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Dmitrii S Maltsev,1 Alexei N Kulikov,1 Venera A Shaimova,2,3 Maria A Burnasheva,1 Alexander S Vasiliev1 1Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russia; 2Academy of Postgraduate Education of the Federal Scientific and Clinical Center of Specialized Medical Care and Medical Technologies, Moscow, Russia; 3“Center Zreniya”, Chelyabinsk, RussiaCorrespondence: Dmitrii S Maltsev, Department of Ophthalmology, Military Medical Academy, 21, Botkinskaya Street, St. Petersburg, 194044, Russia, Email glaz.med@yandex.ruAbstract: Lattice degeneration (LD), routinely diagnosed with indirect ophthalmoscopy, is one of the most common and clinically significant peripheral retinal findings. In this review, we have summarized the data on currently available imaging techniques which help to improve diagnosis and our understanding of LD pathogenesis. Ultra-wide field imaging provides reliable color fundus capturing for the primary diagnosis of LD and may also be used as a screening tool. Wide-field imaging can be used for targeted documentation of LD lesions using true colors and with minimal optical distortions. Information on the status of the vitreoretinal interface, including detection of retinal holes, detachments, and vitreous tractions, can be obtained with peripheral structural optical coherence tomography (OCT) or scanning laser ophthalmoscopy in retro-mode. These techniques clarify the associated risks of rhegmatogenous retinal detachment. Fundus autofluorescence can provide details on atrophic changes. However, the risk of retinal detachment by means of this technique requires further investigation. OCT angiography may be successfully performed for some lesions. Taken together, OCT and OCT angiography demonstrate thinning of the choroid, alteration of local choroidal microcirculation, and, in severe lesions, involvement of the sclera. OCT angiography confirms loss of retinal microcirculation within LD lesion, which was previously shown with f

Erika Fernández-Muñoz,1,&ast; Yolanda Chávez-Romero,1,&ast; Ricardo Rivero-Gómez,1,&ast; Rebeca Aridjis,2,&ast; Roberto Gonzalez-Salinas1,&ast; 1Anterior Segment Surgery Department. Asociación para Evitar la Ceguera en México I.A.P., Mexico City, Mexico; 2LaSalle School of Medicine, Mexico City, Mexico&ast;These authors contributed equally to this workCorrespondence: Erika Fernández-Muñoz, Anterior Segment Surgery Department, Asociación para Evitar la Ceguera en México I.A.P, Vicente García Torres 46, Barrio San Lucas, Coyoacán, PO. 04030, Mexico City, Mexico, Tel +52 55 10841400, Ext 1144, Email efernandez2108@gmail.comPurpose: To determine the energy expenditure in phacoemulsification surgery expressed as cumulative dissipated energy (CDE) among the divide and conquer, ultrachopper-assisted divide and conquer, and phaco-chop techniques for dense cataract removal.Patients and Methods: The clinical data were obtained from the medical charts of dense cataracts patients undergoing routine phacoemulsification employing any of three phaco-fragmentation techniques, including divide and conquer using the Kelman 0.9 mm tip, the ultrachopper tip, and the phaco-chop technique using the Kelman 0.9 mm tip. Cumulated dissipated energy (CDE), longitudinal ultrasound time (UST), and endothelial cell loss were compared among groups at the one-month postoperative.Results: Surgeries from 90 eyes were analyzed, among whom the conventional divide-and-conquer technique group included 30 patients, 32 in the ultrachopper group, and 28 in the phaco-chop technique group. The average CDE in the conventional divide and conquer group was 44.52 ± 23.00, the ultrachopper technique was 43.27 ± 23.18, and 20.11 ± 11.06 in the phaco-chop group. Phaco-fragmentation chop demonstrated significantly lower CDE than the other techniques (p= < 0.0001). The phaco-chop technique showed statistically significantly lower CDE when compared to the other two groups (p=&

Cinthia Minatel Riguetto,1,&ast; Eduardo Buzolin Barbosa,2,&ast; Camila Cristina Atihe,2 Fabiano Reis,3 Mônica Alves,2 Denise Engelbrecht Zantut-Wittmann1 1Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil; 2Department of Ophthalmology and Otorhinolaryngology, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil; 3Department of Radiology, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil&ast;These authors contributed equally to this workCorrespondence: Denise Engelbrecht Zantut-Wittmann, Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences – University of Campinas, Rua Tessália Vieira de Camargo, 126, Campinas, São Paulo, 13084-971, Brazil, Tel +55 19 32894107, Email zantutw@unicamp.brPurpose: This study evaluated the ocular surface disease (OSD), especially dry eye disease (DED) parameters by combining qualitative and quantitative tools, including tear matrix metalloproteinase 9 (MMP-9), in patients with Graves’ disease (GD) with and without Thyroid eye disease (TED).Patients and Methods: A total of 17 active TED, 16 inactive TED, 16 GD without ophthalmopathy, and 16 healthy controls were included. All patients were assessed with CAS, ophthalmometry, qualitative tear MMP-9, Ocular Surface Disease Index (OSDI), ocular surface staining, Schirmer test, meibography, tear meniscus height, conjunctival hyperemia, and non-invasive tear film break-up time. Patients were classified into three subtypes of DED: aqueous tear deficiency, meibomian gland dysfunction (MGD) and mixed dry eye.Results: Inactive TED was shown to be an associated factor with DED (odds ratio 14, confidence interval 2.24– 87.24, p=0.0047), and presented more DED than healthy controls (87.5% versus 33.3%, p=0.0113). MGD was also more prevalent among these subjects than in healthy control (62.5% versus 6.7%; p=0.0273). No significant d

Bin Wei,&ast; Wen-Wen Fu,&ast; Yu Ji, Qi Cheng, Ben-Liang Shu, Qin-Yi Huang, Xiao-Rong Wu Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiao-Rong Wu, Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330000, People’s Republic of China, Email wxr98021@126.comAim: The objective of this study was to examine changes in functional connectivity (FC) in the hippocampus among patients with high myopia (HM) compared to healthy controls (HCs) through the utilization of seed-based functional connectivity (FC) analysis.Methods: Resting-state functional magnetic resonance imaging (fMRI) was conducted on a sample of 82 patients diagnosed with high myopia (HM) and 59 HCs. The two groups were matched based on age, weight and other relevant variables. Using seed-based FC analysis to detect alterations in hippocampal FC patterns in HM patients and HCs. Furthermore, a correlation analysis was performed to examine the associations between the mean functional connectivity (FC) signals in various brain regions of patients with HM and their corresponding clinical manifestations.Results: The FC values in the left temporal pole-temporal gyrus (L-TPOsup), right hippocampus (R-HIP), left medial temporal gyrus (L-MTG) and left hippocampus in HM patients were significantly lower than those of healthy subjects. In the left temporal pole-superior temporal gyrus (L-TPOsup), right orbital part of middle frontal gyrus (RO-MFG), left fusiform gyrus (L-FG), left cerebellum superior (L-Cbe6), left middle temporal gyrus (L-MTG), right thalamus (R-THA), and right hippocampus, FC values were also significantly lower.Conclusion: Brain dysfunction was observed in various regions of the HM patients, suggesting the existence of neurobiological alterations that could lead to impairments in

Baye Ashenef,1 Mengistie Diress,2 Yigizie Yeshaw,2 Baye Dagnew,2 Yibeltal Yismaw Gela,2 Yonas Akalu,2 Abdulhenan Abdurahman,3 Kassa Abebaw1 1Department of Human Physiology, School of Medicine, Debre Markos University, Debre Markos, Ethiopia; 2Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia; 3Department of Human Physiology, School of Medicine, Madda Walabu University, Bale Goba, EthiopiaCorrespondence: Baye Ashenef, Email bayeashenafi77@gmail.comBackground: Visual impairment is one of the most common long-term effects of high blood pressure. It affects one’s quality of life, independence, and mobility. There is a paucity of information regarding the prevalence of visual impairment due to hypertension in Ethiopia. Therefore, this study aimed to determine the prevalence of visual impairment and its associated factors among hypertensive patients in referral hospitals of the Amhara region, Ethiopia, 2021.Methods: An institution-based cross-sectional study was conducted among 423 study participants, which were selected by systematic random sampling technique. Data were collected by using an interviewer-administered structured questionnaire and physical measurements. The collected data were entered into Epi-data version 4.6. Then, exported into SPSS Version 26 for analysis. The crude and adjusted odds ratios and 95% Confidence intervals were calculated. Both bivariable and multivariable logistic regression analyses were done. Variables with a p-value of ≤ 0.05 were stated as significantly associated with visual impairment.Results: The overall prevalence of visual impairment among hypertensive patients was 32.4% (95% CI: 27.9– 37.9). Duration of hypertension ≥ 5 years (AOR =3.06, 95% CI: 1.86– 4.95), history of ocular trauma (AOR =2.50, 95% CI: 1.3– 4.73), and ever alcohol drinking (AOR = 2.72, 95% CI: 1.32– 5.62) were significantly associated with visual impairment.Conclusion: Nearly one-third of hypertensive patient

Majid Moshirfar,1–3 Joshua S Theis,4 David S Cha,5 Kaiden B Porter,4 Carter J Payne,1,6 Phillip C Hoopes1 1Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA; 2John A. Moran Eye Center, University of Utah, School of Medicine, Salt Lake City, UT, USA; 3Utah Lions Eye Bank, Murray, UT, USA; 4University of Arizona College of Medicine Phoenix, Phoenix, AZ, USA; 5Saint Louis University, School of Medicine, Saint Louis, MO, USA; 6Department of Ophthalmology, George Washington University School of Medicine and Health Sciences, Washington, DC, USACorrespondence: Majid Moshirfar, Hoopes Vision Research Center, 11820 S. State St. &num;200, Draper, UT, 84020, USA, Tel +1 801 568 – 0200, Fax +1 415-476-0336, Email cornea2020@me.com

James Chelnis,1,2,&ast; Chantel N Garcia,3,&ast; Haya Hamza4 1New York Eye & Ear Infirmary of Mount Sinai, New York, NY, USA; 2Manhattan Face and Eye, New York, NY, USA; 3Carolina Eye Doctors, Harrisburg, NC, USA; 4Lumenis Be, Yokneam, Israel&ast;These authors contributed equally to this workCorrespondence: James Chelnis, Manhattan Face and Eye, 150 W 58th St &num;1C, New York, NY, 10019, USA, Tel +1 212-484-9707, Email info@manhattanfaceandeye.comPurpose: To evaluate the efficacy of multi-frequency RF and IPL + MGX combination for treatment of Meibomian Gland Dysfunction (MGD).Patients and Methods: Eligible subjects had signs and moderate-to-severe symptoms of DED (Dry Eye Disease) due to MGD. Subjects underwent 4 treatments at 2-week intervals. Each treatment consisted of intense pulsed light (IPL) followed by radiofrequency (RF) on the periocular skin, followed by meibomian gland expression (MGX). The main outcome measure was the quality of meibum in 15 meibomian glands along the lower eyelid, using the modified Meibomian Gland Score (mMGS). The main hypothesis was a reduction of mMGS between the baseline (BL) and the follow-up (FU). Other outcome measures, such as symptoms measured with the OSDI (Ocular Surface Disease Index) questionnaire, meibography, non-invasive tear break-up time (NIBUT), and matrix metallopeptidase 9 (MMP-9) levels in tear samples were evaluated as well.Results: 31 subjects completed the FU. Between BL and FU, mMGS decreased from 30.4 (8.5) to 9.3 (9.5) (− 69.3%, 95% CI: − 55.6% to − 82.9%, p< 0.0001); OSDI decreased from 63.6 (17.2) to 25.0 (20.6) (− 60.7%, 95% CI: − 47.8% to − 73.5%, p< 0.0001); NIBUT did not change (p=0.92). An adjusted model with a historical control was constructed to allow the comparison of these subjects with those treated similarly with IPL+MGX (but without RF) in a different study. This analysis identified that the change in mMGS was larger when RF was included (− 20.9 vs âˆ

