Ophthalmology最新文献

{"title":"Assessment of the Necessity for High-Level Disinfection (HLD) of Reusable Ophthalmic Devices: A Multisociety Position Paper.","authors":"Irene C Kuo, David F Chang, Oliver D Schein, Michael X Repka, Emily M Schehlein, Francis S Mah, Sarah W DeParis","doi":"10.1016/j.ophtha.2026.10.008","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.10.008","url":null,"abstract":"<p><p>Regulatory agencies in the United States and abroad are increasingly citing clinics and surgical facilities for what they deem to be inadequate disinfection of Goldmann applanation tonometry (GAT) tips, gonioscopy lenses, laser lenses, and other reusable clinic devices that contact the ocular surface. These regulators require routine high-level disinfection (HLD) of these reusable devices to prevent infection transmission. A multisociety task force formed to assess the necessity of HLD found no published evidence that these devices transmit sight-threatening infections or that HLD reduces infection transmission compared with lower-level disinfection methods. Meanwhile, routine use of chemical HLD reduces clinic efficiency, increases healthcare costs and waste, and may damage device surfaces potentially affecting patient care. Underlying these mandates for HLD is the nearly century-old Spaulding classification system, which inappropriately groups the ocular surface with heavily contaminated mucous membranes. A task force survey with more than 1000 ophthalmologist respondents found that the most common reprocessing methods were alcohol wiping for GAT tips and either alcohol wiping or soap and water for diagnostic or laser lenses. Many respondents using chemical HLD reported adverse effects, including ocular surface chemical toxicity and device damage. Despite infrequent use of HLD, reported infection transmission was exceedingly rare and generally limited to self-limited adenoviral conjunctivitis. The task force agreed with the majority (88%) of ophthalmologists surveyed that HLD should not be required for these reusable devices in routine clinical care. Instead, HLD should be a discretionary consideration in higher-risk circumstances, such as following use of these devices in patients with suspected infection. This paper presents the summary recommendations of a policy statement approved by the American Academy of Ophthalmology Board of Trustees and endorsed by four subspecialty societies.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Red Alert: A New Presentation of Intraocular Lens Discoloration.","authors":"Malik S Ladki, Stephen M Hamilton, Michael E Snyder","doi":"10.1016/j.ophtha.2026.09.007","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.09.007","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Diabetic Retinopathy and Cardiovascular Risk Factors Among Diverse Hispanic/Latino Adults: HCHS/SOL and SOL Ojos Results.","authors":"Lawrence J Ulanski, Angie Wang, Gavin Tan, Byron L Lam, Thasarat S Vajaranant, Carlos E Mendoza-Santiesteban, Michael L Stewart, Giselle Gutierrez Savoy, Amber Pirzada, Jianwen Cai, D Diane Zheng, Laura Coco, Martha Daviglus, David J Lee, Charlotte E Joslin","doi":"10.1016/j.ophtha.2026.09.037","DOIUrl":"10.1016/j.ophtha.2026.09.037","url":null,"abstract":"<p><strong>Objective: </strong>To estimate diabetic retinopathy (DR) prevalence among Hispanic/Latino adults with diabetes, assess heterogeneity by background group, and evaluate cardiovascular disease (CVD) risk factors.</p><p><strong>Design: </strong>Cross-sectional analysis of SOL Ojos, a multicenter ancillary study embedded within the population-based Hispanic Community Health Study/Study of Latinos (HCHS/SOL).</p><p><strong>Participants: </strong>Adults aged ≥40 years completing HCHS/SOL Visit 3 (V3; 2020-2024) from Chicago and Miami were examined (3,294/3,864; 85.2%). The analytic sample included 1,224 participants with diabetes and gradable retinal imaging (mean age, 62.7 years [95% CI, 61.4-64.0]; 48.6% female).</p><p><strong>Methods: </strong>Participants underwent standardized ophthalmic examinations with centrally graded ultra-widefield fundus imaging. Major CVD risk factors (diabetes, hypertension, hypercholesterolemia, obesity, smoking) were assessed at V3 and analyzed individually and cumulatively. DR, macular edema (ME), and vision-threatening DR (VTDR) were graded using Early Treatment Diabetic Retinopathy Study (ETDRS) protocols. Survey-weighted analyses estimated age-standardized prevalence, and sequentially adjusted logistic regression evaluated associations.</p><p><strong>Main outcome measures: </strong>Age-standardized prevalence of DR outcomes and associations with CVD risk factors.</p><p><strong>Results: </strong>Age-standardized any DR prevalence was 34.7% (95% CI, 29.2-40.2). Among men, any DR and VTDR prevalence was 41.8% (95% CI, 33.5-50.0) and 13.4% (95% CI, 7.4-19.5), versus 27.2% (95% CI, 19.5-34.9) and 9.4% (95% CI, 1.4-17.4) among women. Any DR ranged across Hispanic/Latino backgrounds from 13.9% (95% CI, 1.8-26.0) to 55.4% (95% CI, 49.2-61.6) in men and 15.3% (95% CI, 4.4-26.2) to 39.2% (95% CI, 22.3-56.1) in women, with the highest estimates among Cuban individuals. CVD risk factors were common and clustered (≥4: men 42.7% [95% CI, 34.5-50.9]; women 35.6% [95% CI, 29.3-41.9]). In adjusted models, hypertension was associated with any DR (OR, 3.16 [95% CI, 1.76-5.65]) and VTDR (OR, 2.86 [95% CI, 1.05-7.79]). Overall cumulative CVD risk burden was not significantly associated with VTDR (Type III F test, P=0.1193), despite adjustment for diabetes duration; the 3-risk-factor category had higher estimated odds than the 1-risk-factor category (OR, 5.10 [95% CI, 1.22-21.39]).