Purpose To investigate preoperative ocular risk factors and indications for secondary intraocular lens (IOL) implantation and compare postoperative complications, visual and refractive outcomes in a tertiary referral center. Methods Patients older than 14 years that underwent secondary IOL implantation and had a minimum follow-up of 3 months were enrolled in this retrospective case series. Preoperative ocular risk factors, indications for surgery, postoperative complications, and visual and refractive outcomes including prediction error (PE) and absolute error (AE) were evaluated. IOLs were fixated in following positions: anterior chamber (AC), retropupillary iris-claw (IC), sulcus, and capsular bag or sclera. Results One-hundred eighty-two eyes of 174 patients with mean follow-up of 17 ± 13.6 months were evaluated. Leading cause for surgery was IOL dislocation (75%), followed by secondary aphakia (19%) and IOL opacifications (6%). Previous vitrectomy was the major preoperative ocular risk factor (43%). Mean corrected distance visual acuity improved from preoperative 0.68 ± 0.55 to 0.42 ± 0.31LogMAR by the last follow-up (p = 0.001). PE and AE differed highly depending on the indication for surgery (p = 0.041 and p = 0.008, respectively) and the IOL fixation (p = 0.011 and p = 0.028, respectively), with IC-IOLs showing the lowest PE and AE. Postoperative AC-hemorrhage occurred mainly after IC-IOLs (p = 0.003), and postoperative hypotony was significantly higher in eyes with previous uveitis (p = 0.026). Conclusions Previous vitrectomy seems to be a major underreported risk factor in eyes that undergo secondary IOL implantation. Refractive outcomes depend on indication for surgery and fixation type, with retropupillary IC-IOLs providing the best refractive results, though not statistically significant compared to other IOL positions.

To compare the efficacy of a computer-assisted marker system for toric intraocular lenses (IOLs) (Callisto Eye System) with manual marking techniques. University Eye Hospital Munich, Ludwig-Maximilians-University, Munich, Germany. Prospective case series. This study included patients having cataract surgery with implantation of a toric IOL (Torbi 709 M). They were randomly assigned to 1 of 2 groups based on the marking system used, manual or digital. Patients were included if they had age-related cataract and a regular corneal astigmatism of 1.25 diopters (D) or higher. Visual and refractive outcomes as well as rotational stability were evaluated. Vector analysis was performed to evaluate total astigmatic changes. The study comprised 57 eyes of 29 patients; there were 28 eyes in the manual group and 29 eyes in the digital group. The mean toric IOL misalignment was significantly lower in the digital group than in the manual group (2.0 degrees ± 1.86 [SD] versus 3.4 ± 2.37 degrees; P = .026). The mean deviation from the target induced astigmatism was significantly lower in the digital group (0.10 ± 0.08 D versus 0.22 ± 0.14 D; P = .008). During surgery, the mean toric IOL alignment time was significantly shorter in the digital group (37.2 ± 11.9 seconds versus 59.4 ± 15.3 seconds; P = .003). The mean overall time required to perform the surgery was significantly shorter in the digital group (727.2 ± 198.4 seconds versus 1110.0 ± 382.2 seconds; P < .001). A digital tracking approach for toric IOL alignment was efficient and safe to improve refractive outcomes. Furthermore, image-guided surgery helped streamline the workflow in refractive cataract surgery.

Diabetic retinopathy (DR) is a leading cause of vision loss globally, with early detection and intervention critical to preventing severe outcomes. This narrative review examines the role of retinal biomarkers—molecular and imaging—in improving early diagnosis, tracking disease progression, and advancing personalized treatment for DR. Key biomarkers, such as inflammatory and metabolic markers, imaging findings from optical coherence tomography and fluorescence angiography and genetic markers, provide insights into disease mechanisms, help predict progression, and monitor responses to treatments, like anti-VEGF and corticosteroids. While challenges in standardization and clinical integration remain, these biomarkers hold promise for a precision medicine approach that could transform DR management through early, individualized care.

The enhanced depth of focus IOL with 1.5 D of near add showed excellent intermediate and far visual performance and acceptable near visual restoration. Patient satisfaction was very high, and few patients reported disturbing photic phenomena.

To evaluate the accuracy of a swept-source optical coherence tomography (SS-OCT) biometer compared with a standard partial coherence interferometry (PCI) biometer in terms of phacovitrectomy for vitreomacular pathology and cataract. Department of Ophthalmology, Ludwig-Maximilians-University Munich, Germany. Prospective, nonrandomized, single center consecutive case series. Patients with age-related cataract, regular corneal astigmatism less than 1.25 diopters (D) and a clinically significant vitreomacular pathology (epiretinal membrane [ERM], macular hole, or vitreomacular traction [VMT] syndrome) who had combined phacovitrectomy with internal limiting membrane peeling were enrolled. Objective and manifest refraction, corrected distance visual acuity, SS-OCT biometry, and PCI biometry were obtained preoperatively and 3 months postoperatively. The refractive prediction error and mean absolute error (MAE) were calculated for each biometric device with the Haigis formula. The percentage of eyes with a prediction error within ±0.50 D or less were calculated. The study comprised 79 eyes of 79 patients. The mean refractive prediction error of all eyes was -0.27 D ± 0.76 (SD) for the PCI biometer and -0.28 ± 0.57 D for the SS-OCT biometer (P = .802), and the MAE was 0.61 ± 0.53 D and 0.46 ± 0.43 D, respectively (P = .012). A prediction error within ±0.50 D or less was observed in 55 eyes (70%) with the SS-OCT biometer compared with 42 eyes (53%) with the PCI biometer (P = .0001). The MAE with the SS-OCT biometer was statistically significantly lower in eyes with ERMs or macular holes compared with the PCI biometer (P = .043 and P = .028, respectively), whereas no statistically significant difference was observed in eyes with VMT syndrome (P = .286). The SS-OCT biometer showed a statistically significant lower MAE compared with the PCI biometer, and it is recommended for precise intraocular lens power calculations in combined phacovitrectomy for cataract and vitreomacular diseases.