To characterize spectrum-dependent changes in Scheimpflug tomographic parameters across normal, keratoconus suspect, and eyes with keratoconus classified using the modified Rabinowitz-McDonnell index. This retrospective comparative study included 115 eyes of 115 patients evaluated at a tertiary ophthalmology clinic. Based on the modified Rabinowitz-McDonnell index, eyes were categorized into control (n = 37), keratoconus suspect (n = 51), and keratoconus (n = 27) groups. All eyes underwent Scheimpflug tomography. Anterior and posterior keratometry values, corneal thickness parameters, corneal volume, anterior chamber depth, and pupil diameter were analyzed. Anterior and posterior corneal curvature parameters increased progressively from control group to keratoconus suspect group and were highest in eyes with keratoconus (all p < 0.001). While anterior keratometric parameters and posterior corneal curvature differed significantly between control and keratoconus suspect groups, pachymetric measurements remained comparable, with significant thinning observed only in the keratoconus group (all p < 0.001). Corneal volume was higher in keratoconus suspect group compared with both control and keratoconus groups (p = 0.001). Anterior chamber depth was greater in keratoconus group, while pupil diameter was smaller in keratoconus suspect group (both p < 0.01). When keratoconus is classified using central keratometry, Scheimpflug tomography demonstrates a clear, stage-dependent pattern of corneal change. Curvature-related alterations precede measurable thinning, highlighting that curvature-based classification remains clinically relevant and that tomographic parameters can enhance disease characterization across the keratoconus spectrum.

Background: The escalating prevalence of high myopia represents a critical global health crisis, particularly in Southeast Asia. This pathological refractive status is driven by complex structural changes, primarily axial elongation, which predisposes the eye to sight-threatening complications. While the dominance of axial length in myopia is established, the compensatory role of the anterior segment—specifically whether the cornea or anterior chamber undergoes adaptive morphological changes to counteract elongation—remains a subject of debate. This study utilized high-resolution Swept-Source Optical Coherence Tomography (SS-OCT) to precisely quantify the relationship between Spherical Equivalent (SE) and ocular biometric parameters, isolating the specific contributions of posterior segment elongation versus anterior segment adaptation. Methods: This observational analytic study with a cross-sectional design was conducted at the Ophthalmology Clinic of Dr. M. Djamil General Hospital, Padang, Indonesia. The study recruited patients aged 18–40 years diagnosed with high myopia (SE defined as -6.00 Diopters or worse). Strict exclusion criteria were applied to eliminate confounding anterior segment pathologies. Ocular biometry was performed using the IOLMaster 700, which employs Swept-Source OCT technology for full-eye length tomography. We analyzed Axial Length (AL), Mean Keratometry (K), Central Corneal Thickness (CCT), and Anterior Chamber Depth (ACD). Statistical analysis utilized Pearson and Spearman correlation tests and linear regression modelling. Results: A total of 32 eyes from 32 high myopia patients were analyzed. The mean SE was -8.14 plus or minus 2.09 D, and the mean AL was 26.93 plus or minus 1.92 mm. We found a robust, statistically significant negative correlation between SE and AL (r = -0.86; p less than 0.001), confirming AL as the primary determinant of refractive severity. Notably, a moderate negative correlation was observed between AL and K (r = -0.41; p = 0.02), indicating a paradoxical corneal flattening in longer eyes. No significant correlations were found between SE and CCT or ACD. Conclusion: Axial elongation is the predominant structural mechanism driving high myopia in this cohort. The study identified a distinct compensatory response where the cornea flattens as the eye elongates; however, this emmetropization mechanism is insufficient to neutralize the profound refractive shift caused by posterior segment expansion. These findings suggest that high myopia is a disease of focal posterior scleral remodelling rather than global ocular expansion.

