PurposePressure-Induced Stromal Keratopathy (PISK) is a rare complication of Laser in situ keratomileusis (LASIK), in which rapid diagnosis and management is crucial to avoid potential severe complications. We report the...PurposePressure-Induced Stromal Keratopathy (PISK) is a rare complication of Laser in situ keratomileusis (LASIK), in which rapid diagnosis and management is crucial to avoid potential severe complications. We report the case of a PISK where the interface fluid disappeared immediately after single 30-gauge needle paracentesis.MethodsA 56-year-old man asked for refractive surgery in his left eye (LE). He reported an old blunt trauma that had required cataract surgery many years before. The endothelial cell count was 1241 cells/mm. After a first uneventful femtoLASIK treatment a refractive error persisted, therefore flap lifting retreatment was performed. At the one-week postoperative evaluation, PISK was detected, with an intraocular pressure (IOP, rebound tonometer) of 14 mmHg at the centre of the cornea and 31 mmHg at the peripheral cornea.ResultsWe immediately performed corneal 30-gauge needle paracentesis, which allowed the IOP to lower. Our patient reported rapid subjective vision improvement within the first 30 min and almost complete fluid absorption from the flap interface was noticed after 3 h. A single topical hypotensive drug was then prescribed to avoid any further IOP rise. Three weeks after the procedure the visual acuity was almost fully restored with only a mild residual refractive error.ConclusionThe ocular paracentesis was effective in treating PISK in this case. It could be considered to achieve a rapid IOP lowering in PISK, followed by topical hypotensive drugs to maintain the result. The rebound tonometer proved to be very effective in obtaining a peripheral IOP measurement in this case.
Combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) has long been regarded as a congenital, full-thickness malformation involving all retinal layers and the RPE. However, advances in multimodal imagi...Combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) has long been regarded as a congenital, full-thickness malformation involving all retinal layers and the RPE. However, advances in multimodal imaging have revealed a subset of non-pigmented, inner-retinal lesions with features distinct from the CHRRPE phenotype described classically. These findings raise questions about whether such lesions share a common pathogenesis or represent earlier or separate entities. The term "combined hamartoma," implying a static congenital malformation, may therefore not fully capture their dynamic behavior and their variable retinal involvement. This editorial calls for taxonomical clarity to better align terminology with current imaging evidence and guide future research and treatments.
PurposeTo present the clinical and multimodal imaging features of three patients diagnosed with stellate multiform amelanotic choroidopathy (SMACH), a recently described, rare chorioretinal entity.MethodsCase series.Resu...PurposeTo present the clinical and multimodal imaging features of three patients diagnosed with stellate multiform amelanotic choroidopathy (SMACH), a recently described, rare chorioretinal entity.MethodsCase series.ResultsAll patients, aged 5, 10, and 38 years, presented with unilateral, yellowish choroidal lesions extending from the fovea toward the temporal macula. Multimodal imaging was used for diagnosis. Structural disorganization of the subfoveal choroid with irregular, undulating hyperreflective alterations of the retinal pigment epithelium/Bruch's membrane complex with focal protrusions was noted in all patients, while subretinal fluid (SRF) was present in two patients at presentation on optical coherence tomography (OCT). No patient had systemic findings. The first and the third cases received intravitreal bevacizumab injections and the SRF persisted with fluctuations in both patients. In the second case, although there was no SRF initially, it occurred with fluctuations during follow-up. Throughout the follow-up periods, visual acuities remained stable in all patients without any additional treatment.ConclusionSMACH should be considered in the differential diagnosis of choroidal structural disorganization, particularly in young patients. Notably, one patient was 5 years old, which represents the youngest age reported to date. Multimodal imaging modalities are essential for the recognition of the disease and a confirmed diagnosis of SMACH may prevent unnecessary treatments such as intravitreal injections and photodynamic therapy.
