Correction: Toader et al. Cognitive Crescendo: How Music Shapes the Brain's Structure and Function. Brain Sci. 2023, 13, 1390.

In the original publication [...].

Advances in Transepithelial Photorefractive Keratectomy versus Laser-Assisted In Situ Keratomileusis.

(1) Background: Laser-assisted refractive surgery is a safe and effective surgical correction of refractive error. For most patients, both the newer Trans-PRK and the established LASIK technique can produce the required surgical correction, sparking the question of which technique should be opted for. (2) Methods: The study prospectively evaluated 121 patients (230 eyes) for at least one month postoperatively; 66 patients (126 eyes) and 45 patients (85 eyes) returned for 6 months and 1 year follow-up. (3) Results: No statistical difference was recorded at 1 week or 1 month post-operation. At 6 months, a difference was found for spherical diopters (Trans-PRK -0.0476 ± 0.7012 versus FS-LASIK +0.425 ± 0.874, p = 0.004) and spherical equivalent (Trans-PRK -0.1994 ± 0.0294 versus FS-LASIK +0.225 ± 0.646, p = 0.025) but not for CYL D (Trans-PRK -0.3036 ± 0.5251 versus FS-LASIK -0.4 ± 0.820, p = 0.499). Uncorrected visual acuity was better for Trans-PRK 6 months post-operation (UCVA logMAR 0.02523 versus 0.0768 logMAR; p = 0.015 logMAR). At 1-year, Trans-PRK was favored for spherical diopters (Trans-PRK -0.0294 ± 0.6493 versus FS-LASIK +0.646 ± 0.909, p < 0.001) and spherical equivalent (Trans-PRK -0.218 ± 0.784 versus FS-LASIK 0.372 ± 1.08, p = 0.007). Overall speed in visual recovery, variance of results and surgically induced astigmatism were in favor of Trans-PRK. (4) Conclusions: The study reported improvements for Trans-PRK patients, with both techniques found to be safe and effective.

Cognitive Crescendo: How Music Shapes the Brain's Structure and Function.

Music is a complex phenomenon with multiple brain areas and neural connections being implicated. Centuries ago, music was discovered as an efficient modality for psychological status enrichment and even for the treatment of multiple pathologies. Modern research investigations give a new avenue for music perception and the understanding of the underlying neurological mechanisms, using neuroimaging, especially magnetic resonance imaging. Multiple brain areas were depicted in the last decades as being of high value for music processing, and further analyses in the neuropsychology field uncover the implications in emotional and cognitive activities. Music listening improves cognitive functions such as memory, attention span, and behavioral augmentation. In rehabilitation, music-based therapies have a high rate of success for the treatment of depression and anxiety and even in neurological disorders such as regaining the body integrity after a stroke episode. Our review focused on the neurological and psychological implications of music, as well as presenting the significant clinical relevance of therapies using music.

From Homeostasis to Pathology: Decoding the Multifaceted Impact of Aquaporins in the Central Nervous System.

Aquaporins (AQPs), integral membrane proteins facilitating selective water and solute transport across cell membranes, have been the focus of extensive research over the past few decades. Particularly noteworthy is their role in maintaining cellular homeostasis and fluid balance in neural compartments, as dysregulated AQP expression is implicated in various degenerative and acute brain pathologies. This article provides an exhaustive review on the evolutionary history, molecular classification, and physiological relevance of aquaporins, emphasizing their significance in the central nervous system (CNS). The paper journeys through the early studies of water transport to the groundbreaking discovery of Aquaporin 1, charting the molecular intricacies that make AQPs unique. It delves into AQP distribution in mammalian systems, detailing their selective permeability through permeability assays. The article provides an in-depth exploration of AQP4 and AQP1 in the brain, examining their contribution to fluid homeostasis. Furthermore, it elucidates the interplay between AQPs and the glymphatic system, a critical framework for waste clearance and fluid balance in the brain. The dysregulation of AQP-mediated processes in this system hints at a strong association with neurodegenerative disorders such as Parkinson's Disease, idiopathic normal pressure hydrocephalus, and Alzheimer's Disease. This relationship is further explored in the context of acute cerebral events such as stroke and autoimmune conditions such as neuromyelitis optica (NMO). Moreover, the article scrutinizes AQPs at the intersection of oncology and neurology, exploring their role in tumorigenesis, cell migration, invasiveness, and angiogenesis. Lastly, the article outlines emerging aquaporin-targeted therapies, offering a glimpse into future directions in combatting CNS malignancies and neurodegenerative diseases.

