AJO International最新文献

{"title":"Non-linear association between serum lipid levels and diabetic retinopathy in a nationally representative Korean population","authors":"Seowoong Jun ,&nbsp;Joon Yul Choi ,&nbsp;Tae Keun Yoo","doi":"10.1016/j.ajoint.2025.100176","DOIUrl":"10.1016/j.ajoint.2025.100176","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the associations between serum lipid levels and diabetic retinopathy (DR) in Korean adults with diabetes.</div></div><div><h3>Design</h3><div>Cross-sectional analysis of a nationally representative survey.</div></div><div><h3>Methods</h3><div>We analyzed 1,378 adults with diabetes from the Korea National Health and Nutrition Examination Survey (2008–2011). DR was ascertained from fundus photographs and medical history. Lipids (total cholesterol, HDL, LDL, triglycerides, non-HDL) were modeled by quintiles and with restricted cubic splines. Multivariable logistic regression adjusted for age, sex, systolic blood pressure, hemoglobin A1c, and statin use. Sensitivity analyses used multiple imputation.</div></div><div><h3>Results</h3><div>DR was present in 301/1,378 participants (21.8%). Adjusted models showed no linear trends for cholesterol measures. In quintile analyses, total cholesterol exhibited higher odds of DR at both extremes versus the middle quintile (Q3): Q1 OR 1.63 (95% CI, 1.04–2.57); Q4 OR 1.64 (1.06–2.57); Q5 OR 1.59 (1.03–2.49); P for U-shape = 0.008 (Q2 OR 1.42 [0.90–2.23]). LDL and non-HDL also demonstrated U-shaped patterns (P for U-shape = 0.029 and 0.038). Spline models supported U-shaped association for total cholesterol (P = 0.031), LDL (P = 0.039), and non-HDL (P = 0.014). No consistent nonlinear associations were observed for HDL or triglycerides. Multiple-imputation results were concordant, reinforcing the U-shape for total cholesterol.</div></div><div><h3>Conclusions</h3><div>Total cholesterol, LDL, and non-HDL showed U-shaped nonlinear associations with DR, indicating elevated risk at both low and high concentrations. Maintaining lipids within an intermediate range may support retinal vascular health and refine metabolic risk stratification in diabetes.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100176"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proportion of eyes with visual-acuity improvement after vitrectomy for post-traumatic endophthalmitis: A meta-analysis","authors":"Muhammad Alfatih ,&nbsp;Ananda Kukuh Adishabri ,&nbsp;Ni Luh Putu Yunia Dewi ,&nbsp;Alfiani Zukhruful Fitri Rifa'i ,&nbsp;Michaela Kemuning ,&nbsp;Dillan Cunha Amaral ,&nbsp;Bruno Fortaleza de Aquino Ferreira ,&nbsp;Ricardo Noguera Louzada ,&nbsp;Ari Djatikusumo ,&nbsp;Hashem Abu Serhan","doi":"10.1016/j.ajoint.2025.100174","DOIUrl":"10.1016/j.ajoint.2025.100174","url":null,"abstract":"<div><h3>Purpose</h3><div>Post-traumatic endophthalmitis (PTE) is a leading cause of irreversible vision loss after ocular trauma; despite widespread vitrectomy, outcomes vary and predictors remain unclear. This study aims to systematically evaluate the proportion of eyes showing the best-corrected visual acuity (BCVA) improvement and final BCVA ≥ 20/200 after vitrectomy for PTE and to investigate potential determinants of outcome using meta-regression.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>We conducted a meta-analysis following the PRISMA guidelines and registered the protocol in PROSPERO (CRD42024606195). Eligible studies included ≥80 % of participants undergoing vitrectomy for PTE. The prespecified primary outcome was the proportion with any BCVA improvement; final BCVA ≥20/200 at last follow-up was assessed as an additional outcome. Random-effects meta-analysis was performed, and subgroup and meta-regression analyses were used to explore outcome modifiers. Certainty of evidence was assessed using GRADE.</div></div><div><h3>Results</h3><div>Nine studies (<em>n</em> = 448 eyes) were included. The pooled proportion of eyes with any BCVA improvement was 0.80 (95 % CI 0.63–0.90; I² = 90 %), significantly higher in adults (≥18 years; 0.91) than in children/adolescents (&lt;18 years; 0.65; <em>p</em> &lt; 0.01). Meta-regression suggested higher silicone-oil use and IOFB proportion correlated with BCVA improvement (<em>p</em> = 0.027; <em>p</em> = 0.017), while corneal-entry and baseline retinal detachment were not associated. The proportion achieving final BCVA ≥20/200 was 0.33 (95 % CI 0.23–0.45; I²=67.9 %) with no age difference (<em>p</em> = 0.45). Certainty was low to very low.