Seminars in Ophthalmology最新文献

{"title":"Evaluation of Large Language Model-Generated Recommendations in Glaucoma Surgical Decision-Making.","authors":"Müge Toprak, Büşra Yılmaz Tuğan, Nurşen Yüksel","doi":"10.1080/08820538.2026.2725223","DOIUrl":"https://doi.org/10.1080/08820538.2026.2725223","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the utility, rationality, and safety of glaucoma surgery recommendations generated by three prominent large language models (LLMs) - ChatGPT, Microsoft Copilot, and Google Gemini - when applied to real-world clinical scenarios.</p><p><strong>Methods: </strong>Retrospective records from a tertiary hospital were converted into standardized scenarios and stratified into \"primary\" and \"complex\" glaucoma groups. Each LLM was prompted to suggest a single surgical approach and provide a rationale. A blinded team of glaucoma specialists evaluated the outputs based on six criteria: appropriateness, rationale quality, specificity, adherence to guidelines, feasibility, and safety risk, using a normalized 0-100 scale.</p><p><strong>Results: </strong>Median overall quality scores across all cases were 80.7 for ChatGPT, 80.7 for Copilot, and 82.7 for Gemini, showing no statistically significant difference in general performance (<i>p</i> = .367). However, case complexity significantly affected performance. For Gemini, appropriateness and rationale quality scores dropped significantly in complex cases and were accompanied by a statistically significant increase in safety risk (<i>p</i> = .009). Although ChatGPT and Copilot demonstrated more stability across groups, their rationale quality was significantly lower in complex scenarios than in primary ones (<i>p</i> = .014 and <0.001, respectively). Pairwise analyses revealed that ChatGPT offered superior rationale quality compared to Copilot, while Gemini exhibited higher specificity.</p><p><strong>Conclusions: </strong>LLM-based chatbots can provide acceptable surgical guidance for straightforward primary surgical cases, but their utility is limited in high-risk or complex clinical settings. The observed deficiencies in rationale and increased safety risks in complex cases suggest that LLMs should be integrated as auxiliary decision-support tools under expert supervision rather than used as autonomous decision-makers in glaucoma surgery planning.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":3.1,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851174","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":"Visual and Refractive Outcomes of Corneal Refractive Surgery for Hyperopic and Mixed Astigmatism: A Systematic Review and Meta-Analysis.","authors":"Timoteo González-Cruces, Francisco Javier Aguilar-Salazar, Álvaro Sánchez-Ventosa, Marta Villalba-González, Juan J Prados-Carmona, Alberto Villarrubia, Antonio Cano-Ortiz","doi":"10.1080/08820538.2026.2724546","DOIUrl":"https://doi.org/10.1080/08820538.2026.2724546","url":null,"abstract":"<p><strong>Topic: </strong>To evaluate the visual and refractive outcomes of corneal refractive surgery (PRK, LASIK, and SMILE) for hyperopic and mixed astigmatism. The clinical question addressed was: in adults with hyperopic or mixed astigmatism, how effective and safe are modern corneal refractive procedures, without alternative surgical comparators, in reducing refractive cylinder and improving uncorrected distance visual acuity?</p><p><strong>Clinical relevance: </strong>Hyperopic and mixed astigmatism are less predictable to correct than myopic errors due to biomechanical and ablation-profile complexity. Historically, these treatments showed higher regression and retreatment rates. With advances in excimer and femtosecond platforms, updated evidence is needed to inform clinical decision-making and patient counseling regarding expected efficacy, predictability, and safety.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA 2020 and Cochrane guidelines. PubMed, Scopus, and Web of Science were searched from January 2010 to March 2025. Eligible studies included prospective, retrospective, or randomized human studies evaluating PRK, LASIK, or SMILE for hyperopic or mixed astigmatism. Case reports, small series (<10 eyes), intraocular procedures, and presbyopia treatments were excluded. Risk of bias was assessed using the NIH Quality Assessment Tool for Case Series Studies. Random-effects meta-analyses were performed, and heterogeneity was quantified with I² statistics.</p><p><strong>Results: </strong>Twenty-three studies (3,561 eyes) were included. Mean preoperative cylinder was 2.45 ± 1.23 D. Pooled residual astigmatism was 0.47 D (95% CI, 0.04-0.90) for hyperopic and 0.67 D (95% CI, 0.37-0.97) for mixed astigmatism. Approximately 66% (hyperopic) and 50% (mixed) achieved ≤ 0.50 D residual cylinder; 81% and 83%, respectively, were within ≤ 1.00 D. Uncorrected distance visual acuity (UDVA) of 20/20 or better was achieved in 60% (hyperopic) and 63% (mixed). Loss of ≥1 line of corrected distance visual acuity (CDVA) occurred in 6% (95% CI, 0.01-0.14) of hyperopic and 5% (95% CI, 0.03-0.15) of mixed eyes (pooled random-effects estimates). No significant differences were found between groups in comparative meta-analysis.