Objectives: The aim of this study was to establish the concordance between conventional 20 Mhz ultrasonography and an ultrawide-field (UWF) imaging system (Optos^® California) in the measurement of basal diameters of melanocytic choroidal tumors. Methods: A retrospective study comparing diagnostic tests was conducted in patients with untreated melanocytic choroidal lesions (either nevus or melanoma) who had undergone both UWF imaging and ultrasonography. Only cases with a clear visualization of tumor borders in both imaging modalities were included. Longitudinal and transversal base diameters of the melanocytic tumors were measured by 20 MHz US (one observer) and UWF fundus photography (two observers). Interobserver agreement was assessed for UWF imaging first to validate the technique. Then, UWF imaging measurements were compared with 20 MHz US results. Results: In total, 106 patient images were reviewed, of which 61 were excluded due to unclear visualization of tumor margins. We found excellent concordance (from ICC and defined Bland–Altman plots) for interobserver and inter-technique agreement in estimating basal diameters when using pseudocolor composite and red laser images by comparing them with 20 MHz US results. Conclusions: UWF fundus imaging, when complete visualization of the tumor margins is possible, could be as reliable as ultrasonography in the measurement of the basal diameters of choroidal melanocytic tumors.

In the published publication [...].

Purpose: Tibial bone keratoprostheses are used in situations where conventional corneal transplantation is not viable. However, the prognosis is often guarded in cases of ocular surface diseases, such as autoimmune conditions or chemical burns, because of the risk of tissue necrosis and subsequent prosthesis extrusion. In this study, we describe an innovative approach using a dermal fat graft to manage keratoprosthesis (KPro) exposure and avoid extrusion. Methods: We report the case of a man with a history of bilateral chemical burns caused by caustic soda, who underwent tibial bone keratoprosthesis implantation in the left eye. The procedure was later complicated by buccal mucosa necrosis, leading to prosthesis exposure. This was successfully managed with a dermal fat graft. Clinical history, examination findings, imaging, and a literature review are presented. Results: At 5 years of follow-up, the KPro remained well positioned, with the dermal fat graft fully epithelialized and no evidence of extrusion or other complications. The patient maintained a stable uncorrected visual acuity of 0.3. Conclusions: This case provides the first evidence of a favorable outcome following dermal fat graft implantation as a treatment for KPro exposure to prevent extrusion. Since KPro extrusion is one of the most frequent postoperative complications, its prevention is of utmost importance. The use of a dermal fat graft in such high-risk cases may offer a more stable and biocompatible solution for long-term prosthesis retention.