Penetrating injuries with intraocular foreign bodies (IOFB) remain a major cause of ocular morbidity worldwide. This study aimed to determine the physical and morphometric characteristics of IOFBs and investigate the correlation to the injury pattern. Intraocular foreign bodies retrieved between January 2018 and December 2023 were examined for dimension, weight, shape, and magneticity. In order to classify the shape of the IOFB, various indices were calculated. Clinical records, imaging data, and operative reports were retrospectively analyzed to determine the course of the incident, point of entry, and final intraocular position. Fifty-four IOFBs were removed during the study period. Of these, 39 met the inclusion criteria. The majority of IOFBs were metal and magnetic (n = 32; 82

Comprehensive multimodal imaging is essential for the precise clinical diagnostics of neovascular age-related macular degeneration (nAMD). Noninvasive optical coherence tomography (OCT) is of prime importance regarding the baseline examination, follow-up and monitoring during treatment. The OCT imaging in nAMD eyes enables a high-resolution assessment of the retinal micromorphology, which can be considerably disturbed in different layers. A large number of pathological OCT alterations represent distinct micromorphological OCT biomarkers. These should be taken into account in the assessment of OCT images. This article covers the following important biomarkers: intraretinal, subretinal and subpigment epithelial fluid, outer retinal tubulations, ellipsoid zone integrity, hyperreflective foci, subretinal drusenoid deposits, onion sign, hyporeflective prechoroidal cleft, double layer sign, subretinal hyperreflective material and bacillary layer detachment.

Purpose: The Phase 3 Mylight study was designed to confirm clinical equivalence of proposed biosimilar aflibercept (SOK583A1; Sandoz [proposed biosimilar aflibercept, SDZ-AFL]) to its reference biologic (Eylea; Regeneron Pharmaceuticals, Inc; Bayer AG [reference aflibercept, Ref-AFL]). Method: Mylight was a prospective, double-masked, 2-arm, parallel Phase 3 study. Participants with neovascular age-related macular degeneration were randomized 1:1 to receive eight injections of SDZ-AFL (n = 244) or Ref-AFL (n = 240) over 48 weeks. The primary endpoint was mean change in best-corrected visual acuity score from baseline to Week 8. Secondary endpoints included anatomical outcomes, best-corrected visual acuity at Weeks 24 and 52, safety, and pharmacokinetics. Results: Similarity in mean change in best-corrected visual acuity score was established between SDZ-AFL (n = 235) and Ref-AFL (n = 226) at Week 8 (difference: −0.3 [90% CI, −1.5 to 1.0]) and Week 52. No clinically meaningful differences occurred between groups in anatomical outcomes. Safety profiles were similar, with comparable incidences of treatment-related adverse events (SDZ-AFL: 2.5%; Ref-AFL: 2.9%). The incidence of anti-drug antibodies was similar between groups. Systemic free aflibercept concentrations 24 hours postdose were low and comparable between SDZ-AFL and Ref-AFL. Conclusion: Proposed biosimilar aflibercept matched reference aflibercept in efficacy, safety, and pharmacokinetics in participants with neovascular age-related macular degeneration. Therefore, this Phase 3 study confirmed biosimilarity of SDZ-AFL to Ref-AFL.

OBJECTIVE:To describe the histological findings 7 weeks and 18 months after subretinal implantation of the PRIMA photovoltaic array in eyes with geographic atrophy. DESIGN:Comparative case series SUBJECTS: and controls: Four globes of two deceased study participants from the prospective PRIMAvera study were analyzed. METHODS:The subretinal implant was removed after horizontal sectioning of the globe. Serial sections were performed and stained with hematoxylin-eosin, Masson trichrome as well as periodic acid Schiff for histopathologic analysis. Selected sections were immunohistochemically stained for CD68, CD163, GFAP, CD31, CK18, ARR3, RPBMS, and TRPM1. Both study and fellow eyes were analyzed. MAIN OUTCOME MEASURES:The histopathological analysis focused on the anatomical implant localization, wound healing processes, potential inflammatory reactions adjacent to the implant and at the retinotomy site, the development of retinal gliosis and retinal atrophy as well as a potential encapsulation. RESULTS:Both implants could be removed in toto without obvious retinal trauma. Histologically, the implants were located at the level of the outer plexiform layer, as intended, close to the inner nuclear layer. A tissue layer was identified beneath the implant, consisting of a basement membrane deposit and cellular components. A small rupture of Bruch's membrane was detected (in the globe with an 18 months follow-up) associated with localized subretinal fibrosis. At the implant-retina interface, there was only a minimal tissue response without pseudocapsule formation. Furthermore, no significant inflammatory response was detected. The retina overlying the implant was comparable to the fellow eyes in most areas, with limited focal atrophy of the inner retina 18 months after PRIMA implantation. At the retinotomy site, a full thickness scar was noted with mild atrophic changes in the implant insertion area. CONCLUSIONS:The wireless subretinal PRIMA implant demonstrated good biocompatibility with no significant encapsulation or surrounding inflammatory response. At seven weeks and eighteen months after implantation, retina overlying the implant was viable and layered as in control areas. Histopathologic analysis following innovative surgical techniques can provide important information in addition to in vivo findings.

