Current Opinion in Ophthalmology最新文献_第2页

A look at the emerging trends of large language models in ophthalmology. 审视眼科大语言模型的新兴趋势。

IF 3 2区医学

Current Opinion in Ophthalmology Pub Date : 2025-01-01 Epub Date: 2024-10-23 DOI: 10.1097/ICU.0000000000001097

Ting Fang Tan, Chrystie Quek, Joy Wong, Daniel S W Ting

引用次数: 0

Challenges and outcomes of cataract surgery after vitrectomy. 玻璃体切除术后白内障手术的挑战和结果。

IF 3 2区医学

Current Opinion in Ophthalmology Pub Date : 2025-01-01 Epub Date: 2024-11-08 DOI: 10.1097/ICU.0000000000001096

Bryanna J Lee, Jong Hwa Jun, Natalie A Afshari

{"title":"Challenges and outcomes of cataract surgery after vitrectomy.","authors":"Bryanna J Lee, Jong Hwa Jun, Natalie A Afshari","doi":"10.1097/ICU.0000000000001096","DOIUrl":"10.1097/ICU.0000000000001096","url":null,"abstract":"Purpose of review: This review examines the challenges and outcomes of cataract surgery after pars plana vitrectomy (PPV), focusing on surgical techniques, timing, and complication management.Recent findings: Cataract formation remains the primary complication post-PPV, affecting approximately 80-100% of patients within two years. Nuclear sclerotic cataracts are most common, occurring in 60-100% of patients over 50, followed by posterior subcapsular cataracts (4-34%), which primarily affect younger and diabetic patients. PPV disrupts the normal oxygen gradient in the vitreous, resulting in a more uniform oxygen distribution and accelerating cataract formation.Post-PPV eyes present unique surgical challenges due to anatomical alterations, including zonular instability and capsular changes characterized by increased fragility, the potential for tears, and altered elasticity. Newer intraocular lens power calculations show promise, but unexpected refractive outcomes may occur. The choice between combined phacovitrectomy and sequential surgeries remains debated, with patient-specific factors guiding the approach. Visual outcomes vary depending on preexisting vitreoretinal pathologies and baseline vision before PPV. Further randomized controlled trials are needed to establish treatment guidelines and improve predictive models.Summary: Post-PPV cataract surgery presents unique challenges, including anatomical alterations and an increased risk of capsular complications. These necessitate careful consideration of the surgical approach and highlight the need for further research to optimize outcomes and establish treatment guidelines.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":"70-75"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multimodal corneal imaging before refractive cataract surgery. 屈光性白内障手术前的多模式角膜成像。

IF 3 2区医学

Current Opinion in Ophthalmology Pub Date : 2025-01-01 Epub Date: 2024-10-29 DOI: 10.1097/ICU.0000000000001102

Karolyna Andrade de Carvalho, Louise Pellegrino G Esporcatte, Rachel L R Gomes, Renato Ambrósio

{"title":"Multimodal corneal imaging before refractive cataract surgery.","authors":"Karolyna Andrade de Carvalho, Louise Pellegrino G Esporcatte, Rachel L R Gomes, Renato Ambrósio","doi":"10.1097/ICU.0000000000001102","DOIUrl":"10.1097/ICU.0000000000001102","url":null,"abstract":"Purpose of review: To prospectively review the advances in diagnostics for refractive cataract surgery, focusing on multimodal corneal analysis.Recent findings: The article explores the considerations related to planning refractive cataract surgery, emphasizing its potential to enhance patients' vision performance and quality of life. This review explores preoperative analysis in cataract surgery, focusing on assessing the cornea and ocular surface using multimodal diagnostics, including Placido disk-based corneal topography, Scheimpflug tomography OCT (optical coherence tomography), and biomechanical assessment. Wavefront technology, gene therapy, and artificial intelligence are also relevant in enhancing surgical precision and outcomes. It highlights the importance of preoperative thorough evaluations and technological advancements in ophthalmology.Summary: The rapid evolution and advancement of technology enable excellent refractive outcomes in most cases following cataract surgery. Consideration of appropriate preoperative factors is essential for achieving the desired postoperative outcome.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":"25-34"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cataract surgery with endothelial keratoplasty. 白内障手术与内皮角膜移植术。

IF 3 2区医学

Current Opinion in Ophthalmology Pub Date : 2025-01-01 Epub Date: 2024-10-16 DOI: 10.1097/ICU.0000000000001094