</div></div><div><h3>Conclusion</h3><div>Vitrectomy for PTE often yielded visual improvement, particularly in adults, while ambulatory vision (≥20/200) was less common. Given the single-arm meta-analysis, substantial heterogeneity, and low-certainty ratings, these estimates should be interpreted cautiously. Multicenter randomized trials are needed to verify these findings and to evaluate the potential role of silicone-oil tamponade.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100174"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive review of portable retinal cameras: Technical features, ai integration, and clinical potential","authors":"Luis Filipe Nakayama ,&nbsp;Lucas Zago Ribeiro ,&nbsp;Cindy Lie Tabuse ,&nbsp;Fernando Korn Malerbi ,&nbsp;Caio Regatieri","doi":"10.1016/j.ajoint.2025.100194","DOIUrl":"10.1016/j.ajoint.2025.100194","url":null,"abstract":"<div><div>Purpose: To evaluate and compare commercially available portable retinal cameras with a focus on technical specifications, clinical applications, and the integration of artificial intelligence (AI) for ophthalmic screening, especially in low- and middle-income countries (LMICs). Design: Systematic review of the literature. Methods: Systematic searches of PubMed and OpenAlex were conducted up to September 2025, without language restrictions, using terms such as portable retinal camera, handheld retinal camera, and smartphone-based fundus camera. Devices were included if they were commercially available and described in peer-reviewed publications with technical or clinical data. Prototypes and systems relying solely on external smartphone lenses without integrated optics were excluded. Data extracted included imaging specifications, ergonomics, power sources, AI functionalities, quality control features, and reported clinical applications. Devices were categorized as smartphone-attached or standalone handheld systems. Results: The search retrieved 870 records (PubMed = 277; OpenAlex = 593). After removing duplicates and screening, 509 articles were included in the review, collectively reporting on 38 portable retinal cameras, of which 17 were commercially available. The most frequently reported devices were the Volk Pictor Plus, Phelcom Eyer, Optomed Aurora, ZEISS VISUSCOUT 100, and Remidio FOP. Smartphone attached systems offered greater portability and affordability, whereas standalone handheld systems provided integrated functionality, higher imaging stability, and smoother clinical integration. AI features varied across devices, encompassing referable diabetic retinopathy detection, abnormality triage, systemic risk prediction, and automated image-quality assessment. Clinical applications extended beyond diabetic retinopathy and retinopathy of prematurity to include glaucoma, AMD, and exploratory use in systemic conditions such as sepsis and COVID-19. Conclusion: Portable retinal cameras already demonstrate clear utility in extending ophthalmic screening and diagnostic services, particularly for diabetic retinopathy and retinopathy of prematurity, while also showing potential in broader clinical and systemic applications. Their portability and cost-effectiveness make them valuable for outreach and telemedicine programs, especially in LMICs. The integration of artificial intelligence further enhances their functionality, though variability in device design, regional availability, and regulatory status highlights the need for standardized validation, recurring local assessments, and head-to-head comparative studies. Real-world evaluations remain essential to ensure effective, safe, and equitable deployment.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100194"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Special issue on evidence-based global health in ophthalmology – AJO international","authors":"Mapa Prabhath Piyasena","doi":"10.1016/j.ajoint.2025.100169","DOIUrl":"10.1016/j.ajoint.2025.100169","url":null,"abstract":"","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100169"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior capsule rupture as a performance indicator in resident cataract surgery: An eight-year audit","authors":"Fatma F Shakarchi ,&nbsp;Sam Karimaghaei ,&nbsp;Jamal Azhari ,&nbsp;Alex Kilgore ,&nbsp;Ahmed F Shakarchi ,&nbsp;Andrew Melson ,&nbsp;Paul H. Phillips ,&nbsp;Ahmed B. Sallam","doi":"10.1016/j.ajoint.2025.100181","DOIUrl":"10.1016/j.ajoint.2025.100181","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze intraoperative rates of posterior capsule rupture (PCR) and postoperative visual and refractive outcomes in resident-performed cataract surgeries.