Background and Objective: Corneal neurotization is a novel surgical technique used to restore corneal sensation in patients with neurotrophic keratopathy. Neurotrophic keratopathy is a disorder characterized by dysfunction of the ophthalmic division of the trigeminal nerve, which provides sensory innervation to the cornea. Without sensation, the cornea is at risk of infection, ulceration, perforation, and ultimately, vision loss. Corneal neurotization has emerged as an innovative technique to reinnervate anesthetized corneas by transferring a healthy donor nerve to the affected eye around the corneoscleral limbus. As the field of corneal neurotization rapidly grows, there is a need to synthesize the existing body of literature on corneal neurotization and identify important areas for further research. In this review, we will discuss neurotrophic keratopathy and its current management strategies, followed by an overview of corneal neurotization techniques, outcomes, surgical considerations, and future directions. Methods: PubMed and Google Scholar searches were conducted to retrieve and analyze relevant original papers and reviews on neurotrophic keratopathy and corneal neurotization up until April 2022.Key Content and Findings: Currently, numerous techniques for corneal neurotization exist, including direct nerve transfers, as well as indirect neurotization via interposition nerve grafts. So far, corneal neurotization has been shown to be highly successful in restoring corneal sensation, improving visual acuity,and improving corneal epithelial health. To date, there have been no significant differences in outcomes between direct versus indirect neurotization techniques, different donor nerves, or autologous versus allogeneic interposition grafts. However, there is some evidence that corneal neurotization procedures may be more successful in pediatric patients.Conclusions: Corneal neurotization shows great promise in treating neurotrophic corneas and represents the first management option to date that addresses the underlying pathophysiological mechanism of neurotrophic keratopathy by restoring corneal sensation. As the use of corneal neurotization continues to broaden, additional studies will become important to compare techniques in a systematic manner, with larger sample sizes, as well as standardized outcome measures and follow-up time.

The purpose of this review is to provide a comprehensive and updated overview of the clinical features, imaging modalities, differential diagnosis, diagnostic criteria, and treatment options for Vogt-Koyanagi-Harada (VKH) syndrome, a rare progressive inflammatory condition characterized by bilateral granulomatous panuveitis and systemic manifestations. While the clinical features and disease course of VKH syndrome are well-characterized in the literature, its diagnosis is challenging due to a broad differential that include infectious and noninfectious causes of uveitis and rare inflammatory conditions, as well as a lack of a single diagnostic finding on exam, laboratory testing, or imaging. The evolution of the diagnostic criteria for VKH syndrome reflects the growing understanding of the disease by the ophthalmic community and advancement of imaging technology. Findings on enhanced depth imaging (EDI) optical coherence tomography (OCT) and indocyanine green angiography (ICGA) help detect subtle inflammation of the choroid and were incorporated into new diagnostic criteria developed in the last few years. There is limited research on the treatment for acute VKH, but results of studies to date support the early initiation of immunomodulatory therapy (IMT) due to a high recurrence rate and progression to chronic disease in patients treated with monotherapy with high-dose systemic corticosteroids. This review will provide an in-depth summary of recent literature on advanced imaging modality and IMT to guide clinicians in their management of patients with VKH syndrome.

Background: To compare two swept-source optical coherence tomography (SS-OCT) biometers,IOLMaster 700 and ANTERION.

Methods: This is a retrospective study. Biometric measurements of cataract patients performed between March and July 2021 in the Department of Ophthalmology, United Christian Hospital, Hong Kong, were reviewed. Patients scheduled for cataract surgery were measured with both SS-OCT devices on the same day.The following biometry parameters were compared: keratometry (K), total keratometry (TK), axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), white-to-white (WTW) and the predicted intraocular lens (IOL) power to achieve emmetropia. To assess the agreement between the devices, Bland-Altman analysis with 95% limits of agreement (LoA) were used.

Results: In total, 92 eyes of 47 subjects were measured with both devices. There were statistically significant differences between the two biometers for most measurements (P<0.05) except for flat K, AL and IOL power when using the right eyes for analysis. For the left eyes, there were statistically significant differences in the measurements from the two biometers in all parameters except for flat and steep K. The ANTERION did not obtain ACD, AL and LT in 2 (2.17%), 1 (1.09%) and 5 cases (5.43%) respectively.

Conclusions: The two biometers showed a clinically acceptable agreement in most parameters. Comparisons showed significant differences in most parameters but not clinically relevant except for the TK and WTW, and these two parameters should not be used interchangeably between the devices.

Background and Objective: Ocular surface disease (OSD) is a common yet often overlooked consideration in the management of patients with glaucoma. Although there have been several review articles summarizing the relationship between glaucoma medications and OSD, there is a relative absence of such articles on the effects of glaucoma surgical treatments. Here, we present a comprehensive review of the literature regarding the relationship of glaucoma management and OSD, with an emphasis on surgical considerations.