ABSTRACT Clinical relevance Systemic sclerosis can affect vision quality by causing fibrosis in the cornea and lens, as in all organs. Background The aim of this work is to evaluate corneal and lens densitometry alongside anterior segment parameters in patients with systemic sclerosis (SSc), and to assess whether subclinical structural changes are detectable using Scheimpflug-based imaging. Methods This prospective case-control study included 20 patients with SSc and 20 age- and sex-matched healthy controls. All participants underwent comprehensive ophthalmologic examination, including anterior segment imaging using the Pentacam HR system. Corneal and lens densitometry values were recorded in concentric zones and evaluated in the anterior, central, and posterior layers. Additional parameters such as central corneal thickness (CCT), anterior chamber (AC) depth, AC angle, and corneal volume were also assessed. Results No statistically significant differences were observed in anterior segment parameters (CCT, AC depth, AC angle, corneal volume) or lens densitometry values between SSc patients and controls (p > 0.05). However, significantly reduced corneal densitometry values were found in the anterior and central layers of the 0–2 mm and 2–6 mm zones in the SSc group (p < 0.05). No significant differences were noted in the posterior corneal layer across all zones. Conclusion Although anterior segment and lens parameters appeared unaffected, reduced corneal densitometry in the central optical zone suggests subtle stromal remodelling in patients with long-standing SSc. These microstructural changes may reflect chronic fibrotic remodelling and warrant further investigation.

To assess the outcomes of surgical management of aqueous misdirection (AM) by endoscopic pars plana vitrectomy with hyaloido-zonulo-iridectomy. In this prospective, longitudinal, noncomparative interventional study, 53 eyes from 46 patients with AM refractory to medical and laser therapy after intraocular surgery were enrolled. All eyes underwent lens removal (if phakic), endoscopic pars plana vitrectomy, and hyaloido-zonulo-iridectomy. Primary outcomes included intraocular pressure (IOP), best-corrected visual acuity (BCVA), anterior chamber depth (ACD), postoperative complications, relapse rate, and composite surgical success. Surgical success was defined as the combination of IOP control and anterior chamber reformation, using two alternative IOP thresholds ( ≥ 6 and ≤18 mmHg, or ≥6 and ≤21 mmHg). Continuous variables were analysed using linear mixed models and expressed as estimated means (est)± standard error. Mean age was 59.7 ± 12.2 years. The est. IOP decreased from 34.36 ± 0.82 mmHg to 17.47 ± 0.82 mmHg at 12 months (p < 0.001). The est. BCVA improved from 1.50 ± 0.07 to 0.70 ± 0.07 logMAR at 12 months (p < 0.001). The est. ACD increased from 0.70 ± 0.06 to 3.34 ± 0.06 mm (p < 0.001), with complete anterior chamber reformation in all eyes. Postoperative complications occurred in 22 eyes (41.8%), mostly transient and resolved with medical or YAG laser treatment; only one required glaucoma surgery. At 12 months, overall success was 98.1% using the ≤21 mmHg criterion and 75.5% using the ≤18 mmHg criterion. No relapses were observed. Surgical management using lens removal, endoscopic anterior vitrectomy, and hyaloido-zonulo-iridectomy is a significantly effective and safe treatment for AM.

to contextualize the prevalence of pseudoexfoliation syndrome (PEX) through a systematic literature review and to evaluate its epidemiology, ocular biometric features, and potential systemic associations in a hospital-based cohort of cataract patients from Southern Italy, with particular focus on the neutrophil-to-lymphocyte ratio (NLR) as a marker of systemic inflammation and surgical risk. this study consisted of two components. First, a systematic literature review was conducted according to PRISMA principles to summarize reported PEX prevalence across different populations and geographic regions. Second, a retrospective cross-sectional cohort study was performed including consecutive cataract patients evaluated at a tertiary referral center in Apulia (Italy) between January 2024 and September 2025. Demographic data, ocular biometry, corneal parameters, systemic comorbidities, and preoperative NLR values were collected. Eye-level outcomes were analyzed using linear mixed-effects models with patient-level random intercepts, adjusting for age, sex, and eye side. Associations between NLR, biometric parameters, and surgical complications were assessed using correlation analyses and non-parametric tests.In the absence of a pre-specified primary outcome, ACD was selected a posteriori as the primary biometric endpoint. the literature review confirmed marked heterogeneity in reported PEX prevalence worldwide, ranging from < 1% to > 30%, largely influenced by study design and population characteristics. In the cohort study, 99 of 3,736 cataract patients were diagnosed with PEX, yielding a prevalence of 2.65%. PEX patients were significantly older than non-PEX patients, with no sex predominance. After adjustment, PEX was not independently associated with axial length, anterior chamber depth, aqueous depth, lens thickness, central corneal thickness or endothelial cell density. NLR showed no significant correlation with ocular biometric parameters and did not differ between patients with and without intraoperative or postoperative complications. PEX was relatively uncommon in this Southern Italian cohort and primarily age-related. No association was found between PEX and standard biometric features or between systemic inflammation (NLR) and surgical risk. Larger, multicenter studies integrating genetic and inflammatory markers are warranted to further elucidate PEX pathogenesis.

