Graefe’s Archive for Clinical and Experimental Ophthalmology最新文献

{"title":"Modified double-flanged technique in the management of dislocated posterior intraocular lenses.","authors":"Mehmet Icoz, Sevde Akcay Usta","doi":"10.1007/s00417-025-06795-9","DOIUrl":"10.1007/s00417-025-06795-9","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the modified double-flanged technique in cases of subluxated foldable single-piece intraocular lenses (IOLs).</p><p><strong>Methods: </strong>This retrospective study was conducted on 14 eyes of 14 patients.The following steps were performed in the surgical technique, respectively;the dislocated foldable single-piece IOL was repositioned into the anterior chamber, and the haptic was extracted through the corneal main incision.A 27-gauge needle was passed through the widest part of the haptic, close to the haptic-optic junction.A 6.0 polypropylene suture was passed through the needle. For the same process on the other haptic, the IOL was rotated 180 degrees.The polypropylene part of the created haptic-polypropylene complex was extracted through the scleral tunnel using a 26-gauge needle as a guide. The 1.5 mm tips of the polypropylene were cauterized to form flanges, which were then embedded into the sclera. The preoperative and postoperative first and sixth month ophthalmological findings were evaluated.</p><p><strong>Results: </strong>Both uncorrected visual acuity and best-corrected visual acuity were significantly higher at the postoperative sixth-month follow-up(p < 0.001).Possible causes of IOL subluxation; were pseudoexfoliation in five patients (36%),complicated cataract surgery in three patients (21%),trauma in two patients (14%) and no cause was found in four patients (29%). Of the 28 flanges, 24 (86%) were located intrasclerally, while four (14%) were in the subtenon space.Elevated intraocular pressure was detected in one case (7%) in the early postoperative period, and cystoid macular edema was noted in two cases (14%).</p><p><strong>Conclusion: </strong>This study demonstrated that the modified double-flanged technique could be effectively and safely applied in cases of subluxated foldable single-piece IOL.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1925-1932"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 pandemic on glaucoma surgery in German hospitals.","authors":"Philip Keye, Charlotte Evers, Timothy Gläser, Philip Braun, Patrick Thelen, Daniel Böhringer, Stefan Johann Lang, Thomas Reinhard, Jan Lübke","doi":"10.1007/s00417-025-06787-9","DOIUrl":"10.1007/s00417-025-06787-9","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the quantitative changes in surgical glaucoma care in German hospitals between 2019 and 2022 with special focus on the impact of the COVID-19 pandemic on overall volume and trends within glaucoma surgery.</p><p><strong>Methods: </strong>The quality reports of The Federal Joint Committee (G-BA), containing information on the quantity of surgical glaucoma procedures of 296 German hospitals were obtained in machine-readable form for the years 2019, 2020, 2021 and 2022. We analyzed the annual numbers and proportions of different glaucoma surgery types as categorized by German OPS codes, with special focus on 2020, the first year of the COVID-19 pandemic in Germany.</p><p><strong>Results: </strong>The total number of surgical glaucoma procedures in German hospitals in 2020 decreased by 8.5% compared to 2019 and recovered to pre-pandemic levels in 2021. Within filtration surgery, the number of classic trabeculectomy steadily declined while bleb-forming filtration devices were used more frequently. In all four years, cyclodestructive procedures were the most frequently performed interventions overall.</p><p><strong>Conclusion: </strong>The impact of the COVID-19 pandemic on overall surgical volume, especially in 2020, was substantial but overall moderate and transient. The trend towards minimally invasive procedures and bleb-forming filtration devices accelerated after 2020, resulting in a pronounced decline of classic filtration surgery, such as trabeculectomy.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1967-1975"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the clinical outcomes after manual capsulorhexis on one eye and precision pulse capsulotomy on the other eye.","authors":"Ho Sik Hwang, Hyun Seung Kim, Eun Chul Kim","doi":"10.1007/s00417-025-06783-z","DOIUrl":"10.1007/s00417-025-06783-z","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the clinical outcomes after manual continuous curvilinear capsulorhexis (CCC) on one eye and precision pulse capsulotomy (PPC) on the other eye in cataract surgery.