To report the clinical outcome, observations and complications related to the sulcus implantations of a new accommodative intraocular lens, the Lumina (AkkoLens Clinical b.v., Breda, The Netherlands) along the twenty-four-month period. This prospective, observational multicenter study included 103 eyes from 66 patients who underwent implantation of the Lumina accommodative intraocular lens (IOL) at two specialized centers, each employing a distinct sulcus-based implantation model. At Resbiomed-Vissum Eye Clinic (Sofia, Bulgaria), 54 eyes were treated using the Initial Model, in which the main corneal incision was aligned with the patient's positive corneal meridian. In contrast, at Vissum Instituto Oftalmológico (Alicante, Spain), 49 eyes were treated with the Optimized Model, characterized by a standardized horizontal access tunnel (0-180°), regardless of corneal topography. Patients were evaluated at predefined postoperative intervals (1 day; 1, 3, 6, 12, and 24 months). Visual and refractive parameters-including UDVA, CDVA, UNVA, BCNVA, and CDNVA-along with postoperative observations and complications, were systematically documented. Due to statistically significant differences observed in several baseline and postoperative parameters, the two cohorts were analyzed separately. On postoperative day one, non-severe clinical biomicroscopic findings were observed in 21,35% of eyes, including mild corneal edema (8.74%), transient ocular hypertension (5.83%), pigment dispersion (1.94%), and moderate IOL tilting (1.94%). At the first postoperative month, the rate of clinical observations related to the surgery was 8.73%, with additional findings including moderate IOL decentration and one case of macular edema. From month three onward, abnormal findings such as remained below 1% due to one case of ocular hypertension. From 12 to 24 months, the abnormal findings were observed at 2.91%, such as pigment deposits (1.94%), IOL decentration (0.97%), and delayed ocular hypertension (0.97%). Despite these events, both cohorts with two sulcus-based models achieved excellent final outcomes. Among patients who experienced complications from the first postoperative month onward, visual acuity at 24 months remained highly favorable. In the Sofia group (Centre 1): UDVA 0.05 ± 0.13, CDVA -0.08 ± 0.00, UNVA 0.00 ± 0.00, BCNVA 0.00 ± 0.00, and CDNVA 0.22 ± 0.11 logMAR. In the Alicante group (Centre 2): UDVA was 0.04 ± 0.11 logMAR, CDVA -0.05 ± 0.04, UNVA 0.38 ± 0.18, BCNVA 0.03 ± 0.05, and CDNVA 0.34 ± 0.11. The Lumina IOL exhibited a favorable long-term safety profile, with no major sight-threatening adverse events. Early postoperative observations were transient and clinically insignificant, while late complications-though likely lens-related-did not compromise visual quality. These findings support the anatomical and functional safety of sulcus implantation for accommodative IOLs, confirming its viability as an effective and stable alternative to capsular bag fixation.

To evaluate the current evidence on oculomotor measurement parameters and their normative values through a systematic review. A search of primary studies was conducted using a search equation with free language. Original articles analyzing normal oculomotor function parameters in healthy populations of any age, studies that included a clearly differentiated healthy control group, and articles using any oculomotor measurement test were included. The QUADAS-2 tool was used to assess the risk of bias, applicability, and quality of the studies. The review was conducted independently by the authors and then pooled to determine the final inclusion. A total of 915 articles were identified, of which 750 were excluded after the first review of the title and In the second step, 133 out of 165 investigations were discarded. Ultimately, 32 articles from the initial search were included, along with 10 additional articles identified through a manual search. The findings revealed variations in how oculomotor skills are measured, including differences in stimuli, measurement distances, and parameters assessed. A high risk of bias was observed (≥50 % in the areas of “flow and timing”, “reference standard” and “patient selection”) along with poor applicability (≥50 % in all aspects). There is no clear evidence on normative values for oculomotor skills, nor is there a consensus on the measurement methods, stimulus used, or working distance. Furthermore, there is no agreement on which aspects of oculomotor skills should be assessed. To enhance reliability and applicability, measurement criteria should be standardized, and normative values should be established.

