Ocular surface lesions represent a diverse group of pathologies which may be challenging to diagnose clinically. Anterior segment imaging—including anterior segment optical coherence tomography (AS-OCT), optical coherence tomography angiography (OCTA), ultrasound biomicroscopy (UBM), and in vivo confocal microscopy (IVCM)—provides valuable adjunct information for the diagnosis, management, and monitoring of these lesions. The present review aims to provide an update on the principles, current clinical applications, advantages, limitations, and recent advancements in the imaging modalities used for the evaluation of ocular surface lesions. Notable recent advancements include the application of artificial intelligence in the interpretation of AS-OCT, intraoperative use of AS-OCT, the development of three-dimensional UBM, and expanded applications of each modality for a variety of ocular surface lesions.

Purpose: To compare the long-term outcomes of scleral-sutured intraocular lens (IOL) fixation using expanded polytetrafluoroethylene vs polypropylene sutures, with a focus on suture-related complications. Methods: A retrospective comparative review was conducted of 102 patients who underwent scleral-sutured IOL fixation between 2015 and 2019. Forty-eight eyes of 48 patients received 4-point fixation with expanded polytetrafluoroethylene sutures, and 55 eyes of 54 patients received 2-point fixation with polypropylene sutures. Postoperative complications, visual outcomes, and risk factors for suture-related complications were analyzed over a minimum follow-up of 5 years. Results: No instances of suture breakage were observed in either group over an average follow-up of 6.7 years. Suture exposure rates were 10.4% (5/48) for expanded polytetrafluoroethylene and 18.2% (10/55) for polypropylene ( P = .27). The mean time to suture exposure was 2.7 ± 3.3 years in the expanded polytetrafluoroethylene group and 2.9 ± 2.5 years in the polypropylene group ( P = .88). Mean logMAR visual acuity at final follow-up was 1.0 ± 1.2 in the expanded polytetrafluoroethylene group and 1.5 ± 1.2 in the polypropylene group ( P = .06). The only significant risk factor for suture exposure was concurrent corneal transplantation or glaucoma surgery (odds ratio [OR], 9.3; P = .003). Surgical correction was required in all cases of exposure with expanded polytetrafluoroethylene sutures and in 2 cases with polypropylene sutures. One case of suture-associated infectious scleritis with endophthalmitis occurred in the expanded polytetrafluoroethylene group, and 1 case of endophthalmitis related to an explanted corneal graft occurred in the polypropylene group. Conclusions: Both expanded polytetrafluoroethylene and polypropylene sutures demonstrated durable outcomes with similar complication rates. Suture breakage was not observed in either group, and there were no differences in suture exposure rates between the 2 groups. Risk factors for suture exposure included the performance of a concurrent procedure.

To investigate the mechanical properties of 23-, 25-, and 27-gauge trocars when subjected to representative pressures of posterior segment surgery. Experimental study. There were no subjects included in this study. Twenty-four trocars each from Alcon, Dutch Ophthalmic Research Center (DORC), and Bausch & Lomb (B/L), distributed evenly across 23-, 25-, and 27-gauge sizes were included in this study. These trocars were tested at both 40 mmHg and 60 mmHg of pressure. Two failure end points were identified, and each trocar was tested until it reached both failure points. The number of instrument exchanges required before trocar valve failure at 2 predesignated end points. A total of 72 measurements were made. Most notably between brands, 23-gauge Alcon trocars demonstrated significantly greater competence than their 23-gauge counterparts in B/L and DORC at both 40 mmHg and 60 mmHg pressures (P < 0.01). However, at the 25- and 27-gauge sizes, there were no significant differences in competence between trocar brands (P > 0.05). Based on the findings of this study, 23-gauge valved trocars from B/L and DORC exhibited a significantly lower threshold for compromise compared to that of Alcon valved trocars, likely attributable to differences in valve placement design. Surgeon experience, vitrector preference, and the specific type of surgery performed are important considerations in the choice of vitrector gauge and brand. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.