Acta Ophthalmologica最新文献

{"title":"Choroidal changes and association with Gaussian curvature in high myopic eyes with posterior staphyloma in ultra-wide-field optical coherence tomography angiography.","authors":"Qing Zhao, Linxin Wei, Huan Chen, Yan Luo, Youxin Chen, Zhikun Yang","doi":"10.1111/aos.17477","DOIUrl":"https://doi.org/10.1111/aos.17477","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate choroidal changes in high myopic (HM) patients with posterior staphyloma (PS) and explore their association with Gaussian curvature (K) using ultra-wide-field optical coherence tomography angiography (UWF-OCTA).</p><p><strong>Methods: </strong>HM patients with wide macular PS (Type I PS) and without any PS (control) were recruited. Highest K values (K_max) and choroidal parameters-vessel flow density (VFD), choroidal vascularity volume (CVV) and index (CVI), thickness, and volume-were compared in central and peripheral regions, and the fovea-centered 12-mm ETDRS quadrants of 24 × 20 mm UWF-OCTA images. Associations between choroidal parameters and K values in Type I PS eyes were analysed using multiple linear regression analysis, controlling for the confounding effect of AL.</p><p><strong>Results: </strong>Type I PS eyes showed increased K_max in various subregions (p < 0.05), except the 12-mm ETDRS superior quadrant. CVV, choroidal thickness, and volume were higher in the peripheral region of the UWF-SS-OCTA image in Type I PS eyes (p < 0.05). Central CVI and large and medium choroidal vascular layer-VFD were significantly lower in Type I PS eyes (p < 0.05). Correlation analysis revealed a negative association between macular K_max and central CVI (p < 0.05). In the peripheral region, K_max showed a positive correlation with choroidal thickness and volume (p < 0.05). These correlations were partially confirmed across several quadrants of the 12-mm ETDRS grid.</p><p><strong>Conclusion: </strong>Type I PS eyes exhibit attenuated choroidal perfusion and a potentially reorganized choroidal structure and circulation, associated with Gaussian curvature severity. UWF-OCTA shows promise for non-invasive visualization of the choroidal alterations in PS.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary ocular hypertension as an adverse effect of treatment with intravitreal dexamethasone implant: A retrospective Swedish cohort study.","authors":"Imadeddin Abu Ishkheidem, Martin Breimer, Saba Kamal, Madeleine Zetterberg, Abbas Al-Hawasi, Marita Andersson Grönlund","doi":"10.1111/aos.17475","DOIUrl":"https://doi.org/10.1111/aos.17475","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the incidence and risk factors for secondary ocular hypertension (SOHT) following intravitreal dexamethasone implants (Ozurdex®) in patients with diabetic macular oedema (DME) and macular oedema secondary to retinal vein occlusion (RVO) in a Swedish cohort.</p><p><strong>Methods: </strong>This retrospective study included 309 eyes from 249 patients treated with Ozurdex® at Sahlgrenska University Hospital, Mölndal, Sweden, from 1 January 2016 to 31 December 2023. Electronic medical records were reviewed for data including patient demographics, number of injections, incidence of and treatment modalities for SOHT and rate of Ozurdex® discontinuation.</p><p><strong>Results: </strong>Of the 309 eyes, 217 (70.2%) were in the DME group and 92 (29.8%) in the RVO group. Overall, 117 eyes (37.9%) developed SOHT (intraocular pressure (IOP) ≥25 mmHg or a rise of ≥10 mmHg from baseline); this included 77 of 217 DME eyes (35.5%) and 40 of 92 RVO eyes (43.5%). Men were more than twice as likely as women to develop SOHT (adjusted odds ratio [aOR]: 2.53, p < 0.001). Each unit increase in baseline IOP was associated with an 8% increase in the odds of SOHT (aOR: 1.08 p = 0.025). Of all eyes, 30.5% received IOP-lowering treatment, primarily prostaglandins. None required invasive surgery.</p><p><strong>Conclusion: </strong>Our finding that 30.5% of eyes received IOP-lowering treatment confirms that SOHT is a prevalent complication following intravitreal dexamethasone implants. Male gender and higher baseline IOP were key indicators for developing SOHT after Ozurdex® treatment, emphasizing the need for vigilant monitoring. Most cases were managed with IOP-lowering eye drops, indicating that while common, SOHT is typically manageable without invasive interventions.