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Accurate thickness measurement of corneal layers using anterior segment OCT can be used to improve visual outcomes. Understanding its applications is essential for optometric practices to enhance eye care procedures. To evaluate the thicknesses of different corneal layers for identifying keratoconus (KCN) and subclinical keratoconus (SKCN) using spectral-domain optical coherence tomography (SD-OCT). This prospective study analyzed 60 eyes with KCN, 48 eyes with SKCN, and 53 normal eyes. The central corneal thickness (CCT) and thicknesses of the epithelium, Bowman, stroma, and Descemet-endothelium layers were measured using SD-OCT. One way analysis of variance and the area under the curve (AUC) were used to evaluate the parameters. The Delong method was used to compare AUCs. In KCN, CCT and thicknesses of epithelium, Bowman, stroma, and Descemet-endothelium layers were 495.5 ± 41.7, 52.6 ± 6.4,11.5 ± 1.4, 415.5 ± 38.9, and 12.3 ± 1.7 µm, respectively. These thickness values were respectively 524.5 ± 33.3, 56.8 ± 6.8, 11.5 ± 1.6, 439.8 ± 30.6, and 12.4 ± 1.7 µm in SKCN and 563.8 ± 37.9, 57.7 ± 6.9, 12.2 ± 1.6, 469.5 ± 33.7, and 12.8 ± 2.1µm in normal group. Total cornea and stroma in KCN and SKCN, and epithelium in KCN were significantly thinner compared to the normal group (P < 0.001). The highest AUC values were observed for CCT in KCN (AUC 0.90) and SKCN (AUC 0.782). The diagnostic accuracy was significantly higher for stromal thickness in KCN (sensitivity 81.7%, specificity 73.6%, AUC 0.871) and SKCN (sensitivity 80.0%, specificity 56.6%, AUC 0.751) than other individual corneal layers (Delong, P < 0.001). CCT can accurately distinguish keratoconus from normal eyes. However, central corneal stromal thinning was the most sensitive diagnostic index for early detection of SKCN. Developing standardized stromal maps may be helpful for detecting SKCN. [ABSTRACT FROM AUTHOR]

Given the scarcity of data regarding ocular complications following COVID‐19 vaccination, the approach toward patients with suggestive symptoms and established clinical practice is lacking. Herein, we report the first case of herpetic endotheliithis and secondary stromal keratitis following inactivated COVID‐19 vaccination who experienced a relapse due to poor adherence. [ABSTRACT FROM AUTHOR]

PURPOSE: To provide an update for postoperative pain control strategies to help ophthalmic surgeons establish a more effective management plan for patients who underwent advanced surface ablation surgeries. METHODS: Google Scholar, Scopus, ScienceDirect, and PubMed were the main resources used to search the medical literature. RESULTS: The postoperative cornea's healing process is accompanied by intense pain as the chief complaint in the first days after the operation. Several strategies were developed to relieve postoperative pain after surface ablation procedures. These strategies included different preoperative, intraoperative, and postoperative methods. Considering the preoperative demographic and emotional factors, underlying dry eye, alternative epithelial removal techniques, bandage contact lenses, and topical or oral therapeutic agents are some examples of postoperative pain treatments after surface ablation procedures. CONCLUSIONS: The current review revealed that despite the development of numerous protocols to relieve postoperative pain following surface ablations, the best approach could be a combination of different strategies. In practice, no validated and standardized strategy is available for total elimination of postoperative pain following advanced surface ablation surgeries. [J Refract Surg. 2021;37(11):782–790.] [ABSTRACT FROM AUTHOR]

Abstract Background Despite the progress in vitreoretinal surgery and the importance of silicone oil as an adjunct for the treatment of complex forms of retinal detachment, controversy still surrounds the issue of selecting the proper oil viscosity for clinical use. Herein, we evaluate the outcomes of retinal detachment (RD) surgery after removing silicone oils of different viscosities. Methods In this retropsective cohort study, eighty-two eyes with surgically re-attached retinas, of which 53 were filled with 5000cs silicone oil and 29 with 1000cs silicone oil were enrolled. We evaluated the outcomes and complications following silicone oil removal. Final anatomic success (stable re-attachment), final visual acuity (VA) and intraocular pressure (IOP)were recorded and analysed. Results Of 82 eyes, 41 had proliferative vitreoretinopathy (PVR), 24 were associated with intraocular foreign bodies, 10 had endophthalmitis and 7 had proliferative diabetic retinopathy with tractional retinal detachment. Prior to silicone oil removal, the retina was attached in all eyes, 29% had VA ≥ 6/120 and 52% had IOP ≥ 21 mmHg. After silicone oil removal, the retina remained attached in 59(72%) of the eyes, 34% had VA ≥ 6/120 and 9% had IOP ≥ 21 mmHg. Comparing 1000cs and 5000cs silicone oil filled eyes, redetachment occurred more frequently in the latter group especially in cases with associated PVR. Final VA worse than 6/120 was associated with initial VA < 6/120 (OR = 32.2 95%CI 7.4–140.2) and use of 5000cs silicone oil (OR = 7.9 95%CI 1.9–32.2). No factor was significantly associated with final IOP ≥ 21 mmHg. Conclusion In complicated retinal detachment surgery, use of 5000cs silicone oil may be associated with a poorer anatomic and visual outcome compared with 1000cs silicone oil. However there was no difference between the two viscosities in IOP elevation. A randomized controlled study is necessary to further evaluate such a possibility.

