Introduction The aim of this study was to investigate the 2-year postoperative efficacy of the XEN45 Gel Stent by evaluating the reduction of intraocular pressure (IOP) and the need for eye pressure-lowering medications in a multicenter setting in Switzerland. Methods Patients with various types of glaucoma who received a XEN45 Gel Stent with or without combined phacoemulsification cataract surgery at five hospitals in Switzerland were retrospectively enrolled. Pre- and postoperative IOP, the number of antiglaucoma medications, and the need of subsequent interventions to control IOP were assessed. The success rate was defined as a ≥ 20% reduction of IOP 2 years postoperatively without the need for subsequent glaucoma surgery. Results A total of 345 eyes were included: 44.3% with primary open-angle, 42.0% pseudoexfoliation, and 13.7% with other types of glaucoma. Of these, 206 patients were followed for 2 years. Preoperatively, the mean IOP was 26.3 ± 8.9 mmHg and the mean number of antiglaucoma medications administered was 3.0 ± 1.3. Two years postoperatively, the success rate was 66.0% (95% confidence interval 59.3–72.1%), the IOP had dropped by 43.8% to 14.8 ± 5.7 mmHg, and the number of medications was reduced by a mean of 2.0 ± 1.7 per day. Postoperative complications and the need for interventions remained low. Conclusion The XEN45 Gel Stent successfully reduced IOP and the number of antiglaucoma drugs in most patients at 2 years postoperatively.

Postmortem pathological examinations, animal studies, and anecdotal reports suggest that coronavirus disease 2019 (COVID-19) could potentially affect intraocular tissue. However, published evidence is scarce and conflicting. In our study, we screened 100 eyes of 50 patients hospitalized for COVID-19. Relevant medical and ophthalmological history was assessed as well as symptoms, laboratory results, specific treatments, clinical course, and outcome. Ophthalmic exams including assessment of best corrected visual acuity (BCVA), intraocular pressure (IOP), color perception, ocular motility, ophthalmoscopy as well as optical coherence tomography (OCT) of the macula and the optic disc was performed at hospital admission and 29 to 192 days later. Of the 50 patients included, 14 (28%) were female. Median age was 64.5 (range 29–90) years. COVID-19 severity was mild in 15 (30%), severe in 30 (60%), and critical in five cases (10%). At baseline, median BCVA was 0.1 (0–1.8) Logarithm of the Minimum Angle of Resolution (LogMAR) and median IOP was 16 (8–22) mmHg. At follow-up, no relevant changes in BCVA and IOP were documented. No signs of active intraocular inflammation or optic nerve affection were found and OCT findings were widely stable during the observation period. Our findings suggest that COVID-19 does not regularly affect intraocular tissue.

Despite rising global reports of Acanthamoeba keratitis (AK), the incidence of AK in Switzerland remains unknown. This investigator-initiated, retrospective, multicenter study assessed the nationwide incidence of PCR- and/or culture-positive Acanthamoeba results from January 2010 to December 2023. Data were collected from all tertiary care and large ophthalmological facilities in Switzerland, fully anonymized, and aggregated by month and year. We considered all corneal scraping results, whereby the detection method was specific to local standards. We identified 271 PCR- or culture-positive Acanthamoeba cases over 14 years. Applying the population data from the Federal Statistical Office in Switzerland, this corresponds to a mean incidence of 2.29 cases per million people annually. Infections were most common in summer (87 cases, 32.1%), followed by autumn (74 cases, 27.3%), spring (60 cases, 22.1%), and winter (50 cases, 18.5%). We found no significant change in incidence across the investigated period, p = 0.47. This nationwide study reveals a low but stable incidence of AK in Switzerland, in line with other industrialized countries but well below levels reported in tropical or densely populated regions such as India or Egypt. Seasonal variation supports the influence of environmental exposure and underscores the importance of preventive measures during warmer months.