Impact of preoperative ocular biometry and capsulorhexis morphology on the rotational stability of a toric intraocular lens.

The United States (U.S.) Military has been performing laser refractive surgery to enhance combat readiness, operational capability, and the quality of life for service members since fiscal year 2000. The latest laser refractive surgery adopted by the U.S. Military is small-incision lenticule extraction (SMILE) (Carl Zeiss Meditec AG, Jena, Germany), a type of keratorefractive lenticule extraction (KLEx). However, a limited number of studies have been conducted to determine whether varying levels of altitude have any effect on vision following the procedure. The purpose of this study was to evaluate the effect of decreased barometric pressure and atmospheric oxygen tension (simulated increased altitude up to 22,500 ft) on refractive stability in patients who have undergone bilateral SMILE. Study subjects included active duty military personnel who had undergone bilateral SMILE using the VisuMax femtosecond laser (Carl Zeiss Meditec AG) for the correction of myopia. After being cleared to participate in the study by a military flight medicine physician, each participant underwent altitude chamber training. Uncorrected visual acuity (UCVA), 5% low contrast (LC) UCVA, refractive error, corneal thickness, and anterior chamber volume and depth were each measured at ground level, 10,000 ft, 15,000 ft, 18,000 ft, and 22,500 ft simulated altitude in a hypobaric chamber. Mixed-effects linear regression models were used to evaluate the statistical significance of changes in individual outcome measures across different altitudes. Data from 34 eyes (17 participants) was collected during the study. A statistically significant increase was found in UCVA (-0.04 ± 0.01 LogMAR; P < .001) and LC UCVA (-0.05 ± 0.01 LogMAR; P < .001) as simulated altitude increased from ground level to 22,500 ft. A myopic shift (-0.14 ± 0.05 D; P = .050) was observed at 22,500 ft, as well as decreases in corneal thickness at central (-3.94 ± 0.83 µm; P < .001) and thinnest point (-3.65 ± 0.90 µm; P < .001). There were no statistically significant changes in mean keratometry, anterior chamber volume, or anterior chamber depth. The current study suggests that while high altitude may influence certain aspects of visual performance and corneal properties, overall visual acuity and anterior segment parameters remain stable in military personnel who underwent SMILE.

Purpose Investigate how orbital tissue mechanics, specifically stiffness and damping, influence intraocular pressure (IOP)–induced deformation and the resulting optical behavior of the human eye using a finite element (FE) framework. Methods A three-dimensional FE model of the entire eye was constructed, including corneal, scleral, and lens tissues with hyperelastic and elastic constitutive laws. The surrounding orbital support was represented by three boundary conditions: rigid, elastic (spring), and viscoelastic (spring-dashpot) to characterize different levels of orbital compliance. Unlike previous models, this approach explicitly accounts for orbital stiffness and damping to quantify their effects on ocular globe translation and deformation patterns. Simulations were performed at physiological IOP levels (6.5–26 mmHg), and the resulting variations in corneal curvature, anterior chamber depth, lens position, and optical focus were evaluated. Results The viscoelastic boundary condition significantly modulated IOP-induced eye globe displacement and deformation, producing slightly larger translations and smoothing stress concentrations compared to fixed constraints, indicating its crucial role in biomechanical realism. The changes in the distribution of the scleral strain were clear. Crucially, the resulting optical defocus across the physiological IOP range remained below the clinically non-significant threshold. Conclusions Integrating viscoelastic orbital boundaries demonstrates that the stiffness and damping effects of the orbital fat layer significantly modulate IOP-induced ocular deformation and optical geometry. Furthermore, the findings confirm that moderate pressure variations within the physiological range do not compromise visual performance. These results underscore the critical importance of incorporating extraocular tissue mechanics for accurate personalized tonometry calibration and risk assessment.

