Surgical outcomes of a novel non-diffractive, extended depth-of-focus intraocular lens - preliminary results from a phase 4 study.

To quantify serial central subfield thickness (CSFT) changes after slow-coagulation transscleral cyclophotocoagulation (SC-TSCPC) for glaucoma, estimate the incidence of OCT-confirmed cystoid macular edema (CME), and explore baseline factors associated with CME, including diabetes and prior diabetic macular edema. Retrospective cohort of 31 eyes undergoing SC-TSCPC for glaucoma with OCT imaging preoperatively and postoperatively at 1, 3, 6, 9, and 12 months and at last follow-up (range 9-30 months). OCT-confirmed CME was defined as cystoid intraretinal changes on OCT; increased CSFT alone was not classified as CME. Changes over time were assessed with non-parametric repeated-measures testing, and subgroup comparisons were exploratory and univariate because of the small sample size. Mean baseline CSFT was 279 ± 25um and peaked at 355 ± 153um at 1month, then declined to 293 ± 25um at 12months (p < 0.001 across visits). Mean CSFT at last follow-up remained higher than baseline (294 ± 25 vs. 279 ± 25um; p < 0.001). OCT-confirmed CME developed in 8/31 eyes (25.8%), first detected at 1-6months (mean 2.1 ± 1.8). Eyes that developed OCT-confirmed CME had higher preoperative CSFT than eyes without CME (311 ± 21 vs. 267 ± 15um; p < 0.001). In exploratory univariate analyses, OCT-confirmed CME occurred more frequently in eyes with diabetes mellitus (p = 0.031) and prior diabetic macular edema (p < 0.001). Mean intraocular pressure decreased from 36.1 ± 9.0 to 15.2 ± 3.6mmHg at 12months (p < 0.001). Mean corrected distance visual acuity (CDVA) changed from 0.90 ± 0.90 logMAR preoperatively to 1.02 ± 0.85 logMAR at last follow-up (p = 0.004), and CDVA at last follow-up did not differ between eyes with and without OCT-confirmed CME (p = 0.992). SC-TSCPC was associated with a transient postoperative increase in CSFT and a clinically relevant incidence of OCT-confirmed CME. In this small retrospective cohort, higher preoperative CSFT and diabetes-related retinal disease identified a subgroup with greater observed CME frequency, but these findings should be interpreted as exploratory associations rather than independent risk factors. Postoperative OCT surveillance may help identify early anatomic edema, particularly in higher-risk eyes.

This study aimed to evaluate functional, anatomical, and safety outcomes after switching from aflibercept 2mg to aflibercept 8mg in patients with neovascular age-related macular degeneration (nAMD) requiring short re-treatment intervals in a real-world setting. This single-center prospective observational study included patients with nAMD insufficiently responsive to prior anti-vascular endothelial growth factor (anti-VEGF) therapy requiring re-treatment every 4-6weeks. All eyes had received four consecutive intravitreal injections of aflibercept 2mg prior to switching to aflibercept 8mg as part of routine clinical management. Functional outcome was assessed by distance-corrected visual acuity (DCVA). Anatomical outcomes included central retinal thickness (CRT), central subfield thickness (CST), and optical coherence tomography (OCT) features. Injection burden, responder status, discontinuation, and safety outcomes were evaluated. Follow-up occurred at 3, 6, 9, and 12months. Fifty patients (50 eyes) were included (mean age 78.4 ± 6.9years; 60% female). Median baseline DCVA was 0.19logMAR (IQR 0.12-0.32; 75.5 ETDRS letters), median CST 272µm, and median CRT 338µm. DCVA improved significantly at months3, 6, and 9 (p ≤ 0.046) and remained stable at month12. CRT and CST decreased early and remained improved. Over 12months, 24 patients (48%) completed follow-up, while 26 (52%) discontinued early. Intraocular inflammation (IOI) occurred in 10 eyes (20%), corresponding to 3.0% per injection, and was temporally associated with off-label aliquoted preparation; all cases resolved without permanent visual loss. No further IOI events were observed after transition to on-label preparation. During safety evaluation, seven patients discontinued aflibercept 8mg as a result of precautionary safety measures. Seventeen (34%) required ≤ 8 injections per year. In chronically treated patients with nAMD requiring short re-treatment intervals, switching to aflibercept 8mg was associated with modest anatomical improvement and stable visual function. A reduction in treatment burden was observed in a subset of patients, although overall durability remained heterogeneous and discontinuation rates were high. A cluster of sterile inflammatory events occurred during off-label aliquoted preparation, highlighting the importance of appropriate drug handling. Careful patient selection and strict adherence to on-label preparation procedures are essential to optimize safety. These findings should be interpreted cautiously given the exploratory design, lack of a comparator group, and high discontinuation rate. ClinicalTrials.gov identifier NCT07390253.

