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Introduction: The study aims to demonstrate and estimate the prevalence of clinical corneal ectasia and keratoconus (KC) in patients with relatively low keratometry (low-K KC). Methods: In a retrospective, analytical, and non-interventionist study, one eye was randomly selected from 1054 patients from the original Tomographic Biomechanical Index (TBIv1) study and the external validation (from Rio de Janeiro, Brazil, and Milan, Italy clinics). Patients were stratified into three groups. Group 1 included 736 normal patients, and groups 2 and 3 included 318 patients with clinical KC in both eyes, divided into low-K KC (90 patients) and high-K KC (228 patients), respectively. All patients underwent a comprehensive ophthalmological evaluation along with Pentacam and Corvis ST (Oculus, Wetzlar, Germany) examinations. Cases with maximum mean zone 3 mm keratometry (Kmax zone mean 3 mm) lower than 47.6 diopters (D) were considered as low-keratometry keratoconus, and cases with Kmax zone mean 3 mm higher than 47.6 D were regarded as high-keratometry keratoconus. Results: Ninety (28.30%) of the 318 KC group presented ectasia with low-keratometric values (low-Kmax). The average age in the normal group was 39.28 years (range 6.99–90.12), in the low-Kmax KC group it was 37.49 (range 13.35–78.45), and in the high-Kmax KC group it was 34.22 years (range 12.7–80.34). Mean and SD values and median (range), respectively, of some corneal tomographic and biomechanical parameters evaluated from the low-Kmax KC group were as follows: Belin-Ambrósio enhanced ectasia display (BAD-D) 3.79 ± 1.62 and 3.66 (0.83–9.73); Pentacam random forest index (PRFI) 0.78 ± 0.25 and 0.91 (0.05–1); corneal biomechanical index (CBI) 0.58 ± 0.43 and 0.75 (0–1); TBI 0.93 ± 0.17 and 1 (0.35–1); and stiffness parameter at A1 (SP-A1) 86.16 ± 19.62 and 86.05 (42.94–141.66). Conclusion: Relatively low keratometry, with a Kmax lower than 47.6 D, can occur in up to 28.30% of clinical keratoconus. These cases have a less severe presentation of the disease. Future studies involving larger populations and prospective designs are necessary to confirm the prevalence of keratoconus with low keratometry and define prognostic factors in such cases. [ABSTRACT FROM AUTHOR]

Background: Conjunctival chemosis, a complication of lower blepharoplasty, can cause persistent discomfort and functional disturbances with worsening in the postoperative period following surgery. Methods: A review of the records of the lower blepharoplasty procedures carried out at the Humanitas Research Hospital, Rozzano, Milan, Italy was performed. Patients were categorized into two groups depending on the procedure performed: (1) transconjunctival blepharoplasty with the removal of the fatty lodges with canthopexy and (2) transcutaneous blepharoplasty with the removal of the fatty lodges with lateral canthoplasty. Each group was further divided into two more groups based on the surgical method used, that is either (a) cold blade and disposable cautery or (b) radiofrequency cut and coagulation and colorado tip (respectively 1a, 1b, 2a and 2b). All patients underwent a postoperative follow-up up to 24 months, which included an evaluation of cosmetic appearance, eyelid scarring and the severity of chemosis. The aim of the study was to investigate which of the surgical procedures causes a lower incidence of persistent type 3 conjunctival chemosis. Results: A total of 1047 patients who underwent lower lid blepharoplasty were included in the study. A total of 512 patients underwent transcutaneous blepharoplasty and 535 underwent the transconjunctival procedure. Among the first group of patients, 266 belong to group 1a and 246 to group 1b. In the second group, 264 were categorized as group 2a and 271 as group 2b. The incidence of type 3 chemosis in the transcutaneous blepharoplasty procedure with lateral canthoplasty was statistically significantly higher than in the transconjunctival approach, considering both the cold blade and the radiofrequency (p = 0.012, 0.010, 0.006, 0.004, respectively). Conclusions: A higher incidence of persistent type 3 conjunctival chemosis is associated with lateral canthus surgery and with the use of radiofrequency. [ABSTRACT FROM AUTHOR]

