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To report three cases of massive pseudophakic macular edema occurring the day after uneventful cataract surgery and resolving in 24-72 hours.A 68-years woman affected by systemic lupus erythematosus and antiphospholipid syndrome displayed massive macular edema on OCT scan one day after uneventful cataract surgery. Routine postoperative topical eye drops (Chloramphenicol/Betamethasone QID and Bromfenac BID) were continued without additional medications. Three days later OCT showed a completely recovered, normal fovea. Two similar cases were documented. A 73-year-old man and a 53-year-old man underwent cataract surgery and started the mentioned topical postoperative therapy. Severe macular edema was diagnosed the day after surgery and resolved in 24 and 48 hours, respectively.Massive macular edema may occur immediately after uncomplicated cataract and then disappear within 1 to 3 days, without invasive therapies. This is a very significant event that may follow cataract surgery that was previously unreported.

Background: To report the long-term effects of the new rhNGF treatment on corneal sensitivity in patients with Cases presentation: We present three cases of corneal ulcers due to NK that were treated with rhNGF. In each patient wound healing evolution was documented by clinical pictures and corneal sensitivity measured by Cochet-Bonnet aesthesiometry. Best corrected visual acuity and Type I Schirmer test were also assessed neurotrophic keratopathy. All patients healed within 8 weeks and NK showed no recurrences in the mean follow-up period of 35 weeks. Each subject showed a significant increase of corneal sensitivity and tear secretion, with concomitant improvement in visual acuity. Conclusion: Corneal sensitivity, measured by Cochet-Bonnet aesthesiometer, markedly increased in all eyes. Further studies are warranted to demonstrate a possible mechanism of nerve restoration with rhNGF treatment.

Purpose: Previous reports described unfavorable visual outcomes after surgery for uveitic macular pucker. Our goal was to demonstrate that patients with history of uveitis may benefit from vitrectomy for epiretinal membrane if executed under appropriate circumstances. Methods: We performed pars plana vitrectomy with ERM and ILM peeling in patients with post-uveitic macular pucker who did not show signs of ocular inflammation for at least 3 months after the suspension of immunosuppressive therapy. Visual acuity, central macular thickness at OCT, ocular inflammation, and complications were recorded. Results: Twenty-six eyes were operated. Mean duration of follow-up was 67 months. Visual acuity significantly improved from 20/80 to 20/40 after surgery. Vision increased in 20 (77%), remained stable in 4 (15%), and decreased in 2 (8%) eyes. Best-corrected visual acuity ameliorated by at least 2 ETDRS lines in 14 eyes (54%). Contingency analysis did not show any statistical difference among the different types of uveitis ( p = 0.46). Mean central foveal thickness improved postoperatively (428 ± 104 vs 328 ± 130 microns; p = 0.017). Conclusion: Patients with uveitic epiretinal membrane benefit from vitrectomy with membranectomy if operated when intraocular inflammation had subsided.

Purpose To evaluate overall patient satisfaction, spectacle independence, visual acuity, and prevalence of optical phenomena following bilateral implantation of a new non-diffractive extended depth-of-focus intraocular lens targeted for minimonovision. Methods Multicenter prospective case series. Postoperative far and near visual acuity at 3 months and patient quality of life by NEI-VFQ-25 questionnaire were assessed. Postoperative evaluation included defocus curves analysis, spectacle independence assessment, and recording of photic phenomena. Results The study enrolled 97 eyes of 59 patients that underwent femtosecond-assisted cataract surgery with AcrySof IQ Vivity intraocular lens implantation. Thirty subjects (60 eyes) were eligible for analysis. After 3 months, postoperative achieved binocular uncorrected visual acuity was −0.03 ± 0.06 logarithm of the minimum angle of resolution for distance, 0.06 ± 0.06 logarithm of the minimum angle of resolution for intermediate, and 0.19 ± 0.03 logarithm of the minimum angle of resolution for near. Defocus curve showed a smooth profile with no abrupt decrease of visual acuity. Minimonovision significantly improved visual acuity compared to when minimonovision was neutralized, for values of defocus curves from −1 to −3 D ( p Conclusions Implantation of this new non-diffractive extended depth-of-focus intraocular lens with minimonovision resulted in satisfying far, intermediate, and near visual acuity with a consistent reduction of spectacle dependence and improvement in patient's quality of life.

