Frontiers in ophthalmologyPub Date : 2025-04-11eCollection Date: 2025-01-01DOI: 10.3389/fopht.2025.1568370
Samantha Madala, Shaili Davuluru, Joy Li, Jeffrey Gluckstein, John Martin, Kasra Khatibi, Sandy Zhang-Nunes
{"title":"Management of vision loss associated with complications of cosmetic filler injections.","authors":"Samantha Madala, Shaili Davuluru, Joy Li, Jeffrey Gluckstein, John Martin, Kasra Khatibi, Sandy Zhang-Nunes","doi":"10.3389/fopht.2025.1568370","DOIUrl":"https://doi.org/10.3389/fopht.2025.1568370","url":null,"abstract":"<p><p>Injectable cosmetic fillers have dramatically risen in popularity in recent years. However, as the use of such fillers has become more common, there have been many reports of vision loss secondary to misplaced filler embolizing to the ophthalmic artery resulting in ocular ischemia. Currently, there are no randomized control trials or widely validated clinical guidelines that dictate how injectors should manage ischemic complications of filler embolism. This review aims to explain the possible mechanisms by which a cosmetic filler embolus can occlude the ophthalmic artery, describe the types of treatments that have been attempted thus far, and delineate possible a stroke-like protocol that can be implemented in order to restore perfusion and recover vision after such ischemic complications have occurred.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1568370"},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in ophthalmologyPub Date : 2025-04-11eCollection Date: 2025-01-01DOI: 10.3389/fopht.2025.1562555
Dario Pasquale Mucciolo, Giancarlo Albani, Luca Terracciano, Marco Branchetti, Laura Luchetti, Vittoria Murro, Gianni Virgili, Fabrizio Giansanti
{"title":"Femtosecond laser-assisted <i>in situ</i> keratomileusis for the correction of residual ametropia after penetrating keratoplasty: 1-year follow-up.","authors":"Dario Pasquale Mucciolo, Giancarlo Albani, Luca Terracciano, Marco Branchetti, Laura Luchetti, Vittoria Murro, Gianni Virgili, Fabrizio Giansanti","doi":"10.3389/fopht.2025.1562555","DOIUrl":"https://doi.org/10.3389/fopht.2025.1562555","url":null,"abstract":"<p><strong>Background: </strong>After an optimal corneal transplantation, a residual refractive error is possible due to several factors. We evaluated the 1-yr follow up of laser-assisted <i>in situ</i> keratomileusis using femtosecond laser (LASIK) for the correction of residual ametropia after penetrating keratoplasty (PK).</p><p><strong>Methods: </strong>Ten eyes of 10 patients were treated using corneal Femto-LASIK (F-LASIK) (WaveLight® Refractive Suite, Alcon) to correct refractive errors after PK at Careggi Teaching Hospital (Florence, Italy). The main outcomes included uncorrected and corrected distance visual acuity (UDVA, CDVA), preoperative and postoperative manifest refraction, and corneal topography. All patients were evaluated the day after surgery and 1, 4, 12, 24, 48 weeks later.</p><p><strong>Results: </strong>At the 48-week follow up, all patients showed a significant improvement in their UDVA (mean: 0.95 ± 0.29 LogMAR vs 0.50 ± 0.22 LogMAR, p<0.05) as well as in the spherical equivalent value (SE) (mean: -4.50 ± 2.37 vs. -1.55 ± 0.77, p<0.05), the cylindrical ametropia (mean: -6.13 ± 2.04 vs. -3.20 ± 2.15, p<0.05) and the CDVA also improved (median 0.26 [0.1-0.9] vs 0.22 [0.1-0.4] LogMAR, p<00.05). These values were observed from the 12-week follow up onwards. Post-operative spherical ametropia was not statistically significant. Intraoperative and postoperative complications were not detected.</p><p><strong>Conclusions: </strong>UDVA significantly improved using Femto-LASIK without surgical complications. The refractive results were stable from the 3-mth to the 1-yr follow ups. Femto-LASIK is an effective and safe choice to treat post-PK refractive errors.