To investigate the effect of phacovitrectomy on the post-operative anterior chamber depth (ACD) and refractive outcomes, and to analyze the potential differences between vitreous filling with BSS, air and gas. Methods: Patients who underwent phacovitrectomy were included in this study and invited for repeated post-operative examination including refraction and biometry at least 3 months after the surgery. Data retrieved included demographic information, indication for phacovitrectomy, surgical details, type of vitreous filling (BSS, air or gas), pre-operative and postoperative biometric data including K-readings, axial length (AL), and ACD, as well as spherical equivalent (SE) values of the target and final refraction. Results: Forty-three eyes of 43 patients were included in this study, including 10 eyes filled with BSS, 18 with air and 15 with gas. The mean difference between the final measured spherical equivalent (SE) and the SE of the intended target refraction was 0.61±0.68 D (p = 0.019). Only 58.1% of eyes had a final SE within ±0.5D of the target refraction. Following surgery, AL remained unchanged, while mean pre-operative ACD increased significantly from 3.11±0.34 mm to 4.77±0.47 mm (p < 0.001). There was no difference in refractive error between the vitreous fillings and no correlation with AL or ACD. Conclusions: Phacovitrectomy is associated with lower accuracy of post-operative refraction compared to cataract surgery. This may be attributed to a significant change in ACD, influencing the effective lens position of the IOL, and may require adjustment of the preoperative calculations.

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Purpose To compare the magnitude and duration of intraocular pressure (IOP) increase during the two principal Islamic prayer positions, Rukū (standing while bowing forward at a 90-degree angle), and Sujud (kneeling with the forehead touching the ground) in healthy subjects and patients with primary open-angle glaucoma (POAG). Methods Prospective, observational case series. Ninety-five eyes of 47 patients (27 with POAG and 68 without POAG) were included. Eligible candidates underwent IOP measurements in the sitting position and in two prayer positions using the Goldmann applanation tonometer and the Icare-Pro tonometer. IOP was measured at set intervals until it returned to baseline. Results Mean IOP increased from a sitting baseline value of 16.1  ±  2.9 mmHg (8.6-26) to 19.3  ±  4.2 mmHg (10.2-32.3) following 30 s of Rukū (p ≤ 0.0001) and from 16.1  ±  0.4 mmHg to 22.2  ±  3.1 mmHg (14.9-37) following Sujud (p ≤ 0.0001). IOP increased similarly in the POAG and non-POAG groups in both positions. Twenty-six eyes (27%) failed to normalize within 2mmHg of baseline, but all returned to baseline after another five minutes. Conclusions Performing traditional Muslim prayer positions increases IOP significantly. The increase did not resolve immediately in approximately a quarter of individuals. These findings may have a considerable impact on Muslim patients with glaucoma.

Purpose To investigate the features and treatment response in Caucasian patients with polypoidal choroidal vasculopathy (PCV), initially treated with bevacizumab. Methods 45 eyes of 43 treatment-naïve patients with PCV were included in this retrospective study, all uniformly initially treated with three bevacizumab injections monthly. OCT characteristics and clinical parameters were recorded and analyzed at presentation, after the initial 3 bevacizumab injections and at the final follow up period. Results Following 3 monthly bevacizumab injections visual acuity significantly improved with a mean gain of one line of vision. Central macular thickness (CMT) significantly improved from a mean of 402.1 ± 130.8 μm at presentation to 322.0 ± 96.8 μm (p < 0.01). Subretinal fluid, intraretinal fluid and submacular hemorrhage significantly improved. 53% were later switched to aflibercept and showed better response in the central macular thickness in comparison to those in which bevacizumab injections were continued. No correlation was found between the presence of pachyvessels or increased choroidal thickness and the improvement in VA or CMT. Conclusion Fixed first-line treatment with intravitreal bevacizumab monotherapy in non-Asian PCV patients achieves satisfactory visual and anatomical outcomes.