BackgroundEvidence for Descemet's membrane endothelial keratoplasty (DMEK) in patients under 30 years old remains limited, although understanding outcomes in this demographic is important given the requirement for decade...BackgroundEvidence for Descemet's membrane endothelial keratoplasty (DMEK) in patients under 30 years old remains limited, although understanding outcomes in this demographic is important given the requirement for decades of graft function and concerns about long-term DMEK survival.MethodsWe conducted a retrospective case series at Moorfields Eye Hospital of consecutive patients under 30 years undergoing DMEK between 2015 and 2022. Primary outcome was change in best-corrected visual acuity (BCVA). Secondary outcomes included change in central corneal thickness (CCT), graft failure rates, and post-operative complications.Results18 eyes of 17 patients underwent DMEK surgery (mean age 22.7 ± 5.1) over a mean follow-up of 1072.1 ± 869.8 days. Mean BCVA improvement was 0.36 logMAR from pre-operative to final follow-up ( > 0.05), though significant improvements occurred at 1-month and 12-month intervals ( < 0.001 and < 0.01, respectively). CCT improved significantly from baseline by 111.3 μm (95% CI, 64.3-158.2 μm, < 0.0001). At final follow-up, 22.2% of eyes achieved BCVA ≤ 0.3 logMAR ( = 4). No patient achieved BCVA ≤ 0.1 logMAR. Rebubbling was performed 9 times (50%) in 8 eyes and was similar between both SF6 and air ( > 0.05). Post-operative complications occurred in 11.1% ( = 2) with no rejection episodes, although secondary graft failure occurred in 22.2% ( = 4), all within 12 months.ConclusionsDMEK effectively improves visual and anatomical outcomes in patients under 30, though with higher complication rates than older populations. The complex pathology and longer follow-up requirements in this demographic necessitate careful patient selection and realistic expectations. Larger prospective studies are needed to establish definitive guidelines for this population.
BackgroundThis study aimed to evaluate dynamic thiol/disulfide homeostasis in the tear fluid of patients with type 2 diabetes and to investigate its relationship with the presence of diabetic retinopathy (DR), considerin...BackgroundThis study aimed to evaluate dynamic thiol/disulfide homeostasis in the tear fluid of patients with type 2 diabetes and to investigate its relationship with the presence of diabetic retinopathy (DR), considering it as a potential biomarker of oxidative stress.MethodsA total of 96 individuals were included in the study. Participants were divided into three groups: 32 patients with diabetic retinopathy (Group 1, DR (+)), 31 patients with diabetes but without retinopathy (Group 2, DR (-)), and 33 healthy volunteers (Group 3). All participants underwent a comprehensive ophthalmological examination, including best-corrected visual acuity, slit-lamp biomicroscopy, and fundus evaluation. Tear samples were collected using Schirmer strips and stored in phosphate-buffered Eppendorf tubes at -80 °C until analysis. Total thiol, native thiol, and disulfide levels were analyzed using a spectrophotometric method. Patients with a history of intraocular surgery, trauma, glaucoma, or systemic diseases other than diabetes were excluded.ResultsThere were statistically significant differences between the groups in terms of total thiol, disulfide, disulfide/total thiol, and disulfide/native thiol ratios (p < 0.001). Total thiol levels were significantly lower, while disulfide levels and ratios were significantly higher in the DR (+) group. No significant difference was found in native thiol levels (p = 0.194). HbA1c and fasting blood glucose levels were significantly higher in the DR (+) group compared to the other groups (p < 0.001). Central macular thickness was also significantly greater in the DR (+) group (p < 0.001). Correlation analysis revealed a positive and significant relationship between HbA1c and fasting blood glucose (r = 0.551; p < 0.01), whereas no significant correlation was found between central macular thickness and glycemic parameters.ConclusionThe increased disulfide levels and disulfide ratios in the tear fluid of patients with diabetic retinopathy suggest a shift in thiol/disulfide homeostasis toward oxidative stress. These tear-based biomarkers may serve as valuable tools for the early diagnosis and monitoring of diabetic retinopathy.
