Advances in ophthalmology practice and research最新文献

{"title":"Comparison of binocular visual function among patients with different types of anisometropia","authors":"Li Tang ,&nbsp;Lei Li ,&nbsp;Chunmei Li ,&nbsp;Yulin Yu ,&nbsp;Nan Shu ,&nbsp;Li Zhang","doi":"10.1016/j.aopr.2025.04.005","DOIUrl":"10.1016/j.aopr.2025.04.005","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the perceived eye position, Titmus and stereopsis function across various types of anisometropia to identify differences in binocular visual function.</div></div><div><h3>Methods</h3><div>This study included 204 anisometropic patients (observation group, interocular spherical equivalent difference ≥1.5D or cylindrical ≥1.0D) and 57 non-anisometropic controls (interocular differences &lt;1.5D spherical or &lt;1.0D cylindrical). Participants were initially stratified based on documented amblyopia history (94 with vs. 110 without), followed by further subgrouping of the observation group into hyperopic, myopic, and astigmatic anisometropia types for comparative analysis with controls. Standardized assessments comprised best-corrected visual acuity (BCVA, logMAR), cycloplegic refraction, Titmus near stereopsis (arcsec), binocular perceptual eye position (PEP) deviation, and three-order stereopsis thresholds measured via a computerized binocular vision assessment system. Statistical analysis adhered to CONSORT guidelines (SPSS v26.0, α ​= ​0.05).</div></div><div><h3>Results</h3><div>(1) No significant differences were observed between patients with documented amblyopia history and those without regarding equivalent spherical lens difference, horizontal/vertical PEP, three-order stereopsis, or Titmus test results. (2) The control group demonstrated superior vertical PEP, three-order stereopsis, and Titmus performance compared to all anisometropia subgroups (myopic, hypermetropic, and astigmatic; <em>P</em> ​&lt;0.05), though horizontal PEP showed no significant variation (<em>P</em> ​&gt;0.05). (3) While Titmus results showed no difference between astigmatic and myopic anisometropia groups (<em>P</em> ​= ​0.72), significant differences existed among other groups (<em>P</em> &lt;0.05). Notably, the hyperopic anisometropia group exhibited the poorest normal rates for vertical PEP, Titmus, and three-order stereopsis among all groups (<em>P</em> ​&lt;0.001). Additionally, the astigmatism group outperformed both myopia and hypermetropia groups in 0-order and 1-order stereopsis (<em>P</em> ​&lt;0.05).</div></div><div><h3>Conclusions</h3><div>The study revealed no significant difference in visual function between anisometropic amblyopia patients who achieved normal BCVA (≤0.0 LogMAR) and non-amblyopic anisometropic controls. However, all forms of anisometropia demonstrated varying degrees of impairment to binocular fusion and stereopsis, with hypermetropic anisometropia showing the most pronounced deficits, particularly in near stereopsis. Notably, vertical PEP instability may contribute to the progression of hyperopic anisometropia.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"5 3","pages":"Pages 182-188"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress of in vivo measurement methods of myopia sclera biomechanics","authors":"Xin Shi ,&nbsp;Hao Gu ,&nbsp;Hao Jiang ,&nbsp;Su Zhao ,&nbsp;Zhixuan Chen","doi":"10.1016/j.aopr.2025.04.006","DOIUrl":"10.1016/j.aopr.2025.04.006","url":null,"abstract":"<div><h3>Background</h3><div>The study of the development mechanism of myopia involves many aspects, of which the remodeling and biomechanical changes of the sclera are currently recognized as some of the more important mechanisms. In recent years, new progress has been made in in vivo and ex vivo measurement methods to characterize scleral biomechanics. However, because ex vivo measurement methods cannot be used on the in vivo eyeball, there is still a lack of a reliable in vivo scleral biomechanical measurement method to assess the trend of myopia progression in clinical practice.