CXL does not deteriorate the repeatability of parameters obtained by using the dynamic Scheimpflug analyzer. Changes in these parameters caused by CXL are true biomechanical alterations. Purpose: To evaluate the repeatability of deformation corneal response (DCR) parameters before and after corneal crosslinking (CXL) compared with their untreated fellow eyes (uFEs). Setting: University Hospital Carl Gustav Carus, Dresden, Germany; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. Design: Multicenter, interventional reliability analysis. Methods: 53 eyes of 53 patients with keratoconus who received CXL treatment after the disease progression (CXL group) were included. Patients were measured 3 times using a dynamic Scheimpflug analyzer to determine repeatability before and 1 month after CXL treatment. The uFEs were measured in the same way (uFE group). Reliability of DCR parameters was assessed by a coefficient of repeatability, coefficient of variation, and intraclass correlation coefficient (ICC). Results: The repeatability of DCR parameters did not change after CXL compared with the preoperative values for all investigated DCR parameters (P >.05). In the uFE group, no statistically significant shift was observed regarding the repeatability (P >.05). An ICC greater than 0.75 was achieved in both groups for almost all parameters. Concerning the biomechanical stiffening induced by CXL, integrated inverse radius and stress–strain index were found to be statistically significantly decreased and increased (P <.001), respectively, both indicating stiffening. No changes were observed for the uFE group. Conclusions: The study demonstrated highly repeatable measurements of the dynamic Scheimpflug analyzer before and after CXL. The improvement of certain DCR parameters after CXL confirmed the capability of the device to detect the stiffening effect. [ABSTRACT FROM AUTHOR]

Purpose: This retrospective cross‐sectional study evaluated the potential of an additional biomechanical parameter 'E' as an addition to the tomographic ABCD ectasia/keratoconus (KC) staging. Methods: The Corvis Biomechanical Factor (CBiF) represents the modified linear term of the Corvis Biomechanical Index (CBI) developed based on 448 KC corneas from the Homburg Keratoconus Center (HKC). The CBiF range was divided into five stages (E0 to E4) to create a grading system according to the ABCD stages. Stage E0 was characterized by values smaller than the 2.5 percentile. The thresholds were created by dividing the CBiF range between the 2.5 and 97.5 percentiles into four groups of equal values (E1–E4). The frequency distribution of 'E' was analysed and independently validated based on another 860 KC corneas dataset from Milano and Rio de Janeiro (MR). The relationship between 'E' and the ABCD staging was analysed by cross‐tabulation. The specificity of 'E' was assessed based on healthy controls (112|851) from both datasets (HKC|MR). Results: 'E' was normally distributed with E0 = 37|30, E1 = 86|200, E2 = 155|354, E3 = 101|206, E4 = 69|70 in the KC group and 96.4%|90.5% of the controls classified E0 in the HKC|MR dataset, respectively. Cross‐tabulation revealed that 'E' was most comparable to posterior corneal curvature ('B') in both datasets, while showing a trend towards more advanced stages in comparison to anterior corneal curvature ('A') and thinnest corneal thickness ('C'). Conclusion: The novel Corvis‐derived parameter 'E' provides a biomechanical staging for ectasia/KC potentially enhancing the ABCD staging and may detect abnormalities before tomographic changes, which requires further studies. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to describe the use of near-infrared autofluorescence (NIR-AF) to identify and preserve parathyroid glands (PGs) in a group of patients with advanced hypopharyngeal/laryngeal cancer undergone total (pharyngo)laryngectomy with hemi- or total thyroidectomy. Methods: At San Raffaele Hospital, Milan (Italy), from January 2021 to May 2021, 7 patients affected by cT4a laryngeal squamous cell carcinoma (SCC) underwent surgery using an autofluorescence detection system (Fluobeam–Fluoptics®). For proper surgical planning, the demolition phase envisaged extension of the intervention to 4 hemithyroidectomies and 3 total thyroidectomies associated, respectively, with homolateral or bilateral CCND. Serum calcium, ionized calcium, and parathyroid hormone (PTH) levels at post-operative day (POD) 1 and 2 and at 2 weeks after surgery were monitored. Finally, we compared the data obtained with a cohort of patients who underwent surgery without the adoption of NIR-AF. Results: With the use of NIR-AF, 18/20 PGs were identified, of which 7/18 were preserved exclusively thanks to the use of autoflorescence. The technique also made it possible to identify and isolate three PGs from the surgical specimen, which were subsequently transplanted only after intraoperative histological confirmation. On POD-1, 3/7 patients (42.8%) were hypocalcemic; on POD-2 and after 2 weeks only 1/7 patient (14.2%) was hypocalcemic. Comparing the two groups, we highlighted that the utilization of NIR-AF was related to a significant decrease of median serum (p = 0.026) and ionized calcium levels (p = 0.017) 2 weeks after surgery. Using this new technology, in no case did definitive histological examination reveal the presence of PGs in the surgical specimen, reaching an accuracy of 100%. Conclusions: In our cohort of patients who underwent total (pharyngo)laryngectomy with hemi- or total thyroidectomy, the use of near-infrared autofluorescence improved medium term postoperative hypocalcemia rates. This new technology helps to achieve a better calcemic outcome compared to the standard naked eye approach, since it helps the surgeon to identify and preserve parathyroid glandular tissue with a lower incidence of post-operative hypocalcemia. