Seminars in Ophthalmology最新文献

{"title":"Benign and Malignant Conjunctival Lesions in Children.","authors":"Jacob Pe'er, Shahar Frenkel","doi":"10.1080/08820538.2025.2606291","DOIUrl":"10.1080/08820538.2025.2606291","url":null,"abstract":"<p><p>Conjunctival lesions in children are nearly always benign. The most common are conjunctival nevi. The rare malignant conjunctival tumors in children are usually larger and appear at an older age. Children with xeroderma pigmentosum are a unique group in whom malignant conjunctival tumors can occur at an early age. In this review, we describe common and rare benign and malignant conjunctival lesions in children, grouped by tissue of origin.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"769-782"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797931","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":"Lacrimal History - Part 69: Doyens of Dacryology Series - George Milbry Gould (1848-1922), Erastus Eugene Holt (1849-1931), Functions of the Punctum, and Lacrimal Epidemiology.","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2574191","DOIUrl":"10.1080/08820538.2025.2574191","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"759-764"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281131","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":"5-Year Surgical Success and Outcomes of XEN-45 Microstent Combined with Cataract Surgery.","authors":"Büşra Yılmaz Tuğan, Büşra Kurt Musaoğlu, Nurşen Yüksel","doi":"10.1080/08820538.2026.2667852","DOIUrl":"10.1080/08820538.2026.2667852","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate long-term intraocular pressure (IOP), number of antiglaucoma medications (AGMs), and success after phacoemulsification combined with XEN-45 implantation (Phaco+XEN-45), and to compare these outcomes between primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PEXG).</p><p><strong>Methods: </strong>This retrospective study included 30 patients (30 eyes; 17 POAG, 13 PEXG) who underwent Phaco+XEN-45 implantation. IOP, number of AGMs, postoperative interventions, complete or qualified surgical success (IOP of 5-18 mmHg with AGMs or independent of AGMs, respectively), and failure (failure to achieve qualified success) were evaluated at 1, 2, 3, 4, 5 years postoperatively and at the final follow-up.</p><p><strong>Results: </strong>The median IOP at baseline was 20.5 (14.8-26.5) mmHg and decreased to 16.0 (14.8-17.3) mmHg at 5 years. The median number of AGMs decreased from 3.0 (2.0-3.3) at baseline to 2.0 (0.0-2.3) at 5-year, presenting a significant reduction at all follow-up time points (<i>p</i> < .001). The median IOP did not differ between POAG and PEXG during follow-up, whereas PEXG required more AGMs at 1 and 2 years (<i>p</i> = .048 and <i>p</i> = .031, respectively). Kaplan-Meier analysis showed complete success rates of 60% and 36% and qualified success rates of 100% and 96%, at 1 and 5 years, respectively; with 70% qualified success rate at 8 years. Long-term success did not differ between the POAG and PEXG groups.</p><p><strong>Conclusion: </strong>Phaco+XEN-45 implantation offers a significant reduction in AGMs and a marked decrease in IOP, with an acceptable long-term efficacy and safety profile. The similarity in the success rates of POAG and PEXG suggests that Phaco+XEN-45 is a feasible and safe option for both types of glaucoma with appropriate patient selection and effective postoperative bleb modulation.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"837-845"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842385","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":"Lacrimal History - Part 64: Doyens of Dacryology Series - Cornelius Rea Agnew (1830-1888): Agnew's Knife, Punctocanaliculoplasty, and Cautery of the Lacrimal Sac Epithelium.","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2566595","DOIUrl":"10.1080/08820538.2025.2566595","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"749-753"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150640","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":"Lacrimal History - Part 68: Lacrimal Drainage System and Faith: The 1731 Case of Marie Carteri.","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2572245","DOIUrl":"10.1080/08820538.2025.2572245","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"757-758"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252576","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":"Influence of Capsular Tension Ring Implantation on Rotational Stability of Intraocular Lenses: A Systematic Review and Meta-Analysis.","authors":"Dehai Liu, Lanxin Hu, Rui Qin, Yiyun Liu, Tong Sun, Qianqian Lan, Hong Qi","doi":"10.1080/08820538.2026.2664401","DOIUrl":"10.1080/08820538.2026.2664401","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the influence of capsular tension ring (CTR) implantation on the rotational stability of intraocular lenses (IOLs) by separately analyzing IOL rotation and IOL misalignment.