</div></div><div><h3>Main text</h3><div>In this paper, the research progress of existing in vivo measurement methods of scleral biomechanics in myopia is reviewed, and the advantages and limitations of these methods are discussed. The purpose is to comprehensively introduce the current development status of in vivo measurement methods of scleral biomechanics, look forward to their clinical application and development, and to explore new directions and ideas for the application of scleral biomechanics in the prevention and control of myopia.</div></div><div><h3>Conclusions</h3><div>The review shows that the most urgent problem is to further prove and verify that the biomechanical properties of the sclera can be measured with sufficient sensitivity and accuracy in vivo. Its safety and feasibility in clinical application also need to be considered. Future studies should investigate the multi-level and multi-scale biomechanical properties of the myopic sclera, and develop non-contact and non-invasive in vivo measurement techniques to provide more methods for myopia prevention and control and early screening of myopia in adolescents.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"5 3","pages":"Pages 205-211"},"PeriodicalIF":0.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal associations between smoking and ocular diseases: a Mendelian randomization study","authors":"Zhaohao Huang ,&nbsp;Junjie Chen ,&nbsp;Lu Shi ,&nbsp;Jun Huang","doi":"10.1016/j.aopr.2025.06.002","DOIUrl":"10.1016/j.aopr.2025.06.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the causal associations between smoking and ocular diseases using Mendelian randomization (MR).</div></div><div><h3>Methods</h3><div>A two-sample Mendelian randomization (MR) analysis based on publicly.</div><div>available genome-wide association studies were employed to infer the causal relationship. The effect estimates were calculated using the random-effects inverse-variance-weighted method.</div></div><div><h3>Results</h3><div>Genetically predicted smoking was positively associated with cataract [Odds ratio (OR) ​= ​1.14, 95% confidence interval (CI): ​1.01−1.29; <em>P</em> ​= ​0.027], w−AMD [OR ​= ​1.41, 95%CI: ​1.06−1.88; <em>P</em> ​= ​0.019], diabetic retinopathy [OR ​= ​1.06, 95%CI: ​1.04−1.30; <em>P</em> ​= ​0.01], disorders of optic nerve and visual pathways [OR ​= ​1.46, 95% CI: ​1.00−2.14; <em>P</em> ​= ​0.049] in inverse variance weighted analysis. Suggestive evidence of an inverse association between smoking and myopia was also observed [OR=0.75, 95%CI: ​0.57−0.97; <em>P</em> ​= ​0.031]. No associations were observed for glaucoma, allergic conjunctivitis, pterygium, keratitis, scleritis and episcleritis. After performing weighted median and MR-Egger analysis, consistent results were observed. There was no horizontal pleiotropy in the two-sample MR analysis.</div></div><div><h3>Conclusions</h3><div>Smoking may increase the risks of cataract, w−AMD, diabetic retinopathy, disorders of optic nerve and visual pathways. And smoking may decrease the risk of myopia.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"5 3","pages":"Pages 220-225"},"PeriodicalIF":0.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of image-guided accurate limbal relaxing incisions for astigmatism correction during cataract surgery","authors":"Xiaoxin Hu ,&nbsp;Jiao Qi ,&nbsp;Kaiwen Cheng ,&nbsp;Wenwen He ,&nbsp;Yu Du ,&nbsp;Keke Zhang ,&nbsp;Yi Lu ,&nbsp;Xiangjia Zhu","doi":"10.1016/j.aopr.2025.06.001","DOIUrl":"10.1016/j.aopr.2025.06.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the efficacy of image-guided accurate limbal relaxing incisions (LRIs) for astigmatism correction during cataract surgery.</div></div><div><h3>Methods</h3><div>Consecutive cataract patients with regular corneal astigmatism ranging from 0.75 to 2.50 D, intended for cataract surgery with image-guided LRIs, were recruited in this prospective cohort study. The efficacy of astigmatism correction was evaluated 3 months after surgery, and compared among eyes with preoperative corneal with-the-rule (WTR), against-the-rule (ATR) and oblique astigmatism. Higher-order aberrations and visual quality indices obtained with iTrace were further compared between eyes with single and paired LRIs.