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a predisposition for developing corneal hydrops in keratoconus?-Tomographic and biomechanical analysis of the fellow eyes.","authors":"Vesna Bosic, Hajra Mudassar, Berthold Seitz, Elias Flockerzi","doi":"10.1111/aos.17474","DOIUrl":"https://doi.org/10.1111/aos.17474","url":null,"abstract":"<p><strong>Aim: </strong>Fellow eyes (FE) of 73 keratoconus (KC) patients with acute corneal hydrops (ACH) and 130 KC patients without ACH (total 236 eyes, 110 more severely affected), serving as control groups, were retrospectively analysed to identify potential risk factors associated with the development of ACH.</p><p><strong>Methods: </strong>Tomographic (Pentacam^®) and biomechanical analysis (Corvis ST^®, both Oculus, Germany) were performed. Tomographic parameters are as follows: K-max, thinnest corneal thickness (TCT), Belin/Ambrósio deviation (BAD-D) and the tomographic ABCDE-staging. Biomechanical analysis included Integrated Radius (IR), DA Ratio (1 and 2 mm), stiffness parameter A1 (SP-A1), Ambrósio's relational thickness horizontal (ARTh), Corvis Biomechanical Index (CBI), Corvis Biomechanical Factor (CBiF) and the biomechanical E-staging.</p><p><strong>Results: </strong>Among ACH patients, most were males (77%), with pre-existing conditions including allergies (36%), asthma (10%) and frequent eye rubbing (61%), with no significant differences to the control group (CG). The ABCDE staging showed significantly different distribution patterns, with the ACH-FE predominantly showing stage B4, contrasting with a more heterogeneous distribution in both control groups. ACH-FE showed significantly lower SP-A1 levels than the CG (71 vs. 80 for CG all eyes, p < 0.001 and 71 vs. 76 for more severely affected control eyes, p = 0.01; Mann-Whitney U test).</p><p><strong>Conclusions: </strong>ACH-FE showed a predominant presence in stage B4, yet a heterogenic distribution in the other tomographic parameters ('A'|'C'). Lower SP-A1 values suggest that these eyes may be less stiff and resistant to mechanical stress. Our results potentially indicate a histopathological weakness in the posterior cornea that could predispose one to the development of ACH.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal decompensation after PreserFlo Microshunt surgery.","authors":"Iben Bach Damgaard, Anders Ivarsen, Jesper Hjortdal, Daniella Bach-Holm, Niklas Telinius","doi":"10.1111/aos.17472","DOIUrl":"https://doi.org/10.1111/aos.17472","url":null,"abstract":"","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Juvenile idiopathic arthritis during 20 years in Sweden: Characteristics of children, therapy interventions, occurrence of uveitis and ocular complications.","authors":"Pia Lundgren, Maria Papadopoulou, Rebecka Jernkrok, Natasha Abedi, Eva Karlsson, Michael Damgaard, Stefan Berg, Marita Andersson Grönlund","doi":"10.1111/aos.17466","DOIUrl":"https://doi.org/10.1111/aos.17466","url":null,"abstract":"<p><strong>Purpose: </strong>To assess and compare the characteristics, therapy interventions, occurrence of uveitis and ocular complications in children with juvenile idiopathic arthritis (JIA) screened and examined for uveitis in Gothenburg, Sweden, over 20 years. Biological immunomodulatory treatment was increasingly used during the second half of the over 20 years.</p><p><strong>Methods: </strong>Data were retrospectively collected from children with JIA examined for uveitis at the Queen Silvia Children's Hospital between 2012 and 2021. These data were compared with those from a previously published study of children (the first cohort) screened between 2002 and 2011 in the same setting.