PurposeThis study aimed to evaluate iris melanin concentration using polarization-sensitive anterior segment optical coherence tomography (PS-AS-OCT) and to explore its correlation with iris color in individuals with bro...PurposeThis study aimed to evaluate iris melanin concentration using polarization-sensitive anterior segment optical coherence tomography (PS-AS-OCT) and to explore its correlation with iris color in individuals with brown irides.MethodsIris cross-sectional images were acquired using PS-AS-OCT. Substructural layers were automatically segmented using a deep learning model. The melanin concentration ratio (MCR) was derived from entropy-based PSAS-OCT images to quantify melanin within the iris layers. Iris surface color was analyzed using CIE L*a*b* values from high-resolution photographs. Correlation analyses were performed between MCR and L*a*b* values. Additionally, a three-grade iris color classification was used, and K-nearest neighbors (KNN) modeling assessed the predictive value of MCR.ResultsEighty-eight participants (mean age: 39 years) were included. MCR of the iris stroma showed a strong negative correlation with iris color: L* ( = 0.72), a* ( = -0.56), and b* ( = -0.68), all < 0.001. Stromal MCR significantly differed among color grades ( < 0.001), and the KNN model achieved 85% classification accuracy.ConclusionsPS-AS-OCT-derived stromal MCR is strongly associated with iris color and offers a noninvasive approach for evaluating iris melanin. This technique may provide new insights into ocular pigmentation.
BackgroundPolyhexamethylene biguanide (PHMB) 0.08% has received the orphan drug designation for management of Acanthamoeba keratitis (AK). This review aimed to evaluate the clinical efficacy and safety of PHMB, comparing...BackgroundPolyhexamethylene biguanide (PHMB) 0.08% has received the orphan drug designation for management of Acanthamoeba keratitis (AK). This review aimed to evaluate the clinical efficacy and safety of PHMB, comparing outcomes across different concentrations (0.08% vs. 0.02%) using a dose-stratified meta-analysis.MethodsOnline databases were searched until February 2025 for studies on PHMB 0.02% or 0.08% as mono- or combination therapy. The primary outcome was clinical cure and secondary outcomes included conjunctival hyperemia and pain. Subgroup analyses were performed based on PHMB concentration. A random-effects model was applied; sensitivity analyses and publication bias assessments were conducted.ResultsThe pooled proportion of cure across 17 studies (923 eyes) was 75.75% (95% CI: 64.56%-84.27%; < 0.0001; I² = 85.2%). Subgroup analysis showed the highest cure rate with PHMB 0.08% monotherapy (87.04%; 95% CI: 77.54%-92.88%), followed by 0.02% monotherapy (79.27%; 95% CI: 65.29%-88.60%) and mixed 0.02% regimens (72.59%; 95% CI: 54.86%-85.23%). Conjunctival hyperemia was reported in 15.7%, and subgroup analysis by dose revealed highest prevalence in the 0.08% PHMB group (26.4%; 95% CI: 8.4%-49.2%). Pain was reported in 11.9% ( = 225), with no significant increase at higher concentrations. The pooled proportion of overall adverse events was 40.2% (95% CI 26.2%-55.0%; < 0.0001; I² = 81.4%). Findings were robust across sensitivity analyses, with no publication bias detected.ConclusionThis dose-stratified meta-analysis found PHMB 0.08% monotherapy to have good efficacy and tolerability, supporting its use as a first-line empirical treatment and underscoring the need for standardized protocols and comparative trials.
PurposeTo evaluate the functional and structural outcomes in patients with neovascular age-related macular degeneration (nAMD) switched from ranibizumab or aflibercept to bevacizumab.MethodsThis retrospective study inclu...PurposeTo evaluate the functional and structural outcomes in patients with neovascular age-related macular degeneration (nAMD) switched from ranibizumab or aflibercept to bevacizumab.MethodsThis retrospective study included 197 eyes of 192 patients (mean age 83 ± 6 years; 38% male). Patients previously treated with ranibizumab (n = 79) or aflibercept (n = 118) were transitioned to bevacizumab. Best-corrected visual acuity (BCVA) was recorded with ETDRS charts and converted to logMAR. Spectralis SD-OCT was used to evaluate intraretinal and subretinal fluid, presence of retinal pigment epithelium detachment (PED), PED height and central retinal thickness (CRT) at baseline and after 6 months.ResultsMean BCVA decreased from 0.4 ± 0.3 to 0.5 ± 0.4 logMAR (p = 0.048). The proportion of eyes with intraretinal or subretinal fluid rose from 27% to 69% (p = 0.017). Subgroup analysis indicated greater functional and structural worsening in younger patients and in those switched from aflibercept. Mean PED height showed a non-significant increase from 163 ± 94 to 166 ± 95 µm (p = 0.091), mean PED height showed a non-significant increase from 163 ± 94 to 166 ± 95 µm (p = 0.091). In contrast, mean CRT increased substantially from 294 ± 30 µm at baseline to 310 ± 26 at 6 months (p (p < 1 × 10).ConclusionsSwitching from ranibizumab or aflibercept to bevacizumab may lead to reduced visual function and an increase in structural-OCT markers of disease activity, including greater intraretinal/subretinal fluid, CRT and worsening PED features, particularly in younger individuals and in eyes previously treated with aflibercept.
