International Ophthalmology最新文献

{"title":"Clinical and demographic characteristics of glaucoma patients in Kingston, Jamaica.","authors":"Briana L McIntosh, Osahon J Asowata, Kaitlyn L Funk, Kendall R Pixley, Camara S Brown, Jessica N Cooke Bailey","doi":"10.1007/s10792-026-04020-y","DOIUrl":"10.1007/s10792-026-04020-y","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the clinical, demographic, and imaging features of glaucoma among adults receiving care at Kingston Public Hospital (KPH) Ophthalmology clinic, Jamaica's largest public eye care facility.</p><p><strong>Methods: </strong>We conducted a retrospective, cross-sectional chart review of adult glaucoma patients seen at the KPH Ophthalmology Clinic between January 2018 and March 2023. Included patients had documentation of at least two comprehensive ophthalmic examinations and one high-quality optical coherence tomography (OCT) scan (signal strength ≥ 6). Extracted data included demographics, intraocular pressure (IOP), visual acuity, OCT-derived optic nerve head and retinal nerve fiber layer (RNFL) parameters, visual field (VF) metrics, glaucoma severity, comorbidities, and self-reported treatment adherence. Comparisons were performed by age group (< 40 vs. ≥ 40 years) and sex.</p><p><strong>Results: </strong>A total of 324 patients (619 eyes) were included (mean age 58.3 ± 12.3 years; 66.0% female). At presentation, 51.0% had advanced-stage glaucoma, and only 17.3% reported consistent medication use. Hypertension and diabetes were common comorbidities (80.3% and 38.8%, respectively). Mean Goldmann IOP was 22.0 mmHg, mean RNFL thickness was 75.2 ± 14.9 μm, and mean cup-to-disc ratio was 0.73 ± 0.10. VF indices demonstrated moderate functional loss, with worse mean deviation among men. Longitudinal VF data were limited; only 17% of patients had more than one documented test, limiting cohort-wide assessment of functional progression.</p><p><strong>Conclusion: </strong>This clinic-based characterization of glaucoma in Jamaica reveals a high burden of advanced disease at presentation, low treatment adherence, and gaps in longitudinal monitoring, supporting the need for prospective studies to develop ancestry-and region-specific OCT reference data and improve equitable glaucoma care.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epithelial thickness gradients as a diagnostic biomarker for early-stage keratoconus.","authors":"Zane Jansone-Langina, Jana Gertnere, Viktorija Kezika, Carlos Rocha-de-Lossada, José-María Sánchez-González","doi":"10.1007/s10792-026-04091-x","DOIUrl":"10.1007/s10792-026-04091-x","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate peripheral-central epithelial thickness (ET) gradients in eyes with keratoconus and regular astigmatism, and to determine their potential utility as a non-invasive biomarker for disease detection in early-stage keratoconus.</p><p><strong>Methods: </strong>This retrospective cross-sectional analyzed ET with spectral-domain OCT at the cone apex and at 3 mm in the superior, temporal, nasal, and inferior directions. Epithelial thickness gradients (ΔET) were calculated as the difference between peripheral and central ET. Statistical comparisons were performed using non-parametric tests, with significance set at p < 0.05.</p><p><strong>Results: </strong>A total of 396 eyes (208 keratoconus, 188 regular astigmatism) were analyzed. Central ET was significantly reduced in KC (38.55 ± 5.42 µm) vs controls (48.78 ± 3.94 µm; p < 0.001). While peripheral thickness showed minor differences, the ET gradients (ΔET) were markedly steeper in KC across all quadrants (temporal, superior, nasal, inferior, p < 0.001). Within Stage I KC, eyes with more advanced disease exhibited steeper ΔET values, particularly in the nasal and temporal directions. Mean ΔET, demonstrated significant differences between KC (8.43 ± 4.97 µm) and controls (- 1.55 ± 1.77 µm; p < 0.001), and correlated positively with steep keratometry (r = 0.521, p < 0.001) and negatively with thinnest corneal thickness (TCT) (r =  - 0.641, p < 0.001).</p><p><strong>Conclusion: </strong>ΔET is markedly steeper in keratoconus than in regular astigmatism-even in Stage I-and correlates with steep keratometry and TCT. With areas under the curves (AUCs) up to 0.976, ΔET provides a rapid, non-invasive epithelial-based biomarker for early detection and staging of keratoconus. Its utility for monitoring progression remains to be established in prospective longitudinal studies.