Phacoemulsification is the most commonly performed cataract surgery worldwide, and preoperative evaluation plays a critical role in optimizing surgical outcomes. Regional data describing preoperative characteristics and coexisting ocular diseases remain essential for improving clinical decision-making and planning individualized management strategies. This study aims to describe the preoperative clinical profile, biometric characteristics, and coexisting ocular diseases among cataract patients undergoing phacoemulsification at Utama Eye Clinic, Gresik. This descriptive cross-sectional study utilized secondary data from medical records of patients who underwent preoperative assessment between October and November 2025. Variables included demographic characteristics, blood pressure, random blood glucose (RBG), visual acuity, intraocular pressure (IOP), biometric parameters, operative duration, and ocular comorbidities. Data were analyzed using univariate descriptive statistics. A total of 246 patients were included. Most patients were aged 60-69 years (45.5%) and female (52.8%). Visual acuity &lt;6/60–light perception (LP) was the most common preoperative category (69.1%). Hypertension (57.7%) was more frequent than normotension. The majority of patients had normal RBG values (91.5%) and normal IOP (96.7%). Median biometric measurements were: anterior chamber depth 3.18 mm, lens thickness 4.50 mm, and IOL power 20.00 D. Median operative duration was 11 minutes (range 5–69 minutes). The most common coexisting ocular diseases were posterior capsular fibrosis (PCO) (n=11), high myopia (n=5), glaucoma (n=3), and pseudoexfoliation syndrome (n=3). The study reveals that most patients presented at an advanced age with significant visual impairment and a high prevalence of systemic and ocular comorbidities. Accurate biometric assessment and comprehensive preoperative evaluation, including identification of ocular comorbidities, are essential for optimizing cataract surgical planning and outcomes. These findings provide updated regional data that may support improvements in preoperative screening protocols.

This study aims to assess the agreement between the Pentacam AXL and IOL Master 500 in measuring biometric components and intraocular lens (IOL) power in patients with keratoconus (KCN). In this cross-sectional study, individuals aged over 60 years were randomly selected from 22 districts in Tehran. Inclusion criteria were individuals over 60 years of age, the absence of ocular pathologies aside from KCN and cataracts, no prior ocular surgeries, and no systemic diseases. Optical biometry was conducted for each eye utilizing both the Pentacam AXL and IOL Master 500 devices, with IOL power determined through six formulas: Kane keratoconus, Barret universal 2, Holladay 1, Haigis, Hoffer Q, and SRK/T, based on the biometric data acquired from each device. The agreement between the biometric measurements from the two devices and the calculated IOL powers was analyzed using the Bland-Altman method. A total of 121 eyes from 121 patients with keratoconus were examined in this study. Among these participants, 76 (62.8%) were female. The average age of the individuals was 67.66 ± 6.47 years. The 95% limits of agreement for axial length measurements, as well as K1, K2, ACD, and WTW, between the IOL Master 500 and the Pentacam AXL were recorded as -0.08 to 0.02, -1.28 to 0.79, -1.83 to 1.06, -0.16 to 0.34, and − 0.96 to 0.13, respectively. Among the six formulas utilized for calculating IOL power, a significant difference was observed between the two devices, with the Pentacam AXL consistently yielding higher power values. The most pronounced difference was noted with the Hoffer Q formula, which showed a variation of + 0.55 ± 0.92, whereas the Holladay 1 formula exhibited the least difference at + 0.34 ± 1.98. The 95% limits of agreement for IOL power calculations between the two devices, based on the Kane keratoconus, SRK/T, Hoffer Q, Barrett Universal 2, Holladay 1, and Haigis formulas, were recorded as -1.14 to 2.00, -1.16 to 2.00, -1.25 to 2.37, -1.06 to 2.12, -1.20 to 2.21, and -1.01 to 2.23 respectively. The Pentacam AXL and IOL Master 500 demonstrate a good agreement in their axial length measurements. Nonetheless, discrepancies in keratometry, anterior chamber depth, and white-to-white measurements between the two devices result in variations in IOL power calculations. Additionally, the choice of formula utilized for these calculations further influences the determined power, with values obtained from the Pentacam AXL in conjunction with the Kane keratoconus formula yielding higher power estimates.

