Seminars in Ophthalmology最新文献

{"title":"Longitudinal Ocular Surface Changes in Women with Polycystic Ovary Syndrome Receiving Hormonal or Ovulation-Induction Therapy: A Prospective Cohort Study.","authors":"Mohamed S Emam, Ahmed Sherif, Mohamed R Khedr, Malak I ElShazly, Ayah Marrie","doi":"10.1080/08820538.2026.2740661","DOIUrl":"https://doi.org/10.1080/08820538.2026.2740661","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is a multisystem endocrine disorder associated with hyperandrogenism, insulin resistance, and chronic low-grade inflammation. These systemic changes may affect ocular surface homeostasis, yet longitudinal data on treatment effects are limited. This study aimed to evaluate different ocular surface parameters in women with PCOS and assess their changes following treatment with cyclical estrogen-progestogen therapy (hormone therapy [HT]) or clomiphene citrate.</p><p><strong>Methods: </strong>In this prospective cohort study, 60 women with PCOS and 30 age-matched healthy controls underwent ocular surface evaluation using the Dry Eye Diagnostic System (MediWorks), Schirmer's test, tear breakup time (TBUT), and the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire. PCOS patients were treated with HT for non-fertility indication (<i>n</i> = 30) or clomiphene citrate for fertility indication (<i>n</i> = 30) and re-evaluated at 3 and 6 months. Laboratory markers included LH/FSH ratio, total testosterone, and neutrophil-to-lymphocyte ratio (NLR).</p><p><strong>Results: </strong>At baseline, PCOS patients showed significant reductions (<i>p</i> < .001) in tear function (TBUT, Schirmer's test, NIBUT), a significantly higher proportion of meibomian gland loss, and abnormal lipid layer thickness, significantly higher conjunctival redness, and increased central corneal thickness (CCT) compared with controls (<i>p</i> < .001). Over six months, HT therapy was associated with further significant reduction of tear film stability and meibomian gland morphology (<i>p</i> < .001), alongside a continued increase in CCT, reduced best corrected visual acuity (BCVA), and decreased tear functions assessed by tear break up time (TBUT), Schirmer's test (<i>p</i> < .001). Conversely, clomiphene citrate treatment led to significant increase in tear film parameters, meibomian gland function, and significant decrease in ocular surface staining, and CCT (<i>p</i> < .001), with preservation of visual acuity.</p><p><strong>Conclusion: </strong>PCOS is associated with subclinical ocular surface dysfunction and increased corneal thickness. Treatment modality was associated with differing ocular outcomes: HT use was associated with worsening dry eye parameters, while clomiphene citrate use was associated with improved tear film stability and meibomian gland integrity; this between-group divergence remained significant after adjusting for baseline values and for baseline hormonal/inflammatory covariates (all adjusted <i>p</i> < .001 except IOP). However, because treatment groups were not randomized and differed at baseline, these associations should not be interpreted as causal drug effects. Objective ocular surface assessment should be considered in PCOS management to guide therapy and monitor ocular health.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-12"},"PeriodicalIF":3.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070035","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":"Comparison of Choroidal Vascularity Index Between Type 1 and Type 2 Macular Neovascularization Before and After Anti-VEGF Therapy.","authors":"Lidia Remolí-Sargues, Clara Monferrer-Adsuara, Verónica Castro-Navarro, Belén López-Salvador, Ester Francés-Muñoz, Enrique López-Sánchez, Javier Montero-Hernández","doi":"10.1080/08820538.2026.2740663","DOIUrl":"https://doi.org/10.1080/08820538.2026.2740663","url":null,"abstract":"<p><strong>Purpose: </strong>To compare choroidal structural features and visual and anatomical outcomes between type 1 and type 2 macular neovascularization (MNV) at baseline and following anti-vascular endothelial growth factor (anti-VEGF) therapy.</p><p><strong>Methods: </strong>This retrospective study included 56 eyes of 44 patients with treatment-naïve neovascular age-related macular degeneration treated with intravitreal anti-VEGF. Choroidal vascularity index (CVI), best-corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (CST), and macular fluid status were assessed at baseline and the final follow-up visit.</p><p><strong>Results: </strong>At baseline, CMT was significantly lower in type 1 than in type 2 MNV (<i>p</i> 0.047), whereas CVI did not differ significantly between groups (<i>p</i> 0.091). At the final visit, CVI also showed no significant difference between subtypes. BCVA improved and CMT decreased descriptively in both groups, whereas CST decreased and CVI remained essentially stable. After adjustment for baseline values and actual follow-up duration, no significant differences were found between subtypes in final BCVA, CMT, CST, CVI, or macular fluid status (all <i>p</i> > .05).