In the last decade, we have witnessed substantial progress in our understanding of corneal biomechanics and architecture. It is well known that diabetes is a systemic metabolic disease that causes chronic progressive damage in the main organs of the human body, including the eyeball. Although the main and most widely recognized ocular effect of diabetes is on the retina, the structure of the cornea (the outermost and transparent tissue of the eye) can also be affected by the poor glycemic control characterizing diabetes. The different corneal structures (epithelium, stroma, and endothelium) are affected by specific complications of diabetes. The development of new noninvasive diagnostic technologies has provided a better understanding of corneal tissue modifications. The objective of this review is to describe the advances in the knowledge of the corneal alterations that diabetes can induce.

Healthy pediatric subjects exhibit choroidal differences in refractive error and AL. In the study population, CT and volume show an increase with age after adjusting for AL.

PurposeTo compare dilatation pupil devices implemented on cataract surgery, their advantages and disadvantages.MethodsProspective, interventional study to analyze the following pupil dilatation techniques: iris‐retractor hooks and Morcher‐5s, Perfect‐pupil, Graether, Malyugin and Oasis dilator ring. The following properties were studied: handiness, dilatation obtained, stability, and facility to remove the dilator ring in relation with the form, material, size and length of the necessary incision to proceed with the insertion.ResultsIris‐retractor hooks are the best option in cases of zonular instability and retropulsion syndrome. The principal advantage is their versatility. Dilator‐rings obtained similar results in stability and dilatation. Malyugin and Oasis dilator rings had the best handiness results. Graether and Oasis were the easiest to remove and Morcher and Perfect‐pupil the most complicated.ConclusionsHaving a small pupil is one of the main causes of complications in cataract surgery. There are different surgical devices that allow minimizing intra‐operative risks. Each surgeon needs to select the best option compatible with to his surgical technique. Our study revealed that the most used devices were the iris‐retractor hooks due to the capsular stability that they provides and the Oasis dilator‐ring because of its flexibility and how easy they are to remove.

PurposeTo report the results obtained in a series of 58 eyes with chronic corneal ulcers and persistent epithelial defects resistant to conventional therapy and treated with 0.01% poly‐carboxymethylglucose sulfate based on tissue regenerating agent technology (RGTA, Cacicol®).MethodsA prospective study was made of 58 eyes. The ulcers were essentially chronic and slow‐evolving, with mean vertical and horizontal diameters of 2.4 and 2.7 mm, respectively (range 1‐5.5 mm). The patients received an initial dose of one drop every 48 hours during 10 days. After evaluation of the effects of treatment, new dosing schemes were prescribed for those patients who had improved their clinical condition though without complete resolution of the disease.ResultsImportant variation was observed in the time to recovery of corneal integrity, ranging from a few days to some weeks, depending on the severity and etiology of the case. Full healing was recorded in 50 patients. The patients with large neurotrophic ulcers showed improvement of the lesions, with a decrease in lesion size after 15 days of treatment. All patients reported subjective improvement. The drug showed immediate efficacy in 11 eyes with epithelialisation disorders following PRK or trauma, with recovery of tissue integrity after the first treatment period.ConclusionsThe tissue regenerating agent (RGTA Cacicol®) is an interesting and effective topical adjuvant product for the treatment of severe and chronic corneal ulcers resistant to conventional treatment. Its efficacy remains to be confirmed in the context of double‐blind, randomised clinical trials.

Purpose Adenovirus keratoconjunctivitis (AK)can cause corneal opacities that sometimes remain in time, compromising the vision of the patient. The objetive is to show the different morphologic types of corneal affection as a consequence of AK in patients who have received refractive surgery,and to evaluate the application of refractive keratectomy with excimer laser as a possible treatment of the opacities and visual impairment caused. Methods We analyze three examples of patients with visual impairment caused by corneal opacities secondary to adenovirus keratoconjunctivitis. The first case presents central nummular opacities without refractive history; opacities are treated,by photoablation myopic and associated hyperopic. The second case presents central corneal opacities after adenovirus keratoconjunctivitis, 10 years after PRK practice, causing myopic regression;the visual and refractive result emerges after a new laser photoablation. The third case shows the peculiar corneal fibrosis which appears after AK in a patient who received past LASIK treatment Results In the cases of opacification due to superficial corneal fibrosis, good visual and refractive results are obtained through the use of superficial photoablation with excimer laser, with the associated application of mitomycin C Conclusion The morphology of the lesions observed as a consequence of AK varies in patients with no history of refractive surgery, and in patients with a history of refractive surgery Lasik and surface techniques. Refractive PTK is an alternative to the treatment of opacities in case of suitable corneas