Abstract Background To describe the surgical techniques for transplantation of an autologous retinal graft in cases of chronic retinal detachment with proliferative vitreoretinopathy and full-thickness macular hole. Methods Descriptive case series of three consecutive patients (1 woman and 2 men; ages 60, 60, and 61) who underwent pars plana vitrectomy with peeling of proliferative vitreoretinopathy membranes, followed by relaxing retinectomy, where a notch was created to harvest a full-thickness neurosensory retinal graft. Perfluoro-n-octane was injected to flatten the retinectomy edges and stabilize the graft, which was then separated from the retinectomy edge and gently mobilized under Perfluoro-n-octane using a finesse loop to plug the macular hole. Endolaser was applied to the retinectomy edge under Perfluoro-n-octane, followed by a controlled Perfluoro-n-octane –air exchange and silicone oil (5000 cSt) infusion. Results Primary outcomes were anatomical macular hole closure and retinal reattachment; visual outcomes were assessed by postoperative visual acuity, exam and imaging. Initial visual acuity ranged from light perception to hand motion. Postoperatively, visual acuity improved from light perception and hand motion to 20/400 and 20/200; the retina remained attached, and the macular hole was successfully closed, with the autologous retinal transplant integrating into the surrounding retinal tissue. Conclusions Autologous retinal transplant, coupled with a relaxing retinectomy, may present a promising strategy for closing macular holes and improving visual acuity in cases of complex retinal detachment with proliferative vitreoretinopathy. We show that this procedure can be performed unimanually, potentially reducing technical demands in such cases.

Objectives To assess the efficacy and safety of oral belzutifan in a real-world cohort of pretreated patients with von Hippel-Lindau (vHL)-associated retinal haemangioblastomas (RHs). Methods This retrospective observational study included genetically confirmed vHL patients with RHs, in whom at least one eye had been previously refractory to conventional ocular therapy. Patients received oral belzutifan (120 mg once daily) and underwent standardised ophthalmic follow-up with multimodal imaging. Tumour area was quantified on widefield colour fundus photography and red-free images using standardised image analysis. To minimize clustering bias, the largest lesion per eye was predefined for the primary analysis, with an exploratory analysis including all detected lesions. Overall ocular response (OOR) was assessed at the eye level. Safety monitoring was performed within an interdisciplinary clinical framework. Results Five patients (seven eyes, 14 RHs) were included. Significant tumour regression was observed for the largest lesion per eye (median reduction − 58% [IQR, 17–64]; p = 0.028) and across all lesions (median − 57.2% [IQR, 28.0-66.9]; p < 0.001); nine of 14 lesions showed > 20% size reduction. OOR improved in six of seven eyes; one eye was not evaluable due to pre-existing phthisis bulbi. Changes in best-corrected visual acuity and central subfield thickness were not statistically significant. No genotype-response association was identified. Drug-related adverse events were mostly mild to moderate and manageable. Conclusions Belzutifan was associated with clinically meaningful tumour regression in vHL-associated RHs that were previously mainly refractory to conventional ocular therapy, with an acceptable safety profile. Further prospective studies are warranted.