The measurement of Central Corneal Thickness.

We aimed to compare five different devices that measure Central Corneal Thickness. The Central Corneal Thickness (CCT) is an important parameter in ophthalmology. It is involved in the management of various eye conditions such as: glaucoma, keratoconus, contact lens wearing, corneal dystrophies, refractive surgery and keratoplasty. We measured the CCT using OCT, Topographer (TOPO), Ultrasonography Pachymeter (US), Specular Microscope (MS), and Non-contact Tonometer (TONO). In the analysis of the data collected from 59 patients we found the following mean values: US - 554.51 ± 29.849 µm, OCT - 548.73 ± 31.080 µm, TOPO - 553.76 ± 29.845 µm, MS - 564 ± 32.637 µm, and TONO - 538.9 ± 35.657 µm. Our results confirmed the strong correlation between techniques. Abbreviations: OCT = Optical Coherence Tomography, CCT = Central Corneal Thickness, TOPO = Topographer, US = Ultrasonography Pachymeter, MS = Specular Microscope, TONO = Non-contact Tonometer.

Oculo-orbital complications of odontogenic sinusitis.

Introduction: Odontogenic sinusitis is a well-known, but under-studied bacterial infection of the maxillary sinus that can extend to other sinuses, the orbit, or even the endocranium. Material and methods: We performed an observational retrospective study on the patients with odontogenic sinusitis treated in our hospital over a five-year period. We included patients over 18 years old diagnosed with odontogenic sinusitis and ocular complications and we excluded patients with ocular complications nonrelated to dental-originated sinusitis or patients with odontogenic sinusitis without orbital-ocular complications. Results: We examined the charts of 46 patients. From the total number of patients with oculo-orbital complications generated by odontogenic sinusitis, only 7 were women. The mean age was 33,7 with a standard deviation of 15,7 years. The oculo-orbital complications were assessed according to the Chandler classification. The most frequent orbital complication was preseptal cellulitis followed by orbital cellulitis. All the patients were treated with antibiotic covering both anaerobic and aerobic bacteria and 40 of the patients in our study received surgical treatment. The outcomes were favorable for all the patients in our study with clinical resolution. Conclusion: The oculo-orbital complications of odontogenic sinusitis are severe because they can result in vision loss or other ocular sequelae. The bacteriological features of this sinusitis explain the special characteristics of this infection and can facilitate the extent of the infection to the orbit. Prompt intervention with antibiotics covering anaerobic and aerobic bacteria and surgery addressed to the affected sinus/ sinuses, the dental disease and the orbital pathology ensures a big success rate in the therapy of these complications.

The role of vitreous management in the posterior capsule rupture associated with cataract surgery on the protection of the corneal endothelium.

Introduction: Advances in technology and technique have led to a significant improvement in the prognosis after cataract surgery. However, there are complications that can significantly affect this prognosis, such as posterior capsule rupture and corneal decompensation. For vitreous prolapse associated with posterior capsule rupture, classic or pars plana anterior vitrectomy is required. Aim: The aim of the study was to compare corneal endothelial cell destruction after cataract surgery associated with posterior capsule rupture and classical and pars plana anterior vitrectomy, respectively. Material and method: The study was prospective, on 12 consecutive cases of cataract surgery associated with posterior capsule rupture. Classical anterior vitrectomy was performed in group A, with 5 patients, while pars plana anterior vitrectomy was performed in group B. For all cases, the Stellaris phacoemulsification device (Baush & Lomb, tm) and the associated vitrectomy device was used. Results: Pars plana anterior vitrectomy had a statistically significant lower rate of corneal endothelial damage, both in absolute value and as a percentage of initial density. Conclusions: Pars plana anterior surgery is a somewhat unfamiliar technique for anterior pole surgeons. But it is easy to learn and brings a decrease in the rate of damage to the corneal endothelium.

Micropulse Transscleral Cyclophotocoagulation for Glaucoma after Penetrating Keratoplasty.