</p><p><strong>Methods: </strong>60 eyes from 30 patients who underwent manual capsulorhexis on one eye (CCC group, N = 30) and precision pulse capsulotomy on the other eye (PPC group, N = 30) were retrospectively enrolled. Uncorrected and corrected visual acuity, manifest refraction, and corneal endothelial cell density were evaluated.</p><p><strong>Results: </strong>There were also no significant differences between the two groups according to the change in the corneal endothelial cell density at 3 months after cataract surgery (p > 0.05). The horizontal diameter (mm) and area (mm2) of the capsulotomy of the PPC group were significantly smaller than those of the CCC at postoperative 1 day and 3 months (P < 0.05). The circularity of PPC group was significantly better than that of the CCC at postoperative 1 day and 3 months (P < 0.05) (Table 4). Postoperative reduction of the capsulotomy area of the PPC group (6.64 ± 1.47) was higher than that of the CCC group (3.48 ± 1.21) from 1 day to 3 months after cataract surgery (P < 0.05).</p><p><strong>Conclusions: </strong>PPC was as safe as CCC and more efficient than CCC for making perfectly round capsulotomy. The initial capsulotomy size of PPC was smaller than that of CCC. PPC size decreased more than CCC after several months because it might damage the anterior capsule with thermal energy.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1907-1913"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal changes in ocular biometry and their effect on intraocular lens power calculation accuracy in cataract patients.","authors":"Young In Yun, Richul Oh, Joo Youn Oh, Hyuk Jin Choi, Mee Kum Kim, Chang Ho Yoon","doi":"10.1007/s00417-025-06775-z","DOIUrl":"10.1007/s00417-025-06775-z","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the changes in ocular biometry over time and their impact on intraocular lens (IOL) calculation in adult Korean patients with cataracts.</p><p><strong>Methods: </strong>Inclusion criteria were patients who underwent two consecutive ocular biometric measurements spaced more than one year apart using the IOLMaster 700 between November 2019 and February 2024 at a tertiary hospital in Seoul, Korea. Longitudinal changes in ocular biometry were evaluated. Predictive errors were compared among patients who underwent cataract surgery using the SRK/T, Kane, Barrett Universal II, Cook K6, EVO, Hill-RBF, Hoffer QST, and Pearl DGS formulas.</p><p><strong>Results: </strong>A total of 448 eyes from 448 patients were included. Ocular biometry measured over an average interval of 23.4 months showed that with increasing age, axial length elongated (0.04 ± 0.10 mm, p < 0.001), and the magnitude of total corneal astigmatism increased (0.04 ± 0.39 D, p = 0.018). The mean absolute predictive errors of the final measurements were significantly smaller compared to the initial measurements in the Barrett Universal II, EVO, Kane, and Pearl DGS formulas (difference of -0.05 D, -0.05 D, -0.06 D, and - 0.05 D, respectively). In the subgroup of eyes with an axial length of 25 mm or longer, the final measurements showed even greater reduction in mean absolute predictive errors across multiple formulas, including Barrett Universal II, Cook K6, EVO, Hill-RBF, Hoffer QST, Kane, and Pearl DGS, with reductions of -0.11 D, -0.11 D, -0.10 D, -0.08 D, -0.10 D, -0.09 D and - 0.10 D, respectively.</p><p><strong>Conclusions: </strong>Axial length increases and corneal curvature changes with aging. IOLMaster 700 ocular biometry results measured closer to the date of surgery were more accurate in IOL power calculation than those measured more than one year earlier, with the greatest improvement observed in myopic eyes. Therefore, it is recommended to repeat IOLMaster 700 biometry before surgery if the previous measurements were taken more than a year ago.