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors affecting visual outcomes following vitrectomy for retinal detachment secondary to branch retinal vein occlusion.","authors":"Guoqiao Lin, Xujia Liu, Youming Zhou, Yongqun Xiong","doi":"10.1007/s10792-026-04083-x","DOIUrl":"https://doi.org/10.1007/s10792-026-04083-x","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze clinical characteristics and visual outcomes of retinal detachment (RD) following branch retinal vein occlusion (BRVO) in patients undergoing vitrectomy, and to identify risk factors influencing visual prognosis.</p><p><strong>Methods: </strong>This retrospective study included 28 consecutive eyes with RD secondary to BRVO that underwent vitrectomy between January 2013 and December 2021. Preoperative data included best-corrected visual acuity (BCVA), fibrovascular membrane (FVM) severity (non-FVM, mild FVM, severe FVM), macular status, and retinal detachment extent. All patients underwent 23-gauge pars plana vitrectomy with phacoemulsification. Visual outcomes and complications were analyzed using univariable and multivariable regression models.</p><p><strong>Results: </strong>Mean patient age was 59.3 ± 6.7 years with 60.7% being female. Median preoperative BCVA was counting fingers. Retinal reattachment was achieved in all 28 eyes with no recurrent RD during follow-up. Three patients (10.7%) developed postoperative macular holes (MH), with two achieving spontaneous closure. Multivariable analysis revealed that severe FVM (coefficient = 0.351, 95%CI: 0.119-0.642, P = 0.003) and macula-off status (coefficient = 0.239, 95%CI: 0.064-0.422, P = 0.010) were independent risk factors for poorer final BCVA. Preoperative BCVA did not correlate with final visual outcomes (P = 0.764).</p><p><strong>Conclusion: </strong>In this small retrospective series, vitrectomy achieved a high anatomical reattachment rate for RD secondary to BRVO. Severe fibrovascular membranes and macula-off retinal detachment were identified as independent risk factors associated with poorer visual outcomes. Postoperative MH formation was observed, particularly in eyes with FVM.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between postoperative visual recovery and subjective visual satisfaction in cataract patients with different corneal astigmatism degrees: a retrospective cohort study.","authors":"Miaoying Zhang, Xianling Luo","doi":"10.1007/s10792-026-04054-2","DOIUrl":"https://doi.org/10.1007/s10792-026-04054-2","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the correlation between postoperative visual recovery and subjective visual satisfaction in cataract patients with varying degrees of corneal astigmatism, and to identify factors influencing patient-reported outcomes following modern cataract surgery.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 682 eyes of cataract patients who underwent phacoemulsification with standard monofocal non-toric intraocular lens (IOL) implantation targeting emmetropia between January 2022 and December 2022. Patients were stratified into four groups based on preoperative corneal astigmatism: Group 1 (< 0.75 D, n = 250), Group 2 (0.75-1.50 D, n = 245), Group 3 (1.51-2.50 D, n = 121), and Group 4 (> 2.50 D, n = 66). Primary outcomes included best-corrected visual acuity (BCVA), uncorrected distance visual acuity (UDVA), and patient satisfaction scores measured using the modified NEI VFQ-25 questionnaire. Secondary outcomes encompassed visual symptoms and spectacle independence for distance vision.</p><p><strong>Results: </strong>Mean postoperative UDVA improved significantly across all groups (p < 0.001), with Group 1 achieving 0.12 ± 0.08 logMAR compared to 0.36 ± 0.14 logMAR in Group 4. Postoperative BCVA was ≥ 20/30 in 97.1% of all eyes, confirming good visual potential across groups. Patient satisfaction composite scores decreased progressively with increasing astigmatism magnitude (Group 1: 88.4 ± 9.2 vs. Group 4: 67.1 ± 15.8; p < 0.001). Spectacle independence for distance vision was achieved in 92.5% of Group 1 patients versus 45.5% in Group 4. Multiple regression analysis revealed that postoperative UDVA (β =  - 0.42, p < 0.001), residual astigmatism (β =  - 0.38, p < 0.001), and severity of glare symptoms (β =  - 0.21, p = 0.003) were significant independent predictors of reduced satisfaction (adjusted R2 = 0.57).</p><p><strong>Conclusions: </strong>Higher degrees of preoperative corneal astigmatism are associated with reduced postoperative visual satisfaction despite good BCVA outcomes. These findings support a low threshold for astigmatism management and highlight the importance of comprehensive patient counseling regarding expected visual outcomes based on preoperative astigmatism magnitude.