Cellular uptake and cytotoxicity of nanostructured hydroxyapatite (nanoHAp) are dependent on its physical parameters. Therefore, an understanding of both surface chemistry and morphology of nanoHAp is needed in order to be able to anticipate its in vivo behavior. The aim of this paper is to characterize an engineered nanoHAp in terms of physico-chemical properties, biocompatibility, and its capability to reconstitute the orbital wall fractures in rabbits. NanoHAp was synthesized using a high pressure hydrothermal method and characterized by physico-chemical, structural, morphological, and optical techniques. X-ray diffraction revealed HAp crystallites of 21 nm, while Scanning Electron Microscopy (SEM) images showed spherical shapes of HAp powder. Mean particle size of HAp measured by DLS technique was 146.3 nm. Biocompatibility was estimated by the effect of HAp powder on the adhesion and proliferation of mesenchymal stem cells (MSC) in culture. The results showed that cell proliferation on powder-coated slides was between 73.4% and 98.3% of control cells (cells grown in normal culture conditions). Computed tomography analysis of the preformed nanoHAp implanted in orbital wall fractures, performed at one and two months postoperative, demonstrated the integration of the implants in the bones. In conclusion, our engineered nanoHAp is stable, biocompatible, and may be safely considered for reconstruction of orbital wall fractures.

Background and Objectives: Hyperopia is a refractive error which affects cognitive and social development if uncorrected and raises the risk of primary angle-closure glaucoma (PACG). Materials and Methods: The study included only the right eye—40 hyperopic eyes in the study group (spherical equivalent (SE) under pharmacological cycloplegia over 0.50 D), 34 emmetropic eyes in the control group (SE between −0.50 D and +0.50 D). A complete ophthalmological evaluation was performed, including autorefractometry to measure SE, and additionally we performed Ocular Response Analyser: Corneal Hysteresis (CH), Corneal Resistance Factor (CRF); specular microscopy: Endothelial cell density (CD), Cell variability (CV), Hexagonality (Hex), Aladdin biometry: Anterior Chamber Depth (ACD), Axial Length (AL), Central Corneal Thickness (CCT). IBM SPSS 26 was used for statistical analysis. Results: The mean age of the entire cohort was 22.93 years (SD ± 12.069), 66.22% being female and 33.78% male. The hyperopic eyes had significantly lower AL, ACD, higher SE, CH, CRF. In the hyperopia group, there are significant, negative correlations between CH and AL (r −0.335), CRF and AL (r −0.334), SE–AL (r −0.593), ACD and CV (r −0.528), CV and CRF (r −0.438), CH (r −0.379), and positive correlations between CCT and CH (r 0.393) or CRF (r 0.435), CD and ACD (r 0.509) or CH (0.384). Age is significantly, negatively correlated with ACD (r −0.447), CH (r −0.544), CRF (r −0.539), CD (r −0.546) and positively with CV (r 0.470). Conclusions: Our study suggests a particular biomechanical behavior of the cornea in hyperopia, in relation with morphological and endothelial parameters. Moreover, the negative correlation between age and ACD suggests a shallower anterior chamber as patients age, increasing the risk for PACG.

Background: Fungal keratitis remains a serious threat to vision, often progressing despite medical therapy and requiring surgical intervention. Therapeutic deep anterior lamellar keratoplasty (DALK) and therapeutic penetrating keratoplasty (TPK), are frequently required but carry risks of infection recurrence and graft rejection. As timely identification of the etiological agent is essential for improving the outcomes in infectious keratitis, in vivo confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS-OCT) are instrumental in providing insights that can guide better therapeutic decision-making and improving outcomes in fungal keratitis. Case Description: We report the cases of two previously healthy patients (case one, 56-year-old woman; case two, 38-year-old man), who have presented in our service with unilateral infectious keratitis after ocular trauma with vegetable matter during outdoor activities, with a visual acuity of counting fingers and hand motion, respectively. Slit-lamp examination revealed unilateral extensive corneal infiltrates suggestive for fungal etiology in both cases. In vivo confocal microscopy (HRT-3, Heidelberg Retina Tomograph 3/Rostock Cornea Module, Heidelberg Engineering, Heidelberg, Germany) identified lesions suggestive for Candida Albicans and Acanthamoeba coinfection in case one and filamentous fungal keratitis in case two. Anterior segment optical coherence tomography (MS-39, CSO, Italy) was used to monitor the extent and morphology of the infiltrates. The patients underwent therapeutic DALK and TPK, respectively, with good results at the one-year follow-up. Conclusions: Our cases illustrate the advantages of incorporating IVCM and AS-OCT as complementary imaging techniques into clinical practice. IVCM and AS-OCT in fungal keratitis could lead to an earlier diagnosis, more accurate dynamic treatment response evaluation, and the identification of high-risk features for aggressive fungi for a more tailored medical and surgical management.

