Purpose: The aim of this report was to report 2 patients who presented with acute corneal graft rejection 2 weeks after receiving the BNT162b2 messenger RNA (mRNA) vaccine for severe acute respiratory syndrome coronavirus 2. Methods: Case report. Results: Two men, aged 73 and 56 years, with a history of penetrating keratoplasty due to keratoconus were noted to have acute corneal graft rejection 2 weeks after receiving a first dose of the BNT162b2 mRNA vaccine. Both patients were treated with hourly dexamethasone 0.1% and oral prednisone 60 mg per day with prompt resolution of keratoplasty rejection. Conclusions: The BNT162b2 mRNA vaccine may be have been associated with a low-risk corneal graft rejection that responded well to topical and systemic steroids. Treating physicians should be aware of this potential complication and patients should be advised to report any visual changes after vaccination.

Purpose: To compare 2 different datasets, using Eyetemis, an online analytical tool designed for assessing the spherical equivalent prediction errors (SEQ-PEs) of intraocular lens (IOL) power calculation formulas after cataract surgery. Setting: Institutional. Design: Retrospective case series. Methods: The study comprised 2 distinct datasets of patients who had undergone successful cataract surgery. Dataset 1 includes standard eyes, whereas Dataset 2 includes eyes with keratoconus. An online tool was used for SEQ-PE analysis across the 2 datasets, adhering to ISO standards for evaluating accuracy based on trueness and precision. The tool incorporates robust t tests for comparing the trimmed mean of the data, adjusting for heteroscedasticity. IOL constants in Dataset 1 were optimized for the comparison of Hoffer Q, Holladay 1, SRK/T, Haigis, and Barrett Universal II (BUII) formulas. In Dataset 2, IOL constants from the IOLCon website were used for the comparison of the BUII and its designated KCN version: Barrett TrueK Keratoconus (TrueK [KCN]). Results: For Dataset 1, the trimmed mean SEQ-PE values of all formulas were not significantly different from zero. BUII had superior precision and accuracy compared with all other formulas, except from Haigis (P ≤ .04). For Dataset 2, BUII's trimmed-mean SEQ-PE was significantly different from zero (0.59 diopters [D], P < .01), unlike the TrueK (KCN) (0.12 D, P = .10). In addition, TrueK (KCN) exhibited enhanced precision and accuracy relative to BUII (P < .01). Conclusions: The online analysis tool provides a streamlined approach for assessing the prediction accuracy of SEQ refraction after cataract surgery, effectively evaluating trueness, precision, and overall accuracy through the use of advanced statistical methods.

Purpose: To compare the prediction accuracy of the Barrett True-K for keratoconus with standard formulas (SRK/T, Barrett Universal II, and Kane) and the Kane keratoconus formula. Setting: Shaare Zedek Medical Center, Jerusalem, Israel, and University Eye Clinic, Maastricht, the Netherlands. Design: Multicenter retrospective case series. Methods: Eyes with stable keratoconus undergoing cataract surgery were included. The predicted refractions were calculated for SRK/T, Barrett Universal II, Barrett True-K for keratoconus (predicted and measured), Kane, and Kane adjusted for keratoconus formulas. Primary outcomes were prediction error (PE), absolute error (AE), and percentage of eyes with PE ±0.25 diopters (D), ±0.50 D, and ±1.00 D. Subgroup analyses were performed based on the severity of the keratoconus. Results: 57 eyes were included in the study. The PE was not significantly different from zero for SRK/T, Barrett True-K (predicted and measured), and Kane keratoconus formulas (range 0.09 to 0.22 D, P > .05). The AE of Barrett True-K predicted (median 0.14 D) and Barrett True-K measured (median 0.10 D) were significantly lower from Barrett Universal II (median 0.47 D) and Kane (median 0.50 D), P < .001. Conclusions: The Barrett True-K formulas for keratoconus had higher prediction accuracy as compared with new generation formulas and a similar prediction accuracy as compared with the Kane keratoconus formula.