Background/Objectives: The Tecnis Eyhance is an enhanced monofocal intraocular lens (IOL) designed to improve intermediate vision without compromising distance clarity or increasing the incidence of photic phenomena. Although short-term results have been encouraging, long-term data remain limited. This study presents the 5-year follow-up of a previously published 6-month clinical evaluation, aiming to assess the stability of visual, optical, and patient-reported outcomes over time. Methods: A single-center retrospective study of 18 patients (36 eyes) undergoing bilateral Tecnis Eyhance IOL implantation was conducted. The same cohort from the original 6-month study was re-evaluated after a mean follow-up of 5 years. Visual acuity (distance, intermediate, near), defocus curves, contrast sensitivity, optical quality, effective lens position (ELP), halo size, and patient-reported measures were assessed. Results: Visual acuity remained stable across all distances, with binocular uncorrected intermediate visual acuity (UIVA) ≤ 0.2 logMAR in all patients. No significant changes were observed in optical quality parameters or contrast sensitivity. ELP remained consistent over time (p = 0.298), and posterior capsule opacification (PCO) requiring Nd:YAG capsulotomy developed in 5% of the eyes. Halo size was mild, and subjective glare perception did not increase. Spectacle independence remained high for distance (100%) and intermediate (more than 75%) tasks. Conclusions: This 5-year follow-up study confirms the long-term stability and effectiveness of the Tecnis Eyhance IOL. These findings support its long-term use as a stable monofocal IOL with enhanced intermediate function.

Introduction: Neurofibromatosis type I, also known as Von Recklinghausen disease, is a common phakomatosis affecting 1 in 2500–3000 live births; it may be associated with several common ocular findings, including Lisch nodules, plexiform neurofibromas, optic pathway gliomas, retinal astrocytic hamartomas and choroidal nodules. Case description: This report illustrates clinical evidence of simultaneous presence of retinal reactive astrocytic tumor (RRAT) and two retinal astrocytic hamartomas (RAH) in a 15 y/o patient with NF1, referred to our attention because of an asymptomatic fundus mass in his right eye of recent onset. Conclusion: This case, in addition to considering NF1 as one of the ocular conditions associated with secondary RRAT, underlines the importance of early referral and continuous ophthalmological follow-up in preventing possible complications that could cause significant visual impairment in patients with NF1.

Background/Objectives: The Visual Function and Corneal Health Status (V-FUCHS) questionnaire assesses vision-related quality of life in patients affected by Fuchs endothelial corneal dystrophy (FECD) through 15 items, which are divided into the “visual acuity (VA) Factor” and “glare Factor” domains. The purpose of this study was to translate and validate the Italian version of the V-FUCHS instrument. Methods: The original V-FUCHS questionnaire was translated into Italian using certified forward and backward translation methods and administered to patients with FECD undergoing a unilateral or bilateral Descemet membrane endothelial keratoplasty (DMEK) for FECD and healthy controls. Its test–retest reliability was assessed by administering the questionnaire twice, four weeks apart. Modified Krachmer grade, best-corrected visual acuity (BCVA) and central corneal thickness (CCT) were also measured. Results: A total of 74 participants, aged 45 to 83 years, were prospectively enrolled and divided into five subgroups: mild-to-moderate FECD (n = 18), advanced FECD (n = 15), unilateral DMEK (n = 9), bilateral DMEK (n = 12), and healthy controls (n = 20). Retest reliability confirmed the consistency and agreement of their responses (intraclass correlation coefficient > 0.90 for both factors). The Italian V-FUCHS effectively discriminated between different stages of FECD severity, with significant differences in VA and glare factor scores across all subgroups (p < 0.001). While both BCVA and CCT showed correlations with V-FUCHS scores, only the association between the VA factor and BCVA was statistically significant (p < 0.05), indicating that the VA factor meaningfully reflects patients’ measured VA. Conclusions: The proposed Italian version of the V-FUCHS questionnaire is a valid and reliable tool for assessing visual disability in patients with FECD before and after DMEK. This instrument may aid in optimizing endothelial keratoplasty timings and evaluating postoperative symptomatic improvements in FECD patients.

Background/Objectives: To explore potential dry eye-related ocular surface functional alterations in women at the time of first diagnosis of endometriosis or adenomyosis in a real-world clinical setting. Methods: This was a cross-sectional case–control study. Patients were evaluated at the time of initial diagnosis, prior to initiation of any hormonal therapy, to reflect real-world clinical conditions. Participants underwent a standardized ocular surface assessment comprising the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer test, and multimodal TearCheck^® analysis, including Non-Invasive Break-Up Time (NIBUT), Tear Film Stability Evaluation (TFSE), Meibography, and Abortive Blinking^®. Results: A total of 71 women were included: 41 with endometriosis or adenomyosis and 30 without known gynecological disease. Patients reported significantly higher OSDI scores than controls (p < 0.05). Objective testing demonstrated lower Schirmer values, reduced tear film stability, and more pronounced Meibomian gland dropout in the patient group (all p < 0.05). Differences were consistently observed across both subjective and objective parameters. Conclusions: Women with endometriosis and/or adenomyosis exhibited significantly altered ocular surface parameters compared with women without known gynecological disease. These findings suggest a possible association between gynecological disease and ocular surface dysfunction. Greater awareness of potential ocular involvement may encourage closer collaboration between gynecology and ophthalmology in the care of affected patients.

