Ophthalmology and Therapy最新文献

{"title":"Effectiveness of 0.02% and 0.04% Atropine Therapy for Myopia Control in Czech Children: The MARS Trial.","authors":"Martin Hložánek, Miroslav Dostálek, Rudolf Autrata, Radka Štěpánová, Jana Unar Vinklerová, Jarmila Heissigerová, Pavel Studený, Barbora Čáslavská, Lucie Jeřábková, Nina Zelenayová, Inka Krejčířová, Renáta Brunnerová, Marta Korbasová, Martin Komínek","doi":"10.1007/s40123-026-01506-x","DOIUrl":"https://doi.org/10.1007/s40123-026-01506-x","url":null,"abstract":"<p><strong>Introduction: </strong>Low-dose atropine eye drops slow childhood myopia progression, but randomized evidence in European children and for intermediate concentrations remains limited. This study evaluated 0.02% and 0.04% atropine for 12-month myopia control in Czech children.</p><p><strong>Methods: </strong>The MARS study was an investigator-initiated, phase IIIb, multicenter, randomized, double-masked, placebo-controlled trial. Children aged 6-11 years with documented accelerated prerandomization axial length (AL) elongation and cycloplegic spherical equivalent refraction (SER) from -0.50 to -4.75 D were randomized 2:1:1 to nightly 0.02% atropine, 0.04% atropine, or placebo. The primary endpoint was the between-group difference in AL change at Month 12 for 0.02% atropine versus placebo. Linear mixed-effects models accounted for inter-eye correlation. Repeated-measures and multiple-imputation sensitivity analyses assessed the effect of missing data.</p><p><strong>Results: </strong>A total of 191 participants (351 eyes) were included in the primary analysis. Compared with placebo, adjusted mean between-group differences in AL change were -0.144 mm for 0.02% atropine (95% confidence interval [CI] -0.201 to -0.087; P < 0.0001) and -0.157 mm for 0.04% atropine (95% CI -0.222 to -0.092; P < 0.0001). Corresponding differences in SER progression were 0.352 D (95% CI 0.199 to 0.505; P < 0.0001) and 0.389 D (95% CI 0.214 to 0.564; P < 0.0001). No statistically significant difference was detected between 0.02 and 0.04% atropine for AL (0.013 mm; 95% CI -0.043 to 0.069; P = 0.8935) or SER (-0.037 D; 95% CI -0.189 to 0.115; P = 0.8802). Sensitivity analyses yielded consistent AL estimates.</p><p><strong>Conclusions: </strong>Nightly 0.02% and 0.04% atropine reduced axial elongation and myopia progression over 12 months compared with placebo. The trial was not designed or powered to establish equivalence between the active doses; within this sample, no statistically significant difference was detected between them.</p><p><strong>Trial registration: </strong>European Clinical Trials Database (EudraCT no. 2020-002046-16), Clinical Trials Information System (CTIS), EU Clinical Trial (EU CT) no. 2024-515888-54-00.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112963","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":"Early Real-World Outcomes of Intravitreal Aflibercept 8 mg for Neovascular Age-Related Macular Degeneration in France: A Retrospective Study.","authors":"Jules Fricker, Lucas Sejournet, Jules Prange, Julien Andre, Remy Calvet, Valentin Rougane, Ségolène Gouze, Maxime Oudard, Ambre Ancel, Alexis Kodjikian, Simona Nicoara, Philippe Desmangles, Thibaud Mathis, Laurent Kodjikian","doi":"10.1007/s40123-026-01510-1","DOIUrl":"https://doi.org/10.1007/s40123-026-01510-1","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this work is to evaluate the early real-world effectiveness, anatomical outcomes, and safety of intravitreal aflibercept 8 mg in neovascular aged-related macular degeneration (nAMD) eyes.</p><p><strong>Methods: </strong>This retrospective single-center study included consecutive nAMD eyes treated with at least one aflibercept 8-mg injection between January 2025 and January 2026 in France. Primary outcomes were treatment interval extension and macular drying. Secondary outcomes included changes in best-corrected visual acuity (BCVA), central macula thickness (CMT), OCT biomarkers, and safety. Subgroup analyses were performed according to treatment status, responder profile, and prior anti-VEGF generation. In addition, baseline predictive factors associated with treatment interval extension, achievement of an interval ≥ 12 weeks, and dry macular status were evaluated. A sensitivity analysis was performed in eyes with ≥ 6 months of follow-up.