Background/AimsThe goal of glaucoma care is to preserve vision and quality of life This study aimed to develop, and rank patient-centered priorities for glaucoma care in Croatia and compare them with the perspectives of...Background/AimsThe goal of glaucoma care is to preserve vision and quality of life This study aimed to develop, and rank patient-centered priorities for glaucoma care in Croatia and compare them with the perspectives of ophthalmologists.MethodsA five-phase, Delphi-based national study was conducted involving patients of the Croatian National Glaucoma Referral Center and Croatian ophthalmologists. An initial 20-item questionnaire was completed by 75 patients to identify patient priorities in glaucoma care. The most frequent responses were synthesized into a final 12 patient-centered priority statements, which patients and clinicians ranked independently. Rankings were compared overall and across prespecified patient and clinician subgroups.ResultsThe 20-item questionnaire informed a final 12-item survey completed by 130 patients and 97 ophthalmologists. Highest-ranking items across stakeholders were impaired quality of life and fear of losing sight or independence; patient associations ranked lowest. Clinicians emphasized reducing topical therapy burden and side-effects, whereas patients prioritized innovative and curative treatments (including vision restoration), faster, simpler diagnostics, and better communication with clinicians. Subgroup analyses showed stable patterns across clinician groups; among patients, later disease stage shifted focus toward disease control, longer treatment duration increased preference for innovation, and urban-rural differences were minimal.ConclusionThis study provides a ranked, stakeholder-informed set of glaucoma-care priorities for Croatia. Patient perspectives centered on preventing sight loss, preserving independence, and reducing treatment burden, while highlighting unmet needs in innovation, diagnostics, and communication. These findings complement ongoing European Glaucoma Society initiatives and may inform future Europe-wide strategies in patient-centered glaucoma care.
IntroductionEven with recent improvements, the optimal timing of orbital implant placement after evisceration surgery - particularly in infected cases - remains unclear. This study aimed to compare the long-term outcomes...IntroductionEven with recent improvements, the optimal timing of orbital implant placement after evisceration surgery - particularly in infected cases - remains unclear. This study aimed to compare the long-term outcomes of primary silicone orbital implants after evisceration for infectious and non-infectious causes, focusing mainly on implant-related complications such as exposure or extrusion.MethodsA total of 32 eyes that underwent evisceration were analyzed. Patients were divided into two groups: infectious causes (Group A, = 10) and non-infectious causes (Group B, = 22). Postoperative follow-up duration, implant size, histopathological results, and complications - including implant exposure or extrusion - were evaluated.ResultsDemographic characteristics were similar between the groups. The mean follow-up duration was 34.0 ± 17.7 months in group A and 28.18 ± 18.1 months in group B ( = 0.403). The mean implant size was 17.8 ± 2.6 mm in group A and 18.3 ± 1.8 mm in group B ( = 0.693). Mild symblepharon occurred in 2 patients (20%) in group A, while upper lid ptosis was noted in 2 patients (9%) in group B. No cases of implant exposure, extrusion, or sympathetic ophthalmia were observed in either group.ConclusionOrbital evisceration results in comparable long-term outcomes for both infectious and non-infectious indications, with no observed cases of implant exposure or extrusion. These findings support the safe use of primary silicone implants in both scenarios when appropriate surgical technique is applied and adequate postoperative follow-up is provided.
A 7-year-old boy, diagnosed with bilateral congenital glaucoma presented with elevated intraocular pressure (IOP). Anterior segment optical coherence tomography (AS-OCT) of the right eye revealed an artificial plane with...A 7-year-old boy, diagnosed with bilateral congenital glaucoma presented with elevated intraocular pressure (IOP). Anterior segment optical coherence tomography (AS-OCT) of the right eye revealed an artificial plane within the Haab's striae (HS), corresponding to separation of the Descemet membrane-pre-Descemet layer (DM-PDL) complex. Following medical reduction of IOP, slit-lamp examination demonstrated linear reddish discoloration within the HS, which was confirmed on AS-OCT as a hyperreflective intra-lamellar collection of blood between the posterior stroma and endothelium. The eye had not undergone any previous intraocular surgery or trauma. This observation represents a unique instance of de novo intra-lamellar hemorrhage within Haab's striae in an unoperated eye. The presumed mechanism involves reflux of blood into Schlemm's canal, with secondary ingress into the artificial plane created by partial DM-PDL separation, possibly triggered by a Valsalva maneuvre combined with low IOP. This finding underscores the potential anatomical continuity between the PDL and the trabecular meshwork, as previously demonstrated histologically. Recognition of this phenomenon is important to distinguish it from postoperative endothelial hemorrhage or corneal blood staining and to expand our understanding of corneal structural responses in congenital glaucoma. To our knowledge, this is the first reported case demonstrating intra-lamellar bleeding within a pre-existing Haab's striae, documented non-invasively using high-resolution AS-OCT.
