Frontiers in ophthalmology最新文献

{"title":"Postoperative complications after cataract surgery with and without concurrent minimally invasive glaucoma surgery in patients with primary open angle glaucoma: a comparative risk analysis.","authors":"Sinan Ersan, Abdullah Virk, Daniel Zhu, Charles Zhang, Rebecca Zheng Li, Karen M Allison","doi":"10.3389/fopht.2026.1830822","DOIUrl":"10.3389/fopht.2026.1830822","url":null,"abstract":"<p><strong>Background: </strong>Primary open-angle glaucoma (POAG) is the most common form of glaucoma and a leading cause of irreversible blindness worldwide. Treatment focuses on lowering intraocular pressure (IOP), often through cataract extraction with intraocular lens implantation (CE/IOL) alone or combined with minimally invasive glaucoma surgery (MIGS). However, comparative postoperative complication risks between these approaches remain unclear.</p><p><strong>Methods: </strong>This retrospective cohort study utilized the TriNetX US Collaborative Network to identify all adults (ages ≥18 years) with a diagnosis of POAG who underwent CE/IOL with or without concurrent MIGS between 2006 and 2026. The cumulative postoperative incidence of hyphema, cystoid macular edema (CME), retinal detachment (RD), and endophthalmitis were evaluated at four time intervals up to 90 days postoperatively. Propensity score matching was used to balance baseline characteristics and reduce confounding. Outcomes were compared using relative risks with 95% confidence intervals, and <i>P</i>-values were calculated using chi-square tests.</p><p><strong>Results: </strong>After propensity score matching, each routine cataract surgery cohort (with and without MIGS) comprised 7, 998 patients. Patients undergoing CE/IOL with MIGS had a significantly higher rate of hyphema compared with patients undergoing CE/IOL alone at all reported postoperative time points, with a cumulative incidence of 1.19% versus 0.15% at 1-90 days after surgery, respectively (P<0.0001). Conversely, the cumulative incidence of CME (2.585% vs 2.376%, <i>P</i> = 0.3993), RD (0.215% vs 0.139%, <i>P</i> = 0.2566) and endophthalmitis (0.276% vs 0.15%, <i>P</i> = 0.0862) at 1-90 days postoperatively at 1-90 days postoperatively were not statistically different between groups. Similar associations were observed among patients undergoing routine or complex CE/IOL combined with MIGS compared with those undergoing routine or complex CE/IOL alone with respect to hyphema, CME, and RD.</p><p><strong>Conclusions: </strong>In this large retrospective cohort study, combined CE/IOL with MIGS was associated with a significantly increased risk of postoperative hyphema, while rates of CME, RD, and endophthalmitis remained comparable to CE/IOL alone.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1830822"},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427020","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":"Effects of age on the genetic and clinical characteristics of retinitis pigmentosa.","authors":"Yoshito Koyanagi, Sakurako Shimokawa, Takahiro Hisai, Kaho Yamamoto, Yasuhiro Ikeda, Koh-Hei Sonoda, Yusuke Murakami","doi":"10.3389/fopht.2026.1776570","DOIUrl":"10.3389/fopht.2026.1776570","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate how age affects the genetic and clinical characteristics of retinitis pigmentosa (RP), focusing on the detectability of causative genes and the age at disease onset.</p><p><strong>Methods: </strong>We conducted a single-center study of 506 patients with RP who underwent comprehensive genetic testing through targeted resequencing of 83 known RP-associated genes using next-generation sequencing. Patients were stratified by age at study entry into six groups: <40 years (20-39), 40s (40-49), 50s (50-59), 60s (60-69), 70s (70-79), and ≥80 years. Detection rates of causative genes were calculated and compared across age groups using the Cochran-Armitage trend test. Genetically solved cases included 42 with <i>EYS</i>, 19 with <i>USH2A</i>, 9 with <i>RP1</i>, 14 with <i>RHO</i>, and 7 with <i>RPGR</i>. Clinical data were collected retrospectively. Age at onset was defined as the age when the patient first noticed night blindness, visual field constriction, or decreased best corrected visual acuity. Age at onset was compared across causative genes using an one-way analysis of variance (ANOVA). For pairwise comparisons, the Wilcoxon rank-sum test was applied with Bonferroni correction to adjust for multiple testing.