To investigate the changes in choroidal optical coherence tomography (OCT) radiomic features, their correlations with visual acuity and utility in identifying pathological myopia (PM). A total of 288 myopic participants aged 18-50 years were included. Choroidal radiomic features were extracted and screened from OCT images via PyRadiomics and machine learning. Selected features were analysed for their associations with axial length, spherical equivalent, age and best corrected visual acuity (BCVA). Classification models were built using these features and their performance to identify PM was evaluated and compared with clinical parameters through five-fold cross-validation using metrics including area under the curve (AUC), accuracy, recall and F1 score. A total of 464 radiomic features were extracted and four choroidal intensity and shape features significantly correlated with axial length (p<0.001) were selected. Smaller maximum diameter, higher coarseness and greater perimeter surface ratio were significantly associated with worse BCVA (p<0.05). Radiomic features showed better performance than clinical features in both the internal test set (AUC=0.970 vs 0.938) and external validation set (AUC=0.858 vs 0.753) in identifying PM. Combining radiomic features with risk factors improved classification performance (AUC=0.990 internally and 0.892 externally). Among the included factors, intensity feature was most predictive for PM. OCT-based choroidal intensity and shape features were significantly correlated with axial elongation and visual impairment and outperformed clinical parameters in identifying PM. These features could serve as reliable biomarkers for monitoring high myopia progression.

PurposeTo evaluate the short-term efficacy and optical performance of the ZEISS CT LUCIA 621P intraocular lens (IOL) in cataract patients using a diopter (D)-stratified approach.Patients and MethodsThis retrospective study included 304 eyes of 216 patients who underwent phacoemulsification with CT LUCIA 621P implantation. Eyes were stratified into four groups by implanted IOL power: Group 1 (<20.0 D, n=49), Group 2 (20.0–21.5 D, n=137), Group 3 (22.0–23.5 D, n=60), and Group 4 (≥24.0 D, n=58). Primary outcomes were monocular and binocular photopic/mesopic defocus curves and internal higher-order aberrations (HOAs) at 1 and 3 months because these directly evaluate the optical quality and depth of focus delivered by the non-constant aspheric ZEISS Optic design—the core innovative feature of the CT LUCIA 621P IOL—across the full spectrum of implanted powers. Secondary outcomes provide complementary clinical efficacy data; uncorrected and corrected distance visual acuity (UDVA/CDVA), uncorrected intermediate (UIVA) and near (UNVA), refractive predictability, and contrast sensitivity (CS). Analyses used generalized estimating equations (GEE) with an exchangeable correlation structure.ResultsAll groups achieved excellent refractive predictability with convergence of spherical equivalent (SE) toward emmetropia (p=0.398). Mean monocular UDVA at 3 months was comparable across groups (p=0.498). Monocular and binocular UIVA and UNVA were also comparable (all p>0.23). Photopic and mesopic defocus curves showed similar depth of focus across groups (p>0.05 at most levels). Postoperative spherical aberration (SA) and coma remained low with no significant inter-group differences after generalized GEE adjustment (p>0.17). Photopic CS was comparable across IOL power groups at most spatial frequencies.ConclusionThe CT LUCIA 621P IOL demonstrated consistent refractive predictability, VA across distances, and optical quality across a wide range of implanted powers, supporting its reliable use in contemporary cataract surgery.