</p><p><strong>Conclusion: </strong>No significant differences in CVI were found between type 1 and type 2 MNV at baseline or final follow-up, and longitudinal changes were comparable between subtypes. These findings do not support a predominant role of choroidal vascularity in distinguishing MNV subtypes. As retinal pigment epithelium integrity was not assessed, its potential contribution remains unclear. Larger prospective studies with standardized treatment protocols are needed to clarify the mechanisms underlying different MNV growth patterns.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-8"},"PeriodicalIF":3.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070027","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":"Real-World Outcomes of Faricimab Versus Aflibercept in Treatment-Naïve Neovascular Age-Related Macular Degeneration with Pigment Epithelial Detachment.","authors":"Jung-Tzu Chang, Hsiang-Wen Chien, Tzu-Ying Lee, Kai Wang, Chu-Hsuan Huang","doi":"10.1080/08820538.2026.2735013","DOIUrl":"https://doi.org/10.1080/08820538.2026.2735013","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the real-world early outcomes of faricimab versus aflibercept 2 mg in Asian patients with treatment-naïve neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV), focusing on retinal pigment epithelial detachment (RPED) reduction.</p><p><strong>Methods: </strong>This retrospective study included treatment-naïve nAMD or PCV eyes with baseline RPED receiving three consecutive monthly loading injections of aflibercept or faricimab. Best-corrected visual acuity, central macular thickness (CMT), intraretinal or subretinal fluid, maximum RPED height, and RPED improvement ratio were assessed at baseline and after treatment. RPED was classified as fibrovascular or serous/mixed by optical coherence tomography.</p><p><strong>Results: </strong>Fifty-eight eyes were included: 27 treated with faricimab and 31 with aflibercept. Both aflibercept and faricimab had significantly reduced CMT (-99.7 ± 101.2 and -129.6 ± 109.3 μm; both <i>p</i> < .001) and maximum RPED height (-99.4 ± 205.6 and -151.4 ± 183.5 μm; <i>p</i> = .011 and <0.001, respectively). In the fibrovascular RPED subgroup, the RPED improvement ratio was significantly greater with faricimab (35.6% vs. 16.5%; <i>p</i> = .029). Serous component resolution was also more frequent with faricimab (100% vs 61.5%; <i>p</i> = .045).</p><p><strong>Conclusions: </strong>Both treatments improved retinal anatomy, while faricimab produced greater fibrovascular RPED height reduction and more complete serous component resolution.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":3.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040617","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":"Post-LASIK Interface Fluid Syndrome: Evidence Synthesis and First Cases After Descemet Stripping Only (DSO).","authors":"Juan J Prados-Carmona, Marta Villalba-González, Álvaro Sánchez-Ventosa, Timoteo González-Cruces, Francisco Javier Aguilar-Salazar, David Cerdán-Palacios, Alberto Villarrubia-Cuadrado, Antonio Cano-Ortiz","doi":"10.1080/08820538.2026.2734623","DOIUrl":"https://doi.org/10.1080/08820538.2026.2734623","url":null,"abstract":"<p><strong>Purpose: </strong>To review the mechanisms, clinical spectrum, and management of Interface Fluid Syndrome (IFS) after LASIK and to report a novel form of presentation developing after Descemet Stripping Only (DSO) for Fuchs endothelial dystrophy (FED) in post-LASIK eyes.</p><p><strong>Methods: </strong>This review included 83 studies, comprising clinical data from 225 previously reported eyes. Extracted variables included etiology (ocular hypertension, endothelial dysfunction, or other causes), diagnostic findings, management strategies, and clinical outcomes. Additionally, we report two novel cases of IFS after DSO, a setting that has not been previously described.</p><p><strong>Results: </strong>Among previously published cases, most (81.33%) were purely pressure-dependent, whereas 12% were primarily associated with endothelial dysfunction, and others reflected mixed or alternative mechanisms. Onset ranged from days to 31 years after LASIK. Acute findings typically included increased corneal thickness, reduced visual acuity, and falsely low central IOP measurements. AS-OCT and endothelial assessment were valuable tools for etiological diagnosis. Pressure-driven cases generally resolved rapidly after corticosteroid withdrawal and IOP control, while endothelial-related forms more frequently required surgical procedures such as endothelial keratoplasty. In our two post-DSO cases, transient central endothelial dysfunction triggered early postoperative IFS despite normal IOP, resolving presumably through endogenous endothelial repopulation without transplantation.</p><p><strong>Conclusions: </strong>IFS represents a final common anatomical manifestation of stromal hydration within a pre-existing lamellar plane. Although most cases are pressure-driven, endothelial dysfunction-including transient pump failure after DSO-must be recognized to enable mechanism-based management.