Ophthalmology最新文献

{"title":"Factors Associated with Successful Descemet Membrane Endothelial Keratoplasty in the Diabetes Endothelial Keratoplasty Study.","authors":"Marianne O Price, Loretta B Szczotka-Flynn, Zachariah W Reed, Robin L Gal, Ari M Brandsdorfer, Michael D Greenwood, Mark A Greiner, Ula V Jurkunas, Ellen H Koo, Parag A Majmudar, Paul M Phillips, Francis W Price, Divya Srikumaran, Peter B Veldman, David D Verdier, Roy W Beck, Jonathan H Lass","doi":"10.1016/j.ophtha.2026.07.022","DOIUrl":"10.1016/j.ophtha.2026.07.022","url":null,"abstract":"<p><strong>Objective: </strong>To identify donor, lenticule preparation, recipient, and operative factors associated with 1-year Descemet membrane endothelial keratoplasty (DMEK) success in the Diabetes Endothelial Keratoplasty Study (DEKS).</p><p><strong>Design: </strong>This prospective cohort study was a prespecified secondary analysis of the DEKS randomized, double-masked, multicenter clinical trial.</p><p><strong>Participants: </strong>Individuals undergoing DMEK to treat corneal endothelial dysfunction at 28 clinical sites.</p><p><strong>Methods: </strong>Recipient eyes were randomized to receive a cornea from a donor without or with diabetes in a 2:1 ratio. Details about donor, tissue preparation, recipient, and operative factors were recorded prospectively. The study excluded eyes with a prior penetrating keratoplasty or glaucoma tube shunt. Graft failures were classified as follows. If the recipient stroma was cloudy in the first postoperative week and did not clear or required a regraft within 8 weeks, it was classified as \"primary donor failure\" in the absence of operative complications or as \"early failure\" associated with operative complications. If the recipient stroma cleared in the first postoperative week or cleared after being cloudy in the first postoperative week and later required a regraft or became cloudy without clearing for 90 days, it was classified as \"late failure.\" Proportional hazards and logistic regression were used to estimate risk ratios.</p><p><strong>Main outcome measures: </strong>Graft success at 1 year.</p><p><strong>Results: </strong>Of 1421 DMEK grafts, 1374 (97%) were clear at 1 year, 32 were classified as primary donor failures, 12 as early failures, and 3 as late failures. In multivariate analysis, the 78 cases (5.5%) with operative complications had a lower success rate (89%; hazard ratio for graft failure 4.01; 95% confidence interval, 1.86-8.63; P < 0.001). Three additional factors were associated with slightly higher graft success rates without reaching the defined statistical significance threshold of P < 0.01: baseline donor endothelial cell density ≥2500 versus <2500 cells/mm² (97% vs. 95% success; P = 0.03); tissue peeled by surgeon versus eye bank (99% vs. 96% success; P = 0.02); and recipient diabetes status: no versus yes (97% vs. 94% success; P = 0.02).</p><p><strong>Conclusions: </strong>Descemet membrane endothelial keratoplasty was highly successful across a wide range of donor, recipient, and surgical technique variations. Not surprisingly, graft success was lower in cases with operative complications.</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><p><strong>Trial registration: </strong>NCT05134480, ClinicalTrials.gov.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148606100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genome-Wide and Rare Variant Association Studies of Amblyopia in Admixed American and African Ancestry Groups.","authors":"Kyoung A Viola Lee, Mary C Whitman","doi":"10.1016/j.ophtha.2026.07.017","DOIUrl":"10.1016/j.ophtha.2026.07.017","url":null,"abstract":"<p><strong>Objective: </strong>To identify genetic variants associated with amblyopia in African (AFR) and Admixed American (AMR) ancestry groups, expanding on previous studies conducted in European ancestry.</p><p><strong>Design: </strong>Retrospective ancestry-stratified genome-wide association study (GWAS) and gene-level rare variant association study (RVAS).</p><p><strong>Participants: </strong>Participants in the All of Us Research Program from AFR and AMR ancestry groups who had whole-genome sequencing available. Cases and controls were distinguished based on the presence of International Classification of Diseases 9/10/SNOMED diagnosis codes for amblyopia in electronic health records. This yielded ancestry-stratified subsets of 269 cases and 71 585 controls of AMR ancestry and 366 cases and 79 460 controls of AFR ancestry.