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Purpose: To investigate the inflammatory reaction in eyes with late in‐the‐bag intraocular lens (IOL) dislocation. Methods: This prospective clinical study with fellow‐eye comparison consists of 76 of the patients (76 eyes) with late in‐the‐bag IOL dislocation enrolled in the LION trial. The main outcome measure was anterior chamber flare before surgery measured with a laser flare meter in photon counts per millisecond (pc/ms). The dislocation was graded as 1 (small: optic still covering the visual axis), 2 (optic equator close to the visual axis) or 3 (optic decentred beyond the visual axis, but the IOL–capsule complex partly visible in the pupillary area). The secondary aim was to compare intraocular pressure (IOP) before surgery. Results: Flare levels before surgery were significantly higher in the dislocation eyes than in the fellow eyes with a median flare of 21.5 (range 5.4–135.7) pc/ms versus 14.1 (2.0–42.9) pc/ms, respectively (p ˂ 0.001). A regression analysis of log‐transformed flare values showed that the dislocation eyes had a non‐significant tendency towards higher flare in dislocation grade 1 with a median flare of 24.6 (5.4–135.7) pc/ms compared to grade 2; 19.6 (6.5–41.5) pc/ms (p = 0.06), and no significant difference compared to grade 3; 19.4 (10.2–53.5) pc/ms (p = 0.47). The IOP was significantly higher in the dislocation eyes than in the fellow eyes (p ˂ 0.001). Conclusions: Eyes with late in‐the‐bag IOL dislocation had increased flare levels compared to their fellow eyes. This suggests that inflammation is part of the clinical picture of late in‐the‐bag IOL dislocation. [ABSTRACT FROM AUTHOR]

Purpose: A comparison of the safety and efficacy of the MicroShunt versus trabeculectomy in the early postoperative period, with a particular focus on hypotony. Methods: In this registry study, we evaluated 200 eyes of 200 glaucoma patients who underwent filtration surgery at Oslo University Hospital between 2017 and 2021. Of these patients, 100 had a Preserflo MicroShunt (Santen) implantation and 100 had a trabeculectomy procedure. The patients were examined per standard hospital protocol after filtration surgery. Data were extracted from the 4‐ and 8‐week visits. We defined hypotony as intraocular pressure (IOP) < 6 mmHg. Results: The mean preoperative IOP was 20.6 ± 7.1 mmHg in the MicroShunt group and 21.6 ± 7.1 mmHg in the trabeculectomy group, and the patients used a mean of 3.0 ± 0.9 and 3.1 ± 0.9 glaucoma medications, respectively. After 8 weeks, IOP was reduced to 10.4 ± 5.4 mmHg and 11.3 ± 4.6 mmHg, respectively (p = 0.23). During the early postoperative period, hypotony was registered in 63% of the MicroShunt patients and in 21% of the patients in the trabeculectomy group (p < 0.001); and 11% and 1%, respectively, of the patients developed choroidal detachments (p < 0.003). One patient in the MicroShunt group required reoperation due to hypotony. Conclusions: In this registry study, we found that the Preserflo MicroShunt and trabeculectomy had equally satisfactory IOP‐lowering effects during the early postoperative period. In this same period, a high number of patients in the MicroShunt group developed hypotony. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the intra‐ and postoperative complications, especially the risk of visual axis opacification (VAO), following the implantation of the bag‐in‐the‐lens (BIL) intraocular lens (IOL) in infants with congenital cataract operated on before 12 weeks of age. Methods: Infants operated on before 12 weeks of age between June 2020 and June 2021 with a follow‐up longer than 1 year were included in the present retrospective study. This was a first‐experience cohort of an experienced paediatric cataract surgeon with this type of lens. Results: Nine infants (13 eyes) with a median age at surgery of 28 days (range, 21–49 days) were included. The median follow‐up time was 21.6 months (range, 12.2–23.4 months). The lens was correctly implanted with the anterior and posterior capsulorhexis edges placed into the interhaptic groove of the BIL IOL in seven of 13 eyes; none of these eyes developed VAO. In the remaining six eyes, the IOL was only fixated to the anterior capsulorhexis edge, and in these cases, an anatomical anomaly of the posterior capsule and/or anterior vitreolenticular interface dysgenesis were observed. These six eyes developed VAO. One eye had a partial iris capture in the early postoperative phase. Otherwise, the IOL remained well centred and stable in all eyes. Anterior vitrectomy was necessary in seven eyes due to vitreous prolapse. One patient with unilateral cataract was diagnosed with bilateral primary congenital glaucoma at 4 months of age. Conclusion: Implantation of the BIL IOL is safe even in the youngest age group less than 12 weeks of age. Although being a first‐experience cohort, the BIL technique is shown to reduce the risk of VAO and the number of surgical procedures. [ABSTRACT FROM AUTHOR]

Purpose: The main objective of this study was to examine the pupillary response in patients with Marfan syndrome (MFS) and secondarily to determine whether changes in the pupillary response are associated with the increased disability glare previously shown in the same patient population. Methods: This study included 60 eyes of 34 patients with MFS diagnosed in accordance with the Ghent‐2 criteria and 81 eyes of 44 controls. Pupillary response was measured with a pupillograph and disability glare with a straylight meter. Results: The patients with MFS had a significantly smaller maximum pupil size than the control group, 4.87 (4.50–5.23) mm versus 5.58 (5.25–5.90) mm (p = 0.01). In addition, they exhibited slower contraction velocities (p = 0.03) and longer re‐dilation times (p = 0.01) compared with the control group. The mean straylight value was higher in patients with MFS than controls, even when including pupillary parameters together with lens surgery, cataract, iris colour, axial length and corneal curvature as possible explanatory variables in the analysis. However, when including data from both groups, a significant negative correlation was seen between maximum pupillary diameter and straylight value (p = 0.01). The other pupillary parameters did not correlate with straylight. Conclusion: Patients with MFS had a smaller maximum pupil diameter, slower pupillary contraction and longer re‐dilation time than the controls. Despite the correlation between pupil size and straylight value, the pupillary response demonstrated in MFS eyes could not explain the increased straylight in these patients. [ABSTRACT FROM AUTHOR]

Background: Non‐pulsatile cardiopulmonary bypass (CPB) may induce microvascular dysregulation. In piglets, we compared ocular surface microcirculation during pulsatile versus continuous flow (CF) bypass. Methods: Ocular surface microcirculation in small tissue volumes (~0.1 mm3) at limbus (high metabolic rate) and bulbar conjunctiva (low metabolic rate) was examined in a porcine model using computer assisted video microscopy and diffuse reflectance spectroscopy, before and after 3 and 6 h of pulsatile (n = 5 piglets) or CF (n = 3 piglets) CPB. Functional capillary density, capillary flow velocity and microvascular oxygen saturation were quantified. Results: At limbus, velocities improved with pulsatility (p < 0.01) and deteriorated with CF (p < 0.01). In bulbar conjunctiva, velocities were severely reduced with CF (p < 0.01), accompanied by an increase in capillary density (p < 0.01). Microvascular oxygen saturation decreased in both groups. Conclusion: Ocular surface capillary densities and flow patterns are better preserved with pulsatile versus CF during 6 h of CPB in sleeping piglets. [ABSTRACT FROM AUTHOR]