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Purpose: The purpose of this study was to report the safety and efficacy results of an artificial lamellar implant for the treatment of chronic corneal edema., Methods: The EndoArt (EyeYon Medical, Ness Ziona, Israel), an artificial endothelial replacement membrane designed to treat corneal edema, was implanted in 24 eyes of 24 patients with low-to-normal visual potential. We present the safety and efficacy results from a prospective, open-label, single-arm, multicenter study conducted over a 12-month period., Results: Twenty-four patients were enrolled, with no device-related serious adverse events reported. Seventeen patients completed 12-month follow-up, showing a reduction in average central corneal thickness from 759 ± 116 μm to 613 ± 135 μm. Best-corrected distance visual acuity improved from 1.88 ± 0.79 logarithmic minimum angle of resolution (logMAR) to 1.34 ± 0.57 logMAR. Sixty percent gained at least 3 early treatment diabetic retinopathy study (ETDRS) lines. The EndoArt was removed in 5 cases due to incomplete attachment and replaced by corneal transplants; 1 patient was lost to follow-up, and 1 had a procedure failure. No device-related long-term complications, infections, or inflammations were reported. The implants remained transparent throughout the study., Conclusions: The first-in-human results of EndoArt implantation demonstrated the device's potential to treat patients suffering from corneal edema with a favorable safety profile and effective edema reduction in most subjects, with no device-related serious adverse event. The EndoArt may offer a viable solution in regions facing a shortage of donor corneas, as well as for patients who have poor prognosis with human tissue., (Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: (1) To qualify complaints of quality of vision in patients with (severe) keratoconjunctivitis sicca by examining straylight values and (2) to check for an effect of scleral lens wear on straylight., Methods: Straylight was measured in 16 patients with severe keratoconjunctivitis sicca using the Oculus C-Quant. In 9 of these patients, scleral lenses were used, and straylight was measured with and without scleral lenses. Other tests included the Schirmer test, visual acuity, the van Bijsterveld score, and a straylight questionnaire., Results: Patients with keratoconjunctivitis sicca had a mean straylight OD of log(s) = 1.36 ± 0.19 SD and OS of log(s) = 1.45 ± 0.17 SD. Mean age was 56 ± 9.3 SD. This was significantly higher than the mean age-matched normal value of log(s) = 1.10 (P < 0.001). Such a straylight increase is functionally significant. The difference in straylight with and without scleral lenses was 0.06 log units ± 0.02 SD, but this was not statistically significant for OD (P = 0.134) and OS (P = 0.293). No correlation was found between straylight and the van Bijsterveld score on the corneal section for OD (P = 0.326) and OS (P = 0.433)., Conclusions: Keratoconjunctivitis sicca leads to increased straylight. However, this increase was not correlated to the amount of surface damage graded with the van Bijsterveld score. Further study on the cornea is necessary to determine the source of the increased straylight. Scleral lenses do not have a noteworthy influence on straylight in these patients.

Purpose: To report the incidence of opacification of the intraocular lens (IOL) after Descemet stripping endothelial keratoplasty (DSEK) in an academic ophthalmology clinic., Methods: In this retrospective case series, all patients who underwent DSEK between 2003 and 2013 were included. In 2008, the first patient presented with reduced vision as a result of opacification of the IOL in our clinic. The period between DSEK surgery and diagnosis of IOL opacification, Snellen corrected distance visual acuity before and after the appearance of IOL opacification, IOL specifications, and incidence of IOL exchange were assessed., Results: A total of 160 eyes were operated on. Opacification was seen in 8 eyes (5%) and was diagnosed between 4 and 24 months after DSEK (mean, 9.6; SD, 6.3; range, 4-24 months). The mean Snellen corrected distance visual acuity was 0.6 (SD, 0.2; range, 0.2-0.8) before opacification and 0.3 (SD, 0.2; range, 0.02-0.6) after opacification of the IOL occurred. The IOL material was hydrophilic acrylic in all patients. In 4 eyes, IOL exchange was performed., Conclusions: Opacification of the IOL can be a vision-threatening late complication after DSEK and was seen in 8 of 160 eyes.

Purpose: To report 3 cases of unexplained intraocular lens (IOL) opacification in patients who previously underwent Descemet stripping endothelial keratoplasty (DSEK)., Methods: Case series. Three pseudophakic eyes of 3 patients, who developed a membraneous opacification of the IOL after uneventful DSEK are presented., Results: In 2 eyes, the opacification interfered with visual acuity. In 1 case, an attempt was made to remove the opacification with the aid of YAG laser and surgically, to no avail, necessitating an IOL explantation., Conclusions: IOL opacification can occur in eyes previously subjected to DSEK. The majority of patients subjected to DSEK are pseudophakic; surgeons should be aware of this possible complication. To the best of our knowledge, this has not been described in the literature to date. Further research is required to elucidate the nature of such IOL opacifications and possible ways to prevent them.

