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Pseudophakic bullous keratopathy is the presence of persistent corneal edema following intraocular lens implantation or cataract surgery. A 75-year-old lady presented to us with a right failed descemet stripping automated endothelial kerato- plasty (DSAEK) performed elsewhere and a left eye with decompensating bullous keratopathy. A decision was made to proceed with a right DSAEK in the first instance. A second corneal graft became available due to a late cancellation. After further deliberation, the patient agreed to have the procedure done in both eyes. She received an immediate sequential bilateral endothelial keratoplasty with a DSAEK in the right eye and a descemet membrane endothelial keratoplasty in the left eye. This bilateral sequential endothelial keratoplasty resulted in faster bilateral visual recovery without complications. We postulate this as a viable option to speed bilateral visual recovery; accepting further evidence is required to support our assertion and help generate formal clinical guidance. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusions To assess the risk for pseudophakic cystoid macular oedema (PCME) and posterior capsular opacification (PCO) associated with combined cataract surgery and trabeculectomy compared to cataract surgery alone.Data analysis of subjects who underwent routine cataract surgery without and with concomitant trabeculectomy at the Department of Ophthalmology, Bristol Eye Hospital, the UK, between January 2008 and December 2017. Odds ratios (ORs) for PCME between the types of surgeries were calculated using univariate and multivariate regression analysis. Multivariate Cox regression controlling for age and gender was used to estimate the hazard ratio (HR) for neodymium‐doped yttrium aluminium garnet (Nd:YAG) laser capsulotomies.This study included 56 973 cataract surgeries without and 288 with concomitant trabeculectomy (phaco‐trab) with a mean follow‐up time of 6.9 ± 4.2 years. Baseline variables (age and gender, diabetes, pseudoexfoliation, use of pupil expansion device and postoperative follow‐up time) were comparable between the groups. Postoperative rates of PCME remained non‐significant between the cataract surgery and phaco‐trabe groups both in uni‐ and multi‐variate analysis (OR 0.347, 95%CI 0.049–2.477, p = 0.291). Furthermore, in Cox regression analysis adjusted for the patients' age and gender, Nd:YAG laser capsulotomy rates remained non‐significant between the cataract surgery and phaco‐trabe groups (HR 1.250, 95%CI 0.883–1.769, p = 0.209).In our large cohort study, combining trabeculectomy with cataract surgery did not predispose to an increased PCME or Nd:YAG laser capsulotomy rates. [ABSTRACT FROM AUTHOR]

Purpose: To assess the risk for uveitis, pseudophakic cystoid macular edema (PCME), and posterior capsular opacification (PCO) associated with the use of pupil expansion devices in cataract surgery., Design: A retrospective comparative cohort study., Participants: Patients who underwent routine cataract surgery with and without pupil expansion devices at the Department of Ophthalmology, Bristol Eye Hospital, UK, between January 2008 and December 2017., Methods: This study included 39,460 eyes operated without a pupil expansion device and 699 eyes operated with the device. Odds ratios for uveitis and PCME when using a pupil expansion device were calculated using univariate and multivariate regression analysis, having age, gender, diabetes, pseudoexfoliation, and pupil expansion device as independent variables. Multivariate Cox regression controlling for age and gender was used to estimate hazard ratios (HR) for Nd : YAG laser capsulotomies., Results: Postoperative uveitis and PCME were reported in 3.9% and 2.7% of the eyes operated with a pupil expansion device compared to 2.3% and 1.3% operated without the device (p=0.005 and p=0.002, respectively). In univariate regression analysis, eyes with pupil expansion devices showed a higher risk of postoperative uveitis or PMCE after cataract surgery (OR 1.88, 95%CI 1.39-2.55, p<0.001). In multivariate regression analysis, the risk for PMCE was greater among diabetic patients and in eyes with a pupil expansion device than in those without (OR 1.50, 95%CI 1.24-1.83, P <0.001; OR 1.90, 95%CI 1.16-3.11, P =0.01). In Cox regression analysis adjusted for the patient's age and gender, the use of a pupil expansion device was associated with higher Nd : YAG laser capsulotomy rates (HR 1.316, 95%CI 1.011-1.714, P=0.041)., Conclusion: In our large cohort study, the use of pupil expansion devices in cataract surgery was associated with an increased risk of major postoperative complications. Effective anti-inflammatory treatment and follow-up are warranted in eyes operated with a pupil expansion device., Competing Interests: RT is a scientific adviser advisory board, honoraria to Alcon Laboratories, Inc., Allergan, Inc., Bayer and Novartis AG, and has received clinical trial support study medicines from Bayer AG and Laboratoires Théa. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Yahalomi, Elhaddad, Avadhanam, Tole, Darcy, Levinger, Tuuminen and Achiron.)