</div></div><div><h3>Results</h3><div>Totally, 108 eyes of 108 patients were analyzed. The mean total surgical induced astigmatism (tSIA) vector of all participants was 0.76 ​± ​0.38 D (range: 0.11–1.79 D, preoperative vs. postoperative astigmatism: 1.46 ​± ​0.41 vs. 0.78 ​± ​0.44 D, <em>P</em> ​&lt; ​0.001). Eyes with WTR astigmatism showed higher tSIA (0.89 ​± ​0.32 D vs. 0.42 ​± ​0.21 D vs. 0.48 ​± ​0.36 D, respectively, <em>P</em> ​&lt; ​0.001), as well as higher correction index and lower difference vector and index of success than ATR and oblique astigmatism groups (all <em>P</em> ​&lt; ​0.05). Eyes with paired LRIs exhibited better corneal average height of modulation transfer function, a better corneal performance index and a better quality of vision index than those with single LRI (all <em>P</em> ​&lt; ​0.05).</div></div><div><h3>Conclusions</h3><div>Image-guided LRIs can effectively correct low-to-moderate corneal astigmatism during cataract surgery, especially in eyes with WTR astigmatism.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"5 3","pages":"Pages 212-219"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DeepSeek-R1 outperforms Gemini 2.0 Pro, OpenAI o1, and o3-mini in bilingual complex ophthalmology reasoning","authors":"Pusheng Xu ,&nbsp;Yue Wu ,&nbsp;Kai Jin ,&nbsp;Xiaolan Chen ,&nbsp;Mingguang He ,&nbsp;Danli Shi","doi":"10.1016/j.aopr.2025.05.001","DOIUrl":"10.1016/j.aopr.2025.05.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the accuracy and reasoning ability of DeepSeek-R1 and three recently released large language models (LLMs) in bilingual complex ophthalmology cases.</div></div><div><h3>Methods</h3><div>A total of 130 multiple-choice questions (MCQs) related to diagnosis (n ​= ​39) and management (n ​= ​91) were collected from the Chinese ophthalmology senior professional title examination and categorized into six topics. These MCQs were translated into English. Responses from DeepSeek-R1, Gemini 2.0 Pro, OpenAI o1 and o3-mini were generated under default configurations between February 15 and February 20, 2025. Accuracy was calculated as the proportion of correctly answered questions, with omissions and extra answers considered incorrect. Reasoning ability was evaluated through analyzing reasoning logic and the causes of reasoning errors.</div></div><div><h3>Results</h3><div>DeepSeek-R1 demonstrated the highest overall accuracy, achieving 0.862 in Chinese MCQs and 0.808 in English MCQs. Gemini 2.0 Pro, OpenAI o1, and OpenAI o3-mini attained accuracies of 0.715, 0.685, and 0.692 in Chinese MCQs (all <em>P</em> ​&lt;0.001 compared with DeepSeek-R1), and 0.746 (<em>P</em> ​= ​0.115), 0.723 (<em>P</em> ​= ​0.027), and 0.577 (<em>P</em> ​&lt;0.001) in English MCQs, respectively. DeepSeek-R1 achieved the highest accuracy across five topics in both Chinese and English MCQs. It also excelled in management questions conducted in Chinese (all <em>P</em> ​&lt;0.05). Reasoning ability analysis showed that the four LLMs shared similar reasoning logic. Ignoring key positive history, ignoring key positive signs, misinterpretation of medical data, and overuse of non–first-line interventions were the most common causes of reasoning errors.</div></div><div><h3>Conclusions</h3><div>DeepSeek-R1 demonstrated superior performance in bilingual complex ophthalmology reasoning tasks than three state-of-the-art LLMs. These findings highlight the potential of advanced LLMs to assist in clinical decision-making and suggest a framework for evaluating reasoning capabilities.