Methods: PubMed, Google Scholar, and Cochrane Review searches were performed using the following search terms: ocular surface, dry eye, minimally invasive glaucoma surgeries (MIGS), trabeculectomy,glaucoma medications. The titles and abstracts from those searches were screened for relevance to our review topics. Publications were included if the subjects included glaucoma patients, and if ocular surface outcomes were described. Non-English papers were excluded.
Key Content and Findings: Topical glaucoma medications frequently cause adverse effects on the ocular surface, both through direct action of the medications themselves as well as through toxicity from their associated preservatives. Optimization of the ocular surface may improve medication compliance rates.Traditional surgical treatments for glaucoma, such as trabeculectomy, can exacerbate OSD by disrupting the ocular surface but can also reduce the need for chronic medications. Optimization of ocular surface health is imperative in reducing trabeculectomy complication rates, while also potentially reducing the need for trabeculectomy in patients that are able to achieve intraocular pressure control through improved drop tolerability. The introduction of MIGS represents a promising alternative to existing therapies and has been shown to alleviate the overall medication burden. It would be reasonable to assume that decreasing the medication burden could reduce OSD prevalence and severity. However, more research is needed to directly assess the extent of improvement seen after MIGS.

Conclusions: A comprehensive understanding of the importance of OSD in medical and surgical management of glaucoma is essential in optimizing patient care and improving outcomes.

Backgrounds: To assess changes in anterior segment biometry during accommodation using a swept source anterior segment optical coherence tomography (SS-OCT).

Methods: One hundred-forty participants were consecutively recruited in the current study. Each participant underwent SS-OCT scanning at 0 and ?3 diopter (D) accommodative stress after refractive compensation, and ocular parameters including anterior chamber depth (ACD), anterior and posterior lens curvature, lens thickness (LT) and lens diameter were recorded. Anterior segment length (ASL) was defined as ACD plus LT. Lens central point (LCP) was defined as ACD plus half of the LT. The accommodative response was calculated as changes in total optical power during accommodation.

Results: Compared to non-accommodative status, ACD (2.952±0.402 vs. 2.904±0.382 mm, P<0.001), anterior (10.771±1.801 vs. 10.086±1.571 mm, P<0.001) and posterior lens curvature (5.894±0.435 vs. 5.767±0.420 mm, P<0.001), lens diameter (9.829±0.338 vs. 9.695±0.358 mm, P<0.001) and LCP (4.925±0.274 vs. 4.900±0.259 mm, P=0.010) tended to decreased and LT thickened (9.829±0.338 vs. 9.695±0.358 mm, P<0.001), while ASL (6.903±0.279 vs. 6.898±0.268 mm, P=0.568) did not change significantly during accommodation. Younger age (β=0.029, 95% CI: 0.020 to 0.038, P<0.001) and larger anterior lens curvature (β=?0.071, 95% CI: ?0.138 to ?0.003, P=0.040) were associated with accommodation induced greater steeping amplitude of anterior lens curvature. The optical eye power at 0 and ?3 D accommodative stress was 62.486±2.284 and 63.274±2.290 D, respectively (P<0.001). Age was an independent factor of accommodative response (β=?0.027, 95% CI: ?0.038 to ?0.016, P<0.001).

Conclusions: During ?3 D accommodative stress, the anterior and posterior lens curvature steepened, followed by thickened LT, fronted LCP and shallowed ACD. The accommodative response of ?3 D stimulus is age-dependent.

Background: Dyop® is a dynamic optotype with a rotating and segmented visual stimulus. It can be used for visual acuity and refractive error measurement. The objective of the study was to compare refractive error measurement using the Dyop® acuity and LogMAR E charts.

Methods: Fifty subjects aged 18 or above with aided visual acuity better than 6/12 were recruited. Refractive error was measured by subjective refraction methods using the Dyop® acuity chart and LogMAR E charts and the duration of measurement compared. Thibo’s notation was used to represent the refractive error obtained for analysis.

Results: There was no significant difference in terms of spherical equivalent (M) (P=0.96) or J0 (P=0.78) and J45 (P=0.51) components measured using the Dyop® acuity and LogMAR E charts. However, subjective refraction measurement was significantly faster using the Dyop® acuity chart (t=4.46, P<0.05), with an average measurement time of 419.90±91.17 versus 452.04±74.71 seconds using the LogMAR E chart.

Conclusions: Accuracy of refractive error measurement using a Dyop® chart was comparable with use of a LogMAR E chart. The dynamic optotype Dyop® could be considered as an alternative fixation target to be used in subjective refraction.

Contrast is the differential luminance between one object and another. Contrast sensitivity (CS) quantifies the ability to detect this difference: estimating contrast threshold provides information about the quality of vision and helps diagnose and monitor eye diseases. High contrast visual acuity assessment is traditionally performed in the eye care practice, whereas the estimate of the discrimination of low contrast targets, an important complementary task for the perception of details, is far less employed. An example is driving when the contrast between vehicles, obstacles, pedestrians, and the background is reduced by fog. Many conditions can selectively degrade CS, while visual acuity remains intact. In addition to spatial CS, “temporal” CS is defined as the ability to discriminate luminance differences in the temporal domain, i.e., to discriminate information that reaches the visual cortex as a function of time. Likewise, temporal sensitivity of the visual system can be investigated in terms of critical fusion frequency (CFF), an indicator of the integrity of the magnocellular system that is responsible for the perception of transient stimulations. As a matter of fact, temporal resolution can be abnormal in neuro-ophthalmological clinical conditions. This paper aims at considering CS and its application to the clinical practice.