Background: The direction of deviation in strabismus may influence the predictability of the surgical procedure, but this factor remains insufficiently investigated. The aim of this study was to compare postoperative changes in ocular deviation, measured by video oculography, following surgical treatment in patients with concomitant exotropia and esotropia. Methods: A prospective longitudinal study included 49 patients with horizontal strabismus. All patients underwent an eye examination before and after surgery, with ocular deviation measured in nine gaze positions using video oculography. Preoperative and postoperative results were analyzed separately for esotropias and exotropias to assess surgical efficacy in both conditions. Results: Ocular deviation significantly improved after strabismus surgery in both esotropia and exotropia across all nine gaze positions (p < 0.05). The greatest improvement was observed in the primary position, with an efficacy rate of 75% in exotropia (mean reduction of 14.93 prism diopters) and 78% in esotropia (mean reduction of 17.50 prism diopters). Residual postoperative deviation was similar between the two types of strabismus (p > 0.05). In non-primary gaze positions, surgical efficacy was lower—particularly during complex eye movements—in both groups. Conclusions: Strabismus surgery resulted in a significant reduction in ocular deviation across all gaze positions in patients with concomitant horizontal strabismus, as objectively assessed by video oculography. Postoperative improvements were comparable between exotropia and esotropia, with the highest surgical efficacy observed in the primary gaze position. These findings support the use of objective multigaze evaluation to more comprehensively characterize postoperative alignment and to inform future assessments of surgical outcomes.

Purpose: To evaluate the impact of perioperative Intense Pulsed Light (IPL) therapy on corneal epithelial remodeling and epithelial refractive stability in patients undergoing femtosecond laser-assisted in situ keratomileusis (FS-LASIK) or keratorefractive lenticule extraction (KLEx). Methods: This randomized, controlled, triple-masked clinical trial included 61 patients assigned to either IPL treatment or a placebo prior to and following refractive surgery. Epithelial thickness (ET), epithelial refractive power (Epi-Rx), and Epithelial Wavefront (Epi-WF) were analyzed using anterior segment optical coherence tomography (AS-OCT) and Placido disc-based topography over a six-month follow-up. Results: Both groups exhibited significant postoperative epithelial thickening, primarily within the first month. While IPL-treated eyes showed trends toward slightly lower ET and more gradual Epi-Rx changes, including a late hyperopic shift and progressive cylinder adaptation, differences between groups were not statistically significant. Epi-WF values remained <0.5 in both cohorts. Conclusion: Perioperative IPL improved ocular surface parameters in prior analyses but did not significantly alter corneal epithelial remodeling or refractive stability in this cohort. Observed trends suggest potential benefits for epithelial adaptation and ocular surface stability, warranting further investigation with larger sample sizes and longer follow-up.

To compare and evaluate the agreement between refractive measurements obtained by the new open-field OFA-Osiris (CSO®) aberrometer and the subjective

Background: The impact of cataract surgery on anterior segment structures in subjects affected by primary open-angle glaucoma (POAG) remains incompletely understood. The aim of this study was to characterize changes in anterior segment parameters after cataract surgery in POAG subjects compared with non-glaucoma subjects (control). Methods: A prospective comparative study was conducted, including patients scheduled for cataract surgery who underwent a comprehensive ophthalmic examination before and after surgery using anterior segment optical coherence tomography (OCT). Longitudinal changes and between-group comparisons were analyzed. Results: The results demonstrated a significant enlargement of the anterior chamber and iridocorneal angles after surgery in both groups (p < 0.05), with no significant differences between POAG and control eyes (p > 0.05). Several preoperative parameters, particularly angle-related metrics, were correlated with postoperative anatomical changes, suggesting their potential role as predictors of anterior segment variation (R > 0.50; p < 0.05). Conclusions: In conclusion, this study provides a detailed characterization of anterior segment changes in POAG subjects following cataract surgery, demonstrating anterior chamber enlargement comparable to that observed in non-glaucoma eyes, which may assist clinicians in the management of glaucoma.