Background/Objectives: The purpose of this study is to evaluate clinical outcomes and early postoperative complications in patients undergoing Boston type I keratoprosthesis (BKPro) implantation, with a specific focus on the onset and nature of ocular surface disorders during the early postoperative period. Methods: This retrospective study included 77 eyes that underwent BKPro implantation between 2019 and March 2022. Patients were treated at the Saint Barbara Hospital, Trauma Centre, Sosnowiec, Poland, and District Railway Hospital, Katowice, Poland. Data were collected from medical records, including patient demographics, medical history, surgical outcomes, postoperative visual acuity, and complications. The analysis incorporated both detailed medical history and direct clinical examination results. Results: The most common early postoperative complication was glaucoma, affecting 32 eyes (42%). Retroprosthetic membrane formation occurred in 20 eyes (26%), while partial extrusion of the BKPro was observed in 10 eyes (13%). Severe corneal surface damage was noted in patients with underlying autoimmune diseases (36%) and after chemical burns (24%). Five patients suffered from transient hypotony resulting from keratoprosthesis extrusion. The results highlight the complex nature of managing ocular surface conditions and the frequent challenges associated with early postoperative complications. Conclusions: BKPro implantation is an effective solution for severe corneal diseases that are resistant to conventional treatments. However, it is associated with a significant risk of early complications, particularly glaucoma and retroprosthetic membrane formation. Early identification and management of these complications are crucial for improving outcomes and maintaining visual function. Further research into optimizing postoperative care is needed to minimize these risks and enhance patient outcomes.

Background/Objective: The aim of this retrospective study was to compare corneal parameters and compliance using a Pentacam HR–Scheimpflug (Pentacam HR) and a swept-source OCT Casia (Casia) in keratoconus (KC) patients post penetrating keratoplasty (PKP) and KC patients without PKP, as well as a control group. Pachymetry measurements were also analyzed using a spectral domain OCT Solix (OCT Solix), Pentacam HR, and Casia. Methods: The study included 71 patients (136 keratoconic eyes; group A), 86 eyes with KC post-PKP (group B), 50 eyes with KC without PKP (group C), and 52 control participants (104 eyes). All participants were adults, Polish Caucasian, and met specific inclusion criteria. Patients with ophthalmological or systemic diseases, cognitive impairment, or pregnancy were excluded. Corneal parameters were measured using two devices (Casia and Pentacam HR), while pachymetry was assessed with three devices (Casia, Pentacam HR, and OCT Solix), with the inter-device agreement and group differences analyzed. Results: Significant differences (p < 0.05) were found across all groups. The post-PKP KC eyes showed significant differences in all front parameters and K2 and Astig. back, while the non-PKP KC eyes showed differences in the K1 back (p = 0.025). The controls displayed differences in all parameters except front astigmatism (p = 0.61). The Pentacam HR overestimated the thinnest corneal thickness (TCT) compared to the OCT Casia across groups. The inter-device agreement was excellent for the anterior parameters (ICC > 0.9) but good for the posterior parameters and TCT. Conclusions: This study highlights significant variability in corneal and pachymetry measurements across devices, with OCT Casia providing more consistent and clinically reliable results than Pentacam HR. Clinicians should exercise caution when using these devices interchangeably, particularly for posterior parameters and TCT.

Background/Objectives: Keratoconus (KC) is a bilateral eye disease characterized by corneal thinning and cone-like deformation, leading to visual impairment. This study evaluated the radial peripapillary capillaries (RPCs) in keratoconus patients with and without penetrating keratoplasty (PKP) using OCT and angio-OCT, comparing the results to a control group. Methods: This retrospective study included 149 eyes, 97 from patients who underwent PKP between January 2018 and February 2023 and 52 from patients who did not undergo PKP. The control group comprised 72 patients (144 eyes) who were healthy volunteers. Measurements included the best corrected visual acuity (BCVA), the intraocular pressure (IOP), slit-lamp biomicroscopy, a fundus examination, and corneal topography, as well as OCT and angio-OCT assessments of the RPCs, retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), and central retinal thickness (CRT). Statistical analyses were performed using Student’s t-test and Pearson’s correlation coefficient. Results: The RNFL was significantly thinner in KC eyes after PKP compared to control eyes (p < 0.001), and the CRT was significantly thicker in KC eyes after PKP compared to control eyes (p = 0.003). However, the GCC was similar across the groups (p = 0.0885). Additionally, RPCs inside the disc were significantly reduced in KC eyes after PKP compared to control eyes (p < 0.0001). A significant positive correlation was found between RPC whole vessel density and RNFL thickness as measured via angio-OCT (r = 0.308, p < 0.0001). Conclusions: This study found that the RPC density inside the disc is significantly reduced in keratoconus patients after penetrating keratoplasty, highlighting RPCs inside the disc as a potential diagnostic tool for further assessment of keratoconus.

