Search Results (41)

Background and Clinical Significance: The Fusarium solani species complex is a group of filamentous fungi capable of causing severe ocular infections. It is a frequent cause of mycotic keratitis, which is associated with a poor prognosis due to aggressive biological behavior and resistance to most antifungal agents. Contact lens wear is a well-known risk factor; Case Presentation: A 48-year-old female contact lens wearer presented with a persistent corneal ulcer and hypopyon in the right eye. Initial visual acuity was hand movements. Hyphae of the Fusarium solani species complex were detected in an anterior chamber punctate sample. Intensive topical and systemic antifungal therapy was initiated, followed by therapeutic penetrating keratoplasty (PK) without corticosteroid treatment. Two months later, a second optical PK was performed. Over the subsequent two years, the patient underwent cataract surgery and developed endothelial corneal decompensation. During long-term follow-up, three Descemet membrane endothelial keratoplasties (DMEK) were required due to recurrent endothelial failures. Seven years after the initial presentation, the eye remained clinically stable with a best-corrected visual acuity of 0.0 logMAR; Conclusions: Early therapeutic PK without corticosteroid treatment was likely a key factor in successful infection control in this case of Fusarium solani keratitis. Full visual recovery can be achieved even after multiple penetrating and lamellar corneal transplantations in severe fungal keratitis. Full article

This study addresses the influence of process conditions on the dimensional accuracy, geometric deviations, and surface quality of PLA parts manufactured using high-dynamics material extrusion (MEX) technology. The aim was to identify the dominant sources of variability and to assess within-condition manufacturing consistency and inter-machine consistency. The investigation considered two 3D printers, nine build locations on the working platform, two printing strategies (layer-by-layer and model-by-model), and model face orientation. Additionally, an exploratory comparison of aligned and random seam configurations and an analysis of local temperature variations within the build chamber were performed. Regular dodecahedron geometries were manufactured using a Bambu Lab P1S system and processed under identical high-quality printing parameters. Dimensional measurements were performed using a Linear 100 universal length measuring machine, while full-field geometric deviations were acquired using a GOM Scan 1 structured-light 3D scanner. Surface roughness (Ra) was measured with a MarSurf XR 20 profilometer. Part orientation is the dominant source of dimensional variability, representing the largest relative contribution to linear deviation in the mixed-effects model (ΔR² = 0.776), while local temperature variations near the printing zone were associated with location-dependent dimensional deviations. Within the supplementary temperature dataset, the regression model including temperature and printers explained 66% of the variability in mean linear dimension. This association provides indirect evidence of a thermal contribution but does not establish direct causality. The layer-by-layer strategy provided better dimensional stability than the model-by-model approach. In the exploratory seam comparison, seam configuration did not explain the orientation-dependent LD pattern. Surface roughness variability was primarily geometry-driven (ΔR² = 0.852). Variability between independent manufacturing series and specimens for linear deviation and Ra was low after accounting for the investigated factors, indicating consistent process performance under constant settings; however, the present design did not allow measurement repeatability and reproducibility to be separated. In conclusion, dimensional accuracy in high-dynamics MEX is strongly associated with part orientation, while thermal variations may represent an additional contributing factor; however, the observed correlation between thermal conditions and dimensional variability does not establish direct causality. Full article

This study presents the preliminary development of a clustered hybrid propulsion module, and its experimental validation from static motor characterization to dynamic 1-D vertical drop tests to assess the feasibility of a hybrid propulsion system for soft-landing applications. The research progresses from preliminary design of core components (such as fuel, oxidizer supply system, engine configuration), to the performance verification of the clustering module. First, the trade-off between high regression rates and mechanical integrity was evaluated for paraffin-based fuels. However, high-density polyethylene (HDPE) was utilized as the baseline to ensure predictable combustion behavior. Second, cold flow tests of the designed multi-port manifold demonstrated a highly uniform oxidizer distribution, validating the geometric design with a maximum spatial pressure deviation of 2.44% across the four engines. Third, static fire tests confirmed robust dynamic control capabilities, successfully throttling the average chamber pressure from 100% (7.00 bar) down to 43% (3.01 bar) and back to 100% (7.01 bar) with a transient response time of approximately 0.6 s. Finally, the 1-D vertical drop test validated the operational readiness of the system; the open-loop thrust modulation successfully counteracted the module’s dynamic weight, achieving a terminal descent velocity of 1.46 m/s, which strictly satisfies planetary soft-landing safety criteria. These results demonstrate the feasibility and performance of clustered hybrid propulsion systems for planetary exploration, extending to surface launch technology for sample return missions from the Moon and Mars, and precision booster recovery for small launch vehicles. Full article

