To evaluate the satisfaction and quality of life after laser vision correction (LVC) exclusively in a physician population. Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA. Cohort study. A 12-question survey targeted toward physicians and the unique qualities of their experience with refractive surgery was sent to physicians who had refractive surgery at the Cole Eye Institute between 2000 and 2012. In conjunction, the visual outcomes and clinical information of physicians who received the survey were reviewed. Two hundred twenty-six physicians (439 eyes) met the inclusion criteria for our study. One hundred thirty-two physicians (58%) responded to the survey and reported an overall satisfaction rate of 95.3%. Respondents included surgeons (28.0%), physicians who perform procedures but not surgery (43.2%), and physicians who do not perform procedures or surgery (28.8%). Of the physicians, 84.8% reported an improvement in the quality of vision compared with the corrected preoperative vision, 39.0% reported that their ability to perform procedures accurately had improved and 1.6% said they believed their ability to perform procedures was less. Ninety-six percent reported they would have the procedure again. Visual outcomes showed high levels of surgical predictability, efficacy, and safety. Despite high visual demands, physicians having LVC had a high percentage of good visual outcomes, satisfaction, and quality-of-life improvements.

Purpose: To differentiate a normal cornea from a forme fruste keratoconus (FFKC) with the swept-source optical coherence tomography (SS-OCT) topography CASIA 2 using machine learning artificial intelligence algorithms. Setting: Monocentric, performed in CHU Bordeaux, Bordeaux, France. Design: Retrospective case–control. Methods: 3 groups were included: KC group (108 eyes), FFKC (88 eyes), and normal corneas (162 eyes). The data were analyzed and processed using the Dataiku data science platform. Machine learning models (random forest [RF], logistic regression [LR]) were used to develop a multiclass classifier for automated early KC detection. The models were trained using a training database and tested using a test database. Then, algorithms were compared with the Ectasia Screening Index (ESI), which is an OCT-topography inherent screening score for ectasia. Results: The LR and RF detected FFKC with an area under the curve of 0.99 and 0.98, respectively. The sensitivities of LR (100%) and RF (84%) were better than the ESI (28%) for the diagnosis of FFKC. However, ESI has a maximum specificity (100%) compared with the LR (100%) and 90% for RF. Conclusions: This study identified discriminating topographic parameters to be considered in refractive surgery screening on SS-OCT CASIA 2. An algorithm capable of classifying normal eyes vs FFKC cases was developed, with improved performance compared with the ESI score.

This retrospective study evaluates the effectiveness of combining 0.05% atropine with MF60 contact lenses in managing rapid myopia progression in children over one year. The study involved three groups: the treatment group (TG) with 15 children (53% male, average age 12.9 ± 1.04), the MF group (MF) with 12 children (50% male, average age 12.8 ± 0.8) using only MF60 lenses, and the control group (CG) with 14 children (43% male, average age 12.1 ± 0.76). Baseline myopia and axial length (AL) were similar across groups, with the TG, MF, and CG showing −4.02 ± 0.70 D, −4.18 ± 0.89 D, −3.86 ± 0.99 D, and 24.72 ± 0.73 mm, 24.98 ± 0.70 mm, 24.59 ± 1.02 mm, respectively. Prior to the study, all groups exhibited significant myopia and AL progression, with no previous myopia control management. The treatment involved daily 0.05% atropine instillation, the use of MF60 lenses and increased outdoor activity. Biannual cycloplegic refraction and slit lamp evaluations confirmed no adverse reactions. After one year, the TG showed a significant reduction in myopia and AL progression (−0.43 ± 0.46 D, p < 0.01; 0.22 ± 0.23 mm, p < 0.01), whereas the CG showed minimal change (−1.30 ± 0.43 D, p = 0.36; 0.65 ± 0.35 mm, p = 0.533). The MF group also exhibited a notable decrease (−0.74 ± 0.45 D, p < 0.01; 0.36 ± 0.23 mm). Increased outdoor activity during the treatment year did not significantly impact myopia control, suggesting its limited additional effect in this cohort. The study concludes that the combination of 0.05% atropine and peripheral defocus soft contact lenses effectively controls myopia progression in children.