Comprehensive multimodal imaging is essential for the precise clinical diagnostics of neovascular age-related macular degeneration (nAMD). Noninvasive optical coherence tomography (OCT) is of prime importance regarding the baseline examination, follow-up and monitoring during treatment. OCT imaging in nAMD eyes enables a high-resolution assessment of the retinal micromorphology, which can be considerably disturbed in different layers. A large number of pathological OCT alterations represent distinct micromorphological OCT biomarkers. These should be taken into account in the assessment of OCT images. This article covers the following important biomarkers: intraretinal, subretinal and sub-pigment epithelial fluid, outer retinal tubulations, ellipsoid zone integrity, hyperreflective foci, subretinal drusenoid deposits, onion sign, hyporeflective prechoroidal cleft, double-layer sign, subretinal hyperreflective material and bacillary layer detachment.

AIM: To investigate the intraocular pressure (IOP)-lowering efficacy of bleb-free ab interno trabeculectomy by means of the Kahook Dual Blade (KDB). METHODS: This retrospective cohort study enrolled patients with uncontrolled open angle glaucoma (OAG) who underwent standalone KDB ab interno trabeculectomy. Changes in IOP, the number of preoperative and postoperative IOP-lowering medications, as well as intraoperative and postoperative surgical profiles were analyzed. All participants completed a 6-month follow-up. Arithmetic mean, standard deviation (SD) and frequency were calculated, and the Wilcoxon test was used for statistical analysis. RESULTS: A total of 23 participants (15 males) were included, with a mean age of 69.3±9.6y. The baseline mean IOP was 21.7±5.6 mm Hg, with patients taking an average of 3.1±1.0 topical IOP-lowering medications, and 10 patients received adjuvant systemic acetazolamide preoperatively. At the 3-month follow-up, the mean IOP decreased to 12.7±4.3 mm Hg, with a mean medication score of 2.9±1.8. At the 6-month follow-up, mean IOP was reduced by 40.6% from the baseline level (P<0.01), with a mean medication requirement of 2.8±1.0; one-fifth of all participants discontinued glaucoma medications completely. Only mild postoperative hyphemata occurred in 10 cases, and no other surgery-related adverse complications were observed. CONCLUSION: Standalone ab interno trabeculectomy with KDB yields significant IOP reduction and favorable surgical safety in patients with uncontrolled OAG, meanwhile decreasing the requirement of topical IOP-lowering medications. Long-term therapeutic efficacy remains to be further validated. Distinct from previous published studies, this study focuses on a Caucasian population and confirms surgical efficacy of KDB as a single glaucoma procedure.

Eine umfassende multimodale Bildgebung ist bei der präzisen Diagnostik der neovaskulären altersabhängigen Makuladegeneration (nAMD) essenziell. Die nichtinvasive optische Kohärenztomographie (OCT) ist sowohl für die Erstuntersuchung als auch für die Verlaufskontrolle und das Therapiemonitoring von Bedeutung. Sie ermöglicht eine hochaufgelöste Beurteilung der retinalen Mikromorphologie, die bei nAMD auf unterschiedlichen Ebenen gestört sein kann. Eine ganze Reihe pathologischer OCT-Veränderungen bei nAMD fungiert als sog. mikromorphologische OCT-Biomarker. Diese sollten bei der Beurteilung von OCT-Aufnahmen berücksichtigt werden. In diesem Beitrag werden folgende wichtige Biomarker behandelt: intraretinale, subretinale und subpigmentepitheliale Flüssigkeit, „outer retinal tubulations“, Integrität der ellipsoiden Zone, hyperreflektive Foci, retikuläre Pseudodrusen („subretinal drusenoid deposits“), „onion sign“, hyporeflektive prächorioidale Spalte, „double layer sign“, subretinales hyperreflektives Material und „bacillary layer detachment“.

Die rhegmatogene Netzhautablösung (Amotio retinae) ist ein ophthalmologischer Notfall mit steigender Inzidenz in Deutschland. Trotz etablierter Methoden bleibt die perioperative Lagerung, insbesondere bei immobilen Patienten, eine Herausforderung, die Erfolg und Komplikationsrate maßgeblich beeinflusst. Eine Analyse der aktuellen Trends in der chirurgischen Behandlung und perioperativen Versorgung der Amotio im Vergleich zu 2018 ist essenziell. Online-Umfrage mit 5 hypothetischen Fällen akuter rhegmatogener Amotio wurde an vitreoretinale Chirurg*innen des retina.net gesendet; 27 Fragebögen wurden hinsichtlich demografischer Daten, Operationsmethoden, Anästhesieform, perioperativer Lagerung und Nachsorgestrategien ausgewertet. Es waren 50