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal astigmatism magnitude, axis distribution, and ocular biometric characteristics in cataract surgery candidates: a tertiary center study from the Western Black Sea region of Turkey.","authors":"Burçin Göğüş Çamlı, Özlem Aktaş Özaltun, Burcu Gündüz Çetinkaya, Ahmet Ekizoğlu","doi":"10.1007/s10792-026-04089-5","DOIUrl":"https://doi.org/10.1007/s10792-026-04089-5","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate ocular biometric parameters and corneal astigmatism characteristics in cataract surgery candidates from the Western Black Sea region of Turkey.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included patients who underwent preoperative ocular biometry between December 2023 and December 2025 at the only tertiary referral hospital in Karabük, Turkey. One eye per patient was analyzed. Measurements were obtained using the Nidek AL-Scan optical biometer and included axial length (AL), keratometry (K1, K2, Km), corneal astigmatism magnitude, central corneal thickness (CCT), anterior chamber depth (ACD), and white-to-white distance (WTW). Astigmatism axis was classified as with-the-rule (WTR), against-the-rule (ATR), or oblique. Correlation analyses and multivariate logistic regression were performed to identify factors associated with ATR astigmatism and clinically significant astigmatism (≥ 1.00 D).</p><p><strong>Results: </strong>A total of 1087 eyes were included, with a mean age of 68.82 ± 8.48 years. Mean AL was 23.27 ± 0.92 mm and mean corneal astigmatism was 0.81 ± 0.56 D. WTR astigmatism was most common (45.2%), followed by ATR (37%) and oblique (17.9%), and nearly 1/3 of eyes had astigmatism > 1.00 D. A significant age-related shift from WTR to ATR was observed (p < 0.001). AL was positively correlated with ACD and WTW and negatively correlated with Kmean (p < 0.001). In multivariate analysis, age was independently associated with ATR astigmatism, AL and mean keratometry were associated with ≥ 1.00 D astigmatism.</p><p><strong>Conclusion: </strong>Corneal astigmatism is common in this population, highlighting the need for comprehensive preoperative biometric evaluation; given its dynamic nature, individualized assessment is essential for optimal surgical planning.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Formulation of treatment protocol for ocular surface squamous neoplasia.","authors":"Seyed-Hashem Daryabari, Hossein Aghamollaei, Seyed Rahim Hassanpour, Javad Rezaei, Seyyed Morteza Hosseini Imeni, Mojtaba Sepandi, Mehdi Raei","doi":"10.1007/s10792-026-04080-0","DOIUrl":"https://doi.org/10.1007/s10792-026-04080-0","url":null,"abstract":"<p><p>In this study we report a structured, evidence-based treatment protocol for ocular surface squamous neoplasia (OSSN) by integrating findings from a systematic literature review with expert clinical insights. We performed a two-step methodology. First, a comprehensive systematic review was conducted using PubMed, Scopus, and Web of Science to identify relevant studies on OSSN treatment. Articles were screened based on predefined inclusion and exclusion criteria. Next, a focused group discussion was conducted with expert ophthalmologists to develop a consensus-driven treatment protocol. Discussions were transcribed and thematically analyzed to identify key recommendations for treatment selection and follow-up strategies. Based on the literature review and expert panel consensus, a structured treatment protocol was developed. Surgical treatment is recommended in cases with uncertainty regarding the diagnosis, resource limitations, exclusive corneal involvement, and poor patient compliance with medical treatment or follow-up. Medical treatment with interferon α-2b or 5-fluorouracil is preferred in other scenarios, with agent selection based on side-effect profile and medication availability. Adjuvant therapy is advised when surgical margins are involved. Furthermore, a standardized follow-up schedule is proposed, ensuring long-term monitoring for recurrence. In conclusion, this protocol provides a structured, adaptable framework for OSSN treatment, offering clear guidelines for selecting the appropriate treatment strategy. By balancing evidence-based recommendations with clinical considerations, this protocol aims to optimize patient outcomes.