Frontiers in ophthalmology最新文献

{"title":"Comparing visual outcomes in matched patients receiving a low cylinder power toric IOL or a non-toric IOL.","authors":"Kjell G Gundersen, Richard Potvin, Steffen A Østenstad","doi":"10.3389/fopht.2026.1755069","DOIUrl":"10.3389/fopht.2026.1755069","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate visual and refractive outcomes of the Alcon Clareon^® T2 toric IOL (1.00 D cylinder at the IOL plane, ~ 0.65 D at the corneal plane) versus the Clareon^® non-toric IOL.</p><p><strong>Setting: </strong>Single ophthalmology clinic in Haugesund, Norway.</p><p><strong>Methods: </strong>This was an exploratory single site randomized, unmasked, prospective clinical trial. The study was registered with clinicaltrials.gov (NCT06717607, registered retrospectively on 12/5/2024). Patients presenting for routine cataract surgery in one or both eyes, where at least one eye qualified for implantation of the T2 lens, were enrolled. Qualifying eyes were randomized to a T2 lens or a non-toric lens. Subjects were evaluated monocularly before surgery and three months postoperative. Testing included uncorrected and corrected distance visual acuity (VA), the manifest refraction, low contrast VA (photopic and mesopic, with and without glare) and contrast sensitivity (photopic and mesopic). These latter two tests were conducted with the distance correction in place.</p><p><strong>Results: </strong>Fifty eyes of 43 subjects were successfully enrolled from 6/2022 to 5/2024, including 30 eyes (25 subjects) randomized to the toric IOL and 20 eyes (18 subjects) to the non-toric IOL. Analysis included all enrolled eyes. Subjects were matched for age (p = 0.59), sex (p = 0.30), mean keratometry (p = 0.44), anterior corneal astigmatism (p = 0.97), axial length (p = 0.12) and anterior chamber depth (p = 0.40). Postoperatively, there was no statistically significant difference in the spherical equivalent refraction (p = 0.08). Residual refractive cylinder was statistically significantly lower in the T2 group (0.22 ± 0.22 D vs. 0.59 ± 0.28 D, p < 0.01). The T2 group also had statistically significantly better uncorrected logMAR distance VA than the non-toric group (0.00 ± 0.08 vs. 0.09 ± 0.13, p < 0.01). Low contrast VA was not statistically significantly different between the two lens types under any test condition (p = 0.49 or higher in all cases), nor were photopic or mesopic contrast sensitivity (p = 0.71 and p = 0.63, respectively).</p><p><strong>Conclusions: </strong>Use of the low cylinder power toric IOL provided significantly better UDVA, with no significant differences in distance-corrected contrast sensitivity or low contrast acuity. The achieved cylinder correction was consistent with expectations.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/, identifier NCT06717607.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1755069"},"PeriodicalIF":2.4,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687025","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":"Surgical management of sickle cell retinopathy: a systematic review of clinical outcomes and a single-arm meta-analysis of single-surgery anatomical success.","authors":"Maher Nassor, Ahmed Bakr, Usman Muhammad, Marwan Tahoun","doi":"10.3389/fopht.2026.1842211","DOIUrl":"10.3389/fopht.2026.1842211","url":null,"abstract":"<p><strong>Introduction: </strong>Sickle cell retinopathy is a consequence of sickle cell disease that results from vascular complications. Sickle cell disease is predominantly prevalent in Africa, evidenced by 20% to 30% of the population in Gabon, Cameroon, and Ghana being affected by it. This systematic review aims to evaluate the surgical outcomes of patients with sickle cell retinopathy to inform evidence-based management of late stages of sickle cell retinopathy.</p><p><strong>Methods: </strong>This systematic review was conducted in accordance with the PRISMA 2020 guidelines. A Literature search was conducted on PubMed, Embase (Ovid), and Cochrane (CENTRAL) on 05/08/2025. Inclusion criteria included studies with patients with sickle cell retinopathy who underwent surgery and reported anatomical and/or visual outcomes. A random effects single-arm meta-analysis was carried out in the anatomical success group using JASP software, and the risk of bias was evaluated using JBI and RoB2 tools.