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"5 3","pages":"Pages 189-195"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TOC","authors":"","doi":"10.1016/S2667-3762(25)00023-X","DOIUrl":"10.1016/S2667-3762(25)00023-X","url":null,"abstract":"","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"5 2","pages":"Pages iii-iv"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144146742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of artificial intelligence tools in generating diabetic retinopathy guidelines","authors":"Fan Cao,&nbsp;Shengping Hou","doi":"10.1016/j.aopr.2025.04.004","DOIUrl":"10.1016/j.aopr.2025.04.004","url":null,"abstract":"","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"5 3","pages":"Pages 180-181"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early postoperative changes in corneal densitometry after SMILE with 120-μm and 130-μm cap thickness: a comparative study","authors":"Shirou Wu ,&nbsp;Hongying Jin ,&nbsp;Ting Wan","doi":"10.1016/j.aopr.2025.04.003","DOIUrl":"10.1016/j.aopr.2025.04.003","url":null,"abstract":"<div><h3>Objective</h3><div>To compare early postoperative changes in corneal densitometry after small incision lenticule extraction using 120-μm and 130-μm cap thicknesses.</div></div><div><h3>Methods</h3><div>69 eyes of 39 patients who underwent small incision lenticule extraction (SMILE) with cap thicknesses of 120-μm (n ​= ​34) and 130-μm (n ​= ​35) were included in this study. The corneal densitometry (CD) of three zones (0–2 ​mm, 2–6 ​mm, and 6–10 ​mm) of the anterior, central, and posterior corneal layers was evaluated before, one week, and one month after surgery. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical degree, cylinder degree, and spherical equivalent (SE) were also analyzed and compared between the two groups before and after surgery.</div></div><div><h3>Results</h3><div>Little difference was detected between the two groups in postoperative UCVA, BCVA, SE, and cylinder degree at one month. No statistically significant differences were found between the preoperative and postoperative CD values for the overall (0–12 ​mm) cornea and the 6–10 ​mm zone in either group. A significant increase in CD was observed in the 0–2 ​mm and 2–6 ​mm zones of the anterior layer in the 120-μm group, and the 0–2 ​mm zone of the central layer in the 130-μm group, one week postoperatively. These changes persisted for one month after surgery (<em>P</em> ​&lt; ​0.05). The CD in the central layer (0–2 ​mm and 2–6 ​mm) in the 120-μm group, as well as the total layer (0–2 ​mm and 2–6 ​mm) in both groups, significantly increased at the first postoperative week but returned to preoperative levels by one month after surgery. Additionally, the CD of the anterior layer (0–2 ​mm and 2–6 ​mm) increased significantly in the first week postoperatively, decreased significantly one month postoperatively, but remained significantly higher than baseline in the 130-μm group. In both groups, the CD of the posterior 0–2 ​mm zone decreased. Moreover, the increase in CD in the anterior 2–6 ​mm zone one week postoperatively was significantly higher in the 120-μm group compared to the 130-μm group (ΔCD 2.4 ​± ​1.55 vs. 1.64 ​± ​0.87, <em>P</em> ​= ​0.014). Postoperative corneal wavefront aberrations were significantly higher in the 120-μm group than in the 130-μm group.</div></div><div><h3>Conclusions</h3><div>CD increased mainly in the 0–6 ​mm zone of the anterior layer in the early phase after the SMILE procedure with both the 120-μm and 130-μm groups. The increase in CD in the anterior 2–6 ​mm zone one week postoperatively was higher in the 120-μm group than in the 130-μm group. SMILE with 120-μm and 130-μm cap thickness were both efficient and safe, but eyes with a 120-μm cap thickness showed higher postoperative corneal wavefront aberrations.