</p><p><strong>Methods: </strong>Stratified logistic regression models were adjusted for age, biological sex, and the top 10 principal components of genomic ancestry. GWAS was limited to common variants (minor allele frequency ≥1%), and RVAS was limited to rare variants with coding sequence-altering effects (minor allele frequency >1%, exonic only, excluding synonymous variants) aggregated at the gene level using the SKAT algorithm. Downstream analyses of the significant variants were performed using KEGG and GO pathway analysis and STRING database queries for protein-protein interactions and gene-gene interactions.</p><p><strong>Main outcome measures: </strong>Single-nucleotide polymorphisms were determined to have genome-wide significance if P < 5e-8 in the GWAS, and genes were determined to have significant association with amblyopia in the RVAS if P < 8.0 × 10^-4.</p><p><strong>Results: </strong>In the AMR GWAS, 245 unique single-nucleotide polymorphisms mapping to 97 distinct loci were identified, notably within neurodevelopmental and axonal guidance genes, including ROBO1, SEMA4B, PTPRD, NRXN1, and CAMK2D. The AFR GWAS identified 11 significant variants corresponding to 6 loci mapping primarily to long noncoding RNAs and pseudogenes. The AMR RVAS identified 15 genes, including axonal transport genes (KIF1B and KIF7) and growth factor signaling genes (EGF, ERBIN, and AKAP17A). The AFR RVAS identified a single gene, DLG2, which encodes the postsynaptic protein PSD-93, which promotes the closure of the sensitive period of neuroplasticity for vision in early childhood.</p><p><strong>Conclusions: </strong>Genetic risk architectures for amblyopia differ across ancestries but fundamentally converge on neurodevelopmental signaling, cortical synapse assembly, and sensitive period plasticity rather than ocular structural dynamics.</p><p><strong>Financial disclosure(s): </strong>The authors have no proprietary or commercial interest in any materials discussed in this article.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148606103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eye-Preserving Therapies for Early cT3c Retinoblastoma.","authors":"Zhenyu Xu, Yiran Yao, Jie Yang, Huihui Wei, Yanping Han, Min Zhou, Yitang Liu, Yunhan Zhu, Zining Zhang, Reyizha Mengjiang, Peiwei Chai, Renbing Jia, Xianqun Fan, Xuyang Wen, Jiayan Fan","doi":"10.1016/j.ophtha.2026.07.015","DOIUrl":"10.1016/j.ophtha.2026.07.015","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety and effectiveness of eye-preserving therapies in patients with retinoblastoma presenting with neovascular glaucoma without buphthalmos (defined as early cT3c by the American Joint Committee on Cancer Staging Manual, eighth edition), focusing on overall survival and eye preservation.</p><p><strong>Design: </strong>Retrospective, single-center cohort study.</p><p><strong>Participants: </strong>A total of 132 patients diagnosed with early cT3c retinoblastoma from May 2014 through October 2024.</p><p><strong>Methods: </strong>The patients were divided into primary enucleation (50 patients) and primary eye-preserving (82 patients) groups. They were followed up for survival status and ocular outcomes.</p><p><strong>Main outcome measures: </strong>Overall survival, high-risk pathologic features, globe salvage, and vision preservation.</p><p><strong>Results: </strong>After a median follow-up of 52.9 months, 1 death occurred in each group, and overall survival did not differ significantly between the primary eye-preserving and primary enucleation groups (log-rank test, P = 0.775). Eye-preserving therapies were associated with a lower incidence of high-risk pathologic features (odds ratio [OR], 0.21; P = 0.003), with attenuated severity of both choroidal (OR, 0.25; P = 0.002) and optic nerve invasions (OR, 0.23; P = 0.008). The globe salvage rate was 49.4% (41 of 83) in the primary eye-preserving group. Among these preserved eyes, 46.3% (19 of 41) regained light perception or better after receiving eye-preserving therapies. Importantly, presenting intraocular pressure ≥32 mmHg (hazard ratio [HR], 2.37; P = 0.010) and corneal edema (HR, 2.86; P = 0.007) were high-risk factors for globe salvage failure. Compared with intravenous chemotherapy alone, application of intra-arterial chemotherapy (HR, 0.13; P = 0.001) alone and combined intravenous chemotherapy-intra-arterial chemotherapy regimens (HR, 0.15; P = 0.001) demonstrated a significant association with better globe salvage outcomes. Additionally, cryotherapy (HR, 0.14; P < 0.001) was identified as an independent protective factor for overall globe salvage.