BackgroundNormal tension glaucoma (NTG) is a common subtype of glaucoma that progresses silently and can lead to irreversible vision loss if left untreated. Emerging evidence suggests that inflammation and vascular dysfu...BackgroundNormal tension glaucoma (NTG) is a common subtype of glaucoma that progresses silently and can lead to irreversible vision loss if left untreated. Emerging evidence suggests that inflammation and vascular dysfunction may play a role in its pathogenesis. C-reactive protein (CRP), a marker of systemic inflammation and atherosclerosis, has been widely studied as a prognostic indicator in various diseases. However, its potential association with NTG remains unclear. This meta-analysis aims to clarify the relationship between CRP levels in individuals with NTG compared to those without the condition.MethodsWe systematically searched PubMed, Embase, and Scopus for observational studies published up to 31 October 2023 investigating CRP levels in NTG patients and controls. Study quality and risk of bias were evaluated using the Newcastle-Ottawa Scale. Eligible studies reporting CRP levels were analyzed using standardized mean differences (SMDs) and 95% confidence intervals (CIs).ResultsA meta-analysis of ten case-control studies involving 766 patients revealed that CRP levels were significantly higher in the NTG group compared to controls (SMD: 0.731, 95% CI: 0.147-1.316 ; z = 2.454; = 0.014). However, no significant difference in CRP levels was observed between the POAG group and controls (SMD = 0.093; 95% CI: -0.160-0.345; z = 0.719; = 0.472).ConclusionElevated circulating CRP levels were significantly associated with NTG, suggesting a potential systemic inflammatory contribution to its pathogenesis. Although CRP may serve as an adjunctive marker for identifying high-risk individuals, its clinical value remains provisional and requires confirmation in future prospective studies.
ObjectiveTo assess baseline pigment epithelial detachment (PED) and other OCT biomarkers for predicting response to faricimab in treatment-naïve patients with neovascular age-related macular degeneration (nAMD).DesignThi...ObjectiveTo assess baseline pigment epithelial detachment (PED) and other OCT biomarkers for predicting response to faricimab in treatment-naïve patients with neovascular age-related macular degeneration (nAMD).DesignThis was an observational, retrospective, single-arm, monocentric cohort study.Subjects and methodsFifty-seven eyes of 51 patients with naive nAMD-associated PED and treated with faricimab were included in the study. Best-corrected visual acuity (BCVA) and OCT were performed at baseline, monthly until Month 4, and at Months 6, 9, and 12. Fluid volume dynamics and other OCT biomarkers were quantified using an AI-based tool.ResultsAt Month 12, mean BCVA increased by 4 letters ( < 0.01), mean CRT decreased by 66.2 µm ( < 0.0001), and mean maximum PED height decreased by 70.4 µm ( < 0.001). AI-based PED dynamics showed rapid and sustained reductions from 488.2 nL at baseline to 166.6 nL at Month 12 ( < 0.0001), with more profound reductions in serous versus fibrous PED volume. All AI-quantified OCT biomarkers were significantly ( < 0.0001) changed from baseline after the loading phase. OCT biomarkers, PED, and fluid dynamics during the loading phase were correlated with functional and anatomic outcomes at Month 4 and Month 12.ConclusionsFaricimab had a rapid, profound and sustained drying effect on the retinas of eyes with nAMD and PED, with marked reductions in OCT biomarkers after loading and sustained to Month 12. These improvements coincided with significant improvements in BCVA. PED height, type, and volume at baseline correlated with short- and long-term treatment outcomes.
