PURPOSE: To report the long-term clinical experience following femtosecond intrastromal lenticule implantation (FILI) for the management of moderate to high hyperopia. METHODS: Eligible patients who underwent FILI for moderate to high hyperopia from July 2013 to October 2020 were included. A donor small incision lenticule extraction lenticule, matched for refractive error, was implanted into the recipient's corneal pocket created using a femtosecond laser at 160 µm depth. Visual and refractive outcomes and long-term complications were evaluated at the end of a mean follow-up of 68 ± 17.28 months (5.6 years). RESULTS: Forty-two eyes of 25 patients (mean age: 27.29 ± 5.52 years) were analyzed. The mean spherical equivalent reduced significantly from +5.50 ± 1.96 to +0.66 ± 1.17 diopters (D) at last follow-up visit. Thirty eyes (71%) were within ±1.00 D of spherical equivalent correction. Cumulative uncorrected distance visual acuity of 20/40 or better was achieved in 34 eyes (81%). Efficacy and safety indices were 0.86 ± 0.19 and 1.17 ± 0.39, respectively. There was a significant increase in mean keratometry (Kmean) anterior, central corneal thickness, Q-value, and corneal higher order aberrations and a decrease in Kmean posterior 2 weeks postoperatively, without any significant change in these parameters thereafter ( P > .05). Four eyes of 3 patients underwent enhancement and another 4 eyes underwent explantation of the lenticule followed by exchange (2 eyes) and hyperopic laser in situ keratomileusis (2 eyes). No eye lost more than one line of CDVA. CONCLUSIONS: At 5 years of follow-up, FILI for moderate to high hyperopia showed good safety, efficacy, and reversibility. Modification of nomograms and surgical planning may be employed for further refinement of the outcomes. [ J Refract Surg. 2022;38(6):348–354.]

High myopia is a risk factor for a number of retinal pathologies. OCT is very useful in eyes with high myopia and allows the detection of subtle macular changes that are otherwise undetectable. Aim: To evaluate relationship between the axial length, refractive error and macular thickness in subjects with high myopia. Study Design: Cross sectional observational single centric study. Materials and Methods: 50 diagnosed patients of high myopia(refractive error>= -6 dioptres and/or axial length>=24 mm) along with a control of 50 emmetropic patients were included. Patient's anterior segment evaluation was done by slit lamp. Detailed fundus evaluation was done with indirect ophthalmoscopy and with +78 Dioptre lens along with measuring BCVA (Best corrected Visual Acuity). Axial length was measured using contact biometry. OCT was performed with TOPCON SD-OCT. Average macular thickness, central foveal thickness and total macular volume measured using 3D macula scan of all the cases and controls. Statistical Analysis: Unpaired t test.Results: The mean axial length was 27.40 mm among cases (SD±0.99) and 22.84 mm among controls (SD±0.422). The mean macular volume in cases was 6.90 and in controls was 7.82. The macular volume decreased with increasing axial length (ρ=-0.673) and increasing spherical equivalent (ρ=-0.035). The average macular thickness was inversely correlated with axial length (ρ=-0.605) and directly correlated with spherical equivalent (ρ=-0.049).The mean central subfield foveal thickness was 170.10 µm amongcases and 158.34µm among controls. The axial length and central foveal thickness were found to be positively correlated (ρ=0.727). Conclusion: Average macular thickness and total macular volume are inversely correlated to the degree of myopia, whereas central foveal thickness is positively correlated to the degree of myopia.

A 20-year old Indian female reported dimness of vision in both eyes since 5-6 days. Her best corrected visual acuity [BCVA] in right eye 6/24 (OD) and left eye 6/6 (OS). Anterior segment evaluation revealed conjunctival pallor. An ophthalmological evaluation revealed bilateral hyperemic disc with venous tortuosity and arterial attenuation, Roth spots in entire periphery in both eye. Pre-retinal haemorrhage over macula in right eye and flame shaped haemorrhage around macula in left eye.Hematological evaluation revealed the presence of anemia due to heavy blood loss in menstruation(with haemoglobin~2.1 gm%). General examination showed severe pallor. Other causes of anemia have been ruled out. She was treated with blood transfusion of four packed cell volume[PCV]. This case documents the rare occurrence of anemic retinopathy in patient of anemia due to menorrhagia.