Sitagliptin, an inhibitor of dipeptidyl peptidase-4 widely used in type 2 diabetes therapy, impairs the barrier formed by retinal endothelial cells (REC) during prolonged exposure. Because diabetic macular edema is treated with inhibitors of vascular endothelial growth factor (VEGF)-A signaling, we now studied (1) if sitagliptin interfered with this therapeutic approach and (2) if VEGF-A is involved in sitagliptin-induced barrier dysfunction.Confluent immortalized bovine REC (iBREC) were exposed for two days to sitagliptin and/or tivozanib, an inhibitor of the VEGF receptor 2, with or without VEGF-A. The cell index as an indicator of permeability was continuously measured, and cells and supernatants were harvested. Expressions of regulators of para- and transcellular flow, i.e., claudin-1, claudin-5, and plasmalemma vesicle-associated protein (PLVAP), were determined by subsequent Western blot analyses, and potential secretion of VEGF-A was measured by ELISA.Sitagliptin-exposed iBREC did not secrete VEGF-A, and, accordingly, tivozanib did not prevent the sitagliptin-induced decline of the cell index and the increased expression of tight junction (TJ) protein claudin 1. More TJ-protein claudin-5 was isolated together with proteins from membranes or organelles from sitagliptin-treated iBREC, which did not express PLVAP. The VEGF-A165-induced declines of the cell index and TJ-protein claudin-1 were prevented by tivozanib, and this process was not modulated by sitagliptin.The underlying mechanisms of barrier dysfunctions caused by sitagliptin or VEGF-A are different and independent. Most importantly, the DPP-4 inhibitor does not interfere with blocking VEGF signaling to correct VEGF-A-dependent barrier dysfunction.

Aims/Purpose: Müller cells play a key role in retinal homeostasis, structural support and immune response. They respond to retinal detachment and subsequent hypoxic conditions with increased stress response leading to structural changes. Due to the stabilizing properties of the amniotic membrane, first potential intraocular applications in vitreoretinal pathologies have been published. The aim was to investigate possible effects of amnion on Müller cells in the context of hypoxic damage after retinal detachment in vitro.Methods: Secretome was isolated from cryopreserved amniotic membranes. Immortalized Müller cells (MIO‐M1) with and without hypoxia treatment were incubated with the secretome and toxicity was excluded by a life/death assay and a cell death detection ELISA. A Wst‐1 and BrdU assay were performed for cell activity and proliferation; Western blot analysis and immunofluorescence staining were used to detect changes in protein expression of alpha‐SMA, SOX‐2 and GFAP.Results: Both hypoxia and the addition of amniotic secretome significantly reduced the metabolic activity of the cells. Incubation with secretome led to a statistically significant stagnation under both normoxic (p = 0.005) and hypoxic conditions (p > 0.01) in cell proliferation. Hypoxia led to increased expression of alpha‐SMA (p = 0.6), GFAP (p = 0.02) and SOX‐2 (p = 0.03) in Western blot analysis while secretome led to a normalization of alpha‐SMA (p = 0.03), GFAP (p = 0.1) and SOX‐2 (p = 0.001) under normoxic as well as hypoxic conditions. This observation was affirmed in immunofluorescence. Toxicity was excluded.Conclusions: In vitro simulation of hypoxic conditions in retinal detachment leads to stress responses of Müller cells. The amniotic secretome appears to regulate Müller cell behavior in vitro by supporting a stable phenotype under normoxic and hypoxic conditions. Further studies are needed to evaluate the clinical potential of the amniotic secretome after retinal detachment.