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1915-1924"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choroidal neovascularization secondary to punctate inner choroidopathy vs myopia: clinical outcomes after 1-year of treatment.","authors":"Leonardo Bottazzi, Eugenio Barlocci, Riccardo Sacconi, Marco Battista, Andrea Servillo, Federico Beretta, Francesco Bandello, Giuseppe Querques","doi":"10.1007/s00417-025-06818-5","DOIUrl":"10.1007/s00417-025-06818-5","url":null,"abstract":"<p><strong>Background: </strong>One of the most important complications of punctate inner choroidopathy (PIC) is the development of an inflammatory type 2 choroidal neovascularization (iCNV); however, also myopic macular degeneration due to high myopia could be complicated by a type- 2 CNV (mCNV). The aim of this work is to assess similarities and differences in the response to anti-VEGF treatment between mCNV and iCNV during a one-year follow-up, number of intravitreal injections required to control the CNV and the number of recurrences that occurred during a one-year follow-up were evaluated.</p><p><strong>Methods: </strong>Retrospective, longitudinal, case-control study. Patients diagnosed with myopic iCNV secondary to PIC or to simple myopia referring to San Raffaele Hospital were enrolled from January 2021 to December 2022. Choroidal thickness (ChT) and best-corrected visual acuity (BCVA) were measured at the onset of CNV, after resolution of exudation after treatment, and at 1-year follow-up. Primary outcomes included the analysis of the number of intravitreal injections needed and the incidence of recurrences. Secondary outcomes comprised the analysis of ChT.</p><p><strong>Results: </strong>Thirty-seven eyes (37 patients) were enrolled. Sixteen eyes were affected by myopic iCNV secondary to PIC, and 21 eyes by simple mCNV. BCVA significantly improved in both myopic iCNV group (from 0.27 ± 0.12 at the baseline to 0.11 ± 0.08 LogMAR at 12 months follow-up, p < 0.001) and simple mCNV group (from 0.37 ± 0.22 at the baseline to 0.23 ± 0.17 LogMAR at 12 months follow-up, p < 0.001). A significant difference in ChT was found comparing myopic iCNV and simple mCNV groups (mean sub-CNV ChT of 258 ± 116 μm and 89 ± 14 μm, respectively, p < 0.001). Sub-CNV ChT significantly decreases during the follow-up in the PIC group (from 258 ± 116 μm to 192 ± 118 μm, p = 0.002), whereas no differences were disclosed in the myopic group. CNV secondary to PIC needed more anti-VEGF intravitreal injections to achieve resolution of exudation (3.2 ± 1.2 vs 2.1 ± 1.1 intravitreal injections, p = 0.003) and they were characterized by higher number of relapses (44% vs 20%, p < 0.001) in comparison to simple myopic group.</p><p><strong>Conclusions: </strong>PIC group showed a more aggressive pattern of CNV, characterized by higher number of relapses and intravitreal injections needed. Moreover, a higher ChT below the lesion was detected in PIC group in comparison to simple myopic group.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1859-1865"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A post-hoc analysis of intravitreal aflibercept-treated nAMD patients from ARIES & ALTAIR: predicting treatment intervals and frequency for aflibercept treat-and-extend therapy regimen using machine learning.","authors":"Matthias Gutfleisch, Britta Heimes-Bussmann, Sökmen Aydin, Ratko Petrovic, Alexander Loktyushin, Masahito Ohji, Kanji Takahashi, Annabelle A Okada, Paula Scholz, Hossam Youssef, Ulrike Bauer-Steinhusen, Tobias Machewitz, Kai Rothaus, Albrecht Lommatzsch","doi":"10.1007/s00417-025-06812-x","DOIUrl":"10.1007/s00417-025-06812-x","url":null,"abstract":"<p><strong>Purpose: </strong>To predict potential treatment need during treat-and-extend (T&E) anti-vascular endothelial growth factor (VEGF) treatment in neovascular age-related macular degeneration (nAMD) using an artificial intelligence (AI) model trained using transfer learning.</p><p><strong>Methods: </strong>ARIES and ALTAIR were randomized controlled Phase 3b/4 trials assessing intravitreal aflibercept (IVT-AFL) in patients with nAMD. Following treatment initiation with three monthly injections of IVT-AFL, treatment intervals were re-assessed continuously during the study based on prespecified criteria. In this post- hoc analysis, spectral domain optical coherence tomography (SD-OCT) scans from Week (Wk) 8 and Wk 16 visits from patients treated with T&E regimens of 2 mg IVT-AFL over 2 years were utilized to predict individual treatment intervals and frequency. Automated image segmentation of the SD-OCT scans was performed, predictive models of treatment intervals and frequency were developed using machine learning or logistic regression methods, and their performance was evaluated using a fivefold cross-validation. A transfer learning technique was used to adapt existing AI models previously trained on a pro-re-nata therapy regimen to the T&E dataset.