Crosslinked All-Femtosecond Laser-Cut Corneal Allogenic Intracorneal Ring Segments (AFXL CAIRSs): Pilot Ex Vivo Study and Report of First Two Cases Performed in Italy.

This pilot ex vivo study and first clinical experience in Italy evaluate the impact of using pre-implantation crosslinking on all-femtosecond laser-cut corneal allogenic intracorneal ring segments (AFXL CAIRSs). Six human donor eye-bank corneas were used for this preclinical ex vivo human study. Three donor (D) corneas were used for AFXL CAIRSs.

Raman spectroscopy assisted tear analysis: A label free, optical approach for noninvasive disease diagnostics.

In recent times, tear fluid analysis has garnered considerable attention in the field of biomarker-based diagnostics due to its noninvasive sample collection method. Tears encompass a reservoir of biomarkers that assist in diagnosing not only ocular disorders but also a diverse list of systemic diseases. This highlights the necessity for sensitive and dependable screening methods to employ tear fluid as a potential noninvasive diagnostic specimen in clinical environments.

Bowman Layer Marking for Correct Placement of Corneal Allogeneic Intrastromal Ring Segments.

Corneal allogeneic intrastromal ring segments (CAIRS) refer to the placement of allogeneic rings and segments in intrastromal channels within the cornea. Currently, a deepithelialized donor cornea is used as the allogeneic source for CAIRS and the cut ring is turned sideways and implanted so that the thickness can be varied by varying the distance between the concentric trephine blades. In addition, to obtain a greater effect, CAIRSs are preferred to be implanted with the Bowman layer (BL) facing the corneal apex and posterior stroma facing limbally.

Customized corneal allogenic intrastromal ring segments (CAIRS) for keratoconus with decentered asymmetric cone.

Corneal allogenic intrastromal ring segments (CAIRS) refer to the intracorneal placement of fresh, unprocessed, processed, preserved, or packaged allogenic rings/segments of any type/length. We described uniform-thickness CAIRS previously. We now describe a new technique of customized CAIRS to personalize the flattening effect as per individual topography.

Outcomes of Pre-Descemet Endothelial Keratoplasty for Failed Therapeutic Penetrating Keratoplasty.

Purpose: The aim of this study was to analyze the outcomes of pre-Descemet endothelial keratoplasty (PDEK) for failed therapeutic penetrating keratoplasty.

Methods: This was a retrospective, interventional study that involved 12 eyes of 12 patients with failed therapeutic penetrating keratoplasty that underwent PDEK. All cases had a minimum follow-up of 12 months.

Phacoemulsification, pinhole pupilloplasty, and pre-Descemet's endothelial keratoplasty for keratoconus with Fuchs' endothelial dystrophy.

The comorbidity of keratoconus with Fuchs' endothelial dystrophy with cataract is a rare clinical combination. We present an amalgamation of surgical techniques to manage the above clinical conditions and its complications in single setting. The modified triple procedure, namely, the phacoemulsification, pinhole pupilloplasty, and pre-Descemet's endothelial keratoplasty (PDEK) in the order of description is followed in single sitting.

Hypersonic vitrectomy in intraoperative posterior capsular rupture with retained nuclear fragments.

In our report, we present the hypersonic vitrectomy (Vitesse, Bausch and Lomb) being employed for anterior vitreous liquefaction and removal in posterior capsular rupture. The capsular tear with nucleus drop during conventional phacoemulsification was managed by vitrectomy using the hypersonic vitrector after posterior-assisted levitation followed by intraocular lens (IOL) implantation. The minimal cortical and epinuclear lens particles in the anterior chamber and vitreous were also liquefied with a stoke length of 30 to 40 μm and aspirated via the Vitesse vitrectomy system.

Endodiathermal Tautening of Floppy or Irregular Iris in Endothelial Keratoplasty (Iridodiathermy).

Floppy or irregular irides may be seen during endothelial keratoplasty in complex cases or in eyes with damaged irides and may cause uneven air fill, retro-pupillary air escape, anterior bowing of iris, forward movement of lens-iris diaphragm, shallowing of anterior chamber (AC), bellowing and floppiness of iris, uneven AC depth, difficulty in inserting and opening graft, iris trauma, intraoperative bleeding, and iridodialysis. We present a technique of iridodiathermy for tautening and flattening such irides. With continuous irrigation using AC maintainer, the bipolar endodiathermy probe tip is applied in localized spots to midperipheral iris in the affected area with power and duration adjusted to induce mild localized shrinkage and tightening of iris stroma.

Posterior Corneal Curvature Changes After Pre-Descemet's Endothelial Keratoplasty: A Prospective Analysis.

Purpose: To assess the changes in the posterior corneal curvature after pre-Descemet's endothelial keratoplasty (PDEK) and correlate with the visual outcomes.

Methods: Eyes with pseudophakic bullous keratopathy, aphakic bullous keratopathy, and Fuchs dystrophy undergoing PDEK were included. The main outcome measures were the topography (OrbscanIIz, Bausch and Lomb) indices-total corneal power (TCP) in diopters (D), radius of the posterior curvature (mm), and best-fit sphere of the posterior corneal surface (BFS in D) at preoperative and postoperative 1 month, 3 months, and 6 months.

Intraocular lens power calculation changes before and after isotonic collagen cross-linking in keratoconus patients.

Purpose: To find the intraocular lens (IOL) power calculation changes before and after isotonic collagen cross-linking (CXL) in keratoconus patients.