Koetsier LS, Marinkovic M, Bleeker JC
… +4 more, Rasch CR, Vu KT, Luyten GP, van Rijssen TJ
Eur J Ophthalmol
· 2026 Jul · PMID 41406117
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BackgroundTo describe the characteristics and outcomes of endoresection in patients with uveal melanoma previously treated with ruthenium brachytherapy or proton beam therapy.MethodsIn this retrospective study, data on t...BackgroundTo describe the characteristics and outcomes of endoresection in patients with uveal melanoma previously treated with ruthenium brachytherapy or proton beam therapy.MethodsIn this retrospective study, data on the indication to perform endoresection, best-corrected visual acuity, tumor characteristics, surgery details, and characteristics of ruthenium brachytherapy or proton beam therapy were obtained.ResultsA total of 27 patients (12 men and 15 women) were included, with a median age of 63.5 (range 50.5) years. The indication for endoresection was exudative retinal detachment in 20 patients, glaucoma induced by tumor bleeding in 6 patients, and persistent inflammation in 1 patient. Ruthenium brachytherapy was performed in 6 patients, while 21 patients received proton beam therapy. In the ruthenium group, mean visual acuity before endoresection in Snellen was 0.099 ± 0.197, which increased to 0.285 ± 0.302 after endoresection (p = 0.043). In the proton beam group, mean visual acuity before endoresection was 0.030 ± 0.044, which decreased to 0.020 ± 0.036 after endoresection (p = 0.546). Mean change in visual acuity before and after endoresection was +0.186 ± 0.249 in the ruthenium group and -0.009 ± 0.053 in the proton beam group. Enucleation had to be performed in 1 eye in the ruthenium group and 8 eyes in the proton beam group. No surgery-related vascular events were observed.ConclusionsPatients previously treated with ruthenium brachytherapy have favorable post-endoresection outcomes, opposed to those treated with proton beam therapy. Patient-specific counselling is important before endoresection, as there is a wide variety in expected outcomes.
PurposeTo evaluate the alterations in the Schlemm's canal (SC) and trabecular meshwork (TM) morphology after phacoemulsification surgery in pseudoexfoliative glaucoma (PEXG) patients with swept-source optical coherence t...PurposeTo evaluate the alterations in the Schlemm's canal (SC) and trabecular meshwork (TM) morphology after phacoemulsification surgery in pseudoexfoliative glaucoma (PEXG) patients with swept-source optical coherence tomography (OCT).MethodsIn this retrospective comparative study, patients with PEXG and visually healthy individuals with cataract who underwent phacoemulsification and intraocular lens implantation surgery were included. Anterior segment OCT measurements and intraocular pressures (IOPs) were recorded at the first visit before surgery and at postoperative 1-month visits. Manual measurements obtained from OCT were as follows: SC-diameters; anteroposterior and radial SC diameter (SC-APD, SC-RD); cross-sectional area of SC (SC-CSA); and TM height (TM-H) and cross-sectional area of TM (TM-CSA).ResultsSixty-three eyes of 63 subjects were included in the study, with 43 patients having PEXG and 20 patients serving as controls. There was a significant decrease in IOP after surgery in the PEXG eyes ( 0.001). Preoperatively, SC-diameters were significantly lower in PEXG eyes than in the control group ( 0.001). After surgery, SC-diameters had increased significantly in PEXG eyes ( 0.001). At the preoperative visit, TM-CSA and TM-H were higher in PEXG eyes than in the control group, but only TM-H showed a statistically significant difference ( 199 and 0.015, respectively). There was a significant reduction in TM-CSA and TM-H in PEXG eyes after surgery ( 0.001 and 0.024, respectively).ConclusionThe study showed that both SC dimensions and area increased and TM-H and TM-CSA decreased after phacoemulsification surgery in PEXG eyes. There was a significant correlation between these changes and postoperative IOP in PEXG eyes.
