This pilot study evaluated the therapeutic effects of oral melatonin in patients diagnosed with primary Sjögren’s syndrome (pSS) and dry eye disease (DED). Twelve patients were treated with 5 mg of melatonin daily over an eight-week period. After treatment, significant improvements were recorded in Schirmer I test, tear break-up time (TBUT), and National Eye Institute (NEI) staining scores. Symptom severity decreased according to the Ocular Surface Disease Index (OSDI) and the EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI). Additionally, a significant reduction in serum interleukin-6 (IL-6) levels was observed, while C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) remained unchanged. Visual inspection of individual scores demonstrated a consistent trend of clinical improvement. No adverse effects were reported during the study period. These preliminary findings suggest that melatonin supplementation could represent a safe, adjunctive therapeutic strategy for managing autoimmune dry eye in pSS patients. Further large-scale clinical trials are warranted to confirm these results and explore the underlying mechanisms.

Purpose: To establish a geometric framework for scleral fixation planning in secondary intraocular lens (IOL) implantation that accounts for corneal ellipticity and meridional orientation, and to analyze the limitations of fixed limbus-distance marking. Methods: The limbal boundary is modeled as an ellipse defined by horizontal and ver-tical white-to-white (WTW) diameters. A target circumferential scleral locus is defined concentrically relative to an anatomical reference center. Fixation points are determined as a function of meridional orientation θ using an explicit radial model of the elliptical limbus and an orientation-dependent limbal offset. The framework is analyzed for two-, three-, and four-point fixation configurations, including the effect of uniform circumferential displacement. Results: A constant limbus-distance strategy implicitly assumes rotational invariance of limbal geometry. When the cornea is elliptical, this assumption produces predictable meridional deviations from the intended circumferential scleral locus for vertical and oblique fixation. An orientation-dependent limbal offset preserves geometric symmetry across all meridians and maintains fixation points on a consistent target locus independent of angular configuration. Under representative biometric conditions, maximal geometric deviations from the intended scleral locus approached approximately 0.58 mm when a constant limbus-distance strategy was applied. Conclusions: Scleral fixation planning can be formalized as a geometric problem gov-erned by limbal ellipticity and meridional orientation. An explicit orientation-dependent model provides a technique-independent basis for reproducible fixation planning and reduces reliance on fixed-distance heuristics.

We report a case of herpes simplex virus type 1 (HSV-1) anterior uveitis evolving into an acute iris transillumination-like syndrome with secondary pigmentary glaucoma, highlighting diagnostic challenges and treatment considerations. A 61-year-old immunocompetent woman presented with unilateral anterior uveitis characterized by keratic precipitates and mild anterior chamber inflammation. The condition was initially treated with topical and subconjunctival corticosteroids without antiviral therapy. After an initial resolution of symptoms, upon the cessation of treatment, the patient developed features resembling unilateral acute iris transillumination (UAIT) syndrome with elevated intraocular pressure, diffuse pigment dispersion, and progressive iris transillumination defects. Aqueous polymerase chain reaction (PCR) testing confirmed the presence of HSV-1. Despite the initiation of antiviral therapy, the condition progressed to severe pigmentary glaucoma, with unreliable intraocular pressure measurements due to prior LASIK surgery. Cataract extraction, pars plana vitrectomy, and Ahmed valve implantation were performed, with only partial recovery of visual acuity. This case illustrates that HSV-1 uveitis can mimic or transition into a UAIT-like syndrome, possibly due to steroid use without concurrent antiviral treatment, which may exacerbate viral replication and damage to the iris pigment epithelium. Aqueous PCR testing aids in differential diagnosis, but indicative medical history and clinical findings should remain instrumental. Clinicians should maintain a high index of suspicion for herpetic etiology in anterior uveitis cases and initiate prompt antiviral treatment to prevent potentially sight-threatening complications.

