaps not associated with the characteristics of the retinal vascular network.

Artificial intelligence (AI) has seen significant progress in medical diagnostics, particularly in image and video analysis. This review focuses on the application of AI in analyzing in vivo confocal microscopy (IVCM) images for corneal diseases. The cornea, as an exposed and delicate part of the body, necessitates the precise diagnoses of various conditions. Convolutional neural networks (CNNs), a key component of deep learning, are a powerful tool for image data analysis. This review highlights AI applications in diagnosing keratitis, dry eye disease, and diabetic corneal neuropathy. It discusses the potential of AI in detecting infectious agents, analyzing corneal nerve morphology, and identifying the subtle changes in nerve fiber characteristics in diabetic corneal neuropathy. However, challenges still remain, including limited datasets, overfitting, low-quality images, and unrepresentative training datasets. This review explores augmentation techniques and the importance of feature engineering to address these challenges. Despite the progress made, challenges are still present, such as the "black-box" nature of AI models and the need for explainable AI (XAI). Expanding datasets, fostering collaborative efforts, and developing user-friendly AI tools are crucial for enhancing the acceptance and integration of AI into clinical practice.

Background: Boston Keratoprosthesis Type I (BI-KPro I) is a synthetic cornea that can be used to restore vision in patients with corneal blindness. This retrospective study evaluated the outcomes of BI-KPro implantation in 118 patients. Material: The mean age of the patients was 56.76 ± 14.24 years. Indications for keratoprosthesis implantation were as follows: graft failure, 47 (39.83%); ocular burn, 38 (32.20%); neurotrophic keratopathy, 11 (9.32%), mucous membrane pemphigoid 9 (7.67%); autoimmune, 6 (5.08%); Stevens-Johnson syndrome, 4 (3.39%); and aniridia (2.54%). Methods: The surgeries were performed between March 2019 and June 2022 at a single clinical center in two locations. The postoperative visual acuity, complications, and need for additional surgical procedures were analyzed. Results: The Best Corrected Visual Acuity before surgery was 0.01 ± 0.006. After one year (V1), it was 0.30 ± 0.27; at two years (V2), it was 0.27 ± 0.26; and at three years (V3), it was 0.21 ± 0.23. The percentage of patients with visual acuity better than 0.1 on the Snellen chart was 37.29% after 1 year, 49.35% after 2 years, and 46.81% after 3 years of follow up. The most common complications were glaucoma (78 patients; 66.1%), corneal melting (22 patients; 18.6%), and retroprosthetic membranes (20 patients; 17.0%). Conclusions: The BI-KPro can significantly improve visual acuity. The worst long-term results were obtained in the group of patients with autoimmune diseases; therefore, careful consideration should be given to implanting BI-KPro in this group. The high incidence of de novo glaucoma or the progression of pre-existing glaucoma suggests the need for careful monitoring.

The study investigated a profile of chemokines and growth factors in the aqueous humor (AH) of eyes with Fuch's endothelial corneal dystrophy (FECD) and cataracts in comparison with cataract patients as a control group. A total of 52 AH samples (26 FECD + cataract and 26 cataract/control) were collected before cataract surgery. None of the patients had any clinically apparent inflammation at the time of AH collection. The AH levels of MCP-1 (CCL2), MIP-1α (CCL3), MIP-1β(CCL4), RANTES (CCL5), eotaxin (CCL11), IP-10 (CXCL10), FGF basic, G-CSF, GM-CSF, PDGF-bb, and VEGF were compared between the groups. The analyses were performed using the Bio-Plex 200 System from Bio-Rad. Among the studied parameters, the AH levels of RANTES, eotaxin, and IP-10 significantly increased in the FECD + cataract eyes, compared with the cataract controls ( p < 0.05). Elevated levels of the RANTES, Eotaxin, and IP-10 indicate more intense inflammation in the eyes of patients in the FECD + cataract group. Moreover, these factors exhibit potential as predictive biomarkers for early detection of FECD in cataract patients. The discovery of elevated concentrations of biochemical markers in a patient, who has not yet received a clinical diagnosis, may suggest the need for heightened observation of the other eye to monitor the potential development of FECD.