</p><p><strong>Conclusion: </strong>Modern corneal refractive surgery provides substantial cylinder reduction, high predictability, and excellent safety in hyperopic and mixed astigmatism. Although heterogeneity and predominantly non-randomized designs limit certainty, current laser technologies achieve clinically meaningful outcomes comparable between groups, supporting their use in appropriately selected patients.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-13"},"PeriodicalIF":3.1,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851209","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":"Retinal Microvascular Effects of Internal Limiting Membrane Peeling: A Meta-Analysis.","authors":"Thomas Chontos, Vasiliki Arsoudi, Stylianos A Kandarakis, Spyridon Voutsas, Petros Petrou, Dionysios Vakalopoulos, Vasileios A Tsagkogiannis, Konstantinos Tyrlis, Eleni Ek Kottaridou, Vasileios Zisis, Smaragda Diamanti, Ilias Georgalas","doi":"10.1080/08820538.2026.2724322","DOIUrl":"https://doi.org/10.1080/08820538.2026.2724322","url":null,"abstract":"<p><strong>Introduction: </strong>Internal limiting membrane (ILM) peeling is widely used to relieve tangential traction and improve anatomical closure. As the ILM is continuous with Müller cells enstheathing retinal capillaries, peeling may impact the retinal microvasculature. We evaluated whether peeling impacts retinal vessel density as measured by optical coherence tomography angiography.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, and Cochrane CENTRAL was conducted. Eligible studies included adult patients undergoing vitrectomy with ILM peeling and reported OCT-A vessel densities. Weighted mean differences were calculated for superficial (SCP) and deep capillary plexus (DCP) vessel density (VD) in the parafoveal and perifoveal regions.</p><p><strong>Results: </strong>Ten studies including 260 participants were analyzed for parafoveal outcomes, and five studies including 150 participants for perifoveal outcomes. ILM peeling was not associated with significant changes in any of the examined regions: parafoveal SCP VD (WMD = -0.53%; -1.43 to 0.38; <i>p</i> = .25), parafoveal DCP VD (WMD = 0.92%; -0.41 to 2.24; <i>p</i> = .17), perifoveal SCP VD (WMD = -1.10%; -2.80 to 0.61; <i>p</i> = .21), or perifoveal DCP VD (WMD = 1.37%; -1.39 to 4.14; <i>p</i> = .33). Meta-regression analyses did not identify significant effects.</p><p><strong>Discussion: </strong>ILM peeling does not appear to induce sustained microvascular loss detectable by OCT-A. Any early postoperative changes seem transient and should be interpreted cautiously. From a microvascular perspective, the findings support the safety of ILM peeling. Larger longitudinal studies using standardized OCT-A protocols are needed to confirm these findings and clarify any early VD fluctuations.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-10"},"PeriodicalIF":3.1,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851118","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 Etiological Spectrum of Uveitis in the United States: A Systematic Review and Meta-Analysis.","authors":"Tom Liba, Amit Olami, Yuval Cabir, Adir Sommer, Alon Gorenshtein, Ori Mekiten, Avner Belkin, Asaf Bar, Rita Ehrlich","doi":"10.1080/08820538.2026.2721691","DOIUrl":"https://doi.org/10.1080/08820538.2026.2721691","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the etiologic distribution of uveitis in the United States through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, PubMed Central, and Web of Science identified U.S.-based cohort and cross-sectional studies reporting uveitis etiology. Random-effects meta-analyses pooled proportional estimates. Study quality was assessed using Newcastle-Ottawa-based tools. Included studies spanned 1987-2023, encompassing 11,146 patients across 11 tertiary referral centers and one population-based registry.</p><p><strong>Results: </strong>Twelve studies were included. Undifferentiated uveitis was the most common etiology, accounting for 42.18% (95% CI 32.68-52.29%). Among non-infectious causes, HLA-B27-associated uveitis (5.65%) and sarcoidosis (4.98%) were most prevalent. Toxoplasmosis was the leading infectious cause (4.07%), followed by HSV (3.70%) and CMV (3.14%). Heterogeneity was observed, partly explained by publication era. Sensitivity analyses confirmed a significant temporal trend for undifferentiated uveitis and identified the pre-HAART era as a driver of heterogeneity in infectious etiologies.</p><p><strong>Conclusions: </strong>Undifferentiated uveitis remains the predominant diagnosis in the U.S. with HLA-B27, sarcoidosis, and toxoplasmosis representing key defined etiologies. Because these pooled estimates were derived predominantly from tertiary referral centers and a single population-based cohort, they primarily reflect the included U.S. cohorts and should be extrapolated to the general U.S. population with caution. Regional, temporal, and methodological differences contribute to heterogeneity and should be considered in clinical evaluation and research.