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the correlation between changes in maximum keratometry (Kmax) and ABC values from the ABCD Progression Display (Pentacam) in progressive keratoconus (KC) and to evaluate whether the ABC changes were able to detect progression earlier than Kmax. Setting: Humanitas Clinical and Research Center, Rozzano, Milan, Italy. Design: Retrospective study. Methods: Kmax, ABC values, and thinnest point (ThCT) were recorded at the day of corneal crosslinking (CXL) (T0) and previous follow-up (T-1). In patients without earlier progression in Kmax, follow-up examination (T-2) was used to determine whether any of the ABC parameters reached statistical significance for progression. Results: Seventy-six eyes of 63 patients scheduled for CXL with documented progression (Kmax increase of >1.00 diopter) were included. There was a significant, albeit moderate, correlation between the change in Kmax between T0 and T-1 and the change in both A ([rho] = 0.391) and B values ([rho] = 0.339). There was no significant correlation between the change in Kmax between T0 and T-1 and the change in either C or ThCT. In patients with T-2 examinations, 16 (51.6%) of 31 patients showed a statistically significant change on the ABCD progression display that was not detected with Kmax. Conclusions: This study showed a significant, but moderate, correlation between the change in Kmax and the change in A and B values in progressive KC. Moreover, more than half of the cases showed documented progression earlier with the ABCD progression display than that detected by standard Kmax changes. This study suggests possible changes in progression criteria to allow for earlier intervention. [ABSTRACT FROM AUTHOR]

Purpose: Endoscopic endonasal balloon-assisted dacryoplasty is a minimally invasive surgical approach that can be applied after failure of dacryocystorhinostomy with recurrence of distal acquired lacrimal obstruction. Methods: At the Department of Otolaryngology, San Raffaele Hospital, Milan (Italy), from December 2016 to October 2020, 14 patients underwent trans-nasal balloon-assisted dacryoplasty after a failed dacryocystorhinostomy (both external and endoscopic endonasal). The routinary pre-operative work-up included multidisciplinary study of the lacrimal disease, which consisted in primary ophthalmological and otorhinolaryngological visits associated with nasal endoscopy, in which a radiological exam was added if needed. The surgical approach includes pneumatic enlargement of the stenotic rhinostomy, created during the primary dacryocystorhinostomy, using a high-pressure trans-nasal balloon catheter. Anatomical success was considered when the ostium was patent upon irrigation, while functional success was considered as resolution of epiphora or free lacrimal flow on functional test. Results: Among 14 patients included and after a mean follow-up of 19.5 months (range 13–51 months), anatomic success was achieved in 100% of patients and functional success was achieved in the 85.7% (12/14). Operative time ranged from 9 to 28 min (mean 18 min) and no complications were reported. Conclusion: Trans-nasal balloon-assisted dacryoplasty is a mini-invasive surgical approach to treat failed dacryocystorhinostomies with reliable and stable outcomes in the long term. The absence of post-surgical complications, high success rate and short operative time are the main features of this innovative procedure. [ABSTRACT FROM AUTHOR]