Peters' anomaly (PA) is a manifestation of complex disorders in the development of the anterior segment of the eye. The most recognizable feature of the disease is a doughnut-shaped central corneal opacity and adhesions between the opacity and underlying iris. Glaucoma is observed in 30-70% of patients, with up to 50% of the patients showing concomitant vision-threatening disorders. Up to 60% of patients have systemic abnormalities or developmental delays. Being a rare malformation, PA is one of the most common congenital indications for corneal transplantation in infants. Penetrating keratoplasty is used as the primary method of treatment in cases with corneal opacification of a degree that forbids visual development in both eyes. The heterogeneity of co-occurring ophthalmic and systemic malformations in the spectrum of PA determines the wide range of success, defined by various endpoints: graft clarity or visual acuity. Although surgical advancement has made corneal grafting possible in younger children, it has a higher graft failure rate and worse visual prognosis than adult keratoplasty. Optical sector iridectomy, pupil dilation, or cornea rotation can alternatively be performed. Satisfying results of pediatric keratoprosthesis in particular cases of PA have been described. Postoperative treatment of PA aims to maintain a clear optical pathway and prevent amblyopia. This article therefore aims at reporting the ophthalmic treatment and need for multidisciplinary management of PA, including pharmacological and surgical treatment.

Keratoconus (KC) is a degenerative corneal disorder whose aetiology remains unknown. The aim of our study was to analyse the expressions of cytokines and chemokines in KC patients before and after specified time intervals after corneal cross-linking (CXL) treatment to better understand the molecular mechanisms occurring before and after CXL in KC patients process of corneal regeneration.; Tear samples were gathered from 52 participants immediately after the CXL procedure and during the 12-month follow-up period. All patients underwent a detailed ophthalmological examination and tear samples were collected before and after CXL at regular intervals: 1 day before and after the surgery, at the day 7 visit, and at 1, 3, 6, 9, and 12 months after CXL. The control group consisted of 20 healthy people. 10 patients were women (50%) and 10 were men (50%). The mean age was 30 ± 3 years of age. Tear analysis was performed using the Bio-Plex 3D Suspension Array System. Corneal topography parameters measured by Scheimpflug Camera included: keratometry values (Ks, Kf), PI-Apex, PI-Thinnest, Cylinder.; All the 12 months post-op values of the KC patients' topographic measurements were significantly lower than the pre-op. As for the tear cytokine levels comparison between the patient and control groups, cytokine levels of TNF-α, IL-6, and CXCL-10, among others, were detected in lower amounts in the KC group. The pre-op level of IL-6 exhibited a significant increase the day after CXL, whereas comparing the day after the procedure to 12 months after CXL, this showed a significant decrease. Both TNF-α and IL-1 showed a significant decrease compared to the day before and after CXL. We observed significantly higher levels of IL-1β, IL-10, IFN-γ and TNF-α in moderate and severe keratoconus than in mild keratoconus ( p < 0.05). We also demonstrated a statistically significant positive correlation between both pre-op and 12 months after CXL TNF-α, IFN-γ, IL-6 and Ks and Kf values ( p < 0.05, r > 0); Alterations of inflammatory mediators in tear fluid after CXL link with topographic changes and may contribute to the development and progression of KC.