The main objective of the article was to assess the surgical outcome of micropulse transscleral cyclophotocoagulation in patients presenting with glaucoma after penetrating keratoplasty. We conducted a retrospective study that included 26 eyes of 26 patients who presented with glaucoma after penetrating keratoplasty, and who were treated using micropulse transscleral cyclophotocoagulation between January 2017 and December 2020. The surgeries were performed using the Iridex Cyclo G6 MicroPulse P3 Probe. The intraocular pressure, mean number of antiglaucoma medications, visual acuity, corneal status, and postoperative complications were analyzed. The minimum follow-up period was 12 months. The success rate after 12 months was 76.9%. The baseline median intraocular pressure was 29 mm Hg and decreased to 18 mm Hg after 12 months. The median number of antiglaucoma medications was also reduced from three preoperatively to one after one year. In seven cases (29.92%), the visual acuity decreased and, in four cases (15.38%), the corneal graft was not transparent. We concluded that micropulse transscleral cyclophotocoagulation is an effective and safe method for the treatment of glaucoma after penetrating keratoplasty.

Relationship between allergic rhinitis and allergic conjunctivitis (allergic rhinoconjunctivitis) - review.

Allergic rhinitis and allergic conjunctivitis are so frequently associated that the need to coin a new name to describe the simultaneous manifestations generated the term allergic rhinoconjunctivitis. The significant impact of rhinoconjunctivitis on the quality of life and the wellbeing of the patients is the reason why the medical community shows a great interest to this disease. Another aspect is the financial burden that is not negligible. The anatomical connection between the organs involved facilitates the propagation of the disease. The allergic pathophysiological mechanisms implicated in allergic rhinitis and conjunctivitis also share common features. The diagnosis of rhinoconjunctivitis is based on the concordance between the symptoms, the clinical examination, and the diagnostic tests that should reveal the existence of an allergen specific IgE in vivo or in vitro. Whilst the nasal smear for eosinophils is considered a reliable diagnostic test for allergic rhinitis, the occurrence of eosinophils in the conjunctive is not a trustworthy indicator of allergy. The therapy of allergic rhinoconjunctivitis is based on patient education, pharmacotherapy, and allergen-specific immunotherapy. The local treatment for the allergic rhinitis is primarily based on topical corticosteroids that also manage the ocular symptoms. The first line of treatment of the ocular manifestations is represented by topical antihistamines and mast-cell stabilizers or double action drugs.

Ectopia lentis surgery in Marfan's syndrome: from "couching" to the use of intracapsular tension rings.

In the course of time, correction of the ectopia lentis in Marfan's syndrome has been approached through quite many surgical techniques. They addressed the iris, or the lens and aimed at increasing the aphakic zone, the opacification or removal of the lens. Although associated to many complications, the first techniques proved the courage and imagination of pioneer surgeons and are worth mentioning. They were steps towards the invention of current techniques and devices that make surgery of ectopia lentis safe, easy, and having a favorable prognosis.

Surgical approach in type II Peters anomaly - case report.

Objective: The aim of this report was to present a rare case of apparently unilateral Peters anomaly and describe the clinical characteristics, surgical approach, and visual prognosis. Methods: We presented the case of a 7-year-old female patient with posterior corneal defect due to kerato-lenticular adhesions along with anterior dislocation and opacification of the lens in the left eye and a history of post-traumatic evisceration of the right eye. Systemic associations included mental underdevelopment, left torticollis and scoliosis. No family history of acquired or inherited diseases were determined. We performed cataract extraction in the left eye and opted for aphakia. Results: Based on clinical findings, we considered unilateral Peters anomaly type II. Cataract surgery slightly improved the visual acuity from hand moving to 20/ 400 UCVA (uncorrected visual acuity) and 20/ 100 with +10.0 diopters at 1 month postoperative. No enlargement of the corneal opacity was observed. Conclusions: In this case, we were able to diagnose Peters anomaly only in one eye. The diagnosis required long follow-up with periodic measurement of intraocular pressure (IOP) to early detect glaucoma. The complexity and uniqueness of the case relied on the difficult approach made by the cloudy cornea and anterior lens dislocation. We applied a combination of techniques including adhesiolysis, cataract extraction and anterior vitrectomy. Further interventions such as secondary IOL (intraocular lens) implantation or PKP (penetrating keratoplasty) will be taken into consideration after six-month and one-year postoperative follow-up. Abbreviations: PA = Peters anomaly, DM = Descemet's membrane, IOL = intraocular lens, VA = visual acuity, OVDs = ophthalmic viscosurgical devices, IOP = intraocular pression, PKP = penetrating keratoplasty, BCVA = best corrected visual acuity, UCVA = uncorrected visual acuity.