Purpose: To present the anatomical and functional results of sequential pars plana vitrectomy for treating rhegmatogenous retinal detachment with peripheral breaks and concomitant noncausative macular holes (MHs) in nonhighly myopic patients. Methods: Medical records of patients who underwent rhegmatogenous retinal detachment surgical repair between 2017 and 2023 were reviewed. Of 980 patients with rhegmatogenous retinal detachment, 10 had concurrent MH and underwent sequential pars plana vitrectomy for rhegmatogenous retinal detachment repair and air endotamponade, followed by MH repair using the inverted internal limiting membrane flap technique and C₂F₆ endotamponade after a minimum of 1 week. The main outcomes measured were best-corrected visual acuity change, retinal reattachment rate, MH closure rate, and closure type. Results: The retinal reattachment rate was 90% after the primary surgery and 100% after subsequent surgery. Macular hole closure was achieved in all cases. Macular hole diameters ranged from 291 to 702 µm. Anatomical recovery showed mainly 1A closure types (90%). Functional recovery demonstrated significant best-corrected visual acuity improvement, with a mean visual acuity gain of 1.58 ± 0.41 the logarithm of the minimum angle of resolution. Conclusion: For this infrequent pathology, sequential surgery using the inverted internal limiting membrane flap technique and air/gas endotamponade yielded favorable anatomical and functional outcomes. This controlled and standardized approach using sequential surgeries contributes to the achievement of consistent results.

Background/Objectives: Fuchs endothelial corneal dystrophy (FECD) affects not only the corneal endothelium and Descemet membrane, but also the corneal thickness, shape, and optical quality. This study aimed to evaluate the quantitative and qualitative corneal changes after a Descemet membrane endothelial keratoplasty (DMEK) in patients with FECD and to compare the postoperative remodeling between eyes with subclinical corneal edema (F-SCE) and those with clinically evident corneal edema (F-CE). Methods: This retrospective observational study included 48 eyes of 40 patients with FECD who underwent DMEK between April 2023 and October 2025. The following parameters were assessed preoperatively and at 6 months postoperatively: central corneal thickness (CCT), mean pupillary power (MPP), anterior and posterior corneal astigmatism, total corneal higher-order aberrations (HOAs), anterior and posterior optical path difference (OPD), point spread function (PSF), anterior and posterior corneal surface regularity (RMS/A), and Gullstrand anterior/posterior (A/P) and posterior/anterior (P/A) ratios. The corneal data was obtained using a CSO MS-39 (Costruzione Strumenti Oftalmici, Firenze, Italy). Results: In the F-SCE subgroup, significant postoperative improvement was observed in the CCT (Δ = −84.6 ± 48.1 µm, p < 0.001), MPP (Δ = −1.010 ± 2.183, p < 0.001), posterior corneal regularity (posterior RMS/A) (Δ = −0.117 ± 0.229, p = 0.004), and both Gullstrand ratios (A/P: Δ = +0.111 ± 0.089, p < 0.001; P/A: Δ = −0.078 ± 0.064, p < 0.001). No significant change was detected in the anterior corneal regularity, anterior or posterior astigmatic metrics, total corneal higher-order aberrations, or PSF. In the F-CE subgroup, the postoperative response was greater, with significant improvement in the BCVA, CCT, thinnest corneal point, MPP, anterior and posterior corneal astigmatism, cylinder, total corneal HOAs, anterior and posterior corneal HOAs, PSF, anterior and posterior corneal regularity, and both Gullstrand ratios. Compared with the F-SCE eyes, the F-CE eyes showed significantly greater postoperative change in most structural and optical parameters, although most 6-month postoperative values were no longer significantly different between groups. Conclusions: DMEK induced significant corneal remodeling in both subclinical and clinically evident FECD. The eyes with subclinical edema demonstrated meaningful recovery in visual acuity, pachymetry, and posterior corneal regularity, supporting the presence of functional corneal impairment before a clinically visible edema. The eyes with clinically evident edema showed a broader and greater postoperative response, while the final postoperative values largely converged between groups.