Purpose: To compare the binocular visual outcomes and satisfaction of patients with emmetropia or mild myopia (-0.50 diopters [D]) implanted with a bilateral spherical monofocal IOL. Setting: Ophthalmology Department, Humanitas Clinical and Research Center, Rozzano, Milan, Italy. Design: Prospective nonrandomized study. Methods: This study comprised 2 groups of 30 patients each. Group 1 included patients implanted with bilateral monofocal IOLs with near emmetropic target (plano to -0.25 D). Group 2 included patients with a postoperative bilateral target of -0.50 D. Both groups underwent uncorrected and corrected distance defocus curves postoperatively and subjective questionnaires were used to investigate patient satisfaction postoperatively. Results: The defocus curve showed a significant difference between Group 1 and Group 2 binocular vision (all P values <.01 except at -3.00 D where P value =.32) with Group 1 seeing significantly better than Group 2 at +1.00, +0.50, and 0 but significantly worse in all other points of the defocus. In addition, patients of Group 2 at 0 D of defocus curve (infinite) had a visual acuity close to 0 logarithm of the minimum angle of resolution (logMAR) (0.03 +/- 0.04). The main outcome of Group 2 defocus curves was that, at defocus point 0 D, even if the mean refraction was -0.67 0.15 x 160, mean uncorrected logMAR visual acuity was 0.0 +/- 0.06. Conclusions: Bilateral monofocal IOLs implanted with mild myopic target provided better intermediate visual acuity compared with emmetropia at a minimal cost in terms of uncorrected distance visual acuity. [ABSTRACT FROM AUTHOR]

Aims/Purpose: Keratoconus (KC) is biomechanically characterized by a decreased resistance to deformation when compared to healthy corneas. The aim of this presentation is to give an overview about the development and clinical application of the recently introduced Homburg Biomechanical E‐Staging (BEST) for KC. Methods: The Corvis ST (Oculus, Germany) non‐contact pneumotonometer measures the corneal deformation after applying a standardized air puff. It calculates the quasi‐binary indices Corvis Biomechanical Index (CBI) and Tomographic Biomechanical Index (TBI) to separate healthy from ectatic corneas, without, however providing a biomechanical KC severity stage. The Homburg BEST based on the linearized CBI provides information about biomechanical KC severity in form of E‐stages 0 to 4, thus augmenting the existing tomographic ABCD KC classification by including corneal biomechanics. Several studies and results about the development and clinical application of the Homburg BEST are presented. Results: The Homburg BEST was developed based on two independent KC datasets (Homburg: n = 448, Milano/Rio: n = 860). Since 2022, it has been integrated into the Corvis ST software, thus providing a biomechanical KC severity and progression assessment. The software based on several individual biomechanical parameters indicates KC progression like tomographic progression parameters. However, it is influenced by corneal thickness measurements, increases within the first postoperative months after corneal crosslinking (CXL) and indicates postoperative KC stabilization more than 1 year after CXL. Intracorneal ring segment implantation permanently affects corneal thickness in the midperiphery and contributes to slightly higher postoperative BEST values. Conclusions: Although with limitations, the Homburg BEST enables a biomechanical staging and progression assessment in KC by considering several biomechanical parameters as an addition to the previously purely tomographic or even topographic analysis. [ABSTRACT FROM AUTHOR]

Excimer lasers induces significant changes to corneal structure and corneal biomechanics. The aim of this paper is to describe all laser-tissue interactions which are relevant for clinical practice, particularly, we will focus on laser ablations profiles, causes of regression and haze and prevention of those. At last the manuscript will describe the impact on corneal biomechanics of different Laser Vision Corrections techniques. • This review evaluates the interaction between excimer laser and the cornea, particularly structural and biomechanical changes. • Corneal healing process is conditioned by the curvature gradient as well as the stromal surface quality. • Additionally, excimer laser ablation induces significant changes in corneal biomechanics. [ABSTRACT FROM AUTHOR]

The stress–strain index deteriorates with keratoconus progression. Owing to the focal nature of the disease, no statistically significant difference was observed between healthy individuals and early cases. Purpose: To evaluate the characteristics of corneal material properties in healthy individuals and keratoconic patients using the stress–strain index (SSI). Setting: Vincieye Clinic in Milan, Italy, and Instituto de Olhos Renato Ambrósio in Rio de Janeiro, Brazil. Design: Retrospective observational cross-sectional study. Methods: Records of 1221 patients were divided into 3 groups: healthy corneas (n = 728), bilateral keratoconus (KC, n = 388), and very asymmetric ectasia (VAE, n = 105) when patients presented with clinical ectasia in 1 eye and normal topography (VAE-NT) in the fellow eye. All patients were examined with Pentacam HR and Corvis ST. Severity of KC cases was stratified according to the Pentacam topographic