Background/Aims: To evaluate the correlation between visual acuity (VA) and photoreceptor integrity in eyes with resolved diabetic macular edema (DME) after pars plana vitrectomy (PPV). Methods: Eleven eyes with resolved macular edema following PPV with internal limiting membrane removal for DME were included in this retrospective study. The integrity of the external limiting membrane (ELM) and inner and outer segments (IS/OS) of the photoreceptor junction was evaluated by spectral domain optical coherence tomography. The main outcome measures were percentage of disrupted ELM and IS/OS lines, and correlation between VA and photoreceptor integrity. Results: The mean time after PPV was 78 ± 17 months. The mean lengths of the disrupted ELM and IS/OS lines were 223 ± 167 µm (63%) and 189 ± 175 µm (54%) in the foveola, and 900 ± 522 µm (60%) and 835 ± 582 µm (55%) in the fovea, respectively. Intact ELM and IS/OS lines were positively correlated with VA in both the fovea (p = 0.09 and p = 0.02, respectively) and foveola (p = 0.004 and p = 0.03, respectively). Linear regression analysis showed a statistically significant association of intact ELM and IS/OS lines with VA in the fovea. Disrupted ELM and IS/OS lines had a strong correlation with each other in both the fovea (r = –0.71, p = 0.013) and foveola (r = 0.81, p = 0.02). Conclusions: The integrity of the ELM and IS/OS lines was positively correlated with VA in eyes with resolved DME after PPV.

Both Brinz/Tim and Dorz/Tim showed similar significant and clinically relevant IOP-lowering efficacy, whereas Brinz/Tim provided superior outcomes in terms of ocular comfort.

Fixed dilated pupilla is an uncommon but well-known complication of keratoplasty. The exact mechanism remains unknown but postoperative high IOP seems to be an important risk factor following complicated DALK. Rise in IOP during the management of complications following DALK related to DM was found to be important in the development of FDP in this series.

Purpose: To grade the severity of limbal stem cell deficiency (LSCD) based on the extent of clinical presentation and central cornea basal epithelial cell density (BCD). Methods: This is a retrospective observational case-control study of forty-eight eyes of 35 patients with LSCD and 9 eyes of 7 normal subjects were included. Confocal images of the central cornea were acquired. A clinical scoring system was created based on the extent of limbal and corneal surface involvement. LSCD was graded as mild, moderate, and severe stages based on the clinical scores. The degree of BCD reduction was given a score of 0 to 3. Results: Compared with BCD in control eyes, BCD decreased by 23.0%, 40.4%, and 69.5% in the mild, moderate and severe stages of LSCD classified by the clinical scoring system, respectively. The degree of BCD reduction was positively correlated with larger limbal and corneal surface involvement, and when the central visual axis was affected (all p≤0.0005). The mean CDVA LogMAR was 0.0±0.0 in control eyes, 0.2±0.5 in mild LSCD, 0.6±0.4 in moderate LSCD, and 1.6±1.1 in severe LSCD (p<0.0001). There was a significant correlation between a higher clinical score and CDVA LogMAR (rho = 0.82; p<0.0001) and a greater decrease of BCD (rho = −0.78; p<0.0001). Conclusion: A clinical scoring system was developed to assess the extent of clinical presentation of LSCD. A classification system to grade the severity of LSCD can be established by combining the BCD score with the clinical score.