Purpose: To examine the effectiveness of a standardized combination of intracameral mydriatics and anesthetic (SCIMA) on mydriasis in patients with coexisting diseases such as diabetes mellitus (DM) and pseudoexfoliation syndrome (PXF) during phacoemulsification. Methods: Patients with cataract were included in the study if they achieved pupil dilation diameter ≥ 6.0 mm after the administration of mydriatic eyedrops (ME) during the first visit (V1). During the second visit (V2), pupil size measurements were obtained for phacoemulsification surgery with SCIMA. Effective mydriasis was defined as a pupil diameter ≥ 6.0 mm just prior to capsulorhexis without the use of additional pupil dilating agents. The measurements after ME administration during V1 and after SCIMA use during V2 were compared. Results: 103 patients (103 eyes) were divided into 3 groups: cataract and DM (n = 35), cataract and PXF (n = 32), and cataract without DM or PXF (n = 36). SCIMA administration allowed the achievement of effective mydriasis (≥6.0 mm) in all groups (n = 103; 100%). Mydriasis was significantly larger (p ≤ 0.001) after ME (7.3 mm) than after SCIMA (6.8 mm) administration. Conclusions: Patients with cataract and such comorbidities as DM or PXF are likely to achieve effective pharmacological mydriasis during cataract phacoemulsification after SCIMA application. Mydriasis after ME is slower and larger, while SCIMA is faster.

Full-thickness idiopathic macular hole (MH) is a common cause of visual loss, affecting 3 per 1000 people. It usually affects females in their sixth to eighth decades of life. Best Visual Acuity decreases to less than 0.5. A typical MH’s symptom is the pincushion metamorphopsia, where the shape of an observed object is enrolled inwards and lines are bowed towards the center, in the direction of the fixation point. Over the years many theories of MH formation have been revealed. A recently approved theory states that vitreomacular adhesion with focal contraction of the perifoveal cheloid and pathologic traction can lead to a loss of full-thickness central retina causing a MH. The most valuable diagnostic procedure for MH is optical coherence tomography. Among other useful examinations are fluorescein angiography and angio-OCT. Classification of the stages of development of MH is done with an anatomical Gass classification and the recent The International Vitreomacular Traction Study Group Classification of Vitreomacular Adhesion, Traction, and MH. Natural history of the MH differs in the early and advanced stages. Pharmacological vitreolysis with ocriplasmin is used in the treatment of the disease. The most effective therapy is the posterior pars plana vitrectomy. Dye and peeling of the internal limiting membrane helps to achieve the closure of the MH and the good visual acuity.

Background: This study aimed to evaluate mydriasis stability during cataract surgery in patients with systemic comorbidities such as diabetes mellitus (DM) and pseudoexfoliation syndrome (PXF) after a standardised combination of intracameral mydriatics and anaesthetic (SCIMA). Stable mydriasis is crucial for safe and effective phacoemulsification. Methods: Patients were included if they achieved pupil dilation ≥6.0 mm during the qualifying visit. A total of 103 patients were enrolled, divided into three groups: cataract with diabetes (C + DM group, n = 35), cataract with PXF (C + PXF group, n = 32), and cataract without those comorbidities (C group, n = 36). SCIMA was administered, and pupil diameters were measured at key surgical stages. Stability was defined as a pupil diameter of ≥6.0 mm without additional pharmacological intervention and no significant change in its diameter (≥3.0 mm). Results: Stable mydriasis was achieved in 90.3% of patients: 97.1% in the C + DM group, 90.6% in the C + PXF group, and 83.3% in the C group, with no statistically significant differences (p = 0.14). Conclusions: SCIMA effectively maintains mydriasis stability during cataract surgery, even in patients with systemic comorbidities, ensuring greater surgical safety.

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Purpose: To assess posture-induced ocular cyclotorsion in eyes undergoing conventional cataract surgery (CCS) with intraocular lens (IOL) implantation using the VERION Image-Guided System (Alcon). Methods: Patients with cataracts scheduled for conventional phacoemulsification with IOL implantation were consecutively examined and recruited into the study. All cataract surgeries were performed in December 2023 in the Department of Ophthalmology at the Military Institute of Aviation Medicine (Warsaw, Poland). The degree and direction of ocular cyclotorsion were recorded using the VERION Image-Guided System by comparing preoperative images of the anterior segment of the eye, captured with the patient seated, with intraoperative images obtained in the supine position. In addition, the correlation between axial length (AL) and ocular cyclotorsion was analyzed. Results: The study included 31 eyes of 31 patients (20 women and 11 men). The mean age was 71.35 ± 8.48 years (range, 49–90 years), and the mean AL was 23.59 ± 1.59 mm (range, 20.44–29.22 mm). The mean absolute value of ocular cyclotorsion was 4.26 ± 3.04° (range, 0–11°; median, 4°). Clockwise rotation occurred more frequently (61.29%; 19 eyes) than counterclockwise rotation (35.48%; 11 eyes). Incyclorotation (54.84%) was more common than excyclorotation (41.94%). There was no significant correlation between AL and the degree of ocular cyclotorsion, Spearman’s rank correlation coefficient was ρ=0,14. Conclusions: Posture-related cyclotorsion commonly occurs during CCS and may influence the accuracy of astigmatism correction by affecting the alignment of toric IOLs. The VERION Image-Guided System enables precise assessment and compensation of ocular cyclotorsion during cataract surgery.

Introduction: Modern combat aircraft increase the psychophysiological demands placed on pilots [14]. This necessitates continuous improvement of methods for assessing fitness for flight duty, supported by specialized flight simulators. One such simulator, developed with the participation of the Military Institute of Aviation Medicine, is the stationary flight simulator named SymuLBNP. In the presented study, a criterion of 10% threshold was proposed for evaluating the symmetry of lower limb pressure force on the rudder pedals of the diagnostic and training stand for anti-G maneuver training, which may be applied in future research using the SymuLBNP simulator. The aim of the study was to evaluate the symmetry of lower limb pressure force on the rudder pedals of the diagnostic and training stand for anti-G maneuver training, recorded during scheduled pilot training in aviation medicine, as a factor potentially influencing the results of measuring lower limb pressure force on the rudder pedals of the SymuLBNP simulator. Methods: The study utilized pressure force measurement data on the rudder pedals of the diagnostic and training stand, recorded during routine pilot training in aviation medicine. The statistical analysis was conducted on the measurement results of a group of 258 men aged 18 to 25 years. Differences between the pressure force exerted by the left lower limb and the right lower limb were examined. Results: The analysis of the lower limb pressure force measurements on the pedals of the diagnostic and training stand revealed a statistically significant (alpha = 0.05) asymmetry in the pressure force applied to the rudder pedals by the lower limbs. Based on the analysis of additional parameters describing the obtained results, a criterion was adopted stating that if the value of the symmetry index does not exceed 10%, it can be assumed that the pressure forces exerted by the pilot on the rudder pedals with the left and right lower limbs are symmetrical and will not significantly affect the assessment of the muscular component of the anti-G maneuver performed on the SymuLBNP simulator.