Abstract Background Optic nerve transection and chorioretinitis sclopetaria may occur following blunt ocular trauma. However, simultaneous occurrence has not yet been reported. We report the first case of concomitant optic nerve transection and chorioretinitis sclopetaria. Case presentation A 12- year- old boy with history of BB gun injury to his right eye was referred for loss of vision. His visual acuity was counting fingers at one meter in the right eye and with 3+ relative afferent pupillary defect (RAPD). On slit lamp examination, the right eye appeared normal except for 1+ vitreous reaction. Fundus examination of the right eye revealed a pale disc with superior retinal scar and diffuse submacular fibrosis compatible with chorioretinitis sclopetaria. Orbital CT- scans showed transection of the optic nerve by the BB gun pellet, which was lodged at the orbital apex. Conclusion BB gun injury may cause concomitant optic nerve transection and chorioretinitissclopetaria.

Background and purpose: Reactive oxygen species (ROSs) are continuously produced as byproducts of cell metabolism. Free radicals are an unstable form of ROSs with the tendency to react readily with biomolecules such as amino acids, lipids and DNA. These reactions lead to oxidative damages to the cell. Oxidative stress occurs when the concentration of the ROSs exceeds the capacity of antioxidative protection systems of the body. 5-Hydroxypyridin-4-one derivatives can chelate Fe2+ and Fe3+ due to their α-hydroxyketone moiety. Also, tautomerism in hydroxypyridinone ring leads to enough level of aromaticity resulting in a catechol-like behavior that provides them with good chelating and radical scavenging properties. Experimental approach: Different compounds were synthesized with 5-hydroxypyridine-4-one moiety as the core. The antioxidant properties of molecules were evaluated experimentally by DPPH scavenging method and theoretically using DFT/B3LYP with a 6-31++G (d,p) basis set. Electronic properties were investigated using frontier molecular orbital theory calculations. Furthermore, global descriptive parameters were obtained to find the chemical reactivity of molecules. The natural bond orbital analysis was performed to investigate charge distribution and hydrogen bonding. Findings/Results: Structures of the synthesized compounds were confirmed using IR, 1H-NMR, and 13C-NMR spectral analyses. Among all the synthesized compounds, Va and Vb showed the best antioxidant effect experimentally and computationally. Conclusion and implications: Results of this study were valuable in terms of synthesis, in silico, and in vitro antioxidant evaluations and can be useful for future investigations about the design of novel 5-hydroxypyridin- 4-one derivatives possessing iron-chelating and radical scavenging abilities. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the safety and efficacy of femtosecond laser-assisted MyoRing implantation with concurrent corneal collagen crosslinking (CXL) compared to MyoRing alone for the treatment of progressive keratoconus. Methods: A total of 60 patients were enrolled in this randomized controlled trial. The patients were randomly allocated into two groups. In the first group, MyoRing was implanted, while in the second, it was inserted in the corneal stroma using the same technique, along with simultaneous CXL. Visual, refractive, topographic, and abberometric outcomes were measured preoperatively and at every postoperative visit. Results: Data of 47 patients were available at the end of the study; 28 in the MyoRing group and 19 in the MyoRing + CXL group. The mean uncorrected distance visual acuity (UDVA) improved from 0.79 ±0.39 logMAR to 0.52 ±0.31 logMAR (P <0.05) in the MyoRing + CXL group and from 0.65 ± 0.38 logMAR to 0.62 ± 0.23 logMAR (P = 0.70) in the MyoRing group. CDVA changed from 0.33 ±0.19 logMAR to 0.25 ±0.16 logMAR (P = 0.10) in the MyoRing + CXL group and 0.32 ± 0.22 logMAR to 0.33 ± 0.17 logMAR (P > 0.50) in the MyoRing group. The mean keratometry (Km) decreased from 47.5 ± 2.7 D to 43.8 ± 3.2 D (P < 0.001) in the MyoRing group and 49.3 ± 3.4 D to 45.1 ± 3.0 D (P < 0.001) in the MyoRing + CXL group. Besides, horizontal coma was significantly lower in the MyoRing + CXL group (P = 0.022). Conclusion: MyoRing insertion combined with CXL is a safe and effective method for the treatment of keratoconus. The visual and topographic outcomes were comparable to that for MyoRing insertion after 10 months; however, horizontal coma was significantly lower in the MyoRing + CXL group. [ABSTRACT FROM AUTHOR]

Background: Astigmatism is the leading complication in visual recovery after penetrating keratoplasty (PKP) and deep anterior lamellar keratoplasty (DALK); in this study, we evaluated the outcome of femtosecond laser arcuate keratotomy (FLAK) after DALK and PKP in Iranian keratoconic patients. Materials and Methods: In this prospective interventional case series, refractive and keratometric predictability, efficacy, and complications of FLAK for postkeratoplasty astigmatism in keratoconus were evaluated; 23 eyes of 23 consecutive patients (mean age of 32.43 ± 9.11 years) with high astigmatism were enrolled. The femtosecond laser performed paired 90°-angled arcuate incisions. Results: Mean logarithm of the minimum angle of resolution of corrected and uncorrected visual acuity improved from preoperative values of 0.30 ± 0.18 and 0.85 ± 0.32 to 6-month values of 0.19 ± 0.17 and 0.65 ± 0.33, respectively (P < 0.05). Mean subjective astigmatism was 7.79 ± 2.64 diopter (D) preoperatively and 3.69 ± 2.25D at 6-month after surgery (P < 0.05). Surgically induced astigmatism was 9.27 ± 5.00D. Mean refractive spherical equivalent showed no significant (P = 0.69) hyperopic shift from - 4.21 ± 4.84D preoperatively to - 2.16 ± 6.09D postoperatively. Two (8.7%) microperforations were observed. Conclusion: FLAK is a relatively safe and effective method for the treatment of postkeratoplasty astigmatism. [ABSTRACT FROM AUTHOR]