Surgical Treatment in Silicone Oil-Associated Glaucoma.

Glaucoma is a vision threatening, not uncommon complication of eyes that have undergone pars plana vitrectomy with silicone oil endotamponade. Although most patients respond well to medical antiglaucoma therapy, there are refractory cases where surgery is required to control the intraocular pressure. This review, following a comprehensive literature search in the Medline database, aims to present the most important surgical techniques currently in use for glaucoma associated with silicone oil endotamponade and their indication depending on the mechanism of glaucoma. In cases of pupillary block, the presence of a patent iridotomy or iridectomy must be ensured, either by laser or surgically. When silicone oil is in excess and whenever the retinal status permits it, partial or complete removal of the silicone oil should be performed. Trabeculectomy has shown higher failure rates and more complications in these cases compared to other indications, so alternate methods are warranted. For very high intraocular pressures, glaucoma drainage devices and transscleral cyclophotocoagulation are the most used options, with good efficacy and safety profiles, although rarely they may have serious complications. The Ex-PRESS mini shunt has shown excellent results and lower rates of complications. For less important IOP elevations, minimally invasive glaucoma surgery and selective laser trabeculoplasty may be used, either alone or in conjunction with other methods.

Traumatic Intralenticular Neovascularization in a HLA B27+ Pediatric Patient.

(1) Background: Intralenticular tumors are an entity akin to Schrodinger's cat since, although the human crystalline cells themselves are not known to malignly proliferate, various entities can take the appearance and clinical presentation of a tumor originating in the lens. We present the peculiar case of an 11-year-old male patient of African descent, HLA B27+, with a previous history of minor ocular trauma and unilateral anterior uveitis a year before which was admitted to our department with total opacification of the crystalline lens in the right eye and lens neovascularization. During surgery, a vascular, white fibrotic mass measuring 0.1-0.2 cm was discovered inside the lens bag and was excised. (2) Methods: Retrospective case review. (3) Results: The histopathological exam of the excised mass revealed an abundant infiltrate consisting of CD68+ foamy macrophages and lymphoplasmacytic elements. CD68 is a pan-macrophage marker associated with an active inflammatory mechanism soliciting macrophages, and tissue activated macrophages are correlated to increased stromal and serum levels of vascular endothelial growth factor, providing an explanation for lens angiogenesis. (4) Conclusions: The diagnosis is of a "masquerade tumor" resulted from an abnormal inflammatory process in connection with previous ocular trauma and possibly the patient's HLA B27+ status.

Efficacy of conjunctival flap surgery for deep corneal ulcers.

Aim: To evaluate the clinical efficacy of a selective, partial, pedicle conjunctival flap in the treatment of deep corneal ulcers with or without perforation, resistant to medical treatment. Method: This interventional self-controlled retrospective study included 31 eyes of 31 patients with deep corneal ulcers who underwent conjunctival flap surgery in a tertiary eye care unit between 2017 and 2019. Of these, 9 eyes exhibited corneal perforation. The follow-up period was 12 months. The primary outcome measures were restoring ocular surface integrity and secondary outcome measures were improvement in visual acuity and postoperative complications encountered. Results: Out of the total of 31 patients, 17 patients (55%) were males and 14 patients (45%) were females. The mean age was 56.03 ± 15.46 years. The mean disease duration was 64.10 ± 35.01 days, the mean diameter of the ulcer was 3.61 ± 1.02 mm and the mean depth of the ulcer was 70.65 ± 20.28% of the thickness of the cornea. The etiology was extensive and the corneal ulcers were categorized as infectious (12), noninfectious (16), and unknown (3). An anatomic cure was obtained in 29 (94%) of 31 eyes. Conjunctival flap surgery was unsuccessful in 2 eyes that required evisceration. The postoperative visual acuity (BCVA) improved in 13 (42%) of the 31 eyes, decreased in 9 eyes (29%) and remained unchanged in 9 eyes (29%). The most frequent complications after conjunctival flap surgery were pseudopterygium, cataract and corneal opacity and less frequent complications were glaucoma, astigmatism, flap retraction, corneal perforation and endophthalmitis. Conclusions: Conjunctival flap surgery can successfully treat refractory deep corneal ulcers. It can restore ocular surface integrity and provide metabolic and mechanical support for corneal healing. Also, it can avoid emergency penetrating keratoplasty or create appropriate conditions for a future optic keratoplasty.

Conjunctival flap surgery in the management of ocular surface disease (Review).