To evaluate the long-term safety, stability, and visual outcomes of diagonal haptic capture (DHC) of a 4-haptic hydrophilic acrylic intraocular lens (Akreos adapt, Bausch&Lomb) in eyes with posterior capsule deficiency and an intact anterior capsulorhexis. Single tertiary referral center. Retrospective interventional case series. Medical records were reviewed for patients who underwent cataract surgery complicated by posterior capsule rupture and in whom DHC was used for IOL fixation between 2015 and 2023. Twenty eyes of 20 patients were identified. Fellow eyes with uneventful in-the-bag implantation of the same IOL model served as controls. Median follow-up was 2 years (mean 2.6±2.1 years; range 0-6 years) based on data from referring ophthalmologists, and 8 years (mean 6.0±2.8 years; range 2-9 years) for patients examined at the study center. Mean postoperative corrected distance visual acuity did not differ significantly between DHC eyes and fellow eyes (p>0.4). Refractive predictability and intraocular pressure were comparable between groups. All IOLs remained well centered with normal tilt throughout follow-up. No cases of pigment dispersion glaucoma, uveitis-glaucoma-hyphema syndrome, pseudophacodonesis, or late IOL dislocation were observed. In a subset of eyes, anterior segment optical coherence tomography demonstrated adequate clearance between the IOL and posterior iris without evidence of iris chafing. Diagonal haptic capture of a 4-haptic hydrophilic acrylic IOL provided stable long-term fixation, satisfactory visual and refractive outcomes, and a low incidence of complications. However, these results may be IOL-specific.

To compare Optical Coherence Tomography Angiography (OCTA) biomarkers in epiretinal membrane (ERM) eyes and normal eyes, to investigate the association of each biomarker with best corrected visual acuity (BCVA), and to identify their optimal cut-off values for various best correct visual acuity in ERM eyes. A cross-sectional observational population study of the right eye of 6011 participants aged above 50 was performed. Central subfield thickness (CST_A), foveal avascular zone (FAZ_A), mean vessel density (mVD_full) and mean capillary perfusion density(mCPD_full) were measured by OCTA. Welch's T-test was used to compare different mean values of parameters between normal eye and epiretinal membrane eyes. Multivariable linear regression test was used to assess the correlation between BCVA LogMAR and OCTA parameters. The cut-off values of biomarkers for best corrected visual acuity (BCVA LogMAR ≥ 0.18 / 0.3) in epiretinal membrane eyes were determined using receiver operating characteristic (ROC) and Area under curve (AUC) analysis. ERM eyes had a significantly higher CST_A than normal eyes (Normal: 249.437 (95% CI 248.845 to 250.029) vs. ERM: 308.202 (95% CI 299.915 to 316.489) P < 0.001) A smaller FAZ_A was found in ERM eyes than normal eyes (Normal: 0.269 (95%CI 0.266 to 0.273) vs. ERM: 0.225 (95%CI 0.202 to 0.248) P < 0.001). Both mVD_full and mCPD_full were lower in ERM eyes when compared with normal eyes (mVD_full Normal: 16.397 (95% CI 16.343 to 16.451) vs. ERM 15.610 (95% CI 15.372 to 16.048) (P < 0.001)) (mCPD Normal: 0.399 (95% CI 0.397 to 0.400) ERM: 0.381 (95% CI 0.373 to 0.390) (P < 0.001)). Among CST_A, FAZ_A, mVD_full and mCPD_full, only CST_A was found to be significantly associated with best corrected visual acuity (BCVA). Better visual outcome is associated with smaller CST_A (beta* =0.265). CST_A was found to have an acceptable AUC value for BCVA LogMar ≥ 0.3 in epiretinal membrane eyes (AUC value = 0.708). The AUROC values of other biomarkers were less than 0.7 in predicting BCVA in epiretinal membrane eyes. CST_A was found to be thicker in ERM eyes while mVD_full, mCPD_full and FAZ_A were lower in ERM eyes than normal eyes. CST_A was found to be significantly associated with BCVA in ERM eyes. The cut off value of CST_A was found to be 345.5, with an acceptable AUC value for discriminating BCVA LogMAR ≥ 0.3 in epiretinal membrane eyes.