</p><p><strong>Results: </strong>In total, 205 ARIES and 112 ALTAIR patient datasets were used for training and evaluation. The following results were achieved with an AI model trained using transfer learning (for ARIES) and logistic regression (for ALTAIR). For prediction of the first treatment interval (short [< 12 weeks] or long [≥ 12 weeks]) following treatment initiation, at Visit 4 (Wk 16), the AI model achieved an area under the receiver operating characteristic curve (AUC) of 0.87 and 0.78 for ARIES and ALTAIR, respectively. For assessment of the individual frequency of IVT-AFL in the first and second study years, the model achieved an AUC of 0.84 and 0.79, respectively, for ARIES, and 0.79 and 0.78, respectively, for ALTAIR. For prediction of the last intended individual treatment interval at the end of Year 2, the AI model achieved an AUC of 0.74 and 0.77 for ARIES and ALTAIR, respectively.</p><p><strong>Conclusion: </strong>AI trained using transfer learning can be used to predict potential treatment needs for anti-VEGF treatment in nAMD based on SD-OCT scans at Wk 8 and Wk 16, supporting medical decisions on interval adjustments and optimizing individualized IVT-AFL treatment regimens.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1885-1897"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rAAV2-ND1 gene therapy for Leber hereditary optic neuropathy.","authors":"Xin Li, Jun Yuan, Jia Qi, Kunwei Ruan, Bin Li, Yanping Dan, Yong Zhang","doi":"10.1007/s00417-025-06776-y","DOIUrl":"10.1007/s00417-025-06776-y","url":null,"abstract":"<p><strong>Purpose: </strong>No effective treatment for leber hereditary optic neuropathy (LHON) caused by ND1 mutation is available.This study evaluated the safety and efficacy of a single unilateral intravitreal injection rAAV2-ND1 in various doses for the treatment of LHON.</p><p><strong>Methods: </strong>Twelve patients with LHON (ND1 mutation) in two groups with six participants each.The low-dose group received injection of rAAV2-ND1 in a dose of 1.5 × 10⁸ vg/eye while the high-dose group received 1.5 × 10⁹ vg/eye.The safety endpoint was the incidence of adverse events (AEs).The primary efficacy endpoint was changes of best corrected visual acuity (BCVA).The secondary efficacy endpoints were improvement in visual field (VF), visual field index (VFI), and mean deviation (MD) and change in retinal nerve fiber layer (RNFL) thickness.</p><p><strong>Results: </strong>In total,11 mild eye-related AEs occurred in the participants in both groups, and short-term drug treatment returned to normal.The difference was statistically significant in BCVA of the injected eyes in the low-dose group between 12 months after treatment and at baseline.The differences in BCVA of the uninjected eyes in the high-dose group between baseline and 3 months or 6 months after treatment were statistically significant.At 12 months after treatment, the rate of improvement in BCVA for the injected eyes in the low-dose groups was 66.7% (4/6),while BCVA for the uninjected eyes in the high-dose groups was 50.0% (3/6),and patients in both groups had binocular VF (VFI, MD) and RNFL thicknesses that did not significantly differ from baseline.</p><p><strong>Conclusion: </strong>Preliminary clinical evidence shows that rAAV2-ND1 ophthalmic injection is a safe and effective treatment for LHON due to ND1 mutation.</p><p><strong>Trial registration: </strong>Trial registration number: ChiCTR2000041574, Date:12/29/2020.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"2017-2024"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-specific changes in vision-related quality of life over time - results from the population-based Gutenberg Health Study.","authors":"Alica Hartmann, Stephanie D Grabitz, Philipp S Wild, Karl J Lackner, Thomas Münzel, Jasmin Ghaemi Kerahrodi, Susanne Singer, Katharina Geschke, Jörn M Schattenberg, Stavros Konstantinides, Norbert Pfeiffer, Alexander K Schuster","doi":"10.1007/s00417-025-06741-9","DOIUrl":"10.1007/s00417-025-06741-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To investigate potential gender- and age-specific changes over time in vision-related quality of