Patients with large iris defects not only suffer from functional disadvantages but also from aesthetic limitations. The aim of this study was to evaluate the aesthetic outcome of iris reconstruction using an artificial iris (AI). In this study, 82 eyes of 79 consecutive patients with mostly traumatic partial or total aniridia that underwent iris reconstruction surgery using a custom-made silicone AI (HumanOptics). Pre- and postoperative photographs of 66 patients were analyzed subjectively and objectively. Subjective evaluation was based on questionnaires. Objective evaluation included measurement of pupil centration and iris color analysis. Averaged hues from iris areas were transferred to numerical values using the LAB-colour-system. Single parameters and overall difference value (ΔE) were compared between AI and remaining iris (RI), as well as AI and fellow eye iris (FI).

Patients, eye doctors and laymen rated the overall aesthetic outcome with 8.9 ±1.4, 7.7 ±1.1 and 7.3 ±1.1 out of 10 points, respectively. Mean AI decentration was 0.35 ±0.24 mm. Better pupil centration correlated with a higher overall score for aesthetic outcome. The AI was on average 4.65 ±10 points brighter than RI and FI.

Researchers reported that aniridia treatment using a custom-made artificial iris prosthesis offered a good aesthetic outcome. Pupil centration was a key factor that correlated with the amount of aesthetic satisfaction. The AI was on average slightly brighter than the RI and FI.

The simultaneous maturation of multiple digital and telecommunications technologies in 2020 has created an unprecedented opportunity for ophthalmology to adapt to new models of care using telehealth supported by digital innovations. These digital innovations include artificial intelligence (AI), fifth-generation (5G) telecommunication networks and the Internet of Things (IoT), creating an interdependent ecosystem offering opportunities to develop new models of eye care to address the challenges of COVID-19 and beyond. Ophthalmology has thrived in some of these areas partly due to its many image-based investigations. Telehealth and AI provide synchronous solutions to challenges facing ophthalmologists and healthcare providers worldwide. This article reviewed how countries across the world have utilized these digital innovations to tackle diabetic retinopathy, retinopathy of prematurity, age-related macular degeneration, glaucoma, refractive error correction, cataract and other anterior segment disorders. The review summarized the digital strategies that countries are developing and discussed technologies that may increasingly enter the clinical workflow of ophthalmologists. Furthermore, as countries around the world have initiated a series of escalating containment and mitigation measures during the COVID-19 pandemic, the delivery of eye care services globally has been significantly impacted. As ophthalmic services adapt and form a "new normal," the rapid adoption of some of telehealth and digital innovation during the pandemic was also discussed. Finally, challenges for validation and clinical implementation were considered, as well as recommendations on future directions.

Macular retinal layer thickness asymmetry indices, particularly for the ganglion cell layer, are promising early indicators of glaucomatous damage. Investigators evaluated macular perfusion density asymmetry (MPDA) among normal, preperimetric glaucoma (PPG) and perimetric glaucoma (PG) eyes, and tested the performance of MPDA in differentiating between control and glaucoma eyes with or without visual field (VF) defects.

In this study, 116 eyes (39 normal, 27 PPG and 50 PG eyes) with optical coherence tomography angiography images of the macula were analyzed. No significant difference was found in outer and inner MPDA between the control and PPG groups. However, outer MPDA was significantly higher in the PG group than in the PPG group. Asymmetry of perfusion density and structural parameters were compared, and no significant difference was found between controls and glaucoma patients. Outer MPDA had significantly higher discrimination ability between PPG and PG than did macular ganglion cell layer-inner plexiform layer thickness asymmetry.

In conclusion, investigators found that the discriminant capability of MPDA for discriminating between glaucoma patients with and without VF defects was significantly higher than that of structural asymmetry. They added that MPDA may be helpful in monitoring glaucoma progression in clinical practice.