</p><p><strong>Conclusions: </strong>Primary eye-preserving therapies can secure high rates of globe salvage with partial visual function in patients with early cT3c retinoblastoma, without jeopardizing patient survival. However, eyes exhibiting corneal edema or intraocular pressure ≥32 mmHg demonstrate markedly inferior salvage outcomes; the treatment strategy for such patients must therefore be cautiously individualized.</p><p><strong>Financial disclosure(s): </strong>The authors have no proprietary or commercial interest in any materials discussed in this article.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584676","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":"Interim Results from a Multicenter Observational Safety Study of Patients Treated with Voretigene Neparvovec-Rzyl in the United States.","authors":"Aaron Nagiel, Stephen R Russell, Byron L Lam, Jason I Comander, Tomas S Aleman, Cagri G Besirli, Robert A Sisk, Paul Yang, Christina Y Weng, Daniel C Chung, Aishwarya Thakre, Juha-Matti Savola, David L Rousso","doi":"10.1016/j.ophtha.2026.07.007","DOIUrl":"10.1016/j.ophtha.2026.07.007","url":null,"abstract":"<p><strong>Objective: </strong>To assess long-term safety and exploratory ophthalmic outcomes with voretigene neparvovec-rzyl (VN) in US clinical practice.</p><p><strong>Design: </strong>Prospective, multicenter, observational postauthorization safety study.</p><p><strong>Participants: </strong>Eighty-seven patients (169 eyes) receiving VN at 10 ocular gene therapy treatment centers.</p><p><strong>Methods: </strong>Patients ≥12 months old with viable retinal photoreceptors received VN in ≥1 eye. Subretinal delivery followed a 3-port pars plana vitrectomy modified at surgeons' discretion (e.g., automated foot pedal delivery, prebleb injection, cannula cut, and use of dye for visualization).</p><p><strong>Main outcome measures: </strong>Safety outcomes included treatment-emergent adverse events (TEAEs) and occurrence of chorioretinal atrophy (CRA). Exploratory assessments included changes in best-corrected visual acuity (BCVA) and full-field stimulus threshold (FST). Outcomes were analyzed descriptively; relative risk (RR) was estimated for subgroup comparisons.</p><p><strong>Results: </strong>With a median of 3.7 years of follow up (range, 2.9-4.9), most patients (95%) reported ≥1 TEAE (387 events); 67% procedure related, 9% attributed to VN, and 82% mild. Chorioretinal atrophy, including related terms retinal degeneration and retinal depigmentation, occurred in 24 patients (27%; 45 eyes), typically within 1 year, and was mild (80%) or moderate (20%). The area of CRA was mostly localized to the retinotomy or bleb area, with 40% of eyes with CRA having atrophy outside the bleb area, and highly correlated between fellow eyes (r = 0.97; P < 0.0001). Chorioretinal atrophy risk was higher with automated foot pedal administration of VN (RR, 5.33; 95% confidence interval [CI], 1.27-22.40) and in patients with myopia (RR, 8.40; 95% CI, 1.16-60.69). At 3 years, treated eyes showed sustained improvements in BCVA (-0.13 logarithm of the minimum angle of resolution) and FST (-1.68 log₁₀ cd·s/m²). Best-corrected visual acuity and FST were comparable between CRA and non-CRA eyes, although a subset of CRA eyes showed greater FST improvement at most timepoints up to year 3.</p><p><strong>Conclusions: </strong>This interim analysis supports the long-term safety of VN in a US cohort, consistent with clinical trial results. Chorioretinal atrophy did not seem to diminish sustained functional and anatomical benefits over minimum 3-year follow up. Ongoing data collection will further clarify the occurrence, impact, and risk factors for CRA while continuing to monitor VN safety in clinical practice.