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Purpose Descemet´s membrane ruptures (with a discontinuation of Descemet´s membrane and double detached coiled edges) in the context of complicated anterior segment surgery have rarely been described and its management can be challenging. We report a modified Descemet stripping only (DSO) technique associated with ripasudil drops to treat these cases when other techniques fail. Methods We describe two cases of large Descemet´s membrane detachments associated with Descemet´s ruptures after cataract surgery that did not respond to two SF6 intracameral injections. As the detached Descemet's membrane and coiled edges might have prevented endothelial cell migration, we decided to perform a modified DSO with post-operative ripasudil drops to promote corneal clearance. Results Both cases improved significantly in unaided and best corrected visual acuity (BCVA), corneal clearance and pachymetry, avoiding the need for an endothelial keratoplasty. Endothelial cells were observed on specular microscopy within the area of the descemetorhexis. Conclusion DSO with ripasudil drops might be a valuable tool to recover corneal clearance and avoid endothelial keratoplasty in complex Descemet´s membrane detachments with ruptures that do not respond to other treatments.

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Purpose: Cataract surgery is one of the most usual type of intervention worldwide. Thanks to the improvement of technology and investigation this kind of surgery has reached a very high success rate. Studies have compared laser and conventional techniques in terms of inflammation, but there are also other variables which can influence the final result, such as cataract degree, age or diabetes. The purpose of this study is to establish the influence of cataract degree in the inflammatory profile of the aqueous humour. Methods: The parameters determined in aqueous humour to compare both groups were interleukins (IL) 6 and 8 and cytokine tumour necrosis factor α (TNFα). Samples of aqueous humour were obtained during cataract surgery, before the lens was extracted and were analysed through Enzyme‐Linked Immunosorbent Assay (ELISA). Two study groups were established: femtosecond group (75 samples of aqueous humour from 75 patients) and manual group (54 samples of aqueous humour from 54 patients). Once this classification was made, the non‐parametric statistics of the median, Kolmogorov–Smirnov and the Mann–Whitney test were calculated to verify whether the degree of cataract influenced the inflammatory profile of aqueous humour. Results: No significative differences were noticed between the two types of cataract degrees, early and advanced and their inflammatory reaction to surgery, although there is a slight tendency in IL6 and IL8 to increase their concentrations in advanced cataracts. On the other hand, the opposite happens with the concentration of TNFα that diminishes in advanced cataracts. Conclusions: The inflammatory profile of aqueous humour can be affected by the type of surgery performed (femtosecond or manual surgery) but also by other variables such as age, diabetes or cataract degree. Regarding the last one, cataract itself can modulate ocular inflammation as there was a tendency in IL6 and IL8 to increase in advanced cataracts. Besides that, the decrease in TNFα aqueous humour concentrations in advanced cataracts may be due to a physiological attempt to restore basal cytokine levels.

Purpose: The aim of our study was to assess the visual quality of pterygium patients with total ocular aberrations, and not only corneal aberrations. Methods: 46 eyes of 37 pterygium patients (mean age 48 ± 15 years) were evaluated in a retrospective study. Inclusion criteria were primary pterygium, without any previous surgical treatment. Before surgery, subjective refraction, corrected distance visual acuity (CDVA), with an EDTRS optotype chart, and Zernike coefficients for a 5 millimetres (mm) pupil diameter measured with an Alcon LadarWave total aberrometer (Fort Worth, Texas, USA) were determined. Pterygium size in mm was measured by an experienced ophthalmologist using a slit beam of light from the limbus to the limit of the pterygium. Statistical analysis was performed using SPSS software version 26.0. The Kruskal‐Wallis test with the Tukey–Kramer criterion was used to examine the influence of the extent of corneal invasion on manifest refraction and Zernike coefficients. One‐way analysis of variance (ANOVA) with the Bonferroni criterion was performed to compare different extent values. A p value less than or equal to 0.05 was considered statistically significant. Results: The sample was divided in four groups, according to the extent of corneal invasion. The upper limits of each category were 1, 2, 3 and 4 mm, with 9, 20, 11 and 6 patients in each group, respectively. Preoperatively spheres more positive were found at high corneal invasion groups, statistically significant between 1 and 3 mm, and between 2 and 3 mm (p = 0.013 and p = 0.011) and cylinder axes were between 20° and 50° in all groups. CDVA was lower in patients with greater corneal invasion. Regarding total ocular aberrations, statistically significant differences between groups were found only in a reduced set of Zernike polynomials but oblique astigmatism (2,‐2) appeared in most of the comparatives. Most of the Zernike coefficients, were out of normal limits, compared to control values, including spherical aberration. Conclusions: Pterygium‐induced aberrations also modify the visual quality of patients when the effect of the crystalline lens aberrations is considered, the conclusions are similar to those derived from corneal aberrations. CDVA was lower preoperatively in patients with greater corneal invasion (4 mm).