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New Insights into Ocular Surface, Cornea, Cataract, and Refractive Surgery
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New Insights into Ocular Surface, Cornea, Cataract, and Refractive Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (30 April 2025) | Viewed by 9303

Special Issue Editors

Prof. Dr. Reda Žemaitienė

E-Mail Website
Guest Editor
Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, 44037 Kaunas, Lithuania
Interests: ocular surface; cataract; intraocular lenses; myopia; ocular inflammation; rare eye diseases
Dr. Mikk Pauklin

E-Mail Website
Guest Editor
Eye Clinic, Tartu University Hospital, Tartu, Estonia
Interests: limbal stem cell deficiency; limbal transplantation; amniotic membrane; dry eye; keratoplasty; DALK
Prof. Dr. Marius Žemaitis

E-Mail Website
Guest Editor
Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, 44037 Kaunas, Lithuania
Interests: thoracic oncology; invasive pulmonology; methodology and statistics; biomarkers; immune microenvironment; microbiota

Special Issue Information

Dear Colleagues,

The ocular surface that consists of the cornea, conjunctiva, eyelids, eyelashes, tear film, and associated glands is vital for maintaining the cornea’s smooth refractive surface and is influenced by environmental factors and patients’ lifestyle. Changes in the ocular surface are linked to various systemic diseases, and the tear film is increasingly being recognized as a diagnostic biomarker. Tear film stability is essential for eye health and critical for successful cataract and refractive surgeries. While diagnostics and treatments for corneal diseases have advanced, challenges like corneal blindness and donor tissue shortages persist, spurring new developments. Modern cataract surgeries, including phacoemulsification and femtosecond laser-assisted procedures, are now considered among the most common and safest of all surgeries. Intraocular lenses, which have been in use for 75 years, correct corneal astigmatism and presbyopia, though truly accommodative IOLs are yet to be developed. Moreover, the rapid increase in myopia has reached pandemic levels. The development of the safest and the most effective methods for preventing and treating refractive errors, as well as performing refractive surgery, is extremely relevant today.

The goal of this Special Issue is to provide readers with the newest developments and current knowledge into ocular surface, cornea, cataract, and refractive surgery areas. Original research, clinical experiences, and comprehensive reviews related to (but not limited to) the suggested topics are welcome.

We look forward to hearing from you.

Prof. Dr. Reda Žemaitienė
Dr. Mikk Pauklin
Prof. Dr. Marius Žemaitis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ocular surface
  • tear film
  • dry eye syndrome
  • cornea
  • corneal transplantation
  • keratoconus
  • cataract
  • intraocular lens
  • myopia
  • refractive surgery