Purpose: Long-term quality of vision after Descemet stripping endothelial keratoplasty (DSEK) was evaluated and correlated with corneal characteristics and subjective complaints., Methods: Thirty-four eyes were examined; patients had a single visit 6 to 64 months after DSEK for Fuchs dystrophy. Best-corrected distance acuity (BCDA) and straylight were analyzed. To better evaluate long-term postoperative BCDA changes, longitudinal data were used from earlier visits. Corneal thickness was measured with the Visante anterior segment optical coherence tomography. Interface, stromal, and endothelial haze were semiquantitatively graded using the slit lamp. Vision-related quality of life was evaluated with the 39-item National Eye Institute Visual Function Questionnaire and a straylight questionnaire. Correlation analysis comparing corneal characteristics with visual quality was performed., Results: Mean postoperative time was 1027 ± 453 days. Mean BCDA at this time was 0.33 ± 0.19 logarithm of the minimal angle of resolution. BCDA remained stable with long-term postoperative follow-up. Straylight averaged 1.47 ± 0.19, on average 0.12 log units higher than normal for age-related pseudophakic eyes (P < 0.001). BCDA correlated with corneal haze (r = 0.50), whereas straylight showed a nonsignificant association (P = 0.12). Neither BCDA nor straylight correlated with corneal thickness. Mean Visual Function Questionnaire 39 score was 77/100, and mean score of the straylight questionnaire was 46/100., Conclusion: Quality of vision after DSEK does not return to normal levels of age-matched pseudophakic eyes, with decreased BCDA and increased straylight. Questionnaire scores indicate mild (Visual Function Questionnaire 39) to moderate (straylight) subjective visual impairment. Corneal thickness and haze do not offer an adequate explanation for the decreased visual quality.

Purpose: To evaluate the rate of recurrence and to detect pre- or postoperative complications in pterygium surgery using fibrin glue to attach the conjunctival autograft., Methods: Retrospective case series. In a period of 20 months, 35 patients were operated on for a pterygium using a conjunctival autograft, of which 7 patients were operated (20%) for a recurrent pterygium. The autograft was glued with Tissucol Duo 500, a human tissue glue. Follow-up was at least 1 year., Results: Mean age was 50.4 years (range, 23-80 years), 18 women and 17 men. Success rate was 97.1%. In 1 patient with a primary pterygium, the lesion recurred after 4 months (2.9%). One autograft was lost on the first postoperative day. No other pre- or postoperative problems were encountered., Conclusions: The use of Tissucol fibrin glue seems to be a safe, easy, and effective technique for attaching the conjunctival autograft in pterygium surgery. The recurrence rate of the procedure is low.

Purpose: (1) To quantify the effect of contact lens wear on straylight in rigid and soft contact lens wearers and (2) to relate findings to morphological changes and subjective complaints., Methods: Straylight was measured using the Oculus C-Quant during contact lens wear and after contact lens removal in 30 rigid contact lens wearers and 30 soft contact lens wearers. Semi-quantitative (0-4) slit-lamp grading of anterior segment changes using Efron grading scales and contact lens characteristics were performed. Subjects answered a straylight questionnaire., Results: Soft contact lens wearers had a mean straylight of logarithmic value of the straylight parameter [log(s)] = 0.934 during contact lens wear and after contact lens removal [comparable to log(s) = 0.938 of age-matched normal eyes]. Rigid contact lens wearers had a mean straylight during contact lens wear of log(s) = 1.167. After contact lens removal, log(s) significantly decreased to 0.997 (P < 0.01). Straylight values with rigid contact lenses were strongly increased (P < 0.001) compared with age-matched normal eyes; after contact lens removal, these values decreased but remained elevated. Straylight in rigid contact lens wearers correlated with the amount of deposits on the contact lens (P < 0.01) but not with other variables of the contact lens score. The questionnaire showed more straylight complaints in rigid contact lens wearers than in soft contact lens wearers (P < 0.01)., Conclusions: Rigid contact lens wear leads to increased straylight during contact lens wear and after contact lens removal. This may be because of subclinical effects of contact lens wear on the cornea and is not seen in soft contact lens wearers.

