Purpose: The aim of this study was to investigate the outcome of the meniscus-shaped stromal lenticule addition keratoplasty (MS-SLAK) in corneal regularization and thickness. Methods: Patients waiting for deep anterior lamellar keratoplasty for advanced keratoconus with an intolerance to contact lenses (CLs) underwent the MS-SLAK procedure by FSL 80 kHz ablation (VICTUS, Technolas Perfect Vision, DE). Customized positive meniscus-shaped stromal lenticules were obtained and implanted. Examination was performed at baseline and at 3-, 6-, and 12-month follow-up and included corrected distance visual acuity both with spectacles and CLs (spectacle CDVA and CL-CDVA), manifest refraction spherical equivalent, slit-lamp examination, anterior segment optical coherence tomography, corneal topography, and in vivo confocal microscopy. Results: Fifteen patients completed the study. Statistical increases in corneal thickness values were found from the first follow-up (P < 0.001). Improvement in the Surface Asymmetry Index (P = 0.04), Symmetry Index (P = 0.02), spherical aberration (P < 0.001), coma (P= 0.18), high-order aberration (P = 0.37), and anterior asphericity index (Q) (P = 0.31) were found at 12 months. At the 12-month follow-up, no improvement were found in spectacle CDVA (P = 0.23); however, all patients reported CL wearing tolerance recovery, and significant improvement in CL-CDVA (P = 0.002) was found. The confocal microscopy at 12 months showed a significant increase in keratocyte density within the lenticule and absence of fibrotic reactions in both anterior and posterior interfaces. Conclusions: MS-SLAK seems to be effective in regularizing the corneal surface as showed by the significant improvement in topographic symmetry indices, coma, and high-order aberration. The corneal regularization is also confirmed by the results in anterior Q and the recovery of the CL wearing tolerance.

The aim of this prospective explorative study was to evaluate the safety and the effectiveness of topical polyvinylpyrrolidone-iodine (PVP-I) administered during the time-to-results period for pathogen identification and susceptibility testing in patients with infectious keratitis (IK). A corneal swab (CS) for antimicrobial evaluation was performed at enrollment (T0) and topical 0.66%-PVP-I was administered until the laboratory results were available (T1). Ulcer and infiltrate areas and infiltrate depths were compared between T0 and T1 (i.e., time-to-result period). Patients were then shifted to a specific antimicrobial therapy and followed up until resolution of their infiltrates (Tlast-TL). Twenty-five eyes were enrolled, and none showed clinical worsening leading to protocol withdrawal. At T1, ulcer and infiltrate areas showed significant improvement in Gram-positive IK (n = 13–52%; p = 0.027 and p = 0.019, respectively), remained stable in fungal IK (n = 5–20%; both p = 0.98) and increased in those with Gram-negative bacteria (n = 4–16%; p = 0.58 and p = 0.27). Eyes with negative cultures (n = 3–12%) showed complete resolution at T1 and did not initiate any additional antimicrobial therapy. The administration of 0.66% PVP-I during the time-to-result period seems to be a safe strategy in patients with IK while often sparing broad-spectrum antimicrobial agents. In addition, it showed to be effective in eyes with a Gram-positive bacterial infection.

Purpose: To analyze the objective and subjective visual performances of a new hybrid refractive/aspheric extended depth of focus (EDOF) intraocular lens (IOL).Methods: In this monocentric prospective study patients with bilateral cataracts underwent cataract surgery and were implanted with a Lucidis IOL (SAV-IOL SA, Neuchâtel, Switzerland) in both eyes, 1 week apart from each other. At 3 months from implantation postoperative evaluations included monocular and binocular uncorrected and distance-corrected distant (4 m), intermediate (80 cm, 67 cm) and near (40 cm) visual acuities (UDVA/DCVA, UI80-67VA/DCI80-67VA, UNVA/DCNVA), binocular defocus curves, halometry, contrast sensitivity and objective quality-of-vision measurements. Also, patients were also asked to complete the national eye institute refractive error quality of life (NEI-RQL-42) questionnaire.Results: Twenty-five patients (50 eyes) were included. The mean postoperative binocular UDVA, UI80VA, UI67VA and UNVA were-0.02 ± 0.13, 0.05 ± 0.09, 0.05 ± 0.08 and 0.03 ± 0.1 LogMar, and did not significantly differ from their corrected counterparts. On binocular defocus curves a VA ≥0.05LogMar was found between +0.50 and − 2.50 D of vergence, whereas the mean distance from the central stimulus on halometry was 1.23 ± 0.01. Mean ocular and corneal radical mean square at 4 mm were 0.31 ± 0.28 and 0.19 ± 0.07, respectively; whereas the mean Strehl ratio was 0.2 ± 0.09.Conclusion: Lucidis IOLs demonstrated excellent visual performances, especially at close distances while maintain good quality of vision, contrast sensitivity, and overall patient-satisfaction.