Methods: : Thirty-five eyes of 25 patients who underwent isotonic CXL were included. The cases included conventional CXL (n = 16), accelerated CXL (n = 7), contact lens-assisted CXL (CACXL) (n = 9), accelerated CACXL (n = 3).

i-PDEK: Microscope-integrated OCT-assisted pre-Descemet endothelial keratoplasty.

Four patients with pseudophakic corneal edema were subjected to pre-Descemet endothelial keratoplasty (PDEK) under the direct guidance of microscope-integrated optical coherence tomography (i-OCT). i-OCT facilitated successful type 1 big bubble formation during donor preparation, debridement of the hypertrophic epithelium, planning and placement of surgical wounds, descemetorrhexis with removal of remnant Descemet membrane tags, and identification of correct donor orientation and interface details. It was also possible to discern the stability of intraocular lens, flat iris configuration, adequate stromal hydration, and wound apposition on i-OCT.

Minimally Invasive Micro Sclerostomy (MIMS) Procedure: A Novel Glaucoma Filtration Procedure.

Prcis: Intermediate-term results suggest that ab interno Minimally Invasive Micro Sclerostomy (MIMS) stent-less subconjunctival filtration procedure is a promising treatment option for patients with open-angle glaucoma (OAG).

Purpose: MIMS is a novel ab interno, stent-less, subconjunctival filtration procedure. This study set to investigate the safety, performance, and efficacy of MIMS in OAG patients.

Selective transepithelial ablation with simultaneous accelerated corneal crosslinking for corneal regularization of keratoconus: STARE-X protocol.

Purpose: To evaluate the changes in refractive outcomes and corneal aberrations in central and paracentral keratoconus after selective transepithelial topography-guided photorefractive keratectomy combined with accelerated corneal crosslinking (STARE-X).

Settings: Centro Polispecialistico Mediterraneo, Siena Crosslinking Center, and University of Messina, Italy.

Design: Prospective, interventional, multicentric study.

Persistent asymptomatic vitreous cyst with ten years follow-up: A case report.

Asymptomatic free floating vitreous cyst with macular coloboma constantly been stable for 10 years is a rarely reported case. Here, we report a case of 30-year-old male who presented to us with best corrected visual acuity of 6/12 and 6/18 in right and left eye, respectively. On slit-lamp examination anterior segment was normal.

Glued intraocular lens in eyes with deficient capsules: retrospective analysis of long-term effects.

Purpose: To assess the long-term (6-12 years) results and complications of glued transscleral-fixated intraocular lens (IOL).

Setting: Dr. Agarwal's Eye Center, Chennai, India.

Trocar assisted nonappositional repair of iridodialysis.

Purpose: To describe trocar-assisted method of Nonappositional repair of iridodialysis.

Methods: The technique described involves placement of a 25 G trocar at the limbus wherein the lumen of the cannula works as a guide to introduce a double arm polypropylene suture attached to the long arm needle thereby preventing any accidental entrapment of corneal fibers into the needle.

Results: The technique was performed in 7 cases and no entrapment of corneal tissue was observed while maneuvering the suture needle through paracentesis incision during an iridodialysis repair procedure.

A new normal with cataract surgery during COVID-19 pandemic.

Cataract is the second leading cause of preventable blindness on the globe. Several programs across the country have been running efficiently to increase the cataract surgical rates and decrease blindness due to cataract. The current COVID-19 pandemic has led to a complete halt of these programs and thus accumulating all the elective cataract procedures.

Scleral fixation of intraocular lenses.

Purpose Of Review: To review current, effective and more popular techniques for scleral fixation of intraocular lens (IOLs) and IOL-capsular bag complex.

Recent Findings: Scleral fixation of IOLs became popular, originally with sutured scleral fixated IOLs and later the Scharioth technique of intrascleral haptic fixation. This was further developed as the Glued IOL technique which enjoys widespread adoption all over the world.

Uveitis and deficient lens capsules: Effect of glued intraocular lens on the visual outcome and the reactivation of inflammation.

Purpose: To evaluate the visual outcome and complication profile after glued intraocular lens (IOL) in post uveitic eyes.

Methods: Patients with history of uveitis who had glued IOL with 3 months antecedent quiet anterior chamber (AC) were included in this prospective observational case series. Visual acuity, slit-lamp examination, fundus evaluation, optical coherence tomography, intraocular pressure, specular count and AC inflammation were analyzed before and after glued IOL procedure.

Densitometry Analysis of Corneal Backscatter After Pre-Descemet Endothelial Keratoplasty for Pseudophakic Bullous Keratopathy.

Purpose: To quantify corneal backscattering by densitometry analysis after pre-Descemet endothelial keratoplasty (PDEK).

Design: This is a prospective observational case series.

Methods: Setting: Tertiary care hospital.

Iris and knot configuration after Single Pass Four Throw (SFT) pupilloplasty as imaged by the spectral-domain optical coherence tomography.

Purpose: To analyze the morphological changes in the iris-knot complex configuration using spectral-domain optical coherence tomography (SD-OCT) following the single pass four throw (SFT) pupilloplasty.

Methods: In this retrospective case series, eyes with SFT pupilloplasty were examined by SD-OCT (Optovue). Iris morphology compared to the normal iris, presence of specific patterns (single hump, double humps, peaks and valleys, tethering), prolene suture, knot complex (length and orientation), and intraocular lens (IOL) vault were evaluated.