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

10 pages, 1553 KiB  
Article
Clinical Outcomes Following Suture Fixation of Intraocular Lenses at the University Eye Clinic Freiburg: A Retrospective Analysis
by Mateusz Glegola, Michelle Dreesbach, Daniel Böhringer, Philip Maier and Thomas Reinhard
J. Clin. Med. 2025, 14(7), 2271; https://doi.org/10.3390/jcm14072271 - 26 Mar 2025
Viewed by 214
Abstract
Background: Suture fixation of intraocular lenses (IOLs) is a rare but essential procedure for patients with inadequate capsular support, offering crucial therapeutic benefits. This study analyzes a large cohort of patients undergoing IOL suture fixation, focusing on demographics, risk factors, and clinical [...] Read more.
Background: Suture fixation of intraocular lenses (IOLs) is a rare but essential procedure for patients with inadequate capsular support, offering crucial therapeutic benefits. This study analyzes a large cohort of patients undergoing IOL suture fixation, focusing on demographics, risk factors, and clinical outcomes. Methods: In this retrospective analysis of 332 eyes treated at the Eye Center of the University Hospital Freiburg (2008–2022), we evaluated immediate and long-term postoperative outcomes, including visual acuity and refraction. The follow-up averaged 2.5 years. A detailed analysis of the IOL positioning was performed in 111 patients. Results: The most common indications were pseudoexfoliation syndrome (33%), trauma (17%), and prior complicated cataract surgery (11%). The Zeiss CT27SF lens was used most frequently (91%). The mean spherical equivalent deviation from target refraction was −0.375 diopters overall. According to the detailed analysis, IOL tilt occurred in 6.3% of patients, and decentration occurred in 7.2%. Only three patients (3.6%) required additional ocular procedures specifically for IOL repositioning. Risk factors for further surgery included underlying systemic conditions or multiple previous surgeries. Conclusions: Suture fixation of IOLs proves to be an adequate and effective intervention for visual rehabilitation in patients with compromised capsular support, demonstrating good refractive outcomes and low complication rates. Even in cases where the postoperative visual acuity was comparable to the best-corrected preoperative acuity, the procedure improved refractive correction by reducing the need for extensive refractive aids, such as contact lenses required for aphakia. Full article
(This article belongs to the Special Issue New Insights into Ocular Surface, Cornea, Cataract, and Refractive Surgery)
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15 pages, 992 KiB  
Article
Comparative Functional and Morphological Data of Different IOL Dislocation Treatment Methods
by Renata Vaiciuliene, Ugne Rumelaitiene, Martynas Speckauskas and Vytautas Jasinskas
J. Clin. Med. 2025, 14(5), 1462; https://doi.org/10.3390/jcm14051462 - 21 Feb 2025
Viewed by 314
Abstract
Background: This study compared the visual and morphological outcomes between iris fixation and anterior chamber intraocular lens (ACIOL) implantation for late spontaneously dislocated intraocular lens (IOL)–capsular bag complexes in a tertiary reference center in Lithuania. Methods: A prospective observational study was conducted between [...] Read more.
Background: This study compared the visual and morphological outcomes between iris fixation and anterior chamber intraocular lens (ACIOL) implantation for late spontaneously dislocated intraocular lens (IOL)–capsular bag complexes in a tertiary reference center in Lithuania. Methods: A prospective observational study was conducted between 2017 and 2019 involving 80 patients (83 eyes) with late spontaneous IOL–capsular bag dislocation. Patients underwent repositioning and fixation of the dislocated IOL to the iris (IF group) or IOL exchange with an ACIOL implant (ACIOL group). Pre- and postoperative assessments included best-corrected distance visual acuity (BCDVA), intraocular pressure (IOP), corneal endothelial cell density (ECD) and macular thickness (evaluating whether cystoid macular edema (CME) had occurred). Results: Both groups showed a significant improvement in BCDVA, with a more remarkable improvement in the IF group (median: 0.1 logMAR) than in the ACIOL group (median: 0.3 logMAR), p = 0.001. Corneal astigmatism increased significantly in the ACIOL group (p < 0.001) but remained stable in the IF group. IOP management outcomes were better in the IF group as fewer eyes required additional glaucoma treatment. ECD decreased in both groups, but the decrease was significantly greater in the ACIOL group (p < 0.001). Postoperative CME occurred in 4.4% of IF eyes and 39% of ACIOL eyes (p = 0.01). Conclusions: The iris fixation of late dislocated IOL–capsular bag complexes is a safe and minimally invasive technique that offers better visual outcomes, less astigmatism and fewer complications than ACIOL exchange. Full article
(This article belongs to the Special Issue New Insights into Ocular Surface, Cornea, Cataract, and Refractive Surgery)
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12 pages, 552 KiB  
Article
Enhancing Corneal Sensitivity in Diabetic Patients Through an Innovative Ophthalmic Solution: In Vivo and Vitro Results
by Fabio Scarinci, Giovanna De Simone, Chiara Ciancimino, Claudio Caggiano, Giulio Pocobelli and Alessandra Di Masi
J. Clin. Med. 2025, 14(1), 245; https://doi.org/10.3390/jcm14010245 - 3 Jan 2025
Viewed by 954
Abstract
Background/Objectives: Diabetes is a well-recognised factor inducing a plethora of corneal alterations ranging from dry eye to reduced corneal sensibility, epithelial defects, and reduced cicatrisation. This cohort study aimed to assess the efficacy of a novel ophthalmic solution combining cross-linked hyaluronic acid [...] Read more.
