No author has a financial or proprietary interest in any material or method mentioned.

Healon 5 emerges as a very interesting viscoelastic substance. Visibility is better if the anterior chamber is filled completely. Removal is easier if it is aspirated while moving the irrigation aspiration tip with circular movements over the top and around the border of the IOL.

PurposeTo determine the efficacy of bimanual microincision cataract surgery (B-MICS) performed by surgeons in training, evaluating clinical results, posterior capsule opacification (PCO) incidence, and clear corneal incision (CCI) architecture in a long-term follow-up and comparing results with those obtained by experienced surgeons.Patients and methodsEighty eyes of 62 patients operated on by three surgeons in training who used B-MICS technique for the first time were included in the study (Group A). Eighty eyes of 59 patients who underwent B-MICS by three experienced surgeons were included as a control group (Group B). Best corrected visual acuity, astigmatism, corneal pachymetry, and endothelial cell count were evaluated before surgery and at 1 month and 18 months after surgery. Anterior segment optical coherence tomography images were obtained to study the morphology of CCIs. PCO incidence was evaluated using EPCO2000 software.ResultsOut of 160 surgeries included in the study, mean best-corrected visual acuity improvement at 18 months was 0.343±0.246 logMAR for Group A, and 0.388±0.175 logMAR for Group B, respectively. We found no statistically significant induced astigmatism nor corneal pachymetry changes in either group, while we noticed a statistically significant endothelial cell loss postoperatively in both groups (P<0.05). In Group A, mean PCO score was 0.163±0.196, while for Group B, it was 0.057±0.132 (P=0.0025). Mean length and inclination of the CCIs for Group A and Group B were, respectively, 1,358±175 µm and 1,437±256 µm and 141.8°±6.4° and 148.7°±5.1°. As regards corneal architecture in the 320 CCIs considered, we found posterior wound retractions and endothelial gaps, respectively, 9.8% and 11.6% for Group A and 7.8% and 10.8% for Group B.ConclusionB-MICS performed by surgeons in training is an effective surgical technique even when assessed after a long-term follow-up. PCO incidence resulted in being higher for less experienced surgeons. Corneal incisions were shorter and less angled in surgeons in training in comparison with results obtained by expert surgeons.

A case of pigmentary retinopathy following measles is presented with follow-up of 24 years. A 29-year-old man complained of almost complete blindness during measles infection at the age of 5 (1966). Ophthalmoscopy revealed retinal edema with pallor of the optic disc and in a few months pigment alterations gave the fundus a salt-and-pepper appearance. In 1974 and 1985 a pigmentary retinopathy was present with optic atrophy and typical bone corpuscle deposits, and marked impairment of visual function. In 1990 (i.e. 24 years after the onset of symptoms) the fundus shows pigmentary degeneration with optic atrophy and narrowed vessels, ERG is extinguished and visual fields and dark adaptation cannot be recorded owing to amaurosis. The patient also present bilateral keratoconus. The possible association between these two entities, which to our knowledge has not been previously reported, is discussed.

We report an atypical presentation of Beauveria bassiana keratitis which unusually presented in a 85-year-old patient with a corneal ulcer with an anterior segment inflammation and hypopyon . Despite negative culture and unspecific results from panfungal PCR-based sequencing, the patient was treated for a presumed fungal infection. Following clinical deterioration an emergency surgical intervention with apposition of a corneal patch was performed. Infection resolution was achieved following the introduction of systemic voriconazole to the topical one.