Muhammad A Ahad, Sara M AlHilali, Deema E Jomar

{"title":"Cataract surgery with endothelial keratoplasty.","authors":"Muhammad A Ahad, Sara M AlHilali, Deema E Jomar","doi":"10.1097/ICU.0000000000001094","DOIUrl":"10.1097/ICU.0000000000001094","url":null,"abstract":"Purpose of review: This review aims to provide an updated summary of the combined approach of cataract surgery with endothelial keratoplasty (EK), addressing key considerations, including intraocular lens (IOL) choice and calculation, decision between sequential and triple EK, and modifications in surgical techniques and postoperative management.Recent findings: Advances in imaging techniques (Scheimpflug tomography and anterior segment optical coherence tomography) have improved the ability to detect subclinical corneal edema, aiding in surgical decision-making for EK. Recent studies comparing sequential and triple-EK indicate that both methods yield similar visual outcomes. Though triple-EK offers quicker recovery, it may have higher complication rates. The use of gases like SF6 and C3F8 for anterior chamber tamponade is evolving, with conflicting findings on their efficacy in preventing graft detachment. Furthermore, IOL selection remains crucial, as hyperopic refractive surprises are common, and hydrophilic lenses should be avoided owing to the risk of opacification after EK.Summary: The combination of cataract surgery with EK has emerged as an effective treatment for patients with corneal endothelial diseases and cataract. Careful preoperative evaluation, appropriate IOL selection, and advances in surgical techniques contribute to better outcomes, although patient-specific factors must guide the choice between sequential and triple-EK procedures.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":"39-45"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effect of cataract surgery on lowering intraocular pressure. 白内障手术对降低眼压的影响。

IF 3 2区医学

Current Opinion in Ophthalmology Pub Date : 2025-01-01 Epub Date: 2024-11-27 DOI: 10.1097/ICU.0000000000001112

Yesha S Shah, Anupam K Garg, Pradeep Y Ramulu

{"title":"The effect of cataract surgery on lowering intraocular pressure.","authors":"Yesha S Shah, Anupam K Garg, Pradeep Y Ramulu","doi":"10.1097/ICU.0000000000001112","DOIUrl":"10.1097/ICU.0000000000001112","url":null,"abstract":"Purpose of review: To review the literature evaluating the effectiveness of cataract surgery alone and cataract surgery in combination with other procedures and surgeries on intraocular pressure (IOP) in patients with ocular hypertension and glaucoma.Recent findings: Recent studies of large trials have shown the IOP-lowering effect of cataract surgery and the beneficial effect of minimally invasive glaucoma surgery (MIGS). More studies are being published on when to use cataract surgery alone, with MIGS, or with traditional glaucoma surgeries for both primary open angle glaucoma and primary angle closure glaucoma.Summary: Patients with ocular hypertension and visually significant cataracts would benefit from cataract surgery alone to lower intraocular pressure. Patients with mild to moderate glaucoma would likely benefit from cataract surgery and MIGS to achieve a lower IOP. Patients with more advanced glaucoma would benefit from cataract surgery combined with a traditional incisional glaucoma surgery. Clear lens extraction can be used in patients with primary angle closure and early primary angle closure glaucoma. In patients with more advanced disease, phacoemulsification and another glaucoma surgery is likely to be required to achieve IOP control. MIGS are starting to be used in angle closure glaucoma, although more research needs to be done to define its role.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":"46-53"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implications of myopia in diagnosis and screening of open angle glaucoma.

IF 3 2区医学

Current Opinion in Ophthalmology Pub Date : 2024-12-24 DOI: 10.1097/ICU.0000000000001116

Aiko Iwase, Makoto Araie

{"title":"Implications of myopia in diagnosis and screening of open angle glaucoma.","authors":"Aiko Iwase, Makoto Araie","doi":"10.1097/ICU.0000000000001116","DOIUrl":"10.1097/ICU.0000000000001116","url":null,"abstract":"Purpose of review: Rapid increase in the prevalence of myopia has been documented worldwide. Myopia, especially high myopia, is not only an important risk factor for having open angle glaucoma (OAG), but also has a strong linking with the progression of OAG. Since myopic axial length (AXL) elongation is associated with nonglaucomatous optic nerve head (ONH) and visual field abnormalities, myopia poses a challenge in differential diagnosis of OAG. This review provides an overview of literature studying relationships between myopic AXL-elongation and diagnosis and prognosis of OAG, and functional and structural changes in the eye.Recent findings: Studies using optical coherence tomography (OCT), OCT-angiography, those using standard automated perimetry (SAP), other perimetric or electrophysiological methods showed dose-dependent effects of myopic AXL elongation on the structural changes in the ONH and parapapillary tissues, and functional abnormalities of an eye. Large cohort studies showed approximately one quarter of eyes with nonpathologic high myopia were complicated with various patterns of visual field defects including glaucoma-like ones.Summary: Findings of cross-sectional and longitudinal studies obtained using various fundus imaging devices must be integrated to perimetric results to improve differential diagnosis of OAG in myopic eyes, in which artificial intelligence technology may be useful.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Scleral fixated intraocular lens techniques for the vitreoretinal surgeon: an update.