This retrospective multicenter cohort study investigated the incidence, treatment, and prognostic impact of dysregulated intraocular pressure (DIOP; >24 mmHg requiring therapy) in patients with acanthamoeba keratitis (AK). Eighty-one eyes from 81 patients with confirmed AK were included; co-infections were excluded. DIOP and best corrected visual acuity (BCVA) were assessed at baseline, follow-up, and after penetrating keratoplasty (PKP). Overall, 28% of eyes were managed conservatively, 46% required one PKP, and 26% required two. DIOP occurred in 4% before AK, 11% after AK onset, and 10% after the first PKP. Eyes with DIOP prior to PKP had significantly worse final BCVA compared to those without DIOP (0.5 ± 0.7 vs. 1.8 ± 1.1 logMAR, p < 0.001) and required PKP more frequently (100% vs. 67%, p = 0.01). Time to correct diagnosis was significantly longer in the AK-associated DIOP group (64 ± 50 vs. 50 ± 68 days, p = 0.03). DIOP was also associated with higher rates of prior cortisone use and complications, including fixed dilated pupil, cataract, anterior synechiae, and anterior chamber irritation. Overall, DIOP represents a major complication in AK and is linked to poorer visual outcomes. Earlier therapy may help reduce DIOP and hence improve prognosis. Full article

Descemet stripping automated endothelial keratoplasty (DSAEK) is a well-established surgical technique for the treatment of endothelial dysfunction, in which intracameral gas tamponade plays a critical role in graft adherence. We report the case of a 67-year-old pseudophakic woman with advanced Fuchs endothelial corneal dystrophy and symptomatic pseudophakic bullous keratopathy in the right eye, who presented with progressive visual deterioration and underwent DSAEK using an 8.25 mm donor graft inserted with a Busin glide and tamponaded with a 25% sulfur hexafluoride (SF6) gas–air mixture. On the first postoperative day, slit-lamp examination suggested an appropriate anterior chamber configuration and satisfactory graft attachment. However, detailed multiplanar anterior segment optical coherence tomography (AS-OCT), defined here as assessment using vertical, horizontal, and rotational scan orientations, revealed subtle posterior migration of the gas bubble beneath the iris plane. This clinically occult finding indicated altered anterior segment anatomy associated with a risk of secondary angle-closure mechanisms and raised concern for malignant glaucoma. Prompt surgical re-intervention was undertaken on postoperative day one, involving decompression of the misdirected gas bubble and reinjection of a centrally positioned tamponade. This resulted in restoration of normal anterior chamber configuration and stable graft adherence. Best-corrected visual acuity (BCVA) improved from 0.1 Snellen (1.0 logMAR) preoperatively to 0.7 Snellen (0.15 logMAR) at 2 weeks following surgery. This case highlights the added value of multiplanar AS-OCT in detecting clinically occult posterior gas migration after DSAEK, particularly when the abnormality is scan-orientation-dependent and not apparent on slit-lamp examination, thereby enabling timely intervention in the presence of a potentially sight-threatening postoperative configuration. Full article

Lamellar ichthyosis is a rare congenital disorder of keratinization frequently associated with ocular complications, most commonly cicatricial ectropion and exposure keratopathy. We present a case of severe mixed exposure-related and neurotrophic keratopathy with marked corneal thinning in a 61-year-old man with genetically confirmed lamellar ichthyosis. At presentation, the best-corrected visual acuity (BCVA) in the right eye was limited to hand motion (logMAR 2.3). Slit-lamp examination revealed a large central to inferocentral corneal ulcer measuring approximately 3 × 4 mm with severe stromal thinning in the setting of marked lower eyelid ectropion, incomplete eyelid closure, and chronic ocular surface exposure, while anterior segment optical coherence tomography (AS-OCT) demonstrated a minimal corneal thickness of approximately 165 µm. Microbiological swabs obtained from the conjunctival sac were negative, and no purulent discharge, hypopyon, or anterior chamber inflammatory reaction was present, making active infectious keratitis unlikely. Corneal sensitivity measured with Cochet–Bonnet esthesiometry at presentation, centrally and in all four peripheral quadrants of both eyes, was markedly reduced, more severely in the affected right eye, supporting the presence of a severe neurotrophic component contributing to impaired corneal healing. Intensive conservative therapy including preservative-free lubricants, dexpanthenol gel, autologous serum eye drops, topical insulin, prophylactic antibiotics, and systemic doxycycline was initiated. Serial AS-OCT imaging demonstrated progressive structural recovery, with corneal thickness increasing to 438 µm after one month of treatment and complete corneal epithelialization. The BCVA improved to 0.2 Snellen (0.7 logMAR). This case highlights the diagnostic value of multimodal anterior segment imaging in monitoring severe mixed keratopathy with advanced corneal thinning and demonstrates that intensive conservative therapy may stabilize the ocular surface and prevent corneal perforation in patients with lamellar ichthyosis. Full article