PurposeThis study compares the anatomical and functional outcomes of two treatments for acute submacular haemorrhage (SMH): pars plana vitrectomy with subretinal recombinant tissue plasminogen activator (tPA) and gas tam...PurposeThis study compares the anatomical and functional outcomes of two treatments for acute submacular haemorrhage (SMH): pars plana vitrectomy with subretinal recombinant tissue plasminogen activator (tPA) and gas tamponade versus intravitreal tPA and gas injection.MethodsA retrospective single-centre study was conducted of patients treated for acute SMH at Buckinghamshire Healthcare NHS Trust between January 2016 and December 2022. Patients received either intravitreal tPA and gas ± anti-VEGF (Group A) or pars plana vitrectomy with subretinal tPA and gas tamponade ± anti-VEGF (Group B). The primary outcome was anatomical success, defined as displacement of haemorrhage from the fovea. Secondary outcomes were visual acuity (VA) improvement, central foveal thickness (CFT) reduction, and complication rates.ResultsEighty eyes from 73 patients (mean age: 79.8 ± 11.5 years; 57.5% female) were analysed, with 53 eyes in Group A and 27 in Group B. Anatomical success was achieved in 71.6% of Group A and 77.8% of Group B. VA improved in 66% of Group A and 63% of Group B. CFT decreased by over 50% in both groups. No statistically significant differences were found between the two treatment groups and in anatomical or functional improvement.ConclusionIn this real-world study, both approaches effectively displaced SMH and improved vision with comparable outcomes, suggesting that treatment selection may be best determined by patient-specific and logistical factors.
ObjectiveTo evaluate the efficacy and short-term safety of botulinum toxin type A (BTX-A) injection into the inferior oblique muscle for treating inferior oblique overaction (IOOA) in a pediatric cohort.MethodsWe conduct...ObjectiveTo evaluate the efficacy and short-term safety of botulinum toxin type A (BTX-A) injection into the inferior oblique muscle for treating inferior oblique overaction (IOOA) in a pediatric cohort.MethodsWe conducted a retrospective cohort study at King Khaled Eye Specialist Hospital & Research Center, Riyadh, Saudi Arabia, including children aged 2-15 years with IOOA treated with BTX-A injections between June 2022 and September 2024. Data on demographics, baseline IOOA grade, associated strabismus, and postoperative complications were collected. All included eyes had a baseline IOOA grade of 2+ to 4+ and underwent a 5.00 units injection of BTX-A (Botox, Allergan Inc., Irvine, California, USA) to the inferior oblique muscle in a trans-conjunctival technique. The primary outcome was IOOA resolution, defined as postoperative IOOA grade of 0 or +1 at three months following the injection.ResultsTwenty-three patients (42 eyes) were analyzed. Median age was 6 years (IQR: 5-8), with 56% were female. Bilateral IOOA was present in 83% of included patients, esotropia in 91%, and exotropia in 9%. Three months after injection, 54% of eyes achieved complete or near complete IOOA resolution, and 76% improved by at least one grade. Exotropia decreased from 36% at two weeks to 5% at three months ( < 0.001), while ptosis declined from 29% to 2% ( < 0.001).ConclusionsBTX-A injection into the IO muscle is effective and safe for primary IOOA, with significant short-term improvement and minimal transient complications. The long-term sustainability of the IOOA improvement post BTX-A injection is unknown.
PurposeTo evaluate the impact of oxidative stress and the antioxidant defense system in the pathogenesis of proliferative vitreoretinopathy (PVR).MethodsIn this prospective study, three groups of patients undergoing pars...PurposeTo evaluate the impact of oxidative stress and the antioxidant defense system in the pathogenesis of proliferative vitreoretinopathy (PVR).MethodsIn this prospective study, three groups of patients undergoing pars plana vitrectomy (PPV) were included: Group 1 included patients with rhegmatogenous retinal detachment (RRD) complicated by grade C PVR; Group 2 included patients with RRD without PVR; and Group 3 (control group) consisted of patients undergoing PPV for macular hole or vitreomacular traction. At the initiation of PPV, approximately 0.2 ml of a vitreous sample was obtained. Samples were analyzed for total oxidant status (TOS, µmol HO equivalent/L), total antioxidant status (TAS, mmol Trolox equivalent/L), and oxidative stress index (OSI, TOS/TAS).ResultsA total of 60 eyes from 60 patients were included (n = 20 per group). The mean TAS levels were 1.23 ± 0.62 in Group 1, 1.41 ± 0.64 in Group 2, and 1.84 ± 0.52 in Group 3 (p = 0.008). The mean TOS levels were 18.62 ± 8.56, 14.32 ± 6.57, and 10.42 ± 5.82 in Groups 1, 2, and 3, respectively (p = 0.005). There was a statistically significant difference in OSI values between the groups (Group 1: 24.4 ± 31.51; Group 2: 13.31 ± 13.79; Group 3: 6.88 ± 6.26) (p = 0.001).ConclusionElevated TOS and OSI levels, along with reduced TAS levels in the vitreous samples of patients with PVR, suggest that oxidative stress and impaired antioxidant defense may play a critical role in the pathogenesis of PVR.
