Neurotrophic keratopathy is a corneal disease characterized by impaired corneal innervation. It can lead to corneal epithelial defects, ulcerations, and perforations. Topical insulin has been shown to be effective in treating this disorder. Insulin is a growth factor that can promote corneal epithelial cell proliferation and migration. In addition, it can also inhibit corneal epithelial cell apoptosis. Topical insulin has previously been found to enhance corneal wound healing. This article reviews the current understanding of the mechanism of action of topical insulin in the treatment of neurotrophic keratopathy.

Purpose: The purpose of the study was to assess the biocompatibility of porous terpolymer (polytetrafluoroethylene-co-polyvinylidene fluoride-co-polypropylene, PTFE-PVDF-PP) membranes as an implant material to be placed during nonpenetrating very deep sclerectomy (NPVDS). Another study objective was to determine whether the polymer membrane under investigation could be used to manufacture a new-generation implant, which would actively delay the process of fistula closure and facilitate aqueous humor drainage. Methods: Histological response and tissue tolerance of the implant material were assessed. The study was performed on 38 eyeballs of 19 New Zealand white rabbits (19 implanted, 19 control). Histological assessment was carried out between 2 and 52 weeks after surgery. We routinely assessed inflammatory infiltrate, neovascularization, hemorrhage, and stromal edema as well as connective tissue attachment to the implant and adjacent tissues. Results: At 52 weeks of observation, a statistically significant difference was revealed between the study and control groups in terms of resorptive granulation, tissue, and the inflammatory infiltrate. No features of acute inflammatory response to the implant were observed, and there was an absence of histological features of acute inflammatory infiltrates and subsidence of chronic inflammatory infiltrates and resorptive granulation over time. Conclusions: Slight fibrotic response and insignificant changes in neighboring eye tissues all indicate good tolerance to bioimplant materials. This allows for some optimism regarding the use of hydrophobic terpolymer in the construction of new intrascleral implants. However, the ultimate decision regarding its usefulness and safety in the treatment of glaucoma requires further investigation.

Sub-internal limiting membrane (sub-ILM) hemorrhage is a distinct preretinal bleeding entity in which blood accumulates between the ILM and the retinal nerve fiber layer (RNFL), forming a sharply confined compartment. The ILM’s low permeability and lack of immune cell access create a stagnant microenvironment in which erythrocyte lysis leads to the accumulation of hemoglobin, heme, and iron, promoting the generation of reactive oxygen species. This oxidative burden poses a direct risk to retinal ganglion cells and Müller cell endfeet. Spectral-domain optical coherence tomography (SD-OCT) enables precise identification of sub-ILM blood through its characteristic dome-shaped elevation and hyperreflective contents, distinguishing it from subhyaloid and vitreous hemorrhage. Management options include observation, neodymium-doped yttrium–aluminum–garnet (Nd: YAG) laser membranotomy, pneumatic displacement, and pars plana vitrectomy (PPV). While small, extrafoveal hemorrhages may resolve spontaneously, prolonged blood entrapment is associated with increased retinal toxicity, tractional changes, and proliferative vitreoretinopathy (PVR). Early intervention generally results in faster clearance and improved visual outcomes, particularly for dense or foveal bleeding. Major gaps remain regarding cellular stress responses, biomarkers that predict irreversible damage, and the optimal timing of intervention. Standardized imaging criteria and evidence-based management algorithms are needed to guide individualized treatment.

Background: This study evaluates changes in the foveal avascular zone (FAZ) area and vessel density in patients with full-thickness macular hole (FTMH) before and after vitrectomy using optical coherence tomography–angiography (OCT-A). Methods: A prospective analysis was conducted on 39 patients diagnosed with FTMH who underwent pars plana vitrectomy. OCT-A imaging was performed preoperatively and at 1 and 3 months postoperatively. Parameters analyzed included FAZ area, superficial (SCP) and deep retinal vessel density (DCP), and central retinal thickness (CRT). Results: Preoperative OCT-A images showed a significant difference in the mean FAZ area between affected and healthy eyes (p < 0.01). However, a significant reduction in superficial capillary plexus (SCP) vessel density was noted after vitrectomy. Visual acuity improved significantly after surgery (p < 0.001), but no significant changes in FAZ or total vessel density were observed postoperatively. Postoperative distance visual acuity (DBCVA) correlated with preoperative macular hole size (p < 0.01). Conclusions: Vitrectomy for FTMH does not significantly alter the FAZ area or DCP vessel density, but does reduce SCP vessel density. OCT-A is a valuable tool for assessing retinal microvascular changes post-vitrectomy.

This study aimed to evaluate the impact of preoperative anti-VEGF injections on pars plana vitrectomy (PPV) outcomes in patients with proliferative diabetic retinopathy (PDR). Material and methods: We analysed 232 eyes with proliferative diabetic vitreoretinopathy treated with posterior vitrectomy. There were 112 women and 120 men. The patients were divided into two groups of 116 eyes each. In 116 eyes (study group), an anti-VEGF injection was administered 3 to 5 days before vitrectomy. The control eyes were not injected with anti-VEGF due to systemic contraindications to anti-VEGF treatment or lack of patient consent. All participants underwent pars plana vitrectomy with silicone oil injection. The oil was removed within 2–3 months after PPV. Results: At 2 years of observation, after removal of silicone oil, visual acuity (VA) was 0.24 ± 0.27 logMAR in the study and 0.37 ± 0.45 logMAR in the control group (p = 0.003). Intraocular pressure was 16.84 ± 6.25 mmHg in the study group and 17.78 ± 6.22 mmHg in the control group (p = 0.04). The mean duration of surgery was 47.62 ± 9.87 and 50.05 ± 9.41 min in the study and control groups, respectively (p = 0.02). The size of intraoperative haemorrhage was 0.97 ± 0.86 dd in the study group and 1.51 ± 1.22 dd in the control group (p = 0.003). The frequency of surgery-induced retinal breaks was 0.34 ± 0.56 in the study group and 0.56 ± 0.76 in the control group (p = 0.003). The recurrence rate of retinal detachment was 0.05 ± 0.22 in the study group and 0.1 ± 0.31 in the control group (p = 0.15). Conclusions: Preoperative anti-VEGF therapy shortens the duration of surgery, reduces complications, and improves long-term outcomes in terms of visual acuity and maintenance of normal eye function.