</p><p><strong>Results: </strong>A total of 338 eyes from 267 patients were included (82 treatment-naïve and 256 switched eyes), with a mean follow-up duration of 5.5 ± 3.3 months. In switched eyes, the mean treatment interval increased by +1.8 ± 2.4 weeks (p < 0.001), with significant gains in good responders (+ 2.7 weeks), frequent flyers (+ 0.7 weeks), and poor responders (+ 1.8 weeks) (all p < 0.001). Dry macula rates increased from 39.6% to 70.7% (p < 0.001). Among treatment-naïve eyes, 74.4% achieved a dry macula at the last visit and 97.4% at the 4-week interval following induction. In eyes with ≥ 6 months of follow-up, the interval increased by +1.6 weeks and remained significant (p < 0.001). OCT biomarkers significantly decreased during follow-up (p < 0.001), while BCVA remained stable.</p><p><strong>Conclusions: </strong>Early real-world use of aflibercept 8 mg was associated with improved anatomical outcomes and extended treatment intervals in treatment-naïve and previously treated nAMD eyes, while maintaining stable BCVA and a favorable safety profile. These findings support its potential to reduce treatment burden in routine clinical practice.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112877","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":"Prevalence, Associations, and Visual Impact of Myopic Macular Degeneration in a Multi-ethnic Older Population in Singapore: The PIONEER Study.","authors":"Kai-Xiong Cheong, Fan Wu, Quan V Hoang, Jun-Shi Lai, Yijia Zhang, Hla Myint Htoon, Kyoko Ohno-Matsui, Ecosse L Lamoureux, Seang-Mei Saw, Preeti Gupta","doi":"10.1007/s40123-026-01514-x","DOIUrl":"https://doi.org/10.1007/s40123-026-01514-x","url":null,"abstract":"<p><strong>Introduction: </strong>This study assessed the prevalence, associations, and dietary pattern of myopic macular degeneration (MMD), and its effect on vision among older adults in Singapore.</p><p><strong>Methods: </strong>Community-dwelling adults aged ≥ 60 years in the Population Health and Eye Disease Profile in Elderly Singaporeans (PIONEER) study underwent examinations, including spherical equivalent (SE), axial length (AL), best-corrected visual acuity (BCVA), contrast sensitivity (CS), and fundus photography. Dietary intake was assessed using a validated 110-item interviewer-administered food frequency questionnaire. Dietary patterns were generated by applying exploratory factor analysis. MMD was graded using the meta-analyses of pathologic myopia classification. Associations with MMD were evaluated using multivariable logistic regression, and the impact of MMD on visual outcomes using multivariable linear regression, with SE and AL modelled separately.</p><p><strong>Results: </strong>Among 1643 phakic participants (mean age 70.6 ± 7.6 years), the age-standardised MMD prevalence was 5.1% (95% confidence interval [CI] 4.0-6.2%), rising from 3.1% (60-65 years) across consecutive 5-year brackets (5.6%, 5.9%, 8.0%, 9.8%) to 13.1% (≥ 85 years). Among high myopes aged ≥ 75 years, MMD prevalence approached 80-100%. Multivariable analyses confirmed that more myopic SE, longer AL, and older age were associated with MMD (all p < 0.001). MMD was associated with worse BCVA and CS, with adjusted differences ranging from 0.05 to 0.10 logMAR and - 0.10 to - 0.15 logCS (all p < 0.05). Dietary patterns were not associated with MMD.</p><p><strong>Conclusion: </strong>MMD poses a substantial public health burden among older Singaporeans, presenting as a near-inevitable complication in older high myopes that drives significant visual impairment in distance acuity and contrast sensitivity. The strong structural and age associations, alongside the absence of a dietary association, highlight the need for primary prevention and structural monitoring in high-risk myopic populations.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113001","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":"Combined Accommodation and Fusional Training Paradigm Versus Prism Correction for Small-Angle Acute Acquired Comitant Esotropia: A Cohort Study.","authors":"Shuyang Guo, Ling Ling, Ziqing Ding, Jingrong Liu, Yan Liu, Rui Liu, Zhi Chen, Chen Zhao, Sida Xi, Wen Wen","doi":"10.1007/s40123-026-01507-w","DOIUrl":"https://doi.org/10.1007/s40123-026-01507-w","url":null,"abstract":"<p><strong>Introduction: </strong>This study explored 6-month ocular alignment and visual function outcomes associated with a combined accommodative and fusional training paradigm and compared them with outcomes observed after prism correction in patients with small-angle acute acquired comitant esotropia.