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1562555"},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Assessment of cataract surgery outcomes at Jimma Medical Center, Jimma, Southwest Ethiopia.","authors":"Amare Atoma Gelalcha, Sisay Bekele, Dagmawit Kifle, Wolela Mulatu, Edosa Kejela Keno, Wondu Reta Demissie","doi":"10.3389/fopht.2025.1547898","DOIUrl":"https://doi.org/10.3389/fopht.2025.1547898","url":null,"abstract":"<p><strong>Background: </strong>Globally, cataract is the leading cause of blindness accounting for 51% and affecting approximately 39 million people. Visual rehabilitation is achieved through sight-restoring surgery.</p><p><strong>Objectives: </strong>The study aimed to assess the outcomes of cataract surgery that were performed by senior ophthalmologists and residents at Jimma Medical Center (JMC), Jimma, Southwest Ethiopia.</p><p><strong>Methods: </strong>An institutional-based cross-sectional study was conducted among 341 patients who underwent cataract surgery. The surgery outcomes were assessed using the Physician Quality Reporting System (PQRS) and WHO guidelines. The primary outcomes of the study were post-surgical visual acuity tests, complications within 30 days following surgery, and any additional procedures required. Finally, the outcome of cataract surgery was rated as good, borderline, or poor based on the post-surgical visual acuity test results according to WHO guidelines, and as good vision, no/mild, moderate, or severe visual impairment (VI), and blindness according to PQRS.</p><p><strong>Results: </strong>Out of the 341 cataract surgeries performed, 171 were operated by residents and 170 by senior ophthalmologists, respectively. The overall prevalence of cataract surgery outcomes based on PQRS guidelines for post-operative visual acuity tests showed good vision in 187 cases (54.8%), no/mild VI in 64 cases (18.8%), moderate VI in 46 cases (13.5%), severe VI in 12 cases (3.5%), and blindness in 32 (9.1%). According to the WHO classification, 253 cases (74.2%) had a good outcome, while 45 cases (13.25%) had a borderline outcome and 43 cases (12.6%) had a poor outcome. The prevalence of cataract surgery outcomes varied among healthcare professionals performing the surgeries. Less than 9.7% of patients required re-surgery within the first month of operation due to complications.</p><p><strong>Conclusion: </strong>In summary, 54.8% of the patients achieved good vision with an acuity test result of 6/12 or better. This finding meets the minimum Medicare PQRS measure value of ≥50% for both professionals. The overall outcome of cataract surgery showed a statistically significant difference between residents and senior ophthalmologists who performed the procedures.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1547898"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in ophthalmologyPub Date : 2025-04-04eCollection Date: 2025-01-01DOI: 10.3389/fopht.2025.1562583
Sepideh Cheheltani, Sadia T Islam, Heather Malino, Kalekidan Abera, Sandeep Aryal, Karen Forbes, Justin Parreno, Velia M Fowler
{"title":"Comparative analysis of rodent lens morphometrics and biomechanical properties.","authors":"Sepideh Cheheltani, Sadia T Islam, Heather Malino, Kalekidan Abera, Sandeep Aryal, Karen Forbes, Justin Parreno, Velia M Fowler","doi":"10.3389/fopht.2025.1562583","DOIUrl":"https://doi.org/10.3389/fopht.2025.1562583","url":null,"abstract":"<p><strong>Introduction: </strong>Proper ocular lens function requires biomechanical flexibility, which is reduced during aging. As increasing lens size has been shown to correlate with lens biomechanical stiffness in aging, we tested the hypothesis that whole lens size determines gross biomechanical stiffness by comparing lenses of varying sizes from three rodent species (mice, rats, and guinea pigs).</p><p><strong>Methods: </strong>Coverslip compression assay was performed to measure whole lens biomechanics. Whole mount staining on fixed lenses, followed by confocal microscopy, was conducted to measure lens microstructures.