Ancona C, Marini MG, Minetti F
… +10 more, Csidey M, Maka E, Stachon T, Fries FN, Poli B, Kildsgaard I, Bremond-Gignac D, Szentmáry N, Lagali N, Romano V
Eur J Ophthalmol
· 2026 May · PMID 41400928
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PurposeTo explore the emotional and social burden of congenital aniridia in patients and caregivers through narrative medicine.MethodsPatients with congenital aniridia and their caregivers were enrolled in a multicentric...PurposeTo explore the emotional and social burden of congenital aniridia in patients and caregivers through narrative medicine.MethodsPatients with congenital aniridia and their caregivers were enrolled in a multicentric observational study. Sociodemographic data and personal narratives were collected through interviews or written accounts. A qualitative analysis was conducted and overarching themes identified.ResultsA total of 57 narratives were collected (31 patients, 27 caregivers). Participants reported visiting an average of 5.1 ± 5.9 healthcare facilities over their lifetime. Aniridia impacted work or school life in 39% of patients and 58% of caregivers. Most narratives focused on the lived experience of illness (95% patients, 81% caregivers) or on social perception (48% and 46%), rather than on clinical aspects (10% and 23%). Adaptation to the disease was mainly stable or progressive among adults. Emerging themes included independence, feeling misunderstood, and bullying. Caregivers emphasized the lack of specialized centers, standardized protocols, adequately trained professionals, psychological and practical support, and the lack of humanity among doctors.ConclusionsCongenital aniridia leads to progressive visual impairment with significant emotional and social consequences. Narrative medicine offers valuable insight into patients' and caregivers' lived experiences, highlighting unmet needs and concerns often overlooked in conventional clinical practice.
IntroductionThe aim of this study was to analyze retinal changes using optical coherence tomography angiography (OCTA) in Macular Telangiectasia type-2 (MacTel-2).MethodsThis retrospective study included 65 MacTel-2 pati...IntroductionThe aim of this study was to analyze retinal changes using optical coherence tomography angiography (OCTA) in Macular Telangiectasia type-2 (MacTel-2).MethodsThis retrospective study included 65 MacTel-2 patients (122 eyes) and 65 age- and sex-matched healthy controls (122 eyes). All participants had complete examination notes with fundus autofluorescence, fluorescein angiography, optical coherence tomography, and OCTA. Foveal avascular zone (FAZ) parameters, vascular densities (VDs), and retinal thicknesses (RT) of MacTel-2 patients were compared with healthy eyes.ResultsAcircularity index (AI) and the FAZ perimeter were significantly higher in the MacTel-2 group ( = 0.006 and = 0.04). There was a positive correlation between AI and logMAR ( = 0.287, = 0.001). VDs in the foveal and perifoveal temporal quadrants of the superficial capillary plexus were lower in the MacTel-2 group ( < 0.001 and = 0.021). VDs in the foveal and all parafoveal regions of the deep capillary plexus (DCP) were also decreased compared with the control group ( < 0.05 for all). Additionally, the mean RT in the fovea and all parafoveal regions was significantly lower in MacTel-2 patients compared to controls ( < 0.001 for all).ConclusionVascular density changes in MacTel-2 is seen more frequently in the DCP. Additionally, acircularity index showed a steady worsening with disease progression, suggesting its potential use as a marker.
PurposeThis study evaluated and compared changes in pachymetry measurements at different times after applying riboflavin 0.25%, lissamine green 0.5%, fluorescein 2%, and fluorescein 0.25% - lidocaine HCl 4% eye drops.Met...PurposeThis study evaluated and compared changes in pachymetry measurements at different times after applying riboflavin 0.25%, lissamine green 0.5%, fluorescein 2%, and fluorescein 0.25% - lidocaine HCl 4% eye drops.MethodsCorneal pachymetry was assessed in thirty healthy volunteers (60 eyes) using a Galilei G6 Dual Scheimpflug topographer. Baseline measurements were taken with and without saline. Thickness was measured at 1, 5, and 15 min after dye application.ResultsSignificant increases ( < 0.001) in Central Corneal Thickness (CCT) were observed following riboflavin instillation (N = 60, at 1 min: 17 ± 7.1 µm; at 5 min: 7.1 ± 6.9 µm), fluorescein 0.25% (N = 59, at 1 min: 14.8 ± 14.1 µm; at 5 min: 9.4 ± 7.4 µm; at 15 min: 5.2 ± 6.7 µm), and fluorescein 2% (N = 10, at 1 min: 20 ± 5.7 µm; at 5 min: 18.8 ± 7 µm; at 15 min: 11.2 ± 8.4 µm). There was a high number of artifacts in the measurements with 2% fluorescein (48 eyes), and only three patients showed no artifacts. Lissamine green (N = 58) did not significantly affect pachymetry measurements.ConclusionsRiboflavin 0.25% and fluorescein 0.25% temporarily overestimated pachymetry. Fluorescein 2% caused excessive artifacts, compromising reliability. Lissamine green 0.5% showed no influence in pachymetry. Characteristics from vital dyes should be considered according to programmed examinations when using a Dual Scheimpflug topographer.