BACKGROUND:Geographic atrophy due to age-related macular degeneration (AMD) is the leading cause of irreversible blindness and affects more than 5 million persons worldwide. No therapies to restore vision in such persons currently exist. The photovoltaic retina implant microarray (PRIMA) system combines a subretinal photovoltaic implant and glasses that project near-infrared light to the implant in order to restore sight to areas of central retinal atrophy. METHODS:We conducted an open-label, multicenter, prospective, single-group, baseline-controlled clinical study in which the vision of participants with geographic atrophy and a visual acuity of at least 1.2 logMAR (logarithm of the minimum angle of resolution) was assessed with PRIMA glasses and without PRIMA glasses at 6 and 12 months. The primary end points were a clinically meaningful improvement in visual acuity (defined as ≥0.2 logMAR) from baseline to month 12 after implantation and the number and severity of serious adverse events related to the procedure or device through month 12. RESULTS:A total of 38 participants received a PRIMA implant, of whom 32 were assessed at 12 months. Of the 6 participants who were not assessed, 3 had died, 1 had withdrawn, and 2 were unavailable for testing. Among the 32 participants who completed 12 months of follow-up, the PRIMA system led to a clinically meaningful improvement in visual acuity from baseline in 26 (81%; 95% confidence interval, 64 to 93; P<0.001). Using multiple imputation to account for the 6 participants with missing data, we estimated that 80% (95% CI, 66 to 94; P<0.001) of all participants would have had a clinically meaningful improvement at 12 months. A total of 26 serious adverse events occurred in 19 participants. Twenty-one of these events (81%) occurred within 2 months after surgery, of which 20 (95%) resolved within 2 months after onset. The mean natural peripheral visual acuity after implantation was equivalent to that at baseline. CONCLUSIONS:In this study involving 38 participants with geographic atrophy due to AMD, the PRIMA system restored central vision and led to a significant improvement in visual acuity from baseline to month 12. (Funded by Science Corporation and the Moorfields National Institute for Health and Care Research Biomedical Research Centre; PRIMAvera ClinicalTrials.gov number, NCT04676854.).

Background Rhegmatogenous retinal detachment (RRD) is an ophthalmological emergency with an increasing incidence in Germany. Despite established methods, perioperative positioning is important to improve outcomes and avoid complications but may be challenging, particularly in immobile patients. An analysis of the current trends in surgical treatment and perioperative positioning practices for RRD in Germany compared to historical data from 2018 is essential. Material and methods An online survey with five hypothetical cases of acute RRD was distributed to vitreoretinal surgeons via the retina.net research network. A total of 27 questionnaires were analyzed focusing on participant demographic data, surgical techniques, anesthesia types, perioperative positioning and aftercare strategies. Results Of the respondents 50% were over 50 years old, 86% worked at university eye clinics and 89% had performed over 1000 vitreoretinal procedures. For RRD in the temporal upper quadrant, preoperative and postoperative temporal lateral positioning is recommended. Of the respondents 86% consider postoperative positioning crucial to prevent macular folds. Complete subretinal fluid drainage is favored by 82% and 23 G trocars were used by 77%. For phakic eyes with uncomplicated RRD 86% chose buckling surgery, while 50% opted for silicone oil in complex inferior RRD cases. General anesthesia was preferred by 61%, always in an in-patient setting. Conclusion Preoperative and postoperative temporal lateral positioning followed by prone positioning is favored for temporal upper quadrant RRD, whereas no specific positioning is recommended for inferior RRD managed with silicone oil or buckling surgery. Postoperative positioning after pars plana vitrectomy (ppV) and gas endotamponade is considered by 86% to be decisive in preventing macular folds. The 23 G trocar system remains the preferred choice despite smaller alternatives. In certain cases buckling is still of importance.

Purpose: Multiple clinical visits are necessary to determine progression of keratoconus before offering corneal cross-linking. The purpose of this study was to develop a neural network that can potentially predict progression during the initial visit using tomography images and other clinical risk factors. Methods: The neural network's development depended on data from 570 keratoconus eyes. During the initial visit, numerical risk factors and posterior elevation maps from Scheimpflug imaging were collected. Increase of steepest keratometry of 1 diopter during follow-up was used as the progression criterion. The data were partitioned into training, validation, and test sets. The first two were used for training, and the latter for performance statistics. The impact of individual risk factors and images was assessed using ablation studies and class activation maps. Results: The most accurate prediction of progression during the initial visit was obtained by using a combination of MobileNet and a multilayer perceptron with an accuracy of 0.83. Using numerical risk factors alone resulted in an accuracy of 0.82. The use of only images had an accuracy of 0.77. The most influential risk factors in the ablation study were age and posterior elevation. The greatest activation in the class activation maps was seen at the highest posterior elevation where there was significant deviation from the best fit sphere. Conclusions: The neural network has exhibited good performance in predicting potential future progression during the initial visit.