Literature regarding conjunctival flap surgery was reviewed to describe and discuss the rationale for this type of procedure. The conjunctival flap is an acknowledged surgery for the treatment of various corneal diseases with a chronically compromised ocular surface, such as severe dry eye, neurotrophic or neuroparalytic disease, or bullous keratopathy. The purpose of this surgery is to restore the integrity of the corneal surface and thus to prevent gradual corneal ulceration and secondary infection, as well as to ameliorate pain, reduce the need for frequent medications, improve cosmetic appearance, and offer an alternative to invasive surgery or enucleation. Since the introduction of more effective methods of treating severe ocular surface diseases, conjunctival flap surgery has rarely been the primary modality of treatment and has usually followed a range of medical and surgical treatments. The availability of improved ocular lubricants, more effective antimicrobials, bandage contact lenses, tissue adhesives, and other corneal and conjunctival surgical interventions, has reduced the need for conjunctival flaps. However, conjunctival flaps remain extremely useful in selected cases and deserve a place in the ophthalmologist's repertoire for the management of ocular surface disease.

Clinical and therapeutic particularities of congenital cataracts in pediatric patients with Down syndrome.

Objective: This study aims to identify clinical and therapeutic surgical particularities and postoperative complications encountered in children suffering from Down syndrome and congenital cataract, as well as the existence of a correlation with associated systemic anomalies. Methods: A retrospective interventional study that analyzes cases of congenital cataracts operated on a group of 14 children with Down syndrome, respectively on 26 eyes, was performed. The age of the children at the time of the surgery, the presence of associated ocular and systemic anomalies, the employed surgical technique, the frequency and the type of postoperative complications, were examined. Results: Cataracts present at birth, with recommendations for surgical treatment, were rare among children suffering from Down syndrome, but their frequency increased with age. Most children had systemic anomalies, but also other, usually multiple, ocular anomalies. The rate of postoperative complications was higher than among children with congenital cataracts, but without Down syndrome. In six cases, more than one complication/ case was identified. It was not possible to establish a clear correlation between the number and type of the postoperative complication and the systemic anomalies, nor was it possible to establish a correlation with the functional visual outcomes, because those children had other important ocular anomalies as well. Conclusions: Congenital cataracts with recommendations for surgical treatment in children suffering from Down syndrome have a low incidence, but an increase in frequency can be noticed with age. The recommended surgical technique is the one that involves maneuvers for the prevention of visual axis re-opacification. Per primam implantation is definitely indicated. The risk of postoperative complications is high, in terms of both frequency and number, with the possibility that more than one complication occurs, unrelated to a particular systemic anomaly, in one patient.

Enhancing rotational stability of toric intraocular lenses using a type 2L Cionni capsular tension ring in patients with high myopia.

We present the technique used in a patient with high myopia to obtain rotational stability of a plate-haptic multifocal toric intraocular lens (IOL) (AT LISA tri toric 939MP). Both of the patient's eyes had long axial lengths and large capsular bags. The first operated eye experienced consecutive toric IOL malpositions. In the fellow eye, toric IOL alignment was preserved by implanting a type 2L Cionni capsular tension ring. This was reversely inserted so the two eyelets, which are positioned slightly anterior to the ring, pressed the IOL on the posterior capsule. This unsophisticated technical artifice provided rotational stability of the IOL, even at 12 months postoperatively.

Update on surgical management of corneal ulceration and perforation.

Corneal ulcerations are a medical emergency, and in recalcitrant cases, leading to perforation, a surgical ophthalmological emergency. The urgency of the treatment is dictated by the necessity of preventing complications that can lead to serious ocular morbidities. Medical treatment represents the first therapeutic approach and is a defining step in the further management of a patient with corneal ulceration. Multiple surgical strategies are available, but the option depends on the etiology and parameters of the ulceration: size, depth, and location.

Emergency penetrating keratoplasty in corneal perforations.

Corneal perforations represent an ophthalmological emergency due to their devastating consequences. Emergency treatment is mandatory to try to restore the anatomical integrity of the globe, to salvage useful vision as much as possible and to reduce the possible complications to a minimum. The underlying conditions or disorders responsible for corneal ulcerations, and subsequently for corneal perforations are numerous, and can be either isolated or superimposed. Emergency penetrating keratoplasty is a difficult surgical procedure that is associated with various complications, which can jeopardize the outcome of the eye.