PurposeMelkersson-Rosenthal Syndrome is a rare neuro-mucocutaneous disease characterised by recurrent orofacial swelling, facial palsy and lingua plicata. Patients often do not present with the complete triad of symptoms...PurposeMelkersson-Rosenthal Syndrome is a rare neuro-mucocutaneous disease characterised by recurrent orofacial swelling, facial palsy and lingua plicata. Patients often do not present with the complete triad of symptoms which can make this a diagnostic challenge. We present three cases of suspected MRS seen in our tertiary eye unit, highlighting the challenges in diagnosis and management of MRS.Case descriptionsCase 1 is a 54-year-old female with a background of neuro-sarcoidosis who presented with a several year history of bilateral upper lid swelling and recurrent facial nerve palsy. She experienced complete resolution of symptoms after a period of observation.Case 2 is a 49-year-old female who had a one-year history of recurrent facial nerve palsy associated with facial, neck and lip swelling. She was treated with oral steroids but did not experience complete remission.Case 3 is a 74-year-old female who presented with an 18-month history of bilateral peri-orbital swelling. Biopsy of skin and orbicularis showed granulomatous inflammation. She was treated with oral non-steroid anti-inflammatories as well as topical and oral steroids but without complete resolution.ConclusionMRS is a rare but important differential in patients with recurrent peri-orbital swelling. Given the recurrent nature of MRS and its associations with severe systemic diseases, early recognition and a multi-disciplinary approach is essential to diagnosis and management.
PurposeTo describe the demographic profile and clinical features associated with upper eyelid (UL) hyperlaxity in the Indian subcontinent.MethodsRetrospective chart review of 100 consecutive patients with UL hyperlaxity,...PurposeTo describe the demographic profile and clinical features associated with upper eyelid (UL) hyperlaxity in the Indian subcontinent.MethodsRetrospective chart review of 100 consecutive patients with UL hyperlaxity, presenting at a tertiary eye centre in India, between January 2016 to February 2022. The data collected included the demographics, clinical features including the ophthalmic and systemic manifestations, and management outcomes.ResultsThe average age at presentation was 42.71 (±18.73) years. Majority were males (83%). Syndromic associations included Down's syndrome (2%) and Ehler-Danlos syndrome (1%). Of the 45 investigated, obstructive sleep apnea was diagnosed in 24% cases. Adnexal manifestations included concurrent lower eyelid laxity (70%), blepharoptosis (41%) of which 38% were aponeurotic, lower eyelid retraction (37%), chalazia (25%) of which 58% were either recurrent, multiple, or both, lacrimal gland (LG) prolapse (11%), lash ptosis (11%), lower eyelid ectropion (8%), entropion (5%), and recurrent dacryoadenitis (3%). Chronic papillary conjunctivitis (66%) was the most common ocular surface abnormality followed by meibomian gland dysfunction (31%). Seven cases (7%) had eyelid imbrication syndrome (EIS), of which 60% had retinopathy of prematurity. Surgical management was recommended in 25% cases, indications being ptosis (13%), generalized eyelid laxity (11%), and recurrent globe luxation (2%).ConclusionUL hyperlaxity can be associated with a myriad of ophthalmic manifestations. One should look for novel findings such as EIS, dacryoadenitis, LG prolapse, and lower eyelid retraction in these cases.
