The mean 24-h IOP lowering of TTFC was statistically more significant compared to LTFC in patients insufficiently controlled with latanoprost monotherapy. Measurement of ocular surface health and tear film status favored the BAK-free TTFC compared to LTFC.

Lamellar (anterior and posterior) keratoplasty entails the surgical replacement of diseased-only corneal tissue, while healthy host corneal tissue is preserved. Selective keratoplasty offers several advantages in comparison to penetrating keratoplasty such as a lower rate of graft rejection, less endothelial cell loss, faster/superior visual rehabilitation and enhanced resistance to closed injury. The surgical approach of "partial corneal transplantation" may be divided into anterior and posterior: techniques including superficial and deep anterior lamellar keratoplasty (SALK and DALK, respectively) and endothelial keratoplasty as well as Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK). These novel surgical procedures are rapidly becoming the preferred therapy option for specific corneal dysfunctions involving the corneal stroma (SALK, DALK), or corneal endothelium (DSAEK, DMEK). During the past decade, the continuing advancement of surgical techniques and the development of innovative surgical instruments have significantly enhanced corneal transplantation. Lamellar keratoplasty techniques facilitate corneal surgery, provide patients with superior outcomes and can successfully restore vision in corneal-related blindness. Nevertheless, more long-term evidence is needed to better evaluate these promising new techniques.

Purpose: The aim of our study was to compare the depth of the demarcation line developing in the cornea after the standard Dresden protocol versus the accelerated, pulsed, epithelium-off corneal collagen cross-linking (CXL). Methods: This was a nonrandomized, retrospective case series. Patients with progressive keratoconus were treated with either the standard Dresden protocol (Group 1) or accelerated, epithelium-off CXL using the Avedro (Waltham, MA, USA) device (Group 2). The accelerated CXL protocol involved 18 min of pulsed ultraviolet-A (20 mW/cm², 7.2 J/cm², pulsed pro-file: 1 s on, 2 s off). The depth of the demarcation line was measured about 3 months postoperatively. Results: Fifty-nine eyes of 35 subjects were included in the analysis. Group 1 consisted of 19 eyes, and Group 2 of 40 eyes. The mean age of the participants was 22.21 years in Group 1 and 26.55 years in Group 2 (p = 0.184). The mean preoperative K value was 44.89 D in Group 1 and 45.20 D in Group 2 (p = 0.768). The depth of the demarcation line was 322.50 μm in Group 1 and 319.95 μm in Group 2 (p = 0.937). Conclusions: The demarcation line depth was not statistically significantly different between the two protocols. The significance of the demarcation line depth has not been fully clarified in the literature. Our results support the contention that these two techniques may have similar structural outcomes and ef­ficacies in the treatment of keratoconus.

Choroidal melanoma is the most common primary malignant intraocular tumor that rarely is left undiagnosed. We report a case of a lately detected choroidal melanoma associated with exudative retinal detachment and severe visual loss in the affected eye. The patient was referred to our clinic with visual acuity in the right eye 6/6 while in the left eye was limited to light perception. Ophthalmic examination showed a large pigmented choroidal tumoral mass occupying most of the vitreous cavity and associated exudative retinal detachment. Ultrasonography confirmed a dome-shaped tumor with internal homogeneity, while anterior choroid, ciliary body and angle were found with no invasion. The fellow eye was examined thoroughly and no lesions were detected. Further clinical investigation for metastasis was negative. Negligence of the symptoms, gradual evolution of the tumor and late referral resulted in irreversible loss of vision. The patient had no other systemic pathology and was advised for enucleation in the left eye and follow-up. Choroidal melanoma is a serious malignancy that could threaten the patient's life and requires early detection and treatment. In large lesions enucleation is the treatment of choice.