Purpose This study aimed to assess the efficacy of a platelet-rich plasma (PRP) injection into the lacrimal gland in severe dry eye and to compare it with preservative-free artificial tears. Patients and methods This study included a total of 74 eyes of 40 patients divided into two groups. The intervention group received three PRP injections transcutaneously in the region of the lacrimal gland. The control group was treated with preservative-free artificial tears. Results The intervention group showed improvement in all measured parameters, except the Meibomian gland score, with a statistically significant improvement in the Ocular Surface Disease Index (OSDI) score (P<0.001) and the Schirmer test (P=0.011) and less significant improvement in the ocular surface staining score (P=0.076) and tear breakup time (TBUT) (P=0.09). Compared with the control group, the PRP intervention group showed a statistically significant improvement in the OSDI score (P<0.001), the Schirmer test (P=0.005) and the ocular surface staining score (P=0.013) and less significant improvement in TBUT (P=0.2). Conclusion The use of PRP injections is safe and effective, with improvement in the OSDI, Schirmer test, and ocular surface staining and less improvement in TBUT, but it is not effective in improving Meibomian gland function.

Objective To assess the precision of Barrett Universal II, SRK-T, and Haigis formulas in high myopic eyes for the estimation of intraocular lens power, using optical biometry. Patients and methods This is an interventional prospective study that included 34 eyes with an axial length more than or equal to 26 mm, who underwent uneventful phacoemulsification. One month after the surgery, we recorded the postoperative refraction. Refractive prediction error (RPE), median absolute error (Med AE), and proportion of eyes with postoperative myopic and hyperopic outcomes were compared. Results The lowest mean RPE (−0.11±0.90 D), Med AE (0.15 D), and proportion of eyes with hyperopic outcomes (44.1%) were reported with the Barrett Universal II formula. They were all statistically lower than the results of SKR/T and Haigis formulas (mean RPE 0.16±0.99 and 0.31±0.98 D, respectively; Med AE 0.47 and 0.40 D, respectively; and percentage of hyperopic outcome 70.6 and 76.5%, respectively). Conclusion We concluded that the lowest mean RPE, median AE, and the lowest percentage of hyperopic outcome were reported with the Barrett Universal II formula.

Background New approaches have been created to raise the chances of achieving big bubble (BB) in deep anterior lamellar keratoplasty (DALK); however, the BB formation is still uncertain in all cases. Other factors likely contribute to the success of bubble formation. Aim To evaluate the effect of preoperative curvature of the cornea on the success of BB formation in DALK for keratoconus. Design A prospective, comparative, nonrandomized study. Patients and methods The study was performed on 50 keratoconus patients. We compared the data of 25 patients who had successful type-1 bubble formation versus another 25 patients in whom the bubble formation failed. Both groups were compared regarding the keratometric readings recorded from the preoperative pentacam. Results The analysis showed statistically significant lower K1, K2, and Km values in the group where BB has been successfully achieved. We also found that lower K1 value was the only significant studied factor after the multivariate analysis. Conclusion Keratoconus patients with preoperative flatter corneas have slightly higher chances for successful BB formation during DALK surgery.

Background The corneal cross-linking procedure has been proven to be an effective method to treat and stabilize keratoconus progression, but early vision rehabilitation is still needed in patients. Aim The aim was to compare the results of the combined CXL and intrastromal corneal ring segment implantation procedure to that of the cross-linking-alone procedure in terms of visual acuity, refraction, and some corneal topographic parameters in keratoconic patients. Design This was a prospective, comparative, and interventional study. Patients and methods This study was carried out on 44 keratoconic patients (60 eyes) of both sexes who ranged from 18 to 36 years. Thirty eyes were subjected to the CXL-alone procedure and 30 eyes were subjected to the combined procedure. Measurements were performed in all patients preoperatively and at 3, 6 months, and 1 year postoperatively including unaided visual acuity, best-corrected visual acuity, refractive, and topographic outcomes. Results Through the entire study period, both procedures were safe and effective in treating and stabilizing keratoconus progression. Furthermore, the combined group showed additional improvements over the CXL group for the following: UDVA at 3 months (P=0.0028), best-corrected visual acuity at 1 year (P=0.011), refractive and keratometric astigmatism at all follow-up visits and corneal asphericity at 3 months (P=0.013) and 6 months (P=0.0221) of follow-up. No severe intraoperative or postoperative complications were observed during the entire study period in either group. Conclusions The combined procedure is safe and effective for earlier improvement of visual and refractive outcomes in addition to the corneal stabilizing effect.

We report breakage of the tip of a 25-G advanced ULTRAVIT vitreous cutter during vitrectomy for vitreous hemorrhage. During the procedure, we noticed that the cutter tip broke. We switched to another vitrectomy pack of the same brand, and the procedure continued without further complications. Intraoperative and postoperative examinations revealed no broken pieces remaining in the eye. Breakage of 25-G instruments intraoperatively during vitrectomy is a rare occurrence that can lead to complications. Keeping the vitrectomy probe at a safe distance from the light pipe and inspecting the instruments while working inside the eye can help avoid such an event.