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-11"},"PeriodicalIF":3.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148832435","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":"A Risk Prediction Model for Normal-Tension Glaucoma Progression Integrating Genetic Markers and Corneal Biomechanics.","authors":"Conghui Ma, Liang Dong, Qian Liu","doi":"10.1080/08820538.2026.2722251","DOIUrl":"https://doi.org/10.1080/08820538.2026.2722251","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Normal-tension glaucoma (NTG) is characterized by progressive optic nerve damage despite intraocular pressure remaining consistently within the normal range. Predicting disease progression in patients with confirmed NTG remains challenging. This study aimed to develop and validate an interpretable machine learning model integrating genetic risk scores and corneal biomechanical parameters to predict progression risk in patients with NTG, identify independent predictors, and quantify the contribution of individual features to support precision clinical management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 342 patients with NTG were consecutively enrolled at a tertiary hospital and randomly allocated to training set (&lt;i&gt;n&lt;/i&gt; = 238) and validation set (&lt;i&gt;n&lt;/i&gt; = 104) at a ratio of 7:3. Baseline characteristics and six core indicators were collected. Candidate predictors were selected through univariate analysis and least absolute shrinkage and selection operator (LASSO) regression with 10-fold cross-validation and the λ-1se criterion. Independent predictors were subsequently identified using multivariable logistic regression. Three machine learning models-random forest (RF), support vector machine (SVM), and logistic regression (LR)-were developed. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA). SHapley Additive exPlanations (SHAP) analysis was performed to interpret feature contributions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Univariate analysis revealed significant differences in all six indicators between the progression and non-progression groups (&lt;i&gt;p&lt;/i&gt; &lt; .05). Multivariable logistic regression further confirmed that all six indicators were independently associated with NTG progression (&lt;i&gt;p&lt;/i&gt; &lt; .05). The RF model demonstrated the best predictive performance, with an AUC of 0.760 (95% confidence interval (CI) : 0.678-0.842) in the training set and 0.747 (95% CI: 0.623-0.871) in the validation set. It outperformed both the SVM model (training AUC = 0.704; validation AUC = 0.694) and the LR model (training AUC = 0.742; validation AUC = 0.729). SHAP analysis ranked the features, in descending order of contribution, as mean retinal nerve fibre layer (RNFL) thickness, first applanation velocity, visual field mean deviation, relative tear GNAI1 level, polygenic risk score for NTG, and relative tear PRDX4 level. The calibration curves showed good agreement between predicted and observed probabilities, while DCA demonstrated a high clinical net benefit across a broad range of threshold probabilities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;A model integrating corneal biomechanical parameters, genetic risk scores, and tear molecular biomarkers was developed to predict the risk of NTG progression and demonstrated potential clinical utility. This model may provide a quantitative reference for risk stratification and pers","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-9"},"PeriodicalIF":3.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809075","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":"Esotropia Induced by Optical Correction in Myopic Patients.","authors":"Heba M Fouad, Ahmed Awadein","doi":"10.1080/08820538.2026.2722249","DOIUrl":"https://doi.org/10.1080/08820538.2026.2722249","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a specific pattern of esotropia observed in myopic patients occurring exclusively while wearing refractive correction despite a normal accommodative convergence / accommodation (AC/A) ratio and to evaluate the efficacy of its management.</p><p><strong>Methods: </strong>This is a retrospective study which included children and young adults with high myopia who presented with esotropia with spectacles or contact lenses correction only, and orthophoria or near orthophoria without optical correction. AC/A ratio was measured using gradient method. Ductions and versions were evaluated. The angles of deviations were measured with and without optical correction, for both distance and near. Magnetic resonance imaging of the extraocular muscles was performed. The target angle for surgical correction was the preoperative angle of esotropia at distance with spectacle correction, and the changes in the angles of deviation after surgery were evaluated.