</p><p><strong>Results: </strong>The first 10-year cohort (2002-2011) included 299 children, while the second cohort (2012-2021) included 253 children. The median age at JIA diagnosis was 5 years (range: 1-15 years) in both cohorts (p = 0.72), and girls were overrepresented in both groups, 68.9% and 72.7%, respectively (p = 0.32). Oligoarthritis was less frequent in the first cohort than in the second, 57.5% versus 73.9% (p < 0.001). The presence of anti-nuclear antibodies (ANAs) was similar between the cohorts, 57.6% versus 57.9% (p = 0.95). Uveitis occurred less frequently in the first cohort, 10.7% versus 17.0% in the second (p = 0.032). However, uveitis children had (not significantly) more ocular complications in the first cohort, 46.9% versus 34.9% in the second (p = 0.34) and complications were more often affecting both eyes, 73.3% versus 40.0% (p = 0.14). Systemic treatments, particularly biological immunomodulatory therapies, were less commonly used in the first cohort, 24.4% versus 42.7% in the second cohort (p < 0.001).</p><p><strong>Conclusion: </strong>Over 20 years, we observed a higher occurrence of uveitis in children with JIA in the second 10-year cohort. However, despite being statistically insignificant, we found fewer ocular complications, and less frequent in both eyes. This may indicate a beneficial effect of the increased use of biological immunomodulatory therapy.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the efficacy of postoperative topical antibiotics in cataract surgery: A systematic review and meta-analysis.","authors":"Maria Laura Passaro, Matteo Posarelli, Fabio Claudio Avolio, Mariantonia Ferrara, Ciro Costagliola, Francesco Semeraro, Gianni Virgili, Mor M Dickman, Vito Romano","doi":"10.1111/aos.17469","DOIUrl":"https://doi.org/10.1111/aos.17469","url":null,"abstract":"<p><strong>Purpose: </strong>Cataract surgery is the most frequently performed surgical procedure worldwide, but postoperative endophthalmitis remains a serious complication that can lead to vision loss. While intracameral (IC) antibiotics are well established in significantly reducing the risk of postoperative infections, there is no consensus on the use of postoperative topical antibiotics. This systematic review and meta-analysis aimed to evaluate the efficacy of topical antibiotics in preventing endophthalmitis in patients already receiving IC antibiotics.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Scopus and Cochrane databases yielded 31 studies that met the inclusion criteria, involving patients who underwent cataract surgery via phacoemulsification. The patients were divided into two groups: those receiving IC antibiotics alone and those receiving additional postoperative topical antibiotics. The primary outcome was the incidence of postoperative endophthalmitis.</p><p><strong>Results: </strong>A total of 1 235 051 eyes were included in the meta-analysis, with 608 302 in the IC + T group, which received intraoperative intracameral antibiotics combined with postoperative topical antibiotics, and 626 749 in the IC group, which received intracameral antibiotics alone. The pooled analysis revealed no statistically significant difference in the incidence of endophthalmitis between the two groups (p = 0.97), with an incidence of 0.0004 (95% CI: 0.0003-0.0005) in both groups. These results suggest that the addition of topical antibiotics does not provide further benefit in preventing infections beyond IC antibiotics alone.</p><p><strong>Conclusions: </strong>IC antibiotics as a sole prophylactic measure may be sufficient, and the routine use of postoperative topical antibiotics could be unnecessary. Reducing the use of topical antibiotics may also help mitigate the risk of antimicrobial resistance.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term results after sutureless intrascleral fixation of the Carlevale intraocular lens: Changes in scleral pocket thickness over time.","authors":"Markus Schranz, Ioanna Dimakopoulou, Marcus Lisy, Victor Danzinger, Daniel Schartmüller, Claudette Abela-Formanek","doi":"10.1111/aos.17468","DOIUrl":"https://doi.org/10.1111/aos.17468","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the long-term effects and dynamic changes in scleral thickness above the T-haptic after sutureless scleral-fixated intraocular lens (sSFIOL) implantation using the FIL-SFF Carlevale lens.</p><p><strong>Setting: </strong>Single-centre, single-surgeon, prospective clinical trial, Department of Ophthalmology, Medical University of Vienna, Austria.