Have Deprivation Amblyopia Outcomes Improved for Infants with Unilateral Cataracts?

We retrospectively evaluated the long-term surgical outcomes of congenital cataract in eyes with microcornea, including both aphakic and pseudophakic eyes. A total of 43 eyes from 25 patients who underwent cataract surgery within the first 12 months of life (mean age at surgery: 3.3 ± 2.4 months) were analyzed, with a mean follow-up period of 13.7 ± 2.4 years (range: 10-18 years). The mean corneal diameter was 8.8 ± 0.8mm. The cohort included 14 cases with bilateral aphakia, 4 cases with bilateral pseudophakia, 4 cases with unilateral aphakia, and 3 cases with unilateral pseudophakia. The mean corrected distance visual acuity (CDVA) at the final visit was 0.543 ± 0.709 logMAR. CDVA of 20/40 or better was achieved in 39% of bilateral aphakic eyes, 88% of bilateral pseudophakic eyes, 50% of unilateral aphakic eyes, and 33% of unilateral pseudophakic eyes. The bilateral pseudophakia group demonstrated significantly better CDVA compared to the bilateral aphakia group (p = 0.010). Secondary glaucoma developed in 18.8% of aphakic eyes and 0% of pseudophakic eyes (p = 0.149). Visual axis opacification occurred in 12.5% of aphakic eyes and 54.5% of pseudophakic eyes (p = 0.010). Surgical treatment of congenital cataract in eyes with microcornea resulted in satisfactory long-term outcomes. Secondary glaucoma in aphakic eyes and visual axis opacification in pseudophakic eyes remain important considerations in long-term management.

To compare clinical outcomes of implantable collamer lens (ICL) combined with femtosecond laser-assisted arcuate keratotomy (FSAK) and toric implantable collamer lens (TICL) for high myopia with moderate-to-low astigmatism corrections. In this single-center, non-randomized, parallel-group study, patients with high myopia and moderate-to-low astigmatism (0.75D ~ 2.00D) received either ICL+FSAK or TICL treatment and underwent a 3-month postoperative follow-up. We compared the efficacy, safety, predictability, and stability between the two groups, along with outcomes including vector analysis of astigmatism, intraocular pressure (IOP), corneal endothelial cell density (ECD), vault, modulation transfer function (MTF) cutoff, Strehl ratio (SR), and objective scatter index (OSI). At three months postoperatively, median manifest astigmatism in ICL+FSAK group was - 0.25 diopter (D), similar to that in TICL group was - 0.25D (P = 0.774). At all timepoints, two groups were comparable in terms of uncorrected distance visual acuity, corrected distance visual acuity, manifest spherical equivalent, manifest astigmatism, efficacy index, safety index. At 1day, 1 month, and 3 months postoperatively, median surgically induced astigmatism in ICL+FSAK group were 0.74 D, 0.79 D, and 0.82 D, smaller than those in TICL group (0.86 D, 0.99 D, and 1.01 D) (P < 0.05). Similarly, median correction index postoperatively were 0.69 and 0.75 in ICL+FSAK group, smaller than those in TICL group (0.82 and 0.84) at 1 month and 3 months (P < 0.05). At all timepoints, no significant differences in difference vector or absolute value of angle error occurred between two groups.Similar results also occurred in IOP, ECD, vault, MTF cutoff, SR, and OSI. TICL resulted in higher SIA and CI compared to FSAK, but there was no significant difference in postoperative manifest astigmatism. Therefore, both methods are excellent choices for high myopia with moderate-to-low astigmatism. ChiCTR2400092267. The registration date is November 13, 2024. Chinese Clinical Trial Registry.