</p><p><strong>Conclusion: </strong>In this cross-sectional study of Hispanic/Latino adults with diabetes, more than one-third had DR, with substantial heterogeneity across background groups. Hypertension was associated with DR outcomes, particularly VTDR. Findings provide contemporary prevalence estimates and support longitudinal evaluation of cardiometabolic risk and DR outcomes.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitomycin C Application during Trabeculectomy-Injection versus Sponge: A Report by the American Academy of Ophthalmology.","authors":"Michele C Lim, David Solá-Del Valle, Jullia A Rosdahl, Yvonne Ou, Grace M Richter, O'Rese J Knight, Darrell WuDunn, Stacy L Pineles, Vikas Chopra","doi":"10.1016/j.ophtha.2026.07.042","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.07.042","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the recently published literature on the efficacy and safety outcomes of delivering mitomycin C (MMC) by either sub-Tenon's/subconjunctival injection (MMC-I) or by sponge (MMC-S) during trabeculectomy surgery.</p><p><strong>Methods: </strong>A literature search was last conducted in the PubMed database in May 2026 and yielded 135 articles. Eighteen full-text articles were reviewed, and 11 met all inclusion criteria for this assessment and were assigned a level of evidence rating by the panel methodologist.</p><p><strong>Results: </strong>Six studies were rated level I, 2 were rated level II, and 3 were rated level III. The racial and ethnic backgrounds of study participants represented a diverse mix, and in many studies, a variety of glaucoma diagnoses were included, the majority of which were primary open-angle glaucoma. The MMC-I technique was reported to have used a wider range of drug concentrations (0.05-0.4 mg/mL) than MMC-S (0.1-0.4 mg/mL). The complete success rate of intraocular pressure (IOP) control ranged from 40.3% to 90.9% in the MMC-I group compared with 17.7% to 86.5% in the MMC-S group. The wide range of success rates may be a result of differences in definitions of success, follow-up time, and patient populations. Change in IOP from baseline ranged from 2.8 mmHg (17%) to 19.4 mmHg (58%) in the MMC-I group compared with 5.8 mmHg (31%) to 18.0 mmHg (59%) in the MMC-S group. No significant differences in complications, such as rates of bleb leak, hypotony, choroidal effusion, or choroidal hemorrhage, were reported. Two studies reported significantly fewer 5-fluorouracil injections in the MMC-I group, and 1 reported more glaucoma surgery reoperations in the MMC-S group. Several studies reported a more favorable bleb morphology that was diffuse, lower profile, and less vascular in the MMC-I group than in the MMC-S group.</p><p><strong>Conclusions: </strong>Although MMC-I may offer some advantages over MMC-S trabeculectomy with respect to bleb morphology, level I and II evidence supports the application of MMC using either injection or sponges during trabeculectomy. Both applications result in similar rates of surgical success (a lower IOP and a reduction in medication burden) and have a similar safety profile.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Durable Safety and Efficacy of Voretigene Neparvovec-Rzyl in Postapproval Studies in the USA: CRAning for Perfection.","authors":"Jean Bennett","doi":"10.1016/j.ophtha.2026.08.029","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.08.029","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Brodie et al.: Clinical Outcomes of a Prosthetic Capsular Bag for Scleral Fixation of an Intraocular Lens in Eyes without Capsular Support (Ophthalmology. 2026;133:965–970)","authors":"Paolo Lanzetta,Petros Petrou,Francesco Boscia,Francesco Bonini,Stratos Gotzaridis","doi":"10.1016/j.ophtha.2026.09.018","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.09.018","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"8 1","pages":""},"PeriodicalIF":13.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence That Informs Practice","authors":"Giovanni Montesano,David P. Crabb","doi":"10.1016/j.ophtha.2026.09.009","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.09.009","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"150 1","pages":""},"PeriodicalIF":13.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"This Issue at a Glance","authors":"Sandeep Ravindran","doi":"10.1016/j.ophtha.2026.09.036","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.09.036","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"15 1","pages":""},"PeriodicalIF":13.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149210318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-onset Leber hereditary optic neuropathy: disease triggers and prognostic factors in a large Italian cohort","authors":"Alfredo A. Sadun","doi":"10.1016/j.ophtha.2026.09.006","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.09.006","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":13.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine versus Human Vertical Cup-Disc-Ratio Grading","authors":"Sophia Y. Wang","doi":"10.1016/j.ophtha.2026.09.008","DOIUrl":"https://doi.org/10.1016/j.ophtha.2026.09.008","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"24 1","pages":""},"PeriodicalIF":13.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}