Background and Objectives: Keratoconus is a bilateral but often asymmetric ectatic corneal disease characterized by progressive thinning, increased curvature, and conical shape of the cornea. Previous studies have reported that the use of swimming goggles in patients with keratoconus can lead to increased intraocular pressure (IOP) and a transient reduction in anterior chamber volume (ACV), potentially affecting anterior segment morphology. This study aimed to evaluate the short-term effects of periorbital pressure induced by swimming goggles on corneal parameters in keratoconic eyes. Materials and Methods: A total of 44 eyes of 44 patients (mean age: 26.1 ± 5.1 years) diagnosed with keratoconus Stage 1–4 according to the Amsler–Krumeich classification were included. Measurements were taken using a Pentacam® Scheimpflug camera before swimming goggle application and immediately after 20 min of wear. The parameters assessed included keratometry values (K1, K2, Km, Kmax), central and thinnest corneal thickness, corneal volume within the 10 mm zone (CV10), ACV, anterior chamber depth (ACD), iridocorneal angle (ICA), and pupil diameter (PD). Results: No statistically significant changes were observed in keratometric values, central and thinnest corneal thickness, ACV, ACD, ICA, PD, or IOP (all p > 0.05). CV10 showed a small reduction following goggle wear (Δ = −0.18 mm3, corresponding to a 0.3% decrease), which was statistically significant in the unadjusted analysis (p = 0.008) but did not remain significant after correction for multiple comparisons (p for false discovery rate [FDR] = 0.10). Conclusions: Short-term swimming goggle use may induce subtle reductions in CV10 in keratoconic eyes, suggesting a potential biomechanical sensitivity to transient periocular pressure. Although the observed change in CV10 did not retain statistical significance after multiple-comparison correction, it may reflect an early physiological response in structurally compromised corneas. CV measurements could serve as exploratory indicators of mechanical responsiveness in keratoconus, warranting further investigation in larger controlled studies.

BackgroundCorneal astigmatism is a major determinant of visual outcomes after cataract surgery, and its accurate preoperative characterization is essential for surgical planning and toric intraocular lens (IOL) selection. Data from Southern European populations remain limited.MethodsWe conducted a retrospective cohort study including 600 eyes from 306 consecutive cataract patients aged ≥ 40 years undergoing preoperative biometry at a tertiary university hospital in Southern Italy. Axial length (AL), anterior chamber depth (ACD), keratometric power (K), and corneal astigmatism (CA) were measured using partial coherence interferometry.ResultsThe mean patient age was 72.5 ± 8.5 years. The mean AL, ACD, and average K were 23.5 ± 1.6 mm, 3.1 ± 0.5 mm, and 43.9 ± 1.5 D, respectively. The mean CA was 1.02 ± 0.76 D. Notably, 39.8% of eyes had CA ≥ 1.0 D and 9.3% had CA ≥ 2.0 D. Eyes with AL > 26 mm accounted for 7.1% of the cohort.ConclusionA substantial proportion of cataract patients in Southern Italy present with clinically significant corneal astigmatism, highlighting the importance of systematic preoperative screening. These findings support the routine consideration of toric IOLs to optimize refractive outcomes and meet the rising expectations of cataract surgery patients.

