To evaluate and compare soft HydroCone (Toris K) silicone hydrogel and rigid gas-permeable contact lenses (RGPCLs) in patients with posterior microphthalmos (PMs), for visual rehabilitation and comfort. Methods: The records of 11 patients who were followed up in our hospital with the diagnosis of PM and were fitted with both Toris K and RGPCLs in our contact lens department were reviewed retrospectively. Patient age, gender, axial length (AL), topographic keratometry (K) values and bestcorrected visual acuity (BCVA) with both lens types and subjective lens comfort status were recorded. Results: A total of 22 eyes of 11 patients with a mean age of 20.9611.1 years were included in the study. The mean AL were 16.0160.1 and 15.960.2 mm in the right and left eyes, respectively. Mean K1 and K2 were 48.662.2 and 49.462.2 D, respectively. Mean logMAR BCVA of the 22 eyes before contact lens fitting was 0.6360.56 with spectacle. After Toris K and RGPCLs fitting, mean logMAR BCVA were 0.4360.20 and 0.3560.25, respectively. Both lenses provided better visual acuity than spectacles; RGPCLs also provided significantly better visual acuity than HydroCone lens (P,0.05). Eight of 11 patients (73%) had ocular discomfort with RGPLs, and there was no complaint with Toris K. Conclusions: The corneal surfaces are steeper in patients with PMs than in normal population. For that reason, their vision should be rehabilitated by special design keratoconus lenses like Toris K and RGPCLs. Although vision rehabilitation seems better with RGPCLs, these patients prefer Toris K more because of discomfort.

Purpose We aimed to report our surgical experience with repeat surgery as the next step after an unsuccessful hole closure with the primary single-layered temporal inverted flap technique (IFT). Methods We identified cases with persistent macular holes by reviewing the records of eyes that underwent IFT between October 2018 and October 2021. These cases were evaluated for hole features, anatomical closure, and visual improvement before and after the first and second surgeries. In addition, the technique applied in repeat surgery was recorded. Optical coherence tomography (OCT) images at follow-up were used to evaluate the flap position. Results A persistent hole was identified in 11 (6.4%) of 172 patients who underwent IFT. An inferotemporal displacement was observed in seven eyes, while no flap could be identified in the OCT images of the other four eyes. In the second surgery, the old flap was reinverted in one eye, and a new flap was created from the superior region in five eyes and the nasal region in the other five eyes and was stabilized under perfluorocarbon liquid. A gas tamponade (C3F8/SF6) was used in all patients at the end of surgery. The minimum hole diameter was > 400 µm in all eyes and 100% closure was achieved after the second surgery. Visual acuity gain of ≥ 3 lines was observed in 9 of the 11 eyes (81.8%). The mean visual acuity increase at the last follow-up was significant (p = 0.008). Conclusion With single-layer temporal IFT in the primary surgery of macular holes, unsuccessful results may be observed due to the flap displacement in the early period. In our series, IFT was applied again with the use of the old flap or the creation of a new flap in the second surgery of the persistent holes, and successful results were obtained.