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Background. Fungal keratitis is an extremely rare complication of laser vision correction resulting in poor visual outcomes. Amniotic membrane transplantation should be kept in mind in eyes with corneal perforation prior to penetrating keratoplasty. Aim. To assess the outcomes of multilayered fresh amniotic membrane transplantation (MLF-AMT) in patients with severe keratomycosis after laser-assisted in situ keratomileusis (LASIK). Study design. Hospital-based prospective interventional case series. Methods. Five eyes of 5 patients were included in the study. All cases underwent microbiological scrapings from residual bed and intrastromal injections of amphotericin (50 mcg/mL), with flap amputation if needed, followed by topical 5% natamycin and 0.15% amphotericin. MLF-AMT was performed after corneal perforation. Later, penetrating keratoplasty (PK) was performed when corneal opacity compromised visual acuity. The outcome measures were complete resolution of infection, corneal graft survival, and best-corrected visual acuity (BCVA). Results. The mean age of patients was 22±1.2 years with 4/5 (80%) were females. The mean interval between LASIK and symptom onset was 8.8±1 day, and the mean interval between symptom onset and referral was 14±1.4 days. Potassium hydroxide (KOH) smears showed filamentous fungi, and Sabouraud’s medium grew Aspergillus in all cases. Melted flaps were amputated in 4 (80%) cases. MLF-AMT was performed in all cases due to corneal perforation after a mean time of 12.4±1.2 days of antifungals. In all cases, complete resolution of infection was seen 26±1.8 days after MLF-AMT, and optical PK was done at a mean of 2.4 months later. No postoperative complications after MLF-AMT or PK were observed, with a 0% incidence of corneal graft rejection, and a final BCVA ranged from 20/20 to 20/80 after a mean follow-up of 14±1.1 months. Conclusion. MLF-AMT is a safe and valid option to manage corneal perforation during keratmycosis treatment to avoid emergency therapeutic keratoplasty.

ObjectivesTo study the macular microstructural changes and their relationship to visual acuity (VA) following primary vitrectomy and silicone tamponade for retinal detachment.Patients and methodsA total of 40 cases with macula-off rhegmatogenous retinal detachment underwent 23-gauge vitrectomy with silicone oil tamponade. Cases with open globe injury and other ocular pathology were excluded. Optical coherence tomography (OCT) imaging of the macula was done about 3 and 6 months postoperatively. OCT macular microstructural changes were recorded and correlated to VA.ResultsA total of 36 eyes were evaluated by statistical analysis. The best-corrected VA (BCVA) improved in 35 patients (97.2%) and remained unchanged in one patient (2.8%). Patients were divided into two groups based on 6-month postoperative BCVA: group I with 6-month postoperative BCVA of <1 LogMAR and group II with 6-month postoperative BCVA of ≥1 LogMAR. No disruption of retinal microstructure occurred in 70% of cases in group I. Mild disruption was found in 30% of group I and 25% of group II, whereas severe disruption was found in 75% of group II cases. Epiretinal membrane formed early in three eyes in group II and late in two eyes in group I.ConclusionMacular microstructural changes detected by OCT is directly correlated to visual outcomes of retinal detachment repair.

Purpose: To describe the central three-dimensional (3D) thickness profile of the macula (CMT) and the subfoveal choroidal region (SFCT) in diabetic retinopathy (DR) following panretinal laser photocoagulation (PRP) using swept-source optical coherence tomography (SS-OCT). Methods: A prospective observational study including 17 eyes with proliferative DR (PDR) and 27 eyes with severe nonproliferative DR (sNPDR)] for whom PRP was done. All subjects received SS-OCT imaging before and 3 months after PRP (POM#3). SFCT and CMT changes were analysed at both visits. Intraclass Correlation Coefficients (ICC) and Coefficients of Variation (COV) were used to test the accuracy of thickness data. Results: SFCT has thinned from 233 ± 54 µm before PRP treatment to 216 ± 51 µm 3 months later (p < 0.001). Likewise, CMT declined at POM#3 as compared to pre-PRP status (p<0.001). SFCT was thinner in PDR before and at POM#3 (p<0.05) than sNPDR; whereas, no significant difference was observed in CMT between both groups in the two visits. No significant changes were found between groups in SFCT and CMT at POM#3. Regarding reliability, ICC SFCT =0.98 and ICC CMT =0.99. The COVs for CMT and SFCT were 5.03% and 5.91%, respectively. Conclusion:The mean SFCT and CMT decreased 3 months after PRP. We also reported reliability of SFCT measurements in DR using SS-OCT.

Purpose To describe the changes in the central corneal thickness (CCT), endothelial cell count (ECC), intraocular lens (IOL) position, and refractive error 1 and 3 months after Nd-YAG laser posterior capsulotomy (YAG-PC) for posterior capsular opacification (PCO) in pseudophakic eyes with Fuchs’ endothelial cell dystrophy (FECD). Design Prospective case-control. Participants Fifty pseudophakic eyes of 50 patients with visually significant PCO (25 with healthy corneas, and 25 with FECD grade 1 and 2). Methods FECD was clinically graded, and only patients without clinically evident corneal edema were included in the study (grade 1 and 2). All patients received YAG-PC and were followed up after 1 and 3 months. Best-corrected visual acuity, refractive errors, ACD, CCT, and ECC were assessed and compared between the pre-laser values and that of the 2 follow-up visits. Results In both groups, BCVA showed significant improvement (P<0.05). Compared to healthy controls, a significant hyperopic shift was observed in the FECD eyes at the 2 follow-up visits (P=0.027, and 0.019). A significant backward movement of the IOL was observed in the FECD eyes in the 2 follow-up visits (P=0.043, and 0.02). There was a significant correlation between the hyperopic shift in the FECD eyes and the ACD deepening during the 1st month (R= −0.6, P=0.001) and 3rd month (R= −0.4, P=0.04). Significant drop in the ECC was noted in both groups but without significant increase in the CCT. Conclusion Compared to controls, a hyperopic shift and backward movement of the IOL were observed in the FECD eyes after YAG-PC. No significant corneal thickening was found in both groups despite the significant drop in the ECC. Future studies are required to confirm our results and monitor the long-term changes after YAG-PC in FECD.