Manoj Motwani Cornea Revolution/Motwani LASIK Institute, San Diego, CA, 92121, USACorrespondence: Manoj Motwani, Cornea Revolution/Motwani LASIK Institute, 9710 Scranton Road, Suite 170, San Diego, CA, 92121, USA, Tel +1 858 554-0008, Email drmmlj@gmail.com

Antony William,1 Sophia Kuehnel,1 Spyridon Dimopoulos,2 Jost Hillenkamp,1 Winfried Goebel1 1Department of Ophthalmology, University Eye Hospital Würzburg, Würzburg, Germany; 2Department of Ophthalmology, University Eye Hospital Tübingen, Tübingen, GermanyCorrespondence: Antony William, Department of Ophthalmology, University Hospital Würzburg, Josef–Schneider Straße 11, Würzburg, 97080, Germany, Tel +4993120120646, Email William_a@ukw.dePurpose: To analyse single-operation anatomical success (SOAS) of primary rhegmatogenous retinal detachment (RRD) repair by junior vitreoretinal surgeons guided by preoperative individual case selection by an experienced mentor vitreoretinal surgeon.Methods: Retrospective, single institute, observational study, included all patients who underwent standard pars plana vitrectomy (PPV) or combined encircling band (CB) and PPV and gas tamponade in the treatment of RRD from November 2021 to December 2022 were included. Preoperative selection for the surgery decision, whether standard PPV or combined CB & PPV was undertaken through the senior surgeon; according to the location and extensions of the RRD, number of retinal tears (RT) and lens status. We excluded patients with tractional retinal detachment, RD with proliferative vitreoretinopathy stage C, giant tears, trauma, previous scleral buckle, schisis RD and RD requiring silicone oil. The primary outcome measure was to evaluate the single-operation anatomic success (SOAS). Secondary outcome measures evaluated whether there was a statistical significant difference between both procedures.Results: Eighty-two eyes were included in the study. Forty-five eyes were selected for combined CB&PPV and 37 eyes for standard PPV. SOAS was achieved in 40 eyes (88.8%) in combined group and 35 eyes (94.5%) in standard PPV group. There was no statistically significant difference in the success rate between both operations, p = 0.65.Conclusion: Structured preoperative selection of stand

Ahmed A Alhagaa, Nermeen Mahmoud Badawi, Osama Abd Allah El-Morsy Ophthalmology Department, Faculty of Medicine, Menoufia University, Shebin Elkom, Menoufia, 6132415, EgyptCorrespondence: Ahmed A Alhagaa, Ophthalmology Department, Faculty of Medicine, Menoufia University, Shebin Elkom, Menoufia, 6132415, Egypt, Tel +201006742874, Fax +20482317508, Email ahmed.elhgaa@med.menofia.edu.egBackground: Glaucoma is the most typical cause of permanent blindness. POAG, or primary open angle glaucoma, is the most common type. The pattern electroretinogram (PERG) has become a promising technique for detecting glaucoma early-on. The goal of this study was to assess the ability of PERG to diagnose POAG, especially in early, difficult-to-diagnose cases in comparison with other already established diagnostic methods.Methods: 150 participants (300 eyes) were enrolled in a cross-sectional study at ophthalmology department at Menoufia University Hospital in August 2022 to February 2023. All recruited participants underwent comprehensive ophthalmological and PERG exams. The studied eyes were divided into three groups as 100 normal eyes (Group I), 100 eyes with preperimetric glaucoma (Group II), and 100 eyes with established perimetric glaucoma (Group III).Results: OCT-RNFL average thickness had a significant positive correlation with P50 latency (r=0.289, p=0.041) or P50 amplitude (r=0.302, p=0.018) and N95 amplitude (r=0.640, p=0.001) among group (II). Also, RNFL thickness had negative correlation with P50 amplitude (r= − 0.268, p=0.043) among group (III). RNFL thickness and P50 and N95 amplitude showed highest AUC values in detecting preperimetric glaucomatous eyes vs normal eyes (AUC=0.927, 0.952, 904), and for detecting established perimetric glaucomatous eyes vs normal eyes (AUC=1.00, 0.957, 0.983 respectively) compared with VF MD which showed AUC (0.458 and 0.901 respectively).Conclusion: Glaucoma patients exhibit PERG alterations (comparable to RNFL thickness changes) so, it c

Jennifer R Wong,1,&ast; David V Folden,2,3,&ast; George R Wandling,2,3 Scott Schaefer,2,4 Jeff Stephens,2,4 Calvin Boots,1,2 Carter J Nichols,2,4 Marshall H Everson,2,4 Ryan Johnson2,4 1Praxis Vision, Edina, MN, USA; 2Twin Cities Eye Consultants, Edina, MN, USA; 3North Suburban Eye Specialists, Coon Rapids, MN, USA; 4Edina Eye Physicians & Surgeons, Edina, MN, USA&ast;These authors contributed equally to this workCorrespondence: David V Folden Department of Cataract & Refractive Surgery, Twin Cities Eye Consultants, 3777 Coon Rapids Blvd NW, Coon Rapids, MN, 55433, USA, Tel +1 763-421-7420, Fax +1 763-421-0730, Email foldav@gmail.comPurpose: To report on the visual outcomes of the second-generation (ActivShieldTM) Light Adjustable Lens (LAL) used in cataract surgery for patients with a history of laser refractive surgery (LASIK and/or photorefractive keratectomy [PRK]) using a co-managed, open-access methodology.Patients and Methods: This retrospective case series of consecutive patients with history of laser refractive surgery implanted with the second-generation LAL with an emmetropic target were included in the study. Following surgery, all patients received their ultraviolet (UV) light treatments at a separate open-access facility through a co-managed arrangement. Uncorrected distance visual acuity (UDVA), spherical equivalent (SE), and residual cylinder for eyes with an emmetropic refractive target were the primary outcome measures as documented at the patient’s final, stable, refractive postoperative exam.Results: Thirty-three patients (34 eyes) with a history of laser refractive surgery were included in the study and implanted with the second-generation LAL with a postoperative emmetropic refractive target. Twenty-eight (82.4%) saw 20/20 or better and 9 (26.5%) saw 20/15 or better. The mean SE was 0.01 ± 0.31 D and 33 (97.1%) were within ± 0.50 D SE of plano. The mean residual cylinder was − 0.28 ± 0.32 D and 30 (88.2%) were within

Anh D Bui,1 Angeline Truong,2 Neel D Pasricha,1,3 Maanasa Indaram1 1Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA; 2School of Medicine, University of California San Francisco, San Francisco, CA, USA; 3Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, USACorrespondence: Maanasa Indaram, Wayne and Gladys Valley Center for Vision, UCSF Department of Ophthalmology, 490 Illinois Street, San Francisco, CA, 94158, Tel +1 415 476-2896, Email Maanasa.Indaram@ucsf.eduAbstract: Keratoconus is a disorder characterized by progressive corneal thinning and steepening that may result in significant visual impairment secondary to high astigmatism, corneal scarring, or even corneal perforation. Early detection and screening of keratoconus are essential for effective management and treatment. Several screening methods, such as corneal topography and tomography, corneal biomechanics, and genetic testing, are being developed to detect keratoconus at an early stage. Once detected, prevention of progression is the mainstay of keratoconus management. Corneal collagen cross-linking is a minimally invasive treatment option that can slow or halt the progression of keratoconus. Additionally, recent studies have investigated the potential use of copper sulfate eye drops (IVMED-80) and extracellular vesicles to prevent the progression of keratoconus as non-invasive treatment options. For visual rehabilitation, currently available treatments include scleral lenses, intracorneal ring segments, corneal allogenic intrastromal ring segments, and deep anterior lamellar keratoplasty. The safety and efficacy of these emerging treatment options for keratoconus are currently being investigated.Keywords: keratoconus, corneal cross-linking, intracorneal ring segments, deep anterior lamellar keratoplasty, IVMED-80, extracellular vesicles

Trailuk Yospon,&ast; Kulawan Rojananuangnit&ast; Department of Ophthalmology, Mettapracharak (Wat Rai Khing) Hospital, Nakhon Pathom, Thailand&ast;These authors contributed equally to this workCorrespondence: Kulawan Rojananuangnit, Department of Ophthalmology, Mettapracharak (Wat Rai Khing) Hospital, 52 Moo 2 Rai Khing District Sampran, Nakhon Pathom, 73210, Thailand, Email kulawan@me.comPurpose: To assess the ability of vascular perfusion parameters determined by optical coherence tomography angiography (OCTA) to detect and monitor glaucoma.Methods: This prospective study included healthy, glaucoma suspect and glaucomatous eyes. All eyes underwent comprehensive glaucoma examination, including visual field tests and ocular imaging scans by OCTA. Parameters measured included retinal nerve fiber layer (RNFL) thickness, ganglion cell analysis (GCA), vascular perfusion density (VPD) and flux index (FI) of the optic nerve and peri-papillary area. Ocular parameters in healthy, glaucoma suspect, and glaucomatous eyes were compared by generalized estimating equations (GEE) with adjustments for age, with their relationships analyzed by Pearson’s correlation coefficient. Rates of change per year were compared in glaucomatous eyes with and without glaucoma progression.Results: This study enrolled 238 eyes, including 56 healthy, 79 glaucoma suspect, and 103 glaucomatous eyes. After adjustments for age, the average VPD (45.40 ± 0.19% vs 45.05 ± 0.22% vs 42.89 ± 0.32%, p < 0.001) and FI (0.4210 ± 0.0055 vs 0.4105 ± 0.0039 vs 0.3801 ± 0.0048, p < 0.001) in these three groups differed significantly. Average VPD in the glaucoma group was inversely associated with the severity of glaucoma, being 43.99 ± 0.32%, 42.63 ± 0.43% and 39.27 ± 0.48% in eyes with early, moderate and severe glaucoma, respectively (p < 0.001). Average VPD, as well as VPD in the superior and inferior quadrants correlated well with both OCT determined RNFL and visual field paramet