</p><p><strong>Results: </strong>7 studies, comprising 408 eyes, were included. Overall, the evidence showed that surgical treatment in patients with sickle cell retinopathy results in improved final visual acuity and high single-surgery anatomical success (SSAS, between 60% to 83%). The pooled SSAS data, based on logit-transformed proportions, yielded an effect of 0.83 (95% CI: 0.24-1.42), corresponding to a pooled SSAS of approximately 70% (95% CI: 56-80%), with low, non-significant heterogeneity among the included studies (Q (4) = 5.61, p = 0.230; I² = 29.73% [0.00, 92.46]). Leave-one-out sensitivity analysis confirmed that the estimate was robust, with the pooled SSAS ranging from approximately 66% to 74% across iterations.</p><p><strong>Discussion: </strong>Studies have reported a considerable gain in final visual acuity and anatomical success in patients undergoing surgery for sickle cell retinopathy. The small number of studies and small sample sizes increase heterogeneity. Therefore, although the results indicate favourable surgical outcomes, clinicians must weigh up the benefits of surgery against possible complications. In conclusion, more studies are warranted to guide evidence-based medicine.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251165357, identifier CRD420251165357.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1842211"},"PeriodicalIF":2.4,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686201","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":"Optical coherence tomography acquisition efficiency: comparison of Heidelberg spectralis OCT2 module & Zeiss Cirrus HD-OCT model 6000.","authors":"Charissa H Tan, Michael S Jensen, Shannon Fitch, Richard Ordonez, Abigail Jacketta, Jeff Courtright, Jonathan Shepherd, Mathew Vierkant, Paul Crown, Ben J Brintz, Susan Chortkoff, Brian C Stagg","doi":"10.3389/fopht.2026.1828559","DOIUrl":"10.3389/fopht.2026.1828559","url":null,"abstract":"<p><strong>Aims: </strong>To compare optical coherence tomography (OCT) acquisition times between the Heidelberg SPECTRALIS OCT2^® module (Spectralis OCT2) and Zeiss CIRRUS™ HD-OCT Model 6000 (Cirrus 6000) in a glaucoma clinic setting.</p><p><strong>Methods: </strong>A prospective observational study of 37 glaucoma or glaucoma suspect patients (72 eyes) aged ≥50 years undergoing routine imaging. Each participant received OCT imaging on both platforms during the same visit, with device order randomized. Acquisition times for optic disc/retinal nerve fiber layer (RNFL) and macular scans were recorded using a standardized protocol. Subgroup analyses were performed for eyes with vision worse than 20/40. Image quality and repeat attempts were documented.</p><p><strong>Results: </strong>Total scan time was significantly faster by 41 seconds per person using Cirrus 6000 compared to Spectralis OCT2 (115.9 ± 44.7 vs. 157 ± 46.4 seconds; p < 0.001). Cirrus 6000 also demonstrated significantly shorter RNFL acquisition times (50.8 ± 29.7) compared to Spectralis OCT2 (99.5 ± 32.7 seconds; p < 0.001). Macular scan times did not differ significantly (p = 0.180). Spectralis OCT2 achieved higher completion rates and required fewer repeat attempts. Image quality scores met manufacturer thresholds for acceptable scans in most cases, though direct cross-device comparison is precluded by different scoring scales.</p><p><strong>Conclusions: </strong>Cirrus 6000 offers meaningful time savings for RNFL imaging, which may improve workflow efficiency in high volume glaucoma clinics. However, Spectralis OCT2 demonstrated greater reliability in challenging imaging conditions. Device selection should be individualized based on patient characteristics, clinic workflow, and imaging priorities. There is no single superior platform; aligning device capabilities with clinical needs can optimize both efficiency and diagnostic reliability in glaucoma care.</p><p><strong>Precis: </strong>The Cirrus 6000 achieved significantly faster OCT acquisition times while the Spectralis OCT2 demonstrated greater reliability in challenging imaging conditions. These differences highlight how platform selection can influence workflow efficiency and imaging success in glaucoma clinics.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1828559"},"PeriodicalIF":2.