Background/Objectives: Diabetes is a well-recognised factor inducing a plethora of corneal alterations ranging from dry eye to reduced corneal sensibility, epithelial defects, and reduced cicatrisation. This cohort study aimed to assess the efficacy of a novel ophthalmic solution combining cross-linked hyaluronic acid (CHA), chondroitin sulfate (CS), and inositol (INS) in managing diabetes-induced corneal alterations. Specifically, it evaluated the solution’s impact on the tear breakup time (TBUT), the ocular surface disease index (OSDI), and corneal sensitivity after three months of treatment. Additionally, the solution’s potential to promote wound healing was examined. Methods: Two different populations were retrieved from the database; the first one was composed of 20 diabetic subjects treated for three months with the ophthalmic CAH-CS (OPHTAGON srl, Rome, Italy), while the second group was composed of 20 diabetic subjects who did not want to use any eye lubricant or other treatment. The outcome measures were the TBUT, the OSDI score, and the corneal sensitivity measured using a Cochet–Bonnet aesthesiometer. To investigate the wound-healing properties, in vitro tests were conducted using two cell lines, comparing the results of scratch tests with and without the solution. Results: The results indicate that CHA-CS significantly improved the tear film stability, as evidenced by an increased TBUT and a reduction in dry eye symptoms reflected by lower OSDI scores. Moreover, the solution was associated with an enhanced corneal sensitivity in treated patients. In wound-healing assays, CHA-CS promoted cell motility, suggesting a supportive role in tissue repair compared to untreated cells. Conclusions: Collectively, the results suggest that CHA-CS could serve as an innovative tool for the treatment of diabetic patients with corneal alterations and delayed corneal sensitivity. Clinical trial registration number: Clinical Trial.gov NCT06573606. Full article
(This article belongs to the Special Issue New Insights into Ocular Surface, Cornea, Cataract, and Refractive Surgery)
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10 pages, 1066 KiB  
Article
Cataract Prevalence in Patients with Cutaneous Melanoma in Lithuanian Population
by Lukas Šemeklis, Laura Kapitanovaitė, Grinvydas Butrimas, Kamilija Briedė, Laura Račkauskaitė, Reda Žemaitienė and Skaidra Valiukevičienė
J. Clin. Med. 2024, 13(22), 6717; https://doi.org/10.3390/jcm13226717 - 8 Nov 2024
Viewed by 800
Abstract
Background/Objectives: Sun exposure and ultraviolet (UV) radiation significantly affect human health, especially concerning skin and eye conditions. Sun exposure is a risk factor for both cutaneous melanoma (CM) and cataract. To investigate the association between CM, cataract and the number of common melanocytic [...] Read more.
Background/Objectives: Sun exposure and ultraviolet (UV) radiation significantly affect human health, especially concerning skin and eye conditions. Sun exposure is a risk factor for both cutaneous melanoma (CM) and cataract. To investigate the association between CM, cataract and the number of common melanocytic nevi (CMNs) in the Lithuanian population. Methods: A case–control study with 180 primary diagnosed CM subjects and 182 healthy controls was conducted. Participants underwent ophthalmic and dermatological examination, where a counting of the common melanocytic nevi (CMNs) on the face, outer surfaces of the upper arms, lower arms and hands was performed. A detailed ophthalmic slit lamp examination was conducted; additionally, lens status and cataract formation were evaluated according to the Lens Opacities Classification System III (LOCS III). Results: Subjects with an LOCS III grade of nuclear opalescence (NO) ≥3 had a 1.82 times higher risk of CM, and patients with a nuclear color (NC) grade ≥3 had a 2.02 times higher risk of CM. LOCS III evaluations of cortical (C) and of posterior subcapsular (P) cataract showed a 5.24 and 6.34 times increased risk of CM, respectively. The CMN number on the face increased CM risk by 1.25 times; on the outer surface of the upper and lower arms, correspondingly 1.05 and 1.04 times; and on outer surface of hands—1.29 times. Conclusions: All types of cataracts were found more often in patients with CM than in healthy subjects. The number of CMNs on the face and outer surfaces of arms and hands could be an indicator of higher risk for CM. Full article
(This article belongs to the Special Issue New Insights into Ocular Surface, Cornea, Cataract, and Refractive Surgery)
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19 pages, 9467 KiB  
Article
Biomimetic Curcumin-Loaded Liposomes for the Treatment of Dry Eyes and Meibomian Gland Dysfunction: An In Vivo Study
by Vytautas Baranauskas, Ruta Jaruseviciene, Mantas Grigalavicius, Saulius Galgauskas, Vitalijus Karabanovas and Simona Steponkiene
J. Clin. Med. 2024, 13(21), 6436; https://doi.org/10.3390/jcm13216436 - 27 Oct 2024
Cited by 3 | Viewed by 6434
Abstract
Background/Objectives: Meibomian gland dysfunction (MGD) and dry eye syndrome (DES) are common eye diseases characterized by altered tear film stability and inflammation of the ocular surface, causing significant discomfort and possible visual impairment. This study aimed to investigate the efficacy of curcumin-loaded liposomes [...] Read more.
Background/Objectives: Meibomian gland dysfunction (MGD) and dry eye syndrome (DES) are common eye diseases characterized by altered tear film stability and inflammation of the ocular surface, causing significant discomfort and possible visual impairment. This study aimed to investigate the efficacy of curcumin-loaded liposomes (Lipo@Cur) compared to cyclosporine A-loaded liposomes (Lipo@CycA) in experimental rabbit models of MGD and DES, with a focus on their ability to improve tear film stability and reduce ocular surface inflammation. Methods: MGD and DES were induced using complete Freund’s adjuvant (CFA) and treated to evaluate the effect of liposomal formulations on tear break-up time (TBUT), clinical signs of inflammation (telangiectasia, conjunctival hyperemia, meibomian foramen occlusion), and corneal as well as conjunctival histological cells. Results: Lipo@Cur increased TBUT and reduced the signs of ocular surface inflammation, potentially approaching the effectiveness of clinically approved cyclosporine A encapsulated in liposomes (Lipo@CycA). Histological analysis suggested improvements in corneal epithelial thickness and goblet cell density in the treated groups, which may indicate a reversal of DES-induced damage to the ocular surface. Conclusions: Plant-originated curcumin encapsulated in liposomes offers a promising therapeutic strategy for the management of MGD and DES that may improve patient outcomes by addressing the underlying inflammatory mechanisms of these conditions. Full article
(This article belongs to the Special Issue New Insights into Ocular Surface, Cornea, Cataract, and Refractive Surgery)
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