</p><p><strong>Methods: </strong>PubMed, EMBASE, Web of Science, CENTRAL, and Google Scholar were searched through October 2025. IOL rotation was defined as the absolute axis change from the immediate postoperative position to final follow-up. IOL misalignment was defined as the absolute deviation between the intended surgical axis and the measured postoperative axis. Outcomes included mean rotation or misalignment (degrees) and the proportion of eyes exceeding 5-, 10-, and 15-degree thresholds. Random-effects models were used to calculate pooled mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals (CIs). Subgroup analyses were stratified by IOL haptic design and high myopia status. Evidence certainty was assessed using the GRADE framework.</p><p><strong>Results: </strong>Twelve studies (1251 eyes; 639 CTR, 612 non-CTR) were included. CTR implantation did not significantly reduce mean IOL rotation (MD - 0.40 degrees; 95% CI, -1.20 to 0.39; <i>p</i> = .322). No significant differences were observed for the proportion of eyes with rotation exceeding 5 degrees (<i>p</i> = .150), 10 degrees (<i>p</i> = .065), or 15 degrees (<i>p</i> = .176). For IOL misalignment, the overall pooled effect was not significant (MD - 1.46 degrees; 95% CI, -3.08 to 0.17; <i>p</i> = .079). However, subgroup analysis demonstrated a significant interaction by haptic design (<i>p</i> = .005). CTR implantation significantly reduced misalignment for loop-haptic IOLs (MD - 1.25 degrees; 95% CI, 1.73 to -0.77; <i>p</i> < .001) and for plate-haptic IOLs (MD - 3.18 degrees; 95% CI, -6.29 to -0.08; <i>p</i> = .045). The proportion of IOL misalignment exceeding 5 degrees was significantly lower in the CTR group (RR 0.53; 95% CI, 0.31 to 0.89; <i>p</i> = .018).</p><p><strong>Conclusions: </strong>CTR implantation did not significantly reduce mean IOL rotation or the proportion of outlier rotation at final follow-up (moderate-certainty evidence). Exploratory analysis based on very low-certainty observational evidence suggests that CTR may reduce IOL misalignment, particularly for loop-haptic IOLs, but these findings require confirmation in adequately powered RCTs.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"826-836"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779774","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":"Lens-Induced Uveitis: A Systematic Review of Pathophysiology, Diagnosis, and Treatment.","authors":"María Elisa Rodríguez-Malagón, Andrea Salazar-Vitale, Natalia Mayela Cantón-Muñiz, Rogelio Jaime Correa-Chapa, Alejandro Rodriguez-Garcia","doi":"10.1080/08820538.2026.2670454","DOIUrl":"10.1080/08820538.2026.2670454","url":null,"abstract":"<p><strong>Introduction: </strong>Lens-induced uveitis is an adaptive, immune-mediated reaction to lens proteins that are exposed to the anterior chamber. Although uncommon, its clinical presentation and management remain variable, and no standardized care algorithm exists. We aim to review the clinical characteristics, diagnostic approaches, and therapeutic strategies for lens-induced uveitis as reported in the literature.</p><p><strong>Methods: </strong>A systematic review was conducted using PubMed, Web of Science, CINAHL, Google Scholar, Cochrane, and Scopus databases up to October 31, 2025.</p><p><strong>Results: </strong>Twenty-nine studies encompassing 252 eyes were included. Most cases (82.54%) involved a disrupted lens capsule, consistent with the central role of crystallin exposure in triggering a phacogenic inflammatory response. At final follow-up, 64.69% of eyes had a visual acuity of light perception or worse. Surgical removal of lens material was the predominant definitive treatment, and earlier intervention in more recent reports appeared associated with better visual outcomes.</p><p><strong>Discussion: </strong>Lens-induced uveitis remains a vision-threatening condition largely driven by delayed diagnosis and persistent exposure to lens-derived antigens. Early clinical recognition and timely surgical removal of antigenic material are essential to avoid irreversible inflammatory damage. Improved awareness of its characteristic clinical features may support earlier intervention and better visual outcomes.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"808-818"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856958","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":"Repurposing Fenofibrate for Early Diabetic Retinopathy: A Systemic and Disease-Modifying Approach.","authors":"Abdulrahman Alfaleh, Hayder M Al-Kuraishy, Mubarak Alruwaili, Duaa Eliwa, Gaber El-Saber Batiha","doi":"10.1080/08820538.2026.2673068","DOIUrl":"10.1080/08820538.2026.2673068","url":null,"abstract":"<p><strong>Objective: </strong>Diabetic retinopathy (DR) remains a major cause of blindness worldwide, highlighting the need for accessible treatments that prevent its onset and progression. This review explores the potential of repurposing fenofibrate, a traditional lipid-lowering drug, as a systemic, disease-modifying therapy for DR.</p><p><strong>Methods: </strong>This narrative synthesis of clinical and molecular studies was conducted to evaluate therapeutic impact of fenofibrate on DR. Evidence from trials was integrated with recent mechanistic data to clarify lipid-independent pathways of fenofibrate in retinal protection.