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-13"},"PeriodicalIF":3.1,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018114","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":"ICL Sizing and Vault Prediction: A Systematic Review of Mathematical Models and Calculation Formulas.","authors":"Francisco Javier Aguilar-Salazar, Antonio Cano-Ortiz, José María Sánchez-González, Timoteo González-Cruces","doi":"10.1080/08820538.2026.2731256","DOIUrl":"https://doi.org/10.1080/08820538.2026.2731256","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically identify and analyse published formulas and nomograms for implantable collamer lens (ICL) sizing and vault prediction, evaluating their input parameters and reported performance.</p><p><strong>Methods: </strong>A systematic review was conducted including studies that developed nomograms for ICL sizing or vault prediction. PubMed and Scopus databases were searched, and the references of included studies were screened. The search period ranged from January 2010 to July 2025. The review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed using the Prediction model Risk of Bias Assessment Tool (PROBAST).</p><p><strong>Results: </strong>A total of 675 records were identified, of which 38 studies were included. Twenty studies developed AS-OCT-based nomograms (11,177 eyes from 7,085 patients), and 18 used UBM (21,767 eyes from 15,393 patients). No significant differences were found between AS-OCT and UBM nomograms in predictive performance for R² (<i>p</i> = .169, 95% CI: -0.155 to 0.372) or MAE (<i>p</i> = .159, 95% CI: -152.36 to 203.80 µm). This finding should be interpreted cautiously given substantial heterogeneity in populations, devices, and validation strategies across studies, and does not imply true clinical equivalence between the two modalities.</p><p><strong>Conclusion: </strong>Multiple nomograms and machine learning models are available for ICL sizing and vault prediction; but no single approach performed universally better across populations, devices, and clinical settings. Because measurement conditions, imaging platforms, institutional protocols, and surgeon-specific factors can all influence model performance, any chosen formula should be validated locally before routine use, and combining multiple validated nomograms may support safer clinical decision-making.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-14"},"PeriodicalIF":3.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921013","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":"Quality of Life and Treatment Cost Among Sjögren's Disease Patients Visiting a Tertiary Eye Center: Impact of Ocular Sicca and ESSPRI.","authors":"Ashish Ranjan, Kirtida Oza, Sayan Basu, Swati Singh","doi":"10.1080/08820538.2026.2730605","DOIUrl":"https://doi.org/10.1080/08820538.2026.2730605","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate health-related quality of life (HR-QoL) in Sjögren's disease (SjD) patients, treatment cost, and their correlation with disease-related parameters.</p><p><strong>Method: </strong>HR-QoL questionnaires, including the Short Form Health Survey (SF-36), were completed by patients diagnosed with SjD according to 2016 ACR/EULAR criteria and age- and sex-matched healthy volunteers. Dry eye symptomatology (Ocular Surface Disease Index (OSDI) and tear film parameters (Keratograph), ESSPRI scores, and treatment details were also documented, and the association between QoL scores and clinical parameters was tested.</p><p><strong>Results: </strong>Forty patients participated (mean age, 51.6 ± 12.4 years; 95% female), with moderate ESSPRI scores for dryness (6.3), fatigue (5.6), and pain (5.4). The mean OSDI score and disease duration were 32.5 ± 17.7 and 2.12 ± 0.82 years, respectively. Compared with healthy Indians, SjD patients had significantly worse physical, mental, social, and emotional scores on the SF-36. Twenty-four individuals reduced their workload, and five discontinued their jobs. 55% (<i>n</i> = 22) incurred monthly expenditures of 500 to 2000 rupees for ocular drops, whereas only 35% (<i>n</i> = 14) spent that much on oral medications. The multivariable regression identified age (β = -0.35, <i>p</i> = .01) and fatigue (β = -1.93, <i>p</i> = .03) as significant predictors of a worse physical composite score, whereas the mental composite score was not associated with disease parameters.</p><p><strong>Conclusion: </strong>Patients with Sjögren's disease have poor QoL, and worse physical health is associated with increasing age and fatigue rather than ocular sicca alone. These findings underscore the importance of fatigue management and multidisciplinary support in the management of SjD.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-5"},"PeriodicalIF":3.1,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901134","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":"Understanding Pterygium Surgery Outcomes: Revisiting Definitions of Recurrence and Postoperative Complications.","authors":"Mehrnaz Atighehchian, Ahmad Kheirkhah, Minas Coroneo, Seyedeh Fatemeh Ghalibafan, Siamak Zarei-Ghanavati, Golshan Latifi, Ali R Djalilian, Mehran Zarei-Ghanavati","doi":"10.1080/08820538.2026.2717752","DOIUrl":"https://doi.org/10.1080/08820538.2026.2717752","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pterygium surgery results in various postoperative outcomes, but inconsistency in standard benchmark reporting for recurrence and postoperative complications hinders meaningful comparisons within the literature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This structured narrative review aims to synthesize the existing literature on pterygium surgery outcomes, focusing on how recurrence and postoperative complications have been defined and reported.