Viona Viona,1,&ast; Iwan Soebijantoro,2,&ast; Tjahjono D Gondhowiardjo3,&ast; 1Department of Research, Jakarta Eye Center (JEC) Eye Hospitals and Clinics, Jakarta, Indonesia; 2Department of Glaucoma, Jakarta Eye Center (JEC) Eye Hospitals and Clinics, Jakarta, Indonesia; 3Department of Corneal and Refractive Surgery, Jakarta Eye Center (JEC) Eye Hospitals and Clinics, Jakarta, Indonesia&ast;These authors contributed equally to this workCorrespondence: Viona Viona, Jalan Terusan, Jl. Arjuna Utara Jl. Kedoya Raya No. 1, Kedoya Sel., Kec. Kb, Jeruk, West Jakarta, 11520, Jakarta, Email vionagunawan@yahoo.comPurpose: We evaluate the reduction of corneal astigmatism and the improvement of visual outcomes of this surgical method in the Indonesian population. We also assess the accuracy and predictability of using femtosecond laser astigmatic keratotomy (FLAK) combined with cataract surgery.Patients and Methods: In a retrospective study, a total of 275 subjects (78 with against-the-rule (ATR) astigmatism, 178 with with-the-rule (WTR) astigmatism, and 19 with oblique (OBL) astigmatism) with preexisting corneal astigmatism ranging from 0.75D to 3.00D underwent FLAK. All subjects completed a 3-month follow-up. The femtosecond laser used for creating paired AK 2.2 mm, primary incision, and paracentesis incision was the FEMTO Z8 NEO from Ziemer Ophthalmic System, Switzerland. The surgical approach was guided by the “NAPA” nomogram.Results: The reduction in postoperative astigmatism was 56.90% for the WTR group, 49.46% for the ATR group, and 47.33% for the oblique group. A significant reduction in astigmatism was observed at the 1-week, 1-month, and 3-month follow-up intervals in both the WTR and ATR groups. The reduction in astigmatism was more favorable in cases of moderate astigmatism within the WTR group, as compared to the ATR and oblique groups. Postoperative astigmatism reduction was found to be more predictable in the right eye than in the left eye.Con

Chuchu Churko,1 Alemayehu Bekele Kassahun,1 Tamiru Getachew,2 Belachew Bokicho,3 Haileyesus Deboch Terefe,3 Selamawit Dagne,4 Tsegaye Yohanes1 1Collaborative Research and Training Center for Neglected Tropical Diseases, College of Medicine and Health Sciences, Arba Minch University, Arba Minch Town, Southern Nation Nationality Region, Ethiopia; 2Department of Medical Anatomy, Arba Minch University, Arba Minch Town, Southern Nation Nationality Region, Ethiopia; 3Disease Prevention and health Promotion Directorate, Hawassa Town, Southern Nation Nationality Region, Ethiopia; 4Orbis International Ethiopia, Arba Minch Branch Office, Arba Minch Town, Southern Nation Nationality Region, EthiopiaCorrespondence: Chuchu Churko, Tel +251920315157, Email churkochuchu2005@gmail.comBackground: Post-operative trichiasis (PTT) is a major challenge following corrective eyelid surgery for trachomatous trichiasis. There is a scarcity of research on post-operative trichiasis in Southern Ethiopia, particularly in the study area. This study aimed to assess the prevalence of post-operative trichiasis in patients who underwent corrective surgery.Objective: To assess the prevalence of post-operative trichiasis in the Gamo Zone in Southern Ethiopia in 2021.Methods: A descriptive community-based cross-sectional study was conducted in the Dita district, Southern Ethiopia. The data were collected between 2014 and 2020. Three Qualified trachoma trichiasis (TT) graders working on a trachoma impact survey were recruited for this study. Eye examinations were performed by graders on all study subjects using a loupe to identify post-operative trichiasis. All patients underwent upper eyelid surgery only. A systematic sampling technique was used to select 459 participants from the TT Surgery Logbook.Results: Of the 459 study participants, more than three quarter 353 (76.9%) were female. The mean age of the study subjects was 48.38 years with a standard deviation of +-10.4. A total of 10 upper eyelids (

Tom Kornhauser,1 Christian M Ponder,1 Philip W Dockery,1 Anna B Sharabura,2 Wade Brock,2,3 John Nguyen,4 John D Pemberton1 1Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA; 2College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA; 3Arkansas Oculoplastic Surgery, PLLC, Little Rock, AR, USA; 4West Virginia University, Department of Ophthalmology and Visual Sciences, Department of Otolaryngology and Head and Neck Cancer, Morgantown, WV, USACorrespondence: Tom Kornhauser, Jones Eye Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72207, USA, Tel +501-686-5822, Fax +501-686-7037, Email tkornhauser@uams.eduPurpose: To elicit, from a survey of oculoplastic surgeons, the timing and reason for delaying Jones tube placement after the excision of nasal or lacrimal drainage system malignancy.Methods: The authors reviewed current literature and distributed an anonymous survey to 627 members of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) to determine the length of time members wait to perform a Jones tube placement after the removal of nasal or lacrimal drainage system malignancy. The survey also included questions about the rationale for this waiting period.Results: Fifty-eight members of ASOPRS (9.3%) responded to our survey, 49 (84.4%) of whom had performed Jones tube placement on patients who had an excision of a nasal or lacrimal drainage system malignancy. Nearly 52% of respondents waited one year for Jones tube placement. However, a sizeable number of respondents opted to wait five years (15.1%). The most common rationale for waiting was a concern for tumor recurrence (42 responses).Conclusion: There is no consensus on when to perform Jones tube placement after the excision of nasal or lacrimal drainage system malignancy. This survey demonstrates a broad array of waiting periods between operations, although most surgeons w

Ahmet Kaan Gündüz,1,2,&ast; Di&gbreve;dem Tetik1,&ast; 1Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey; 2Private Eye Clinic, Farilya Business Center 8/38, Ankara, 06510, Turkey&ast;These authors contributed equally to this workCorrespondence: Ahmet Kaan Gündüz, Farilya Business Center 8/38, Ufuk Universitesi Cad, Çukurambar, Ankara, 06510, Turkey, Email drkaangunduz@gmail.comAbstract: Sclerochoroidal calcification (SCC) is a rare disease which is characterized by calcium deposition in the sclera. The choroid is secondarily involved. Typical localization is in the midperipheral region, outside the vascular arcades. SCC is mostly located in the superotemporal quadrant. Often times, the patients are referred with the diagnosis of an amelanotic tumor. SCC may be dystrophic or metastatic. Metastatic SCC lesions are associated with conditions altering calcium and phosphate metabolism including primary and secondary hyperparathyroidism, vitamin D intoxication, renal failure, hyperphosphatemia, and destructive bony lesions. SCC lesions have a characteristic appearance and appear as distinct, ill-defined, yellow-white, elevated scleral/choroidal masses funduscopically. The purpose of this literature review is to review the current knowledge on SCC, highlight the imaging features, and discuss the differential diagnosis as well as management options.Keywords: sclerochoroidal calcification, hyperparathyroidism, renal failure, ultrasonography, fluorescein angiography, optical coherence tomography

Astrid Hönekopp, Sarah Weigelt Department of Rehabilitation Sciences, Research Unit Vision, Visual Impairments & Blindness, TU Dortmund University, Dortmund, GermanyCorrespondence: Astrid Hönekopp, TU Dortmund University, Department of Rehabilitation Sciences, Otto-Hahn-Straße 20, Dortmund, D-44227, Germany, Tel +49 231 755 8049, Fax +49 231 755 6219, Email astrid.hoenekopp@tu-dortmund.deAbstract: With the increasing prevalence of myopia, evaluating its relationship with objective light exposure as a potential adjustable environmental factor in myopia development has been an emerging research field in recent years. From a thorough literature search, we identify ten wearable light meters from human studies on light exposure and myopia and present an overview of their parameters, thereby demonstrating the wide between-device variability and discussing its implications. We further identify 20 publications, including two reanalyses, reporting investigations of light-myopia associations with data from human subjects wearing light meters. We thoroughly review the publications with respect to general characteristics, aspects of data collection, participant population, as well as data analysis and interpretation, and also assess potential patterns regarding the absence or presence of light-myopia associations in their results. In doing so, we highlight areas in which more research is needed as well as several aspects that warrant consideration in the study of light exposure and myopia.Keywords: light exposure, outdoor exposure, myopia, wearables, lux

Rayssa Medeiros Léda,1 Daniela Cristina Schroff Machado,2 Wilson Takashi Hida,3 Antônio Francisco Pimenta Motta,4 Thiago de Faria Pacini,5 Rivadavio Fernandes Amorim1 1Department of Medical Sciences, Universidade de Brasília (UnB), Brasília, DF, Brazil; 2Department of Ophthalmology, Luz Hospital de Olhos e Laser, Goiânia, Goiás, Brazil; 3Department of Ophthalmology, Hospital Oftalmológico de Brasília, Brasília, DF, Brazil; 4Department of Ophthalmology, Rita Lavinia Hospital Dia, Salvador, Bahia, Brazil; 5Department of Ophthalmology, Hospital Pacini, Brasília, DF, BrazilCorrespondence: Rivadavio Fernandes Amorim, Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Campus Darcy Ribeiro, Asa Norte, Brasília, DF, CEP: 70910-900, Brasil, Tel +55 61 3107-1913 ; +55 61 981533379, Email rivadavioamorim@hotmail.comPurpose: To analyze whether femtosecond laser-assisted surgery leads to less cumulative dissipated energy (CDE) and decreased endothelial cell loss compared to conventional surgery.Patients and Methods: This non-blinded, non-randomized, quasi-experimental clinical trial was conducted at one center and involved one surgeon. Patients with cataracts and 50– 80 years old were included, and the exclusion criteria were radial keratotomy, trabeculectomy, drain tube implant, corneal transplant, posterior vitrectomy, and re-implantation of intraocular lens. In total, 298 patients were recruited between October 2020 and April 2021, and the data collected included sex, laterality, age, ocular comorbidities, systemic comorbidities and CDE. An endothelial cell count was performed before and after surgery. Patients were divided according to femtosecond laser-assisted phacoemulsification or conventional phacoemulsification. The femtolaser patients were submitted to the equipment, and then, immediately after treatment, phacoemulsification surgery was performed. In the conventional method, the “divide and conquer” technique was

Rashed Alfuzaie Ibn Sina Hospital, Shuwaikh, KuwaitCorrespondence: Rashed Alfuzaie, Email ralfuzaie@gmail.comAbstract: The gut-eye axis has been hypothesized to be a factor in many eye pathologies. This review examines papers from PubMed about this topic. Bacterial commensals could either be protective by regulating the immune system or prove to be damaging to the gut mucosal wall and incite an inflammatory process. The balance between the two appears to be crucial in maintaining eye health. Imbalances have been implicated in ophthalmologic conditions. The use of probiotics, dietary modifications, antibiotics, and faecal microbiota transplant in mice with pathologies such as those encountered in our practice appears to reverse disease course or at least prevent its progression. Clinical trials are currently underway to investigate their clinical significance in diseased patients.Keywords: ophthalmology, gastrointestinal microbiome, gut-eye axis, inflammation, faecal microbiota transplant