Background: this study aimed to assess the effectiveness and safety of phaco-endocyclophotocoagulation (phaco-ECP) in patients with glaucoma over five consecutive years., Methods: Thirty-eight patients (38 eyes) with primary and secondary glaucoma were enrolled to undergo phaco-ECP (Endo Optiks URAM E2, Beaver-Visitec International, Waltham, MA, USA). The primary outcome measures were intraocular pressure (IOP) reduction, success rates, glaucoma medication use, and visual acuity after phaco-ECP. An IOP reduction of 20% compared to the baseline value without re-intervention was considered a successful treatment. Complete success was defined as a cessation of antiglaucoma medications. Secondary outcome measures included intraoperative and postoperative complications. Measurements were performed preoperatively and in the first week and 1, 3, 6, 12, 18, 24, 30, 36, 42, 48, 54, and 60 months postoperatively., Results: The mean ± SD values of IOP preoperatively, at 12, 24, 36, 48, and 60 months postoperatively were 22.6 ± 6.7 mmHg, 15.9 ± 3.9 mmHg ( p < 0.001), 15.9 ± 2.9 mmHg ( p < 0.001), 15.6 ± 2.7 mmHg ( p < 0.001), 15.5 ± 3.8 mmHg ( p < 0.001), and 15.2 ± 2.6 mmHg ( p < 0.001), respectively. The mean IOP at the last follow-up was reduced by 32.7%. The decrease in the number of antiglaucoma medications was statistically significant at each follow-up visit compared to the baseline. The qualified success rate was 40.6%. All patients at the 60-month follow-up visit required the use of antiglaucoma medications-none of the patients achieved complete success. During the follow-up period, nine patients (28.3%) that required retreatment due to nonachievement of the target IOP were considered failures. Six patients (15.8%) were lost from the follow-up. A total of 23 patients were evaluated 60 months after their phaco-ECP. Complications directly associated with the procedure, such as corneal edema (25.6%), IOP spikes (20.5%), IOL dislocation (2.6%), and uveitis (12.8%), were observed in our patients. Hypotony was not observed in any of our patients., Conclusions: The phaco-ECP procedure was effective, well-tolerated, and safe for reducing IOP in glaucoma patients with cataracts over a long-term follow-up. Randomized, larger-scale studies are required to validate the results obtained.

To demonstrate the results of ray tracing higher- and lower-order aberrations in pseudophakic eyes with rotationally asymmetrical segment multifocal lenses, total high- and low-order aberrations, measured by root mean square value (RMS), refraction, uncorrected distance and uncorrected near visual acuity (UCDVA and UCNVA), and tear break-up time, were measured at scotopic size in 42 eyes of patients implanted with bifocal refractive Mplus15/Mplus30 IOL with +1.5 dpt near addition (42 eyes of patients implanted with Mplus15)/+3.0 dpt near addition (91 eyes of patients implanted with Mplus30), and 107 eyes of control group. No significant differences were noticed between the examined groups concerning UCDVA, UCNVA, and tear break-up time ( p < 0.001). Coma and total high-order aberrations were significantly higher for the Mplus30 lens in comparison to the Mplus15 lens and the control group (Coma, Trefoil p < 0.001, Secondary Astigmatism p = 0.002). The spherical aberrations were significantly higher in the lower-addition lens ( p = 0.016) in comparison to the control group and to the higher-addition lens group ( p < 0.001). Both intraocular lens models were successful at reaching refractive aim, good distance, and near function with the lower higher-order aberrations for the low-addition lens.

