Melissa Yuan, Amer Alsoudi, Chase A Ludwig, Eubee Baughn Koo, Karen M Wai, Prithvi Mruthyunjaya, Ehsan Rahimy
{"title":"Risk of Endophthalmitis After Cataract Surgery in Immunosuppressed Patients.","authors":"Melissa Yuan, Amer Alsoudi, Chase A Ludwig, Eubee Baughn Koo, Karen M Wai, Prithvi Mruthyunjaya, Ehsan Rahimy","doi":"10.3928/23258160-20260913-01","DOIUrl":"https://doi.org/10.3928/23258160-20260913-01","url":null,"abstract":"<p><strong>Background and objectives: </strong>The aim of this study was to determine whether systemic immunosuppression increases postoperative endophthalmitis risk following cataract surgery and to characterize risk differences across immunosuppressant medication classes.</p><p><strong>Patients and methods: </strong>Retrospective cohort study using the TriNetX federated health research network identified 422,786 immunosuppressed patients (medication exposure within 90 days pre-surgery) and 263,913 non-immunosuppressed patients undergoing cataract surgery. After 1:1 propensity score matching for age, sex, race, diabetes, ethnicity, autoimmune diagnosis, year of surgery, and prior intravitreal injections, 208,935 patients remained per cohort. Patients were identified using International Classification of Diseases, Tenth Revision (ICD-10) and Current Procedural Terminology (CPT) codes, with medications categorized as corticosteroids, classic non-biologic immunosuppressants, small molecule inhibitors, or biologic immunomodulators. Endophthalmitis outcomes were assessed at 1 to 42 days (acute), 43 to 365 days (delayed onset), and 1 to 90 days postoperatively.</p><p><strong>Results: </strong>Immunosuppressed patients showed significantly elevated 90-day endophthalmitis risk (odds ratio [OR] 1.77, 95% CI 1.42-2.21, <i>P</i> < .0001; risk difference 0.128%). Risk elevation persisted for acute (OR 1.86, 95% CI 1.52-2.24, <i>P</i> < .0001) and delayed (OR 2.07, 95% CI 1.51-2.84, <i>P</i> < .0001) timeframes. Classic non-biologic immunosuppressants demonstrated strongest association (OR 5.03, 95% CI 3.97-6.37, <i>P</i> < .0001), followed by systemic corticosteroids (OR 1.77, 95% CI 1.40-2.23, <i>P</i> < .0001). Small molecule inhibitors showed non-significant trends. Biologic immunomodulators demonstrated a lower observed risk for acute endophthalmitis (OR 0.58, 95% CI 0.41-0.81, <i>P</i> = .0015).</p><p><strong>Conclusion: </strong>Systemic immunosuppression significantly increases acute and delayed-onset postoperative endophthalmitis risk following cataract surgery, with substantial variation across medication classes. Classic immunosuppressants and corticosteroids confer the highest risk, whereas biologic immunomodulators do not appear to increase risk.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"1-7"},"PeriodicalIF":1.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167605","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}
Farid José Thomaz Neto, Marisabel Andrade, Jett Noby Nguyen, Nyan Lin Zaw, Bahareh Kheiri, Mitul C Mehta, Stephanie Lu, Mohammad Riazi Esfahani, Baruch D Kuppermann
{"title":"Changes in Macular Area Following Epiretinal Membrane Removal and Its Correlation With Anatomical and Functional Parameters.","authors":"Farid José Thomaz Neto, Marisabel Andrade, Jett Noby Nguyen, Nyan Lin Zaw, Bahareh Kheiri, Mitul C Mehta, Stephanie Lu, Mohammad Riazi Esfahani, Baruch D Kuppermann","doi":"10.3928/23258160-20260922-01","DOIUrl":"https://doi.org/10.3928/23258160-20260922-01","url":null,"abstract":"<p><strong>Background and objective: </strong>This study aimed to evaluate changes in macular area after pars plana vitrectomy (PPV) with epiretinal membrane (ERM) peeling and determine correlations with visual acuity (VA) and optical coherence tomography (OCT)-based anatomical parameters.</p><p><strong>Patients and methods: </strong>This retrospective study included 29 eyes with idiopathic ERM undergoing PPV and membrane peeling. Macular area was quantified using infrared images at baseline and 7 to 9 days, and 30 days and 3 months postoperatively. OCT parameters-including central macular thickness (CMT), inner retinal thickness (IRT), macular volume, disorganization of retinal inner layers (DRIL), and ellipsoid zone (EZ) status-were analyzed. Correlations between macular area change, VA (logMAR), and OCT parameters were assessed.</p><p><strong>Results: </strong>Macular area significantly increased from 37.59 ± 11.67 mm<sup>2</sup> to 42.77 ± 10.92 mm<sup>3</sup> at 3 months (<i>P</i> < .001). VA improved from 0.48 ± 0.19 to 0.20 ± 0.17 (<i>P</i> < .001). CMT decreased from 508.68 ± 74.01 µm to 395.03 ± 63.62 µm (<i>P</i> < .001). DRIL decreased from 82.8% to 31%. EZ disruption decreased from 37.9% to 17.2%; however, this change did not reach statistical significance (exact McNemar <i>P</i> = .070). Macular area change was not significantly correlated with visual acuity improvement at 3 months (<i>r</i> = 0.081, <i>P</i> = .758), although macular area at 3 months was negatively correlated with CMT (<i>r</i> = -0.560, <i>P</i> = .016).</p><p><strong>Conclusion: </strong>Macular area expansion after ERM peeling appears to reflect structural recovery following release of retinal traction. Although some associations with visual outcomes were observed, independent prognostic value remains uncertain and requires confirmation in larger prospective studies.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"1-7"},"PeriodicalIF":1.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170719","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}