This retrospective comparative study analyzes the early postoperative impact of laser vision correction for myopia on the optical quality and stability of functional vision using a double-pass aberrometer. Retinal image quality and visual function stability were assessed preoperatively, one and three months after myopic laser in situ keratomileuses (LASIK) and photorefractive keratectomy (PRK) using double-pass aberrometry (HD Analyzer, Visiometrics S.L, Terrassa, Spain). The parameters analyzed included vision break-up time (VBUT), objective scattering index (OSI), modulation transfer function (MTF), and Strehl ratio (SR). The study included 141 eyes of 141 patients, of whom 89 underwent PRK and 52 underwent LASIK. No statistically significant differences were noted between the two techniques in any analyzed parameters at three months postoperatively. However, a significant drop was observed in all parameters one month after PRK. Only the OSI and VBUT remained significantly altered from baseline at the three months follow-up visit, with an increased OSI by 0.14 +/− 0.36 (p < 0.01) and a shortened VBUT by 0.57 +/− 2.3 s (p < 0.01). No correlation was found between the changes in optical and visual quality parameters and age, ablation depth, or postoperative spherical equivalent. The stability and quality of the retinal images were similar between LASIK and PRK at three months postoperatively. However, significant degradation in all parameters was found one month after PRK.

Objectives: This study evaluated the therapeutic potential of topical Ripasudil hydrochloride hydrate in managing various forms of corneal edema. Methods: This retrospective study included 96 patients of 72.20 ± 10.52 years, with 53 females (55.2%) who were treated with Ripasudil for corneal edema, with a mean treatment duration of 5.2 ± 2.3 months, divided into four groups: post-cataract surgery (n = 32), Fuchs endothelial corneal dystrophy (FECD; n = 29), post-Descemet membrane endothelial keratoplasty (DMEK; n = 25), and post-penetrating keratoplasty (PKP; n = 10). All patients were treated with Ripasudil, typically administered three times daily in the first week and twice daily in the following months. Clinical efficacy outcomes were assessed using changes in best-corrected visual acuity (BCVA), central corneal thickness (CCT), and endothelial cell count (ECC) with specular microscopy, anterior segment optical coherence tomography (OCT), and slit-lamp examination, while intraocular pressure (IOP) was measured using the iCare tonometer. Results: Ripasudil treatment led to a reduction in CCT and improvement in visual acuity across most groups, with minimal changes in ECC. CCT decreased by 30.44 μm (p < 0.001), 25.56 μm (p < 0.001), 8.41 μm (p = 0.05), and 6.80 μm (p > 0.1); visual acuity improved by 0.27 (p = 0.001), 0.18 (p = 0.02), 0.17 (p = 0.025), and 0.07 logMAR units (p > 0.1); and ECC changed by +7.0 (p > 0.1), 15.4 (p > 0.1), −7.6 (p > 0.1), and 2.3 cells/mm² (p > 0.1) in the post-cataract surgery, FECD, post-DMEK, and post-PKP groups, respectively. Conclusions: No adverse events or progression of edema were recorded during the follow-up period. These findings support the role of Ripasudil as a non-invasive pharmacological approach to managing corneal edema and delaying or possibly avoiding surgical interventions, such as corneal transplantation, in selected cases.

A novel technique for Descemet membrane endothelial keratoplasty (DMEK) graft handling and centration without the endothelium touching the posterior part of the anterior chamber (AC), is presented here. It is particularly suitable for vitrectomized eyes, deep AC, and AC intraocular lenses (ACIOLs), potentially reducing surgery time and endothelial cell loss during surgery. This retrospective interventional case series includes 27 eyes with complex ocular pathology. All utilized a “Wave maneuver” to center an early elevated graft without completing graft centration on the bottom of the AC. Successful graft attachment and centration were evaluated intra and post-operatively. Best-corrected visual acuity (BCVA), central corneal thickness (CCT), and donor endothelial cell density (ECD) were measured pre-operatively, and three and six months post-operatively. DMEK grafts were successfully attached and centered in all cases. No maneuver-related complications were observed intraoperatively. BCVA improved from a pre-operative 0.2 ± 0.63, to 0.43 ± 0.49 and 0.76 ± 0.51 at the three- and six-month follow-ups, respectively (p < 0.01). CCT decreased from a pre-operative 742 ± 118, to 546 ± 87 and 512 ± 67 at three and six months, respectively (p < 0.01). ECD decreased from 2878 ± 419 cells/mm² to 1153 ± 466 cells/mm² at three and six months, respectively (p < 0.01). The “Wave maneuver” may be very beneficial in DMEK cases where the AC is either very deep or the bottom of the AC is compromised. The “Wave maneuver” learning curve was brief.