</p><p><strong>Methods: </strong>This prospective, single-center, nonrandomized cohort study enrolled 42 patients with small-angle acute acquired comitant esotropia. Following counseling regarding both treatment options, patients selected visual training (N = 22) or prism correction (N = 20). The training group completed a 6-month, two-step paradigm: accommodative facility training using ± 2.00 diopter flippers and computer-based fusional divergence training with red-blue glasses. The prism group received prism correction to relieve diplopia. Examinations were performed at baseline, 1 week, 1 month, 3 months, and 6 months.</p><p><strong>Results: </strong>At 6 months, the training group achieved complete motor success (orthophoria without diplopia) in 16/22 (72.7%) at distance and 17/22 (77.3%) at near, compared with 0/20 at either fixation distance in the prism group. Functional success, defined as an ocular deviation of ≤ 5 PD at both distance and near without diplopia, was achieved in 20/22 (90.9%) of the training group versus 0/20 (0.0%) of the prism group. All patients in the prism group reported relief of diplopia during prism wear but persistent diplopia when assessed without prism correction. The training group also showed more favorable changes in several stereopsis and accommodative measures.</p><p><strong>Conclusions: </strong>In this small nonrandomized cohort, preference-based selection of combined visual training was associated with more favorable 6-month outcomes than prism correction when outcomes were assessed without prism correction. These exploratory findings are hypothesis-generating and require confirmation in adequately powered randomized studies.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT06622044.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112909","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":"Ocular Surface Outcomes with Different 0.05% Atropine Dosing Frequencies in Children with Myopia: A Secondary Analysis of a Randomized Trial.","authors":"Minsong Xue, QingLin Xu, Haoran Wu, Yao Tang, Zhiwei Luo, WenYu Gao, Yuexiang Deng, Lijun Hou, Xiaoning Li, Zhikuan Yang","doi":"10.1007/s40123-026-01467-1","DOIUrl":"10.1007/s40123-026-01467-1","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to compare the effects of three dosing frequencies of 0.05% atropine on the ocular surface in children with myopia.</p><p><strong>Methods: </strong>In this sub-analysis of a randomized controlled trial, children with myopia (aged 6-14 years) were randomized to 0.05% atropine once daily (Qd), twice weekly (Biw), or once weekly (Qw). Objective parameters, including noninvasive tear breakup time (NIBUT), tear meniscus height (TMH), lipid layer thickness (LLT), incomplete blink rate (IBR), and bulbar conjunctival hyperemia index (BCHI), were assessed at baseline, 2 weeks, and 12 months. Subjective symptoms were evaluated using the Ocular Surface Disease Index (OSDI).</p><p><strong>Results: </strong>Among 130 children (260 eyes) completing objective assessments (Qd: n = 43; Biw: n = 49; Qw: n = 38), a representative subset of 78 completed the OSDI questionnaire. Dosing frequency had no differential effect on any outcome (time-by-group interaction: all P > 0.05). Across all groups, first and average NIBUT increased significantly from baseline through 12 months (P < 0.001), with a shift toward less severe dry eye grades (P < 0.001). IBR decreased, indicating improved blink quality (P < 0.001) and BCHI decreased by 12 months (P = 0.001). LLT increased transiently at 2 weeks (P = 0.003), while TMH remained stable (P = 0.712). OSDI scores remained stable, with no significant differences among regimens (P = 0.193).</p><p><strong>Conclusions: </strong>During the 12-month follow-up period, ocular surface parameters and subjective symptoms remained comparable among the three 0.05% atropine dosing regimens, with no evidence of clinically significant deterioration.</p><p><strong>Trial registration: </strong>ChiCTR2100043506.