</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":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562494","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":"Comparative Five-Year Risks of Systemic Complications with Biologic versus Conventional Therapy in Noninfectious Uveitis.","authors":"Muhammad Z Chauhan, Jawad Muayad, Jamie L Surgent-Nahay, Akbar Shakoor, Jennifer E Thorne, Ahmed B Sallam","doi":"10.1016/j.ophtha.2026.06.030","DOIUrl":"10.1016/j.ophtha.2026.06.030","url":null,"abstract":"<p><strong>Purpose: </strong>To compare 5-year systemic complication risks in noninfectious uveitis (NIU) patients treated with systemic biologic versus conventional therapy.</p><p><strong>Design: </strong>Multicenter, retrospective clinical cohort study.</p><p><strong>Participants: </strong>Adult patients (≥18 years old) with NIU from the TriNetX Collaborative Network.</p><p><strong>Methods: </strong>We identified patients with NIU. We assembled propensity score-matched comparisons: biologic therapy versus no systemic therapy (n = 6896 each) and biologic versus conventional therapy with corticosteroids matched (n = 5994 each) between January 1, 2005, and January 1, 2024. A prespecified subgroup analysis of Analysis 2 restricted to patients receiving combination biologic + conventional therapy versus conventional therapy alone (n = 3653 each) was also conducted. We used time-to-event analyses to identify incidence of systemic complications.</p><p><strong>Main outcome measures: </strong>Incidence of serious infections, hematologic cytopenias, heart failure, thromboembolic events, diabetes mellitus, malignancy, psychiatric illness, all-cause hospitalization, and all-cause mortality.</p><p><strong>Results: </strong>After propensity score matching, cohorts were balanced on all measured covariates (all standardized mean differences [SMDs] <0.1). Compared with no systemic therapy, biologic treatment was associated with higher 5-year risks of serious infections, including pneumonia (hazard ratio [HR], 1.41, 95% confidence interval [CI], 1.20-1.67), sepsis (HR, 1.43, 95% CI, 1.16-1.77), and hematologic cytopenias (HR, 1.58, 95% CI, 1.44-1.74), representing 5-year Kaplan-Meier-estimated cumulative incidences of 6.43%, 3.87%, and 30.12%, respectively, in biologic-treated patients. Risks of heart failure, thromboembolic events, psychiatric illness, diabetes, and all-cause mortality did not significantly differ between groups. When compared with conventional immunomodulatory therapy, biologic treatment demonstrated a largely comparable 5-year safety profile, with the primary exceptions of higher rates of hematologic cytopenias (HR, 1.28, 95% CI, 1.16-1.41), psychiatric illness (HR, 1.13, 95% CI, 1.01-1.27), and hospitalization (HR, 1.20, 95% CI, 1.07-1.35).</p><p><strong>Conclusions: </strong>In patients with NIU, systemic biologic therapy was associated with higher risks of serious infections and hematologic cytopenias compared with no systemic treatment, while demonstrating a 5-year safety profile broadly comparable to conventional immunomodulatory therapy. These findings support guideline-concordant stepwise immunosuppression and underscore the importance of individualized risk assessment, infection surveillance, and hematologic monitoring for patients requiring systemic therapy.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found after the references.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397366","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":"Value of 10-2 Visual Field Testing for Detecting Progression in Patients with Glaucoma.","authors":"Ryo Tomita, Dominique Salh, Oksana M Dyachok, Michael E West, Glen P Sharpe, Paul E Rafuse, Lesya M Shuba, Marcelo T Nicolela, Balwantray C Chauhan","doi":"10.1016/j.ophtha.2026.06.029","DOIUrl":"10.1016/j.ophtha.2026.06.029","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the value of the 10-2 test of the Humphrey Field Analyzer (Carl Zeiss Meditec) in detecting visual field (VF) progression in early glaucoma.</p><p><strong>Design: </strong>Prospective longitudinal study.</p><p><strong>Participants: </strong>Patients with open-angle glaucoma and healthy participants.</p><p><strong>Methods: </strong>Participants were examined with the 24-2 and 10-2 tests every 4 months. Only those with 5 pairs of tests or more were included. To analyze the same area as the 10-2, only the central 12 test locations of the 24-2 test were included, from which global and quadrant mean deviation (MD) slopes and pointwise total deviation (TD) slopes were computed. A range of criteria for progression based on pointwise TD slope cutoffs was used.