Ariesanti Tri Handayani,1 Clara Valentina,1 I Gusti Ayu Ratna Suryaningrum,1 Putu Dian Megasafitri,1 I Gusti Ayu Made Juliari,1 Ida Ayu Ary Pramita,1 Shintaro Nakayama,2,3 Eisuke Shimizu,2,3 Anak Agung Mas Putrawati Triningrat1 1Ophthalmology Study Program Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia; 2Department of Ophthalmology, Keio University School of Medicine, Shinjuku, Tokyo, Japan; 3OUI Inc ., Minato, Tokyo, JapanCorrespondence: Ariesanti Tri Handayani, Ophthalmology Study Program Faculty of Medicine, Udayana University, Jl. Diponegoro, Dauh Puri Klod, Kec, West Denpasar, Denpasar City, Bali, 80113, Indonesia, Tel +62818-375611, Email ariesanti@unud.ac.idIntroduction: Dry eye disease (DED) is a multifactorial disease of tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability leading to decrease of vision, productivity and quality of life, and blindness. DED diagnosis remains difficult and underdiagnosed regarding inconsistency between subjective symptoms and clinical findings. Tear break-up time (TBUT) is an objective indicator of tear film stability in diagnostic DED. A novel smartphone attachment, namely SEC (smart eye camera), could mimic conventional slit lamp to assess TBUT and beneficial in facilitating DED diagnosis. Reliability between a non and an ophthalmologist in TBUT assessment and DED diagnosis is observed in this study.Purpose: To determine interobserver reliability of TBUT measurement for diagnosing DED using SEC.Design: This a cross-sectional analytic study involving 99 participants (198 eyes) aged 40 years who visited Pratama Gema Santi Hospital, Nusa Penida, from September 2nd to 4th, 2022, with consecutive sampling technique.Methods: Fluoresceined eyes were filmed using the SEC device and apps, continued by masked ophthalmologist and resident assessing TBUT based on the video. The primary outcome is interobserver reliability for TBUT measurement and DED diagnosis

Bonnie An Henderson,1 Jaime Aramberri,2 Robin Vann,3 Adi Abulafia,4 Margaret Ainslie-Garcia,5 John Berdahl,6 Nicole Ferko,5 Kjell Gunnar Gundersen,7 So Goto,8,9 Preeya Gupta,10,11 Samuel Multack,12– 14 Elizabeth Persaud,5 Duna Raoof,15 Giacomo Savini,16 H John Shammas,17 Li Wang,18 Wendy Zhi Wang5 1Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, USA; 2Ophthalmology Clinic Miranza Begitek, San Sebastian, Spain; 3Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA; 4Department of Ophthalmology, Shaare Zedek Medical Center, Hadassah Faculty of Medicine, the Hebrew University, Jerusalem, Israel; 5EVERSANA, Burlington, ON, Canada; 6Vance Thompson Vision, Sioux Falls, SD, USA; 7IFocus Øyeklinikk AS, Haugesund, Norway; 8Herbert Wertheim School Optometry and Vision Science, University of California, Berkeley, CA, USA; 9Department of Ophthalmology, National Hospital Organization, Tokyo Medical Center, Meguro-ku, Tokyo, Japan; 10Triangle Eye Consultants, Raleigh, NC, USA; 11Department of Ophthalmology, Tulane University, New Orleans, LA, USA; 12Laser and Cataract Institute, Frankfort, IL, USA; 13Advocate South Suburban Hospital, Hazel Crest, IL, USA; 14Advocate Trinity Hospital, Chicago, IL, USA; 15NVISION Eye Center, Newport Beach, CA, USA; 16IRCCS - G.B. Bietti Foundation, Rome, Italy; 17Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA; 18Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USACorrespondence: Bonnie An Henderson, Tufts University School of Medicine, Boston, MA, USA, Tel +1 617 957 9279, Email bonnieanhenderson@gmail.comPurpose: To obtain consensus on the key areas of burden associated with existing devices and to understand the requirements for a comprehensive next-generation diagnostic device to be able to solve current challenges and provide more accurate prediction of intraocular lens (IOL) power and presbyopia correcti

Chia-Wen Hsiao,1 Hang Cheng,1 Rana Ghafouri,2 Nicole C Ferko,2 Brandon D Ayres3 1Alcon, Fort Worth, TX, USA; 2Eversana, Burlington, ON, Canada; 3Thomas Jefferson University Hospital, Philadelphia, PA, USACorrespondence: Nicole C Ferko, Eversana Life Science Services, 3228 S Service Road, Burlington, ON, Canada, Tel +1 (905) 978-3111, Email nicole.ferko@eversana.comBackground: Ophthalmic viscosurgical devices (OVDs) are commonly used during cataract surgery to protect the corneal endothelium. A systematic literature review and meta-analysis were conducted to assess the clinical evidence of OVDs composed of chondroitin sulfate-hyaluronic acid (CS-HA) versus other OVDs in maintaining endothelial cell density (ECD) and corneal thickness (CT).Methods: MEDLINE and EMBASE databases were searched from 2000 to 2020. Randomized controlled trials (RCTs, N ≥ 20 per group) comparing an OVD containing CS-HA (ie, VISCOAT®, DuoVisc® or DisCoVisc®) to any other OVD were included. The identified comparators were limited to the OVDs found in the literature, which included those composed of HA-only or hydroxypropyl methylcellulose (HPMC). Outcomes of focus included changes in ECD (baseline to 3 months) and CT (baseline to 24 hours). Meta-analyses were performed using R software, to assess mean differences (MD) in ECD and CT change between CS-HA OVDs and HA-only or HPMC OVDs.Results: A total of 966 abstracts were screened, and data were extracted from 12 RCTs. Meta-analyses using a random-effects model revealed significantly lower percent (%) decrease in ECD for CS-HA OVDs compared to both HA-only (MD: − 4.10%; 95% CI: − 5.81 to − 2.40; p < 0.0001; 9 studies) and HPMC (MD: − 6.47%; 95% CI: − 10.41 to − 2.52; p = 0.001; 2 studies) products. Similarly, % CT increase was significantly lower with CS-HA than with HA-only OVDs (MD: − 3.22%; 95% CI: − 6.24% to − 0.20%; p = 0.04; 4 studies). However, there were no significant differences when comparing % CT change betw

Chisom T Madu, Oluwafisayo Adeoye, Imani Nwokeji City University of New York School of Medicine, Ophthalmology Specialty Interest Group, New York, NY, USACorrespondence: Chisom T Madu, City University of New York School of Medicine, Ophthalmology Specialty Interest Group, 160 Convent Avenue, New York, NY, 10031, USA, Email cmadu000@citymail.cuny.edu

Zachary Zavodni,1 Li-Chen Pan,2 Kaitlyn Mok,2 Hang Cheng,3 Derek O’Boyle4 1The Eye Institute of Utah, Salt Lake City, UT, USA; 2Veranex Solutions, Inc., Boston, MA, USA; 3Alcon Vision, LLC, Fort Worth, TX, USA; 4Alcon Laboratories Ireland Ltd., Cork, IrelandCorrespondence: Kaitlyn Mok, Veranex Solutions, Inc, 33 Arch Street, Boston, MA, USA, Tel +1 617-865-8408, Email kaitlyn.mok@veranex.comPurpose: Inefficiencies from manual data entry and non-integration exist throughout the cataract surgery workflow. The aim of this study was to evaluate the impact of SMARTCataract, an innovative cloud-based digital surgical planning platform (SPS) on efficiency in preoperative (diagnostic workup, surgery planning), intraoperative, and postoperative phases of cataract surgery. The primary objective aimed to assess time and number of manual transcription data points (TPs) required for all pre-, intra-, and postoperative devices that integrate with the SPS and surgery planning time across three patient types (post-refractive, astigmatic, conventional). The secondary objective aimed to assess the overall efficiency impact of the SPS on the surgery workflow for the three patient types by leveraging time-and-motion methods and workflow mapping.Patients and Methods: This prospective, observational, real-world, pre- and post-cohort time-and-motion study included patients undergoing evaluation for cataract surgery and/or surgery at the study site. Assessed variables included time and TPs required for clinical activities and devices associated with traditional manual methods (pre-cohort) versus the SPS (post-cohort). Statistical analyses (t-test) were performed comparing performance time using the SPS versus traditional methods for each integrated technology and surgery planning activity.Results: The SPS demonstrated statistically significant time savings over traditional methods in TP data input time taken across all integrated pre-, intra-, and postoperative devices (p< 0.0001). Th

Robert E Morris,1– 3 Ferenc Kuhn,2,4 Cole Richardson1– 3 1Retina Specialists of Alabama, LLC, Birmingham, AL, USA; 2Helen Keller Foundation for Research and Education, Birmingham, AL, USA; 3Department of Ophthalmology, University of Alabama at Birmingham (UAB), Birmingham, AL, USA; 4Department of Ophthalmology, University of Pécs Medical School, Pecs, HungaryCorrespondence: Robert E Morris, Helen Keller Foundation for Research and Education, 2208 University Boulevard, Suite 101, Birmingham, AL, 35233, USA, Tel +1 205 936 0704, Email rmorris@rmeyes.comAbstract: Encircling (360 degree) retinal detachment prophylaxis using indirect ophthalmoscope laser delivery recently achieved strong proof of safety and effectiveness by preventing the development of peripheral retinal tears and detachments in the eyes of patients with Stickler syndrome (syndromic eyes). Untreated, Stickler syndrome patients have a 65% lifetime risk of retinal detachment (half by age 20, 80% bilateral). This report describes an optimal technique of encircling laser retinopexy to also prevent the more common retinal detachments seen in aging (non-syndromic) eyes that share with Stickler syndrome the common pathogenesis of peripheral retinal tears caused by vitreous traction.Keywords: retinal tear, retinal detachment, retinal detachment prevention, 360-degree laser retinopexy, encircling laser prophylaxis, ora secunda cerclage, Stickler syndrome

Abdelrahman M Elhusseiny,1,2,&ast; Mohamed M Khodeiry,3,4,&ast; Richard K Lee,4 Tarek Shaarawy,5 Salman Waqar,6 Mohamed S Sayed6 1Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA; 2Department of Ophthalmology, Boston Children’s Hospital, Boston, MA, USA; 3Department of Ophthalmology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA; 4Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; 5Department of Ophthalmology, Hôpitaux Universitaires de Genève, University of Geneva, Geneva, Switzerland; 6Glaucoma Division, Moorfields Eye Hospitals, Dubai, United Arab Emirates&ast;These authors contributed equally to this workCorrespondence: Mohamed S Sayed, Glaucoma Division, Moorfields Eye Hospitals, Dubai, United Arab Emirates, Tel +97144297888, Email msayed82@hotmail.comPurpose: The Paul glaucoma implant (PGI, Advanced Ophthalmic Innovations, Singapore, Republic of Singapore) is a recently developed novel non-valved glaucoma drainage device (GDD) designed to effectively reduce the intraocular pressure (IOP) in glaucoma patients with a theoretically reduced risk of postoperative complications such as hypotony, endothelial cell loss, strabismus, and diplopia. Limited literature has evaluated its use in adult glaucoma; however, its use in pediatric glaucoma has not been reported to date. We present our early experience with PGI in refractory childhood glaucoma.Patients and Methods: This study was retrospective single-surgeon case series in a single tertiary center.Results: Three eyes of 3 patients with childhood glaucoma were enrolled in the study. During nine months of follow-up, postoperative IOP and number of glaucoma medications were significantly lower than preoperative values in all the enrolled patients. None of the patients developed postoperative complications including postoperative hypot