Megan E Chung, Steven R Sanislo, Christoper Or, Karen M Wai, Stephen J Smith
{"title":"Proliferative Sarcoid Retinopathy With Bilateral Tractional Retinal Detachment.","authors":"Megan E Chung, Steven R Sanislo, Christoper Or, Karen M Wai, Stephen J Smith","doi":"10.3928/23258160-20260913-02","DOIUrl":"https://doi.org/10.3928/23258160-20260913-02","url":null,"abstract":"<p><p>A 28-year-old male patient without previously diagnosed systemic disease or any ocular history presented with 3 months of progressive blurred vision in both eyes. His ocular exam revealed bilateral vitreous hemorrhage, tractional retinal detachments (TRDs), and extensive retinal neovascularization (NV). His systemic workup revealed elevated angiotensin-converting enzyme, bilateral hilar, and mediastinal adenopathy on computed tomography (CT) chest scan, and extensive multifocal leptomeningeal-enhancing nodules within the posterior fossa on magnetic resonance imaging (MRI) brain scan, confirming sarcoidosis with neurologic and ocular involvement. Ocular complications of sarcoidosis predominantly involve the anterior segment, with anterior uveitis as the most common presentation overall. While posterior findings of ocular sarcoidosis are less common, these include but are not limited to retinal periphlebitis with candlewax drippings, choroidal granulomas, and optic nerve involvement, with cystoid macular edema representing the leading cause of vision loss. This report presents a unique case of bilateral TRDs and retinal NV as the initial manifestation of sarcoidosis. Improved awareness of atypical ocular presentations of sarcoidosis is critical for facilitating earlier diagnosis and timely intervention.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"1-4"},"PeriodicalIF":1.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167686","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":"Direct Ophthalmic Viscoelastic Device Plug Technique for Sclerotomy Closure in 25-Gauge Microincision Vitrectomy Surgery.","authors":"Masaki Nakamura, Akira Watanabe, Yuki Yamada, Chiharu Koike, Tadashi Nakano","doi":"10.3928/23258160-20260819-02","DOIUrl":"10.3928/23258160-20260819-02","url":null,"abstract":"<p><strong>Background and objective: </strong>This study describes a direct ophthalmic viscoelastic device (OVD) plug technique for sclerotomy closure and compares it with conventional scleral massage in 25-gauge micro-incision vitrectomy surgery (MIVS).</p><p><strong>Patients and methods: </strong>This retrospective comparative study included 79 eyes: 41 treated with the OVD-plug technique and 38 with scleral massage. The primary outcome was the proportion of eyes requiring suturing at one or both superior ports.</p><p><strong>Results: </strong>Suturing was required in 36.6% of eyes in the OVD-plug group and 57.9% in the scleral-massage group, but the difference was not statistically significant (<i>P</i> = .073). In exploratory multivariable analysis, air/gas tamponade, but not treatment group, was significantly associated with a lower likelihood of suturing. Postoperative intraocular pressure and hypotony were similar between groups.</p><p><strong>Conclusions: </strong>The OVD-plug technique showed a numerically lower suturing rate, but its comparative effectiveness remains uncertain. Air/gas tamponade was associated with lower odds of suturing.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"642-648"},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113165","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}
B Michelle Kim, Kenny Y Wang, Mohamad Rani Hassoun, Kannan Sharma, Matthew R Starr
