Background: To describe cases of retinal vascular events shortly after administration of mRNA or adenoviral-vectored COVID-19 vaccines. Design: Retrospective, multicenter case series. Methods: Six cases of retinal vascular events shortly after receiving COVID-19 vaccines. Results: A 38-year-old, otherwise healthy male patient presented with branch retinal arterial occlusion four days after receiving his second dose of SARS-CoV-2 vaccination with Comirnaty^® (BioNTech^®, Mainz, Germany; Pfizer^®, New York City, NY, USA). An 81-year-old female patient developed visual symptoms twelve days after the second dose of SARS-CoV-2 vaccination with Comirnaty^® and was diagnosed with a combined arterial and venous occlusion in her right eye. A 40-year-old male patient noticed blurry vision five days after his first dose of SARS-CoV-2 vaccination with Comirnaty^® and was diagnosed with venous stasis retinopathy in his left eye. A 67-year-old male was diagnosed with non-arteritic anterior ischemic optic neuropathy in his right eye four days after receiving the first dose of Vaxzevria^® (AstraZeneca^®, Cambridge, UK). A 32-year-old man presented with a sudden onset of a scotoma two days after receiving the second dose of SARS-CoV-2 vaccination with Spikevax^® (Moderna, Cambridge, UK) and was diagnosed with a circumscribed nerve fiber infarction. A 21-year-old female patient developed an acute bilateral acute macular neuroretinopathy three days after receiving the first dose of SARS-CoV2-vaccine Vaxzevria^® (AstraZeneca^®, Cambridge, UK). Conclusion: This case series describes six cases of retinal vascular events shortly after receiving mRNA or adenoviral-vectored COVID-19 vaccines. The short time span between received vaccination and occurrence of the observed retinal vascular events raises the question of a direct correlation. Our case series adds to further reports of possible side effects with potential serious post-immunization complications of COVID-19 vaccinations.

Purpose: We report the incidence of malignant tumors of the eyelid in Germany between 2009 and 2015. Methods: Data pertaining to the period between 2009 and 2015 were extracted from the German Cancer Registry. The International Classification of Diseases for Oncology-3 codes for tumors of the eyelid or canthus were used to identify incidence rates and survival probabilities. Crude and age-standardized incidence rates (ASR) were calculated by age, year, and gender and the individual federated states. Survival was calculated using the Kaplan-Meyer and Life tables methods, and COX-Regression was used to calculate hazard ratios for overall and cancer-specific survival. Results: This study examined data pertaining to 42,710 patients who had been diagnosed with malignant tumors of the eyelid. Basal cell carcinoma was by far the most common tumor of the eyelid (87.1%), followed by squamous cell carcinoma (10.1%) and malignant melanoma (1.1%). ASRs of basal cell carcinoma, squamous cell carcinoma, and melanoma were 65.1, 7.49, and 0.83 per million, respectively. Sebaceous cell carcinoma did not appear to be of high prevalence in Germany. Cancer-specific survival was generally high, exceeding 95%. The overall survival of patients with melanoma was considerably lower than those with other cancers. Both survival rates were inferior to that of basal cell carcinoma (74.9%). Cancer-Specific survival at five years for all groups exceeded 95%. Conclusions: The incidence rates of malignant lid tumors match that of the European countries but shows a different pattern than Asian countries.

Purpose: To evaluate vision-related quality of life (VRQL) before and after Descemet membrane endothelial keratoplasty (DMEK). Methods: The study was conducted in patients with Fuchs endothelial dystrophy or pseudophakic bullous keratopathy undergoing DMEK alone or in combination with cataract surgery (triple-DMEK) between August 2019 and March 2020 at the University of Leipzig Medical Center. Best-corrected visual acuity (BCVA) was measured. Visual acuity factor (VAF) and glare factor (GF) scores were calculated using the Visual Function and Corneal Health Status Instrument questionnaire answered by patients before surgery and 6 months thereafter. Subgroup analyses were performed for DMEK versus triple-DMEK, and for first versus second eyes, in addition to correlation analyses of scores with preoperative BCVA. Results: Forty-six patients were included in this analysis. VAF score improved from 0.68 ± 0.54 to 0.02 ± 0.57 (P < 0.0001) and GF score improved from 0.53 ± 0.43 to -0.11 ± 0.39 (P < 0.0001) during follow-up. Both scores improved without significant differences after surgery in the first and in the fellow eye (P < 0.0001) and after DMEK and triple-DMEK (P < 0.0001). The improvement of scores did not correlate with preoperative BCVA (r = 0.06, P = 0.68 for VAF; r = -0.09, P = 0.54 for GF). Conclusion: VRQL improves similarly after DMEK and triple-DMEK and between first and second operated eye. The extent of improvement is independent of the preoperative BCVA. The results of this study can be useful when planning DMEK by enabling a prediction of anticipated VRQL gain.

Purpose: To investigate the need of rebubbling for small graft detachments after Descemet Membrane Endothelial Keratoplasty (DMEK). Methods: In this retrospective study we evaluated 111 eyes from 111 patients that showed graft detachment after DMEK surgery and have achieved graft adherence by injection of air or 20% sulfur hexafluoride (SF₆) to the anterior chamber (rebubbling group; n = 57) or by spontaneous adherence without intervention (control group; n = 54) at final examination. Subgroups in terms of the maximum height and in terms of the detachment area in relation to graft area were formed. Outcome measures were the increase in best-corrected visual acuity (BCVA) and the decrease in central corneal thickness (CCT) from the measurement before DMEK to six months after surgery and postoperative endothelial cell density. Results: BCVA increased in the rebubbling group and the control group, the difference being 0.22 logMAR, p = 0.048. For eyes with a maximum height less than 500 µm, the increase of BCVA was 0.39 ± 0,36 logMAR in the control group and 0.62 ± 0,53 logMAR in the rebubbling group, p = 0.045. There was no difference of statistical significance of BCVA between both groups regarding the detachment area of less than 20% in relation to graft area. The mean decrease in CCT and postoperative endothelial cell density showed no significant difference between the rebubbling group and the control group. Conclusion: Compared to spontaneous graft adherence, a rebubbling shows no beneficial effect on the clinical outcome for small detached DMEK grafts. Rebubbling does not decrease postoperative endothelial cell density.