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3335-3348"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760401","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":"Visual Acuity Influences Visual Outcome in Endophthalmitis: A 10-Year Retrospective Observational Cohort Analysis.","authors":"Yvonne Nowosielski, Charlotte Erlacher, Sarah Maier, Teresa Rauchegger, Alexander Franchi, Matus Rehak","doi":"10.1007/s40123-026-01468-0","DOIUrl":"10.1007/s40123-026-01468-0","url":null,"abstract":"<p><strong>Introduction: </strong>Endophthalmitis is a severe, sight-threatening intraocular infection that may follow ophthalmic procedures or arise endogenously. Since the Endophthalmitis Vitrectomy Study (EVS, 1995), surgical and antimicrobial strategies have evolved. This study aimed to evaluate treatment approaches, microbial spectrum, and outcomes of endophthalmitis cases at the University Eye Clinic Innsbruck over the past decade.</p><p><strong>Methods: </strong>A retrospective observational cohort analysis of all patients treated for endophthalmitis between January 2013 and December 2023 was conducted. Cases were categorized as exogenous, endogenous, or keratitis-related. Data on etiology, treatment, time to intervention, microbial isolates, and best-corrected visual acuity (BCVA, logMAR) were assessed. Treatment included tap and inject, pars plana vitrectomy (PPV) within 24 h after presentation, or delayed surgery. Regression analyses identified predictors of visual outcome and re-intervention.</p><p><strong>Results: </strong>A total of 118 eyes from 110 patients (median age 72 years) were included. Exogenous cases accounted for 60.2%, endogenous for 28.8%. Median BCVA at diagnosis was 2.3 logMAR, improving to 1.0 logMAR at 6 months. Pathogens were isolated in 58.5% of cases-mainly Staphylococcus epidermidis (57%) in exogenous and Candida albicans (20.6%) in endogenous infections. Median time to intervention in exogenous cases was 3.5 h. BCVA at diagnosis and timepoint were significantly associated with visual outcome over time (p < 0.001, respectively; exogenous cases only). Re-intervention was required in 78 eyes; hazard was significantly higher after delayed surgery in exogenous cases (HR of 5.7, 95% CI [2.9-11.1], p < 0.001 (n = 71, 39 re-interventions).</p><p><strong>Conclusions: </strong>Visual acuity remains the main prognostic factor for visual recovery. In exogenous endophthalmitis, delayed surgery is associated with a high re-intervention rate, which may be reduced by initial tap-and-inject treatment. Prospective studies are needed to establish optimal timing and treatment strategies.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3293-3304"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761191","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":"Four-Year Outcomes of Faricimab in Diabetic Macular Edema in the RHONE-X Extension Trial: A Podcast.","authors":"Veeral S Sheth, Stela Vujosevic","doi":"10.1007/s40123-026-01470-6","DOIUrl":"10.1007/s40123-026-01470-6","url":null,"abstract":"<p><p>Diabetic macula edema (DME) is a leading cause of vision loss among people with diabetes and requires long-term management strategies that balance efficacy, safety, and durability. Although antivascular endothelial growth factor (VEGF) therapies have improved outcomes, challenges remain in achieving sustained disease control and reducing intravitreal injection frequency. Faricimab is a dual angiopoietin-2/anti-VEGF-A inhibitor designed for intraocular use, which targets the vascular and inflammatory components of DME. The phase 3 YOSEMITE and RHINE clinical trials demonstrated the efficacy, durability, and safety of faricimab throughout 2 years in treatment-naive and previously treated patients with DME. RHONE-X (NCT04432831) was a phase 3, multicenter, nonrandomized, open-label extension trial of the YOSEMITE/RHINE clinical trials that assessed the long-term safety and efficacy of faricimab treat-and-extend (T&E) for an additional 2 years. In this podcast, two retina specialists, Dr. Veeral Sheth (USA) and Dr. Stela Vujosevic (Italy), discuss the outcomes of faricimab after 4 years in DME and the implications on clinical practice. The speakers note that faricimab was well tolerated throughout 2 years of RHONE-X with a safety profile consistent with that observed during 2 years in YOSEMITE/RHINE. Furthermore, vision and anatomical improvements achieved during YOSEMITE/RHINE were maintained through the RHONE-X study, while treatment burden was eased with approximately 80% of patients on a faricimab dosing interval of ≥ every 12 weeks by the end of RHONE-X. Additionally, the proportion of aflibercept-treated patients achieving retinal drying increased after switching to faricimab. The speakers discussed the potential real-world clinical implications of these findings, including improved quality of life for patients and the ability for clinicians to treat more patients due to the reduced treatment burden, while maintaining safety and efficacy. In conclusion, findings from RHONE-X demonstrated the long-term safety, efficacy, and durability of faricimab T&E in DME, all relevant for real-world practice.Trial Registration: ClinicalTrials.gov identifier: NCT04432831. Supplementary material 1 (MP4 1,48,502 kb).