To assess the performance of GPT-5 in refractive surgery planning by comparing its recommendations with expert surgeons and reporting visual outcomes of surgeon-planned Smooth Incision Lenticule Keratomileusis (SILK) procedures. This retrospective, observational study included 134 eyes from 67 patients who underwent SILK procedure using the ELITA femtosecond laser platform from January 2024 to September 2025. GPT-5 generated refractive plans based on manifest and cycloplegic refraction, autorefractometry, visual acuity, keratometry, and pachymetry. These were compared with surgeon-derived values using paired t-tests and correlation analysis. Preoperative and postoperative (1- and 3-month) uncorrected and corrected distance visual acuity (UDVA, CDVA), mean keratometry (Km), and thinnest corneal point were analyzed. Axis concordance was quantified as the absolute angular deviation (Δ Axis) between AI- and surgeon-planned astigmatism axes. AI-generated spherical corrections were more conservative than surgeons' (- 4.29 ± 2.42 D vs. - 4.70 ± 1.98 D; p = 0.0025), whereas cylindrical power did not differ significantly (p = 0.9241). The mean Δ Axis was 61.9° ± 50.1°, indicating substantial misalignment. UDVA improved from 0.74 ± 0.36 logMAR preoperatively to - 0.06 ± 0.07 logMAR at 3months (p < 0.0001), and postoperative UDVA did not differ significantly from preoperative CDVA, confirming excellent visual recovery. GPT-5 generated refractive plans that were partially consistent with expert surgeon decisions but lacked the clinical precision required for clinical implementation. In contrast, surgeon-planned SILK procedures achieved excellent visual acuity, corneal stability, and refractive predictability, reinforcing the safety and efficacy of Kerato Lenticule Extraction (KLEx) in real-world clinical practice.

To compare 3-year visual outcomes of toric and nontoric intraocular lens (IOL) implantation in children aged 3-8 years with congenital cataracts and ≥2.0D corneal astigmatism. Prospective, nonrandomized, comparative, single-center clinical study SUBJECTS: We enrolled children with congenital cataract who had ≥2.0D corneal astigmatism and were aged 3 to 8 years. Among 236 eligible patients, we included 194 who completed the 3-year follow-up. Participants underwent toric IOL implantation (toric group) or nontoric monofocal IOL implantation (nontoric group) based on the parental preference. The primary outcome was corrected distance visual acuity (CDVA) during the 3-year follow-up period, which was measured in logMAR units. Among the 194 participants (75 [38.7%] female), there were 106 and 88 patients in the nontoric and toric groups, respectively. Both groups demonstrated significant improvements in uncorrected distance visual acuity (UDVA) and CDVA at the endpoint (P < .001). At 3 years, the toric group had a significantly better mean CDVA than the nontoric group (P = .003). The toric group had a significantly higher proportion of eyes that achieved nonamblyopic vision (CDVA ≥ 0.8) than the nontoric group (86.4% vs. 69.8%, P = .009). In the subgroup analysis, among patients with preoperative corneal astigmatism >3.0 D, the toric group exhibited significantly better CDVA than the nontoric group from 3 months to 3 years postoperatively (P < .001). Contrastingly, among patients with astigmatism ≤ 3.0 D, there was no significant between-group difference in CDVA. Notably, the toric group demonstrated significantly lower postoperative refractive astigmatism than the nontoric group throughout the follow-up period (P < .05). None of the patients rotated ≥ 10° or required IOL repositioning surgery. For children aged 3 to 8 years with congenital cataracts and corneal astigmatism ≥2.0 D, toric IOL implantation provided superior long-term visual outcomes and reduced amblyopia rates compared with nontoric monofocal IOL implantation. This supports its consideration as the preferred surgical approach for optimizing visual rehabilitation in this population.