PURPOSE: To present a novel technique to prevent Argentinian flag sign in intumescent white cataracts. METHODS: Surgical technique. RESULTS: After puncturing the anterior lens capsule, the liquefied cortical material is easily shifted from the retronuclear space to the anterior chamber by gently injecting viscoelastic above the mid periphery of the anterior capsule (not inside the bag). After depressurizing the intracapsular forces, capsulorhexis can be safely completed. CONCLUSIONS: This is a convenient strategy when at risk of observing Argentinian flag sign during the removal of mature cataracts. [ Journal of Refractive Surgery Case Reports. 2021;1(3):e45–e46.]

Lamellar macular holes are a vitreoretinal condition characterized by abnormalities in foveal contour with splitting of the neuroepithelium and often an intact photoreceptor layer. Recent developments in high-resolution imaging have increased our ability to study the details of the vitreoretinal interface and to distinguish between different forms of lamellar holes. A new classification is needed to help clinicians in the management of lamellar macular holes. Some clinicians prefer to observe these clinical entities, especially when visual acuity is maintained or alterations of the photoreceptor layer are present. Nevertheless, lamellar holes may sometimes progress, and visual acuity can deteriorate. On the other hand, surgical treatment may lead to positive anatomical and functional outcomes, but not without risks. This review provides a critical overview of the available data on lamellar macular holes, focusing on diagnosis and managing options.

A foldable acrylic intraocular lens (IOL) with a 6.0 mm optic was removed through a 2.2 mm corneal incision as a single piece with minimal wound trauma. By viscodissection, the IOL was freed from its position in the capsular bag and moved into the anterior chamber. Vannas scissors were introduced through a 2.2 mm corneal incision. A 4.5 mm straight slit was cut at each optic-haptic junction on opposite sides, perpendicular to each haptic shaft. This pair of parallel cuts generated 3 IOL segments in an S configuration that remained connected. The IOL was grasped by one haptic and removed as a single piece.

Objectives Palate morphology is constantly changing throughout an individual's lifespan, yet its asymmetry during growth is still little understood. In this research, we focus on the study of palate morphology by using 3D geometric morphometric approaches to observe changes at different stages of life, and to quantify the impact of directional and fluctuating asymmetry on different areas at different growth stages. Materials and Methods The sample consists of 183 individuals (1–72 years) from two identified human skeletal collections of 19th and early 20th Century Italian contexts. A 3D‐template of 41 (semi)landmarks was applied on digital palate models to observe morphological variation during growth. Results Asymmetrical components of the morphological structure appears multidirectional on the entire palate surface in individuals, Directional and fluctuating asymmetry of human palate.

KNM-OG 45500 is a hominin fossil composed of parts of a frontal bone, left temporal bone, and cranial vault pieces. Since its discovery along the Olorgesailie Formation (Kenya) in 2003, it has been associated with the Homo erectus hypodigm. The specimen, derived from a geological context dated to ca. 900 Ka BP, has been described as a very small individual of probable female sex. However, despite its status as an important hominin specimen, it has not been used in a quantitative comparative framework because of its fragmentary condition. Here, we undertake a virtual reconstruction of the better-preserved fragment, the frontal bone. We additionally apply geometric morphometric analyses, using a geographically diverse fossil and modern human sample, in order to investigate the morphological affinities of KNM-OG 45500. Our results show that the frontal shape of KNM-OG 45500 exhibits similarities with Early Pleistocene fossils from Eurasia and Africa that are assigned to H. erectus sensu lato (s.l.). Its size, on the other hand, is notably smaller than most other Homo erectus fossils and modern humans and similar to the specimens from Dmanisi (Georgia) and to Homo naledi. Taken together, our analyses of the frontal bone suggest a taxonomic attribution of KNM-OG 45500 to H. erectus s.l. and extend even further the range of size variability associated with this taxon around 900 Ka BP.