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A structured literature search of PubMed was performed to identify studies reporting definitions of pterygium recurrence and postoperative complications through June 2025. Studies were reviewed and categorized narratively according to recurring patterns in outcome definitions and reporting practices. Eligible studies included case series, clinical trials, and randomized controlled trials that reported postoperative recurrence or complications. Exclusion criteria included case reports (≤3 cases), non-English publications, inaccessible full texts, reviews, and unrelated topics. Recurrence definitions were categorized into four groups according to descriptive patterns across studies, while postoperative complications were thematically classified into seven major categories. Findings were synthesized narratively. Due to heterogeneity in definitions, a quantitative meta-analysis was not feasible.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of the 1,264 articles screened, 527 met the inclusion criteria. Among these, 330 studies provided a clear definition of recurrence, while the remaining studies did not specify criteria. The 330 studies were categorized into four main groups for recurrent definition. Category A, the most commonly reported definition, was described as fibrovascular regrowth extending beyond the limbus onto the cornea and included 169 studies. In addition, 83 studies reported the same definition but specified a minimum corneal extension of 0.5-2 mm. Category B included 49 studies that used the Prabhasawat Tseng four-stage grading scale, which classifies recurrence based on the extent of fibrovascular tissue from the limbus onto the cornea. Category C consisted of 12 studies that distinguished between conjunctival and corneal recurrence, and Category D included 17 studies that employed author definitions.Additionally, postoperative complications were classified into seven major groups based on the clinical characteristics of graft-related issues, toxic effects, inflammation, infection, healing abnormalities, drug-induced, and other less frequently reported issues. Each category was further subdivided into specific clinical complication entities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Substantial variation exists in the literature on how recurrence and post-operative complications are defined following pterygium surgery. Establishing standardized classification systems is necessary and will enhance consistency in outcome reporting, improve clinical deci","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-6"},"PeriodicalIF":3.1,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901114","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":"Sclerotherapy in Orbital and Peri-Orbital Pathology: A Systematic Review of Current Applications and Emerging Frontiers.","authors":"Ayushi Agarwal, Prerna Sinha, Arman A Khan, Jessica Y Tong, Dinesh Selva","doi":"10.1080/08820538.2026.2727974","DOIUrl":"10.1080/08820538.2026.2727974","url":null,"abstract":"<p><strong>Aim: </strong>To highlight current and emerging applications of sclerotherapy in orbital and peri-orbital pathology while identifying evidence gaps and future directions.</p><p><strong>Methods: </strong>Systematic review of 108 studies identified through PubMed, Embase, Scopus, and Web of Science databases from inception to April 2026 with independent dual-reviewer screening.</p><p><strong>Results: </strong>Of the 108 included studies, 82 (75.9%) addressed vascular indications and 26 (24.1%) addressed non-vascular indications. All evidence was low-level (Level 3 or 4), with no randomized trials identified. A pooled analysis of 315 cases managed with intralesional bleomycin achieved a favourable response in 86.2% of evaluable patients (<i>n</i> = 269), with sight-threatening complications in 1.3% (<i>n</i> = 4) cases. Non-vascular indications spanned dermoid cysts, conjunctival, orbitopalpebral, and eyelid cysts, intrascleral cysts, xanthelasma, malar festoons, and lacrimal sac obliteration. Foam sodium tetradecyl sulphate demonstrated the broadest indication profile, while trichloroacetic acid was the most common sclerosant for conjunctival cysts in anophthalmic sockets. Bleomycin showed higher response rates in macrocystic variant than microcystic or previously intervened disease. Routine image-guidance appeared prudent, particularly for deep, complex, or distensible orbital vascular lesions.</p><p><strong>Conclusion: </strong>Sclerotherapy is a versatile, minimally invasive modality applicable across a broad spectrum of orbital and peri-orbital pathologies. Prospective registries employing standardized ISSVA-based lesion classification and outcome reporting are warranted to formulate evidence.