Purpose: To evaluate donor posterior disk thickness measured with anterior segment optical coherence tomography after Descemet stripping endothelial keratoplasty., Methods: Fifteen patients (17 eyes) after Descemet stripping endothelial keratoplasty, using manually dissected donor posterior disks, were measured with the Visante anterior segment optical coherence tomography (Carl Zeiss Meditec Inc, Dublin, CA). Optical coherence tomography scans were made in a radial pattern, 45 degrees apart, starting in the horizontal axis. Thickness measurements of the donor posterior disks were taken centrally and at fixed radii toward the periphery and were correlated to postoperative change in spherical equivalent (SE), best-corrected visual acuity (BCVA, in Snellen), and improvement in BCVA., Results: Median BCVA was 20/30 (range 20/60-20/20) postoperatively. Median postoperative improvement in BCVA was 4 lines (range 1-11). Median follow-up time was 15.5 months (range 6-32 months). Median postoperative change in SE was -0.25 diopters (range -4.25 to +3.00 diopters). Median central disk thickness was 128.3 microm (range 55-181 microm) and increased significantly toward the periphery: median disk thickness at the 1.5 mm radius was 140.8 microm (range 72-199 microm) and at the 3.0 mm radius was 161.5 microm (range 102-245 microm). No correlation was found between (central) donor disk thickness and postoperative BCVA or change in SE. A nonstatistically significant trend was seen toward more improvement in BCVA with thinner donor disks., Conclusions: Optical coherence tomography measurements of the manually dissected donor posterior disk showed significant variation in thickness, without a statistically significant effect on postoperative BCVA or improvement thereof. Central thickness varied significantly from the peripheral thickness within donor posterior disk.

Purpose: To report a case of an upper eyelid mass induced by a rigid contact lens retained for more than 3 years in the eye of a patient with a general history of keloids and to provide a review of the literature on retained contact lenses., Methods: Case report., Results: A 45-year-old woman with an ophthalmologic history of dry eyes and follicular chronic conjunctivitis presented at our department complaining of irritation, mucous discharge, and contact lens intolerance in her left eye. The ophthalmic examination revealed a visual acuity of 20/20 in both eyes and bilateral blepharitis. A pseudoptosis and an impressive mass growing from the superior tarsal conjunctiva with a lot of mucous discharge were present in the left eye. After a delay of 3.5 years with persisting complaints, a double lid eversion revealed the presence of a hard contact lens retained in the deep fornix of the left eye. After removing the lens and a short period of treatment with local corticosteroids, the mass and the symptoms disappeared., Conclusions: In patients who wear or wore contact lenses and present with one-sided chronic irritation and tissue proliferation, the possibility of a retained contact lens should be considered. The previous history of dry eyes and chronic conjunctivitis led us to miss the diagnosis at the first visits, despite persisting complaints. No other cases about the effects of a retained contact lens in a patient with keloids have been previously reported.

Purpose: The purpose of this paper is to report a case of corneal staining after treatment with topical tetracycline., Methods: A patient with crystalline keratopathy caused by Streptococcus viridans after corneal transplantation was treated topically with tetracycline eye drops, based on results of bacterial sensitivity testing. After 3 weeks of intensive treatment, the donor cornea was stained with a brownish hue, which was ascribed to the tetracycline drops., Results: One patient with crystalline keratopathy developed corneal staining after intensive treatment with topical tetracycline eye drops. After a year of follow-up, the staining of the cornea had not changed significantly., Conclusion: Hourly topical tetracycline eye drops may induce corneal pigmentation. To our knowledge, this is the first published case report of corneal staining caused by tetracycline eye drops.

Purpose: To report the clinical results of posterior lamellar keratoplasty (PLK) using predissected organ-cultured donor corneal tissue implanted after stripping of the Descemet membrane., Methods: Twenty-two eyes of 22 patients in whom a PLK procedure was performed for pseudophakic bullous keratopathy and/or Fuchs endothelial dystrophy were evaluated. In all eyes, the recipient Descemet membrane was excised by performing a descemetorhexis. Just after harvesting the donor tissue, each cornea had a posterior lamellar dissection made at approximately 80% stromal depth, and each cornea was preserved in an organ culture system for 10 to 21 days. During surgery, a posterior lamellar disk was trephinated from the predissected donor cornea and inserted through a 5.0-mm scleral incision into the anterior chamber of the recipient by folding the donor. Specular microscopy was performed at 6, 12, and 18 months to measure the endothelial cell density., Results: In 3 eyes (14%), the posterior donor disk did not attach to the recipient posterior stroma, so a penetrating keratoplasty was performed in a secondary procedure. The transplants in the remaining 19 eyes cleared and maintained clarity throughout the follow-up period. In these eyes, best corrected visual acuity (BCVA) ranged from 0.25 to 1.0 up to 27 months of follow-up. Postoperative astigmatism averaged 1.7 +/- 1.0 D. Endothelial cell density averaged 1650 +/- 390 cells/mm at 6 months, 1560 +/- 350 cells/mm at 12 months, and 1500 +/- 430 cells/mm at 24 months. Two eyes developed mild interface haze., Conclusion: PLK can be performed using an organ-cultured donor posterior disk. Visual rehabilitation may be slower than in PLK with fresh donor tissue.