PURPOSE: To evaluate the outcome of accelerated and conventional corneal cross-linking (CXL) procedures regarding their effect on morphological and optical properties of the cornea. METHODS: One hundred fifty-three eyes of 153 patients were evaluated before and during a 15-month follow-up period after CXL (76 eyes in the conventional group and 77 eyes in the accelerated group). Measured variables include corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), refraction, maximum keratometry, endothelial cell density, anterior and posterior stromal keratocyte density, and subbasal nerve density. All variables were compared between the two study groups. RESULTS: Cylindrical and spherical components of refraction improved significantly during 15 months of follow-up. No difference was observed between the two study groups. UDVA and CDVA improved in the same manner, with no intergroup differences. Endothelial cell density did not change significantly during the follow-up period in either group. K-max increased slightly in the first month of the follow-up, but started to decrease at postoperative visits without any significant difference in the two groups. Anterior stromal keratocyte density and subbasal nerve density decreased significantly in both groups 1 month postoperatively. Both variables had a more significant decrease in the conventional group at all visits before the 1-year visit. At the final 15-month visit, there were no significant differences in any value between the two groups. CONCLUSIONS: Accelerated and conventional CXL seem to have a comparable and acceptable effect on keratoconus in the short-term follow-up period. [ J Refract Surg . 2014;30(12):837–842.]

To investigate recent evidence in prophylaxis and management of post-cataract surgery endophthalmitis. We conducted a literature search using Pubmed database for post cataract surgery endophthalmitis, and relevant articles were selected from original English papers published since 2015. Forty-nine articles were published regarding post-cataract surgery endophthalmitis from January 2015 to February 2016. A low incidence of post-cataract surgery endophthalmitis has been reported. A growing number of articles are focusing on preventing endophthalmitis using intracameral antibiotics. Based on the current evidence, intracameral antibiotics seems to be effective in preventing endophthalmitis after cataract surgery.

Background: We describe corneal endothelial cell density and morphology in normal Iranian eyes and compare endothelial cell characteristics in the Iranian population with data available in the literature for American and Indian populations. Methods: Specular microscopy was performed in 525 eyes of normal Iranian people aged 20 to 85 years old. The studied parameters including mean endothelial cell density (MCD), mean cell area (MCA) and coefficient of variation (CV) in cell area were analyzed in all of the 525 eyes. Results: MCD was 1961 ± 457 cell/mm² and MCA was 537.0 ± 137.4 μm². There was no statistically significant difference in MCD, MCA and CV between genders (Student t-test, P = 0.85, P = 0.97 and P = 0.15 respectively). There was a statistically significant decrease in MCD with age (P < 0.001, r = -0.64). The rate of cell loss was 0.6% per year. There was also a statistically significant increase in MCA (P < 0.001,r = 0.56) and CV (P < 0.001, r = 0.30) from 20 to 85 years of age. Conclusion: The first normative data for the endothelium of Iranian eyes seems to confirm that there are no differences in MCD, MCA and CV between genders. Nevertheless, the values obtained in Iranian eyes seem to be different to those reported by the literature in Indian and American populations.

Artificial intelligence (AI) holds immense promise for transforming ophthalmic care through automated screening, precision diagnostics, and optimized treatment planning. This paper reviews recent advances and challenges in applying AI techniques such as machine learning and deep learning to major eye diseases. In diabetic retinopathy, AI algorithms analyze retinal images to accurately identify lesions, which helps clinicians in ophthalmology practice. Systems like IDx- DR (IDx Technologies Inc, USA) are FDA-approved for autonomous detection of referable diabetic retinopathy. For glaucoma, deep learning models assess optic nerve head morphology in fundus photographs to detect damage. In age-related macular degeneration, AI can quantify drusen and diagnose disease severity from both color fundus and optical coherence tomography images. AI has also been used in screening for retinopathy of prematurity, keratoconus, and dry eye disease. Beyond screening, AI can aid treatment decisions by forecasting disease progression and anti- VEGF response. However, potential limitations such as the quality and diversity of training data, lack of rigorous clinical validation, and challenges in regulatory approval and clinician trust must be addressed for the widespread adoption of AI. Two other significant hurdles include the integration of AI into existing clinical workflows and ensuring transparency in AI decisionmaking processes. With continued research to address these limitations, AI promises to enable earlier diagnosis, optimized resource allocation, personalized treatment, and improved patient outcomes. Besides, synergistic human-AI systems could set a new standard for evidence-based, precise ophthalmic care.

To assess the clinical outcomes after continuous intracorneal ring (ICR) implantation for the management of keratoconus using femtosecond laser technology. Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Prospective nonrandomized consecutive case series. All patients presented with reduced visual acuity, contact lens intolerance, and a central corneal thickness of more than 360 μm. A Myoring ICR was inserted in an intrastromal pocket created by a femtosecond laser. The visual, refractive, aberrometric, and corneal biomechanical outcomes were measured preoperatively as well as 1, 3, and 6 months and 1 year postoperatively. The study comprised 98 keratoconic eyes of 98 patients with a mean age of 30.7 years ± 9.01 (SD). Fifteen eyes (15.3%) had grade I keratoconus, 37 eyes (37.7%) had grade II keratoconus, 24 eyes (24.5%) had grade III keratoconus, and 22 eyes (22.4%) had grade IV keratoconus. The uncorrected and corrected distance visual acuities and spherical and cylindrical errors improved 1 month after surgery (P<.001); however, no changes were detected thereafter (P>.05). The mean keratometry and corneal astigmatism decreased 1 month after surgery (P<.001); however, no significant change was observed at the 3-month or 1-year visits compared with the 1-month values (P>.05). Primary coma decreased significantly (P=.03), and spherical aberrations increased significantly (P<.001) postoperatively. Continuous ICR implantation in keratoconus appears to be an acceptable substitute for keratoplasty in advanced keratoconus. No author has a financial or proprietary interest in any material or method mentioned.