Purpose: The purpose of the study is to show the excellent anatomical result of the inverted flap-assisted technique with platelet-rich plasma under air for retinitis pigmentosa complicated with macular hole. Methods: A 32-year-old woman, previously diagnosed with retinitis pigmentosa, was referred to our department complaining of decreased central vision in her left eye for 4 weeks. At the time of presentation, the optical coherence tomography and fundoscopy examination showed the presence of a macular hole of 620 μm in diameter. The closure of the macular hole was observed after the surgical procedure, but endophthalmitis occurred 5 days, postoperatively. Results: In our presented case, the cover flap-assisted technique with platelet-rich plasma under air for retinitis pigmentosa complicated with macular hole resulted in excellent anatomical outcomes with unremarkable visual recovery. Conclusion: The physiopathology of full-thickness macular holes in retinitis pigmentosa patients remains still not fully elucidated. Pars plana vitrectomy with the adjunct of highly concentrated pure platelet-rich plasma have shown successful results.

Complete vitreous removal is mandatory for successful vitreoretinal surgery performed for any indication: retinal detachment, macular hole [1], epiretinal membrane [2], and vitreous hemorrhage [3]. Accuracy in vitreous removal is indeed crucial to avoid tractional forces in the vitreous cavity that could lead to rhegmatogenous detachment or recurrence [4]. Many techniques have been developed to perform vitrectomy phases and several surgical instruments and vitreous substitutes have been introduced to optimize the vitreous removal and retina stabilization to reduce complications.

Purpose: To evaluate visual acuity, refractive outcomes, rotational stability, and patient-reported satisfaction 3 months after bilateral implantation of the Lucidis Toric extended-depth-of-focus (EDOF) intraocular lens in cataract patients with 1.00–3.00 D of regular corneal astigmatism.Methods: Prospective, single-arm study of 25 patients (50 eyes) undergoing phacoemulsification with bilateral Lucidis Toric IOL implantation. The primary endpoint was binocular uncorrected distance visual acuity (UDVA) at 3 months. Secondary endpoints included monocular/binocular UDVA, distance-corrected VA (DCVA) at 4 m; intermediate (80 cm, 66 cm) and near (40 cm) uncorrected and distance-corrected acuities; defocus curve; residual spherical equivalent (SE) and cylinder; IOL rotation; optical quality (MTF cutoff, Strehl ratio, HOA RMS); contrast sensitivity; halometry; and NEI-RQL-42. Paired t-tests or Mann–Whitney tests compared pre-/postoperative values.Results: At 3 months, the mean postoperative spherical equivalent was 0.17 ± 0.52 D (median 0.00 D; range −0.75 to +0.75 D) and the mean refractive cylinder was 0.04 ± 0.32 D (median 0.00 D; range −0.50 to +0.50 D). Median IOL rotation was 2.1 ± 2.3 degrees, with no eyes requiring repositioning. Mean binocular UDVA, UI80VA, UI66VA and UNVA were −0.01 ± 0.1, 0.08 ± 0.24, 0.04 ± 0.1, and 0.01 ± 0.14 logMAR, respectively. There were no statistically significant differences between uncorrected and distance-corrected visual acuities at any distance. The binocular defocus curve showed visual acuity better than 0.1 logMAR from +0.50 D to −3.00 D. NEI-RQL-42 scores indicated high patient satisfaction, particularly in clarity of vision, far, near vision, activity limitations, and glare domains.Conclusion: Bilateral Lucidis Toric EDOF IOL implantation delivers stable rotational performance, broad-range uncorrected vision, and high spectacle independence in astigmatic cataract patients. Future randomised, head-to-head trials with longer follow-up are warranted.