Background: Scleral fixation of intraocular lenses (IOLs) is a valuable option in cases of aphakia or inadequate capsular support, yet conventional sutured and sutureless approaches can pose technical challenges and complication risks. The needle-guided scleral fixation technique offers a simplified, single-suture solution that enhances safety and reproducibility. Methods: In this retrospective interventional case series, 30 eyes with insufficient capsular support underwent IOL implantation using Meduri’s needle-guided single-suture technique at the G. Martino University Hospital, Messina. The surgical method employs a 24-gauge needle to guide a double-armed 10-0 polypropylene suture through the sclera for precise IOL anchorage, minimizing vitreous manipulation. Outcomes were assessed over 24 months, including best-corrected visual acuity (BCVA), IOL centration, intraocular pressure (IOP), and postoperative complications. Results: Mean BCVA improved from X to Y LogMAR at two years (p < 0.05). All IOLs remained well-centered without tilt or decentration. Mild conjunctival hyperemia occurred in 70% of cases, resolving spontaneously. No suture erosion, vitreous hemorrhage, or retinal detachment was observed. Conclusions: The needle-guided single-suture technique provides a stable, efficient, and reproducible method for posterior chamber IOL fixation in aphakic eyes lacking capsular support. Its minimal learning curve and reduced surgical complexity make it an attractive alternative to both traditional sutured and modern sutureless methods, particularly in centers without vitreoretinal expertise. Full article

Objective: This study aims to examine the anterior chamber structure and related factors in 8-year-old children based on data from The Yamanashi Adjunct Study of the Japan Environment and Children’s Study (JECS). Methods: A total of 709 children aged 8 years (350 boys and 359 girls) who participated in the JECS Adjunct Study were included. The right eyes were primarily used for measurements. Optical Coherence Tomography (OCT) was utilized to scan the anterior chambers of the participants’ eyes. The following parameters were measured: Angle Opening Distance (AOD500, 750), Trabecular Iris Space Area (TISA500, 750), Anterior Chamber Angle (ACA500, 750), Peripheral Iris Thickness (IT500, 750), and Peripheral Corneal Thickness (PCT500, 750). The relationships between anterior chamber structure, axial length (AL), spherical equivalent (SE), logMAR (without correction), and body height were analyzed. Results: A significant negative correlation was found between SE and ACA (500: coefficient = −0.19; 750: −0.24), AOD (500: −0.19; 750: −0.24), and TISA (500: −0.17; 750: −0.23) (p < 0.001). Conversely, a significant positive correlation was observed between AL and ACA (500: 0.22; 750: 0.26), AOD (500: 0.25; 750: 0.30), and TISA (500: 0.24; 750: 0.29) (p < 0.001). Boys exhibited a longer AL (boys: girls = 23.30 ± 0.76 mm; girls = 22.79 ± 0.72 mm) and greater CT (500: boys = 812.82 ± 51.94 mm; girls = 784.48 ± 51.81 mm; 750: boys = 776.01 ± 48.64 mm; girls = 751.34 ± 49.63 mm) compared to girls (p < 0.001) despite no significant difference in body height. CT and IT showed no correlation with AL or SE, and visual acuity had minimal correlation with IT and CT. Conclusions: In our cohort of eight-year-old children, the anterior chamber angle structure correlates with ocular structures and refractive error, revealing notable differences between boys and girls. Full article

Background/Objectives: Different surgical techniques are available in cases of missing or insufficient capsular bag support. Next to the anterior chamber or iris-fixated intraocular lenses (IOL), the implantation of the Carlevale IOL provides a sutureless and scleral fixated treatment method. Methods: In a retrospective single-center study, the perioperative data of 100 patients who consecutively received a scleral fixated Carlevale IOL combined with a 25 gauge (G) pars plana vitrectomy between September 2021 and June 2024 were investigated. The intraoperative and postoperative results were analyzed in terms of complication rates and refractive outcomes. Results: IOL dislocation was the most common surgical indication (50%) for sutureless Carlevale IOL implantation, followed by postoperative aphakia in 35 patients (35%). Nearly every fourth patient (24%) had a preoperative traumatic event, and 21% had pseudoexfoliation (PEX) syndrome. The average surgery time was 60.2 (±20.1) min. Intraoperative intraocular hemorrhage occurred in seven cases, and IOL haptic breakage in two patients. Temporary intraocular pressure fluctuations represented the most common postoperative complications (28%). Severe complications such as endophthalmitis or retinal detachment were not observed in our cohort. The mean refractive prediction error was determined in 67 patients and amounted to an average of −0.7 ± 2.0 diopters. The best corrected visual acuity (BCVA) at the last postoperative follow-up showed an improvement of 0.2 ± 0.5 logMAR (n = 76) compared to the preoperative BCVA (p = 0.0002). The postoperative examination was performed in 72% of the patients, and the mean follow-up period amounted to 7.2 ± 6.4 months. Conclusions: Overall, sutureless and scleral fixated implantation of the Carlevale IOL represents a valuable therapeutic option in the treatment of aphakia and lens as well as IOL dislocation in the absence of capsular bag support with minor postoperative complications and positive refractive outcomes. Full article