</div></div><div><h3>Design</h3><div>Prospective continuous audit.</div></div><div><h3>Methods</h3><div>We performed a continuous prospective audit for all residents’ cataract surgeries from July 2017 to January 2025. We grouped residents into senior trainees, in their final postgraduate year (PGY-4) of ophthalmology residency, and junior trainees, in PGY-2 and PGY-3. We used a funnel plot to visualize the variations in PCR rates across and within grades. The primary outcome measure was PCR rate, and the other outcomes were best corrected visual acuity (BCVA) and deviation from refractive target (±1.0 diopter).</div></div><div><h3>Results</h3><div>Our study included 3985 cataract surgeries performed by 23 residents. Senior residents (PGY-4) performed 3186 (80%) of these surgeries. Resident-performed cataract surgeries had an overall PCR rate of 3.5%, with significantly higher rates among junior compared to senior trainees (6.5% vs 2.7%; RR=0.42, P &lt; 0.001) and greater inter-surgeon variability early in training and below the 100 surgeries mark. In multivariable analysis, senior residents remained significantly less likely to have PCR (adjusted RR = 0.38, 95% CI: 0.27–0.53), while complex cases were independently associated with a four-fold higher risk (adjusted RR = 4.15, 95% CI: 2.98–5.73). Most patients (91.7%) achieved a BCVA of 20/40 or better, and 91.4% achieved a refraction within ±1D of the refractive target.</div></div><div><h3>Conclusion</h3><div>Cataract surgeries performed by residents have an acceptable PCR rate and excellent BCVA and refractive outcomes. Appropriate outcome tracking is essential for resident surgical development, and a continuous audit of surgical logbooks can help bridge the gap created by unstructured reporting of surgical complications.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100181"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the diagnostic and therapeutic gaps in retinoblastoma: A referral center’s perspective from Southeast Asia","authors":"Thanaporn Kritfuangfoo ,&nbsp;Duangnate Rojanaporn","doi":"10.1016/j.ajoint.2025.100199","DOIUrl":"10.1016/j.ajoint.2025.100199","url":null,"abstract":"<div><h3>Purpose</h3><div>To highlight diagnostic and therapeutic disparities in retinoblastoma care and share our institutional approach to bridging these gaps in a resource-limited setting in Southeast Asia.</div></div><div><h3>Design</h3><div>Perspective and selected literature review.</div></div><div><h3>Methods</h3><div>A narrative overview of our referral center’s experience was combined with key findings from the literature. We describe evolving diagnostic resources, as well as treatment advancements such as intra-arterial chemotherapy (IAC) and high-dose intravitreal topotecan.</div></div><div><h3>Results</h3><div>Significant disparities persist between high- and low-resource settings in both diagnosis and treatment of retinoblastoma. While high-income countries have access to advanced tools such as aqueous humor analysis, molecular diagnostics, and globe-salvaging therapies, many lower-resource centers must rely primarily on clinical examination and imaging, as aqueous humor testing remains unavailable in most regions. In these settings, close clinical monitoring is essential, particularly in diagnostically uncertain cases. Treatment options are also limited, with restricted access to IAC and other advanced modalities. At our center, protocol refinements, multidisciplinary coordination, and adaptation of emerging therapies have contributed to improved outcomes. In institutions without IAC capability, high-dose intravitreal topotecan may offer a feasible alternative when used in combination with other available treatments.</div></div><div><h3>Conclusion</h3><div>Retinoblastoma management in resource-limited settings requires tailored approaches. Institutional adaptation of IAC protocols and incorporation of emerging therapies such as high-dose intravitreal topotecan can improve outcomes, even in advanced disease. Broader access to diagnostic tools, regional training, and inter-institutional collaboration are essential to bridge global gaps in retinoblastoma care.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinoblastoma: Bridging the gap in diagnosis and treatment in Nigeria","authors":"Dupe S. Ademola-Popoola ,&nbsp;Ibrahim A. Yusuf","doi":"10.1016/j.ajoint.2025.100198","DOIUrl":"10.1016/j.ajoint.2025.100198","url":null,"abstract":"<div><h3>Purpose</h3><div>Retinoblastoma is generally curable and the most common intraocular childhood cancer, with a 3-year survival of 95 %-99.5 % in high-income countries compared to 80 % in MICs and 57 % in LMICs. This article highlights the gap in retinoblastoma management as well as the efforts made to improve its diagnosis and treatment in Nigeria, a case study for a LMIC.