Background: The aim of this study was to analyse the concentration of the nerve growth factor (NGF-β) in patients with keratoconus (KC) who are undergoing collagen fibre cross-linking (CXL) surgery in order to better understand the pathogenesis of this disease and observe the molecular changes occurring after the procedure. Among many cytokines, β-NGF seems to play an important role in the healing processes of corneal damage. Therefore, its role in the regenerative process after CXL treatment may affect the course of treatment and its final results. Tear samples from 52 patients were collected in this prospective study. Additionally, the patients also had a number of tests performed, including corneal topography using optical coherence tomography. Flat (K 1), steep (K 2), cylindrical (CYL), and central corneal thickness (CCT) keratometry were assessed. The tear samples were collected, and other tests were performed before the CXL procedure and afterwards, during the 12-month follow-up period. The NGF concentration was measured using the Bio-Plex Magnetic Luminex Assay. Lower levels of NGF-β were detected in the KC patients than in the control group ( p < 0.001). The day after the procedure, the NGF-β level was significantly lower (on average by 2.3 pg/mL) ( p = 0.037) than before the procedure, after which, the level of the reagent increases, but only in the group with the advanced cone, one month after CXL it was significantly higher ( p = 0.047). Regarding the correlation of NGF with topographic measurements, the following were found: NGF-β correlates significantly ( p < 0.05) and positively (r > 0) with K1 before the CXL procedure; NGF-β correlates significantly ( p < 0.05) and positively (r > 0) with K1 one month after CXL; NGF-β correlates significantly ( p < 0.05) and positively (r > 0) with CYL nine months after CXL; and, after twelve months, NGF-β correlates significantly ( p < 0.05) and positively (r > 0) with K2 and K1. Corneal sensitivity did not statistically and significantly correlate with the level of NGF-β secretion. Our study suggests that NGF may be crucial in the development and progression of KC as well as in the repair mechanisms after CXL surgery. Further research is needed on the role of NGF and other inflammatory biomarkers for rapid diagnosis and selection of targeted therapy in patients with keratoconus.

BACKGROUND Glaucoma, a vision-threatening condition, results from optic nerve damage and affects millions of people worldwide. Often asymptomatic, it is hereditary, with risk factors like hypertension, diabetes, and steroid use. Despite its link with intraocular pressure (IOP), not everyone with high IOP develops glaucoma. After pars plana vitrectomy (PPV), patients face increased IOP risks. Traditional treatment includes pharmacotherapy, and, when ineffective, surgical interventions. Continuous-wave transscleral cyclophotocoagulation (CW-TSCPC) is an alternative for refractory glaucoma but can have complications. Our study compares the efficacy and safety of CW-TSCPC after PPV. MATERIAL AND METHODS The study group consisted of 18 patients diagnosed with glaucoma who underwent the CW-TSCP procedure as the first-choice therapy after conservative treatment of glaucoma proved ineffective. The comparison group consisted of 12 patients who underwent the CW-TSCP procedure after conservative drug treatment and in whom surgical treatment of glaucoma had been unsuccessful. All patients had inadequate control of IOP after PPV. RESULTS Study and comparison group patients showed a decrease in IOP during the follow-up, independent of the type of endotamponade used (P<0.05). When the indication for PPV was retinal detachment hemorrhage into the vitreous chamber, a significant decrease in IOP between 0 days and 180 days was only found in the study group (P<0.05). In contrast, when the indication for PPV was the state after uveitis or proliferative diabetic retinopathy, a significant decrease in IOP was found at 180 days in the study and comparison groups (P<0.05). CONCLUSIONS The analysis showed that the CW-TSCPC procedure can be recommended as the first-choice invasive treatment in patients with increased IOP after PPV.

Visual acuity is one of the most important parameters for evaluating the vision of patients with keratoconus. This study reviewed 295 articles related to keratoconus published between 2017 and 2022 in which visual acuity was one of the parameters measured. The methodology of visual acuity testing in studies on keratoconus was thoroughly analyzed. The analysis showed that the most commonly indicated chart for testing visual acuity papers on keratoconus is the Snellen chart. It was shown that in 150 out of 295 articles, the authors do not describe the methodology for testing visual acuity. What is more, it was also shown that in 68 of the 295 articles which were analyzed, a procedure for converting visual acuity tested with a Snellen chart into a logMAR scale was used. In this review, we discuss the validity and reliability of such conversions. In particular, we show that insufficient description of visual acuity testing methodology and lack of information on the conversion of visual acuity results into the logMAR scale may contribute to the misinterpretation of visual acuity test results.

