This is the first report of the clinical use of prestained, preloaded tissue for DMEK. The characteristics and handling of the tissue were not different from those of surgeon-loaded tissue. Because punching, staining, and loading the graft intraoperatively is not necessary, the surgery time and risk of damaging donor tissue are reduced when using preloaded tissue.

Purpose To analyze clinical signs and symptoms of ocular surface disease in patients with diabetes mellitus (DM), based on severity of diabetic peripheral neuropathy (DPN). Methods This cross-sectional study included participants who were carefully phenotyped by a multidisciplinary team and categorized into groups based on severity of DPN. All study participants underwent ophthalmic evaluation and completed the Ocular Surface Disease Index (OSDI) and Visual Function Questionnaire (VFQ-25). Results The 34 study participants were: healthy controls (n=9), patients with DM and mild or no DPN (n=16), and patients with DM and severe DPN (n=9). Tear osmolarity was increased, and corneal nerve fiber length was decreased, with increasing severity of DPN. In addition, patients with DM were found to have decreased Schirmer’s test values when compared to healthy controls. No statistically significant differences were found between groups in OSDI, tear break-up time, or corneal sensitivity. No statistically significant correlations were noted between the OSDI or VFQ-25 scores and clinical signs of dry eyes. Conclusions This study demonstrates increased clinical signs of ocular surface disease, but not an increase in subjective symptoms of dry eyes, with increasing severity of DPN. Furthermore, no significant correlation was found between OSDI scores and clinical signs of dry eye. A periodic evaluation of the ocular surface is important for patients with DM, in addition to retinopathy screening, as they may be asymptomatic but have severe dry eye disease, which can lead to further ocular surface complications such as corneal ulceration.

Objective comparison of phacoemulsification efficiency and chatter found that optimized Ozil-IP and Ellips-FX were similar in both parameters and in general, both performed better than preceding technology. The study parameters can significantly affect efficiency and chatter, which strongly correlate with each other.