</div></div><div><h3>Design</h3><div>Perspective article</div></div><div><h3>Methods</h3><div>This perspective is based on the authors clinical and programmatic experience in developing national and regional retinoblastoma services, combined with synthesis of published evidence and collaborative inputs from African and international partners involved in retinoblastoma care.</div></div><div><h3>Results</h3><div>Multi-level scalable strategies, including task shifting, affordable treatment innovations, legislation, telemedicine, regional and international collaborative efforts have been implemented successfully. These efforts transformed a new service into a referral center and established a network of retinoblastoma services. Human capacity was developed to enhance early detection, improve access and delivery of essential treatments, and attract resources, thereby enabling cure within a resource-limited setting.</div></div><div><h3>Conclusions</h3><div>Increasing national, regional and global initiatives remain crucial not only to scale up successful programs but also to urgently address the lack universal access to care, genetic testing across many African countries, and survivorship support, providing long-term care of complications, including other non-ocular cancers, which are becoming evident, thereby closing the survival gaps and offering a model for retinoblastoma care progress</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100198"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is renal function associated with glaucoma or suspected glaucomatous optic neuropathy -Findings from health screening data in Japan","authors":"Risa Nakazawa ,&nbsp;Ryo Asaoka ,&nbsp;Shigeki Muto ,&nbsp;Hiroshi Murata ,&nbsp;Kazunobu Sugihara ,&nbsp;Kaori Ishii ,&nbsp;Akira Obana ,&nbsp;Masaki Tanito","doi":"10.1016/j.ajoint.2025.100195","DOIUrl":"10.1016/j.ajoint.2025.100195","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to examine the association between chronic kidney disease (CKD) and glaucoma in large-scale health checkup data in Japan.</div></div><div><h3>Design</h3><div>Retrospective cross-sectional study.</div></div><div><h3>Methods</h3><div>The dataset consisted of 23,761 eyes of 12,020 subjects in two regions in Japan (Hamamatsu City and Shimane Prefecture). Subsequently, the associations between glaucoma and CKD, CKD stage, and estimated glomerular filtration rate (eGFR) were investigated using the linear mixed model, with adjustment for age, sex, hypertension, diabetes, lipidemia, body mass index, smoking status, and intraocular pressure (IOP), using each data set. Similarly, the association between IOP and CKD, CKD stage, and eGFR was also investigated.</div></div><div><h3>Results</h3><div>The prevalence of glaucoma was 4.5%. The mean age of those with glaucoma or suspected glaucomatous optic neuropathy was older (58.6 years old) than those without (53.6 years old) in the datasets. In this dataset showed no significant association was found between glaucoma or suspected glaucomatous optic neuropathy and CKD, stage of kidney function, and eGFR (P &gt; 0.05). However, a significant association was found between IOP and CKD (β = − 0.71 [95% CI: −1.30 to −0.13] mmHg, p = 0.016), and eGFR (per 10 mL/min/1.73 m²: β = 0.064 [95% CI: +0.012 to +0.12] mmHg, p = 0.016).</div></div><div><h3>Conclusions</h3><div>The current study with a large-scale health screening program in Japan suggested no association between CKD/renal function and glaucoma or suspected glaucomatous optic neuropathy.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100195"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging gaps in ophthalmology education through large language models","authors":"Shahrzad Gholami ,&nbsp;Beth Wilson ,&nbsp;Sarah Page ,&nbsp;Daniel B. Mummert ,&nbsp;Joseph Carr ,&nbsp;Robert R. McNabb ,&nbsp;Rahul Dodhia ,&nbsp;Juan M. Lavista Ferres ,&nbsp;William B. Weeks ,&nbsp;Dale E. Fajardo ,&nbsp;Karine D. Bojikian","doi":"10.1016/j.ajoint.2025.100166","DOIUrl":"10.1016/j.ajoint.2025.100166","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the performance of general-domain large language models (LLMs), particularly OpenAI’s Generative Pre-trained Transformer (GPT) models, within the American Academy of Ophthalmology (AAO) Self-Assessment Program, which is based on AAO’s Basic and Clinical Science Course.