Background: This study assessed the efficacy and safety of Ahmed valve implantation in patients with aniridic glaucoma for three consecutive years., Methods: Six adult patients (seven eyes) with Ahmed valve (AV) implants for aniridic glaucoma were enrolled in the study. The primary outcome measures were intraocular pressure reduction, glaucoma medication use, success rates, and visual acuity after AV implantation. A 30% reduction in IOP from baseline without the need for re-intervention was considered an effective treatment. The cessation of antiglaucoma medications was defined as complete success. Intraoperative and postoperative complications were included as secondary outcome measures. Measurements were performed preoperatively, at the first week, and 1, 3, 6, 12, 18, 24, 30, and 36 months postoperatively., Results: A total of seven eyes (6 patients) were evaluated 36 months after AV implantation. The mean ± SD values of IOP preoperatively at 1 day, 1 week, and 1, 3, 6, 12, 18, 24, 30, and 36 months postoperatively were 30.4 ± 4.0 mmHg, 14.6 ± 4.6 mmHg, 16.1 ± 4.6 mmHg, 20.7 ± 7.0 mmHg, 14.5 ± 2.7 mmHg, 16.5 ± 5.9 mmHg, 16.2 ± 4.0 mmHg, 16.3 ± 4.3 mmHg, 17.2 ± 10.1 mmHg, 17.6 ± 6.9 mmHg, and 18.2 ± 5.5 mmHg, respectively. At the last follow up, the mean IOP was reduced by 40.2%. The qualified success rate was 85.7%. One patient (one eye) at the last follow-up visit did not require antiglaucoma medications, resulting in a complete success rate of 14.3%. Intra- and postoperative mild or moderate subconjunctival bleeding was observed in all the patients. No other major/minor intraoperative or postoperative complications were noted., Conclusions: In long-term follow up, the AV implantation procedure is well-tolerated and relatively safe for reducing IOP in adult aniridia patients with glaucoma. These results should be validated through studies involving a larger patient cohort.

Background: Obtaining corneas in a country of 38 million, Poland, is extremely inefficient. In Poland, about 1000 corneas are transplanted annually, of which over 500 come from multi-organ donations. To our knowledge, such a low percentage of donations is in the absence of reporting of potential corneal donors. There is no computer system in our country for tissue donor reporting. The aim of the work is to present an innovative application developed for this purpose., Material and Methods: It was a cross-sectional, observational study. The questionnaires were collected from doctors who had access to the app., Results: Almost all participants (47/52) answered that they would use this app if it was available in the hospital, 46 acknowledged that the application could encourage doctors to report tissue donors, and 48 confirmed it should be integrated with the IT system of hospitals and should be available in all of them., Conclusion: Despite advances in medicine and technology and increased awareness of organ donation and transplantation, the gap between supply and demand is constantly growing. Due to the large number of patients awaiting corneal transplants in Poland, it is necessary to introduce changes aimed at improving this situation. The newly developed app may contribute to increasing donor reporting., Competing Interests: Declaration of Competing Interest All the authors declare no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

The growing incidence of myopia worldwide justifies the search for efficient methods of myopia prevention. Numerous pharmacological, optical, and lifestyle measures have already been utilized, but there remains a need to explore more practical and predictable methods for myopia control. This paper presents a review of the most recent studies on the prevention of myopia progression using defocus-incorporated multiple-segment spectacle lenses (DIMSsl), repeated low-level red-light (RLRL) therapy, and a combination of low-dose atropine (0.01%) with orthokeratology lenses.

The purpose of this study was to describe ocular surface and anterior eye segment findings in various types of ichthyoses., Methods: This was a single-center prospective observational study. The study group consisted of five patients (P1-P5) aged 13-66 years. Multimodal imaging was performed, including slit-lamp examinations, swept-source optical coherence tomography (SS-OCT), and in vivo confocal microscopy (IVCM)., Results: All patients were diagnosed with moderate-to-severe dry eye disease (DED). The corneas showed a significant pattern of irregularity, with a significant difference between the corneal thickness at the apex (CAT) and the corneal thinnest thickness (CTT), exceeding 375 µm. Three patients were diagnosed with ectasia patterns based on SS-OCT. All patients showed abnormalities in at least one Fourier index parameter for at least one eye at 3 or 6 mm in the keratometric, anterior, or posterior analyses. IVCM examinations revealed changes in all corneal layers., Conclusions: By combining the results of multimodal imaging, we were able to detect preclinical abnormalities, distinguish characteristic changes common to ichthyosis, and reveal the depth and characteristics of corneal abnormalities. Therefore, patients with ichthyosis should be examined for DED and ectatic disorders early in clinical practice.