</p><p><strong>Results: </strong>Nine patients were identified. The mean age at presentation was 13.6 ± 5.2 years; 6 patients were females (66.7%). The mean angle of esotropia with optical correction was 44 ± 5 PD for distance and 43 ± 4 PD for near. The mean angle of esotropia for near without optical correction was 4 ± 3 PD. Mean spherical equivalent was -10.6 ± 1.8 Diopters. All patients underwent bilateral medial rectus muscle recession. Mean medial muscle recession was 6.9 ± 0.4 mm. Mean follow up was 8 ± 4 months. Successful outcome was achieved in 8 patients, one patient had residual esotropia of 25 PD. None of the patients developed exotropia without glasses after surgery.</p><p><strong>Conclusion: </strong>Esotropia in myopic patients may appear only with optical correction, including glasses or contact lenses. The exact cause of the absence of esotropia without optical correction cannot be confirmed but cannot be attributed to a high AC/A ratio. These patients benefit from bilateral medial rectus recession similar to those who have esotropia without optical correction, without carrying the risk of overcorrection without spectacles or contact lenses.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-6"},"PeriodicalIF":3.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809026","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 Effect of Preoperative Preservative Burden on the Success of Ab-Interno Trabeculotomy.","authors":"Berke Temel, Ahmet Kaderli, Sinem Karabulut, Başak Memiş, Sema Tamer Kaderli, Şafak Korkmaz, Funda Yılmaz, Sabahattin Sül","doi":"10.1080/08820538.2026.2716933","DOIUrl":"https://doi.org/10.1080/08820538.2026.2716933","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of preoperative cumulative preservative burden on 1 year surgical outcomes of Kahook Dual Blade (KDB) and Gonioscopy-Assisted Transluminal Trabeculotomy (GATT).</p><p><strong>Methods: </strong>This retrospective study included 46 eyes (23 KDB, 23 GATT). A Preservative Burden Index (PBI) was calculated by incorporating specific concentrations of preoperative topical preservatives. Main outcomes were 1-year complete and qualified success rates. Receiver operating characteristic (ROC) analysis determined the optimal PBI cut-off. Kaplan-Meier analysis and multivariable Cox regression identified independent risk factors for surgical failure.</p><p><strong>Results: </strong>Preoperative PBI was significantly higher in the GATT group than the KDB group (0.71 ± 0.43 vs. 0.34 ± 0.32, <i>p</i> < .001). At 1 year, complete success was 43.4% for KDB and 8.7% for GATT, while qualified success was high in both (91.3% and 100%, respectively). ROC analysis identified a critical PBI cut-off of 0.36 predicting surgical failure. Kaplan-Meier analysis showed significantly lower surgical survival in patients exceeding this threshold. Multivariable Cox regression confirmed surgical technique (KDB vs. GATT) was not a significant failure predictor (HR = 2.15, <i>p</i> = .1). Instead, a low PBI significantly reduced the hazard of failure (HR = 0.30, <i>p</i> = .002).</p><p><strong>Conclusion: </strong>High preoperative preservative burden independently increases surgical failure risk in both KDB and GATT. Minimizing preservative exposure before surgery may optimize long-term minimally invasive glaucoma surgery outcomes.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-8"},"PeriodicalIF":3.1,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797837","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":"Uveitis-Associated Ocular Hypotony: A Systematic Review.","authors":"Masuma Firoz, Prisha Jonnalagadda, Naiesa Freeman, Neloy Shome, Ahmed F Shakarchi, Muhammad Z Chauhan, Ahmed B Sallam","doi":"10.1080/08820538.2026.2716934","DOIUrl":"https://doi.org/10.1080/08820538.2026.2716934","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic hypotony is an uncommon but potentially vision-threatening complication of uveitis, particularly in pediatric populations. This review synthesizes current evidence on its pathophysiology, epidemiology, clinical presentation, diagnosis, management, and prognosis in adults and children.</p><p><strong>Methods: </strong>We searched PubMed (MEDLINE), Scopus, and the Cochrane Library from March through April 2026 using the MeSH terms \"Uveitis\" and \"Hypotony, Ocular\" and the keywords \"uveitis,\" \"hypotony,\" and \"ocular hypotony.\" Additional studies were identified through reference review and expert recommendation. Eligible English-language human studies addressing chronic uveitis-associated hypotony were included. Quality was assessed qualitatively. The review was registered in PROSPERO (CRD420261381085).