</p><p><strong>Results: </strong>Fenofibrate significantly reduced the progression of DR independent of serum lipid levels. Mechanistic insights indicate both PPAR-α-dependent and -independent actions that collectively protect retinal microvasculature. These include suppression of inflammation, reduction of oxidative stress, enhancement of endothelial function, and preservation of blood-retinal barrier integrity. The convergence of clinical and molecular evidence suggests that fenofibrate may exert direct retinal benefits beyond its metabolic effects.</p><p><strong>Conclusions: </strong>Fenofibrate represents a practical, systemic therapy capable of halting early DR progression. By targeting underlying pathogenic mechanisms, it offers a preventative approach that complements current late-stage ocular interventions and may reduce the global burden of diabetes-related vision loss.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"783-798"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147933192","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":"Intraoperative Intraocular Dexamethasone After Cataract Surgery: A Systematic Review and Meta-Analysis of Drop-Replacement and Add-On Strategies.","authors":"Sultan Abdulrahman A Alhassan","doi":"10.1080/08820538.2026.2740659","DOIUrl":"https://doi.org/10.1080/08820538.2026.2740659","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative corticosteroid regimens after cataract surgery rely on correct drop use and completion of a taper. We evaluated whether one intraoperative dose of dexamethasone could replace topical corticosteroids or improve outcomes when added.</p><p><strong>Methods: </strong>PubMed, CENTRAL, ClinicalTrials.gov, and WHO ICTRP were searched through 25 July 2026; citation searching was updated on 3 August 2026. Reports from each trial were linked, replacement and add-on strategies were analyzed separately, and random-effects models were used for comparable outcomes.</p><p><strong>Results: </strong>Thirteen reports represented 11 study families and 1,079 participants or eyes. Across two Surodex studies, steroid augmentation was less frequent than with topical dexamethasone (risk ratio 0.20, 95% confidence interval 0.08-0.53; I²=0%). A 2026 quasi-experimental study favored intracameral dexamethasone for minimal or absent day-3 inflammation (risk ratio 3.14, 95% confidence interval 1.59-6.23). Add-on intracameral dexamethasone reduced day-1 inflammation (Hedges g=-0.58, 95% confidence interval -1.03 to -0.13; I²=64.5%) and day-7 inflammation (g=-0.76, 95% confidence interval -1.11 to -0.42; I²=0%). Overall safety appeared comparable, although one study reported device migration in three of seven eyes.</p><p><strong>Conclusion: </strong>Intraoperative dexamethasone can control postoperative inflammation and may reduce reliance on topical corticosteroids, but heterogeneous formulations, nonrandomized evidence, incomplete reporting, and imprecise safety estimates preclude universal replacement.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-8"},"PeriodicalIF":3.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114849","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":"Effect of Proteolytic Enzymes on Descemet Membrane Endothelial Keratoplasty (DMEK) Graft Elasticity.","authors":"Gil Ben-David, Assaf Ben-Arzi, Irit Bahar, Eitan Livny","doi":"10.1080/08820538.2026.2739296","DOIUrl":"https://doi.org/10.1080/08820538.2026.2739296","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the proteolytic effect on Descemet membrane endothelial keratoplasty (DMEK) graft elasticity.</p><p><strong>Methods: </strong>The ex-vivo experimental study included 19 DMEK-grafts treated with elastase, hyaluronidase, collagenase-IV, or collagenase-VIII at varying concentrations and temperatures. The maximal-scroll-width (MSW) served as a quantitative marker for scroll-tightness. Following enzymatic treatment, endothelial toxicity was evaluated by vital dye staining and endothelial cell shedding into the immersion buffer solution was quantified using a hemocytometer.</p><p><strong>Results: </strong>Collagenase-IV (<i>N</i> = 6) at 1-2.5 mg/mL, 37°C for 30-45 min increased MSW by a mean of 22.1% (<i>p</i> < .05), whereas higher concentrations at room-temperature (RT) decreased MSW by 9.7% (<i>p</i> > .05). Collagenase-VIII (<i>N</i> = 2) showed no significant effects. Elastase (<i>N</i> = 7) at 1-2.5 mg/mL, RT for 90-120 min increased MSW by 6.7% (<i>p</i> < .05), while exposure at 37°C reduced MSW by 10.5% (<i>p</i> < .05). Hyaluronidase (<i>N</i> = 4) at 1-2.5 mg/mL, 37°C for 120 min decreased MSW by 19.2% (<i>p</i> < .01), whereas at RT, 1 mg/mL for 60 min increased MSW by 23% (<i>p</i> < .01). 29% of injured endothelial cells were observed across all the groups. Endothelial cell shedding was not significantly different between the two groups (<i>p</i> > .05).</p><p><strong>Conclusion: </strong>Collagenase IV showed promising preliminary effects under selected experimental conditions; however, given the small subgroup sizes and variable findings, further controlled studies are required.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":3.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081429","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}