</p><p><strong>Results: </strong>Among the three species, guinea pig lenses are the largest, rat lenses are smaller than guinea pig lenses, and mouse lenses are the smallest of the three. We found that rat and guinea pig lenses are stiffer than the much smaller mouse lenses. However, despite guinea pig lenses being larger than rat lenses, whole lens stiffness between guinea pigs and rats is not different. This refutes our hypothesis and indicates that lens size does not solely determine lens stiffness. We next compared lens microstructures, including nuclear size, capsule thickness, epithelial cell area, fiber cell widths, and suture organization between mice, rats, and guinea pigs. The lens nucleus is the largest in guinea pigs, followed by rats, and mice. However, the rat nucleus occupies a larger fraction of the lens. Both lens capsule thickness and fiber cell widths are the largest in guinea pigs, followed by mice and then rats. Epithelial cells are the largest in guinea pigs, and there are no differences between mice and rats. In addition, the lens suture shape appears similar across all three species.</p><p><strong>Discussion: </strong>Overall, our data indicates that whole lens size and microstructure morphometrics do not correlate with lens stiffness, indicating that factors contributing to lens biomechanics are complex and likely multifactorial.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1562583"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in ophthalmologyPub Date : 2025-03-28eCollection Date: 2025-01-01DOI: 10.3389/fopht.2025.1554777
W Daniel Stamer, Thomas Chiu, Da-Wen Lu, Tsing Hong Wang, Prin Rojanapongpun, Ngamkae Ruangvaravate, Youn Hye Jo, Marlene R Moster, Murray Fingeret, Nora Lee Cothran, Jessica Steen, Ian Benjamin Gaddie, Ömür Uçakhan-Gündüz, Wesam Shamseldin Shalaby, Cindy M L Hutnik
{"title":"Real-world impact of latanoprostene bunod ophthalmic solution 0.024% in glaucoma therapy: a narrative review.","authors":"W Daniel Stamer, Thomas Chiu, Da-Wen Lu, Tsing Hong Wang, Prin Rojanapongpun, Ngamkae Ruangvaravate, Youn Hye Jo, Marlene R Moster, Murray Fingeret, Nora Lee Cothran, Jessica Steen, Ian Benjamin Gaddie, Ömür Uçakhan-Gündüz, Wesam Shamseldin Shalaby, Cindy M L Hutnik","doi":"10.3389/fopht.2025.1554777","DOIUrl":"https://doi.org/10.3389/fopht.2025.1554777","url":null,"abstract":"<p><p>Latanoprostene bunod ophthalmic solution (LBN) 0.024% is a topical nitric oxide (NO)-donating prostaglandin F2α (PGF2α) analog first approved in November 2017 for reduction of intraocular pressure (IOP) in patients with ocular hypertension (OHT) or open-angle glaucoma (OAG). This narrative review describes the unique mechanism of action of LBN and summarizes available real-world data. Upon instillation, LBN is metabolized into latanoprost acid and butanediol mononitrate, which is further reduced to NO and an inactive metabolite. Latanoprost acid increases aqueous humor outflow primarily through the uveoscleral (unconventional) pathway, whereas NO increases outflow through the trabecular (conventional) pathway. Eight studies were identified: 2 studies in newly diagnosed, treatment-naïve patients with OHT or OAG, 4 studies of adjunctive therapy in patients with glaucoma receiving other IOP-lowering therapies, and 2 studies in which patients with glaucoma switched to LBN monotherapy or adjunctive therapy. Decreases in IOP after initiating LBN in newly diagnosed patients or adding/switching to LBN were generally consistent with reductions observed in clinical trials and sustained throughout the studies. Rates of discontinuation due to inadequate IOP lowering ranged from 12.2% to 17.1%. LBN was generally well tolerated in real-world studies; the most common adverse events were consistent with the known safety profile of LBN. Data from real-world studies provide important insights regarding the potential effectiveness and tolerability of LBN in the clinical setting and suggest that LBN is well tolerated and associated with significant, clinically meaningful, and durable reductions in IOP.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1554777"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in ophthalmologyPub Date : 2025-03-25eCollection Date: 2025-01-01DOI: 10.3389/fopht.2025.1535805