Background/Objectives: Surgery performed in the steep Trendelenburg position is considered potentially detrimental to ocular structures. This study aimed to evaluate morphological changes in the anterior segment during robot-assisted laparoscopic prostatectomy (RALP). Methods: This was a single-center, prospective observational study involving 60 eyes of 30 consecutive patients undergoing RALP between May and November 2021. Anterior segment images were obtained using a Smart Eye Camera before surgery (supine and awake), during surgery (supine and steep Trendelenburg under anesthesia), and after surgery (supine). Assessed parameters included the iridocorneal angle, the ratio of peripheral anterior chamber depth to peripheral corneal thickness based on Van Herick Plus grading, and pupil diameter. Each parameter in the steep Trendelenburg position under anesthesia was compared with measurements obtained in the supine position under anesthesia and in the awake condition. The primary outcome was the comparison of anterior segment morphological changes between the supine and steep Trendelenburg positions during RALP. Results: Upon transition to the steep Trendelenburg position, anterior chamber depth significantly decreased (p < 0.001), recovering after returning to the supine position. The proportion of eyes classified as having narrowed anterior chambers increased significantly (p < 0.001), with more than 60% showing shallower chambers relative to preoperative measurements. Extreme anterior chamber narrowing occurred in 3 out of 410 intraoperative assessments (1%). Pupils were uniformly constricted under anesthesia. Conclusions: Steep Trendelenburg positioning significantly reduces anterior chamber depth. This morphological alteration may contribute to the marked increase in intraocular pressure observed during RALP.

To compare healthy eyes to the fellow eyes of acute primary angle closure (F-APAC), healthy eyes to the fellow eyes of chronic primary angle closure glaucoma (F-CPACG), and these fellow eyes to each other (F-APAC vs. F-CPACG). This study included patients with PACG (72 eyes) and healthy individuals(22 eyes). Parameters were measured on ultrasound biomicroscopy images, including anterior chamber depth (ACD), anterior chamber width (ACW), anterior chamber area (ACA), lens vault (LV), relative position lens vault (RPLV), anterior segment depth (ASD), angle opening distance at 500μm (AOD500), trabecular iris space area at 500μm (TISA 500), trabecular iris angle at 500μm (TIA500), iris thickness at 500μm (IT500), peripheral iris thickness maximum (PITMAX), iris curvature (IC). Multivariate logistic regression analysis was performed to determine the most important parameters associated with F-APAC compared with F-CPACG. In total, 94 eyes of 94 patients were included. The ACD(P < 0.001), ACW(P < 0.018), ACA(P < 0.001), ASD(P = 0.006), AOD500(P < 0.001), TIA500(P < 0.001) and TISA500(P < 0.001) of the F-APAC were smaller than the healthy, and LV(P < 0.001), RPLV(P < 0.001), IC(P < 0.001) were larger than that. The ACD(P < 0.001), ACA(P < 0.001), ASD(P < 0.001), AOD500(P < 0.001), TISA500(P < 0.001) and TIA500(P < 0.001) of the F-CPACG were smaller than the healthy, and the LV(P < 0.001), RPLV(P < 0.001), PITMAX(P = 0.030), IC(P < 0.001) were larger than that. The LV(P = 0.027), AOD500(P = 0.013), TISA500(P = 0.03), TIA500(P = 0.006), IC(P = 0.48) of F-APAC were larger than F-CPACG, and PITMAX (P = 0.037) was smaller than F-CPACG. Multivariate logistic regression showed that only larger LV was significantly associated with APAC(P = 0.017). LV (AUC, 0.643) performed relatively in distinguishing the F-APAC and the F-CPACG. Anterior shift of the lens and iris bombe promoted the occurrence of APAC, thickening of the peripheral iris played vital roles in CPACG. Additionally, the LV was an important parameter to distinguish APAC or CPACG.

