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Accurate intraocular lens (IOL) calculation in subjects with irregular astigmatism is challenging. This study evaluated the accuracy of using Scheimpflug-derived central 2-mm equivalent keratometry reading (EKR) values for IOL calculation in irregular astigmatism.This retrospective study included subjects (31 eyes of 30 patients) who underwent cataract surgery and IOL calculation using the 2-mm central EKR methods. We compared prediction error (PE) and absolute PE (APE) outcomes using SRK/T and Barrett Universal II formulas for keratometry data obtained from the IOLMaster 500 and Pentacam (anterior corneal sim k) devices.Cataract surgery and IOL calculation using the 2-mm central EKR methods resulted in improved visual acuity (uncorrected: from 1.13 ± 0.38 to 0.65 ± 0.46 logMar, p 0.01; best-corrected: from 0.45 ± 0.24 to 0.26 ± 0.20 logMar, p 0.01) after surgery. The percentage of subjects with best-corrected visual acuity of 6/6 was 22%, 6/9 was 58%, and 6/12 was 71%. For both the SRK/T and the Barrett formulas, the PE was similar to those obtained by IOLMaster ( 0.14) but lower than those obtained by the anterior corneal sim k (p 0.02). IOLMaster provided keratometry reading in only 23/31 (74.1%) of cases.The use of Scheimpflug central 2-mm EKR for IOL calculation in irregular astigmatism was beneficial in terms of visual acuity improvement. It had comparable refractive prediction performance to the IOLMaster 500 and better than the anterior corneal sim K. The 2-mm EKR method can be used when IOLMaster cannot provide a reliable reading in abnormal corneas.

Objective To assess the effect of the type of diabetes on the formation of pseudophakic cystoid macular edema (PCME) and posterior capsular opacification (PCO) following cataract surgery. Methods Cohort study of patients who underwent cataract extraction at the Department of Ophthalmology, Bristol Eye Hospital, Bristol, UK, between 2003 and 2017. The rate of PCME and Nd:YAG laser capsulotomies following cataract surgery were assessed and compared between non-diabetic, type 1 (DM1) and type 2 diabetes (DM2) patients. Multivariate Cox regression controlling for age and gender was used to estimate hazard ratios (HR) for Nd:YAG laser capsulotomies. Results Included were 53,471 consecutive cataract surgeries (21,884 male and 31,587 female patients, with a mean age of 74.4 ± 10.9 years). Overall, 42,651 eyes (79.8%) were non-diabetic, 823 eyes (1.5%) of DM1, and 9997 eyes (18.7%) of DM2 patients. The mean follow-up time was 6.8 ± 4.2 years. PCME was found in 0.9% of non-diabetics, 2.1% of DM1, and 1.6% of DM2 patients (P = 0.003 and P

Acute rejection (AR) of corneal transplants (CT) has a profound effect on subsequent graft survival but detailed immunological studies in human CT recipients are lacking. In this multi-site, cross-sectional study, clinical details and blood samples were collected from adults with clinically-diagnosed AR of full thickness (FT)-CT (n=35) and posterior lamellar (PL)-CT (n=21) along with Stable CT recipients (n=177) and adults with non-transplanted corneal disease (n=40). For those with AR, additional samples were collected 3 months later. Immune cell analysis was performed by whole-genome microarrays (whole blood) and high dimensional multi-color flow cytometry (peripheral blood mononuclear cells). For both, no activation signature was identified within the B cell and T cell repertoire at the time of AR diagnosis. Nonetheless, in FT- but not PL-CT recipients, AR was associated with differences in B cell maturity and regulatory CD4 + T-cell frequency compared to stable allografts. These data suggest that circulating B cell and T cell subpopulations may provide insights into the regulation of anti-donor immune response in human CT recipients with differing AR risk. Our results suggest that, in contrast to solid organ transplants, genetic or cellular assays of peripheral blood are unlikely to be clinically exploitable for prediction or diagnosis of AR.

Allergic conjunctivitis is a common trigger for patients to attend primary care and A&E departments. Children can be affected from a young age with seasonal, perennial and occasional allergic eye disease. There can be a range of symptoms from mild allergic eye disease affecting their quality of life to more severe disease, which can result in visual impairment. Vernal keratoconjunctivitis is a more rare form of allergic eye disease but can lead to sight-threatening complications.

To evaluate the efficacy of topical mitomycin C as a treatment of corneal conjunctival intraepithelial neoplasia.An open prospective analysis of 20 cases of corneal conjunctival intraepithelial neoplasia with recurrent disease (17 patients) or refusing surgery (three patients) were treated with topical mitomycin C. Treatment was with mitomycin C eye drops, either 0.02% or 0.04%, four times daily for 1 week followed by a week off the cycle then repeated for a second week. Patients were examined weekly until the lesions were eradicated.Clinical resolution of disease occurred in 18/20 cases. The mean time to resolution was 4.5 weeks, the mean number of cycles of treatment was two. Average follow up was 13 months with four cases of recurrent disease. These four cases were retreated with complete resolution in two cases. Epithelial toxicity occurred in 10/20 eyes and lid toxicity in two cases. There were no long-term complications on discontinuing mitomycin C.Mitomycin C is effective in inducing regression of corneal conjunctival intraepithelial neoplasia. Complications are common but self-limiting. An optimal regimen is still to be established.