Jenny Shunyakova, Margaret Reynolds, Amal Taylor, Erin G Sieck, James T Walsh, Lynn M Hassman
{"title":"Case Report: ROSAH syndrome presents diagnostic and therapeutic challenges.","authors":"Jenny Shunyakova, Margaret Reynolds, Amal Taylor, Erin G Sieck, James T Walsh, Lynn M Hassman","doi":"10.3389/fopht.2025.1535805","DOIUrl":"10.3389/fopht.2025.1535805","url":null,"abstract":"<p><strong>Background: </strong>Retinal dystrophy, optic nerve edema, splenomegaly, anhidrosis, and headache (ROSAH) syndrome is an autosomal dominant disorder caused by a heterozygous missense mutation in alpha kinase 1 (ALPK1). This series reports the presentation and treatment outcomes of three first-degree relatives with ROSAH syndrome.</p><p><strong>Methods: </strong>Retrospective chart review, whole exome sequencing.</p><p><strong>Results: </strong>A 16-year-old male presented with bilateral optic disc edema, macular edema, retinal degeneration, and vitreous inflammation. His mother and brother had similar clinical features. Whole exome gene sequencing identified a shared heterozygous mutation in the ALPK1 gene c.710C>T, consistent with ROSAH syndrome. Ophthalmic manifestations in this family included optic nerve edema, macular edema, panuveitis, glaucoma, and widespread retinal cone and rod dysfunction. While the proband's macular edema improved with intravitreal dexamethasone and systemic tocilizumab, immune suppression did not prevent retinal degeneration.</p><p><strong>Conclusion: </strong>A diagnosis of ROSAH syndrome, suggested by the concomitant presentation of optic disc edema, uveitis, and retinal degeneration, can be made by targeted genetic sequencing of the ALKP1 gene. While ROSAH-associated ocular inflammation and macular edema may respond to local steroids and immune suppression, retinal degeneration may progress despite these therapies.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1535805"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in ophthalmologyPub Date : 2025-03-24eCollection Date: 2025-01-01DOI: 10.3389/fopht.2025.1545602
Xinyue Qiu, Ziman Jiao, Yuxin Liu, Yunhao Zhou, Haiyu Li, Xin Chen, Guanghui Liu
{"title":"Risk factors of retinal vein occlusion in East Asia: a meta-analysis.","authors":"Xinyue Qiu, Ziman Jiao, Yuxin Liu, Yunhao Zhou, Haiyu Li, Xin Chen, Guanghui Liu","doi":"10.3389/fopht.2025.1545602","DOIUrl":"10.3389/fopht.2025.1545602","url":null,"abstract":"<p><strong>Objective: </strong>With the intention of developing a more targeted control strategy for retinal vein occlusion (RVO) in East Asian populations, a meta-analysis was conducted to evaluate the risk factors associated with RVO in this region.</p><p><strong>Methods: </strong>PubMed, Web of Science, Cochrane Library, CNKI, Wanfang and VIP databases were searched for studies that reported risk factors of RVO in East Asia, published from the establishment of the database to May 2024. To further filter the articles, Newcastle-Ottawa Scale (NOS) evaluation method was utilized to assess the quality of selected articles. After valid data were extracted, Meta-analysis was performed by Review Manager software.</p><p><strong>Results: </strong>A total of 21 literatures were included, including 27561 cases in the RVO group (Case group) and 514578 cases in the non-retinal vein occlusion (NRVO) group (Control group). Results of meta-analysis showed that chronic kidney disease [odds ratio (OR)=4.14, 95% confidence interval (CI): (1.86%, 9.24%)], hypertension [OR=4.11, 95% CI: (3.09%, 5.48%)], hyperlipidemia [OR=3.45, 95%CI: (2.32%, 5.12%)], diabetes mellitus [OR=3.00, 95%CI: (1.88%, 4.80%)], homocysteine [OR=0.87, 95%CI: (0.59%, 1.15%)], have statistically significant differences between the RVO group and the NRVO group(<i>P</i><0.05).