IF 3 2区医学

Current Opinion in Ophthalmology Pub Date : 2024-12-23 DOI: 10.1097/ICU.0000000000001118

M Ali Khan

{"title":"Scleral fixated intraocular lens techniques for the vitreoretinal surgeon: an update.","authors":"M Ali Khan","doi":"10.1097/ICU.0000000000001118","DOIUrl":"https://doi.org/10.1097/ICU.0000000000001118","url":null,"abstract":"Purpose of review: To describe recent evidence regarding surgical techniques for secondary scleral fixation of intraocular lenses (IOLs), with attention to information most relevant to the surgical practice of vitreoretinal surgeons.Recent findings: Recent studies have reported favorable outcomes in patients treated with scleral fixation of IOLs using Gore-Tex suture and flanged intrascleral haptic fixation (ISHF). ISHF can be achieved using trocar-cannulas or double needle-based techniques. Recent data has focused on refractive outcomes data, as well as postoperative complications related to specific IOL choices, including haptic breakage, rotation/ tilt, and opacification. Studies directly comparing Gore-Tex sutured and ISHF techniques offer additional insights.Summary: Favorable refractive and surgical outcomes can be achieved using both sutured and sutureless scleral fixation techniques. These techniques can be combined effectively with pars plana vitrectomy (PPV) and are thus well suited for the skillset of a vitreoretinal surgeon. Future studies on iris-based fixation techniques and IOL types not yet available in the United States will be of interest. As these techniques are more widely used, prospective data as well as longer term outcomes will continue to clarify their risk/benefit profile.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Minimally invasive glaucoma surgery in angle closure.

IF 3 2区医学

Current Opinion in Ophthalmology Pub Date : 2024-12-19 DOI: 10.1097/ICU.0000000000001117

Nicole Shu-Wen Chan, Chelvin C A Sng

引用次数: 0

Overlap syndrome: a case series and literature review of concurrent pigment dispersion and pseudoexfoliation syndromes. 重叠综合征：并发色素分散和假性剥脱综合征的病例系列和文献综述。

IF 3 2区医学

Current Opinion in Ophthalmology Pub Date : 2024-11-08 DOI: 10.1097/ICU.0000000000001107

Pooja Shah, Srinath Soundararajan, David Fleischman

{"title":"Overlap syndrome: a case series and literature review of concurrent pigment dispersion and pseudoexfoliation syndromes.","authors":"Pooja Shah, Srinath Soundararajan, David Fleischman","doi":"10.1097/ICU.0000000000001107","DOIUrl":"https://doi.org/10.1097/ICU.0000000000001107","url":null,"abstract":"Purpose of review: The purpose of this review is to present two cases of overlap syndrome, or concurrent pigment dispersion syndrome and pseudoexfoliation syndrome. The summary of existing literature highlights the importance of accurate diagnosis and potential treatment options of overlap syndrome.Recent findings: The cases describe two patients with overlap syndrome and resulting progressive glaucoma. The condition tends to present after age 50 years old, with presence of both pseudoexfoliative material and pigment dispersion signs. The pigment dispersion syndrome may be quiescent at the time of pseudoexfoliation onset and may have gone undiagnosed. This form of glaucoma poses challenges in controlling intraocular pressure and may progress rapidly, often requiring surgical intervention.Summary: This paper reviews the common examination findings of pigment dispersion syndrome and pseudoexfoliation, which may aid clinicians in the diagnosis of the rare condition, overlap syndrome. The connection between the two conditions remains unclear, though studies of possible genetic associations are underway. The two-hit theory, or initial damage to the trabecular meshwork increasing susceptibility to future damage, is plausible given the severe nature of the condition. Though definitive conclusions regarding treatment strategies and outcomes of overlap syndrome are lacking, increased awareness, diagnosis, and study of the condition may help guide the management of overlap syndrome.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnosing glaucoma progression with optical coherence tomography. 利用光学相干断层扫描诊断青光眼进展。

IF 3 2区医学

Current Opinion in Ophthalmology Pub Date : 2024-11-08 DOI: 10.1097/ICU.0000000000001106

Laura D Palmer, Atalie C Thompson, Sanjay Asrani

{"title":"Diagnosing glaucoma progression with optical coherence tomography.","authors":"Laura D Palmer, Atalie C Thompson, Sanjay Asrani","doi":"10.1097/ICU.0000000000001106","DOIUrl":"https://doi.org/10.1097/ICU.0000000000001106","url":null,"abstract":"Purpose of review: Optical coherence tomography (OCT) is a widely used tool to diagnose and monitor glaucoma by objectively measuring the ganglion cell layer and the retinal nerve fiber layer (RNFL) thickness. The presence of RNFL thinning raises suspicion for glaucoma progression. Therefore, this review aims to discuss current approaches to using OCT for detecting glaucomatous change, limitations, and recent advancements.Recent findings: Previously established approaches to determining glaucomatous progression on OCT include quantitative and qualitative methods. The most common quantitative methods include event-based and trend-based analysis. Decreasing RNFL thickness or loss of the ganglion cell layer are indicative of glaucomatous changes. However, interpretation of OCT scans is strongly impacted by artifacts, which can be because of epiretinal membrane or posterior vitreous detachment. Race and aging also may impact interpretation of RNFL progression. More recent research focuses on loss of the RNFL because of the effects of systemic conditions. Given the limitations in the current approaches, recent advancements indicate a promising role for artificial intelligence in determining true glaucomatous progression.Summary: This review highlights current approaches to identifying glaucoma progression on OCT, limitations to these approaches, and the potential role for artificial intelligence.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0