Background/Objectives: To propose a combined surgery of surgically induced macular detachment (MD) and autologous internal limiting membrane (ILM) transplantation to treat refractory full thickness macular holes (FTMHs). Methods: A series of patients affected by refractory FTMHs underwent a combined surgery. The following demographic and clinical data were collected: age, gender, eye, lens status, and best corrected visual acuity (BCVA). The tomographic pre- and post-operative parameters were the following: pre-operative FTMH diameter, refractory FTMH morphology (flat/with cuff), FTMH closure, foveal profile (regular/flat/inverted), flap displacement, and outer retinal layers restoration. Results: The study included a total of 14 pseudophakic eyes (14 patients). In all of the patients, surgical FTMH closure was reached. The mean BCVA improved after surgery from 1.1 ± 0.14 to 0.48 ± 03 logMAR (p < 0.0001). Statistical analysis demonstrated that the larger the FTMH, the poorer the post-operative gain in BCVA (p −0.5). The post-operative regular foveal profile was obtained in 50% of the eyes with a mean post-operative BCVA of 0.3 logMAR. A negative correlation between the time interval from diagnosis to surgery and post-operative BCVA gain was highlighted (p −0.8). Conclusions: The proposed combined surgical technique led to encouraging anatomical and functional results. Surgically induced MD increased the elasticity of the retina, and the free flap isolated the macular hole from the vitreous chamber favoring its closure. Full article

Background: This study aimed to compare the anterior segment characteristics of patients with central serous chorioretinopathy (CSCR) to those with diabetic retinopathy (DR) and healthy controls. Additionally, it explored the possible associations between quality of life and anxiety with CSCR. Methods: A single-center, cross-sectional study involving patients aged 23–61 years diagnosed with CSCR or DR, and healthy patients. Comprehensive ophthalmic examinations included best-corrected visual acuity (BCVA, LogMAR), objective and subjective refraction, and anterior and posterior segments optical coherence tomography (OCT) imaging. Participants completed the Quality-of-Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and the Beck Anxiety Inventory (BAI). Statistical analysis included Kruskal–Wallis, Tukey post-hoc, Chi-square, and Spearman correlation tests to compare the three groups. Results: A total of 53 patients were recruited (16 CSCR, 8 DR, 29 controls; 52.8% males), with an additional 16 CSCR patients completed only the questionnaires. CSCR and DR patients were the same age as the controls (43.8 ± 9.0, 42.7 ± 9.9, 37.06 ± 13.61 years, respectively, p = 0.19). CSCR and DR patients had similar BCVA, lower than controls (0.19 ± 0.30, 0.15 ± 0.13, 0.01 ± 0.02 LogMAR, respectively, p < 0.01). CSCR patients exhibited more hyperopic refraction compared to healthy controls (p < 0.01) and reported significantly lower life enjoyment and satisfaction than DR and healthy individuals (51.56 ± 9.17, 53.75 ± 7.81, 60.03 ± 7.32, respectively, p < 0.01). No significant correlations were found between anxiety levels and pupil size, anterior chamber depth (ACD), amplitude of accommodation (AA), and intraocular pressure (IOP) among study groups (p > 0.05). Conclusions: CSCR patients demonstrated lower life enjoyment and satisfaction, reduced BCVA, and hyperopic refraction compared to healthy patients. They also tended to have higher stress and anxiety levels. Both CSCR and DR patients shared similar anterior segment characteristics. Full article