life (VRQoL) on a population-based level. Further, factors associated with changes in VRQoL will be explored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The Gutenberg Health Study is a population-based, prospective, observational, single-center cohort study in Germany. VRQoL was quantified at baseline and 5-year follow-up using the visual function scale (VFS) and socio-emotional scale (SES-VRQoL). VFS and SES-VRQoL are calculated using the \"National Eye Institute 25-Item Visual Functioning Questionnaire\" (NEI-VFQ-25). Both scales range from 0 to 100, 0 corresponds to the sum that would be achieved if a participant had answered all items with the worst performance, and 100 corresponds to the sum of all items answered with the best possible performance. Distance-corrected visual acuity was measured in both eyes. Univariable and multivariable linear regression analyses were conducted to identify ophthalmic and sociodemographic predictors of VRQoL.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 10,152 participants (mean age 54.2 years; 49.2% female) were included in the analysis. The mean visual functioning decreased from 89.6 (IQR: 81.3, 95.1) at baseline to 85.9 (IQR: 79.2, 92.6) at 5-year follow-up in the VFS (p &lt; 0.001). Participants' socio-emotional well-being remained the same from baseline to 5-year follow-up in the SES-VRQoL. In multivariable linear regression analysis, older age (0.03, p = 0.002) and female gender (-1.00, p &lt; 0.001) were associated with a VFS change. Higher baseline socioeconomic status was associated with a slightly positive increase in VFS (0.07, p = 0.001). Deterioration of visual acuity in the better and worse-seeing eye was associated with negative VFS change over 5 years (better-seeing eye: -5.41, p &lt; 0.001, worse-seeing eye: -7.35, p &lt; 0.001). Baseline socioeconomic status was associated with SES-VRQoL change (0.06, p &lt; 0.001). The negative change in visual acuity showed an association with negative SES-VRQoL in the better (-4.15, p &lt; 0.001) and worse-seeing eye (-3.75, p &lt; 0.001). Stratification of the regression models by age and gender showed greater reductions in VFS scores with visual acuity changes in participants aged 65 years or older and a more pronounced decrease in female participants over 5 years.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study demonstrated an association between visual acuity change and change in VRQoL over 5 years, with a greater decrease in female participants and participants aged 65 years or older. The better-seeing eye and the worse-seeing eye both had an impact on changes in VRQoL.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key messages: &lt;/strong&gt;What is known Previous studies have predominantly used cross-sectional designs to investigate the correlation between visual acuity and vision-related quality of life, with limited insights into how visual acuity changes over time affect vision-related quality ","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1825-1835"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the impact of pupil expansion techniques on cataract surgery: unveiling key complications and clinical outcomes: a comparative analysis of 1266 eyes.","authors":"Asaf Achiron, Tal Yahalomi, Michael Ostrovsky, Eliya Levinger, Eyal Cohen, Omar Elhaddad, Derek Tole, Kieren Darcy, Raimo Tuuminen","doi":"10.1007/s00417-025-06748-2","DOIUrl":"10.1007/s00417-025-06748-2","url":null,"abstract":"<p><strong>Background: </strong>In cataract surgery, inadequate pupil dilation presents a major surgical challenge by narrowing the operation field and restricting visibility and movement. We aim to compare cataract surgery complication rates and clinical outcomes using different pupil expansion methods.</p><p><strong>Methods: </strong>This retrospective cohort study grouped patients according to four techniques of mechanical pupil expansion techniques: sphincterotomy (N = 339), iris stretching (N = 242), iris hooks (N = 391) and expansion rings (N = 294). Incidences and odds ratios for major complications and outcomes were compared between the groups.