PurposeTo present the first case of multifocal vitelliform paravascular retinopathy (MVPR) identified in Turkey and to describe its multimodal imaging features and clinical course.MethodsA 59-year-old woman underwent a r...PurposeTo present the first case of multifocal vitelliform paravascular retinopathy (MVPR) identified in Turkey and to describe its multimodal imaging features and clinical course.MethodsA 59-year-old woman underwent a routine ophthalmic examination during evaluation for a chalazion. Comprehensive multimodal imaging, including fundus photography, fundus autofluorescence (FAF), optical coherence tomography (OCT), and fluorescein angiography (FA), was performed.ResultsBest-corrected visual acuity was 20/20 in both eyes. Fundus examination revealed multiple, small, round, yellow-white lesions distributed along the vascular arcades and surrounding the macula bilaterally. FAF showed predominantly hypoautofluorescent lesions with areas of mixed hypo- and hyperautofluorescence. OCT sections through the lesions demonstrated disruption of the ellipsoid zone and dome-shaped hyporeflective cavities in the outer retina, while FA revealed hyperfluorescent lesions ( Figure 1). The patient had a history of diabetes and hypertension but no other systemic or ocular disease. Laboratory and systemic imaging findings were unremarkable. Full-field ERG and EOG were within normal limits.ConclusionThis case represents the first reported instance of MVPR in Turkey. The imaging features and benign, asymptomatic clinical course were consistent with those of previously reported MVPR cases. Further studies are required to clarify the underlying pathophysiology and long-term prognosis of this newly described condition.
PurposeFamilial exudative vitreoretinopathy (FEVR) is a rare genetic disorder characterized by incomplete retinal vascular development, leading to ischemia, aberrant neovascularization (NV), and retinal detachment (RD)....PurposeFamilial exudative vitreoretinopathy (FEVR) is a rare genetic disorder characterized by incomplete retinal vascular development, leading to ischemia, aberrant neovascularization (NV), and retinal detachment (RD). This report describes a case of RD with concurrent NV and FEVR, successfully managed with encircling scleral buckling (SB) surgery without additional peripheral laser ablation.Case DescriptionA 16-year-old female with high myopia presented with a four-day history of decreased vision in her right eye (RE). Fundus examination revealed subtotal RD involving the inferior and superonasal quadrants, multiple foci of NV in the inferior quadrant, peripheral avascular retina, and a thick subretinal gliotic band. The left eye (LE) displayed an attached retina with similar peripheral avascularity. Fluorescein angiography confirmed extensive peripheral avascularity and leaking neovascular fronds in the RE, consistent with FEVR. The patient underwent SB surgery in the RE using an encircling band without subretinal fluid drainage or transscleral cryotherapy. Over six weeks, serial examinations demonstrated progressive resolution of subretinal fluid, complete retinal reattachment, and regression of NV in the RE without additional laser treatment.ConclusionEarly retinal reattachment with SB alone may be sufficient to achieve both anatomical reattachment and regression of NV in selected cases of FEVR-related tractional or rhegmatogenous RD, potentially reducing the need for adjunctive ablative therapy.
PurposeThe management of retinal artery occlusion (RAO) remains controversial and lacks standardized guidelines. We report a case of branch retinal artery occlusion (BRAO) treated with pars plana vitrectomy (PPV) and mec...PurposeThe management of retinal artery occlusion (RAO) remains controversial and lacks standardized guidelines. We report a case of branch retinal artery occlusion (BRAO) treated with pars plana vitrectomy (PPV) and mechanical embolus displacement 22 h after onset, along with a focused practical review of current surgical strategies.MethodsA 50-year-old man with type 2 diabetes and hypertension presented with sudden visual loss and an inferior field defect in the left eye. After unsuccessful digital massage, IOP-lowering therapy, and anterior chamber paracentesis, a 25-G three-port PPV was performed 22 h after symptom onset. Posterior vitreous detachment was induced; intraoperative IOP was set at 8 mmHg; a diamond-dusted membrane scraper was used to gently displace and fragment the embolus distally. A PubMed search for qualitative synthesis identified 20 studies (61 eyes).ResultsRetinal perfusion was restored intraoperatively. Best-corrected visual acuity improved from counting fingers to 6/9 at 1 week and 6/6 at 1 month, remaining stable at 6 months. OCT showed resolution of inner retinal edema; fluorescein angiography confirmed complete reperfusion without recurrence. Literature analysis compared surgical approaches regarding PPV technique, invasiveness, timing, and visual outcomes versus non-invasive strategies.ConclusionsPPV with minimally invasive embolus manipulation may restore retinal perfusion and achieve meaningful visual recovery beyond the conventional 4-6-h therapeutic window. This case in association with the reviewed literature suggest that in selected patients, vitrectomy, controlled IOP and targeted instrumentation is a viable and relatively safe option. Prospective trials are needed to define optimal timing, techniques, and patient selection.