Background: Retro-mode is a novel technique capable of creating pseudo-3D images of the retina. However, its clinical utility remains unknown. This study aimed to evaluate the Nidek Mirante multimodal imaging platform for ocular assessment in patients with various retinal conditions., Methods: A total of 115 participants with central serous chorioretinopathy (CSR) and age-related macular degeneration (AMD) were included. Two experienced graders independently evaluated the images, and statistical analysis was performed to assess interclass correlation coefficients (ICC) between graders and modalities; Results: For CSR detection, retro-mode demonstrated exceptionally high ICC rates (ICC = 1; 100%), while color and autofluorescence (FAF) showed moderate coefficients (0.69 and 0.78, respectively). The detection of pigment epithelial detachment was high across all methods, with only retro-mode deviated right (DR) allowing detection in 69% of cases, while retro-mode DR and deviated left (DL) achieved 100% detection. FAF-green achieved a 95% detection rate. In detecting retinal atrophy, most modalities demonstrated high detection rates, with the lowest detection rates offered by retro-mode DL (ICC = 0.85) and DR (ICC = 0.89), while retro-mode ring aperture offered 0.97. Infra-red and fluorescein angiography imaging offered the highest detection rates among the tested modalities, with 97% and 100%, respectively., Conclusion: Retro-mode showed promise for comprehensive ocular evaluation and diagnosis, with certain imaging modalities demonstrating higher accuracy in detecting specific retinal features.

Background: This study aimed to assess the effectiveness and safety of transscleral microcyclophotocoagulation (µCPC) in patients with glaucoma for eighteen consecutive months., Methods: Sixty-one patients (64 eyes) with primary and secondary glaucoma were enrolled to undergo µCPC (diode laser FOX 810, A.R.C. Laser, Nuremberg, Germany). The primary outcome measures were intraocular pressure (IOP) reduction, success rates, glaucoma medication use, and visual acuity after µCPC. An IOP reduction of 20% compared to the baseline value without re-intervention was considered a successful treatment. Complete success was defined as cessation of antiglaucoma medications. Secondary outcome measures included intraoperative and postoperative complications. Measurements were performed preoperatively and at the first week, and 1, 3, 6, 12, and 18 months postoperatively., Results: The mean ± SD values of IOP preoperatively at 1 day, 1 week, 1, 3, 6, 12, and 18 months postoperatively were 25.1 ± 8.4 mmHg, 17.3 ± 4.5 mmHg ( p < 0.001), 16.5 ± 6.1 mmHg ( p < 0.001), 20.5 ± 8.3 mmHg ( p < 0.001), 17.1 ± 6.2 mmHg ( p < 0.001), 18.0 ± 7.1 mmHg ( p < 0.001), 15.8 ± 3.2 mmHg ( p < 0.001), and 17.0 ± 5.9 mmHg ( p < 0.001), respectively. The mean IOP at the last follow-up was reduced by 32.5%. The decrease in the number of antiglaucoma medications was statistically significant at each follow-up visit compared to the baseline. The qualified success rate was 38.5%. Two patients at 18-month follow-up did not require the use of antiglaucoma medications-complete success rate-3.1%. During the follow-up period, twenty-five eyes (39.1%) that required retreatment due to nonachievement of the target IOP were considered as failures. Eleven patients (12 eyes-18.8%) were lost to follow-up. A total of 26 patients (27 eyes) were evaluated 18 months after µCPC. Hypotony was observed in one patient (1.6%) and uveitis in two patients (3.1%) after the procedure. There were no other significant intraoperative or postoperative complications observed., Conclusions: The µCPC is well tolerated and safe for reducing IOP in glaucoma patients in medium-term follow-up; however, success is moderate. Randomized, larger studies are needed to confirm the obtained results.