Purpose To investigate clinical and inflammatory changes in the ocular surface of insulin-dependent type I diabetic patients. Methods Two hundred and nine eyes of 106 patients with diagnosis of type I diabetes were recruited in a prospective observational study. Ocular surface clinical assessment, corneal sensitivity and tear film stability tests were performed to evaluate ocular surface system function. Ocular Surface Disease Index (OSDI) questionnaire was administered to all enrolled subjects. Conjunctival impression cytology specimens were also collected to detect neuromediators and inflammatory molecules. Duration of disease, HbA1c levels and diabetic retinopathy stage were recorded. Results Corneal sensitivity assessed by Cochet-Bonnet esthesiometer was reduced in patients with more chronic disease, higher HbA1c levels and proliferative diabetic retinopathy. Tear break-up time (TBUT) was reduced in subjects with long-standing diabetes or with more severe retinopathy. OSDI questionnaire scores showed direct correlation with increased HbA1c values. Significant increase of NPY, STAT-5 and ICAM-1 was found in diabetic patients compared to healthy controls. A direct correlation between NPY concentration and ICAM-1 values in patients with type I diabetes was demonstrated. Conclusions Patients with long-standing type I diabetes showed chronic inflammation of the ocular surface, due to neurogenic dysregulation of para-inflammatory homeostatic mechanisms. These patients with ocular surface system failure complained of ocular discomfort but had modest reduction of corneal sensitivity and no signs of neurotrophic keratopathy. Disease duration, increased HbA1c levels and severe diabetic retinopathy appear the most critical factors.

OBJECTIVE This study aims to develop a comparative basis for assessing the developmental stage of KNM-ER 42700 based on the ontogenetic pattern of the ectocranial surface of the basicranium in modern humans and chimpanzees. MATERIALS AND METHODS A total of 33 landmarks were collected from an ontogenetic sample of modern humans (80), chimpanzees (51), and 12 individuals classified as Homo erectus s.l. Ontogenetic trajectories were analyzed, and common aspects were extracted for the purpose of discriminating age groups. A regression of size on the extracted shape variables was used to investigate common ontogenetic allometry. RESULTS The basicranial development of chimpanzees and humans follows different trajectories; however, similarities are also present. The common shape component of development extracted can be used to define age groups in both chimpanzees and modern humans. The extracted shape component presents a similar ontogenetic and static-allometric pattern in these two species. The developmental stages of H. erectus s.l. specimens were attributed following these common traits. Our analysis correctly assigned developmental stages to those specimens of H. erectus for which developmental ages are known. DISCUSSION The component used for assessing the developmental stage has an ontogenetic allometric component. However, this shape component can discriminate age group irrespective of size and is no longer related to size when static allometry is considered. Adult H. erectus s.l. specimens were attributed to the adult category. KNM-WT 15000 fell with the late juvenile age group, whereas D2700 plotted in the region of overlap between the juvenile and adult age groups and Mojokerto with the younger age groups, as predicted by their known developmental ages. KNM-ER 42700 fell within the adult variability despite its incompletely fused spheno-occipital synchondrosis.

OBJECTIVES A prevailing hypothesis in paleoanthropology is that early Pleistocene hominin bones were accumulated in South African caves by carnivores, which used those shelters, and the trees surrounding them, as refuge and feeding sites. We tested this hypothesis at the site of Drimolen, by comparing its hominin age-at-death distribution to that of the nearby and roughly contemporaneous site of Swartkrans. MATERIALS AND METHODS We employed standard dental aging systems in order to categorize the Drimolen hominin teeth into age classes of 5 years each. We then compared the age-at-death distribution for Drimolen with the published data available for the Swartkrans hominins. RESULTS Age-at-death distributions indicate that the age category "young adults" is the best represented age category at Swartkrans and the most poorly represented one at Drimolen. Moreover, Drimolen has a preponderance of infant specimens. Both sites have a low frequency of old adult specimens. CONCLUSIONS Differences observed in frequencies of the age-at-death categories suggest different mechanisms of hominin skeletal accumulation at Drimolen and Swartkrans. Swartkrans' frequency curve reflects mortality in a population subjected to predation and is thus consistent with the carnivore-accumulating hypothesis. In contrast, the Drimolen curve is similar to that of wild populations of living apes. Living primates have been observed exploiting caves as sleeping shelters, for nutritional, security, drinking, and thermoregulatory purposes. We suggest that similar cave use by Pleistocene hominins can explain, in large part, the accumulation of hominin bones at Drimolen. Such a conclusion is another illustration of the growing awareness that a "one-size-fits-all" taphonomic model for South African early Pleistocene hominin sites is probably insufficient.