Anti-scarring Drugs And Drug Delivery systems (DDSs) that are more effective and safer than mitomycin C have been sought to improve the outcome of glaucoma filtration surgeries. Drugs that selectively inhibit wound healing, including anti-transforming growth factor-β and anti-vascular endothelial growth factor antibodies, have been investigated, although their advantages are yet to be verified in humans. In addition, novel sustained release DDSs with fewer toxic effects have been studied for application after glaucoma surgeries. Several potential biomaterials for such DDSs, including gelatin hydrogel, have been introduced.

A 34-year-old man presented with binocular proptosis for half a year and sight lost for seven days. The patient had a facial lymphoma resection and postoperative chemotherapy five years ago.

Ocular diseases are devastating as most of them would cause irreversible visual impairment and blindness. Conceptually, cell replacement therapy with new ocular cells generated by ocular stem cells can substitute the degenerated or damaged cells in the diseased tissue. This concept has first been applied in the limbal transplantation by limbal progenitor cells. Unfortunately, patients with limbal stem cell deficiency and the endogenous progenitor cells present in human corneal endothelium as well as retina have limited regenerative power. In recent decades, other stem cell sources for ocular cell regeneration have been explored and are now feasible with the use of pluripotent stem cells, such as the embryonic stem cells (ESCs) and the induced pluripotent stem cells (iPSCs). Nevertheless, autologous transplantation would not be applicable using ESCs, whereas the variability of reprogramming methods as well as genetic instability of iPSCs has hindered their direct applications. Alternatively, human adult stem cells, such as hematopoietic stem cells (HSCs) and mesenchymal stem cells (MSCs) are found throughout the body and can be efficiently isolated from patients while maintaining the characteristics of self-renewal and multipotency. Superiorly, adult stem cells harness the potential to protect the ocular cells, where MSCs are able to modulate the microenvironments of the diseased eye for neuroprotection. This article compiled the current progress of MSCs in ocular research. Moreover, the updated clinical trials of adult stem cells in ocular diseases are summarized. In addition, potential challenges and future prospects of stem cell research in ophthalmology would also be discussed.

Purpose: Choroidal neovascularization is a common complication following several retinal conditions, most commonly age-related macular degeneration (AMD). We present a case of bilateral extramacular choroidal neovascularization in a patient with wet AMD.

Methods/Patients: Interventional Case Report. Clinical, radiologic, and angiographic correlation.

Results: An 89 year old Caucasian male with Age-related Macular Degeneration (AMD) developed bilateral vitreous hemorrhages and subretinal hemorrhages after which were noted bilateral extramacular choroidal neovascular membranes. The vitreous hemorrhage in the left eye cleared on its own, while vitrectomy was performed in the right eye. Bevacizumab (Avastin) was injected into both eyes. Eighteen months after initial presentation and three months after Bevacizumab, the patient was asymptomatic, both neovascular membranes were inactive, and visual acuity had improved to 20/70 OD and 20/100 OS.

Conclusions: We report the first case of aggressive bilateral extramacular choroidal neovascular membranes in a patient with wet AMD. The pathophysiology that causes AMD to target the macula and fovea in most cases, but the extramacular region in this case, has yet to be elucidated.

Objective: To describe the method of Intraocular lens (IOL) power calculation in eyes after Intracorneal Ring Segment (ICRS) surgery for the treatment of post-LASIK ectasia.

Design: Retrospective observational case-series.

Participants: Three eyes of 2 patients were included in this study.

Methods: Corneal curvature in the central effective optical zone was averaged using corneal topography and k-reading (Kr) was calculated using Jarade IR method for Kr after LASIK. The calculated Kr was used in SRK-T formula for IOL calculation. Accuracy of this IOL calculation method was judged using the manifest refraction outcome after cataract surgery. All eyes were targeted for emmetropia after cataract.

Results: In our series, one eye developed cataract after ICRS surgery for the treatment of ectasia after hyperopic LASIK (+4 D) and 2 eyes developed cataract after ICRS surgery for the treatment of ectasia after myoic LASIK (-10 D). The spherical equivalent of manifest refraction after cataract surgery was within 1.25 D in all eyes.

Conclusion: Using the average corneal curvature in the central effective optical zone to calculate Kr “by Jarade IR” method was found to be accurate in calculating IOL power in ectatic eyes treated by ICRS surgery

Purpose: Choroidal osteoma is a rare tumor which features intraocular bone formation. This tumor can be complicated by choroidal neovascularization which is a cause of impaired vision in this condition. We present a case of choroidal osteoma with choroidal neovascularization as a complication.

Methods: Case report with clinical and angiographic correlation.

Results: A 16 year old female presented with a choroidal osteoma in the left eye complicated by choroidal neovascularization. The patient was treated with Bevacizumab; an intravitreal anti-Vascular Endothelial Growth Factor (Anti-VEGF). Following treatment there was improvement in vision as well as resolution of the choroidal neovascular membrane.