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671451","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":"Long-term Impact of Intravitreal Injections on the ocular surface; a 2-year follow-up study.","authors":"Agni Malmin, Markus Vicente Tørud Olsen, Vilde Marie Thomseth, Inga-Britt Kjellevold Haugen, Tor Paaske Utheim, Vegard Asgeir Forsaa","doi":"10.3389/fopht.2026.1829818","DOIUrl":"10.3389/fopht.2026.1829818","url":null,"abstract":"<p><strong>Background: </strong>Intravitreal injection (IVI) therapy is the most frequently performed intraocular procedure worldwide, with topical povidone-iodine (PVP-I) as the standard pre-injection antiseptic. However, PVP-I has been shown to exert cytotoxic effects on the ocular surface. The purpose of this study was to evaluate the impact of two years of serial anti-vascular endothelial growth factor (VEGF) IVI on ocular surface parameters.</p><p><strong>Methods: </strong>Patients with neovascular age-related macular degeneration (nAMD) receiving unilateral intravitreal anti-VEGF injections were examined at two time points, separated by a two-year interval. An aseptic protocol with PVP-I was applied prior to each injection. Tear meniscus height (TMH), bulbar redness (BR), and meibomian gland (MG) loss were assessed using the Oculus Keratograph 5M, with the fellow eye serving as control. For statistical analysis, the related-samples Wilcoxon signed-rank test was applied to non-normally distributed data, and the paired-sample Student's t-test to normally distributed data.</p><p><strong>Results: </strong>Sixty patients (mean age, 78.6 ± 8.5 years; range, 55-96) were included. Between examinations, patients received a mean of 15.5 ± 6.5 IVI (range, 5-30). A significant increase in mean BR was observed in untreated fellow eyes compared with baseline measurements (1.68 ± 0.47 vs. 1.41 ± 0.46; <i>p</i> < 0.001). At follow-up, BR was significantly higher in fellow eyes than in treated eyes (<i>p</i> < 0.001), and this difference had increased over the study period. Median TMH increased significantly in untreated eyes (0.42 mm [IQR, 0.28-0.57] vs. 0.31 mm [IQR, 0.23-0.47]; <i>p</i> = 0.003), whereas the increase in treated eyes was not significant (<i>p</i> = 0.74). At follow-up, mean TMH did not differ significantly between treated and fellow eyes (<i>p</i> = 0.15). Both treated and untreated eyes showed significant MG loss after two years of serial IVI; however, no significant differences in mean MG loss were detected between eyes in either the upper or lower eyelid at follow-up.</p><p><strong>Conclusions: </strong>Eyes receiving repeated intravitreal anti-VEGF injections with preoperative PVP-I antisepsis were significantly less hyperemic than fellow untreated eyes, and this difference increased over two years of continued treatment. Potential mechanisms include a beneficial alteration of the ocular surface microbiome by PVP-I or an antiangiogenic effect of anti-VEGF therapy.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/study/NCT04458012, identifier NCT04458012.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1829818"},"PeriodicalIF":2.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655152","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":"Successful outcomes of pediatric dacryocystorhinostomy with adjunctive 5-fluorouracil.","authors":"Alina K Sinha, Ethan L Kahana, Tomas E Meijome, Adam Jacobson, Jane Z Spadaro, Stella Y Chung, Alon Kahana","doi":"10.3389/fopht.2026.1805226","DOIUrl":"10.3389/fopht.2026.1805226","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether nasal intramucosal 5-fluorouracil (5-FU) injection improves outcomes after external dacryocystorhinostomy (DCR) in pediatric patients with nasolacrimal duct obstruction (NLDO).</p><p><strong>Methods: </strong>Multi-center retrospective non-comparative case series review of all DCR cases with intra-operative 5- FU injection performed between 2014 and 2023 on all patients age < 18 years. Each case was reviewed to determine if the patients had epiphora recurrence following surgery with 5-FU injection.</p><p><strong>Results: </strong>Sixteen pediatric patients with NLDO (19 eyes) underwent DCR and nasal intramucosal injections of 5-FU intra-operatively. One had a lost stent. Ten (53%) eyes were in patients with craniofacial syndromes. In all patients with the use of 5-FU there was no recurrence of tearing. Eight of the patients (42%) had already had at least one or two failed stents prior in which recurrence had occurred. There were no post-operative complications.