To describe clinical characteristics, patterns, and management options in benoxinate-induced keratopathy. Retrospective single-center study in which patients using benoxinate hydrochloride 0.4% for greater than 1 month and present with keratopathy and/or corneal complications were enrolled. A total of 36 eyes were included, 90.5% belonged to welders. Median corrected distance visual acuity (CDVA) was 2.3 logMAR (hand motion). Secondary corneal abscess was present in 47.2% of eyes and 66.7% of eyes showed ring-shaped corneal deposits. Approximately 13.9% had corneal perforation at presentation and 22.3% had marked corneal thinning. All eyes except one had varying degrees of epithelial defects, mean defect 50.7±38.1 mm 2 . Approximately 47.2% received medical treatment and 52.7% were treated surgically. Size of epithelial defect was correlated to CDVA and presence of abscess ( P =0.007 and 0.041). Choice of management was affected by size of epithelial defect and CDVA ( P <0.001 and=0.006). CDVA did not improve after reepithelialization ( P =0.157). Benoxinate-induced keratopathy is a potentially blinding and preventable disease. Stricter laws preventing over the counter availability is needed.

To evaluate the safety, efficacy, and refractive predictability of PresbyEDOF, an individualized corneal laser technique for presbyopia correction. In this retrospective, single-center case series, 114 eyes of 57 patients (mean age 54 ± 4.7 years) were treated with PresbyEDOF using the SCHWIND AMARIS 1050RS. The treatment induced approximately 1.5 D of extended depth of focus in both the near-dominant and far-dominant eye, with a planned anisometropia of 1.5 D. Primary outcomes at 3 months included binocular uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), refractive predictability, change in corrected distance visual acuity (CDVA), residual astigmatism, retreatment rate, and visual disturbances. Binocular UDVA of 0.0 logMAR was achieved in 92% of patients. UNVA of ≥0.0 logMAR was achieved in 40% and ≥0.2 logMAR in 93% of patients. CDVA remained unchanged in 38% of eyes, decreased by one line in 27%, and improved by one line in 35%. Residual astigmatism >0.5 D occurred in 4% of eyes. Retreatment was required in three patients (5.3%), including two cases retargeted for improved intermediate vision. No intraoperative complications, ectasia, or infections were observed. All patients reported improved visual quality, with photic phenomena described as rare and transient. PresbyEDOF demonstrated favorable distance and near visual outcomes, high visual quality, and low residual astigmatism at 3 months. The technique appears to be a safe and effective corneal approach for presbyopia correction, warranting further prospective studies with longer follow-up.

To evaluate the clinical outcomes and safety of customized corneal cross-linking (cCXL) for the treatment of keratoconus. Electronic databases were searched through May 1, 2025, yielding 394 records. Primary outcomes were 12-month changes in maximum keratometry (Kmax), corrected distance visual acuity (CDVA), and thinnest corneal thickness (TCT). Secondary outcomes included additional keratometric indices, uncorrected distance visual acuity, spherical equivalent, higher order aberrations, endothelial cell density, and demarcation line depth. Nineteen studies were included in the systematic review, with 14 studies eligible for meta-analysis. Both single-arm analyses of cCXL and comparative analyses versus non-customized CXL were performed. Subgroup analyses were conducted according to epithelial status and irradiation pattern. At 12 months, cCXL significantly reduced Kmax by -1.29 diopters [D] (95% CI: -1.55 to -1.03 D) and achieved greater Kmax flattening than non-customized CXL (additional -1.39 D; 95% CI: -1.82 to -0.95 D; P < .001). CDVA improved by -0.10 logarithm of the minimum angle of resolution (logMAR) (95% CI: -0.12 to -0.07; P < .001), exceeding the improvement with non-customized CXL (mean difference: -0.06 logMAR; P = .031). TCT decreased modestly (-4.42 μm; 95% CI: -7.24 to -1.60 μm; P = .006). Significant reductions were observed in total higher order aberrations (-0.24 μm; 95% CI: -0.37 to -0.11 μm; P = .016) and vertical coma (-0.25 μm; 95% CI: -0.49 to -0.00 μm; P = .049). Outcomes were comparable between epithelium-on and epithelium-off cCXL, and no significant endothelial cell loss or serious adverse events were reported. Customized CXL is a safe and effective treatment for keratoconus and provides superior topographic and visual outcomes compared with non-customized CXL through tailored energy delivery.

