DMEK using tissue from UK eye-banks resulted in high survival and excellent visual acuity. ECD through 1 year was superior to DSEK in a similar cohort. Our low re-bubble rate (2%) may be attributable to use of intracameral air at temporarily elevated intraocular pressure.

Ocular graft-versus-host disease (GVHD) is a severe complication of allogenic hematopoietic stem cell transplantation (HSCT). It is a term used to describe a spectrum of signs and symptoms including ocular surface inflammation, dry eye syndrome, lacrimal and meibomian gland dysfunction. We present a case of a 73-year-old man with chronic myeloblastic leukaemia and chronic GVHD. On examination, severe corneal thinning was detected in his left eye. We performed multi-layer amniotic membrane patching of the affected area, in an ambulatory setting, without using sutures or glue, but only a bandage contact lens to keep amniotic membranes attached. Three months post-amniotic-membrane-patching symptoms improved, corneal integrity was maintained, and corneal thickness increased significantly. Multi-layer amniotic membrane patching without glue and sutures may be sufficient enough to prevent further deterioration of corneal thinning and can be safely performed as an outpatient procedure, reducing the need for tectonic corneal transplantation.

Aerosol sized less than 10 μm is not produced during phacoemulsification of human crystalline lens. A mobile laminar air flow machine significantly reduced the number of particles sized 10 μm or lesser within the surgical field.

The Covid-19 pandemic has emerged rapidly and is now part of our everyday life and work. At the time of writing this editorial all routine clinical activity and surgery that had previously been stopped is set for a phased reopening over the next 6 weeks to 6 months. Ophthalmic examination includes close working distance to our patients at the slit lamp (<20 cm). Many nasolacrimal outpatient procedures can easily convert into droplet infection and even aerosol i.e reflux from lacrimal washout. In addition, many slit lamp based  procedures and examinations can lead to prolonged exposure and in some cases even aerosol generation. Thus loosely fitted surgical masks, despite their electret filter to trap nanoparticles may offer little or no protection at all. Evidence is overwhelming that ophthalmologists need enhanced PPEs including surgical cap, gown, fit tested mask, gloves and goggles for all ophthalmic examinations. Hesitation in implementing new PPE guidance for ophthalmology will probably cost lives. An overview of the use of PPE is discussed in the following paragraphs.