</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3193-3201"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796366","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":"Initial Visual and Refractive Outcomes of Ray-Tracing-Guided LASIK (Wavelight Plus) Versus KLEx (SMILE Pro).","authors":"Sanjana Molleti, Hanna Pawlowski, Randle M Uyeda, Cole S Elsner, Mina M Sitto, Jonathan C Davis, Calisa G Lee-Choi, Phillip C Hoopes, Majid Moshirfar","doi":"10.1007/s40123-026-01475-1","DOIUrl":"10.1007/s40123-026-01475-1","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluates visual and refractive outcomes of our initial experience using ray-tracing-guided Wavelight Plus (WLP) LASIK and SMILE Pro KLEx carried out by one surgeon at a single center.</p><p><strong>Methods: </strong>A retrospective, non-randomized study was conducted at one refractive surgery center. Patients undergoing WLP or SMILE Pro with at least 1 month of postoperative follow-up were included. Outcomes were assessed at 1 and 3 months and included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), safety and efficacy indices, and vector analysis of astigmatism. Additionally, a comparison with wavefront-optimized (WFO) LASIK, an established procedure with a well-refined nomogram at the study center, was provided as an internal benchmark.</p><p><strong>Results: </strong>A total of 160 eyes from 93 patients were analyzed, including 50 eyes treated with WLP, 55 with SMILE Pro, and 55 with WFO. WLP demonstrated significantly better UDVA than SMILE Pro at both 1 month (p < 0.001) and 3 months (p = 0.033) and was more likely to achieve a UDVA of 20/20. Residual astigmatism was significantly lower in the WLP group than in both the WFO and SMILE Pro groups at 1 and 3 months (all p < 0.001). Vector analysis showed a correction index of 1.13 for SMILE Pro, 1.11 for WFO, and 1.08 for WLP at 3 months.</p><p><strong>Conclusions: </strong>In our initial experience with the WLP and SMILE Pro platforms, WLP achieved better UDVA and more precise astigmatic correction compared with SMILE Pro. Additionally, WLP, without the use of a nomogram, had comparable safety and efficacy outcomes to WFO. Based on our initial experience at one center, astigmatic correction appears to be a limiting factor for KLEx platforms in achieving outcomes similar to modern LASIK platforms.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3401-3419"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796374","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":"Twelve-Month Visual, Refractive, and Ocular Wavefront Outcomes of SmartSight KLEx, Pooling Original and NOVA Workflows, on the SCHWIND ATOS: A Single-Surgeon Cohort Study.","authors":"Ivan Gabrić, Filip Grulović, Ivan Samuel Modrić, Nataša Drača, Tomislav Kuzman","doi":"10.1007/s40123-026-01474-2","DOIUrl":"10.1007/s40123-026-01474-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;To report the visual, refractive, astigmatic, and ocular higher-order aberration (HOA) outcomes of keratorefractive lenticule extraction (KLEx) with the SCHWIND ATOS femtosecond laser platform in a large single-surgeon cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this retrospective consecutive series, 2518 eyes of 1292 patients underwent single-surgeon KLEx (SmartSight procedure, SCHWIND ATOS platform) for myopia or myopic astigmatism. Data from two treatment workflows were pooled: the original SmartSight lenticule workflow (1886 eyes) and, from 2025, SmartSight NOVA with CenTrax-assisted centration (632 eyes); workflow-stratified outcomes are reported separately in Table 4. Refraction, uncorrected and corrected distance visual acuity ( (UDVA and CDVA, respectively), and pyramidal-wavefront aberrometry (OSIRIS-T corneal topographer and ocular aberrometer; 4 and 6 mm) were recorded for 12 months of follow-up (primary; 3 months secondary). The target was emmetropia; astigmatism used the Alpins vector method. Denominators were endpoint specific, and inference was clustered by patient.