Mini-Scleral Lens: An Effective Mode of Visual Rehabilitation in Eyes With Resolved Hydrops.

OBJECTIVES: To evaluate the visual outcome of mini-scleral contact lenses (MSLs) in keratoconus following the resolution of acute hydrops. METHODS: This was a prospective observational case series of patients of healed hydrops in keratoconus fitted with an MSL (Keracare, Acculens, Lakewood, CO) who were managed for acute hydrops medically or surgically at least 3 months prior. Uncorrected visual acuity, best spectacles-corrected visual acuity, best lens-corrected visual acuity, topographic indices, keratometric indices, contact lens parameters, and ocular aberrometric changes were evaluated. All patients were followed up for at least 3 months. RESULTS: Eighteen eyes of 17 patients were included in the analysis. The mean post-hydrops topographic values of the eyes included flat keratometric value (K1) 64.93±10.88 (range 44.30-93.40) diopters (D), steep keratometric value (K2) 70.41±10.92 D (range 45.8-98.6 D), and Kmax of 79.53±17.73 D (range 50-130.2). The final mini-scleral lens's mean dioptric power was -8.56±3.96 D (range -18 to -4). Visual acuity significantly improved from post-hydrops resolution uncorrected visual acuity of 1.5±0.71 logMAR to 0.79±0.18 logMAR best spectacles-corrected visual acuity to 0.27±0.01 logMAR best lens-corrected visual acuity ( P -value <0.0001). Similarly, there was considerable improvement in corneal aberrometric values after wearing an MSL. At the 3-month follow-up, 15 patients (16 eyes) were compliant to contact lens use with a minimum of 6 to 8 hr daily while two patients (2 eyes) were poorly compliant. CONCLUSIONS: A MSL is a valuable option for visual rehabilitation in keratoconus following the resolution of acute hydrops.

Comparison of clinical outcomes between femtosecond laser-assisted cataract surgery versus conventional phacoemulsification in vitrectomized eyes - A prospective interventional study.

PURPOSE: To compare the clinical outcomes and surgical safety between femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification cataract surgery (CPCS) in vitrectomized eyes. METHODS: A prospective interventional comparative study was conducted at a tertiary eye care center. Sixty consecutive cases requiring cataract surgery following pars plana vitrectomy were allocated into Group 1 (n = 30), who underwent FLACS with intraocular lens implantation, and Group 2 (n = 30), who underwent CPCS with intraocular lens implantation, and followed up for 3 months. Primary outcome measures were intraoperative ultrasonic cumulative dissipated energy (CDE) and intraoperative and postoperative complications. The secondary outcome measures were postoperative changes in endothelial cell count (ECC) and central corneal thickness (CCT). RESULTS: Baseline corrected distance visual acuity (CDVA), ECC, and CCT were comparable. Intraoperative CDE was significantly less in the FLACS group (8.11 vs. 15.83 percentage seconds; P = 0.012) with no intraoperative complication in either group. The postoperative CDVA was comparable between the groups with a trend toward earlier visual recovery in the FLACS group. The postoperative day (POD) 1 endothelial cell loss was higher in the CPCS group (7.54% vs. 2.05%), with the mean endothelial cell density being significantly higher in the FLACS group throughout the follow-up period (P < 0.05). POD-1 corneal edema was higher in the CPCS group compared to FLACS with no significant difference on follow-up. Intraoperative migration of silicone oil to the anterior chamber was observed in 40% versus 0% in the CPCS versus FLACS groups, respectively. CONCLUSION: FLACS can be safely performed in post-vitrectomy eyes with lesser intraoperative ultrasonic energy used, postoperative endothelial cell loss, and change in CCT compared to CPCS.

Bimanual technique for placement of footplates of phakic intraocular lens in eyes with intraoperative miosis.

We describe and assess the efficiency of a novel technique of placing implantable collamer lens (ICL) footplates in the sulcus in poorly dilated pupils utilizing perioptic holes and two instruments simultaneously (Sinskey hook and ICL manipulator). Twelve eyes of 10 patients underwent ICL implantation through this technique. The technique employs a bimanual approach engaging perioptic holes in the eyes with intraoperative miosis. Perioptic holes were engaged with a Sinskey hook and pulled slightly back, while the footplates were tucked under the iris by using an ICL manipulator. All patients had uneventful surgery. At 1 week follow-up, uncorrected distance visual acuity (UCDVA) was -0.01 ± 0.04 logMAR with a mean vault of 606.17 ± 108.33 microns. No complications were noted. However, too small a pupil is a limiting factor; this technique can be of use in up to mid-dilated pupils. Bimanual placement of haptics of ICL may represent a safe and effective technique in insufficient mydriasis or intraoperative pupillary miosis.

Fungi-mediated synthesis of nanoparticles: characterization process and agricultural applications.

In the field of nanotechnology, the use of biologically active products from fungi for the reduction and synthesis of nanoparticles as an alternative to toxic chemicals has received extensive attention, due to their production of large quantities of proteins, high yields, easy handling, and the low toxicity of the residues. Fungi have become valuable tools for the manufacture of nanoparticles in comparison with other biological systems because of their enhanced growth control and diversity of metabolites, including enzymes, proteins, peptides, polysaccharides, and other macro-molecules. The ability to use different species of fungi and to perform the synthesis under different conditions enables the production of nanoparticles with different physicochemical characteristics. Fungal nanotechnology has been used to develop and offer products and services in the agricultural, medicinal, and industrial sectors. Agriculturally, it has found applications in plant disease management, crop improvement, biosensing, and the production of environmentally friendly, non-toxic pesticides and fertilizers to enhance agricultural production in general. The subject of this review is the application of fungi in the synthesis of inorganic nanoparticles, characterization, and possible applications of fungal nanoparticles in the diverse agricultural sector. The literature shows potential uses of fungi in biogenic synthesis, enabling the production of nanoparticles with different physiognomies. © 2023 Society of Chemical Industry.

Occurrence of Hemi-Central Retinal Artery Occlusion Following Embolization in a Case of Recurrent Juvenile Nasopharyngeal Angiofibroma.

Preoperative embolization is currently widely followed in the treatment of juvenile nasopharyngeal angiofibroma (JNA) to reduce intraoperative bleeding. However, embolization can result in untoward complications like stroke and blindness. The authors present the case of a 14-year-old boy with recurrent JNA who developed hemi-central retinal artery occlusion after embolization of branches of the external carotid artery. It was managed by intraocular pressure reduction and globe massage to dislodge the possible embolus. At 4 weeks' follow-up, there was near complete recovery in visual acuity; however, residual hemi-field defect persisted. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:385-387.].

Central serous chorioretinopathy in a patient of juxtapapillary excavation misdiagnosed as optic disc pit maculopathy.

A 29-year-old healthy man had blurring of vision in the left eye for the past 2 months and was referred for the surgical management of optic disc pit maculopathy. Colour fundus examination and optical coherence tomography (OCT) revealed a large deep retinochoroidal excavation close to the temporal edge of the optic disc with an isolated central neurosensory detachment at the macula with underlying multiple small pigment epithelium detachments in the absence of retinoschisis. Fundus fluorescein angiography (FFA) confirmed the presence of multi-focal leakage at the macula and pooling into subretinal space in the form of a 'smoke-stack'. A correct diagnosis of juxtapapillary excavation and central serous chorioretinopathy was made and lifestyle modifications were advised in view of the acute episode. The clinical signs, OCT and FFA feature helped in the differentiation and appropriate management of maculopathy in this case.