To assess the clinical characteristics and surgical outcomes of retinal detachment (RD) associated with presumed trematode-induced granulomatous intermediate uveitis (PTIGIU). A review of the medical records of patients diagnosed with RD secondary to PTIGIU over a 3-year period was conducted. Main outcome measures were the type and morphology of RD, final functional and anatomical outcomes. Out of 98 eyes with PTIGIU, 41 eyes (41.8%) were diagnosed with RD secondary to PTIGIU and were operated upon and completed 6-month follow-up period. Mean age was 12.6 years and logMAR corrected distance visual acuity 1.76. All eyes had vitritis of variable grades. Thirty-five eyes (85.4%) had tractional retinal detachment (TRD) and four eyes (9.8%) had combined tractional-rhegmatogenous retinal detachment. According to the extent of retinal detachment, the eyes were grouped into Group 1: 28 eyes, with subtotal peripheral RD, and Group 2: 13 eyes, with total RD or subtotal RD reaching posterior pole. The former group showed better functional and anatomical outcomes ( P = 0.019 and 0.028, respectively). Approximately 80.5% of all eyes showed final anatomical success and visual improvement (median corrected distance visual acuity 0.40, P < 0.001) at the final follow-up. Tractional retinal detachment is a common complication to PTIGIU, and early intervention is essential to avoid devastating ocular complications.

To analyze the clinical outcomes of pinhole pupilloplasty (PPP) in eyes with higher order aberrations (HOAs) due to scarred cornea. In this prospective, interventional series, eyes with central or paracentral localized corneal opacity (partial or full thickness) with adjacent clear corneal zone with or without cataract were included. Phacoemulsification with posterior chamber intraocular lens (IOL) implantation was performed followed by PPP. HOAs were assessed with the Pentacam HR (Oculus Optikgeräte GmbH) and optimum pupil size was determined by placing the pinhole template and recording the pinhole size that enabled patients to see distinctly. Postoperative visual outcomes, patient satisfaction score, change in HOAs, and pupil size were documented. Overall, 25 eyes of 24 patients underwent the procedure. The mean size of the corneal scar was 4.5 ± 2.4 mm (2 to 12 mm) (linear [n = 5] and non-linear [n = 20]) and the mean depth was 462.4 ± 108.6 μm (range: 158 to 600 μm). PPP was combined with phacoemulsification and posterior chamber IOL in 23 eyes and with glued IOL in 2 eyes. Postoperatively, there was significant improvement in uncorrected (P < .001) and corrected (P < .001) distance visual acuity. There was significant reduction in pupil size (P < .001) and optimum pinhole (P = .071) size was attained for all eyes. There was no significant difference in the postoperative period for HOA root mean square values (P = .118) except one case that underwent corneal suture removal. No change in corneal topography (P = .249) was observed. A negative correlation was observed between reduction of pupil size and improvement in corrected distance visual acuity; however, it was not statistically significant (r = -0.136, P = .517). Seventy-five percent of the patients reported being highly satisfied (score 3) and 25% of the patients were satisfied (score 2) with the surgical outcomes. PPP leads to satisfactory visual outcomes and can be considered as an alternative in eyes with central or paracentral corneal scar with residual clear cornea.

To assess visual and refractive outcomes of intracapsular and add-on toric intraocular lens (tIOL) implantation in postkeratoplasty astigmatism. Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany. Retrospective observational analysis. This study analyzed postkeratoplasty eyes which underwent either intracapsular (G1) or supplementary sulcus-fixated tIOL implantation (G2). Refractive outcomes were assessed by performing vector analysis. 134 eyes of 117 patients with previous penetrating (n = 129, 96.3%) or deep anterior lamellar keratoplasty (n = 5, 3.7%) were included. Intracapsular tIOL implantation was performed in phakic eyes (n = 115, 85.8%), while add-on tIOL implantation in the ciliary sulcus was performed in pseudophakic eyes (n = 19, 14.2%). Data were obtained for 102 eyes (76%) at 6 weeks and for 121 eyes (90%) at 10 months. Mean IOL cylinder power was 8.4 ± 2.6 diopters (D) for G1 and 5.7 ± 0.5 D for G2. Mean uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA, logMAR/Snellen) in G1 significantly improved from 1.1 ± 0.4 (∼20/250) to 0.5 ± 0.3 (∼20/63) and from 0.5 ± 0.3 (∼20/63) to 0.2 ± 0.2 (∼20/32), respectively (both P < .001). In G2, mean UDVA and CDVA significantly improved from 1.1 ± 0.2 (∼20/250) to 0.5 ± 0.1 (∼20/63) and from 0.5 ± 0.2 (∼20/63) to 0.3 ± 0.2 (∼20/40, both P < .001), respectively. Mean refractive cylinder decreased from -6.9 ± 2.6 to -2.6 ± 1.8 D in G1 and from -8.0 ± 2.7 to -4.2 ± 1.9 D in G2 (both P < .001). Intracapsular and add-on tIOL implantation can effectively reduce moderate to high mostly regular postkeratoplasty astigmatism while improving visual acuity.