</p><p><strong>Methods: </strong>Thirty-six eyes of 36 consecutive patients met the inclusion criteria for this post hoc analysis. Visual acuity, tilt and decentration of the IOL, as well as complications, were evaluated alongside imaging of the scleral pockets during multiple time points using the anterior optical coherence tomography (AS-OCT) system Tomey CASIA 2 in the bleb mode. The OCT scan pattern, oriented parallel to the T-shaped haptic of the IOL, facilitated manual analysis of images to measure scleral pocket thickness on both the temporal and nasal haptics. To compensate for distortions and non-perpendicular image acquisition, distal T-haptic thickness was also measured to calculate the relative scleral pocket thickness. For statistical evaluation, a linear mixed model was used, where we corrected for multiple measurements.</p><p><strong>Results: </strong>The mean follow-up period was 28 ± 11 months. Measured scleral thickness above the T-haptic exhibited a significant decrease on both temporal and nasal sides, translating to an estimated annual decrease of approximately 0.03 mm (p < 0.001). Postoperatively, best-corrected visual acuity (BCVA) significantly improved from 0.77 ± 0.74 logMAR preoperatively to 0.41 ± 0.60 (p < 0.001). IOL tilt increased slightly from 7.23° ± 3.43° to 7.71° ± 3.70° (p = 0.003), while decentration significantly decreased from 0.41 ± 0.21 to 0.39 ± 0.20 mm (p < 0.001) postoperatively.</p><p><strong>Conclusions: </strong>Long-term evaluation of Carlevale sSFIOL implantation demonstrated a significant improvement in postoperative BCVA. However, we observed a thinning of the scleral pocket thickness, raising questions about its clinical significance and the viability of subconjunctival placement of T-haptics in the long term. Further studies are necessary to evaluate the long-term patency of the scleral pocket.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cataract surgery in megalocornea: A qualitative and quantitative evaluation of published literature.","authors":"Sabrina Vaccaro, Mariacarmela Ventura, Maria Laura Passaro, Mariantonia Ferrara, Francesco Semeraro, Sorcha Ní Dhubhghaill, Vito Romano","doi":"10.1111/aos.17467","DOIUrl":"https://doi.org/10.1111/aos.17467","url":null,"abstract":"<p><p>Megalocornea is a rare condition characterized by an enlarged anterior chamber and an extended ciliary ring, often accompanied by early cataracts and zonular anomalies. This systematic review evaluates the outcomes of cataract surgery in patients with megalocornea, focusing on surgical techniques, intraocular lens (IOL) implantation, complications, and visual outcomes. A comprehensive literature search was conducted using PubMed, Google Scholar, and Scopus. Data regarding the included eyes, including preoperative best-corrected visual acuity (BCVA), primary surgery, sequential intraocular lens (IOL) implantation, type of implant, IOL formulae used, follow-up, final BCVA, reported complications, additional surgeries, and IOL-related drawbacks, were collected. A total of 30 studies involving 66 eyes meeting the inclusion criteria were identified. The most common surgical approaches were phacoemulsification (62.1%) and extracapsular cataract extraction (33.3%). IOL displacement occurred in 25% of cases, and further surgery was required in 21.5%. Overall, patients experienced significant improvement in visual acuity, with an average best-corrected visual acuity (BCVA) improvement of -1.05 logMAR. Individuals with megalocornea present unique challenges when undergoing cataract surgery, particularly the risk of IOL displacement due to zonular weakness and capsular enlargement. Despite these risks, appropriate IOL selection and surgical techniques can lead to favourable visual outcomes.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between red blood cell transfusion timing and the development of retinopathy of prematurity: Application of the two-phase theory.","authors":"Salma El Emrani, Lizanne A Derks, Angela M Tjiam, Michaela van Bohemen, Jacqueline U M Termote, Lotte E van der Meeren, Irwin K M Reiss, H Rob Taal, Enrico Lopriore, Nicoline E Schalij-Delfos","doi":"10.1111/aos.17471","DOIUrl":"https://doi.org/10.1111/aos.17471","url":null,"abstract":"<p><strong>Purpose: </strong>Red blood cell (RBC) transfusions are believed to be associated with retinopathy of prematurity (ROP), but the underlying mechanism is not fully understood, partly due to the lack of information on RBC transfusion timing. The aim was to determine the association between the timing and amount of RBC transfusions and the development and severity of ROP.