To evaluate long-term keratoconus stability after corneal crosslinking (CXL) with riboflavin. In this prospective study, 57 eyes of 55 patients with progressive keratoconus, consecutively treated with ultraviolet A (UVA) - riboflavin CXL, were examined with the corneal topographer Pentacam, the biometer IOLMaster and the analyzer of corneal biomechanics Ocular Response Analyzer before and during a 24 months follow-up after CXL. Twenty-four months after CXL, there was a significant improvement in best corrected visual acuity (BCVA) (P<0.01), a significant decrease in corneal thinnest point (CTP), keratometry readings at the keratoconus apex (K max), and corneal volume (CV) (P<0.01), and a significant increase in axial eye length (AL) (P=0.01). No significant changes in anterior chamber volume (ACV) and depth (ACD), (P=0.8), corneal hysteresis (CH) (P=0.16) and corneal resistance factor (CRF) (P=0.06) were found. However, in the subgroup of patients with decreased K max readings 24 months after treatment, both CH and CRF showed a significant reduction (P<0.01). In the first month after the procedure, CXL induces a reduction in corneal volume. During the 24 months follow-up the cornea tends to recover its original volume with a persistence of the CXL efficacy.

Purpose: To analyze and quantify the pattern of corneal astigmatism in patients awaiting cataract surgery to provide information for cataract surgeons and intraocular lens (IOL) manufacturers and to establish the demand for toric IOLs in a hospital. Methods: This cross-sectional retrospective study evaluated keratometric (K) values measured by partial coherence interferometry (IOLMaster) in cataract surgery candidates, who were then analyzed and correlated by age and axial length (AL) ranges. Results: The study evaluated the K values in 757 eyes of 380 patients with a mean age of 71.9 ± 10.2 years (range 33–96 years). The mean corneal astigmatism was 1.02 ± 0.69 D (range 0.06–4.57 D). It was 1 D or higher in 316 (41.74%) eyes. The mean AL was 23.56 ± 1.35 mm (range 20.53–31.86 mm). Conclusions: Our study shows that roughly 50% of the eyes have more than 1 D of astigmatism. The results can help hospitals plan and analyze the amount and costs of using toric IOLs in patients with corneal astigmatism.

More than two years after the onset of the COVID-19 pandemic, healthcare providers are facing an emergency within an emergency, the so-called long COVID or post-COVID-19 syndrome (PCS). Patients diagnosed with PCS develop an extended range of persistent symptoms and/or complications from COVID-19. The risk factors and clinical manifestations are many and various. Advanced age, sex/gender, and pre-existing conditions certainly influence the pathogenesis and course of this syndrome. However, the absence of precise diagnostic and prognostic biomarkers may further complicate the clinical management of patients. This review aimed to summarize recent evidence on the factors influencing PCS, possible biomarkers, and therapeutic approaches. Older patients recovered approximately one month earlier than younger patients, with higher rates of symptoms. Fatigue during the acute phase of COVID-19 appears to be an important risk factor for symptom persistence. Female sex, older age, and active smoking are associated with a higher risk of developing PCS. The incidence of cognitive decline and the risk of death are higher in PCS patients than in controls. Complementary and alternative medicine appears to be associated with improvement in symptoms, particularly fatigue. The heterogeneous nature of post-COVID symptoms and the complexity of patients with PCS, who are often polytreated due to concomitant clinical conditions, suggest a holistic and integrated approach to provide useful guidance for the treatment and overall management of long COVID.

This retrospective comparative study proposes a multi-formula approach by comparing no-history IOL power calculation methods after myopic laser-refractive-surgery (LRS). One-hundred-thirty-two eyes of 132 patients who had myopic-LRS and cataract surgery were examined. ALMA, Barrett True-K (TK), Ferrara, Jin, Kim, Latkany and Shammas methods were evaluated in order to back-calculate refractive prediction error (PE). To eliminate any systematic error, constant optimization through zeroing-out the mean error (ME) was performed for each formula. Median absolute error (MedAE) and percentage of eyes within ±0.50 and ±1.00 diopters (D) of PE were analyzed. PEs were plotted with corresponding mean keratometry (K), axial length (AL), and AL/K ratio; then, different ranges were evaluated. With optimized constants through zeroing-out ME (90 eyes), ALMA was better when K ≤ 38.00 D-AL > 28.00 mm and when 38.00 D < K ≤ 40.00 D-26.50 mm < AL ≤ 29.50 mm; Barrett-TK was better when K ≤ 38.00 D-AL ≤ 26.50 mm and when K > 40.00 D-AL ≤ 28.00 mm or AL > 29.50 mm; and both ALMA and Barrett-TK were better in other ranges. (p < 0.05) Without modified constants (132 eyes), ALMA was better when K > 38.00 D-AL ≤ 29.50 mm and when 36.00 < K ≤ 38.00 D-AL ≤ 26.50 mm; Barrett-TK was better when K ≤ 36.00 D and when K ≤ 38.00 D with AL > 29.50 mm; and both ALMA and Barrett-TK were better in other ranges (p < 0.05). A multi-formula approach, according to different ranges of K and AL, could improve refractive outcomes in post-myopic-LRS eyes.

We read with great interest the review by Zhang et al (2017) concerning the invasive and noninvasive means of measuring intracranial pressure. We would like to congratulate the authors for their interesting paper, but we were a bit disappointed reading the section dedicated to the role of ultrasound in the measurement of the optic nerve sheath diameter (ONSD).