</p><p><strong>Main outcome measures: </strong>Measures included the area under the receiver operating characteristic curve (AUC) separating patients with glaucoma from healthy participants for global, sectoral, and pointwise analyses and overlap in the proportion of patients identified by the 2 tests at matched specificity.</p><p><strong>Results: </strong>One eye each from 96 patients with glaucoma with early visual field damage and 56 healthy participants was included in the analysis. The participants were followed up for a median of 4.69 and 4.49 years with 13 and 11 pairs of tests, respectively. The AUCs of the MD slopes for the 2 tests were not significantly different for global (P = 0.25) or quadrant (P > 0.11) analysis. At 90% specificity for global MD slope, the overlap in patients classified as progressing with both tests was 53%, whereas for quadrant MD slope, the overlap was less. The AUCs were not different for pointwise slope cutoffs of more than -1.25 dB/year, but were significantly higher for the 10-2 test when cutoffs were -1.25 dB/year or less. Patients showing progression with only the 10-2 test with steeper pointwise slope cutoffs showed worse baseline MD on the 10-2, but not 24-2, test.</p><p><strong>Conclusions: </strong>For global and sectoral analyses, little evidence showed that the 10-2 test provided additional information about central visual VF compared with the 24-2 test. Pointwise analyses support the use of the 10-2 test for following up patients with selectively worse central VF loss at baseline and who are at risk of faster progression.</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":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397498","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":"Ophthalmic Drug Shortages in the United States","authors":"Robert T. Eakins BS,&nbsp;Lieu Nguyen Lowrie MD,&nbsp;Brian C. Stagg MD,&nbsp;Adaora Okudo MD,&nbsp;Rachel Simpson MD,&nbsp;Marrisa Larochelle MD,&nbsp;Erin R. Fox PharmD,&nbsp;Ian Pitha MD, PhD","doi":"10.1016/j.ophtha.2026.02.025","DOIUrl":"10.1016/j.ophtha.2026.02.025","url":null,"abstract":"<div><h3>Purpose</h3><div>To survey ophthalmic drug shortages in the United States from 2001 through 2024.</div></div><div><h3>Design</h3><div>Retrospective database review.</div></div><div><h3>Subjects</h3><div>Patient data were sourced from the University of Utah Drug Information Service (UUDIS) national database.</div></div><div><h3>Main Outcome Measures</h3><div>The UUDIS drug shortage reports from 2001 through 2024 were reviewed, and shortages resulting from drug discontinuation, business decision, or duration of 1 day or less were excluded from analysis. The remaining 3086 drug shortage reports from 2001 through 2024 were reviewed by a panel of 4 ophthalmologists and 1 clinical pharmacist.</div></div><div><h3>Methods</h3><div>Drugs used in ophthalmology were highlighted, and their clinical applications were established. Drug delivery route (local vs. systemic), the cause of the shortage, the duration of the shortage, and whether the drug was patent protected during the shortage were assessed.</div></div><div><h3>Results</h3><div>Of 3086 shortage reports, 379 reports were of ophthalmic medications, of which 329 shortages had resolved and 50 remained active as of June 2024. On average, ophthalmic medications accounted for 15% of active shortages at any given time. Systemic and locally delivered medications were represented equally; most shortages were of anti-infective medications (35%) and steroids (26%). The leading causes of ophthalmic medication shortages were unknown (63%), manufacturing problems (20%), and supply and demand mismatch (10%). Median duration of ophthalmic medication shortage was 326 days (interquartile range [IQR], 145–695 days), nearly 30 days longer than the median duration for all drugs (298 days; IQR, 111–619; <em>P</em> = 0.023). Mean shortage duration of ophthalmic medications that were patent protected during each shortage was significantly less (184 days; IQR, 48–422 days) than medications that experienced a shortage while off-patent (359 days; IQR, 164–755 days; <em>P</em> &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>Ophthalmic drug shortages constitute a significant portion of total drug shortages, the median shortage length is greater than that for all medications, and shortage duration is influenced by patent status.