Dian Irawati,1 Muhamad Adli,1 Dedi Fitri Yadi2 1Department of Anesthesiology, National Eye Center Cicendo Eye Hospital-Universitas Padjadjaran, Bandung, West Java, Indonesia; 2Department of Anesthesiology, Dr. Hasan Sadikin General Hospital- Universitas Padjadjaran, Bandung, West Java, IndonesiaCorrespondence: Dian Irawati, Department of Anesthesiology, National Eye Center Cicendo Eye Hospital-Universitas Padjadjaran, Tel +62 8138932261, Email dyeanirawati@gmail.comBackground: The combination between sedatives and opioids is one of the recommended anesthetic options in ophthalmic procedures and regimens are more advantageous as smaller amounts of each drug can be administered to reduce side effects and have proper outcomes due to the synergistic effects. This study aims to observe the use of low-dose propofol and fentanyl for patients undergoing phacoemulsification surgery.Material and Methods: This observational study involves a sample of 125 adult patients who underwent elective cataract procedures using the phacoemulsification technique and had an American Society of Anesthesiologists (ASA) physical status of 1 to 3. Dose amount of fentanyl and propofol, Ramsay score, hemodynamic parameter, side effects, and patient satisfaction were evaluated, recorded, and analyzed using a 5-point Likert scale.Results: The result showed the mean absolute dose of propofol was 12.46± 4.376 mg, with a range between 10 and 30 mg, while the mean per body weight was 0.21± 0.075 mg. Similarly, the mean absolute dose for fentanyl was 25.04± 3.012 mcg within the range of 10– 50 mcg, and the per-body weight dose was 0.43± 0.080 mcg. About 90.4% and 9.6% of the patients reached Ramsay 2 and 3, respectively. The analysis of systolic, diastolic blood pressure, mean arterial pressure, and pulse rate showed that the combination of low-dose fentanyl and propofol was significantly lower than before therapy administration in all four values (p < 0.05).Conclusion: The combination of low

Clayton Blehm,1 Brad Hall2 1Gainesville Eye Associates, Gainesville, GA, USA; 2Sengi, Penniac, NB, CanadaCorrespondence: Clayton Blehm, Gainesville Eye Associates, 2061 Beverly Road, Gainesville, GA, 30501, USA, Tel +1 770-532-4444, Email claytonblehm@gmail.comPurpose: To determine the refractive stability of a new hydrophobic acrylic intraocular lens (IOL) when implanted bilaterally.Methods: This was a prospective, evaluator masked, single surgeon study of 58 eyes of 29 patients. Patients were bilaterally implanted with the Clareon monofocal IOL (CNA0T0, Alcon Vision LLC). Refractive stability was evaluated between 1 and 3 months postoperatively. At 3 months postoperatively, data were also collected for binocular uncorrected and distance corrected visual acuities at distance (4 m) and intermediate (80 cm and 66 cm) and binocular defocus curve.Results: Postoperative refraction was statistically equivalent between 1 and 3 months postoperatively (p < 0.001). Mean postoperative uncorrected distance visual acuity was − 0.01 ± 0.10 logMAR, and mean corrected distance visual acuity was − 0.04 ± 0.06 logMAR. Mean postoperative uncorrected intermediate visual acuity was 0.16 ± 0.13 logMAR and 0.24 ± 0.14 logMAR at 80 cm and 66 cm, respectively. With distance correction in place, mean visual acuity at 80cm and 60cm was 0.16 ± 0.13 logMAR and 0.23 ± 0.14 logMAR, respectively.Conclusion: The Clareon monofocal IOL can provide stable refraction, excellent distance vision, and functional intermediate vision postoperatively.Keywords: hydrophobic acrylic IOL, cataract surgery, Clareon

Sloan W Rush,1,2 Samuel Huseman,1,2 Ryan B Rush2,3 1Panhandle Eye Group, Amarillo, TX, USA; 2Department of Surgery, Texas Tech University Health Science Center, Amarillo, TX, USA; 3Southwest Retina Specialists, Amarillo, TX, USACorrespondence: Ryan B Rush, Southwest Retina Specialists, 7411 Wallace Blvd, Amarillo, TX, 79106, USA, Tel +1 806 351-1870, Email ryan.rush.md@gmail.comPurpose: To evaluate patient preferences in regards to the timing of the initial postoperative examination after undergoing cataract surgery.Methods: A retrospective, consecutive case series analysis from a single private practice institution was performed using a standardized phone survey on patients who underwent cataract surgery. Subjects were classified into one of two possible study groups according to the timing of their initial postoperative cataract surgery examination: Group A received the initial postoperative cataract surgery examination on the same day as the surgery, whereas Group B received the initial postoperative cataract surgery examination on the day following the operation.Results: There were 80 subjects contacted for the phone survey of which 70 (35 in each study group) completed the survey and therefore were included in the analysis. Group A subjects responded favorably in regards to preference and realizing reduced time and cost savings compared to Group B (p < 0.0001 for both). There were no subjects in Group A who would have preferred next-day initial postoperative care, whereas 31.4% of subjects in Group B would have preferred same-day care if given the opportunity.Conclusion: Patients undergoing cataract surgery both prefer and report time and cost savings with same-day initial postoperative care compared to next-day initial postoperative care. Patient preferences regarding their postoperative care should be one of the many factors that a surgeon ought to take into consideration when providing follow-up care after cataract surgery.Keywords: postoperative cataract

Debdulal Chakraborty,1 Milan Thakkar,2 Ramesh Venkatesh,3 Sangeeta Roy,4 Maulik Bhavsar,5 Helene Karcher6 1Disha Eye Hospital, Kolkata, West Bengal, India; 2Dr. Milan’s Retina Care Centre, Rajkot, Gujarat, India; 3Narayana Nethralaya, Bangalore, Karnataka, India; 4Susrut Eye Foundation and Research Centre, Kolkata, West Bengal, India; 5Novartis Healthcare Pvt. Ltd., Mumbai, Maharashtra, India; 6Novartis Pharma AG, Basel, SwitzerlandCorrespondence: Debdulal Chakraborty, Disha Eye Hospital, Kolkata, West Bengal, India, Email devdc@rediffmail.comObjective: To evaluate the short-term effectiveness and safety outcomes following brolucizumab treatment in patients with neovascular age-related macular degeneration (nAMD) as a part of real-world clinical practice in India.Methods: This was a retrospective, observational, multicentre study including patients (≥ 50 years old) diagnosed with nAMD. Anonymized data of the patients receiving the first dose of brolucizumab intravitreal injection (IVI) who were either treatment-naïve or previously treated with a single or a combination of other anti-VEGF IVIs were included. The present study reported the change in retinal fluid levels from baseline to month 3, best-corrected visual acuity (BCVA), central retinal thickness (CRT), and the number of injections received. The adverse events in the three months after brolucizumab treatment initiation were also monitored.Results: The study included 63 patients (65 eyes) from four study centres across India (mean age: 69.1 ± 9.7 years). A total of 82 brolucizumab injections were administered during the 3 months of study duration, with 52/65 (80.0%) eyes receiving only 1 injection. Resolution of IRF, SRF, and PED was observed in 76.9%, 64.6%, and 67.7% of eyes, respectively. Further, a significant reduction in CRT was observed (baseline: 403.5 ± 118.7 μm; month 3: 308.3 ± 73.8 μm; p < 0.001), and BCVA also improved notably from 0.7 ± 0.5 logMAR at baseline to 0.5 ± 0.4 logMAR

Alexandre Assi,1 Ahmad M Mansour,2 Abdul Razzak Charbaji,3 Maurizio Battaglia Parodi4 1Beirut Eye Clinic and VitreoRetinal Department, Beirut Eye Specialist Hospital, Beirut, Lebanon; 2Department of Ophthalmology, American University of Beirut, Beirut, Lebanon; 3Department of Statistics and Research Methodology, Lebanese American University, Beirut, Lebanon; 4Department of Ophthalmology and IRCCS Ospedale San Raffaele, University Vita-Salute, Milan, ItalyCorrespondence: Ahmad M Mansour, Department of Ophthalmology, American University of Beirut, POB 113-6044, Beirut, Lebanon, Tel +9613377633, Email ammansourmd@gmail.comPurpose: To study the anatomic outcome of leaving vitreous cortex remnants (VCR) during pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD).Methods: The study comprised patients with RRD who had PPV by a single surgeon between January 2019 and December 2020 and followed for 6 months. After intravitreal injection of triamcinolone acetonide, the topographic pattern of VCR at the periphery (p) and macula (m) was divided into 2 types by extent: complete or 4 quadrants (pVCR4Q), and between 2 and 4 quadrants ≥ 2 quadrants (pVCR> 2Q), or by location > 1 inferior retinal quadrant (pVCR> 1InfQ), and at the macula (mVCR). Anatomical failure or retinal re-detachment within 6 months after surgery was the primary outcome measures. The occurrence of grade C proliferative vitreoretinopathy (PVR) and epiretinal membrane (ERM) were used as secondary outcome indicators.Results: A 6-month prospective follow-up was performed on 103 patients. pVCR4Q was detected in 31 eyes, pVCR> 2Q in 40 eyes, pVCR> 1InfQ in 40 eyes and mVCR in 54 eyes. Recurrent RRD developed in 9 (8.7%) eyes, PVR grade C in 6 (5.8%) eyes and ERM in 11 (10.7%) eyes. According to multivariate regression analysis, the existence of any type of VCR did not correlate with anatomical failure, PVR or ERM.Conclusion: The initial success rate of PPV and the growth

Hashem Abu Serhan,1 Jehad Feras AlSamhori,2 Abdelmonem Siddiq,3 Abdul Rhman Hassan,4 Sara Irshaidat,5 Leen Abu Serhan,6 Abdullah Alawadhi,7 Abdelaziz Abdelaal,8 Wejdan Al-Thawabieh9 1Department of Ophthalmology, Hamad Medical Corporations, Doha, Qatar; 2Faculty of Medicine, University of Jordan, Amman, Jordan‬‬‬‬‬‬; 3Faculty of Pharmacy, Mansoura University, Mansoura, Egypt; 4Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University School of Medicine, Detroit, MI, USA; 5Department of Pediatrics, King Hussein Cancer Center, Amman, Jordan; 6Faculty of Medicine, Hashemite University, Zarqa, Jordan; 7Department of Ophthalmology, Islamic Hospital, Amman, Jordan; 8Harvard Medical School, Postgraduate Medical Education, Boston, MA, USA; 9Department of Ophthalmology, Dr. Sulaiman Al Habib Hospital, Riyadh, Saudi ArabiaCorrespondence: Hashem Abu Serhan, Department of Ophthalmology, Hamad Medical Corporations, PO 3050, Doha, Qatar, Tel +974-77912335, Email HAbuserhan@hamad.qaPurpose: Congenital nasolacrimal duct obstruction (CNLDO) is fairly common in newborns. The main aim of this cross-sectional study is to assess the preferred practice patterns of CNLDO among ophthalmologists in Jordan.Methods: This cross-sectional study was conducted across all ophthalmological practices in Jordan, using convenience sampling. An online questionnaire, designed through Google Forms, was distributed through social media. The survey contained four domains: baseline characteristics of participants and the diagnosis (7 items), medical management (3 items), and surgical management (11 items) of CNLDO. Descriptive statistics were conducted using SPSS (IBM SPSS Corp, SPSS Statistics ver. 26, USA).Results: Eighty-three physicians responded to the survey, with an average age of 40.6 ± 8.6. More than half of the participants (53.0%, n = 44) were general ophthalmologists. Only 37.3% of our sample (n = 31) regularly evaluated the refraction of a child presenting