</p><p><strong>Conclusion: </strong>The occurrence of RVO is closely related to its risk factors, such as chronic kidney disease, hypertension, hyperlipidemia, diabetes mellitus and high homocysteine. In the process of diagnosis and treatment of RVO, doctors should focus on the above risk factors to prevent the occurrence of the disease.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1545602"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Associations between refractive error components and higher-order aberrations in simple myopia and compound myopic astigmatism.","authors":"Sahar Mohaghegh, Shahram Bamdad, Haleh Kangari, Saeed Rahmani","doi":"10.3389/fopht.2025.1532931","DOIUrl":"10.3389/fopht.2025.1532931","url":null,"abstract":"<p><strong>Aim: </strong>To investigate associations between refractive error components and higher-order aberrations (HOAs) in adult myopic subjects.</p><p><strong>Methods: </strong>A total of 1370 myopia right eyes, aged 18-40, were included in a cross-sectional study. Subjective cycloplegic refractions and distance aberrometry measured with a Shack-Hartmann device were analyzed. Zernike components of horizontal coma (Z<sub>3</sub> <sup>1</sup>), vertical coma (Z<sub>3</sub> <sup>-1</sup>), oblique trefoil (Z<sub>3</sub> <sup>3</sup>), vertical trefoil (Z<sub>3</sub> <sup>-3</sup>), spherical aberration, and total root-mean-square (RMS) wave-front error for 6 mm pupil were analyzed. Pearson's correlations were calculated between sphero-cylindrical components and HOAs based on vector analysis for the astigmatism axis. Total subjects were divided into two subgroups: simple myopia (SMY, 648 eyes) and compound myopic astigmatism (CMA, 722 eyes). HOAs were compared between the two subgroups.</p><p><strong>Results: </strong>Total RMS wave-front error correlates with spherical equivalent myopia (r = -0.1, P<0.05) and J45 (r = 0.1, P<0.001). J0 correlates positively with vertical coma (Z<sub>3</sub> <sup>-1</sup>) (r = 0.1 p <0.001) and negatively with oblique trefoil (Z<sub>3</sub> <sup>3</sup>) and vertical trefoil (Z<sub>3</sub> <sup>-3</sup>), (r = -0.1, p < 0.001; r = -0.1, P < 0.05). The total RMS wavefront-error was larger in the CMA (|0.37| ± 0.18 µm) compared to the SMY (|0.34| ± 0.16 µm, P <0.001). The mean values of vertical coma (Z<sub>3</sub> <sup>-1</sup>), vertical trefoil (Z<sub>3</sub> <sup>-3</sup>), and oblique trefoil (Z<sub>3</sub> <sup>3</sup>) differed between the two subgroups.</p><p><strong>Conclusion: </strong>Total RMS wave-front error increases with increasing myopia and astigmatism. Increasing myopia power does not show a systematic correlation with HOAs components. A weak systematic correlation is suggested between astigmatism direction and third-order aberrations.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1532931"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in ophthalmologyPub Date : 2025-03-13eCollection Date: 2025-01-01DOI: 10.3389/fopht.2025.1506445
Emmanuel Lee Boniao, Alexander Gungab, Blanche Xiao Hong Lim, Gangadhara Sundar
{"title":"Pediatric orbital fractures in Singapore: demographics, etiology, and the role of bioresorbable implants.","authors":"Emmanuel Lee Boniao, Alexander Gungab, Blanche Xiao Hong Lim, Gangadhara Sundar","doi":"10.3389/fopht.2025.1506445","DOIUrl":"10.3389/fopht.2025.1506445","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to analyze the demographic characteristics, etiology, fracture types, interventions and treatment outcomes, with a focus on the increasing role of bioresorbable implants compared to traditional non-resorbable implants in pediatric orbital fractures.</p><p><strong>Methods: </strong>This was a retrospective cohort study conducted at the Department of Ophthalmology, National University Hospital, Singapore, of pediatric patients (aged 18 years or younger) treated surgically for orbital fractures from January 2005 to May 2023. Data was extracted from the hospital's electronic medical records, including demographic details, causes of fractures, types of fractures, implants used (bioresorbable and non-bioresorbable), and clinical outcomes.