PurposeThis study aimed to develop a reproducible manual segmentation method using a computer-assisted technique and to (1) compare extraocular muscle volumes between TED patients and healthy controls and (2) assess the...PurposeThis study aimed to develop a reproducible manual segmentation method using a computer-assisted technique and to (1) compare extraocular muscle volumes between TED patients and healthy controls and (2) assess the intra- and inter-observer reliability of this method.MethodsA retrospective study of MRI scans was performed on 13 patients previously diagnosed with TED and 16 healthy controls. Image segmentation and the derived muscle volume measurements were performed by two independent observers using the software 3D slicer. The groups compared muscle volumes, and intra- and inter-observer reproducibility was assessed.ResultsA statistically significant difference in muscle volume was demonstrated; the mean medial and lateral recti volumes in the TED group were 1342.75 and 1066.7 mm, respectively, compared to 787.67 and 764.3 mm in the control group. The segmentation protocol appears to have good inter-observer reliability. The intraclass correlation coefficient was good for inter-observer measures of the medial recti and intra-observer measures of both horizontal recti.ConclusionThis volumetric analysis verifies that structural MRI contains useful information regarding muscle volume in patients with TED compared to healthy controls. Building a dataset of segmented MRI volumes will help facilitate the creation of supervised machine-learning models for automated volumetric analysis of the extraocular muscles.
PurposeThe aim of this research was to investigate the contribution of histatin peptides in the pathophysiology of keratoconus.MethodsThis prospective study investigated the presence of histatin peptides in corneal epith...PurposeThe aim of this research was to investigate the contribution of histatin peptides in the pathophysiology of keratoconus.MethodsThis prospective study investigated the presence of histatin peptides in corneal epithelial samples taken from 66 adult patients with keratoconus (stage 1, n = 22; stage 2, n = 21; and stage 3, n = 23) and 20 postmortem controls. The histatin-1, -3, and -5 levels were measured using the ELISA method.ResultsHistatin-3 significantly increased in stage 1 (control, 274.05 ± 15.72 ng/mg total protein, vs. patients, 528.17 ± 47.45 ng/mg total protein, p < 0.001) and stage 2 (374.33 ± 15.05 ng/mg total protein, p < 0.05), but no changes for histatin-1 and -5 levels were observed. Histopathological analysis showed that corneal epithelial cell thickness increased in keratoconus, and this increase augmented proportionally with the stages. The histopathological scores were significantly elevated in stages 2 and 3. Interestingly, positive correlations were observed between histatin-1 and histatin-3 levels in all stages.ConclusionThese preliminary data suggest that histatin-3 may be involved in the early stages of keratoconus. These findings are preliminary and should be confirmed in larger, prospective cohorts.
PurposeTo evaluate the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) combined with complete vitreous chamber fluid-air exchange via pars plana in vitrectomized patients with unstable compartme...PurposeTo evaluate the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) combined with complete vitreous chamber fluid-air exchange via pars plana in vitrectomized patients with unstable compartmentalization between the anterior and posterior segment.MethodsThis case series presents a modified (full-filling) DSAEK technique, involving complete fluid-air exchange via pars plana, in six eyes with endothelial dysfunction and corneal edema who had undergone prior vitrectomy and lacked stable anterior-posterior segment compartmentalization (aphakic, iris-claw IOL, scleral fixed IOL, IOL in the ciliary sulcus). Preoperative and postoperative data, including visual acuity, corneal thickness, and endothelial cell density, were collected. The primary outcome was single-surgery graft adhesion; secondary outcomes included complications, re-bubbling rate, and visual acuity improvement.ResultsThe full-filling DSAEK technique achieved complete graft adhesion in all cases at all follow-up visits, with improved visual acuity and decreased corneal thickness. No major complications were recorded, including donor graft dislocation and need of rebubbling.ConclusionWhen performing DSAEK, completely filling the ocular cavity with air via pars plana is a safe and effective technique in poorly compartmentalized vitrectomized eyes to achieve graft adhesion and improving surgical success.