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"5 3","pages":"Pages 196-204"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From stress to sight: The role of mechanical forces in the retinal diseases","authors":"Di Wu ,&nbsp;Ye Liu ,&nbsp;Xiaogang Luo ,&nbsp;Chengshou Zhang ,&nbsp;Yifei Zheng ,&nbsp;Jianfeng Meng ,&nbsp;Mei Yang ,&nbsp;Hemlata Bisnauthsing ,&nbsp;Ping Rao ,&nbsp;Baohua Ji ,&nbsp;Wai Kit Chu","doi":"10.1016/j.aopr.2025.04.002","DOIUrl":"10.1016/j.aopr.2025.04.002","url":null,"abstract":"<div><h3>Background</h3><div>The retina, a light-sensitive neural tissue critical for vision, exists in a dynamic mechanical environment where it is continuously exposed to mechanical forces. These forces, including traction forces, intraocular pressure-related stress, and hemodynamic forces, are closely linked to the progression of retinal diseases. A comprehensive understanding of retinal mechanosensation and mechanotransduction is essential for understanding the pathological mechanisms under aberrant mechanical conditions.</div></div><div><h3>Main Text</h3><div>This review synthesizes current knowledge on advanced biomechanical assessment techniques, and aging-associated biomechanical alterations in retinal tissues, emphasizing how mechanical forces drive structural and functional pathology.</div></div><div><h3>Conclusions</h3><div>By elucidating the mechanosensitive mechanisms remodeling retinal cell behavior and fate, this review highlights the critical role of biomechanics in retinal disease pathogenesis. The integration of mechanistic insights with biomechanical assessment techniques offers transformative potential for diagnosing mechanical dysfunction and developing mechanotargeted therapies.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"5 3","pages":"Pages 157-164"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing benzodiazepine-ketamine and benzodiazepine-fentanyl sedation in phacoemulsification: A double-blind crossover non-inferiority clinical trial (BEKEF study)","authors":"Adriano Cypriano Faneli ,&nbsp;Ricardo Danilo Chagas Oliveira ,&nbsp;Pablo Amado ,&nbsp;Eduardo F. Marback ,&nbsp;Rodrigo Amaral Torres ,&nbsp;Juliana Fernandes Marback ,&nbsp;Larrie Laporte ,&nbsp;Caio Vinicius Saito Regatieri ,&nbsp;Cristina Muccioli","doi":"10.1016/j.aopr.2025.04.001","DOIUrl":"10.1016/j.aopr.2025.04.001","url":null,"abstract":"<div><h3>Background</h3><div>Topical anesthesia for cataract surgery often requires adjunctive sedation to manage intraoperative discomfort and improve patient cooperation. Ketamine and fentanyl, combined with benzodiazepines, are commonly used sedation regimens, but their comparative safety and efficacy in the cataract surgery context remain underexplored. This study aimed to evaluate whether ketamine combined with midazolam is non-inferior to fentanyl combined with midazolam for sedation during phacoemulsification, with a non-inferiority margin of 10%.</div></div><div><h3>Methods</h3><div>This prospective, double-blind, crossover, non-inferiority trial randomized 75 patients to receive both sedation regimens for bilateral phacoemulsification. A 15-day washout period was implemented between surgeries. Adequate sedation was defined as a Ramsay Sedation Scale score of 2–3. The primary outcome was sedation adequacy, with secondary outcomes including patient and surgeon satisfaction, surgical metrics, and complications.</div></div><div><h3>Results</h3><div>Of the 75 randomized patients, 65 (130 eyes) completed the study. Adequate sedation was achieved in 86.2% of cases with ketamine and 89.2% with fentanyl, with a within-participant difference of 3.1% (95% CI: −2.3%–5.3%), confirming non-inferiority. Patient satisfaction scores were similarly high between regimens (ketamine: 4.87 ​± ​0.36; fentanyl: 4.91 ​± ​0.28; <em>P</em> ​= ​0.45). Complications were infrequent, with two cases of nausea and two of bradycardia in the fentanyl group and one case of nausea and two of hypertension in the ketamine group.</div></div><div><h3>Conclusions</h3><div>Ketamine combined with midazolam is a safe and effective alternative to fentanyl-based sedation for cataract surgery, providing comparable sedation quality and satisfaction. These findings support ketamine's use in cataract surgery.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"5 3","pages":"Pages 175-179"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}