Mucous membrane pemphigoid (MMP) is a systemic cicatrizing autoimmune disease that primarily affects orificial mucous membranes, such as the conjunctiva, the nasal cavity, the oropharynx, and the genitalia. Ocular involvement occurs in about 70% of all MMP cases. Ocular MMP (OcMMP) also encompasses the conditions linear immunoglobulin A disease, mucosal dominated epidermolysis bullosa acquisita, and anti-laminin 332/anti-epiligrin/anti-laminin 5 pemphigoid. It is a complex clinical entity that may lead to ocular surface failure and result in inflammatory and infectious complications, as well as potentially devastating visual loss. Early diagnosis and appropriate treatment are of paramount importance and require a high level of expertise as this condition can be extremely challenging to diagnose and treat even for experienced clinicians. In this review we provide an up-to-date insight on the pathophysiology of OcMMP, with an emphasis on the current state of its diagnostics and therapeutics. Our the aim is to increase our understanding of OcMMP and highlight modern diagnostic and therapeutic options.

To evaluate the success (eradication of infection) or failure (recurrence of infection in the cornea or sclera, or endophthalmitis) of early therapeutic deep anterior lamellar keratoplasty (DALK) for active Acanthamoeba keratitis (AK) poorly responsive to medical treatment. Retrospective, noncomparative case series of 11 patients (11 eyes) affected by active AK poorly responsive to medical treatment who underwent early therapeutic DALK. Surgery was performed in all cases within 30 to 60 days from the onset of symptoms. Corneal ulcer depth was less than 300 μm in all cases. A 3-drug combination (chlorhexidine gluconate, propamidine isethionate, and neomycin sulfate) was the antiamoebic protocol used preoperatively and postoperatively. Cannula big bubble and "layer-by-layer" manual dissection techniques were performed. Eradication of infection, episodes of rejection, postoperative endothelial cell density, and the best spectacle-corrected visual acuity were evaluated. Histologic examination of surgical margins was performed, and margin clearance was assessed. Mean follow-up was approximately 2 years. Four descemetic DALK and 7 predescemetic DALK were performed. One small Descemet membrane rupture occurred. Peripheral surgical margins were free of infection in all cases. Deep surgical margins not free from infection were found in 2 cases. However, no episode of infection recurrence was observed. The postoperative average best spectacle-corrected visual acuity was 0.8 (range, 0.6-1.0). No case of rejection was recorded. Early therapeutic DALK could be considered a new approach to eradicate active infection in AK cases poorly responsive to medical treatment, with significant ulcer in the optical zone. Further studies are needed to validate this new indication for DALK.

To report the level of agreement, repeatability, and correlation of axial length (AL), mean keratometry, central corneal thickness, anterior chamber depth, lens thickness, and corneal diameter measurements of 2 swept-source optical coherence tomography (SS-OCT) biometers, the IOLMaster 700 (reference biometer) and the Argos (new biometer). Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom. Retrospective case series. Each patient had SS-OCT biometry with the reference biometer and new biometer. In addition to reporting the statistical results derived from both eyes, this study included a subgroup analysis of right eyes and left eyes. The level of agreement between the biometers was represented with the Bland-Altman method. Power vector analysis of the J0 (Jackson cross-cylinder, axes at 0 degrees and 90 degrees) and J45 (Jackson cross-cylinder, axes at 45 degrees and 135 degrees) vectorial components of astigmatism was performed. Internal consistency was assessed with the Cronbach α coefficient of reliability. The dispersion of probability distribution was computed with the coefficient of variation. The intraoperator repeatability was calculated using the intraclass correlation coefficient (ICC). The study comprised 112 patients (218 eyes). There was a statistically significant difference between the 2 biometers in all measurements (P < .05) except AL. The level of correlation between the reference biometer and the new biometer was very high for all the parameters except corneal diameter, and the agreement was high. The ICC and internal consistency were excellent with both biometers. The new biometer provided good agreement and repeatability compared with the reference biometer.