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-18"},"PeriodicalIF":3.1,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897800","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":"Evaluation of Ocular Surface Inflammation and Corneal Microstructural Changes in Pterygium Using in Vivo Confocal Microscopy: A Comparative Study of Surgical Techniques.","authors":"Cansu Kaya Bal, Merve Simsek, Özlem Barut Selver, Cem Simsek","doi":"10.1080/08820538.2026.2729727","DOIUrl":"https://doi.org/10.1080/08820538.2026.2729727","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate ocular surface, corneal sensitivity, subbasal nerve morphology, and dendritic cells (DCs) density in eyes with pterygium using in vivo confocal microscopy (IVCM), and to compare postoperative outcomes between amniotic membrane transplantation (AMT) and conjunctival autografting (CAG).</p><p><strong>Methods: </strong>This prospective study included 41 patients with unilateral primary pterygium. Baseline and first-month postoperative findings were evaluated. Eyes with pterygium were compared with fellow eyes regarding dry eye parameters, corneal sensitivity and IVCM findings. Postoperative changes in ocular surface parameters, subbasal nerves, and DCs were evaluated following AMT or CAG.</p><p><strong>Results: </strong>Preoperatively, eyes with pterygium had significantly lower tear film break-up time than fellow eyes (<i>p</i> = .036), whereas no significant differences were observed in IVCM parameters. At one month postoperatively, ocular surface disease index scores improved (<i>p</i> < .001), while corneal sensitivity decreased (<i>p</i> = .037). DCs and subbasal nerve tortuosity also decreased significantly (<i>p</i> = .041 and <i>p</i> = .016, respectively). Changes from baseline in ocular surface and IVCM parameters did not differ significantly between the AMT and CAG groups (all <i>p</i> > .05).</p><p><strong>Conclusions: </strong>Pterygium is associated with ocular surface inflammation and corneal microstructural alterations detectable by IVCM. Surgical treatment improves the health of the ocular surface, and both methods showed favorable anti-inflammatory results in a short follow-up period of one month; however, it would be more beneficial to evaluate this in conjunction with long-term outcomes. IVCM may serve as a valuable tool for assessing postoperative inflammatory changes in pterygium patients.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-9"},"PeriodicalIF":3.1,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892361","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":"The Role of Artificial Intelligence in Teaching Ophthalmology Skills: A Systematic Review.","authors":"Abu Bakar Butt, Rachel Leong, Michael Balas, Marko M Popovic","doi":"10.1080/08820538.2026.2725232","DOIUrl":"https://doi.org/10.1080/08820538.2026.2725232","url":null,"abstract":"<p><strong>Background: </strong>Ophthalmology training requires visual interpretation, procedural skill, and supervised clinical reasoning, but trainee volume, faculty availability, and case mix constrain education. AI-enabled tools may support scalable instruction, assessment, and feedback.</p><p><strong>Objective: </strong>To evaluate AI-enabled interventions for improving ophthalmology diagnostic, clinical reasoning, and surgical skills, and summarize knowledge acquisition, AI performance metrics, and learner perceptions.</p><p><strong>Methods: </strong>This PROSPERO-registered review (CRD420251231199) followed PRISMA guidelines. Embase, Ovid MEDLINE, and Cochrane Library were searched through November 15, 2025. Eligible studies were observational or randomized trials in which trainees or clinicians performed ophthalmic diagnostic, clinical, or surgical tasks using AI-based instruction or assessment. Outcomes included diagnostic accuracy, knowledge, clinical reasoning, surgical skill, usability, satisfaction, and educational value. Risk of bias was assessed using ROBINS-I. Findings were synthesized narratively.</p><p><strong>Results: </strong>Seven studies (200 participants) spanned image-based deep learning for diagnostic training, video-based deep learning for surgical assessment, and large language models for educational simulation. AI-tutored learners showed greater gains than lecture-based instruction in disease recognition and diagnosis (Cohen's d = 0.82, <i>p</i> = .016); an AI myopia system produced large gains in classification and lesion detection (d = 1.3-2.3) where lecture alone showed none (<i>p</i> = .16-0.63). AI-based patient simulation was rated comparably to human actors (<i>p</i> = .48). AI-derived surgical metrics distinguished attending from resident performance (AUC 0.55-0.998).</p><p><strong>Conclusion: </strong>AI-enabled interventions show promise as adjuncts to ophthalmology training, particularly for diagnostic learning and objective feedback. Evidence remains limited by small samples and heterogeneity, requiring larger, standardized studies to define AI's role.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-8"},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888592","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}