Femtosecond Laser-Assisted Graft Preparation and Implantation of Corneal Allogeneic Intrastromal Ring Segments for Corneal Ectasia: 1-Year Results.

Purpose: To evaluate the outcomes of patients treated with corneal allogeneic intrastromal ring segments cut with femtosecond laser (Femto-CAIRS) without concomitant corneal crosslinking.

Methods: Patients with keratoconus treated with Femto-CAIRS at the American University of Beirut Medical Center were included (May 2022-January 2023). A proprietary software program was developed on the femtosecond laser to cut allogeneic segments.

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.

Comparison of Elisar-Fast and Sita-Fast Strategy for Visual Field Assessment in Glaucoma.

Purpose: To compare two fast threshold strategies of visual field assessment: SITA-Fast (SF; Humphrey field analyser) and Elisar-Fast (EF; Advanced vision analyser) in patients with glaucoma.

Methods: In this cross-sectional observational study, of total 192 subjects, 138 subjects [150 eyes, 80 glaucoma subjects (91 eyes) and 58 healthy controls (59 eyes)] were analysed and included. Each subject underwent 24-2 EF and SF in randomized order with a minimum time interval of 1 hour between tests.

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.

Impact of COVID-19 on ophthalmic surgical procedures in sub-Saharan Africa: a multicentre study.

Background: The COVID-19 pandemic had a profound impact on healthcare and ophthalmology services globally. Numerous studies amongst various medical and surgical specialties showed a reduction in patient attendance and surgical procedures performed. Prior published ophthalmic literature focused on specific types of procedures and were usually single centre.

Comparative study of the outcomes of newly developed polypropylene-based modified trabeculectomy and glaucoma shunt surgery in neovascular glaucoma.

Background: Neovascular glaucoma (NVG) is a secondary glaucoma with a poor visual prognosis. Trabeculectomy with antifibrotic agents, glaucoma drainage devices (GDDs), and cyclo-destructive procedures are recommended in patients who are refractory to medical management. However, due to the poor success rate of conventional trabeculectomy and the higher cost of GDDs, alternative procedures need to be looked at.

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.

Reverse 4-Throw Pupilloplasty for Endothelial Keratoplasty.

Purpose: The aim of this study was to describe the feasibility and applicability of a reverse 4-throw (RFT) pupilloplasty technique for endothelial keratoplasty.

Methods: In RFT, the 9-0 polypropylene suture needle and a 26-Gauge needle pierce the iris tissue from the posterior surface to emerge on the anterior surface along the proximal and distal portion of iris tissue to be apposed, respectively. The 9-0 needle is threaded into the barrel of a 26-Gauge needle and is withdrawn from the eye.

Global warming impact of fluorinated gases in ophthalmic surgeries at a tertiary eye center in India.

Purpose: Global warming is one of the greatest health threats of the 21 st century. The ophthalmic sector contributes to the emission of greenhouse gases, thus altering the natural environment. There is currently no data on global emissions of fluorinated gases in ophthalmic surgery.

Multicolor imaging: Current clinical applications.

Multicolor (MC) imaging is an innovative pseudocolor fundus imaging modality based on confocal scanning laser ophthalmoscopy. It effectively scans the retina at different depths to create a composite image. The green reflectance image depicts the middle retinal while blue reflectance image provides images of the retinal surface.

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.

Refractive cataract surgery.

Purpose Of Review: The aim of this study to provide an overview of recent publications and opinions in refractive cataract surgery.

Recent Findings: With the advent of intraocular lenses (IOLs) on different platforms, the surgeon has a wide arena of types of IOL to choose, depending on the patient's visual requirement. Optimization of the tear film, integrating tomography and topography devices for appropriate keratometry values, biometry, use of advanced formulas for IOL power calculation and application of newer IOLs can help achieve target refraction in cases scheduled for cataract surgery.

Optimum pinhole size determination in pinhole pupilloplasty for higher-order aberrations.

Purpose: To determine optimal pinhole size (OPS) and establish a relationship with visual acuity (VA) and RMS (root mean square) values in cases with higher-order aberrations (HOAs) undergoing pinhole pupilloplasty (PPP).

Setting: Private practice, India.

Design: Prospective, interventional study.

Effects of hydroxychloroquine therapy on choroidal volume and choroidal vascularity index.

Purpose: To determine changes in choroidal volume (CV) and choroidal vascularity index (CVI) in patients on hydroxychloroquine (HCQ) therapy.

Methods: Retrospective analysis of patients on HCQ therapy. CV and CVI were assessed below the central foveal region on spectral-domain optical coherence tomography using an automatic denoising and localization algorithm.

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.

Extended Dehydration of Corneal Allogenic Intrastromal Ring Segments to Facilitate Insertion: The Corneal Jerky Technique.

Purpose: The aim of this study was to describe a new technique to facilitate the insertion of corneal allogenic intrastromal ring segments.

Methods: A single-segment corneal allogenic intrastromal ring segment (CAIRS) was trephined from donor corneas and allowed to markedly dehydrate for 75 minutes before the start of the procedure with a room humidity of 35% to 45%. The duration of the insertion step and the intrastromal segment size at 1 week as measured by optical coherence tomography were compared with previously performed single-segment CAIRS procedures using the conventional technique.

DMEK surgical training: An instructional guide on various wet-lab methods.

Descemet membrane endothelial keratoplasty (DMEK) is a partial-thickness corneal transplantation procedure that involves selective transplantation of the Descemet membrane and endothelium. DMEK offers significant advantages over other keratoplasty techniques, such as faster visual rehabilitation, better final visual acuity due to minimal optical interface effects, lower risk of allograft rejection, and less long-term dependence on topical steroids. Despite all its advantages, DMEK has been found to be more challenging than other corneal transplantation techniques, and its steep learning curve appears to be an obstacle to its widespread use and adoption by corneal surgeons worldwide.

Outcomes of Pythium keratitis: a meta-analysis of individual patient data.

Background: Pythium keratitis is a difficult-to-treat corneal infection.

Methods: A meta-analysis of individual patient data from observational studies of Pythium keratitis was performed. The outcomes of interest were therapeutic penetrating keratoplasty (TPK) and globe removal (evisceration, enucleation, or exenteration); the main exposures were linezolid and azithromycin use.