</p><p><strong>Conclusion: </strong>Adjuvant intramucosal 5-FU demonstrated a 100% success rate of epiphora not recurring following pediatric DCR without any complications in this small sample size, particularly in patients with increased risk of recurrence.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1805226"},"PeriodicalIF":2.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655199","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":"Differential tear metabolomics in blepharokeratoconjunctivitis and herpes simplex keratitis: potential biomarkers for clinical differentiation.","authors":"Zi-Wen Wang, Zhen-Ning Wu, Hui-Zhen Wang, Shi-You Zhou","doi":"10.3389/fopht.2026.1842136","DOIUrl":"10.3389/fopht.2026.1842136","url":null,"abstract":"<p><strong>Objective: </strong>To characterize tear metabolomic differences between active blepharokeratoconjunctivitis (BKC) and herpes simplex keratitis (HSK; epithelial type) and identify diagnostic biomarkers.</p><p><strong>Methods: </strong>Tear samples were collected from 24 HSK patients, 19 BKC patients, and 15 healthy controls from October 2020 to 2021. Diagnoses were confirmed by clinical manifestations, medical history, and nested PCR (nPCR). Metabolomic profiling was performed via LC-MS/MS, and data were analyzed using MetaboAnalyst 5.0.</p><p><strong>Results: </strong>Compared to healthy controls, HSK exhibited 21 altered metabolites, while BKC showed 19 altered metabolites. After FDR correction, L-isoleucine, L-phenylalanine, pantothenol were significantly expressed lower in both HSK and BKC. Moreover, 4-dodecylbenzenesulfonic acid, carnosol were lower in HSK-specific, and sorbitol was lower in BKC-specific than in control. A combined panel of metabolites 4-dodecylbenzenesulfonic acid, carnosol and sorbitol showed good specificity and sensitivity for differentiation of BKC/HSK. All of them showed significant differences with area under curve values exceeding 0.79.</p><p><strong>Conclusion: </strong>The disease-specific differential expression of carnosol, 4-dodecylbenzenesulfonic acid in HSK, and sorbitol in BKC provide mechanistic insights into HSV-1 infection and chronic immune-mediated ocular surface inflammation, respectively. The combination of clinical signs with nPCR result and a metabolite panel (4-Dodecylbenzenesulfonic Acid+ Carnosol +Sorbitol) may be optimal for HSK/BKC discrimination.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1842136"},"PeriodicalIF":2.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13414838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622781","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":"PCG with biallelic CYP1B1 and CPAMD8 variants: a longitudinal case report.","authors":"Khaled Abu-Amero, Gorka Sesma","doi":"10.3389/fopht.2026.1829921","DOIUrl":"10.3389/fopht.2026.1829921","url":null,"abstract":"<p><p>Primary congenital glaucoma (PCG) is a rare developmental disorder caused by dysgenesis of the trabecular meshwork and anterior chamber angle. We report a five-year longitudinal case of severe bilateral PCG in a male presenting at two months of age with photophobia, tearing, corneal edema, and markedly elevated intraocular pressure (IOP). The patient required four surgical interventions, including deep sclerectomy with mitomycin C and trabeculotomy ab externo, to achieve long-term IOP control. Serial axial length measurements documented rapid buphthalmos, and ultrasound biomicroscopy revealed progressive posterior staphyloma, peripheral anterior synechiae, and iris thinning consistent with anterior segment dysgenesis (ASD). Whole exome sequencing identified compound heterozygosity: <i>CYP1B1</i> c.182G>A (p.G61E), the well-characterized Saudi founder mutation for PCG, and <i>CPAMD8</i> c.3061G>A (p.V102M), a novel ultra-rare variant predicted to be damaging. The coexistence of these two heterozygous variants in genes affecting complementary anterior segment developmental pathways supports a digenic inheritance model. To our knowledge, this is the first reported case of combined <i>CYP1B1</i> and <i>CPAMD8</i> variants in congenital glaucoma, underscoring the value of comprehensive genetic analysis in severe or atypical pediatric glaucoma presentations.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1829921"},"PeriodicalIF":2.