</p><p><strong>Results: </strong>43 cases of pediatric orbital and orbitofacial fractures met the criteria undergoing surgical intervention. Most occurred in males (81.4%, n=35). Causes of fractures were sports-related incidents and play (46.5%, n=20), assault (30.2%, n=13), road-traffic accidents (16.3%, n=7), and non-play related accidents (7%, n=3). Most pediatric orbital fractures were unilateral (88%, n=38). While most were pure or simple orbital fractures (74.4% n=32), 25.6% (n=11) were complex orbitofacial fractures. Amongst simple orbital fractures, blowout fractures (91%, n=29) were the most common, involving the inferior (58.6%, n=17), combined floor and medial wall (20.6%, n=6), medial wall (13.8%, n=4) and roof (6.9%, n=2). Amongst the complex fractures, zygomaticomaxillary complex fractures were the most frequent (45.4%, n=5), followed by cranioorbital fractures (27.3%, n=3) and Le Fort II & III fractures (27.3%, n=3). Orbital tissue entrapment was common (56%, n=24), and most patients with entrapment underwent urgent surgical intervention (65%, n=28), usually within 24 hours (53%, n=23). The majority of those who underwent surgery had implants placed (89%, n=25), with most being bioresorbable (64.3%, n=18). All patients (100%) who underwent surgery showed clinical improvement without significant complications.</p><p><strong>Conclusion: </strong>Although simple pediatric orbital blowout fractures are still the most common among pediatric patients, the study showed that a quarter of them presented with complex orbitofacial fractures requiring multidisciplinary management. Most fractures occurred in males and typically associated with increasing play and physical activity in teenagers. The study also showed that early intervention is crucial to better outcome, with the increasing role of bioresorbable implants in this population reducing long term implant related complications.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1506445"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontiers in ophthalmologyPub Date : 2025-03-13eCollection Date: 2025-01-01DOI: 10.3389/fopht.2025.1547363
Ruiping Gu, Yue Guo, Yuan Zong, Rui Jiang, Zhongcui Sun
{"title":"Levitation of posteriorly dislocated intraocular lens: I.V. catheter connected to the vitreotome aspiration.","authors":"Ruiping Gu, Yue Guo, Yuan Zong, Rui Jiang, Zhongcui Sun","doi":"10.3389/fopht.2025.1547363","DOIUrl":"10.3389/fopht.2025.1547363","url":null,"abstract":"<p><strong>Background: </strong>To introduce a new, simple, and affordable technique that uses a 22G intravenous (I.V.) catheter connected to the vitreotome aspiration to lift the intraocular lens (IOLs) off the retina.</p><p><strong>Methods: </strong>This retrospective, non-comparative, single surgeon, interventional, consecutive case series examined 4 patients (4 eyes) who underwent the surgical procedure from March 12 and October 22, 2023. Reliability, reproducibility, and intraoperative and postoperative complications of the technique were analyzed.</p><p><strong>Results: </strong>Four patients presenting with posteriorly dislocated IOLs were included. After a complete 23G vitrectomy under wide-angle viewing system or high magnification contact lens, the 22G I.V. catheter was connected to the vitreotome aspiration and active aspiration was applied. When the IOLs were lifted towards the posterior chamber by continuous vacuum aspiration, they were be safely grasped using intraocular forceps and reposited with scleral fixation suturing or removed through a limbal incision. None of the IOLs fell during active aspiration.</p><p><strong>Conclusion: </strong>Connection of I.V. catheter with vitreotome aspiration to lift the IOLs off the retina was a new, simple, safe, and affordable technique.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1547363"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}