</p><p><strong>Results: </strong>This single-center study included 1266 adult patients who underwent routine cataract surgery with mechanical pupil dilatation. The mean (± SD) age was 75.5 (± 13.0) years and 727 (57%) patients were male. The risk of pseudophakic cystoid macular edema (PCME) did not differ between the groups. Iris hooks were associated with the highest incidence of posterior capsular rupture (PCR) (3.3%) as compared to sphincterotomy, stretching and expansion rings (0.9%, 0.4% and 1.4%, respectively, P = 0.016). However, this effect was not supported by multivariable analysis. Zonular dialysis tended to be higher among eyes operated with iris hooks and pupil expansion rings, compared with iris stretching and sphincterotomy (2.0% and 1.7%, respectively, P = 0.058) and was found to be independently associated with a specific mechanical pupil expansion method on multivariable analysis (P = 0.050). No differences were observed for other complications, intraocular pressure or best-corrected visual acuity (VA) gain. Surgeon seniority was a significant protective factor from postoperative uveitis on multivariable analysis (P = 0.032).</p><p><strong>Conclusions: </strong>Our large cohort study found no difference between the groups regarding major complications or clinical outcomes, suggesting that all four methods may be equally safe.</p><p><strong>Key messages: </strong>WHAT IS KNOWN : • In cataract surgery, inadequate pupil dilation presents a major surgical challenge by narrowing the operation field and restricting visibility and movement. • Different pupil dilation methods have been used, ranged from topical and intracameral mydriatics and visco-mydriasis to mechanical dilation maneuvers. • Four principal techniques of mechanical pupil expansion, including sphincterotomies, manual iris stretching, iris retracting hooks and pupil expansion rings, are available.</p><p><strong>What is new: </strong>• This single-center study included 1266 adult patients found no difference between the groups regarding major complications or clinical outcomes such as pseudophakic cystoid macular edema (PCME), posterior capsular rupture, zonular dialysis, intraocular pressure, uveitis or best-corrected visual acuity gain. • Surgeon seniority was a significant protective factor from postoperative uveitis.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1597-1603"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12238154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of a multi-action tear substitute based on 0.15% cross-linked hyaluronic acid, 3% trehalose and liposomes with stearylamine: A randomized, single-mask, controlled study.","authors":"Antonio Ballesteros-Sánchez, Giovanni Roberto Tedesco, Carlos Rocha-de-Lossada, Fedele Russo, José-María Sánchez-González, Davide Borroni","doi":"10.1007/s00417-025-06765-1","DOIUrl":"10.1007/s00417-025-06765-1","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety of TriMix, a new multiple-action tear substitute in patients with dry eye disease (DED).</p><p><strong>Methods: </strong>This was a randomized, multicenter, single-masked, hyaluronic acid (HA)-controlled clinical trial conducted between July, 2023 and May, 2024. A total of 115 patients were randomly allocated to receive either TriMix tear substitute or 0.15% HA tear substitute 3 times daily. Clinical outcomes include ocular surface disease index (OSDI) questionnaire, non-invasive tear film break-up time (NIBUT) and Schirmer I test (ST) without anesthesia at 3 and 6 months of follow-up.</p><p><strong>Results: </strong>Of the 115 patients randomized, 80 completed the study (TriMix, n = 56; HA, n = 24). At months 3 and 6, improvements from baseline were statistically greater with TriMix tear substitute compared to HA 0.15% tear substitute for OSDI: -3.7 points (95% CI, -6.9 to -0.6; p = 0.011) and - 7.5 points (95% CI, -10.3 to -4.6; p < 0.001), respectively. Similar results were reported for NIBUT: 0.9 s (95% CI, 0.3 to 1.6; P = 0.040) and 1.6 s (95% CI, 0.7 to 2.6; P < 0.001), respectively. Regarding safety, no serious ocular adverse events occurred. Three patients complained of burning after instillation of TriMix tear substitute.</p><p><strong>Conclusion: </strong>This RCTs demonstrate that TriMix tear substitute provides statistically significant and clinically evidence of the reduction of DED symptoms with a satisfactory safety profile through 6 months of follow-up. Findings suggest the use of this tear substitute, but results should be confirmed independently over longer time periods.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":"1613-1621"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}