Optimal centration of an intraocular lens (IOL) is important for obtaining its intended visual properties. The bag-in-the-lens (BIL) approach is a surgical technique that optimizes centration by centring the lens using both an anterior and a posterior capsulorhexis. The BIL is a monofocal hydrophilic IOL with a biconvex optic and two elliptical plane haptics. The space between the haptics creates an equatorial groove. The IOL is then suspended by placing both anterior and posterior capsular bag rhexis openings into this equatorial IOL groove. As a result, the BIL IOL captures residual lens epithelial cells and therefore additionally seals its position avoiding opacification of the visual axis. In this review, we offer an overview of current literature on the BIL technique.

This report presents a case of unilateral retinitis pigmentosa (URP) with associated symptoms and microphthalmia in the right eye of a young female patient. A 23-year-old with a previous diagnosis of URP and a constricted visual field in one eye was examined. Slit lamp examination of the right eye revealed a moderate posterior subcapsular and mild nuclear sclerotic cataract, with a clear lens in the left eye. Funduscopic examination of the right eye showed diffuse retinal pigmentary epithelium atrophy with peripheral bone spicule pigmentation, cystoid macular edema, and glial clusters protruding from the optic nerve. Left eye fundoscopy revealed unremarkable retinal findings. Fundus autofluorescence, optical coherence tomography, Humphrey visual field, and full-field electroretinogram testing indicated compatible results with our funduscopic findings of URP. Axial length (AL) measurements and anterior chamber angle assessment by gonioscopy suggested microphthalmia of the right globe. The left eye was shorter than average but within normal limits. Salivary genetic testing revealed genetically sensitized retinae carrying heterozygous variants in the INPP5E, FSCN2, RP1L1, and WFS1 genes. The patient is a carrier of a pathogenic variant of INPP5E, while the significance of the other identified variants is uncertain. This case report showcases the unique presentation of URP, glial tissue abnormality, and microphthalmia, suggesting a potentially shared genetic link between retinal pigmentary degeneration and malformation of other ocular structures. Further study is required to understand any shared genetic and/or proteomic etiology. These discoveries may aid in possible future treatment modalities for retinal cilioretinopathy disease and related disorders.

Background and objective Laser-based procedures such as yttrium aluminum garnet (YAG) capsulotomy, peripheral iridotomy (PI), and selective laser trabeculoplasty (SLT) are core competencies in ophthalmology, often involving a significant learning curve. This study assessed the impact of a structured simulation training program in improving ophthalmology residents' confidence in performing YAG capsulotomy, PI, and SLT in the United Kingdom (UK). Methods A prospective study was conducted involving 40 UK ophthalmology residents in their first two years of training, none of whom had prior laser experience. Residents undertook a blended learning program, composed of e-learning modules, instructional videos, and a hands-on workshop using SimulEYE[®] model eyes (insEYEt, LLC, Westlake Village, CA, USA) under the supervision of a consultant. Confidence was assessed before and after training using a 10-point Likert scale. Descriptive statistics and paired Student's t-tests were used to compare pre- and post-training scores. Results Thirty-nine residents completed both pre- and post-training surveys. Following the intervention, resident confidence significantly increased across all three procedures (p < 0.0001). For YAG capsulotomy, the mean confidence score increased from 4.41 to 6.74. Confidence in performing PI rose from 2.82 to 8.21, while confidence in SLT improved from 2.41 to 7.28. Conclusions A structured simulation-based training program was associated with marked improvements in resident confidence across all three laser procedures, particularly for PI and SLT. The blended approach, integrating pre-course theoretical preparation with supervised hands-on simulation, offers an effective and reproducible model for early procedural training. Future studies should evaluate whether these gains are sustained over time and translate into improved clinical performance and patient outcomes.

Diabetic macular edema (DME) is the leading cause of vision loss in patients with diabetes. Conventional therapies like intravitreal injections (IVI) of anti-vascular endothelial growth factor (VEGF) agents and corticosteroids are often limited by the frequent injections and risks of complications. Suprachoroidal space (SCS) injection has emerged as a novel drug delivery technique. It targets eye precisely, resulting in high drug concentration in the posterior segment while reducing exposure to anterior segment tissues-thereby potentially lowering risks of both cataract formation and elevated intraocular pressure. Clinical data shows that SCS injection of triamcinolone acetonide (TA) can significantly improve vision, reduce both macular edema and treatment frequency in DME patients. In this review, we mainly aim to introduce the advantages and clinical evidence of SCS injection, and emphasize its potential role in optimizing DME management strategy.

To report a case of long-standing occupational ocular argyrosis with histopathological confirmation during cataract surgery. A 57-year-old male silver worker with a 16-year history of ocular argyrosis and progressive visual deterioration underwent comprehensive ophthalmological examination and phacoemulsification with intraocular lens implantation. The anterior lens capsule obtained during capsulorhexis was submitted for histopathological examination. Clinical examination revealed bilateral diffuse corneal deposits, periocular pigmentation, and characteristic findings consistent with chronic silver deposition patterns. The right eye demonstrated a mature cataract with complete cortical opacity. Phacoemulsification was performed successfully without complications. Histopathological analysis confirmed characteristic silver deposits within the capsular matrix, providing a definitive diagnosis of ocular argyrosis. Postoperative visual acuity improved from hand motion to 0.9. This case demonstrates successful cataract surgery outcomes in a patient with long-standing occupational ocular argyrosis. Histopathological examination of surgical specimens provides invaluable diagnostic confirmation and demonstrates the systemic nature of silver deposition. The case emphasizes the importance of long-term monitoring in patients with occupational silver exposure and confirms that cataract surgery can be performed safely with excellent visual outcomes in patients with concurrent ocular argyrosis.