Background/Objectives: In the context of increasing bacterial resistance and the need for effective ophthalmic antiseptics, this study evaluates the antimicrobial efficacy of Corneial MED^®, a novel ophthalmic solution containing polyhexamethylene biguanide (PHMB) and cross-linked hyaluronic acid. The study investigates the in vitro fungicidal and bactericidal properties of this solution against clinically relevant fungal and bacterial strains and its impact on conjunctival flora in vivo. Methods: The in vitro assessment included time-kill assays to determine the fungicidal or fungistatic activity against Candida albicans, Aspergillus flavus, and Aspergillus fumigatus. The bactericidal activity was evaluated against Staphylococcus aureus (methicillin-sensitive and -resistant), Staphylococcus epidermidis, Pseudomonas aeruginosa, and Escherichia coli. In vivo, 43 patients undergoing cataract surgery were treated with the solution for three days preoperatively. Results: Corneial MED^® demonstrated a fungistatic effect against C. albicans and A. fumigatus, while it exhibited limited activity against A. flavus. The tested solution effectively reduced bacterial load within minutes, outperforming competitor ophthalmic solutions in activity against P. aeruginosa and E. coli. Conjunctival swabs indicated a significant reduction in bacterial load post-treatment, confirming the solution’s efficacy in reducing potential ocular pathogens. Conclusions: These findings highlight the potential of PHMB-based antiseptic solutions as a viable alternative to traditional disinfectants, particularly for preoperative prophylaxis and infection control. Further clinical trials are needed to confirm long-term safety and efficacy. The combination with cross-linked hyaluronic acid not only enhances tolerability but also extends antimicrobial action, making it a promising candidate for ophthalmic disinfection.

Bilateral acute retinal necrosis (BARN) represents a broad ophthalmological field of severe retinal pathologies associated with poor visual prognosis and blindness. The purpose of this review is to examine the clinical spectrum in detail over the past few years, exploring laboratory and instrumental diagnosis, and providing useful and up-to-date guidance in this field. A systematic review of this field has been performed through the PRISMA guidelines, searching in the PUBMED database. Serological laboratory tests on blood or polymerase chain reaction (PCR) on aqueous humor or vitreous samples are crucial to identifying the underlying cause and choosing the timeliest strategic treatments. Often, the main cause remains herpesviruses, with Varicella zoster (VZV) predominating over the others. There are also other causes that one needs to be carefully aware of. Anatomical and functional recovery is unfavorable if they are not individuated in a quick time. Early diagnosis and timely treatment offer a better chance of visual improvement and the avoidance of complications. Complications worsen the visual prognosis over months and may require a surgical approach.

Background: Epithelial ingrowth is an uncommon but potentially vision-threatening complication after keratorefractive lenticule extraction (KLEx). Although this complication is well described after flap-based refractive surgery, its occurrence after flapless lenticule extraction remains rare and is mainly reported in isolated cases. This narrative review summarizes the available literature on epithelial ingrowth after KLEx, with particular attention to proposed mechanisms, clinical presentation, imaging findings, and surgical management. An illustrative case of severe epithelial ingrowth managed with crocodile-forceps extraction is also presented. Methods: A literature search was performed to identify published reports describing epithelial ingrowth after SMILE/KLEx. Relevant articles were reviewed and compared with regard to onset, suspected mechanism, clinical severity, treatment strategy, anatomical outcome, visual recovery, and recurrence. Results: The affected eye developed extensive epithelial ingrowth associated with a postoperative tunnel laceration and marked visual deterioration during the first postoperative week. Surgical clearance through the original incision was performed using crocodile forceps followed by copious interface irrigation. Approximately one hour after treatment, AS-OCT demonstrated complete clearance of the hyperreflective interface material, corneal topography showed marked regularization, and wavefront aberrometry demonstrated a reduction in overall OPD RMS from 1.21 to 0.58 µm and higher-order RMS from 1.03 to 0.37 µm at a 4 mm pupil. Visual acuity subsequently improved over the following postoperative days, with no recurrence during 6-month follow-up. Conclusions: Severe epithelial ingrowth after KLEx may require prompt surgical intervention when rapid progression and visual deterioration occur. In this case, crocodile-forceps-assisted interface clearance through the original incision was feasible and was associated with rapid anatomical and optical recovery without cap-to-flap conversion or chemical adjuvants. Further cases are required to determine the reproducibility, safety, and long-term outcomes of this approach.

Background/Objectives: Acanthamoeba keratitis (AK) is a rare but sight-threatening corneal infection, often associated with contact lens wear and resistant to conventional therapies. Preventive strategies capable of reducing Acanthamoeba adhesion to corneal epithelium may represent an important tool for infection control. This study aimed to evaluate the amebicidal and preventive activity of CORNEIAL MED eye drops against Acanthamoeba castellanii adhesion and early adhesion layer on human corneal epithelium (HCE). Methods: Reconstructed HCE models were exposed to A. castellanii under four experimental conditions: negative control (HCE only), positive control (HCE + A. castellanii), co-incubation with CORNEIAL MED and A. castellanii (Study 1), and treatment with CORNEIAL MED after initial A. castellanii adhesion (Study 2). Adherent amoebae were quantified using EDTA detachment and Neubauer chamber counting. The early adhesion layer was characterized by scanning electron microscopy (SEM). Statistical analysis considered p < 0.05 as significant. Results: In Study 1, simultaneous application of CORNEIAL MED with A. castellanii reduced amoeba adhesion by 33.0 ± 11% compared with controls (p = 0.0529). In Study 2, when the product was applied 3 h after amoeba inoculation, adhesion was significantly reduced by 51.9 ± 6.5% (p < 0.05). SEM confirmed a decrease in amoebic colonization and biofilm density in treated samples. Conclusions: CORNEIAL MED demonstrated a measurable inhibitory effect on A. castellanii adhesion to HCE, particularly when applied after initial pathogen contact. These findings suggest a potential preventive role of CORNEIAL MED in reducing AK risk, although further in vivo studies are warranted.