Introduction: Given the increasing use of electronic devices, and the increasing number of complaints with its use, we intend to evaluate the prevalence of manifestations of dry eye and ocular fatigue in a population of individuals, who use the computer daily to perform all their professional tasks, as well as to correlate these complaints with the number of hours of digital use as well as their possible improvement with behavioural measures and use of tear drops.Material and Methods: A total of 77 individuals (154 eyes) were evaluated on two separate days with a 1-month interval. They completed two questionnaires: OSDI and PEG Eye Fatigue. An objective ocular surface assessment was performed: Schirmer test without anesthetic, DR-1a Dry Eye Monitor™, hyperemia evaluation, lacrimal break up, presence of keratitis and lesions in the conjunctiva, as well as near accommodation point and near convergence point. After the first evaluation, the subjects were divided into two groups: group A (< 2 hours of computer working) and group B (> 2 hours of computer working). Some environmental measures to reduce complaints and recommendation of use of artificial tears were explained to the latter.Results: There was a statistically significant difference in the majority of the parameters evaluated in the group B, in relation to the morning period (group A) - tear film (p = 0.032), hyperemia (p < 0.001), BUT (p < 0.001), keratitis (p < 0.001), conjunctival lesion (p = 0.002) and accommodation point (p < 0.001). In the evaluation – one month later - there were no statistically significant differences in any of the parameters analysed in the group A, and in group B there was a decrease in most parameters at the end of that period - Schirmer test (p = 0.005), lacrimal film (p = 0.022), keratitis (p < 0.001), conjunctival lesion (p = 0.005) and fatigue score (p < 0.001).Discussion: It was thus possible to show the appearance of ocular fatigue and ocular surface changes with prolonged use of computers (> 2 hours) as well as a significant improvement in symptomatology (subjective assessment) as well as of ocular surface changes (objective evaluation) with the implementation of postural measures, regular breaks and use of lubricants. This is the first study, to the best of our knowledge, of digital asthenopia in which, in addition to the subjective evaluation, the presence of ocular surface modifications (objective assessment) were evaluated and the respective improvement with the aforementioned ergophthalmological measures were evaluated.Conclusion: This survey highlights the increased overall level of awareness that we need to have to face the rapid and wide-scale changes driven by the emergence of digital technology and, more particularly, its impact on user’s vision and posture. We concluded that the longer we use the electronic devices (more than two hours) the more severe the complaints and rates of ocular surface changes are. Environmental and ocular strategies can attenuate or even eliminate the discomfort caused by this syndrome, and increase professional performance and quality of life.

Digital asthenopia (DA) or Computer Vision Syndrome can occur after prolonged use of digital devices and is usually managed with ergophthalmological measures and the use of artificial tears. This prospective, controlled study evaluated the use of hyaluronic acid artificial tears on the signs and symptoms of DA in participants of a videogame convention. Subjects (n = 56) were randomized into a control group (CG, n = 26), which followed ergophthalmological measures, and a study group (SG, n = 30), which followed ergophthalmological measures and instilled 1 drop of artificial tears with hyaluronic acid 0.15% four times a day. Subjects were evaluated before and after playing for three consecutive days for eye dryness (SPEED questionnaire), conjunctival hyperemia, corneal fluorescein staining, conjunctival lissamine green staining, tear breakup time, Schirmer I test, near convergence and accommodation, and using questionnaires for DA symptoms. After 3 days of intense videogaming, the SPEED score of CG increased significantly (p = 0.0320), while for the SG it was unchanged. Similarly, the CG presented significant increases in ocular fatigue (p = 0.0173) and dryness (p = 0.0463), while these parameters decreased significantly in the SG (p = 0.0149 and p = 0.00427, respectively). This study confirms the protective effect of hyaluronic acid artificial tears against DA symptoms associated with prolonged visual display terminal use.

