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Four patients with pseudophakic corneal edema were subjected to pre-Descemet endothelial keratoplasty (PDEK) under the direct guidance of microscope-integrated optical coherence tomography (i-OCT). i-OCT facilitated successful type 1 big bubble formation during donor preparation, debridement of the hypertrophic epithelium, planning and placement of surgical wounds, descemetorrhexis with removal of remnant Descemet membrane tags, and identification of correct donor orientation and interface details. It was also possible to discern the stability of intraocular lens, flat iris configuration, adequate stromal hydration, and wound apposition on i-OCT. Preoperative visual acuity was counting fingers (50%), 0.78 logMAR (25%), and 1.48 logMAR (25%), whereas postoperative visual acuity was 0.6 logMAR (50%) and 0.3 logMAR (50%). At 6-months of follow-up, all grafts were clear and well attached, the mean central corneal thickness, graft size, graft thickness, and endothelial cell loss were 557.25 ± 13.45 μm, 7.75 ± 0.20 mm, 25.5 ± 2.64 μm, and 21.6 ± 0.02%, respectively. To conclude, i-OCT helped during various surgical steps of PDEK.

Purpose To describe a novel modification of tuck-in Tenon's patch graft (TPG) using temporary horizontal mattress sutures and fibrin glue to hitch the graft in the management of corneal perforations. Design Ambispective interventional case series. Methods Modified technique of autologous TPG was used to seal corneal perforations measuring 3–5 mm, using horizontal mattress sutures to hitch the graft in a lamellar pocket, followed by application of fibrin glue. The horizontal mattress sutures were removed after the reformation of the anterior chamber. The primary outcome measure was a well formed anterior chamber in the post-operative period and the secondary outcome was epithelization time. Results The surgery was performed in 22 eyes. The mean age was 43.86 ± 16.02 (26–66) years, with 14 males and eight females. The etiologies of corneal perforation included dry eye (n = 10), neurotrophic keratitis (n = 6), trauma (n = 2), chemical injury (n = 2) and exposure (n = 2). The mean size of the perforation with the thinned-out area was 4.3 mm (range 3–5 mm). The mean duration of epithelialization was 14.31 ± 2.63 days (7–21 days). No intraoperative complications were observed. All eyes had a well-formed anterior chamber in the immediate postoperative period. Postoperatively, two eyes had graft pseudoectasia due to a thick graft and supra tenon haemorrhage each; one eye each had graft thinning with the formation of pseudopterygium and graft melting. Conclusion Tenon's patch graft, along with the use of temporary horizontal mattress sutures and fibrin glue, is an effective modification of the technique for managing corneal perforations measuring 3–5 mm.

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An 11-year-old boy presented with right eye post-Corneal Collagen Cross-Linking (CXL) keratitis, which was complicated by acute corneal hydrops (CH). Keratitis was managed by topical antibiotics, and CH was managed conservatively. Cornea was monitored with serial anterior segment optical coherence tomography (ASOCT) scans. Spontaneous resolution of CH usually takes 8–12 weeks, but in this case it completely resolved in 3 weeks. Rapid resolution of CH after post-CXL keratitis could be attributed to a thinner cornea, increased interlamellar cohesive strength between collagen fibrils of corneal stroma coupled with normal functioning endothelial pump.

Laser-assisted in situ keratomileusis (LASIK) is one of the most commonly performed kerato-refractive surgery globally. Since its introduction in 1990, there has been a constant evolution in its technology to improve the visual outcome. The safety, efficacy, and predictability of LASIK are well known, but complications with this procedure, although rare, are not unknown. Literature review suggests that intraoperative complications include suction loss, free cap, flap tear, buttonhole flap, decentered ablation, central island, interface debris, femtosecond laser-related complications, and others. The postoperative complications include flap striae, flap dislocation, residual refractive error, diffuse lamellar keratitis, microbial keratitis, epithelial ingrowth, refractive regression, corneal ectasia, and others. This review aims to provide a comprehensive knowledge of risk factors, clinical features, and management protocol of all the reported complications of LASIK. This knowledge will help in prevention as well as early identification and timely intervention with the appropriate strategy for achieving optimal visual outcome even in the face of complications.

A 55-year-old patient presented with exposure of both the haptics beyond the conjunctiva of the scleral fixated multipiece intraocular lens (IOL). Two diagonally opposite scleral pockets were created, and the exposed haptics was redirected and repositioned aseptically into these pockets to facilitate intrascleral fixation. Herein, we report a simple rescue method for management of exposed haptic after Yamane technique of scleral fixated IOL.