Implantation of the Artisan PIOL is effective in improving visual acuity in patients with stable keratoconus. Long-term safety remains to be established as no postoperative endothelial cell counts were performed.

Non-mydriatic fundus photographs have a high rate of ungradable images in patients with dark irides. Instillation of only one drop of tropicamide improves the quality of fundus photographs, which is not furthered by adding more drops. This strategy can be used in tele-ophthalmology programs.

The responsible pathogens in acute and chronic dacryocystitis are significantly different. Because of the high prevalence of gram-negative bacteria and also culture-negative samples and considering the necessity of treatment in acute dacryocystitis, selecting an appropriate antibiotic with a good coverage of gram-negative and gram-positive bacteria seems essential.

Background/aims To quantify the longitudinal changes of the macular microvasculature and the foveal avascular zone (FAZ) parameters in patients recovered from coronavirus disease-2019 (COVID-19) using optical coherence tomography angiography (OCTA) analysis. Methods This observational, longitudinal study was performed on patients recovered from COVID-19. The OCTA images were recorded at baseline and after 1 and 3 months at the follow-up examination. Vessel density (VD) of the retinal superficial (SCP) and deep capillary plexus (DCP), as well as the area of the FAZ of patients who had recovered from COVID-19, were measured. Results In total, 36 eyes of 18 patients (62.2% female) with a mean age of 34.5 ± 7.5 years old were included. Regarding SCP, while the VDs of the whole image, fovea, and parafovea were comparable at different time points, the mean VDs in inferior hemifield, as well as superior and inferior regions of perifovea, underwent significant reductions at month 3, compared to the baseline. In DCP, the mean of VD in the whole image was 54.3 ± 2.7 at the first visit which significantly decreased to 52.1 ± 3.8( P = 0.003) and 51.4 ± 2.7( P = 0.001) after 1 and 3 months, respectively. The VDs in all regions of parafovea and perifovea revealed a significant reduction after 1 and 3 months, compared to the first visit. The mean FAZ area was 0.27 ± 0.08 mm 2 , 0.26 ± 0.08 mm 2 , and 0.27 ± 0.08 mm 2 at the baseline, month 1, and month 3, respectively ( P > 0.05). Conclusion Based on the results, the patients who had recovered from COVID-19 had a progressive decrease of VD at the follow-up visit 3 months after COVID-19 infection.

PurposeTo report a case of Idiopathic retinal vasculitis, arteriolar macroaneurysms, and neuroretinitis (IRVAN). syndrome in a young female.Case reportA 21-year-old woman presented with unilateral visual acuity (VA) loss. Ophthalmological examination disclosed unilateral optic disc swelling, star-shaped macular exudation, multiple aneurysms surrounded by perivascular exudation, retinal vasculitis, and mild vitreous reaction. The left eye examination was entirely normal. Clinical and paraclinical findings were compatible with IRVAN syndrome criteria. The patient was treated with a short course of oral steroid, a trans-septal triamcinolone acetonide injection, selective laser photocoagulation in peripheral non-perfusion areas, and intravitreal bevacizumab. In spite of primary good response, after each treatment cessation, VA dropped with increasing central macular thickness (CMT), but response to intravitreal triamcinolone (4 mg/0.1 cc) was permanent and good.ConclusionIRVAN syndrome can have unilateral presentation. All treatment options were temporary except intravitreal steroid injection in our case. The effect of steroid in IRVAN will need further evaluation.

