The use of confocal microscopy and noncontact esthesiometry allow the detection of the presence of corneal neuropathy in patients with dry eye.

Combined cataract surgery and Glaukos iStent implantation seems to be an effective and safe procedure to treat coexistent open-angle glaucoma and cataract.

Objective: To describe the ocular manifestations in a case of novel coronavirus disease 2019 . Material and methods: A case of unilateral panuveitis and optic neuritis as initial presentation of COVID-19. Results: As it is published, angiotensin-converting-enzyme-2 receptors can be found in many organs, such as the eyes, nerves, and vessels, so extrapulmonary involvement would be expected. According to current evidence and clinical characteristics of the patient, uveitis and optic neuritis could be produced by the virus. Conclusions: It is fundamental to consider panuveitis and optic neuritis as an unusual presentation of ocular involvement in COVID-19 so proper care can be given to the patients.

BackgroundCollagen cross linking (CXL) of the cornea has been developed recently as a new treatment for multidrug-resistant infectious keratitis. The aim of this study is to summarize the previously published data and evaluate the effectiveness of this treatment.ResultsThe search identified 12 articles. The number of eyes was 104. The infectious keratitis was associated with bacteria in 58 eyes (57f%): Gram-positive bacteria in 44 (43%; 4 of which were infected with Mycobacterium (3.6%)) and Gram-negative bacteria in 14 eyes (13%), fungus in 13 eyes (12%), and Acanthamoeba in 7 eyes (7%). In 26 eyes (25%), the microbiological culture was negative or not performed. The mean time of re-epithelization after CXL was 20.7±28.1 days (minimum of 3, maximum of 145). Sixteen eyes underwent deep or lamellar keratoplasty. The pooled analysis suggested that CXL has a favorable effect on the block of corneal melting in 85% (95%; CI 0.77, 0.91) of eyes.ConclusionAlthough randomized controlled trials are needed, the available evidence supports the use of CXL in the treatment of infectious keratitis.

Purpose. To evaluate the long-term efficacy and safety of the iStent inject device (Glaukos Corporation, Laguna Hills, CA) combined with phacoemulsification in patients with coexistent cataract and open-angle glaucoma or ocular hypertension (OHT). Methods. A prospective, uncontrolled, nonrandomized, interventional case series study was conducted in patients with both mild or moderate open-angle glaucoma or OHT and cataract. Patients underwent cataract surgery along with the implant of two iStent inject devices. Outcome measures were intraocular pressure (IOP), topical hypotensive medications required, and best-corrected visual acuity (BCVA). Results. 20 patients were enrolled. Mean follow-up was 47.4 ± 18.46 months. Mean baseline IOP was 19.95 ± 3.71 mmHg with medication and 26 ± 3.11 mmHg after washout. Mean end-follow-up IOP was 16.25 ± 1.99 mmHg, representing an IOP decrease of 36.92%, 9.74 ± 3.14 mmHg (P < 0.001), from baseline washout IOP. The mean number of medications was significantly reduced from 1.3 ± 0.66 to 0.75 ± 0.79 (P = 0.017). 45% of patients were medication-free by the end of follow-up. Mean log⁡MAR BCVA improved significantly from 0.42 ± 0.16 to 0.18 ± 0.16 (P < 0.001). No complications of surgery were observed. Conclusion. The iStent inject device combined with cataract surgery served to significantly reduce both IOP and medication use in the long term in patients with coexistent open-angle glaucoma or ocular hypertension (OHT) and cataract.

Spectralis OCT LTMH measurements were more reliable than the new Keratograph data. Agreement between the devices was poor.

Combined cataract surgery with implantation of GTS-400-iStent seems to be an effective and safe procedure.

PURPOSE: To evaluate the safety and efficacy of intracorneal ring segments (ICRS) for high astigmatism after penetrating keratoplasty (PKP). SETTING:METHODS: This retrospective noncomparative study comprised eyes with high post-PKP astigmatism (>4.00 diopters [D]), contact lens intolerance, and a minimum follow-up of 24 months who had ICRS (Kerarings) implantation by mechanical stromal dissection. Corrected distance visual acuity (CDVA), refractive astigmatism, spherical equivalent (SE), surgically induced astigmatism (SIA), central corneal curvature, topographic corneal astigmatism, average corneal power, and complications were assessed. RESULTS:The mean CDVA was statistically significantly better postoperatively (0.23 G 0.21) than preoperatively (0.98 G 0.27) (P Z .007); no eye lost CDVA. The mean refractive astigmatism decreased from 6.17 G 1.12 D to 4.04 G 1.67 D (P Z .068) and the mean SE from À3.17 G 5.48 D to À0.12 G 2.40 D (P Z .34). The mean SIA was 4.55 G 2.83 D. The mean central corneal curvature decreased from 46.28 G 1.73 D to 42.09 G 3.20 D (P<.01); the mean topographic corneal astigmatism, from 7.07 G 2.52 D to 4.48 G 2.00 D (P<.05) and the mean average corneal power from 45.92 G 1.59 D to 41.88 G 3.37 D (P<.01); all decreases were statistically significant. One patient developed deep vascularization in the lower temporal stromal channel that resolved after ICRS removal. One patient reported significant night halos.CONCLUSION: Implantation of ICRS for high post-PKP astigmatism reduced corneal curvature and topographic astigmatism, significantly improving CDVA.