We report a new surgical technique that uses biological glue to implant a posterior chamber intraocular lens (PC IOL) in eyes with a deficient or absent posterior capsule. Two partial-thickness limbal-based scleral flaps are made 180 degrees apart diagonally, and the haptics of the PC IOL are externalized to place them beneath the flaps. Fibrin glue is used to attach the haptics to the scleral bed, beneath the flap. This simple method of PC IOL implantation requires no specially designed haptics. It provides good flap closure and IOL centration and stability without suture-related complications.

A new surgical technique for endothelial keratoplasty is described, in which the composite of pre-Descemet's layer (Dua's layer) with Descemet's membrane and endothelium is transplanted subsequent to the removal of the recipient's Descemet's membrane. The technique was performed in five eyes of five patients, with successful attachment of the graft and good postoperative visual recovery in all cases. Postoperative optical coherence tomography showed good graft attachment without interface abnormalities and a mean graft thickness was 28±5.6 μm. This study demonstrates the practicality of the technique, termed pre-Descemet's endothelial keratoplasty (PDEK), which can be a viable option in endothelial keratoplasty with some potential advantages.

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CACXL technique was effective and safe in performing cross-linking in corneas less than 400 μm after epithelial abrasion and appeared effective based on stromal demarcation line depth.

Purpose To evaluate the visual acuity and quality-related satisfaction of patients implanted with a refractive design multifocal intraocular lens (IOL), and evaluate the factors predicting it including angle kappa. Setting Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai. Methods In this prospective trial, 50 eyes of 44 consecutive patients were included. All patients underwent phacoemulsification with multifocal IOL implantation (Rezoom IOL, Abbott Medical Optics). The preoperative and postoperative assessment included slit lamp biomicroscopy, uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA) and kappa angle assessment. At 1 year, 37 patients (43 eyes), who finished follow-up, were asked to rate their symptoms on a graded questionnaire (0-5 for five queries). Results The decimal scores for UCVA and BCVA were 0.38 ± 0.21 and 0.47 ± 0.17 (preoperative), and 0.75 ± 0.22 and 0.99 ± 0.11 (postoperative), respectively. Symptom scores were haloes 0.98 ± 1.7, glare 0.69 ± 1.48, blurred distance 1.0 ± 1.7, intermediate 1.34 ± 1.6, near 1.06±1.8. On regression analysis haloes depended on angle kappa and distance UCVA (R 2 ¼ 0.26, P ¼ 0.029), and glare on angle kappa (R 2 ¼ 0.26, P ¼ 0.033). Poor satisfactions with distance, intermediate, and near vision were linked with distance UCVA (R 2 ¼ 0.17, P ¼ 2.3 Â 10 À4 ), distance UCVA (R 2 ¼ 0.1, P ¼ 0.04), and near UCVA (R 2 ¼ 0.12, P ¼ 0.03), respectively. The strongest predictor, however, for overall visual discomfort was distance UCVA (R 2 ¼ 0.1, P ¼ 0.04).Conclusions Our study suggests that there may be a role of misalignment between the visual and pupillary axis (angle kappa) in the occurrence of photic phenomenon after refractive multifocal IOL implantation.

Phacoemulsification with in-the-bag PC IOL and CTR implantation in eyes with zonular dialysis of up to approximately 150 degrees had a success rate of 90.47%. Visual recovery was not as good as in normal eyes because of the problems associated with zonular dialysis.

This pilot study indicates that CAIRS with CXL may be a simple, safe, and effective option for treating keratoconus. Further studies are recommended to determine long-term outcomes. [J Refract Surg. 2018;34(5):296-303.].

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