KC classification. The SSI distribution across the different groups and its correlation with age, biomechanically corrected intraocular pressure (bIOP), and central corneal thickness (CCT) were assessed. Results: A statistically significant difference between healthy individuals and each of the keratoconic groups (P <.001) was observed, and a progressive reduction in the SSI was observed across the groups. A significant correlation was observed between the SSI and age in all groups (P <.010) but KC severe subgroup (P =.361). No correlation between the SSI and bIOP and CCT was observed in all KC subgroups and VAE-NT groups (P >.050). Among healthy eyes, there was only a mild correlation between the SSI and bIOP (R = 0.12, P =.002) and CCT (R = 0.13, P =.001). Conclusions: This study estimates the in vivo corneal material properties in healthy individuals and patients with KC using a new method. The SSI showed a progressive deterioration within the advance in disease stages while being relatively independent of bIOP and CCT but positively correlated with age. [ABSTRACT FROM AUTHOR]

To introduce and clinically validate a new method of estimating intraocular pressure (IOP) in patients with keratoconus and soft corneas with the aim of significantly reducing dependence on corneal biomechanics. Vincieye Clinic, Milan, Italy, and Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Brazil. Retrospective case series. This study comprised participants enrolled at two hospitals on two continents. Numerical analysis based on the finite element method was performed to simulate the effect of tonometric air pressure of the Corvis ST dynamic Scheimpflug analyzer on eye globes with wide variations in thickness, geometry, and tissue. The numerical predictions of ocular behavior were used to develop a new algorithm to produce predictions of the biomechanically corrected IOP (bIOP) in eyes with a soft cornea (bIOP s). Predictions of the bIOP s were assessed in the keratoconic clinical datasets (because on average these corneas are softer) and compared with the previously developed bIOP algorithm predictions obtained for normal healthy eyes. The study comprised 722 eyes (722 participants). The main outcome was the absence of a significant difference in IOP between healthy eyes and keratoconic eyes when the bIOP and bIOP s algorithms were used (P >.05). There was, however, a significant difference with the uncorrected Scheimpflug analyzer IOP in both groups (P <.001). Furthermore, the bIOP s predictions were significantly less affected by corneal thickness and patient age than the Scheimpflug analyzer IOP. The bIOP s algorithm was more reliable at estimating the IOP in eyes with a soft cornea and was validated for use in eyes with keratoconus. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study is to assess the variations in anterior chamber depth (ACD), axial length (AXL), and intraocular pressure (IOP) in both phakic and pseudophakic eyes undergoing preoperative intravenous mannitol infusion. The study was conducted at the Ophthalmology Department of IRCSS Humanitas in Milan, Italy. This is a prospective and non-randomized study.40 patients with phakic eyes and 40 patients with pseudophakic eyes scheduled for cataract surgery in their fellow eye were included. Prior to the surgery, comprehensive ophthalmic examinations were conducted, including IOP measurement, and bilateral biometry performed with Anterion® (Heidelberg Engineering GmbH, 69,115, Heidelberg, Germany). All patients received intravenous infusion of mannitol before the surgery. One hour after cataract extraction, the patients underwent the same set of examinations. We analyzed the changes AXL, ACD and IOP in the eye opposite to the one that underwent surgery.The comparison between preoperative and postoperative parameters showed no differences in AXL (p = 0.34 and p = 0.53) and in ACD (p = 0.38 and p = 0.31) in the phakic and in the pseudophakic group, respectively. Instead, a statistically significant difference was found between the mean preoperative and postoperative IOP (p = 0.02) for the phakic group and (p = 0.03) for the pseudophakic group.The administration of mannitol does not lead to any changes in the ACD and AXL, regardless of whether the eyes are phakic or pseudophakic. However, there is a statistically significant reduction in IOP. Nonetheless, it is important to consider the various side effects associated with mannitol infusion.Methods: The purpose of this study is to assess the variations in anterior chamber depth (ACD), axial length (AXL), and intraocular pressure (IOP) in both phakic and pseudophakic eyes undergoing preoperative intravenous mannitol infusion. The study was conducted at the Ophthalmology Department