PurposeThis study aimed to examine the relationship between axial length (AL) and anterior segment biometry in Chinese children and adolescents with high axial myopia.MethodsA cross-sectional study was conducted involving 366,278 Chinese students aged 7 to 18 years from January 2020 to December 2022. The SUOER μ-Meter optical biometric was used for measuring ocular biometric parameters. A multivariate linear regression model was used to examine the correlation with AL.ResultsAmong the participants, 28,877 exhibited high axial myopia (AL ≥ 26 mm). The average keratometry (K) and lens thickness (LT) in the high axial myopia group were significantly lower than those in both the non-myopia and normal myopia groups (all p < 0.001). Central corneal thickness (CCT) and anterior chamber depth (ACD) were significantly greater in the high axial myopia group compared to both non-myopia and normal myopia groups (all p < 0.001). Multivariate linear regression analysis demonstrated that K (β = −0.265), CCT (β = 0.001), ACD (β = 1.609), and LT (β = −0.607) were all correlated with AL (all p < 0.001). After adjusting for gender and age, when AL was <27 mm, AL was negatively correlated with LT; similarly, when AL exceeded 27 mm, there was no linear correlation between AL and LT (p > 0.05).ConclusionIn Chinese children and adolescents, a high AL (i.e., ≥26 mm) was associated with significantly lower K, thicker CCT, and deeper ACD, and thinner LT compared with subjects having AL < 26 mm. When AL was <27 mm, LT thinning may contribute to myopia compensation; however, when AL exceeds 27 mm, this compensatory effect of crystalline lens thickness appears to diminish.

Purpose: To identify independent risk factors associated with significant postoperative rotation (≥10°) of plate-haptic toric intraocular lenses (IOLs) and to develop and externally validate a predictive nomogram. Two independent eye centers in China. A prospective observational study with a training cohort and an external validation cohort. A total of 805 eyes from 805 cataract patients with regular corneal astigmatism (≥0.75 D) who underwent phacoemulsification and plate-haptic toric IOL implantation between August 2021 and December 2024 were included. Patients from one center formed the training cohort, while patients from the second center served as the external validation cohort.LASSO regression followed by multivariable logistic regression was used to identify predictors of significant toric IOL rotation (≥10° at 2 weeks postoperatively). A predictive nomogram was developed and validated through receiver operating characteristic (ROC) analysis, calibration curve, and decision curve analysis (DCA). Age (OR = 1.04, p = 0.002), anterior chamber depth (ACD) (OR = 7.71, p < 0.001), lens thickness (LT) (OR = 5.13, p < 0.001) and white-to-white (WTW) (OR = 2.36, p = 0.002) were identified as independent predictors. The nomogram demonstrated good discriminative performance with an AUC of 0.809 in the training cohort and 0.848 in the Validation cohort. Calibration and DCA analyses confirmed the accuracy and clinical utility of the model. A validated nomogram based on age, ACD, LT and WTW provides a useful tool for individualized preoperative risk assessment of significant toric IOL rotation, aiding surgical decision-making.

Background/Objectives: Hemodialysis (HD) is the commonest life sustaining form of kidney replacement therapy in the world; however, this method of treatment have many adverse effects, and even a single HD session affects many organs, including the eyes. The aim of this study was to assess the effect of a single HD session on the ophthalmologic findings in patients with End-stage Renal Disease (ESRD). The second aim of the study was to examine the correlation of these changes with each other and between changes in systemic stressors related to the HD session. Methods: This was a single-center cross-sectional observational study conducted on 32 patients undergoing HD. Selected parameters of the anterior and posterior segment of the eye as well as systemic parameters were assessed before and after a single HD session. Results: Best corrected visual acuity (BCVA) improved, and lens thickness (LT), axial length (AXL), average macular thickness (MT), central MT and total vessel density (VD) of the deep capillary plexus DCP increased significantly after a single HD session. The Schirmer test results, tear break up time (TBUT), anterior chamber depth (ACD), central and average choroidal thickness (CT) decreased significantly after HD. Body weight loss was the only significant systemic change. Decrease in TBUT correlated positively with Schirmer's test results decrease. Increase in CCT correlated positively with AXL increase. Decrease in central and average CT correlated positively with IOP decrease. Increase in central MT correlated positively with increase in average MT. Decrease in central CT correlated positively with average CT decrease. Change in VD of the SCP correlated positively with change in VD of DCP. Apart from the positive correlation between SBP change and Schirmer's test results change, there were no correlations between systemic and ophthalmic parameters changes. Conclusions: Our study showed that HD affected the parameters of the anterior and posterior segments of the eye. Numerous correlations between these changes suggest that they are interrelated and represent the complex response of the eye to the HD process.