Background/Objectives: Dry eye disease (DED) is a common condition that can significantly impact cataract surgery outcomes. Preoperative management strategies, including the use of moisturizing eye drops, may improve ocular surface health and postoperative recovery. This study aimed to compare postoperative outcomes in 71 patients undergoing cataract surgery between June 2022 and May 2023 at a single center with and without preoperative keratostill moisturizing eye drops (sterile aqueous 0.3% hydroxypropyl methylcellulose solution) determined using the ocular surface disease index (OSDI), tear break-up time (TBUT), and optical coherence tomography (OCT) at diagnosis, on the day of surgery, and at two weeks postoperatively. Methods: A prospective observational study was conducted on 71 patients undergoing cataract surgery at Saint Barbara Hospital Trauma Center, Sosnowiec, Poland, from June 2022 to May 2023. Patients were randomly assigned to a test group (moisturizing eye drops) or a control group (no preoperative eye drops). The OSDI, TBUT, and OCT were evaluated at the baseline, preoperatively, and postoperatively. Results: The test group showed a significant improvement in OSDI scores (preoperative: 6.34 vs. baseline: 11.81; p < 0.001), which further decreased postoperatively (3.30; p < 0.001). TBUT also significantly increased from baseline to the preoperative visit (6.20 s to 7.97 s; p = 0.002) and remained stable after surgery (7.78 s). In contrast, the control group demonstrated only a minimal postoperative change in OSDI (3.92 to 3.70; p > 0.05) and a significant postoperative decrease in TBUT (5.96 s to 5.69 s; p = 0.864). Only the control group showed a significant postoperative decrease in epithelial thickness in operated eyes (p = 0.021), whereas no significant changes were observed in the test group. Conclusions: The preoperative use of moisturizing eye drops significantly improves the tear film stability, ocular comfort, and epithelial integrity, leading to better postoperative outcomes in cataract surgery patients.

Background/Objectives: The corneal epithelium plays a vital role in maintaining corneal transparency and ocular surface integrity. Chronic topical use of antiglaucoma medications may induce epithelial changes, especially with the concurrent use of multiple agents. This study aimed to evaluate the association between the number and class of antiglaucoma medications and central corneal epithelial thickness (CET), measured using a spectral-domain optical coherence tomography (SD-OCT) device. Methods: This cross-sectional study included 456 eyes from 242 adults (median age 72 years), grouped by the number of antiglaucoma agents used (0–4 medications). All pharmacologically treated participants had received the same regimen for ≥6 months. CET was measured using SD-OCT (SOLIX, Optovue). Generalized estimating equations (GEEs) accounted for inter-eye correlation. Two models were constructed: one evaluating specific medication effects and another assessing CET reduction per additional drug used. Age and sex were included as covariates. Results: CET progressively decreased with the number of medications, ranging from 53 µm in controls to 48 µm with quadruple therapy. Multivariable GEE analysis confirmed a cumulative thinning effect, with each additional medication associated with further CET reduction (β = −2.83 to −9.17 µm, p < 0.001). Latanoprost exerted the most pronounced single-drug effect (β = −3.01 µm, p < 0.001). Age was a modest negative predictor, while sex showed no significant effect. Conclusions: The cumulative number and specific class of antiglaucoma medications have a significant impact on corneal epithelial thickness. These results emphasize the need for vigilant ocular surface evaluation in patients on multi-drug regimens and propose CET as a surrogate marker for the burden of topical therapy.

Background/Objectives: Keratoconus (KC) is a bilateral asymmetric corneal ectasia characterized by progressive corneal thinning, irregular astigmatism, and impaired visual acuity. The National Eye Institute (NEI) developed the Visual Function Questionnaire (VFQ-25) to assess the impact of visual impairment on quality of life. This study aimed to evaluate the effect of penetrating keratoplasty (PKP) on quality of life and visual acuity in KC patients one year postoperatively. Methods: A retrospective study was conducted between January 2018 and December 2022 at the Ophthalmology Department of Saint Barbara Hospital, Trauma Center, Sosnowiec, Poland. A total of 71 patients (86 eyes) diagnosed with KC underwent PKP. The VFQ-25 questionnaire and visual acuity measurements were assessed preoperatively and one year postoperatively. Results: The study cohort included 71 patients (20 females, 28.17%; 51 males, 71.83%). Preoperative visual acuity ranged from less than 0.05 on the Snellen chart to 0.5. Postoperatively, visual acuity improved to a range of 0.1–1.0. A visual acuity of 1.0 was achieved in 21 eyes (24.42%; 5 females, 24%; 16 males, 76%), with a statistically significant improvement (p < 0.01). The mean VFQ-25 composite score increased from 57.96 (±17.58) preoperatively to 81.42 (±14.66) postoperatively (p < 0.001). Domains with the lowest preoperative scores were “role difficulties,” “general vision,” and “mental health,” while “color vision” scored highest. Conclusions: PKP significantly enhances both objective visual acuity and subjective quality of life in KC patients, as reflected in VFQ-25 questionnaire outcomes.