of IRCSS Humanitas in Milan, Italy. This is a prospective and non-randomized study.40 patients with phakic eyes and 40 patients with pseudophakic eyes scheduled for cataract surgery in their fellow eye were included. Prior to the surgery, comprehensive ophthalmic examinations were conducted, including IOP measurement, and bilateral biometry performed with Anterion® (Heidelberg Engineering GmbH, 69,115, Heidelberg, Germany). All patients received intravenous infusion of mannitol before the surgery. One hour after cataract extraction, the patients underwent the same set of examinations. We analyzed the changes AXL, ACD and IOP in the eye opposite to the one that underwent surgery.The comparison between preoperative and postoperative parameters showed no differences in AXL (p = 0.34 and p = 0.53) and in ACD (p = 0.38 and p = 0.31) in the phakic and in the pseudophakic group, respectively. Instead, a statistically significant difference was found between the mean preoperative and postoperative IOP (p = 0.02) for the phakic group and (p = 0.03) for the pseudophakic group.The administration of mannitol does not lead to any changes in the ACD and AXL, regardless of whether the eyes are phakic or pseudophakic. However, there is a statistically significant reduction in IOP. Nonetheless, it is important to consider the various side effects associated with mannitol infusion.Results: The purpose of this study is to assess the variations in anterior chamber depth (ACD), axial length (AXL), and intraocular pressure (IOP) in both phakic and pseudophakic eyes undergoing preoperative intravenous mannitol infusion. The study was conducted at the Ophthalmology Department of IRCSS Humanitas in Milan, Italy. This is a prospective and non-randomized study.40 patients with phakic eyes and 40 patients with pseudophakic eyes scheduled for cataract surgery in their fellow eye were included. Prior to the surgery, comprehensive ophthalmic examinations were conducted, including IOP measurement, and bilateral biometry performed with Anterion® (Heidelberg Engineering GmbH, 69,115, Heidelberg, Germany). All patients received intravenous infusion of mannitol before the surgery. One hour after cataract extraction, the patients underwent the same set of examinations. We analyzed the changes AXL, ACD and IOP in the eye opposite to the one that underwent surgery.The comparison between preoperative and postoperative parameters showed no differences in AXL (p = 0.34 and p = 0.53) and in ACD (p = 0.38 and p = 0.31) in the phakic and in the pseudophakic group, respectively. Instead, a statistically significant difference was found between the mean preoperative and postoperative IOP (p = 0.02) for the phakic group and (p = 0.03) for the pseudophakic group.The administration of mannitol does not lead to any changes in the ACD and AXL, regardless of whether the eyes are phakic or pseudophakic. However, there is a statistically significant reduction in IOP. Nonetheless, it is important to consider the various side effects associated with mannitol infusion.Conclusions: The purpose of this study is to assess the variations in anterior chamber depth (ACD), axial length (AXL), and intraocular pressure (IOP) in both phakic and pseudophakic eyes undergoing preoperative intravenous mannitol infusion. The study was conducted at the Ophthalmology Department of IRCSS Humanitas in Milan, Italy. This is a prospective and non-randomized study.40 patients with phakic eyes and 40 patients with pseudophakic eyes scheduled for cataract surgery in their fellow eye were included. Prior to the surgery, comprehensive ophthalmic examinations were conducted, including IOP measurement, and bilateral biometry performed with Anterion® (Heidelberg Engineering GmbH, 69,115, Heidelberg, Germany). All patients received intravenous infusion of mannitol before the surgery. One hour after cataract extraction, the patients underwent the same set of examinations. We analyzed the changes AXL, ACD and IOP in the eye opposite to the one that underwent surgery.The comparison between preoperative and postoperative parameters showed no differences in AXL (p = 0.34 and p = 0.53) and in ACD (p = 0.38 and p = 0.31) in the phakic and in the pseudophakic group, respectively. Instead, a statistically significant difference was found between the mean preoperative and postoperative IOP (p = 0.02) for the phakic group and (p = 0.03) for the pseudophakic group.The administration of mannitol does not lead to any changes in the ACD and AXL, regardless of whether the eyes are phakic or pseudophakic. However, there is a statistically significant reduction in IOP. Nonetheless, it is important to consider the various side effects associated with mannitol infusion. [ABSTRACT FROM AUTHOR]