Diagnostic test accuracy of CT for open globe injury: A systematic review and meta-analysis of overall impression and individual imaging signs.

To investigate the correlation between anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV), and IOP with white-to-white (WTW) corneal diameter in myopic eyes. This prospective study conducted at Qassim University, included 163 myopic eyes. Refraction was measured using an autorefractometer, axial length (AL) using IOL Master, and anterior chamber parameters, WTW corneal diameter, and central corneal thickness (CCT) using Pentacam. IOP was assessed with a non-contact tonometer. Correlation analysis was used to assess associations between measured parameters and WTW corneal diameter. For myopic eyes (spherical equivalent: -3.90 ± 1.75 D), mean ocular parameters were: ACD 3.18 ± 0.23mm, ACA 40.02 ± 3.75°, ACV 194.19 ± 18.75mm³, IOP 18.9 ± 2.90 mmHg, and WTW 12.06 ± 0.38mm. Bivariate analysis showed WTW corneal diameter positively correlated with ACD, ACV, ACA, AL, CCT, and IOP (P < 0.001). Multiple regression revealed age, myopia severity, AL, and CCT explained 43.6% of WTW variance, 32.7% in ACD, 26.7% in ACA, 23.0% in ACV, and 47.1% in IOP. Age was positively associated with WTW, ACA, and ACV (P < 0.001). Myopia severity was negatively associated with ACA and positively with ACV (P < 0.05). AL correlated positively with WTW, ACD, ACA, and IOP (P < 0.05), while CCT was significantly associated with most parameters (P < 0.05). Larger WTW corneal diameter predicts deeper anterior chamber and higher IOP in myopic eyes. High myopia shows posterior eye segment expansion with limited anterior growth, and an age-related changes indicate structural remodeling during ongoing myopia progression differs from classical physiological patterns. These findings underscore the importance of WTW corneal diameter as a significant predictor of ocular biometry and refractive development, particularly in young populations with progressing myopia.

The global pandemic of coronavirus disease 2019 (COVID-19) has been associated with diverse ocular manifestations, yet its potential link with acute primary angle closure (APAC) remains poorly characterized, particularly during the Omicron variant wave. The aim of the present study was to explore the clinical characteristics of APAC following COVID-19 infection during the Omicron epidemic period in China. A retrospective comparison was conducted between patients with APAC who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ribonucleic acid within 15 days before APAC onset (post-COVID-19 group; December 2022 to January 2023), and patients with APAC from the same seasonal period before the pandemic (pre-pandemic group; December 2018 to January 2019). The pre-pandemic group comprised 50 eyes of 48 patients, and the post-COVID-19 group comprised 86 eyes of 78 patients. Demographic, clinical and treatment data were compared between the two groups. The post-COVID-19 group exhibited a significantly deeper anterior chamber depth (ACD) and thinner lens. The post-COVID-19 group also exhibited more extensive angle closure with less frequent ciliary body detachment and a lower proportion of patients treated with glucocorticoid eyedrops. Although patients in the post-COVID-19 group presented with a greater ACD than those in the pre-pandemic group, the ACDs of both groups were within the clinically shallow range. This suggests a potential pathophysiological mechanism involving anterior chamber angle obstruction and inflammation, possibly triggered by SARS-CoV-2 infection, rather than pure pupillary block. Therefore, it is recommended that ophthalmologists should be vigilant for APAC in patients post-infection with COVID-19, even in those with only moderately shallow anterior chambers.