IntroductionAngioid streaks is a rare retinal condition with pathological fissures in Bruch's membrane due to an abnormal and calcified Bruch's membrane. The condition can occur idiopathic or in association to other cond...IntroductionAngioid streaks is a rare retinal condition with pathological fissures in Bruch's membrane due to an abnormal and calcified Bruch's membrane. The condition can occur idiopathic or in association to other conditions. Development of macular neovascularization (MNV) in these angioid streaks, and MNV-related exudation, development of atrophy or in rare cases traumatic rupture can lead to visual symptoms.Case descriptionThis report describes a case of angioid streaks which was diagnosed after a blunt trauma that lead to visual symptoms and further examination revealed MNV with traumatic rupture. Anti-vascular endothelial growth factor treatment using faricimab was commenced with three injections at four weeks intervals. Family history raised suspicion of a systemic disease, and genetic work-up led to a diagnosis of pseudoxanthoma elasticum. The MNV treated with faricimab led to excellent visual results and no exudative recurrence during a follow-up period of 8 months after the last injection.ConclusionThis case report presents a clinical approach for managing MNV with traumatic rupture secondary to angioid streaks and is also the first case to present results of faricimab use for these lesions.
PurposePre-retinal cysts are rare and poorly characterized clinical entities. Unlike intraretinal cysts commonly associated with macular diseases, pre-retinal cysts have distinct etiologies and require specific diagnosti...PurposePre-retinal cysts are rare and poorly characterized clinical entities. Unlike intraretinal cysts commonly associated with macular diseases, pre-retinal cysts have distinct etiologies and require specific diagnostic and therapeutic strategies. Proper differentiation and comprehension of glial retinal homeostasis are key to appropriate management.Case presentationWe report the case of a 65-year-old man with a history of post-traumatic retinal detachment treated surgically, and a subluxated intraocular lens (IOL) replaced with an iris-clipped lens for UGH syndrome. The patient experienced multiple episodes of spontaneously resolving vitreous hemorrhage. Inter-episode fundus examination revealed three large pre-retinal cysts in the superotemporal quadrant, located along the edges of the reattached retina, associated with intermittent intracystic hemorrhages. Management involved surgical excision, coagulation, and en bloc excision of the cysts. Pathologic examination of the cyst showed a glial proliferation, with a pilocytic astrocytic morphology, consistent with a benign proliferation.DiscussionAfter an in-depth etiological and pathological investigation, tumoral, infectious, and congenital causes were ruled out. This case represents a unique manifestation of multiple pre-retinal cystic astrocytic glial proliferations, complicated by recurrent intra-cystic and vitreous hemorrhages, successfully managed with surgical en-bloc excision.
PurposeWet lab training on animal eye and surgical simulators are being utilized to enhance surgical outcomes and reduce complications. The study aimed to determine the effectiveness of structured surgical simulator trai...PurposeWet lab training on animal eye and surgical simulators are being utilized to enhance surgical outcomes and reduce complications. The study aimed to determine the effectiveness of structured surgical simulator training in improving the phacoemulsification surgery skills of ophthalmology residents.MethodsA retrospective study of the resident cataract surgical program from November 2019 to November 2022. The residents during our study period were categorized into two groups: Group A, representing the period without mandatory wet-lab/simulator training, and Group B, representing the period following the introduction of mandatory wet-lab/ simulator training before supervised surgeries in the operating room. Preoperative, intraoperative, and postoperative surgical data was collected and analyzed. The performance of resident cataract surgery in the two groups was compared. Outcome measures were the incidence of complications and mentor takeover rate.ResultsA total of 227 eyes were included in the study, 126 in group A and 101 in group B. Posterior capsule rupture was seen in 11 patients (8.73%) in Group A and 8 patients (5.94%) in Group B ( = 0.82) with a significantly lower need for surgeon takeover (26 cases (18.6%) in Group A and 9 cases (10.8%) in Group B ( = 0.015). Overall intraoperative and postoperative complication rates were lower in Group B ( = 0.18).ConclusionThese findings emphasize that integrating wet lab/simulator-based training into residency programs increases surgical independence of residents.