Juha Välimäki Department of Ophthalmology, Päijät-Häme Central Hospital, Wellbeing Services County of Päijät-Häme, Lahti, 15850, FinlandCorrespondence: Juha Välimäki, Department of Ophthalmology, Wellbeing Services County of Päijät-Häme, Päijät-Sote, Keskussairaalankatu 7, Lahti, 15850, Finland, Tel +358 3 819 4801, Fax +358 3 819 4803, Email juha.valimaki@paijatha.fiPurpose: Larger surface area glaucoma drainage implant plates are associated with greater IOP reduction. Older age and short axial length of the eye have been reported to be risk factors for postoperative hypotony and suprachoroidal hemorrhage after glaucoma surgery. This pilot study, the first of its type, was conducted to determine the clinical outcome of intraoperative Baerveldt implant plate size reduction in elderly patients (≥ 80 years) with short axial length (< 22 mm).Methods: This was a retrospective study with a minimum 18-month follow-up involving 24 consecutive uncontrolled glaucoma patients who had previously undergone Baerveldt implantation with implant plate size reduction. Success was defined as intraocular pressure (IOP) < 21 mmHg with at least a 30% reduction in IOP from baseline on two consecutive follow-up visits, IOP > 5 mm Hg on two consecutive follow-up visits, and neither reoperation of glaucoma nor loss of light perception. The distance between the rectus muscles at the equator of the eyeball was measured using a surgical caliper. The Baerveldt implant plate was cut with straight dissecting scissors considering the distance between the muscles.Results: The mean ±SD preoperative IOP before GDI was 30.2 ± 6.9 mmHg, and the mean IOP at the last follow-up visit was 13.3 ± 5.1 mmHg, the mean pressure drop being 16.9 mmHg (56%) (P< 0.001). The number of antiglaucoma medications declined from mean 3.7 ± 1.0 (range 2– 5) to 1.6 ± 1.1 (range 0– 3) at the last visit (P< 0.001). The success rate at the last follow-up visit was 79% (19 of 24 eyes). F

Reiker G Ricks,1,2 Ivan A Cardenas,1,2 Emilie L Ungricht,1,2 Randall J Olson,1 Jeff H Pettey1 1Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 2University of Utah School of Medicine, Salt Lake City, UT, USACorrespondence: Jeff H Pettey, John A. Moran Eye Center, University of Utah, 65 Mario Capecchi Drive, Salt Lake City, UT, 84132, USA, Tel +1 801-581-2352, Fax +1 801-581-3357, Email jeff.pettey@hsc.utah.eduPurpose: To evaluate efficiency of grooving, nuclear fragment removal, and changes in pressure control in the Oertli Faros using traditional peristaltic and Speed and Precision (SPEEP) features. The SPEEP mode uses novel peristaltic technology permitting independent control of flow and vacuum.Methods: A porcine lens model was used with an enclosed chamber simulating the anterior segment. Grooving efficiency is evaluated with flow rates of 10, 30, and 50 mL/min using whole lenses. Lens cubes were emulsified at 20, 40, 60, 80, and 100% power with both SPEEP and non-SPEEP modes. Surge was evaluated with pressure gauges placed on the irrigation tubing and aspiration tubing. Pressure readings were recorded per the following: fluid and vacuum were initiated for 15 seconds, vacuum tubing was occluded for 5 seconds, tubing patency was then re-introduced for 15 seconds. Differences between sensors were recorded.Results: No significant increase in efficiency was seen with increasing flow rate from 30 to 50 mL/min using SPEEP. No significant differences were shown in lens fragment removal in SPEEP and non-SPEEP modes at any power tested. Pressure difference measurements were not significantly different with SPEEP and non-SPEEP modes.Conclusion: We showed that lower flow rates show comparable efficiency of grooving when using the SPEEP mode. The SPEEP function did not show increased efficiency in nuclear fragment removal when compared to traditional mode. Surge control was also comparable with both SPEE

Stephen A LoBue,1,2 Sofya Gindina,2 Nicholas J Saba,2 Tom Chang,2 Michael J Davis,2 Steven Fish2 1Department of Ophthalmology, Acuity Eye Group, Pasadena, CA, USA; 2Department of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, NY, USACorrespondence: Tom Chang, Department of Ophthalmology, Acuity Eye Group, 100 E California Blvd, Pasadena, CA, 91105, USA, Email tchang@acuityeyegroup.comPurpose: To study the effects of intravitreal injection (IVI) of anti-VEGF (vascular endothelial growth factor) agents on intraocular pressure (IOP) and find associations with acute pressure spikes.Methods: This was a three-month, prospective study of patients receiving outpatient IVI of anti-VEGF agents for diabetic retinopathy (DR), age-related macular degeneration (AMD), and retinal vein occlusion (RVO) at the Acuity Eye Group Medical Centers. IOP was measured pre- and post-injection at 10-minute intervals up to 50 minutes after injection with a handheld tonometer. Patients with an IOP greater than 35 mmHg at 30 minutes received an anterior chamber paracentesis (ACP), while patients below 35 mmHg were monitored without intervention.Results: A total of 617 patients (51% female, 49% male) received IVI for DR (n = 199), AMD (n = 355), and RVO (n = 63). ACP was performed in 17 patients. Average pre-injection IOP was 16 ± 4 compared to 24 ± 7 mmHg for the non-ACP vs ACP group, respectively (mean ± standard deviation), p < 0.0001. IOP returned to baseline in 98% of patients at 50 minutes. A diagnosis of glaucoma and glaucoma suspect was more prevalent in the ACP group compared to the non-ACP group, 82.3% vs 14.2% and 17.6% vs 9.0%, respectively, p < 0.0001 and p > 0.05. Patients with a pre-injection IOP > 25 mmHg and a history of glaucoma had a 58.3% rate of ACP. A 31-gauge needle had a higher mean increase in IOP from baseline compared to 30-gauge needle, p < 0.0001.Conclusion: IOP spikes are most significant in the first 10 minutes after IVI but typically resol

Ezzat Nabil Abbas Ibrahim,1,&ast; Ehab Tharwat,2,&ast; Mahmoud Mohammed Ahmed Ali Khalil,1 Ahmed Rabie Mohammed,1 Mostafa F Mohammed,1 Ahmed Mohammed Madinah Alkady,1 Ezzeldin Ramadan Ezzeldin,2 Riad Elzaher Hassan Ahmed,2 Yasser H Al-Faky,3 Mohamed Hassanein,1 Ahmed N Elsayed,1 Mohammed Eid Abd El-Salam1,&ast; 1Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; 2Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt; 3Department of Ophthalmology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudia Arabia&ast;These authors contributed equally to this workCorrespondence: Ehab Tharwat, Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Alkawthar Building at Alshenawy St, from Algeish St, Mansoura, Dakahlia, Egypt, Tel +20 10 06952497, Fax +20 50 2507370, Email ehabtharwat71@domazhermedicine.edu.egPurpose: This study aims to assess the combination of anterior lamellar recession (ALR) with blepharoplasty, suprasternal fixation, and internal eyelash bulb extirpation of aberrant lashes posteriorly located in patients with any grade of upper eyelid trachomatous cicatricial entropion.Patients and Methods: We reviewed the clinical data of eighty-six patients (143 eyelids) including age, gender, systemic medical illnesses, and comprehensive ophthalmological assessment. Eyelid evaluation was recorded, including laterality, previous surgical technique used, possible trichiasis etiology, abnormality of the lid margin, tarsal plate consistency (shrinkage or loosening), skin fold overhanging, laxity of the pretarsal skin, margin reflex distance 1 (MRD1), lagophthalmos, and lid retraction. The success rate was assessed at 3, 6, 9, and 12 months postoperative.Results: The success rate was 97.2% in the third month, which decreased significantly to 92.3% in the 6th month and 90.2% in the 9th month (P = 0.01, and 0.001 respectively). In the 9th month, we had fourteen fa

Blake Oberfeld,1,2 Fatemeh Golsoorat Pahlaviani,1 Nathan Hall,1 Henisk Falah-Trzcinski,1 Jonathan Trzcinski,1 Ta Chang,3 David Solá-Del Valle1 1Glaucoma Service, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, MA, USA; 2Department of Ophthalmology, University of Florida, Gainesville, FL, USA; 3Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USACorrespondence: David Solá-Del Valle, Glaucoma Service, Massachusetts Eye and Ear Infirmary and Harvard Medical, 243 Charles St, Boston, MA, 02114, USA, Tel +1 617-573-3670, Fax +1 617-573-3707, Email David_Sola-DelValle@MEEI.HARVARD.EDUPurpose: Combining two or more MIGS (cMIGS) promises to be more efficacious than single MIGS (sMIGS). This study compared the efficacy of PEcK, which combines Phacoemulsification (Phaco), Endocyclophotocoagulation (ECP), and Kahook dual blade (KDB), relative to both of its constituent sMIGS, Phaco/ECP (Endo Optiks, NJ) and Phaco/KDB (New World Medical, CA) for the first time.Patients and methods: Data was collected retrospectively from 1833 visits of 271 patients who underwent PEcK, Phaco/ECP, or Phaco/KDB from 2016– 2021 at Massachusetts Eye and Ear. Primary outcomes included Generalized Estimating Equations (GEE) of intraocular pressure (IOP) and medication burden, as well as survival models.Results: Mean preoperative IOP was 17.6 ± 5.0 (SD) mmHg on 3.0 ± 1.4 medications in the PEcK group (n = 128), 17.9 ± 5.1 mmHg on 2.2 ± 1.5 medications in the Phaco/ECP group (n = 78), and 16.1 ± 4.3 mmHg on 0.4 ± 1.0 medications in the Phaco/KDB group (n = 65). For more than 36 months, all procedures resulted in significant patterns of IOP and medication reduction (all p < 0.001), before and after statistical adjustment. The reduction pattern in IOP was significantly different when comparing all groups over time and favored PEcK (p = 0.04), but the reduction pattern in medications was not significantly different (p = 0.11). Procedures did not diffe