</p><p><strong>Methods: </strong>This retrospective dual-center cohort study included 1177 neonates born in 2004-2022 with a gestational age at birth ≤28 weeks. Primary outcomes were any stage ROP and severe ROP based on maximum staging. Phase I of ROP was defined as ≤32.0 weeks postmenstrual age and phase II as >32.0 weeks postmenstrual age. Logistic regression analyses were adjusted for gestational age at birth, small for gestational age, mechanical ventilation duration, postnatal corticosteroids, sepsis, and necrotizing enterocolitis.</p><p><strong>Results: </strong>Multivariate analysis showed independent associations with severe ROP for RBC transfusion (OR 5.1; 95% CI 1.8-14.3), number of RBC transfusions (OR 1.2; 95% CI 1.1-1.3), RBC transfusion in phase I (OR 2.5; 95% CI 1.2-5.3), number of RBC transfusions in phase I (OR 1.2; 95% CI 1.0-1.3), RBC transfusion in phase II (OR 4.1; 95% CI 2.7-6.3) and number of RBC transfusions in phase II (OR 1.9; 95% CI 1.5-2.4).</p><p><strong>Conclusion: </strong>Based on maximum ROP staging, RBC transfusions in phases I and II are both associated with a high risk of severe ROP. A randomized controlled trial is urgently needed to determine the potential effect of RBC transfusions in phase II on ROP progression.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified penetrating deep sclerectomy versus conventional trabeculectomy for the treatment of glaucoma: A 12-month randomized prospective study.","authors":"Zhike Xu, Lixiang Wang, Xin Wei","doi":"10.1111/aos.17465","DOIUrl":"https://doi.org/10.1111/aos.17465","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the surgical outcomes and adverse events of modified penetrating deep sclerectomy with conventional trabeculectomy.</p><p><strong>Methods: </strong>A prospective randomized clinical study that successively recruited patients with moderate and advanced primary open-angle glaucoma (POAG) and primary angle closure glaucoma (PACG) in West China Hospital. The modified penetrating deep sclerectomy creates a small triangular intrascleral lake, which aims to reduce the risk of flap adhesion in conventional trabeculectomy and sudden hypotony associated with the dissection of a larger rectangular deep scleral flap. The primary effectiveness endpoint was the IOP by non-contact tonometer with or without medication use at each follow-up visit. The primary safety endpoint was the incidence of all complications during the study.</p><p><strong>Results: </strong>A total of 19 patients (21 eyes) were randomized to modified deep sclerectomy and 21 patients (21 eyes) to conventional trabeculectomy. Age, sex ratio, pre-operative intraocular pressure (IOP) and the number of IOP-lowering medications used were comparable between the two groups. At the end of the follow-up period (12 months), IOPs were (15.52 ± 3.28) mmHg and (19.66 ± 4.01) mmHg in the modified deep sclerectomy and conventional trabeculectomy groups, respectively (p = 0.006). Deterioration of the visual field appeared in four eyes (19.0%) and seven eyes (33.3%) in the two groups (p = 0.33). At 12 months, the average areas of the aqueous outflow pathway were (0.67 ± 0.30) and (0.43 ± 0.26) mm², demonstrating a significant difference (p = 0.016). Using 18 and 15 mmHg as the IOP criteria for surgical success, the modified penetrating deep sclerectomy group showed a higher overall success rate than the conventional trabeculectomy group at 12 months (18 mmHg: 80.95% vs 52.38%, Log Rank p = 0.033; 15 mmHg: 52.38% vs 4.75%, Log Rank p = 0.001). Complication rates were similar between the two groups (23.8% vs 33.3%, p = 0.55), and no sight-threatening complications were reported.</p><p><strong>Conclusions: </strong>Modified deep sclerectomy shows superior efficacy in IOP control and maintenance of the outflow pathway opening, with comparable rates of adverse events, resulting in a higher overall success rate.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}