Introduction and objectives: Sub-Tenon anesthesia techniques are commonly employed in ophthalmology. However, there is speculation that these techniques may have hemodynamic effects on the eye, potentially affecting patients with impaired ocular perfusion. This study aims to evaluate the impact of sub-Tenon anesthesia during cataract surgery on retinal vessel density (VD) and perfusion density (PD) in eyes affected by diabetic maculopathy (DM) or retinal vein occlusion (RVO), using optical coherence tomography angiography (OCTA). Methods: The study included 20 patients receiving sub-Tenon anesthesia with unpreserved mepivacaine 2% for unilateral cataract surgery: 10 with DM and 10 with RVO, analyzing a total of 40 eyes (20 treated and 20 untreated). Blood pressure, intraocular pressure (IOP), and retinal microvascular changes measured via OCTA (VD, PD) were documented before and shortly after sub-Tenon anesthesia. The contralateral eye, which did not receive anesthesia, served as a control. Results: A negative association between sub-Tenon anesthesia to VD and PD was observed, with a VD-change of −1.5 ± 2.8 mm/mm ² ( p = 0.02) in the treated eye compared to 0.7 ± 3.4 mm/mm ² in the untreated eye ( p = 0.36) and a PD-change of −3.7 ± 7.0% ( p = 0.029) in the treated eye compared to 1.6 ± 8.2% in the untreated eye ( p = 0.38), suggesting a potential hemodynamic effect of sub-Tenon anesthesia. However, the quality of OCTA images strongly influenced these findings. After excluding lower-quality images (signal strength index <6), no statistically significant difference was observed between the intervention and control eyes, indicating a false positive correlation due to image artifacts. In the overall population, no significant changes in blood pressure and intraocular pressure were observed before and after the injection. Conclusion: This study did not prove retinal microvascular changes associated with sub-Tenon anesthesia. The observed VD and PD reductions were likely caused by OCTA image artifacts rather than true hemodynamic changes.

A 78-year-old Ukrainian woman who had immigrated to Switzerland presented with a rapid growing subcutaneous infraorbital mass. Surgical excision of the mass revealed a well-circumscribed, encapsulated tumor, adherent to the skin. The excision showed a soft tissue inflammation with parts of Dirofilaria spp. The number of cases of human dirofilariosis reported in the last 50 years has gradually increased. Dirofilaria repens is now endemic in many countries and is currently considered to be one of the fast spreading zoonoses in Central, Eastern and Northern Europe. The first empirical evidence of Swiss spreading of D. repens infections was in a dog from southern Switzerland in 1998. Ours is the first case of human orbital dirofilariosis found in a Ukranian patient reported in Switzerland. Our purpose is to inform the ophthalmologist to consider orbital dirofilariosis in the differential diagnosis of inflammatory masses of the orbit and to warn about the spread of this infection in Switzerland.

Purpose: To evaluate intraocular pressure (IOP), medication burden, best-corrected visual acuity (BCVA), and safety outcomes after ab externo PRESERFLO MicroShunt (PreserFlo) implantation in routine clinical practice. Methods: This retrospective single-center study included patients undergoing PreserFlo implantation (standalone or combined with phacoemulsification) between 2019 and 2022. IOP, BCVA, and glaucoma medications were collected preoperatively and postoperatively (day 1, week 1, month 1, year 1, and year 2). Hypotony was defined as IOP ≤ 5 mmHg. Complete success at 2 years required IOP ≤ 21 mmHg with ≥20% reduction from baseline without glaucoma medication. Results: Eighty-one eyes of 74 patients (mean age 73.2 years) were included. Mean baseline IOP was 24.0 ± 10.2 mmHg, decreasing to 12.5 ± 3.8 mmHg at year 1 (p < 0.0001) and 13.5 ± 3.4 mmHg at year 2 (p = 0.0005). Mean BCVA was 0.63 ± 0.30 at baseline, 0.70 ± 0.31 at year 1, and 0.73 ± 0.27 at year 2, indicating stable visual acuity during follow-up. Mean IOP reduction was 39.6% at year 1 and 33.8% at year 2; 75.6% and 73.3% achieved ≥20% IOP reduction at years 1 and 2, respectively. Medications decreased from 3.09 ± 1.02 to 0.44 ± 0.97 (year 1) and 0.45 ± 0.85 (year 2), and their medication-free rates were 80.5% and 73.3%, respectively. Complications occurred in 55.6% of eyes; 27.2% required postoperative interventions (needling 20.9%); 15.0% required further glaucoma surgery. Complete success rates were 60.2% (year 1) and 52.0% (year 2). Conclusions: PreserFlo implantation provided sustained mid-term IOP reduction with substantial medication sparing and stable BCVA.