</p><p><strong>Results: </strong>Chronic uveitic hypotony is multifactorial, involving reduced aqueous production, increased uveoscleral outflow, and cyclitic membrane formation. Prevalence is ~10% in adult cohorts and 10-19% in JIA-associated pediatric uveitis. Risk factors include childhood onset, longer disease duration, severe inflammation, and prior intraocular surgery. Management is stepwise: inflammatory control with corticosteroids, steroid-sparing agents, and biologics; pharmacologic IOP elevation; and surgery combining vitrectomy, silicone oil, and fluocinolone implants.</p><p><strong>Discussion: </strong>Early aggressive inflammation control is essential, as visual recovery in chronic cases is limited. Current evidence is constrained by heterogeneous definitions, inconsistent reporting, and limited pediatric data, underscoring the need for standardized evaluation and treatment approaches.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-13"},"PeriodicalIF":3.1,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797860","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":"Impact of Cataract Surgery Steps on Postoperative Dry Eye Disease: A Narrative Review.","authors":"Alina Ghazou, Brian Bowden, Yousuf M Khalifa","doi":"10.1080/08820538.2026.2713201","DOIUrl":"https://doi.org/10.1080/08820538.2026.2713201","url":null,"abstract":"<p><strong>Introduction: </strong>Dry Eye Disease (DED) is a common multifactorial condition exacerbated by cataract surgery. This review explores how each step of cataract surgery may contribute to postoperative DED.</p><p><strong>Methods: </strong>A narrative review was conducted examining preoperative, intraoperative, and postoperative factors implicated in the development and severity of DED following cataract surgery.</p><p><strong>Results: </strong>Preoperative assessments reveal a high prevalence of pre-existing, often undiagnosed, DED among cataract surgery candidates; the effect of dilating drops on tear film stability warrants further investigation. Intraoperatively, povidone-iodine irrigation, lid speculum use, corneal incision size and location, and prolonged ocular surface exposure disrupt ocular surface homeostasis. Postoperative antibiotics, steroids, and NSAIDs, particularly preserved formulations requiring frequent instillation, may further exacerbate dry eye symptoms. Symptom resolution parallels corneal nerve regeneration and stabilization of corneal aberrations, typically occurring within three months. Sodium hyaluronate improves postoperative tear film parameters, while ophthalmic viscosurgical devices and preservative-free drops may minimize DED risk.</p><p><strong>Discussions: </strong>DED following cataract surgery results from cumulative surgical and pharmacologic exposures across the perioperative period. Preoperative screening and preservative-free regimens may reduce its incidence and severity.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-9"},"PeriodicalIF":3.1,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797834","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":"Short-Term IOP Lowering Effect on the Contralateral Eye After 180° Selective Laser Trabeculoplasty.","authors":"Rasha Eltanamly, Riham S H M Allam, Mina M Habib, Maha A Albadawi","doi":"10.1080/08820538.2026.2717431","DOIUrl":"https://doi.org/10.1080/08820538.2026.2717431","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the contralateral intraocular pressure (IOP) lowering effect following 180° selective laser trabeculoplasty (SLT) in the untreated eye and to compare IOP reduction between treated and untreated eyes.</p><p><strong>Methods: </strong>This prospective, interventional, non-randomized study included 40 treated eyes and 40 fellow eyes with open-angle glaucoma, and insufficient IOP control. Preoperative and postoperative IOP were measured using a Goldmann applanation tonometer. Subjects were treated with 50 non-overlapping laser pulses over 180° of the angle. IOP was measured bilaterally before SLT and at 1 week, 1 month, 3 months, and 6 months thereafter.</p><p><strong>Results: </strong>IOP changes were assessed in both the treated and contralateral eyes, revealing a significant reduction throughout the six-month follow-up. In the treated eye, IOP decreased from 20.23 ± 4.74 mmHg pre-SLT to 15.58 ± 3.13 mmHg (<i>p</i> < .001), while the contralateral eye decreased from 18.28 ± 3.87 mmHg to 15.88 ± 3.89 mmHg (<i>p</i> = .004) at the last follow-up visit. The treated eye consistently showed a greater percentage reduction, with contralateral effects of 65.47%, 68.14%, 60.32%, and 58.64% at 1 week, 1 month, 3 months, and 6 months, respectively. A strong positive correlation was found between IOP reduction in the contralateral eye and the corresponding treated eye (<i>r</i> = 0.718, <i>p</i> < .001), and a moderate correlation with the treated eye's baseline IOP (<i>r</i> = 0.368, <i>p</i> = .020).</p><p><strong>Conclusion: </strong>A statistically significant contralateral IOP reduction was observed following 180° SLT.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":3.1,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764972","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}