For many decades only a few formulas have been available to calculate the intraocular lens (IOL) power for patients undergoing cataract surgery: the Haigis, Hoffer Q, Holladay 1 and 2 and SRK/ T. In recent years, several new formulas for IOL power calculation have been introduced with the aim of improving the accuracy of refraction prediction in eyes undergoing cataract surgery. These include the Barrett Universal II, the Emmetropia Verifying Optical (EVO), the Kane, the Naeser 2, the Olsen, the Panacea, the Pearl DGS, the Radial Basis Function (RBF), the T2 and the VRF formulas. Although most of them are unpublished so that their structure is unknown, we give an overview of each formula and report the results of the studies that have compared them. Their performance in short and long eyes is provided and a special focus is given on the issue of segmented axial length, which is a promising method to obtain more accurate outcomes in short and long eyes. Here, the group refractive index originally developed for the IOLMaster may not represent the best method to convert the optical path length into a physical distance.The issue of posterior and total corneal astigmatism (TCA) is discussed in relation to toric IOLs; the latest formulas for toric IOLs and their results are also reported.

Dry eye disease (DED) is among the most common condition encountered during ophthalmic practice, reducing patient’s quality of life and work productivity. Most of DED cases have an evaporative component originated from a meibomian gland dysfunction (MGD). Conventional treatments such as tear substitute, warm compresses, topical anti-inflammatory agents and/or antibiotics often are not able to provide a complete and long-term relief of symptoms and signs. Intense pulsed light (IPL) has been widely used in the field of dermatology to treat various skin conditions, and it has been recently introduced in the ophthalmic practice for the management of DED due to MGD. To date, several clinical studies showed positive results of IPL as adjuvant therapy for DED in terms of both safety and efficacy. The treatment is usually well accepted among patients for its non-invasive nature; very rare are the major adverse reactions. Moreover, results can be maintained over time with periodic sessions of IPL. This review summarizes the clinical outcomes of IPL therapy in MGD patients pointing out its potential role in the therapeutic algorithm of the disease. Further clinical investigations are desirable to identify factors able to predict the positive outcomes of the procedure and therefore to select in advance those patients who best benefit from IPL therapy.

Purpose: To assess whether omega-3 fatty acid (FA) supplementation is more efficacious than placebo in amelioration of signs and symptoms of dry eye disease. Methods: We performed a systematic literature search in PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials databases. We included randomized clinical trials comparing omega-3 FA supplementation with placebo in patients with dry eye disease. The outcome measures were dry eye symptoms, breakup time (BUT), Schirmer test, and corneal fluorescein staining. The pooled effect sizes were estimated using a random-effects model. Heterogeneity was evaluated using the Q and I2 tests. Sensitivity analysis and assessment of publication bias were performed. Meta-regression was performed to evaluate the source of heterogeneity. Results: Seventeen randomized clinical trials involving 3363 patients were included. Compared with placebo, omega-3 FA supplementation decreased dry eye symptoms [standardized difference in mean values (SDM) = 0.968; 95% confidence interval (CI) 0.554–1.383; P < 0.001] and corneal fluorescein staining (SDM = 0.517; 95% CI, 0.043–0.991; P = 0.032), whereas it increased the BUT (SDM = 0.905; 95% CI, 0.564–1.246; P < 0.001) and Schirmer test values (SDM = 0.905; 95% CI, 0.564–1.246; P < 0.001). No evidence of publication bias was observed, and sensitivity analyses indicated the robustness of results obtained. Meta-regression analysis showed a higher improvement of dry eye symptoms and BUT in studies conducted in India. Conclusions: This meta-analysis provides evidence that omega-3 FA supplementation significantly improves dry eye symptoms and signs in patients with dry eye disease. Therefore, our findings indicate that omega-3 FA supplementation may be an effective treatment for dry eye disease.

Background—It is recognized that inflammation is an underlying cause of dry eye disease (DED), with cytokine release involved. We systematically reviewed literature with meta-analyses to quantitatively summarize the levels of tear cytokines in DED. Methods—The PubMed, Embase, Web of Science, Ovid, Cochrane, and Scopus databases were reviewed until September 2019, and original articles investigating tear cytokines in DED patients were included. Differences of cytokines levels of DED patients and controls were summarized by standardized mean differences (SMD) using a random effects model. Study quality was assessed by applying Newcastle-Ottawa-Scale and the GRADE quality score. Methods of analytical procedures were included as covariate. Results—Thirteen articles investigating 342 DED patients and 205 healthy controls were included in the meta-analysis. The overall methodological quality of these studies was moderate. Systematic review of the selected articles revealed that DED patients had higher tear levels of interleukin (IL)-1β, IL-6, chemokine IL-8, IL-10, interferon-γ, IFN-γ, and tumor necrosis factor-α, TNF-α as compared to controls. Evidence was less strong for IL-2 and IL-17A. Conclusions—Data show that levels of tear cytokines in DED and control display a great variability, and further studies of higher quality enrolling a higher number of subjects are needed, to define a cut-off value.