The surgical management of glaucoma is currently undergoing significant advancements, driven by the increasing prevalence of glaucoma and the continuous pursuit of surgical techniques that minimise patient burden. Furthermore, the growing demand for an improved quality of life among patients plays an increasingly critical role in the evolution of treatment modalities and surgical interventions. The objective of minimally invasive glaucoma surgery (MIGS) is to achieve sustained and effective intraocular pressure (IOP) reduction while preserving ocular anatomy and minimising tissue disruption. This can be accomplished at the level of the trabecular meshwork, Schlemm’s canal, or the suprachoroidal space through the implementation of aqueous humour drainage implants or surgical techniques. Recently, novel implants have been introduced that facilitate aqueous outflow toward the subconjunctival space, similar to trabeculectomy, but with greater efficiency and a lower rate of surgical complications. In addition to monotherapy with topical hypotensive agents, selective laser trabeculoplasty (SLT) has been incorporated into international guidelines as a first-line treatment for primary open-angle glaucoma (POAG). Moreover, clinical studies investigating excimer and femtosecond laser trabeculotomy have demonstrated promising outcomes. Cyclodestructive laser procedures, historically reserved for refractory glaucoma, have significantly improved in safety and efficacy due to optimised energy delivery, enhanced intraoperative visualisation, and precise dosing, resulting in more predictable therapeutic outcomes.

Pregnancy causes several changes in the pregnant woman's body, which can cause both mild and severe ophthalmological symptoms. Some of the symptoms may be considered physiological as they are caused by hormonal changes and are mostly reversible after delivery, others may be caused by pathological ocular changes which may be related to pre-existing ocular conditions such as diabetic retinopathy, glaucoma, refractive errors. There are also new ocular abnormalities which may compromise vision or even predict a life-threatening condition. This manuscript describes also these most important pathologies causing serious ocular abnormalities. The need for cooperation between ophthalmologists, obstetricians-gynecologists, neurologists and diagnostic imaging specialists should be emphasized to ensure that both maternal and fetal long-term health problems are avoided.

Purpose: to create a register with the data of the Hungarian cataract procedure for the year of 2024.
Methods: A questionnaire with 14+1 questions was sent to Hungarian institutions which are dealing with ophthalmic surgeries (cataract and refractive surgeries), 61 answered.
Results: Cataract operations were performed by 319 specialist and 44 residents in 2024. During this period 71,569 cataract surgeries were reported. Today more then 90% of cataract procedures are performed in a one-day surgery basis both in hospitals and one-day ophthalmic surgery centers. In 2024, the number of surgeries were in 4 institutions above 3,000, in 5 other institutions it was between 2,500–3,000 and in 16 cases between 100-500 and in none of the institutions was it below 100. The penetrance of the drop anesthesia is almost 100%, retrobulbar (4.5%) and peribulbar anaesthesia (1.08%) is still used unfrequently, general anaesthesia was available in 0.84% of the cases. The mode of incision is corneal wound in 99.21% in all institutions, in limited cases limbal incisions (0.59%) may be used if necessary and in 5 institutions other wound structure was created. The mode of nucleus removal was phacoemulsification in 98.73%, in 0.2% it was extracapsular cataract extraction (ECCE) and suction. The cortex was removed in 3.0% by bimanual technique and in most of the cases with one-handed I/A device. In 1.4% femtolaser assisted cataract procedure (FLACS) were performed. In 99.17% of the cases, surgeons used foldabel intraocular lenses and in 0.48% PMMA lenses. Silicon lenses were not reported at all. In 30.6% of the lens material was hyrdophilic and in 68.23% hydrophobic. In 12.73% toric intraocular lenses were implanted, in 2.82% multifocal lenses were used and in 1.14% multifocal-toric lenses were chosen. In 3.24% EDOF lenses were preferred in 2024. Intracameral cefuroxim were administered in all institutes at the end of the surgery, subconjunctival antibiotics was applied in 1.0%, into the conjunctival sac in 23%, subconjunctivally below 3.0%. During the preoperative period topical antibiotics is used in 14 institutions. Postoperatively in 90.0% only modern fluorokinolons, in 4.0% fluorokinolons/or aminoglykozids and in 4.0% only aminoglycosids were prescribed for 12 days on average. The ratio of tobramycion use decreased further. The surgical treatment of presbyopia is performed rather with multifocal lenses instead of other corneal procedures. The average hospital stay decreased to 4.5 hours in 2024, the average waiting time was 82 days (5 days more compared to 2023) and in 25 institutions there was a possibility for paying cataract procedures. According to the data in 3.8% the patients (2,818 catarat procedures) covered the expenses of the cataract operations, which is a slight increaqse compared to 2023. At the end of 2023, waiting list comprised of 11.675 patients, which means 227 patients on averagy in each institutions. The number of refractive procedures were around 9,000 in 2024, and 2 types of refractive procedures were performed, namely surface (PRK) and incisional (femto-LASIK). SMILE method (130) was also available in Hungary in 2024. LASEK, epi-LASIK were not performed in 2024. In case of surface refractive procedures in 94.0% of the cases Mitomycin-C was applied, and in 95.0% of the cases wavefront technology was used during reatemtn planning. The number of phototherapeutic keratectomies (PTK) is similar during the past years, the number of crosslinking (CXL) slightly increased. In the treatment of presbyopia Laser Blended Vision (LBV) technique was used in Hungary, Supracor treatment was not applied.
Conclusions: The COVID-19 pandemia decreased the number of cataract surgeries approximately by 30% in Hungary between 2020–2022. In 2024 surgical numbers increased, on the other hand the yearly number is still lower than in 2019. The implantation of multifocal lenses decreased, however the implantation of EDOF lenses increased. In order to keep the human resource, the achievement based financing should be introduced in the hospitals in order to motivate personal.