Mark C Vital,1 Kevin Y Jong,1 Clarise E Trinh,1 Tomy Starck,2 David Sretavan3 1Houston Eye Associates, Houston, TX, USA; 2UltraVision, San Antonio, TX, USA; 3Centricity Vision Inc., Carlsbad, CA, USACorrespondence: Mark C Vital, Houston Eye Associates, 2855 Gramercy Street, Houston, TX, 77025, USA, Tel +1 713 668 6828, Fax +1 832 553-7154, Email MVital@HoustonEye.comPurpose: To compare endothelial cell density (ECD), percentage of hexagonal cells (%Hex) and coefficient of variation (CV) in cell size following lens cataract surgery with phacoemulsification performed using Continuous Curvilinear Capsulorhexis (CCC) or Precision Pulse Capsulotomy (PPC).Patients and Methods: Sixty-seven subjects were randomly assigned to undergo lens cataract removal with the capsulotomy step performed using either CCC or PPC. Specular microscopy images were obtained pre-operatively, 1 month and 3 months after surgery. ECD, %Hex and CV were analyzed in a masked fashion by an independent reading center.Results: The mean percentage ECD loss at 1 month was 11.5% in the CCC group and 12.3% in the PPC group (P = 0.818; t-test). At 3 months, the mean percentage ECD loss was 11.7% in the CCC group and 12.4% in the PPC group (P = 0.815; t-test). The mean %Hex at 1 month was 54.3% in the CCC group and 54.7% in the PPC group (P = 0.695; t-test). At 3 months, the mean %Hex was 56.2% in the CCC group and 54.7% in the PPC group (P = 0.278; t-test). The CV at 1 month was 34.4% in the CCC group and 34.3% in the PPC group (P = 0.927; t-test). At 3 months, the CV was 32.7% in the CCC group and 33.4% in the PPC group (P = 0.864; t-test).Conclusion: No differences in ECD loss, %Hex and CV were observed between patients who received CCC or PPC. PPC use during cataract surgery does not result in any increased endothelial cell loss beyond that normally associated with this surgery.Keywords: automated capsulotomy, zepto, corneal endothelium

Majid Moshirfar,1– 3 Devon Hori Harvey,4 Qiancheng Wang,5 Carter J Payne,1,6 David G West,7 Phillip C Hoopes1 1Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA; 2John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA; 3Utah Lions Eye Bank, Murray, UT, USA; 4The Ohio State University College of Medicine, Columbus, OH, USA; 5Baylor College of Medicine, Houston, TX, USA; 6Department of Ophthalmology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA; 7University of Utah School of Medicine, Salt Lake City, UT, USACorrespondence: Majid Moshirfar, Hoopes Vision Research Center, 11820 South State St Ste 200, Draper, UT, 84020, USA, Tel +1 801 568-0200, Fax +1 415-476-0336, Email cornea2020@me.comPurpose: To compare corneal power difference maps (∆maps) obtained from the Pentacam in patients with 1 year follow-up after LASIK, PRK, and SMILE with further stratification to low, moderate, and high myopia.Patients and methods: This retrospective study was comprised of patients who had preoperative and 1-year postoperative power maps that were obtained–front sagittal (SagF), refractive power (RP), true net power (TNP), and total corneal refractive power (TCRP)–for evaluation. Measurements were recorded and compared at the 4mm, 5mm and 6mm pupil and apex zones. Comparisons were made between each specific power ∆map and the surgically induced refractive change (SIRC). Further analysis of the ∆maps was performed based on degree of myopia (high, moderate, and low). Correlation and agreement were also assessed with regression and limits of agreement (LoA).Results: There were 172 eyes in the LASIK group, 187 eyes in the PRK group, and 46 eyes in the SMILE group. In the LASIK group, TNP ∆map at 5mm pupil zone had the least absolute mean difference with SIRC (0.007 ± 0.42D). In the PRK group, TNP ∆map at 5mm apex zone was most accurate compared to SIRC (0.066 ± 0.45D). In the SMILE gr

Matthew CH Rohn,1 Flynn O’Sullivan,2 Stuart I Brown,2 Eric Hernandez,2 Shyamanga Borooah,2 Iliana Molina2 1Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA; 2Department of Ophthalmology, Shiley Eye Institute, School of Medicine, University of California-San Diego, La Jolla, CA, USACorrespondence: Iliana Molina, Shiley Eye Institute, 9415 Campus Point Dr, La Jolla, CA, 92093-0946, USA, Tel +1 858 822 2585, Fax +1 858 822 1754, Email imolina@health.ucsd.eduSignificance: The need for early identification and treatment of young children’s refractive error needs has become a public health concern. The UCSD Eyemobile for Children (EyeMobile) provides vision screenings and comprehensive eye exams on the Eyemobile among a population of underserved, predominantly Hispanic preschool and elementary school children. The program also provides spectacles for children who fail eye exams due to refractive error.Methods: We performed a retrospective cross-sectional analysis of all children screened from 2011 to 2017 by the Eyemobile across 10 San Diego elementary schools. We examined demographics, distance and near visual acuity, autorefraction, stereopsis, and color vision. To measure compliance to our spectacle program, we checked if children who were prescribed spectacles were wearing them, as instructed, at the following year’s screening. Differences between compliance measures with respect to school, age, ethnicity, and gender were determined using chi-square analysis, while all other measures were fit to a binary logistic regression to determine statistically significant factors.Results: A total of 12,176 elementary school children were screened between 2011 and 2017. Of these children, 5269 (43.3%) were referred for a comprehensive eye examination. Across six years, 3163 (60.0%) of the children referred completed their eye examinations. There was a significant increase (p < 0.001) in exam completion in the successive years. Exam compl

Saeed Aljohani,1 Jingyun Wang,2 Mitchell Scheiman,3 Qing-Qing Tan,4 Hongxin Xu,5 Nawaf Almutairi,1 Saleh Alshammeri1 1Department of Optometry, College of Applied Medical Science, Qassim University, Buraydah, Qassim, Saudi Arabia; 2SUNY College of Optometry, New York, NY, USA; 3Salus University, Wyncote, PA, USA; 4Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China; 5Panorama Windows Ltd, New York, NY, USACorrespondence: Saeed Aljohani, Email sa.aljohani@qu.edu.saBackground: Previous studies have shown that it is necessary to evaluate adherence during the treatment process, using educational intervention methods which have been shown to improve adherence with patching treatment. A previous study reported that an educational cartoon had significantly improved adherence with patching. However, this black-white cartoon is not commercially available.Objective: This study investigates the feasibility of a 4-minute educational cartoon video in improving adherence with patching therapy for amblyopic children.Methods: Children (3 to 10 years old) with unilateral amblyopia who were prescribed 2 hours or 6 hours of patching per day were enrolled. Objective adherence to the treatment was tracked using a microsensor. Children returned after 4 weeks ± 2 days to measure adherence. Participants with adherence ≤ 50% were eligible to watch the educational cartoon video. They continued with the previously prescribed treatment (2 hours or 6 hours patching) for an additional week to evaluate the follow-up adherence.Results: A total of 27 participants were enrolled. The mean age (SD) was 6.6 (1.5) years. Twenty-two participants (12 in the 2 hours patching group and 10 in the 6 hours patching group) had adherence ≤ 50% and watched our cartoon video. The cartoon video improved mean adherence (SD) from 29.6% (11.9%) to 56.8% (12.1%) in all 22 participants from both regimens (paired 2-tailed t-test, t= − 11, P < 0.000).Conclusion: T

Michael Balas,1 Diana Vasiliu,2 Gener Austria,2 Tina Felfeli3– 5 1Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; 2Health System Intelligence Team, Health System Performance & Support Portfolio, Ontario Health, Toronto, ON, Canada; 3Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada; 4Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, ON, Canada; 5The Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, CanadaCorrespondence: Tina Felfeli, Toronto Western Hospital, 399 Bathurst Street, 6-East Room 432, Toronto, ON, M5T 2S8, Canada, Tel +1 647 678 1634, Fax +1 416 340 3459, Email tina.felfeli@mail.utoronto.caObjective: To investigate the effects of the COVID-19 pandemic on case volumes and wait-times for ophthalmic surgery in Ontario, Canada.Design: Population-based retrospective cohort study.Participants: Patients undergoing ophthalmic surgery in Ontario, Canada, from 2010 to 2021, collected from the Ontario Health Wait Times Information System (WTIS) database.Methods: The WTIS contains non-emergent surgical case volume and wait-time data for six ophthalmic subspecialty surgery types, three priority levels (low, medium, high) and 14 different regions in Ontario. Case volume and wait-times were compared between the COVID-19 pandemic (2020– 2021) and the preceding time period (2010– 2019) across all stratifications.Results: There was a significant decrease in case volumes and significant increase in wait-times across geographic regions, priority levels, and subspecialty surgeries from the pre-pandemic to pandemic period. Moreover, COVID-19 exacerbated pre-existing wait-time disparities between sexes, with females waiting 4.1 days longer than males overall to receive surgery in 2010– 2019 compared to waiting 8.8 days longer in 2020– 2021 (117% increase).Conclusion: These findings highligh

Katarzyna Biela,1,2,&ast; Mateusz Winiarczyk,1,&ast; Dorota Borowicz,2,&ast; Jerzy Mackiewicz1,&ast; 1Department of Vitreoretinal Surgery, Medical University of Lublin, Lublin, 20079, Poland; 2Department of Ophthalmology, Provincial Hospital in Zamosc, al. John Paul II 10, Zamosc, 22400, Poland&ast;These authors contributed equally to this workCorrespondence: Katarzyna Biela, Provincial Hospital in Zamosc, al. John Paul II 10, Zamosc, 22400, Poland, Email biela.katarzyna@outlook.comAbstract: Dry eye disease (DED) is a multifactorial ocular surface disorder characterized by loss of tear film homeostasis with associated ocular symptoms, like dryness, foreign body sensation, and inflammation. Numerous reports confirm an increase in dry eye symptoms after cataract surgery. DED also significantly disturbs preoperative biometric measurements, mainly by changes in keratometry measurements. The purpose of this study is to evaluate the effect of DED on biometric measurements before cataract surgery and postoperative refractive errors. PubMed database was searched for keywords: cataract surgery, dry eye disease, refractive error, refractive outcomes, keratometry, and biometry. Four clinical studies evaluating the effect of DED on refractive errors were included. In all studies, biometry was performed before and after dry eye treatment, and the mean absolute error was compared. Various substances have been used to treat dry eye, such as cyclosporin A, liftitegrast, and loteprednol. The refractive error was significantly lower after treatment in all studies. The results unanimously indicate that refractive errors can be reduced by proper treatment of DED before cataract surgery.Keywords: dry eye disease, cataract surgery, refractive error, refractive outcome, biometry