The reconstruction of complex orbitomaxillary defects requires biomaterials that can simultaneously provide structural stability, biocompatibility, and accurate restoration of facial volume and contour. While rigid polymers such as polyetheretherketone (PEEK) offer reliable mechanical support, they do not adequately replicate the viscoelastic behavior of soft tissues. This report presents a translational revision case employing a personalized hybrid biomaterial approach that combines a 3D-printed PEEK implant for structural orbital floor support with a patient-specific polydimethylsiloxane (PDMS) implant for malar volumetric augmentation. Reconstruction was planned using CT segmentation and contralateral mirroring. Patient-specific implants were subsequently designed using CAD/CAM techniques, combining a rigid PEEK implant for structural orbital support with a flexible PDMS implant for malar volumetric augmentation with complementary mechanical properties. Revision surgery included the removal of inadequately positioned titanium hardware, the release of incarcerated extraocular muscles, and the restoration of orbital anatomy and facial symmetry. Postoperative imaging demonstrated stable implant positioning and sustained orbitomaxillary stability. Despite successful anatomical reconstruction, residual functional sequelae, including strabismus related to the severity of the initial orbital trauma, persisted and were addressed separately in a staged manner, resulting in satisfactory ocular alignment and resolution of diplopia in primary gaze. This case underscores the complementary functional roles of rigid and elastic polymers and highlights the translational potential of PDMS as a permanent, patient-specific implant material for volumetric and contour restoration in craniofacial reconstruction.

The widespread presence of microplastics (MPs) and associated plastic-derived com-pounds, bisphenols (BPs), in the environment – originating from plastic production or adsorption of environmental pollutants – results in unavoidable human exposure. There-fore, assessing their occurrence in human biological samples is essential for understand-ing potential health risks. In this study, pyrolysis gas chromatography-mass spectrometry was used to analyse human intraocular fluids – aqueous humour (AH) and vitreous hu-mour (VH)—to identify 11 microplastic polymer clusters. A method based on dansyl chloride derivatization combined with ultra-performance liquid chromatography-tandem mass spectrometry was employed to screen for five bisphenols (BPs) in blood serum col-lected from the same patients. Potential MPs isolated from ocular samples were qualita-tively assessed by stereomicroscopy. The number of particles ranged from 14 to 69 per gram in AH and from 21 to 34 per gram in VH. Among AH samples, the most frequently detected polymer clusters were C-PMMA, C-PVC, C-PET, and C-PP, with average levels ranging from 0.41 to 0.82 µg/g. The three VH samples contained only C-PMMA, with an average concentration of 0.55±0.12 µg/g. Polymers such as C-PA66 (0.30±0.21 µg/g) and C-PA6 (0.15±0.44 µg/g) were occasionally observed in AH. Analysis of 13 human serum samples demonstrated exposure to bisphenol A (BPA; 3.90–5.63 ng/mL) and bisphenol AF (BPAF; 2.13–4.54 ng/mL), but no clear correlation was observed between serum BP levels and intraocular MPs within the limitations of the present dataset. These findings suggest the presence of MPs and BPs in human biological samples; however, the results should be interpreted with caution owing to potential background contamination and the pilot na-ture of the study.

To establish a geometric framework for scleral fixation planning in secondary intraocular lens (IOL) implantation that accounts for corneal ellipticity and meridional orientation, and to analyze the limitations of fixed limbus-distance marking. The limbal boundary was modeled as an ellipse defined by the horizontal and vertical white-to-white (WTW) diameters. A target circumferential scleral locus is defined concentrically relative to an anatomical reference center. Fixation points are determined as a function of the meridional orientation θ using an explicit radial model of the elliptical limbus and an orientation-dependent limbal offset. The framework is analyzed for two-, three-, and four-point fixation configurations, including the effect of uniform circumferential displacement. A constant limbus-distance strategy implicitly assumes rotational invariance of limbal geometry. When the cornea is elliptical, this assumption produces predictable meridional deviations from the intended circumferential scleral locus for vertical and oblique fixation. An orientation-dependent limbal offset preserves geometric symmetry across all meridians and maintains fixation points on a consistent target locus, independent of angular configuration. Under representative biometric conditions, the maximal geometric deviation from the intended scleral locus approached approximately 0.58 mm when a constant limbus-distance strategy was applied. Scleral fixation planning can be formalized as a geometric problem governed by limbal ellipticity and meridional orientation. An explicit orientation-dependent model provides a technique-independent basis for reproducible fixation planning and reduces reliance on fixed-distance heuristics.