To determine the efficacy and safety of surgical implantation of artificial iris-lens diaphragm in patients with anatomic or functional iris deficiencies, aphakia or cataract. Svyatoslav Fyodorov MNTK Eye Microsurgery, Cheboksary, Russia. Twenty eyes of 19 consecutive patients with combined iris and lens pathology of traumatic or congenital etiology were identified for an interventional noncomparative case series. The newly proposed model of an elastic iris-lens diaphragm with a colored haptic and additional support elements was implanted using various fixation approaches. Fifteen eyes (75%) experienced improvement in corrected visual acuities. The best spectacle-corrected visual acuity (BSCVA) in 2 eyes did not change, while the uncorrected visual acuity (UCVA) in these eyes increased. There were 3 eyes in which BSCVA deteriorated with no change or even slight improvement in UCVA. All patients were satisfied with the cosmetic results of the surgery and reported a decrease in glare and photophobia. There was 1 intraoperative complication of vitreous hemorrhage. Postoperatively, 2 cases of hyphema, 1 case of ciliochoroidal detachment, 4 eyes with exaggerated immediate postoperative reaction, and 1 eye with persistent low-grade cyclitis were observed. In 1 eye, there was persistent intraocular pressure rise. One eye showed signs of cystoid macular edema. No iris-lens diaphragm decentrations and no new or extensions of old retinal detachments were seen during the follow-up period. Artificial iris-lens diaphragm implantation effectively improved postoperative outcomes by correcting aphakia, reducing glare disability, and addressing cosmetic issues faced by iris-deficient, and aphakic or cataract patients. Although the iris-lens diaphragm appears to be safe, long-term results must be clarified in studies with longer follow-up and a larger patient population.

The accurate diagnosis of keratoconus, especially in its early stages of development, allows one to utilise timely and proper treatment strategies for slowing the progression of the disease and provide visual rehabilitation. Various keratometry indices and classifications for quantifying the severity of keratoconus have been developed. Today, many of them involve the use of the latest methods of computer processing and data analysis. The main purpose of this work was to develop a machine-learning-based algorithm to precisely determine the stage of keratoconus, allowing optimal management of patients with this disease. A multicentre retrospective study was carried out to obtain a database of patients with keratoconus and to use machine-learning techniques such as principal component analysis and clustering. The created program allows for us to distinguish between a normal state; preclinical keratoconus; and stages 1, 2, 3 and 4 of the disease, with an accuracy in terms of the AUC of 0.95 to 1.00 based on keratotopographer readings, relative to the adapted Amsler–Krumeich algorithm. The predicted stage and additional diagnostic criteria were then used to create a standardised keratoconus management algorithm. We also developed a web-based interface for the algorithm, providing us the opportunity to use the software in a clinical environment.

Congenital aniridia (AN) is a hereditary autosomal dominant developmental disorder of the eye. Heterozygous mutations in the PAX6 gene and chromosomal rearrangements involving the 11p13 locus lie behind the pathogenesis of the AN. The key role of the PAX6 gene in the regulation of embryogenesis and the pleiotropic effect of this transcription factor explain the damage of several tissues of the anterior and posterior segments of the eye, brain structures, and the disturbance of morphogenesis and endocrine function of the pancreas observed in AN. Recently AN has been considered a syndromic pathology by several researchers. The review suggests classification and summarizes information on the clinical characteristics and genetic basis of various forms of AN. The problem of discrimination of clinical-genetic variants of the dysgenesis of the anterior segment of the eye and the differential diagnosis of PAX6-associated AN with WAGR syndrome, anterior dysgenesis, other rare monogenic and chromosomal syndromes is discussed, and the role of molecular diagnostics is emphasized.