Background:Persistent severe serous choroidal detachment is a rare complication after glaucoma surgery. Surgical treatment with choroidal fluid drainage through a scleral incision is an option in these cases. Combining this procedure with pars plana vitrectomy and gas endotamponade has potential advantages. In the following, the perioperative course of this surgical option in a small cohort will be presented. Methods:This is a retrospective cohort study of the postoperative course of ab externo drainage of persistent serous choroidal detachment (≥4 weeks) in combination with pars plana vitrectomy and gas endotamponade in six eyes of six patients after exhausting all conservative treatment options. Inclusion criterion was persistent hypotony with severe serous choroidal detachment after intraocular pressure (IOP) lowering surgery due to medically uncontrolled glaucoma. Eyes were evaluated according to resolution of choroidal detachment, change in IOP and visual acuity (VA), postdrainage complications, and need for further surgeries. Results:Before surgery, all patients presented with flat anterior chamber, decreased vision, and persistent choroidal detachment. The surgery itself was uneventful, but due to the complexity of the cases, tailoring the procedure to each patient's needs was required. Complete resolution of choroidal effusion was achieved by one month in 5 eyes and in 1 eye by month 3. There was an increase in average IOP from 5 (±2.1) mmHg before surgery to 11.3 (±3.7) mmHg and in VA from 1.7 (±0.8) to 1.2 (±0.6) logMAR. Five out of six patients required additional surgery, mainly to further increase the IOP even though choroidal detachment had already resolved. Conclusion:Ab externo choroidal fluid drainage combined with pars plana vitrectomy and gas endotamponade seems to be an effective and safe treatment option in persistent ocular hypotony. Although repeated surgeries might be necessary, large-scale prospective studies must be undertaken to provide corroborative evidence.

Magnetic intraocular foreign bodies can be removed with magnetized disposable forceps. Aim of this study is to compare the forceps magnetizability of different size, form and manufacturer. The forceps were magnetized using an established procedure. The inducible magnetic flux density was measured at the tip of the forceps. The mass that can be lifted with the magnetized forceps was then tested using steel balls in BSS solution. The weight of the metal parts of the forceps was measured. The magnetic flux density that could be induced, the weight of the steel balls that could be lifted and the mass of stainless steel used in the forceps were as follows: Alcon end-grasping 23G: 7.12 mT, 87.43 mg, 1191 mg; Alcon end-grasping 25G: 6.43 mT, 87.43 mg, 1189 mg; Alcon serrated: 4.39 mT, 63.78 mg, 1284 mg; Alcon serrated 23G: 3.62 mT, 13.74 mg, 1200 mg; Alcon serrated 25G: 2.4 mT, 13.74 mg, 1195 mg; DORC end-grasping 23G: 5.52 mT, 32.54 mg, 153 mg; Synergetics end-grasping 23G: 4.35 mT, 16.37 mg, 193 mg; Vitreq BV end-grasping 23G: 2.65 mT, none, 88 mg. The magnetizability of a disposable microforceps seems to depend on the mass of steel at the tip of the forceps. The structure of the iron lattice could have an even greater influence. Not every disposable forceps can be sufficiently magnetized for this technique. What is known: • Steel intraocular foreign bodies can be lifted with magnetized forceps. What is new: • Not every forceps can be magnetized sufficiently. • Whether forceps can be magnetized well or poorly seems to have less to do with the stainless steel mass of the forceps. • The iron lattice structure of the used steel could be responsible for the magnetizability of the forceps.

PurposeThis study aims to evaluate the epidemiological patterns, treatment strategies, and survival outcomes of conjunctival malignancies in Germany between 2009 and 2019.MethodsA total of 1,532 cases were analyzed, with the crude incidence rate calculated. The survival rates were investigated using life tables and Cox regression analysis.ResultsThe overall incidence rate was 1.7 per million. Incidence rates varied across age groups, peaking in the 75+ age group. Carcinomas (43%), melanomas (30%), and lymphomas (20%), were the most prevalent malignancies. Of the total cases with reported treatment, surgical intervention was undertaken in 64.5% of the patients. The 5-year overall survival rates were 90.4% for lymphomas, 73.8% for melanomas, and 72.9% for carcinomas. Age at diagnosis emerged as a significant prognostic factor in the Cox regression analysis.ConclusionsThis study provides the first population-based incidence data on conjunctival malignancies in Germany, noting a generally low incidence with survival rates comparable to other regions. The findings underscore the importance of consistent reporting and further research into risk factors for a deeper understanding of these malignancies. The study calls for improved reporting systems and further investigations into genetic factors and targeted prevention strategies for high-risk groups.