Joakim Thylefors,1 Gunnar Jakobsson,2 Madeleine Zetterberg,2 Rafi Sheikh1 1Ophthalmology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden; 2Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Västra Götaland, SwedenCorrespondence: Joakim Thylefors, Ophthalmology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Kioskgatan 1A, Lund, SE - 22242, Sweden, Tel +46 40 333 134, Email joakim.thylefors@med.lu.sePurpose: To analyze preoperative visual acuity before cataract surgery regarding the risk of rhegmatogenous retinal detachment (RRD) after cataract surgery.Methods: The preoperative visual acuity in an observational cohort study of patients undergoing cataract surgery in Skåne, southern Sweden, during 2015– 2017 was analyzed with data retrieved from the Swedish National Cataract Register. This was then cross-referenced with patients undergoing surgery for retinal detachment at the Skåne University Hospital in Lund from 2015 to 2020. The main outcome was the risk–benefit ratio of measuring preoperative visual acuity before cataract surgery and the risk of RRD.Results: The mean visual acuity in the whole study group (N=58,624), expressed as LogMAR, was 0.40 ± 0.32 (SD). In the group with RRD (n=298), the mean visual acuity was 0.44 ± 0.36 (p=0.07). In the subgroups of RRD, those aged < 60 years 0.49 ± 0.44 (p=0.07), aged < 60 years and axial length (AL) > 25 mm 0.42 ± 0.38 (p=0.68), and in those aged < 60 years, AL > 25 mm and male sex 0.44 ± 0.39 (p=0.53). However, there is considerable variations in visual acuity of the various groups and in the high-risk group with RRD aged < 60 years with AL> 25 mm, 15% had a visual acuity of 0.8 or better in the operated eye.Conclusion: There must be strong indications for performing cataract surgery in those with a high risk of retinal detachment, and the patient must be given adequate information

Ghaida Alahmadi,1 Azza MY Maktabi,2 Gorka Sesma,1 Saleh Almesfer1 1Pediatric Ophthalmology and Strabismus Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; 2Pathology and Laboratory Medicine Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaCorrespondence: Gorka Sesma, Pediatric Ophthalmology and Strabismus Division, King Khaled Eye Specialist Hospital, Al Urubah Branche Road, West Building 2 nd Floor, Riyadh, 11462, Saudi Arabia, Tel +966114849700, Fax +966114821908, Email gsesma@kkesh.med.saPurpose: To evaluate the efficacy of intravitreal chemotherapy for vitreous seeding in patients with retinoblastoma (Rb).Design: Retrospective, single-arm cohort study.Methods: This study was conducted at a tertiary eye center. Between 2013 and 2021, 27 patients (27 eyes) with vitreous Rb receiving adjuvant intravitreal melphalan (IVM) as secondary/salvage treatment in one eye were included. Patients who were unable to follow-up or treated elsewhere were excluded. Survival analysis was performed to assess the incidence of enucleation in the melphalan-treated group, as well as in bilateral cases with eyes receiving melphalan and those receiving standard treatment, consisting of chemotherapy, thermotherapy, and enucleation according to the disease stage.Results: The median (interquartile range) follow-up time was 65 months (range, 34– 83 months). Seventeen patients (63%) had bilateral disease. Sixteen eyes (59%) were saved. The Kaplan–Meier survival estimates for eyes receiving melphalan were 100% at 1 year (95% confidence interval [CI]:11.2– 14.3), 75% (95% CI:14.2– 48.9) at 3 years, and 50% at 5 years. Melphalan-treated patients with bilateral disease showed a significantly higher number of saved eyes than the standard treatment group (P=0.002). Tumor recurrence was the primary cause of enucleation, accounting for 36% of the cases. In the vitreous hemorrhage group, the odds of enucleation were 13 times higher (95% CI:1.04– 165.28)

Alanna Wood,1,2 Benjamin Lim,2 Jim Matthews,3 Tanya Karaconji,1,2 Sophia L Zagora,1,2 Robyn V Jamieson,1,2,4,5 John R Grigg,1,2,4 Michael Jones,2,&ast; Neil Rowe,2,&ast; Stephen Hing,2,&ast; Craig Donaldson,2,&ast; James EH Smith2,&ast; 1Save Sight Institute, Discipline of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, Sydney, NSW, Australia; 2Department of Ophthalmology, The Children’s Hospital at Westmead, Sydney, Australia; 3Sydney Informatics Hub, The University of Sydney, Sydney, NSW, Australia; 4Eye Genetics Research, The Children’s Hospital at Westmead, Save Sight Institute, Children’s Medical Research Institute, University of Sydney, Sydney, NSW, Australia; 5Disciplines of Genetic Medicine, and Child and Adolescent, Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia&ast;These authors contributed equally to this workCorrespondence: Alanna Wood, Tel +61 404 072 401, Email wood.alanna@gmail.com; Alanna.wood@sydney.edu.auPurpose: Secondary glaucoma following childhood cataract surgery remains the most common complication in the paediatric population. This study aimed to determine the incidence, time to progression and risk factors associated with the development of secondary glaucoma following childhood cataract surgery in a paediatric population. Outcome measures were the detection of secondary glaucoma, postoperative time frame to development of glaucoma and risk factors in its development.Patients and Methods: A retrospective case series was conducted between 2003 and 2017 at a tertiary children’s hospital in Sydney. The patient population included those 16 years or less of age who underwent congenital cataract extraction, with or without an intraocular lens implantation and who had been followed up for a minimum of six months following surgery. Patients were excluded if they had cataract aetiology other than congenital idiopathic cataract. Multivariate Cox Regression analysis wa

Kamran Hosseini,1 Subba Gollamudi,2 Harvey Reiser,3 Tom Walters,4 Richard L Lindstrom5 1Surface Ophthalmics, Pleasanton, CA, USA; 2VRF Eye Specialty Group, Memphis, TN, USA; 3Eye Care Specialists, Kingston, PA, USA; 4Texan Eye, PA — Keystone Research, Austin, TX, USA; 5Minnesota Eye Consultants, Bloomington, MN, USACorrespondence: Kamran Hosseini, Surface Ophthalmics, Inc, 5000 Hopyard Road, Ste. 402, Pleasanton, CA, 94588, USA, Email khosseini@surfaceophthalmics.comPurpose: To compare the preservative-free corticosteroid 0.2% betamethasone sodium phosphate BID (SURF-201) to vehicle BID in patients undergoing routine cataract surgery.Methods: Phase 2, multicenter, randomized (1:1 ratio), double-masked, vehicle-controlled, parallel-group study in patients scheduled for uncomplicated cataract surgery without the aid of a femtosecond laser. Subjects instilled topical medications for 16 days beginning the day before cataract surgery (Day − 1), 1 dose administered at least 1 hour prior to cataract surgery (on Day 0) and 1 dose on the evening after cataract surgery, and then 2 doses administered each day through Day 15; patients were re-evaluated on Days 22 and 32 to ensure no rebound inflammation. Primary outcome was the difference in the proportion of subjects with anterior chamber cell (ACC) grade 0 between the two groups at Day 15. Secondary outcomes included pain scores and overall safety.Results: There was a statistically significant difference (P=0.004) in the proportion of subjects in the SURF-201 treatment group with an ACC grade of 0 at Day 15 (n=22/39 [56.4%]) compared to subjects in the vehicle treatment group (n=9/43 [20.9%]). There was no statistically significant difference (P=0.528) in the proportion of subjects in the SURF-201 treatment group who had a visual analog scale pain score of 0 at Day 15 (n=35/38 [89.7%]) compared to subjects in the vehicle group (n=33/40 [82.5%]). A slightly higher incidence of adverse events occurred in subjects in the SUR

Andrew Tirsi,1,2,&ast; Paras P Shah,1,&ast; Vasiliki Gliagias,1 Daniel Barmas-Alamdari,2 Derek Orshan,2 Joby Tsai,2 Celso Tello1,2 1Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11549, USA; 2Department of Ophthalmology, Manhattan Eye, Ear, and Throat Hospital, New York City, NY, 10065, USA&ast;These authors contributed equally to this workCorrespondence: Andrew Tirsi, 210 East 64th Street, New York City, NY, 10065, USA, Tel +1 201 982 4168, Email ATirsi@northwell.eduPurpose: Spectral domain optical coherence tomography (SD-OCT) with posterior pole asymmetry analysis (PPAA) provides a mapping of posterior pole retinal thickness with asymmetry analysis between hemispheres of each eye. We investigated whether these structural abnormalities were correlated with functional retinal ganglion cell (RGC) loss, quantified by steady state pattern electroretinogram (ssPERG), in glaucoma suspects (GS).Methods: Twenty GS (34 eyes) were enrolled in a prospective study at the Manhattan Eye, Ear, and Throat Hospital. All subjects underwent ophthalmological examination, including Humphrey visual field, Spectralis Glaucoma Module Premium Edition (GMPE) SD-OCT PPAA, and ssPERG testing. The ability of ssPERG parameters (Magnitude [Mag, μv], MagnitudeD [MagD, μv], and MagD/Mag ratio) to predict PPAA thickness (total, superior, and inferior thickness, [μm]) was tested via adjusted multivariate linear regression analysis.Results: Mag explained 8% of variance in total PPAA change (F(1,29)=6.33, B=6.86, 95% CI: 1.29– 12.44, p=0.018), 8% in superior PPAA change (F(1,29)=5.57, B=6.92, 95% CI: 0.92– 12.92, p=0.025), and 7.1% in inferior PPAA change (F(1,29)=5.83, B=6.80, 95% CI: 1.04– 12.56, p=0.022). Similarly, MagD explained 9.7% of variance in total PPAA change (F(1,29)=8.09, B=6.47, 95% CI: 1.82– 11.13, p=0.008), 10% in superior PPAA change (F(1,29)=7.33, B=6.63, 95% CI: 1.62– 11.63, p=0.011), and 8.5% in inferior PPAA change (F(1

Ryan Duong,1 Abdullah Abou-Samra,1 Joseph D Bogaard,1 Yevgeniy Shildkrot2,3 1Department of Ophthalmology, University of Virginia, Charlottesville, VA, USA; 2RetinaCare of Virginia, Augusta Eye Associates PLC, Fishersville, VA, USA; 3Virginia Commonwealth University, Richmond, VA, USACorrespondence: Ryan Duong, Department of Ophthalmology, University of Virginia, Charlottesville, VA, USA, Email rtd6bp@uvahealth.orgAbstract: Asteroid hyalosis (AH) is a benign clinical entity characterized by the presence of multiple refractile spherical calcium and phospholipids within the vitreous body. First described by Benson in 1894, this entity has been well documented in the clinical literature and is named due to the resemblance of asteroid bodies on clinical examination to a starry night sky. Today, a growing body of epidemiologic data estimates the global prevalence of asteroid hyalosis to be around 1%, and there is a strong established association between AH and older age. While pathophysiology remains unclear, a variety of systemic and ocular risk factors for AH have recently been suggested in the literature and may provide insight into possible mechanisms for asteroid body (AB) development. As vision is rarely affected, clinical management is focused on differentiation of asteroid hyalosis from mimicking conditions, evaluation of the underlying retina for other pathology and consideration of vitrectomy in rare cases with visual impairment. Taking into account the recent technologic advances in large-scale medical databases, improving imaging modalities, and the popularity of telemedicine, this review summarizes the growing body of literature of AH epidemiology and pathophysiology and provides updates on the clinical diagnosis and management of AH.Keywords: asteroid hyalosis, epidemiology, risk factors, imaging, management, posterior lens calcification, telemedicine