To evaluate the efficacy and safety of cataract surgery in patients who underwent posterior chamber phakic intraocular lens (PCpIOL) explantation combined with phacoemulsification and intraocular lens (IOL) implantation, with a minimum follow-up period of 2 years postoperatively. Methods: Retrospective study done at a tertiary eye care hospital in South India. Electronic medical records of 57 eyes of patients who underwent PCpIOL explantation combined with phacoemulsification and IOL implantation due to cataract development between 2009 and 2022 were analyzed for visual outcomes, IOL power predictability, and intraoperative or postoperative complications. Phacoemulsification was performed in 54 eyes, and femtosecond laser-assisted cataract surgery (FLACS) was performed in three eyes. Efficacy and safety of cataract surgery in these patients. Anterior subcapsular cataract development remains the most common cause for pIOL explantation. The phakic IOL models explanted in our study were implantable collamer lens (ICL) V4b, implantable phakic contact lens (IPCL) V1, and IPCL V2. Good improvement in corrected distance visual acuity (CDVA) was observed post-phacoemulsification, with 80.6% achieving CDVA of 0.3 logMAR or better. A total of 86.1% of the eyes were within +/-1.00 D of the target refraction (spherical equivalent). No intraoperative or early postoperative complications were noted. Posterior capsular opacification developed in 11 eyes, and retinal detachment (RD) in one eye. Phacoemulsification post-PCpIOL explantation yields good visual outcomes, a high safety profile, and stable refraction, without increased complications. The Barrett Suite formula reliably predicts IOL power calculation. A detailed preoperative fundus examination, with emphasis on the peripheral retina, is vital prior to PCpIOL implantation and phacoemulsification.

To evaluate the 1-year clinical outcomes of the Acriva BB T UDM 611 toric intraocular lens (IOL) following cataract surgery in patients with preoperative corneal astigmatism, focusing on rotational stability, refractive efficacy, visual acuity, contrast sensitivity (CS), and safety. This prospective longitudinal study included 39 eyes of 32 patients with age-related cataract and regular corneal astigmatism ≥1.0 diopter who underwent phacoemulsification and toric IOL implantation at a tertiary eye care center. Preoperative and postoperative assessments included uncorrected (UDVA) and corrected distance visual acuity (CDVA), corneal and refractive astigmatism, IOL rotation, decentration, and tilt. The CSV-1000 test was used to measure CS at 2.5 m under photopic, mesopic, and mesopic with glare conditions. Adverse events were recorded. The mean logMAR UDVA improved significantly from 0.95± 0.39 preoperatively to 0.06 ± 0.10 at 1 year (p < 0.001). The refractive cylinder decreased from -2.17 ± 1.75 D to -0.21 ± 0.32 D (p < 0.001). The mean IOL rotation was 1.61° ±2.35°, with 89.7% of eyes within ±5° and all within ±10° of the intended axis. No IOL repositioning was required. No patients reported disturbing visual phenomena, and no vision-threatening complications occurred during the follow-up. The Acriva BB T UDM 611 toric IOL demonstrated excellent rotational stability, significant refractive accuracy, and favorable safety and CS outcomes at 1 year postoperatively. These results support its efficacy in correcting pre-existing corneal astigmatism in cataract patients.