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13414795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622834","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":"Early retinal volume changes after switching to brolucizumab in refractory neovascular age-related macular degeneration.","authors":"Takaaki Matsuki, Kunihiko Akiyama, Ken Watanabe, Toru Noda, Mariko Sasaki","doi":"10.3389/fopht.2026.1872499","DOIUrl":"10.3389/fopht.2026.1872499","url":null,"abstract":"<p><strong>Background: </strong>This retrospective observational study primarily focused on the evaluation of early anatomical changes and intraocular inflammation (IOI) following the switch to intravitreal injection of brolucizumab (IVBr) in patients with neovascular age-related macular degeneration (nAMD) who were refractory to aflibercept or ranibizumab and unable to extend injection interval beyond 10 weeks while resolving retinal fluids.</p><p><strong>Results: </strong>Data from 23 patients were analyzed. Switch to brolucizumab resulted in rapid decreases in central foveal retinal thickness (CRT) (247 (130) to 227 (94)) μm, P < 0.001), pigment epithelial detachment volume (0.18 (0.47) to 0.11 (0.19) mm³, P = 0.04) and central choroidal thickness (159 (118) to 168 (78) μm, P = 0.018), although decrease in central retinal volume (CRV) (9.80 (1.40) to 9.70 (1.30) mm³, P = 0.111) was not significant.Three eyes exhibited IOI, observed on post-injection day 2 after the second IVBr. Two eyes exhibited only mild anterior chamber inflammation, while one eye exhibited vasculitis obliterans. While CRT decreased, CRV increased in all three eyes.As a <i>post-hoc</i> analysis, CRV in eyes without IOI exhibited significant decrease (9.90 (1.45) to 9.70 (1.20) mm³, P = 0.002).</p><p><strong>Conclusion: </strong>Switch to brolucizumab therapy resulted in early anatomical changes. An increase in CRV despite improvement in central foveal parameters may represent a potential warning sign of brolucizumab-associated IOI and warrants further prospective validation.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1872499"},"PeriodicalIF":2.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13414279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622829","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":"Cataract and glaucoma surgery in microphthalmic, nanophthalmic, and high hyperopic eyes: a systematic review and meta-analysis.","authors":"Rebecca Zheng Li, Abdullah Virk, David Bulanov, Justin Zhang, Eugene Wang, Henry Qin, Trang Bui, Karen Allison","doi":"10.3389/fopht.2026.1872292","DOIUrl":"10.3389/fopht.2026.1872292","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Topic: &lt;/strong&gt;This systematic review and meta-analysis evaluates refractive error (RE), visual acuity (VA), intraocular pressure (IOP), and anterior chamber depth (ACD) outcomes following surgical procedures in adults (≥ 18 years) with nanophthalmos, microphthalmos, and high hyperopia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance: &lt;/strong&gt;Nanophthalmos, microphthalmos, and high hyperopia are a spectrum of anatomic variants characterized by short axial length and crowded anterior segment. These features create significant risks for angle-closure glaucoma and complex cataract surgery. As existing literature is fragmented and limited to small case series, this study provides a comprehensive evaluation of surgical safety and efficacy in these high-risk populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a search was conducted across five databases (Cochrane, PubMed, Scopus, Ovid MEDLINE, and Embase via Ovid) for studies published between January 2010 and December 2024. Eligible studies reported original clinical data on surgical interventions for adult (≥ 18 years) patients with nanophthalmos, microphthalmos, or high hyperopia with concomitant cataract or glaucoma. Meta-analysis, subgroup analysis, and meta-regression were performed to assess changes in RE, VA, IOP, and ACD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Meta-analysis of 21 articles involving 957 patients (1,110 eyes) suggests that surgical intervention is associated with improvement in clinical parameters across a spectrum of short eyes. Standalone phacoemulsification significantly reduced RE in nanophthalmic eyes (mean difference (MD) = -13.20 diopters (D); 95% confidence interval (CI): -15.19, -11.22; Q = 3.51, p = 0.48, I&lt;sup&gt;2&lt;/sup&gt; = 0.0%) at medium-term