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

The ability to predict lift is crucial for enabling flapping flights on planets with varying air densities and gravities. After determining the lift required for a flapping flight on Earth, it can be predicted under different conditions using a scaling equation as a function of air density and gravity, assuming the cycle-average lift coefficient remains constant. However, in flapping wings, passive deformation due to aerodynamic and inertial forces may alter the flapping-wing kinematics, complicating predictions. In this study, we investigated changes in the lift coefficient of flapping wings under various air density and gravity conditions simulated using a low-pressure chamber and tilting stand, respectively. The current study found that the cycle-averaged lift coefficients remained nearly constant, varying by less than 7% across the air density and gravity conditions. The difference between the measured and predicted hovering frequencies increased under a lower air density due to the higher vibration-induced friction. The power consumption analysis demonstrated higher energy demands in thinner atmospheres and predicted a required power of 5.14 W for a hovering flight on Mars, which is a 66% increase compared to that on Earth. Future experiments will test Martian air density and gravity conditions to enable flapping flights on Mars. Full article

Background: The aim of this retrospective study was to compare the surgical and refractive outcomes using the Carlevale IOL (FIL SSF; SOLEKO) with those of the retropupillary-fixated Artisan IOL (Aphakia Model 205; OPHTEC), implanted through a 6 mm sclerocorneal tunnel incision in both groups. Methods: This study included 51 consecutive eyes (25 Carlevale and 26 Artisan IOLs). Due to complex preoperative conditions (e.g., dislocated polymethylmethacrylat IOL, luxated Cataracta rubra), all patients underwent lens explantation using a standardized 6 mm sclerocorneal tunnel incision and a 23 G or 25 G pars plana vitrectomy. Visual acuity (VA), spherical equivalent, refractive prediction error (PE), incision-suture time, and complication rates were recorded preoperatively and during the follow-up period. Results: The average follow-up period was 40.9 ± 5.7 days. VA improved by 0.28 ± 0.39 logMAR (p < 0.0001) in the Carlevale group and by 0.36 ± 0.47 logMAR (p < 0.0001) in the Artisan group. The improvement was comparable between both groups (p = 0.921). The deviation of the PE was −0.67 ± 0.56 in the Carlevale group and 0.34 ± 0.71 in the Artisan group (p < 0.0001). The mean incision-suture time was 42.5 ± 5.8 min in the Carlevale group and 28.2 ± 6.4 min in the Artisan group. Anterior chamber and vitreous hemorrhages were the most common complications, occurring in 12% in the Carlevale group and 17.2% in the Artisan group. Conclusions: The use of the Carlevale IOL, implanted using a sclerocorneal tunnel technique, presents a valid option for treating complex lens dislocations. The scleral fixation of the Carlevale IOL minimizes risks associated with iris fixation, such as chronic inflammation and pupil distortion, making it particularly suitable for patients with damaged irises. Full article

Objectives: This study aimed to describe the outcomes of a staged procedure combining Descemet membrane endothelial keratoplasty (DMEK) and sutureless scleral fixation (SSF) of a one-piece intraocular lens (IOL) in a case series. Co-performing endothelial keratoplasty (EK) and SSF is associated with intraoperative and postoperative complications such as graft deployment difficulties, air migration, graft detachment, and IOL opacification or tilt, all of which are evaluated in this study. Methods: This is a retrospective observational case series. Clinical data were collected from eight eyes of eight patients who underwent DMEK for endothelial failure and had previously received an SSF with one-piece IOL following complete vitrectomy. During DMEK surgery, an air leak test was conducted to check for air migration into the posterior chamber. If instability was detected, pupilloplasty was performed. Intraoperative and postoperative data, including DMEK graft unfolding time, were collected. Corrected Distance Visual Acuity (CDVA), refraction, endothelial cell density (ECD), central corneal thickness (CCT), intraocular pressure (IOP), and complications were recorded over a 12-month follow-up period. Results: We performed pupilloplasty in four patients (50%). The median CDVA improved from preoperative 0.85 logMAR (range: 0.60 to 1.00) at baseline to 0.18 logMAR (range: 0.10 to 0.70, p = 0.012) at 12 months. The median refraction value changed significantly from −1.00 to −0.50 at 12 months. The median percentage reduction in ECD after 12 months was 33.4% (range 30 to 40). The median baseline CCT was 689 μm (range: 651 to 701) at baseline visit and 541.5 μm (range: 525 to 591, p = 0.008) at 12 months. The median IOP was reduced significantly during follow-up. The median graft unfolding time was 6 min (5 to 9). One patient required rebubbling for partial detachment on postoperative day one. No complications occurred within 12 months. Conclusions: The effective compartmentalization of the anterior and posterior chambers in vitrectomized eyes with an SSF one-piece IOL and pupilloplasty can facilitate critical steps of DMEK surgery in complex eyes. Additionally, the air leak test could prove useful in identifying the need for iris-lens diaphragm reconstruction. Full article