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Mean preoperative spherical equivalent (SEQ) was - 3.86 ± 1.93 diopters (D). At 12 months post-procedure, in 830 eyes with a complete acuity record and 930 with paired SEQ, mean SEQ was - 0.04 ± 0.31 D, with 92.9% within ± 0.50 D and 98.2% within ± 1.00 D; achieved correction tracked attempted (slope 0.98). UDVA was 20/20 or better in 94.9% of eyes, and 94% saw uncorrected at least as well as preoperatively corrected. One of 830 eyes lost exactly two CDVA lines; none lost more than two. Astigmatic outcomes are documentation dependent: among eyes with an explicitly recorded postoperative cylinder, 68.6% were within 0.50 D, whereas the whole-cohort estimate (89.9%) rests on the unvalidated convention that a blank cylinder field denotes plano, and postoperative axis was not captured, so vector indices are exploratory. Paired mean SEQ changes from month 3 through month 12 were &lt; 0.05 D. An enhancement-as-failure composite (any enhancement before 12 months counted as failure) was met by 89.6% of eyes. In a paired wavefront subset (412 eyes), HOA induction was modest and coma-dominated: total ocular HOA rose from 0.14 to 0.18 µm at 4 mm (P &lt; 0.001) and was not significantly changed at 6 mm (P = 0.10). Preoperative spherical aberration was positive; ocular spherical aberration decreased modestly while total corneal spherical aberration was preserved at 12 months (P = 0.59).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In this large single-surgeon series, pooling data from the original SmartSight workflow and the SmartSight NOVA, KLEx on the SCHWIND ATOS delivered accurate, safe, and stable 12-month outcomes with excellent uncorrected vision and only modest higher-order aberration induction. As a single-surgeon experience using an evolving offset and two treatment workflows that are temporally confounded with each other and","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3421-3439"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796338","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":"Modulation of Total Corneal Astigmatism, Corneal Thickness, and Corneal Higher-Order Aberrations Following Tear-Enhancing Drop Instillation: A Retrospective Comparative Study.","authors":"Monika Sarnat-Kucharczyk, Aleksandra Ziemba, Anna Hitnarowicz, Ewa Mrukwa-Kominek, Sudi Patel","doi":"10.1007/s40123-026-01472-4","DOIUrl":"10.1007/s40123-026-01472-4","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to quantify changes in corneal astigmatism, thickness, and corneal higher-order aberrations after instilling a tear-enhancing drop (Systane Hydration Ultra, SHU) or 0.9% saline.</p><p><strong>Methods: </strong>This retrospective comparative study included 56 eyes (SHU, n = 38; 0.9% saline, n = 18). Corneal pachymetry and optical parameters were assessed using CASIA2 swept-source anterior segment optical coherence tomography. Measurements were acquired immediately after a natural blink (baseline, time 0). Subsequently, one drop of SHU or 0.9% saline was instilled, and measurements were repeated at 5 and 10 min postinstillation.</p><p><strong>Results: </strong>No clinically relevant changes in mean total corneal astigmatism (TCA), apparent corneal thickness (CT), or corneal higher-order aberrations were observed following instillation of either SHU or 0.9% saline. On a case-by-case basis, changes observed in the 0.9% saline group correlated with preinstillation values. CT tended to reduce with saline and generally increase with SHU. The induced change in TCA (y) 10 min after instillation significantly correlated with preinstillation. (i) CT (t) in SHU cases, where y = 0.317-0.003t +0.006t² (r² = 0.361, n = 38, p < 0.001); and (ii) TCA (x) in 0.9% saline cases, where y = 0.68x-0.30 (r² = 0.562, n = 18, p < 0.001). Overall, the induced change in TCA exceeded 0.50 D in 18% of SHU and 17% of 0.9% saline 10 min after instillation.</p><p><strong>Conclusions: </strong>Tear supplementation induces short-term case-specific changes in astigmatism and optical parameters, particularly within the first 5 min after Systane Hydration Ultra instillation. These findings may be relevant when interpreting corneal measurements in patients with mild ocular surface dysfunction undergoing refractive or cataract assessment.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"3317-3334"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758640","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}