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical ROCK inhibition accelerates recovery after Descemetorhexis Without Endothelial Keratoplasty (DWEK) in Fuchs endothelial corneal dystrophy: a prospective comparative clinical trial.","authors":"Parul Jain, Avinash Pradhan, Paromita Dutta, Pushkar Rangari, Punita Kumari Sodhi","doi":"10.1007/s10792-026-04078-8","DOIUrl":"https://doi.org/10.1007/s10792-026-04078-8","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the clinical efficacy and recovery kinetics of Descemetorhexis Without Endothelial Keratoplasty (DWEK) performed with and without adjunctive topical ripasudil 0.4% in eyes with Fuchs endothelial corneal dystrophy (FECD).</p><p><strong>Setting: </strong>Cornea and Refractive Surgery Services, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India.</p><p><strong>Design: </strong>Prospective, randomized, interventional, comparative clinical study.</p><p><strong>Methods: </strong>Twenty-four eyes with mild-to-moderate FECD underwent phacoemulsification with a standardized 4-mm central DWEK and were randomized to DWEK-alone (Group A) or DWEK + topical ripasudil 0.4% four times daily for eight weeks (Group B). Primary outcomes were changes in best-corrected visual acuity (BCVA, logMAR), central corneal thickness (CCT), and peripheral endothelial cell density (ECD) over 6 months. Secondary outcomes were time to corneal clearing, optical quality (higher-order aberrations), and complications.</p><p><strong>Results: </strong>BCVA improved significantly in both groups, with faster recovery in Group B (0.24 ± 0.11 vs. 0.36 ± 0.14 logMAR at 6 months; p < 0.05). CCT decreased more rapidly in Group B (572.1 ± 27.5 µm vs. 590.2 ± 29.8 µm; p = 0.04). Peripheral ECD remained stable in Group A but showed a mild gain in Group B (p = 0.04). Group B achieved earlier corneal deturgescence (mean 8 ± 2 weeks vs. 12 ± 3 weeks). No eye in either group developed persistent edema, interface haze, or required rescue keratoplasty.</p><p><strong>Conclusions: </strong>Adjunctive topical ripasudil after DWEK accelerates endothelial recovery, corneal deturgescence, and visual rehabilitation compared with DWEK alone, without compromising safety.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractive outcomes following low astigmatism correction guided by toric calculator recommendations.","authors":"Rita Zlatkin, Olga Reitblat, Ilanit Trifonov, Asaf Laks, Susan Xia, Michal Cahn, Adi Einan-Lifshitz, Irit Bahar, Ruti Sella","doi":"10.1007/s10792-026-04071-1","DOIUrl":"https://doi.org/10.1007/s10792-026-04071-1","url":null,"abstract":"<p><strong>Purpose: </strong>To examine refractive outcomes after cataract extraction with a toric correction of 1.0 diopter as recommended by the Barrett Toric Calculator.</p><p><strong>Methods: </strong>Retrospective analysis of patients who underwent cataract surgery in two tertiary medical centers with a toric intraocular lens (IOL) providing a 1.0 diopter correction in the IOL plane. Electronic patient charts were screened for preoperative and postoperative data, including visual acuity, subjective refraction, biometry measurements, and corneal tomography. Refractive outcomes were compared to a control group with low astigmatism who had undergone cataract extraction with a non-toric monofocal lens and another group with high-toric IOLs.</p><p><strong>Results: </strong>Twenty-six eyes with low-toric IOLs (LT) were compared to 28 non-toric monofocal IOLs (NT) and 47 high-toric IOLs (HT). The trimmed (tr) mean centroid prediction error in refractive astigmatism (RA) was similar between LT and HT groups (0.08D@1.3° vs. 0.11D@93.0°, p  =  0.24), as was the postoperative RA centroid (0.09D@109.8° vs. 0.2D@93.9°, p = 0.1). The LT group had a lower tr-mean centroid and absolute postoperative RA than the NT group (0.09D@09.8° vs. 0.49D@175.7°, p<0.001, 0.29D vs. 0.84D, p = 0.001). Simulation showed improved outcomes with low-toric IOLs in the NT group: lower centroid astigmatism (0.11D@35.1°, p = 0.001) and lower absolute residual astigmatism (0.54D, p = 0.009).</p><p><strong>Conclusions: </strong>Correction of 1.0 diopter in the IOL plane demonstrates comparable accuracy and precision to higher astigmatism correction with toric IOLs, with potentially favorable refractive outcomes compared to patients eligible for this correction but fitted with monofocal non-toric IOLs.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transscleral diode cyclophotocoagulation for refractory glaucoma: real-world efficacy and safety.","authors":"Elif Ertan, Merve Uran","doi":"10.1007/s10792-026-04082-y","DOIUrl":"https://doi.org/10.1007/s10792-026-04082-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety of transscleral diode laser cyclophotocoagulation (TSCPC) in patients with refractory glaucoma using real-world clinical data from a tertiary referral center.