Purpose: Amniotic membrane transplantation (AMT) has shown promising results as an antifibrotic agent in trabeculectomy. We aimed to evaluate the additional effect of AMT in MMC-augmented trabeculectomy. Patients and Methods: This retrospective study analyzed the results of the first 12 postoperative months of glaucomatous eyes submitted to Moorfields Safer Surgery Trabeculectomy with MMC alone (non-AMT group) compared to MMC and AMT (AMT group). Both groups were compared in terms of intraocular pressure (IOP), number of antihypertensive medications and need for surgical reinterventions. Absolute and relative success rates 12 months after surgery were defined as IOP < 18 mmHg, without and with the use of antihypertensive medications, respectively. Results: The analysis included 51 eyes of 45 glaucoma patients (29 eyes in the non-AMT group and 22 in the AMT group). Mean IOP decreased from 24.72± 5.11 mmHg and 26.86± 10.62 mmHg preoperatively in non-AMT and AMT groups to 12.86± 4.22 mmHg and 12.60± 4.43 mmHg, respectively, at 12 months (p = 0.84). Postoperative number of medications decreased significantly in both groups. Absolute success was seen in 71% of non-AMT eyes and 55% of AMT eyes (p = 0.46), whereas relative success was obtained in 14% and 30%, respectively (p = 0.55). Reinterventions were needed in 28% of the eyes (11 bleb injection/needling and 4 Ahmed tube implantation) in the non-AMT group and in 27% of the AMT group (10 bleb injection/needling and 1 Ahmed tube implantation) (p = 0.89). Conclusion: Trabeculectomy combined with MMC and AMT did not show better results than trabeculectomy with MMC alone.

Purpose: To evaluate the effects of topical insulin in patients with persistent corneal epithelial defects that are refractory to the standard treatment. Methods: A retrospective, hospital-based, clinical study was performed on 17 eyes of 16 patients with different types of refractory persistent epithelial defects who were treated with topical insulin. The treatment was continued until the defect either was resolved or persisted after three months. Patients’ demographic information, etiology, comorbidities, and clinical data were reviewed. The rate of epithelial healing was considered as the primary outcome measure. Results: Neurotrophic keratitis was the most common cause of persistent epithelial defects (58.8%), and within this category, herpetic eye disease was the main comorbidity (44.4%). The mean follow-up time was 17.91 months. Eleven out of fifteen eyes (77.3%) had complete improvement and only one patient did not respond to the treatment. The mean time of reepithelization for the eyes with full recovery was 31.27 days (ranging from 6 to 61 days). The best-corrected visual acuity improved significantly after treatment (P < 0.005), and there were no reports of complications or side effects during the study period. Conclusion: Our results suggest that topical insulin, due to its good safety profile, availability, and affordability, could be a good therapeutic alternative for persistent epithelial defects.

Introduction: Single-haptic iris-claw intraocular lens (IOL) dislocation is not an uncommon complication. A few different surgical techniques are available for its refixation but usually involve a more invasive approach. We aim to demonstrate an original and simple approach for refixation of single haptic retropupillary iris-claw IOL subluxations. Methods: We present a case of an 80-year-old male with a single haptic retropupillary iris-claw IOL subluxation in a previously vitrectomized eye. We used a new surgical approach to refix this type of subluxation. Results: This new technique uses only two 30-gauge needles (one of them connected to a viscosurgical device) to re-enclavate the subluxated haptic of the retropupillary iris-claw IOL. By minimising surgical manipulation, the patient's postoperative period was uneventful. Conclusions: We highlight a new, quick, safe, and unusual surgical approach to single-haptic retropupillary iris-claw IOL dislocation in vitrectomized eyes. Because of its characteristics, we named it the “fencing” IOL repositioning technique.

Combined trabeculectomy–phacoemulsification is known to provoke more inflammation and yield a poorer long-term efficacy than trabeculectomy alone. This study evaluates whether a similar trend exists for Ahmed glaucoma valve implantation when performed with or without concurrent phacoemulsification. We retrospectively analyzed 51 eyes from patients who underwent either Ahmed-Alone (n = 25) or PhacoAhmed (n = 26) surgery over a 5-year period. The primary outcomes included intraocular pressure (IOP), the use of IOP-lowering medications, and the need for further surgical intervention. Absolute success was defined as IOP reduction > 20% and IOP < 21 mmHg without medication; relative success allowed for continued pharmacologic therapy. Both groups showed a significant IOP reduction, with similar final mean IOP values (Ahmed-Alone: 14.02 ± 4.76 mmHg; PhacoAhmed: 13.89 ± 4.17 mmHg; p = 0.99) and comparable reductions in medication use (p = 0.52). Reinterventions occurred less frequently and later in the PhacoAhmed group (12% vs. 27.3%; median time: 27.1 vs. 12 months). Absolute success was not achieved in any PhacoAhmed case but occurred in 9.3% of Ahmed-Alone cases; relative success rates were similar (83.3% vs. 81.4%; p = 0.291). These findings suggest that combining phacoemulsification with Ahmed valve implantation does not significantly alter efficacy or safety profiles. Additional prospective studies are warranted to assess long-term outcomes.