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004, P = 0.003). The mean reflux flow of both beveled-tip cutters was significantly faster than that of the flat-tip cutters (P = 0.006, P = 0.006). CONCLUSION The beveled-tip cutters have a greater velocity of aspirating frontal and proximal flow resulting in higher aspiration rates and greater reflux flow velocity.PURPOSE To report a series of 21 patients with perifoveal exudative vascular anomalous complex (PEVAC) and to investigate the anatomical changes over time. METHODS We conducted a retrospective study. Clinical data of consecutive patients, presenting at the Rotterdam Eye Hospital between 2014 and 2019, were analyzed. The data collected included best-corrected visual acuity, fundus photography, optical coherence tomography (OCT), OCT-angiography, fluorescence angiography, and indocyanine green angiography. RESULTS We included 21 patients with a PEVAC lesion with a mean follow-up of 24.3 ± 13.8 months (range, 9-46 months). Patients with PEVAC were on average 75.3 ± 11.1 years (range, 53-90 years). The large perifoveal vascular aneurysmal abnormality was associated with small retinal hemorrhages in six patients and hard exudates in three patients. The PEVAC lesion was associated with intraretinal cystic spaces on OCT in 15 patients. Twelve of 21 patients showed no changes in cystic spaces on OCT during follow-up 9 patients had stable cystic spaces and 3 patients had no cystic spaces. In contrast, in 9 of 21 patients, we observed changes in cystic spaces on OCT during follow-up. In two patients, cystic spaces appeared during follow-up, and in seven patients, there was a spontaneous resolution of cystic spaces. In three of these seven patients, the PEVAC lesion completely disappeared. Two patients, with stable intraretinal cystic spaces on OCT, were treated with intravitreal injections of anti-vascular endothelial growth factor without improvement. CONCLUSION Perifoveal exudative vascular anomalous complex is an idiopathic perifoveal retinal vascular abnormality that is associated with intraretinal cystic spaces. These intraretinal cystic spaces associated with a PEVAC lesion, and even the PEVAC lesion itself, can have a spontaneous resolution over time.PURPOSE To report a case of acute zonal occult outer retinopathy in which adaptive optics (AO) facilitated visualization of abnormal photoreceptors previously thought to be in an area of normal retina on conventional optical coherence tomography (OCT). METHODS Case report. RESULTS A 51-year-old woman presents with 11-month history of photopsias and scotoma in the temporal visual field of her left eye. Ocular imaging including fluorescein angiography, fundus autofluorescence and OCT suggested the diagnosis of acute zonal occult outer retinopathy in the left eye. Adaptive optics optical coherence tomography (AO-OCT) revealed photoreceptor abnormalities not previously identified in conventional OCT, in areas apparently normal on multimodal imaging. LEE011 in vitro On enface and cross-sectional AO-OCT, round and evenly spaced hyperreflectivity corresponding to normal cone mosaic (Pattern 1) was adjacent to unevenly and disrupted cone hyperreflectivity (Pattern 2) and areas with hyporeflectivity or no cone reflectivity (Pattern 3). Cross-sectional AO-OCT of Patterns 2 and 3 also revealed attenuation of ellipsoid zone with loss of interdigitation zone. CONCLUSION Adaptive optics OCT documented cone photoreceptors in finer details than conventional OCT and revealed early changes in a patient with acute zonal occult outer retinopathy, in an area of the retina thought to be normal on conventional multimodal imaging. These findings may provide important insight into pathogenesis and progression of the disease.A novel microinvasive glaucoma surgery device, the Beacon Aqueous Microshunt (BAM), drains aqueous humor directly from the anterior chamber to the surface of the eye vs draining to enclosed spaces within the eye, where outflow resistance, including the episcleral venous pressure, might limit drainage effectiveness. The BAM has a 0.030 mm by 0.048 mm channel and provides a fixed resistance. For implantation, a 1.4 mm wide transcorneal incision into the anterior chamber was created with a posterolimbal outer placement under topical anesthesia. The surgery was easy to execute and had a flat learning curve. Preliminary and early experience have shown success with lowering intraocular pressure immediately after surgery. In conclusion, the BAM offers a promising minimally invasive surgical procedure.PURPOSE To assess the visual outcomes of small-incision lenticule extraction (SMILE) after the first year of treatments at a military refractive surgery center and compare with photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) outcomes during the same period. SETTING Warfighter Refractive Eye Surgery Program and Research Center, Fort Belvoir, Virginia, USA. DESIGN Retrospective study. METHODS Records of service members who underwent either SMILE, PRK, or LASIK for myopia from March 2017 to February 2018 were reviewed. Preoperative and up to 6-month postoperative data were collected. Visual outcomes were compared between treatments. RESULTS Of 563 treated eyes, 173 underwent SMILE, 304 PRK and 86 LASIK. In comparing SMILE with PRK 1 month postoperatively, SMILE (145 eyes, 87.9%) attained uncorrected distance visual acuity (UDVA) ≥20/20 more vs PRK (214 eyes, 73.8%; p less then 0.01). Similarly, SMILE (152 eyes, 94.4%) achieved more eyes with manifest spherical equivalent (MSE) within ±0.50 diopters (D) from intended target vs PRK (250 eyes 85.9%; p=0.01). None lost ≥1 line of corrected distance visual acuity in SMILE vs 16 (5.5%) PRK eyes (p less then 0.01). Thereafter, there were no other significant differences except SMILE had 117 eyes (95.1%) vs PRK with 224 eyes (99.6%) achieving UDVA ≥20/20 at 3 months postoperatively (p=0.01). In assessing SMILE vs LASIK, all parameters were comparable, however, 77 SMILE eyes (96.3%) had MSE within ±0.50 D from target vs 31 LASIK eyes (83.8%) at 6 months postoperatively (p=0.02). CONCLUSIONS The first year after SMILE treatments in a U.S. military center demonstrated early postoperative outcomes superior to PRK. SMILE seemed more predictable compared with LASIK.

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