Background/Objectives: During cataract surgery, topical anesthesia is routinely achieved through the instillation of topical anesthetic eye drops, while different agents may be applied to the corneal surface during the procedure to support lubrication and protection. The impact of these intraoperative strategies on corneal integrity and postoperative ocular surface recovery remains an area of clinical interest. This study aimed to compare the intraoperative and postoperative effects of applying a topical anesthetic gel (Ophtesic, Horus Pharma) on the corneal surface versus the use of balanced salt solution (BSS) during cataract surgery. Methods: In this longitudinal, observational prospective study, 24 eyes of 24 patients undergoing phacoemulsification received either topical anesthetic gel (n = 15) or BSS irrigation (n = 9). Central corneal thickness (CCT) and epithelial thickness were measured preoperatively and on postoperative days 1, 5, and 15 using anterior segment optical coherence tomography (AS-OCT). Basal epithelial cell (BEC) density was assessed by in vivo confocal microscopy (IVCM), while OSDI score, non-invasive breakup time (NI-BUT), and Schirmer test I values were evaluated preoperatively and on postoperative days 5 and 15. Patient and surgeon satisfaction were rated using a Likert-like scale. Results: Both groups showed increased CCT and epithelial thickness at day 1. In the gel group, CCT returned to baseline by day 15 (p = 0.361), and epithelial thickness normalized by day 5 (p = 0.066). In the BSS group, CCT remained elevated at day 15 (p < 0.05), and epithelial thickness decreased at day 5 (p < 0.05) before returning to baseline. BEC density normalized at day 15 in the gel group (p = 0.107) but remained altered in the BSS group (p < 0.05). NI-BUT Schirmer I, and OSDI showed a trend toward faster recovery in the gel group than in the BSS group. Conclusions: In this exploratory study, intraoperative application of a topical anesthetic gel appeared to support early normalization of corneal and tear film parameters while providing effective anesthesia. Further studies are warranted to confirm these observations and evaluate potential long-term benefits.

Background: The graft–host interface plays a critical role in visual recovery after Ultra-Thin Descemet Stripping Automated Endothelial Keratoplasty (UT-DSAEK). This study evaluated graft–host interface morphology using quantitative Mean Grey Intensity (MGI) analysis, comparing three different Descemetorhexis techniques: ophthalmic viscosurgical device (OVD)-assisted, balanced salt solution (BSS)-assisted and air-assisted stripping. Materials and methods: This retrospective comparative study included 59 eyes with Fuchs’ endothelial corneal dystrophy (FECD) undergoing UT-DSAEK. According to Descemetorhexis technique, patients were divided into three groups: OVD-assisted (VISCO, n = 21), BSS-assisted (BSS, n = 20), and air-assisted (AIR, n = 18). The primary outcome was graft–host interface reflectivity, quantitatively assessed using MGI measurements obtained with ImageJ software on in vivo confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS-OCT). Best-corrected visual acuity (BCVA) was evaluated as a secondary outcome. Examinations were performed at 6 and 12 months postoperatively. Longitudinal comparisons were conducted using repeated-measures analysis of variance. Results: BCVA significantly improved over time in all groups ( p < 0.001). At 6 months, the AIR group demonstrated significantly better visual acuity recovery and the lowest interface reflectivity on both IVCM and AS-OCT ( p < 0.01), whereas the VISCO group exhibited the highest values on both modalities ( p < 0.001). The BSS group showed intermediate results. At 12 months, reflectivity significantly decreased in all groups on both imaging modalities ( p < 0.001). Although the VISCO group showed the greatest absolute reduction over time, its reflectivity values remained slightly higher than those of the AIR and BSS groups. The AIR group maintained the lowest reflectivity at both time points. Conclusions: Descemetorhexis technique is significantly related to differences in early graft–host interface morphology following UT-DSAEK. OVD-assisted stripping is associated with higher early reflectivity, whereas BSS and particularly air-assisted techniques promote faster optical clearing and visual recovery. Over time, progressive interface remodelling leads to a reduction in reflectivity across all techniques, suggesting a tendency toward long-term convergence in optical quality regardless of the intraoperative medium used.