follow-up and in high hyperopic eyes (MD = -9.23 D; 95% CI: -15.02, -3.45; Q = 322.19, p &lt; 0.001, I&lt;sup&gt;2&lt;/sup&gt; = 97.8%) at medium-term follow-up with high heterogeneity in the effects. Standalone phacoemulsification significantly improved VA in nanophthalmic eyes at both short-term (MD = -0.66 logarithm of the minimum angle of resolution (logMAR); 95% CI: -1.30, -0.02; Q = 98.45, p &lt; 0.001, I&lt;sup&gt;2&lt;/sup&gt; = 97.0%) and medium-term (MD = -0.70 logMAR; 95% CI: -1.30, -0.09; Q = 97.14, p &lt; 0.001, I&lt;sup&gt;2&lt;/sup&gt; = 93.8%) follow-up with high heterogeneity in the effects. In contrast, phacoemulsification + filtering surgery resulted in a significant worsening in VA at short-term follow-up for nanophthalmic eyes (MD = 0.28 logMAR; 95% CI: 0.21, 0.35; Q = 1.24, p = 0.27, I&lt;sup&gt;2&lt;/sup&gt; = 19.4%). Significant IOP reduction was achieved primarily through combined procedures in both nanophthalmic and microphthalmic eyes. Presence of concomitant glaucoma was associated with a greater reduction in IOP across all axial lengths. Significant ACD deepening was achieved across all axial lengths (MD = 1.30 millimeters (mm), 95% CI: 0.86, 1.74; Q = 244.55, p &lt; 0.001, I&lt;sup&gt;2","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1872292"},"PeriodicalIF":2.4,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13407367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610791","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":"Subepithelial nevus and papilloma of the lacrimal caruncle: a case report and literature review.","authors":"Siriphat Daocharoenporn, Weerawan Chokthaweesak, Chawawat Kangwanwongpaisan, Siroratt Narkcham, Bunyada Putthirangsiwong","doi":"10.3389/fopht.2026.1766863","DOIUrl":"10.3389/fopht.2026.1766863","url":null,"abstract":"<p><strong>Background: </strong>Lacrimal caruncular tumors are rare and exhibit a diversity of possible histopathological types. The majority of caruncular tumors are benign, followed by premalignant and malignant lesions, which are associated with a poorer prognosis. Clinical diagnosis is challenging. Therefore, a tissue biopsy is considered and performed based on the presence of features suggesting malignant or undetermined tumors for a definite diagnosis and proper management. The coexistence of different types of benign caruncular tumors is extremely rare and has been rarely described.</p><p><strong>Case presentation: </strong>We herein describe the case of a 63-year-old Thai woman with a history of chronic progressive painless visual loss in her right eye who reported a non-progressive painless hyperpigmented mass without a history of associated contact bleeding on her left lacrimal caruncle. Ophthalmic examination revealed a large hyperpigmented choroidal mass with adjacent exudative retinal detachment in her right eye and a papilliform pinkish lesion over a well-defined, homogeneous, hyperpigmented mass on her left caruncle. Magnetic resonance imaging (MRI) scans of the orbit indicated a malignant choroidal melanoma in her right eye. The regional and distant metastatic work-ups were unremarkable. The patient was treated with a right globe enucleation concurrent with complete tumor removal of the left caruncular mass based on the presence of intratumorally dilated vessels with a feeding vessel to the overlying papilliform lesion, raising suspicion of malignancy, using the no-touch technique, followed by double freeze-thaw cryotherapy. Histopathological examination disclosed a choroidal melanoma in the right eye and a subepithelial caruncular nevus with an overlying conjunctival papilloma emerging from the conjunctival epithelium of the nevus in the left eye. The patient made a complete recovery with no evidence of recurrence at the 12-month follow-up.</p><p><strong>Conclusion: </strong>Coexistence of benign caruncular tumors is extremely rare. We report a rare case of a subepithelial nevus combined with a papilloma at the lacrimal caruncle. Complete tumor resection using the no-touch technique is the primary treatment. Adjunctive double freeze-thaw cryotherapy may be considered to further prevent tumor cell seeding and postoperative recurrences.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1766863"},"PeriodicalIF":2.4,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610714","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}