Blepharoplasty is a widely performed aesthetic procedure, generally associated with minor and transient side effects. However, in rare instances, serious complications such as orbital compartment syndrome (OCS) can develop, posing a significant threat to vision. Until this case report, an infectious aetiology had not been described as a cause of OCS following blepharoplasty. OCS results from a rapid increase in intraorbital pressure, which, if left untreated, can cause irreversible optic nerve damage within hours. Key warning signs include exophthalmos, restricted ocular motility, and sudden vision loss. Given the condition’s rapid progression, immediate intervention – often requiring surgical decompression – is essential. This case underscores the necessity of vigilance in post-blepharoplasty care and highlights the critical role of multidisciplinary collaboration in managing severe intraorbital complications.

Introduction:Descemet membrane detachment (DMD) mostly occurs as an intraoperative complication of intraocular interventions, especially cataract surgeries. There are many risk factors, and the frequency of DMD is surprisingly high, but it often remains hidden in the absence of clinical symptoms and signs. However, in cases of central involvement or large extent, choosing the optimal management can be challenging for the surgeon.
Materials and Methods:: Our case presentation aims to demonstrate the anterior segment optical coherence tomography (AS-OCT)-based evaluation and management of cataract surgery-related DMD with the help of AS-OCT images and literature data.
Case report: During the incision closure of a 64-year-old male patient’s routine cataract surgery, we experienced the separation of corneal layers. An AS-OCT examination was performed to determine the exact location and extent of the DMD. After the shortage of air injected into the anterior chamber and conservative therapy, we decided to apply 20% SF6 intracamerally. As a result of this therapy, the DMD resolved.
Discussion: Since clinically manifest cases may occur less frequently, DMD is thought to be an uncommon complication related to cataract surgery; however, according to literature data, it can be observed in nearly 43% of operations. It should be considered in cases of persistent postoperative corneal oedema. Among the various classifications, we highlight the HELP algorithm, which provides a therapeutic approach in the management of DMD using AS-OCT-based parameters (the DMD’s height, extension, length and position to the pupil).

The article describes a case study of occult macular dystrophy (OMD), a rare autosomal dominant retinal disorder causing progressive central vision loss without visible retinal abnormalities. The condition’s subtle presentation often leads to misdiagnosis, as standard retinal exams typically appear normal. Diagnosis relies on electrophysiological tests, particularly multifocal electroretinograms (ERG), which show reduced central retinal responses despite the normal full-field ERG results. Advances in optical coherence tomography (OCT) have enabled the identification of microstructural anomalies in the photoreceptor layers. However, the definitive diagnosis of OMD can only be confirmed through genetic sequencing, which identifies specific pathogenic variants associated with the disorder. The patient first presented with mild myopia at age 14, with normal retinal findings. Over the years, her vision progressively declined, culminating in significant central visual field loss by age 38. Optical coherence tomography showed microstructural retinal abnormalities, suggesting a possible diagnosis of occult macular dystrophy. Even though the full-field ERG results were normal, the multifocal ERG test revealed lower central responses, which match the signs of OMD. Genetic testing confirmed OMD, identifying a pathogenic RP1L1 gene variant. This study emphasises the importance of early, comprehensive diagnostics, including electrophysiological and genetic testing, for accurate OMD diagnoses. It also highlights the need for genetic counselling due to the condition’s dominant inheritance and variable penetrance. This case is the first genetically confirmed OMD reported in Hungary, underscoring the rarity of the condition and the diagnostic challenges it presents in clinical practice.

Introduction: Choroidal effusion is considered a rare disease. Intraocular interventions, such as the complication of glaucoma surgeries, can lead to choroidal effusion; however, this condition may also result from inflammatory and infectious diseases, trauma, tumours, drug reactions, scleral abnormalities, or venous stasis.
Objective: To describe the aetiology, the diagnostics and the therapeutic possibilities of choroidal effusion through a case report.
Case report: In November 2023, a 73-year-old female patient was examined with suspected retinal detachment. During her admission, the best corrected visual acuity (BCVA) was 0.5. Her ophthalmological anamnesis included moderate hypermetropia and bilateral cataract surgery; general anamnesis included treated high blood pressure. During biomicroscopy, the anterior segment was normal, but fundoscopy revealed that a massive choroidal detachment appeared in all four quadrants of the posterior pole, extending to the ora serrata. After ultrasound and UBM examination, idiopathic, type III. choroidal effusion syndrome was confirmed. Oral acetazolamide therapy was indicated in addition to local cycloplegics and anti-inflammatory drugs. She received 500 mg of methylprednisolone infusion therapy 3 times, after which we used oral methylprednisolone in a decreasing dose. Due to the lack of any signs of regression, anterior chamber reconstruction was made, and the fluid was drained from the suprachoroidal space. Considering the persistent cystoid macular oedema, anti-VEGF injection treatment was used. At the last visit, leopard- spot retinopathy was visible in the affected eye, the cystoid macular oedema and the suprachoroidal fluid resolved, and the BCVA was 1.0.
Conclusion: Idiopathic choroidal effusion is a relatively rare disease. Its diagnosis requires the exclusion of several ocular and systemic pathologies. Treatment should be considered between conservative and surgical management, taking into account the aetiology of the disease.