Purpose: The present study aimed to evaluate the efficacy and safety of ultrasound ciliary plasty (UCP) in patients with open-angle glaucoma for three consecutive years., Methods: Sixty-one patients (62 eyes) with primary and secondary glaucoma were enrolled to undergo UCP. The primary outcome measures were intraocular pressure (IOP) reduction, success rates, glaucoma medication use and visual acuity after UCP. An IOP reduction of 20% compared to the baseline value without re-intervention was considered a successful treatment. Complete success was defined as cessation of antiglaucoma medications. Secondary outcome measures included intraoperative and postoperative complications. Measurements were performed preoperatively and at the first week, and 1, 3, 6, 12, 18, 24, 30 and 36 months postoperatively., Results: A total of 41 patients (41 eyes) were evaluated 36-month after UCP. The mean ± SD values of IOP preoperatively at 1 day, 1 week, 1; 3; 6; 12; 18; 24; 30 and 36 months postoperatively were 22.7 ± 5.0 mmHg, 17.1 ± 4.2 mmHg (p < 0.001), 15.7 ± 4.8 mmHg (p < 0.001), 18.8 ± 4.8 mmHg (p < 0.001), 17.3 ± 3.7 mmHg (p < 0.001), 16.9 ± 3.2 mmHg (p < 0.001), 16.6 ± 2.7 mmHg (p < 0.001), 16.3 ± 3.0 mmHg (p < 0.001), 15.8 ± 3.4 mmHg (p < 0.001), 15.3 ± 2.1 mmHg (p < 0.001) and 16.3 ± 3.0 mmHg (p < 0.001), respectively. The mean IOP at the last follow-up was reduced by 28.5%. The qualified success rate was 64.0%. All patients at 36-month follow-up visit required the use of antiglaucoma medications - none of the patients achieved complete success. The decrease in the number of antiglaucoma medications was statistically significant at each follow-up visit compared to the baseline. Choroid detachment was observed in three patients (4.8%), while macular oedema was observed in three patients (4.8%) after the procedure. No other major intraoperative or postoperative complications occurred., Conclusion: Ultrasound ciliary plasty seems to be an effective and well-tolerated method to reduce IOP in patients with refractory glaucoma. Further studies with a larger group are needed to confirm the efficacy of this procedure., (© 2022 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

BACKGROUND This study from a single center in Poland included 120 patients with myopia, and the aim was to compare vision correction and corneal thickness at the 180-day follow-up after femtosecond laser-assisted in-situ keratomileusis (FS-LASIK), photorefractive keratectomy (PRK), or small incision lenticule extraction (SMILE). MATERIAL AND METHODS The effectiveness and safety of laser vision correction (LVC) procedures were evaluated by determining pre- and post-procedure uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) values on the Snell chart. Twenty patients with diagnosed mild myopia (sphere maximum -3.0 diopters D; cylinder maximum 0.5 D) were qualified for PRK surgery. Fifty patients with diagnosed intolerance (sphere maximum -6.0 D; cylinder maximum 5.0 D) were eligible for the FS-LASIK procedure. Fifty patients with diagnosed myopia (sphere maximum -6.0 D cylinder 3.5 D) were qualified for the SMILE procedure. RESULTS Regardless of which procedure was performed, both UDVA and CDVA improved significantly postoperatively (P<0.05). In addition, the UDVA and CDVA values were similar in the postoperative period (P>0.05). For each procedure, the EI was no less than 0.94. Regardless of which type of LVC procedure was performed, CET at the center and 1.5 mm from the center in 4 meridians thickened, and this change was not statistically significant over the observation period (P>0.05). CONCLUSIONS Our analysis demonstrated similar effectiveness of the 3 methods - PRK, FS-LASIK, and SMILE - in patients with mild and moderate myopia.