Conclusion: We present a case of choroidal osteoma with choroidal neovascular membranes. Subfoveal Choroidal Neovascularization (CNV) associated with choroidal osteoma may be safely treated with bevacizumab. Larger studies are required to fully evaluate the management and long-term outcomes of anti-VEGF therapy for CNV associated with choroidal osteoma.

Infliximab is a chimeric monoclonal antibody against Tumor Necrosis Factor-α (TNF-α), initially developed for treatment of rheumatoid arthritis and inflammatory bowel disease

Purpose: To evaluate etiologies, management, and outcomes of patients with Giant Retinal Tears (GRT) undergoing primary surgery at tertiary referral center.

Methods: A Retrospective, consecutive case series of 94 patients with at least 3 months follow up after silicon oil removal. 57 eyes (60.6%) underwent vitrectomy, 36 eyes (38.3%) underwent combined vitrectomy with buckling and 1 eye (1.1%) underwent scleral buckling. Perfluorocarbon (PFCL) heavy liquid to flatten GRT f lap intraoperative has been used then PFCL air exchange then air silicon exchange in all eyes undergoing vitrectomy. Fellow eye was observed for retinal detachment.

Results: Idiopathic cause constitute 47 eyes (50%), 25 eyes (26.6%) are myopic and 22 eyes (23.4%) have history of trauma. 85 eyes (90.4%) achieved anatomic success. Visual acuity at the last follow-up was at least 20/400 in 71 eyes (75.5%) of patients. Recurrent retinal detachment after Silicon Oil Removal (SOR) was found in 21 eyes (22.3%) of which, 50% had Proliferative Vitreoretinopathy Grade C (PVR-C) or more (p value 0.03) and 20% had GRT size more than 180° (p value 0.04). Pars Plana Vitrectomy (PPV) alone (p value 0.89) or combined PPV with buckling (p value 0.98) have no significant correlation with recurrent Retinal Detachment (RD). 21% of the fellow eye had retinal detachment.

Conclusion: Idiopathic cause constitutes the majority 50%. Patients with GRT who underwent surgery achieved high anatomic success rate. PVR-C or more remain the most significant risk factor for recurrent RD after SOR whereas PPV alone or combined PPV with buckling have no significant correlation with recurrent RD.

Purpose: To report the efficacy of Ocriplasmin in the treatment of small-medium sized idiopathic full thickness Macular Holes with focal Vitreomacular traction in comparison with vitreous surgery.

Methods: Retrospective observational single-centre small case series (n=6) studythat included patients who underwent vitrectomy after unsuccessful treatment ofsmall-medium size full thickness Idiopathic macular holes with ocriplasmin.

Results: 6 eyes with full-thickness macular holes and VMT were included, whereby in 4 eyes an epiretinal membrane was present (66.7%). Resolution of VMT after intravitreal injection of ocriplasmin was shown in three out of six eyes (50%) and in all six eyes after vitrectomy (100%). Of all six eyes presenting macular holes with a mean size of 265 µm ± 109 µm at baseline visit, five eyes showed persistent macular holes at the second follow-up visit with a mean size of 335 µm ± 166 µm. After vitrectomy no macular hole could be detected at the f inal follow-up visit.

Conclusion: We present our clinical experience with intravitreous injection of Ocriplasmin to confirm the presumed therapeutic effect in patients suffering from Vitreomacular Traction (VMT) with small-medium sizedfull thickness Macular holes (MH). Small macular holes could frequently be closed with only Ocriplasmin and without surgery with a 17% closure rate. Enlargement in all holes that failed to close with Ocriplasmin was observed in all treated eyes which makes us believe that the VMT could have a Protective role. Ellipsoid zone disruptions were evident in 50% of treated eyes and more common in eyes with successful VMT release. Although data on Ocriplasmin from several studies remain controversial but so far the results are consistent with the results and recommendations of other clinical studies and the European Medicine Agency. We agree that replacing vitrectomy for MHs with one injection of Ocriplasmin would be a very attractive option but so far Pars plana vitrectomy remain the treatment of choice for most eyes with MHs. Further Work is recommended to reveal the Cause of the ellipsoid zone Changes, the mechanisms of tractional forces and to investigate the Long term side effects of Ocriplasmin.

Purpose: To analyze and compare the refractive outcomes of standard phacoemulsification with femtosecond laser-assisted cataract surgery performed during the initial learning curve and a year later by experienced surgeons.

Methods: This single-center retrospective study was divided into 3 groups: Group 1, 63 patients who underwent standard phacoemulsification (control group) prior to femtosecond laser acquisition by two anterior segment surgeons; Group 2, the first 104 patients who underwent femtosecond laser-assisted cataract surgery by the same surgeons from Feb 19, 2014 to April 30, 2014 (learning curve group) and Group 3,108 patients who underwent femtosecond laser-assisted cataract surgery by the same surgeons a year later from Feb, 2015 until June 30, 2015 (experienced group).