Purpose: To compare high-order aberration between the eyes with pterygium and normal fellow eyes.Method: This comparative cross-sectional study comprised 31 patients with unilateral pterygium. NIDEK OPD-Scan wavefront aberrometry was performed in all patients in both eyes. Then, aberometric parameters were compared between the eyes.Results: Sixty-two eyes of 31 patients (23 men and 8 women) with a mean age of 42.5 6 5.9 years were included in the study. Root mean square (RMS) of total higher-order aberration increased statistically significantly in the involved eyes compared with normal fellow eyes (1.85 6 2.22 and 0.36 6 0.44 mm; P = 0.001). All RMS of Zernike orders and all RMS of different aberrations were higher in the involved eyes group and were statistically significant except for spherical aberration. The most significant differences belonged to RMS of total trefoil (1.37 vs. 0.25 mm) and RMS of total coma (0.37 vs. 0.14 mm) (P = 0.0001). With decreasing the uninvolved optical zone (increasing the size of pterygium), RMS of all aberrations increased and the differences were statistically significant except for spherical aberration.Conclusion: Pterygium and its size have significant influence on high-order aberrations of the eye especially on measured total coma and total trefoil in compared with normal fellow eye.

Purpose:To evaluate the effectiveness of corneal cross-linking in improving the signs and symptoms of bullous keratopathy.Materials and Methods:This prospective non-randomized case series evaluated 20 eyes with bullous ketratopathy that underwent corneal cross-linking (C3R) with riboflavin and ultraviolet-A (UVA, 370 nm, 3 mW/cm2). C3R was performed for 30 min in a routine procedure after removal of epithelium. Central corneal thickness (CCT), corneal haze, visual acuity (VA), and the presence of irritating symptoms were recorded before the procedure, and at 1 week, 1 months, 3 months, and 6 months after the procedure.Results:The mean CCT was 872 ± 162 μm (range: 665-1180 μm) before the procedure. Following the procedure, CCT was 855 ± 175 μm after 1 week, 839 ± 210 μm after 1 month, 866 ± 185 μm after 3 months, and 863 ± 177 μm after 6 months (P>0.05, all visits). There was no significant improvement in VA or corneal clarity after 6 months. Improvement of the following symptoms: burning, pain, and foreign body sensation were reported after 6 months by 83.3%, 75.0%, and 66.7% of patients, respectively. Persistent epithelial defect occurred in five patients (25%) resolved with frequent lubrication and bandage contact lenses.Conclusion:The outcomes of this study indicate corneal cross-linking is not an effective treatment for bullous keratopathy with respect to VA and CCT, although it can improve irritation and discomfort.

Objectives This study aimed to evaluate the retinal and choroidal changes in the macular region of patients with Coronavirus Disease 2019 (COVID-19) using structural spectral-domain optical coherence tomography (SD-OCT) analysis. Methods This cross-sectional observational case-control study included patients recovered from COVID-19. The COVID-19 in all participants was confirmed using the reverse transcription-polymerase chain reaction (RT-PCR) technique. The participants had mild to moderate degree of disease without a history of hospitalization, steroid usage, or blood saturation below 92%. Macular SD-OCT was performed at least two weeks and up to one month after recovery from systemic COVID-19. Quantitative and qualitative changes detected by macular SD-OCT imaging were evaluated in COVID-19 recovered patients and compared with the results of age-matched normal controls. Results Participants in this study included 30 cases (60 eyes) and 60 healthy controls (120 eyes). In total, 17 (28.3%) eyes in patient group showed at least one abnormal finding indicated by macular SD-OCT imaging included hyperreflective lesions in different retinal layers. In addition, dilated choroidal vessels and retinal pigment epitheliopathy were evident in 41 (68.3.6%) and 4 (6.6%) eyes in patient group, respectively, and their OCT findings resembled those with pachychoroid spectrum. No statistically significant differences were observed in retinal layers or retinal volume between the two groups. The mean ± SD subfoveal choroidal thickness (SFCT) was determined at 380.3 ± 12.40 μm, which was significantly thicker than that in control group (310.7 ± 57.5 μm) (P < 0.001). Conclusion Regarding retinal thickness, no significant change was observed in different retina layers of patients with COVID-19; however, there were striking qualitative changes, such as hyperreflective lesions in different retinal layers. The evaluation of choroidal structure and thickness demonstrated remarkable abnormal pachyvessels and significant thickening of the SFCT but the clinical significance of these findings is unknown.