{"title":"Glaucoma Progression and Development Following Secondary Intraocular Lens Surgery.","authors":"B Michelle Kim, Kenny Y Wang, Mohamad Rani Hassoun, Kannan Sharma, Matthew R Starr","doi":"10.3928/23258160-20260819-03","DOIUrl":"10.3928/23258160-20260819-03","url":null,"abstract":"<p><strong>Background and objective: </strong>This study aimed to investigate glaucoma progression following secondary intraocular lens (SIOL) implantation by surgical approach.</p><p><strong>Patients and methods: </strong>This was a single-center retrospective study of 440 eyes that received SIOL implantation, including scleral-sutured, scleral-fixated, anterior chamber, and sulcus-fixated. Glaucoma progression was defined as new diagnosis, procedure for intraocular pressure (IOP) control, or IOP elevation ≥ 24 mmHg or ≥ 5 mmHg above baseline requiring additional medications. Risk factors were assessed using multivariable analysis.</p><p><strong>Results: </strong>Mean age at surgery was 71.3 years and 29.3% of patients had prior glaucoma. Overall, 33.2% developed glaucoma progression. Prior glaucoma (hazard ratio 2.08 [95% CI 1.47-2.94], <i>P</i> < .001) and cystoid macular edema (1.63 [1.06-2.52], <i>P</i> = .026) were associated with glaucoma progression on multivariable analysis. There was no difference in glaucoma progression between scleral-sutured, scleral-fixated, anterior chamber, or sulcus-fixated implantation techniques.</p><p><strong>Conclusion: </strong>Our results suggest that surgeons should use their preferred SIOL implantation technique but closely monitor postoperative IOP.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"634-641"},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113203","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}
Andreas Gonzalez, Ellen Kang, Dhruv P Patel, Seenu M Hariprasad
{"title":"Reconsidering Ophthalmology Electronic Medical Record Architecture in the Age of Interoperability and Artificial Intelligence.","authors":"Andreas Gonzalez, Ellen Kang, Dhruv P Patel, Seenu M Hariprasad","doi":"10.3928/23258160-20260813-01","DOIUrl":"10.3928/23258160-20260813-01","url":null,"abstract":"","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"620-624"},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025775","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":"Focal Laser Photocoagulation for Large, Persistent Retinal Pigment Epithelial Detachment: A Case Series.","authors":"Jun Young Ha, Jae Eun Kang, Yun Sik Yang","doi":"10.3928/23258160-20260909-01","DOIUrl":"10.3928/23258160-20260909-01","url":null,"abstract":"<p><strong>Background and objective: </strong>This study aimed to describe outcomes of focal laser photocoagulation for large, persistent pigment epithelial detachment (PED).</p><p><strong>Patients and methods: </strong>Ten eyes underwent focal 577-nm yellow laser photocoagulation at the peripheral PED margin and were reviewed for 6 months, longer when available.</p><p><strong>Results: </strong>Eight eyes achieved complete PED regression within 6 months: four predominantly serous, two mixed serous-fibrovascular with inactive type 1 choroidal neovascularization (CNV), and two with polypoidal choroidal vasculopathy. In mixed and polypoidal lesions, regression predominantly involved the serous component. The mean time to regression was 2.5 months, and best-corrected visual acuity improved from 0.41 to 0.25 logMAR. Two eyes with active type 1 CNV showed incomplete responses. Seven eyes maintained regression over a mean 49.9-month follow-up. No laser-related complications occurred.</p><p><strong>Conclusion: </strong>Focal laser photocoagulation was associated with regression of large, persistent PEDs, with responses influenced by lesion composition and neovascular activity. These preliminary findings require confirmation in larger controlled studies.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"649-657"},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025744","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}
Ashish Sharma, Lihteh Wu, Steven Bloom, Grace Baldwin, John B Miller, Joan W Miller, Luis Andres Lesmes, Rishabh Gupta, Mathew W MacCumber, Abhishek Upadhyaya, Awaneesh M Upadhyay, Deependra V Singh, Kourous A Rezaei
{"title":"RWC Update: Is Visual Acuity Still the Right Primary Endpoint in Age-related Macular Degeneration?; Black Cataract; Radiation Retinopathy.","authors":"Ashish Sharma, Lihteh Wu, Steven Bloom, Grace Baldwin, John B Miller, Joan W Miller, Luis Andres Lesmes, Rishabh Gupta, Mathew W MacCumber, Abhishek Upadhyaya, Awaneesh M Upadhyay, Deependra V Singh, Kourous A Rezaei","doi":"10.3928/23258160-20260921-01","DOIUrl":"https://doi.org/10.3928/23258160-20260921-01","url":null,"abstract":"","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":"57 10","pages":"615-618"},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183851","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":"Methotrexate Sequestration at the Silicone Oil-Fluid Interface After Vitrectomy for Traumatic Retinal Detachment.","authors":"Adam El Fouani, Ahmed F Shakarchi, Sami H Uwaydat","doi":"10.3928/23258160-20260730-02","DOIUrl":"10.3928/23258160-20260730-02","url":null,"abstract":"","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"679"},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840873","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}