Results: Mean absolute refraction prediction errors were 0.37 ± 0.25 Diopters (D) in the control group, 0.30 ± 0.24 D in the “learning group” and 0.30 ± 0.24 D in the experienced group with no significant differences among groups. The percentages of eyes within 0.5 D of the targeted refraction were 69.8%, 90.5% and 82.5% in the control group, learning group, and experienced group, respectively (p

Conclusion: There was no statistically significant difference in the mean postoperative refraction prediction errors between femtosecond laser-assisted cataract surgery and standard phacoemulsification in either the learning curve or experienced group. However, a higher percentage of patients were within 0.5 D of the targeted refraction in the learning curve femtosecond laser-assisted cataract surgery group compared with the standard phacoemulsification group.

Scleral fixated Intraocular Lenses (IOLs) have grown in popularity as an effective solution to aphakic eyes with insufficient capsular support. A rare but debilitating complication includes development of Uveitis-Glaucoma Hyphema (UGH) syndrome. Recurrent hemorrhages with UGH syndrome are even more unusual (UGH-Plus syndrome). Classically, this syndrome develops following anterior chamber IOLs, but the literature is scarce with reference to UGH-Plus syndrome after posterior chamber IOL implantation. We present two cases of patients with scleral-tunneled IOLs who developed UGH-Plus syndromeresulting from haptic interference with ciliary body vessels. We describetwo different IOL sparing management approaches including introduction of a novel surgical solution.

An asymptomatic 36-year-old woman presented to our hospital for a routine ophthalmic examination. Slit lamp biomicroscopy revealed in her right eye tiny pigmented opacities on the anterior lens capsule.

Purpose: To compare the change in asphericity and other Higher Order Aberration (HOA) in Custom-Q vs. Wavefront Optimized (WFO) LASIK ablation profile patients in an Asian population.

Setting: Prospective matched-cohort study in refractive center.

Method: Thirty-four eyes of 17 patients with myopia seeking laser correction at Nobel Clinic in Taipei, Taiwan were enrolled in a prospective cohort study. Utilizing the latest WaveLight®EX500 Excimer Laser (Alcon, Inc., Switzerland), each patient received both Custom Q (CQ) and WFO LASIK ablation treatments (CQ on OD and WFO on OS). Each patient was measured thrice, as follows: (1) Before the Lasik procedure, (2) 1 week after the procedure, and (3) 1 month after the procedure.

Results: The custom-Q ablation group comprised a mean SE of -5.32 diopter (D), and the WFO ablation group comprised a mean SE of -5.41 diopter (D). Their frequencies with which Custom-Q and WFO achieved postoperative Uncorrected Distance Visual Acuity (UCDVA) were not statistically different from each other (P>0.05). No statistically significant differences were found in contrast sensitivity, astigmatism, coma, and trefoil. However, the change of spherical aberration was higher in the WFO ablation profile. Patient questionnaire shows a mild preference for Custom-Q over WFO.

Conclusion: Custom-Q and WFO LASIK provided similar results in myopic refractive correction and achieved post op UCDVA and contrast sensitivity. However, Custom-Q produced less changes in asphericity and HOA changes; Asian patients showed marginal preference for Custom-Q in terms of optic quality.

In Germany about 30 thousand patients are affected by one of the over 100 forms of inherited degenerative diseases of the retina, worldwide about 2 million.

Background/Purpose: To evaluate the effectiveness of primary neodymium-doped yttrium aluminum garnet (Nd:YAG) laser posterior capsulotomy in pediatric cataract surgeries.

Methods: Retrospective analyses of 19 eyes of 11 patients with developmental cataract who had undergone cataract surgery between 2012 to 2016 were included in the study. All the cases that had undergone phacoemulsification with foldable acrylic Intra Ocular Lens (IOL) in which the posterior capsule was left intact, and followed by Nd:YAG capsulotomy after one to two weeks’ of surgery were included. Traumatic cataracts and those which needed anterior vitrectomy due to dehiscence of posterior capsule were excluded from the study.

Results: The mean age of the study population was 7.42 ± 3.39 years withaminimum age of 3 years andamaximum of 14 years. The maximum follow-up period was found to be 33 months. The mean preoperative visual acuity in the study group was 0.87 log MAR units anda statistically significant improvement was noted post operatively. All 19 eyes had a clear visual axis at thelast follow up. No eye developed visual axis opacification or required any further intervention.

Conclusion: This study proposes that leaving the vitreous undisturbed and performing YAG capsulotomy after two weeks is moreeffective than a primary posterior capsulorhexis with anterior vitrectomy especially in children older than 3 years. It is a safe and easier method even at the hands of inexperienced surgeons who may have to take up a developmental cataract in under developed and less accessible parts of the world.

Patient was a 59-year-old man who presented with progressive visual blurring in his right eye for 2 weeks and was admitted on November 6, 2023. The patient reported that he experienced progressive visual blurring after using a trigger point gun to massage the right eye socket 2 weeks prior, which worsened upon lying down.