</p><p><strong>Methods: </strong>This retrospective study reviewed the medical records of 143 patients who underwent primary TSCPC for refractory glaucoma between December 2022 and January 2024. Data regarding intraocular pressure (IOP), best-corrected visual acuity (BCVA), number of IOP-lowering medications, repeat treatments, and postoperative complications were collected. Surgical success was defined as achieving an IOP between 6 and 21 mmHg with at least a 20% reduction from baseline, with (qualified success) or without (complete success) adjunctive medical therapy, in the absence of glaucoma-related phthisis bulbi, loss of light perception, or the need for additional glaucoma surgery other than repeat TSCPC.</p><p><strong>Results: </strong>A total of 143 eyes from 143 patients (57.0% male) with a mean age of 62.0 ± 15.7 years were included. Neovascular glaucoma was the most common diagnosis (62.0%). Mean IOP decreased significantly from 35.9 ± 11.0 mmHg preoperatively to 16.2 ± 8.3 mmHg at the 12-month follow-up (p < 0.001). Overall surgical success was achieved in 65.8% of eyes, including 16.8% complete success and 49.0% qualified success. The mean number of antiglaucoma medications decreased from 2.8 ± 1.0 to 1.5 ± 1.1 (p < 0.001). Postoperative complications occurred in 10.9% of eyes and were predominantly mild and transient. No cases of persistent hypotony or phthisis bulbi were observed.</p><p><strong>Conclusions: </strong>In a real-world tertiary care setting, TSCPC was associated with significant IOP reduction and an acceptable safety profile over 12 months in patients with refractory glaucoma. Despite the high proportion of neovascular glaucoma cases, no sight-threatening complications such as persistent hypotony or phthisis bulbi were observed during follow-up. However, longer-term studies are needed to confirm the durability and long-term safety of these outcomes.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Old clear penetrating keratoplasty with high astigmatism: conservative solution with customized foldable Toric Piggyback intraocular lens.","authors":"Cecilia Mularoni, Andrea Servillo, Daniele Gaudenzi, Edoardo Fabbri, Alessandro Mularoni","doi":"10.1007/s10792-026-04081-z","DOIUrl":"https://doi.org/10.1007/s10792-026-04081-z","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety of toric foldable intraocular lens (IOL) for high astigmatism correction in eyes with prior penetrating keratoplasty (PK).</p><p><strong>Methods: </strong>Clinical data were retrospectively collected at baseline and 12 months postoperatively from pseudophakic patients with high astigmatism (> 2 D), and previous PK, who underwent implantation of customized foldable toric IOLs using the piggyback technique. Uncorrected and best-corrected visual acuity (UCVA, BCVA), manifest refraction, keratometry, refractive and topographic cylinder, endothelial cell count (ECC), and complications were assessed. To account for inter-eye correlation, analyses were performed using generalized estimating equations (GEE), and estimated differences (est.) with 95% confidence intervals (CI) were reported.</p><p><strong>Results: </strong>Fourteen eyes of 11 patients (2 women, 9 men; mean age 62 ± 21 years) were included. The mean interval between PK and piggyback implantation was 24.18 years. Uncorrected and best-corrected visual acuity improved at 12 months (UCVA: est. - 0.69 logMAR; 95% CI, - 0.84 to - 0.54; p < 0.001; BCVA: est. - 0.20 logMAR; 95% CI, - 0.29 to - 0.11; p < 0.001). Total refractive astigmatism was reduced (est. - 4.09 diopters; 95% CI, - 5.20 to - 2.99; p < 0.001), whereas topographic astigmatism remained unchanged (est. - 0.03 diopters; 95% CI, - 0.21 to 0.16; p = 0.76). Endothelial cell count did not show a statistically significant change over time (est. - 67.8 cells/mm²; 95% CI, - 139.6 to 4.0; p = 0.07). One eye experienced recurrent IOL rotation (80°), requiring explant and replacement.</p><p><strong>Conclusions: </strong>The favorable refractive outcomes and safety profile support the use of the piggyback technique with a customized toric foldable IOL for correcting high astigmatism in pseudophakic eyes that have undergone PK many years before. Larger sample size and prospective study are needed.</p>","PeriodicalId":14473,"journal":{"name":"International Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}