</div></div><div><h3>Methods</h3><div>We input 3357 questions into GPT-4o, GPT-4-Turbo, o1 and o3-mini via Microsoft’s Azure OpenAI Service using zero-shot and chain-of-thought (CoT) prompting. Questions with images were analyzed using the multimodal version of GPT-4o and GPT-4.1. The performance of the LLMs was compared to 1371 unique residents who had previously participated in the program. Additionally, we compared the performance on 1399 questions, including information on 3 question types: recall, interpretation, and decision-making or clinical management. Average accuracy rates were used to evaluate performance and compare statistical significance across categories.</div></div><div><h3>Results</h3><div>o1 (CoT) was the most accurate model (95% confidence interval [CI]: 90.3%–92.1%) with performance ranging from 95.17% (general medicine) to 86.9% (cornea) and 91.1% accuracy on a synthesized sample test. It also outperformed residents in recall-type, interpretation-type, and decision-making or clinical management questions (95.7%, 85.3%, and 90.8%, respectively, <em>P</em> &lt; 0.001). Third-year residents were more accurate than first-year or second-year residents (78.2%, 68.3%, 74.9%, respectively). On multimodal inputs, adding images improved the model’s accuracy but all models still underperformed compared to residents.</div></div><div><h3>Conclusions</h3><div>The accuracy of the LLMs models continues to improve, with o1 (CoT) showing the highest overall performance. Multimodal inputs can enhance model accuracy, but current models still need improvement. LLMs shows great potential in democratizing access to high-quality medical knowledge.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100166"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of intracameral antibiotics in reducing postoperative endophthalmitis risk after cataract surgery: A meta-analysis","authors":"Hashem Abu Serhan ,&nbsp;Hamad A. Alkorbi ,&nbsp;Elhassan Mahmoud ,&nbsp;Muhammad Zain Kaleem ,&nbsp;Omar Abousaad ,&nbsp;Mohamed Nasser Elshabrawi ,&nbsp;Ibrahim M. Alrawi ,&nbsp;Abdulrahman Nasir Al Khatib ,&nbsp;Ahmed E. Habib ,&nbsp;Ayman G. Elnahry","doi":"10.1016/j.ajoint.2025.100168","DOIUrl":"10.1016/j.ajoint.2025.100168","url":null,"abstract":"<div><h3>Purpose</h3><div>Postoperative endophthalmitis is a rare but serious complication following cataract surgery, often leading to severe vision loss and increased healthcare burden. This systematic review and meta-analysis aimed to evaluate the effectiveness of intracameral antibiotic prophylaxis in reducing the risk of postoperative endophthalmitis.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across PubMed, Cochrane Library, Scopus, and EMBASE up to September 18, 2024. Studies were included if they compared intracameral antibiotic prophylaxis with no prophylaxis in patients undergoing cataract surgery. The primary outcome was the odds of developing postoperative endophthalmitis. Random-effects and quality-effects models were used for meta-analysis, with heterogeneity assessed via the I² statistic. Subgroup analyses were conducted based on antibiotic type, study design, and geographic region.</div></div><div><h3>Results</h3><div>A total of 25 studies involving 5665,621 participants were included. The pooled odds ratio (OR) for the risk of endophthalmitis with intracameral antibiotics was 0.31 (95 % CI: 0.15–0.61), indicating a 69 % reduction in risk compared to no prophylaxis. Subgroup analysis revealed significant differences in efficacy based on antibiotic type, with moxifloxacin (OR: 0.24, 95 % CI: 0.20–0.29) and vancomycin (OR: 0.11, 95 % CI: 0.04–0.30) showing the greatest protective effects. Sensitivity analyses confirmed the robustness of results, though publication bias was suggested by funnel and Doi plots asymmetry.</div></div><div><h3>Conclusions</h3><div>Intracameral antibiotic prophylaxis significantly reduces the risk of postoperative endophthalmitis following cataract surgery, with moxifloxacin and vancomycin showing the strongest protective effects. Given the variability in efficacy across antibiotic types, further randomized controlled trials are needed to optimize prophylactic strategies. These findings support broader adoption of intracameral antibiotics to enhance patient safety and reduce the global burden of post-cataract endophthalmitis.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100168"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}