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"133 7","pages":"Pages 895-902"},"PeriodicalIF":10.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Periocular Leishmania donovani Mimicking Dacryocystitis and Cellulitis","authors":"Victor Codina Alonso MD,&nbsp;Christopher Van Issum MD,&nbsp;Sophie Prod’hom MD","doi":"10.1016/j.ophtha.2026.02.001","DOIUrl":"10.1016/j.ophtha.2026.02.001","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"133 7","pages":"Page e97"},"PeriodicalIF":10.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356074","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":"Corneal Transplant Surgery Assisted by a Microsurgical Robot","authors":"Alexandre Denoyer MD, PhD","doi":"10.1016/j.ophtha.2026.03.020","DOIUrl":"10.1016/j.ophtha.2026.03.020","url":null,"abstract":"","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"133 7","pages":"Pages 916-918"},"PeriodicalIF":10.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502008","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":"Severe Congenital Ptosis Repair","authors":"Lora R. Dagi Glass MD,&nbsp;Vinay K. Aakalu MD, MPH,&nbsp;Seanna R. Grob MD,&nbsp;Catherine Y. Liu MD, PhD,&nbsp;M. Reza Vagefi MD,&nbsp;Michael K. Yoon MD,&nbsp;Stacy L. Pineles MD,&nbsp;Edward J. Wladis MD","doi":"10.1016/j.ophtha.2026.03.014","DOIUrl":"10.1016/j.ophtha.2026.03.014","url":null,"abstract":"<div><h3>Purpose</h3><div>To review the literature on the outcomes of severe congenital ptosis repair in the pediatric population and to assess the rates of exposure keratopathy and other complications.</div></div><div><h3>Methods</h3><div>A literature search was last conducted in May 2025 in the PubMed database. Articles were limited to original research in the English language that included detailed postoperative data on at least 25 eyelids with severe congenital ptosis (defined as levator function of 4 mm or less) after any given ptosis repair technique with at least 6 months of postoperative follow-up. The initial search identified 209 citations; 30 articles were reviewed in full text, and 11 articles were selected for inclusion in this assessment. The panel methodologist assigned a level of evidence rating to each of the included studies.</div></div><div><h3>Results</h3><div>One study was rated level I, 1 study was rated level II, and 9 studies were rated level III. The included studies examined frontalis flap, frontalis suspension, and maximal levator resection surgeries. They focused on a wide range of pediatric ages (infancy to 16 years), but the average age range in all cases was squarely in the younger pediatric demographic (ages 1–8 years). The literature demonstrated variable descriptions of success, revision surgery, and exposure keratopathy. Significant overlap in success, exposure, and revision exists for all 3 surgical techniques. Perhaps biased by the greater number of articles defining success, frontalis suspension surgery studies demonstrated the widest range of efficacy and had the additional surgery-specific complications of sling infections, extrusions, and granulomas.</div></div><div><h3>Conclusions</h3><div>Although the level of evidence and dearth of comparative literature precluded evaluation of clear equivalency data, frontalis flaps, frontalis suspension, and maximal levator resection appear to have overlapping rates of success and rates of exposure. Risks of surgery may influence surgical choice. Frontalis-related techniques were associated with unique risks, including sling-specific inflammation, infection, and exposure; and flap-related lid displacement with supraduction. Long-term, multi-institutional, comparative prospective studies would allow further insight into surgical durability and complication rates.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found after the references.</div></div>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"133 7","pages":"Pages 909-915"},"PeriodicalIF":10.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777712","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}