</p><p><strong>Results: </strong>The mean age of participants was 58.8 years, and our sample included 235 males and 271 females. Case numbers by age group were as follows: <40 years, 58; 40s, 92; 50s, 94; 60s, 125; 70s, 104; and ≥80 years, 33. Detection rates of causative genes declined steadily with age: 39.7% (<40), 41.3% (40s), 36.2% (50s), 27.2% (60s), 19.2% (70s), and 3.0% (≥80), showing a statistically significant trend (p = 8.22 × 10^-7, Cochran-Armitage trend test). In subset analysis, mean onset ages were <i>RPGR</i> (5.2 years), <i>EYS</i> (19.5 years), <i>RHO</i> (24.3 years), <i>RP1</i> (25.2 years), and <i>USH2A</i> (34.1 years), indicating a significant difference among genes (p < 0.001). Pairwise comparisons showed significantly earlier onset in the <i>RPGR</i> group relative to <i>USH2A</i> (p = 0.004).</p><p><strong>Conclusions: </strong>The detection rate of known causative genes of RP was lower in the elderly patients, potentially reflecting factors associated with a late-onset phenotype.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1776570"},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427048","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":"Teleophthalmology for triage and management of corneal pathologies at vision centres: a prospective observational service evaluation study in north India.","authors":"Nikunj Vinodbhai Patel, Meenal Kataria, Manvi Aggarwal, Nagma Ansari, Atanu Majumdar, Shalinder Sabherwal, Birendra Singh, Umang Mathur, Manisha Acharya","doi":"10.3389/fopht.2026.1867442","DOIUrl":"10.3389/fopht.2026.1867442","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the feasibility of teleophthalmology for triage and management of corneal diseases at vision centres (VCs) in rural and semi-urban North India.</p><p><strong>Methods: </strong>All patients presenting to the VCs with corneal pathology who underwent teleconsultation for corneal disease during the study period (March-September 2024) were included in the study. Those who reported before or after the study period were not included. After registration and preliminary examination at the VC, unstained and stained images of patients with corneal pathologies were sent to an in-training cornea fellow at the tertiary centre via a web-based application. Management at the VC was carried out by vision technicians under specialist supervision; acute cases received preliminary emergency care and were referred to a secondary care hospital. Non-acute pathologies were managed at the primary level or referred as needed. Primary outcomes were the proportion of patients managed at VCs versus those referred, and compliance with referrals. Secondary outcomes were factors influencing referral compliance and reporting timelines for emergency and non-emergency cases.</p><p><strong>Results: </strong>Of 4, 825 patients with corneal disease, 2, 022 (41.91%) were managed at VCs, while 2, 803 (58.09%) were referred. Hot (acute/emergency) corneal cases comprised 1, 852; cold (non-acute/non-emergency) cases comprised 2, 973. Overall referral compliance was 27.58% (772/2, 803 referred cases). Regression analysis identified significant predictors of referral uptake, including proximity to hospitals and longer-established centres (p<0.001 for most associations). Acute cases and those from centres more than one year old were more likely to reach the hospital after referral.</p><p><strong>Conclusions: </strong>Teleconsultation provided by specialist ophthalmologists enabled local triage and management of corneal diseases at the primary level, reduced unnecessary referrals, and helped counsel patients in emergency conditions. This model can be adopted by other ocular specialities and strengthen primary care in resource-constrained areas.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1867442"},"PeriodicalIF":2.4,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13337378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407245","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":"Orbital metastasis from breast carcinoma: structured literature review and report of four cases.","authors":"Christian Kim, Mica Bergman, Roxana Fu, Caroline Vargason, Michael A Burnstine","doi":"10.3389/fopht.2026.1749352","DOIUrl":"10.3389/fopht.2026.1749352","url":null,"abstract":"<p><strong>Purpose: </strong>Breast carcinoma is the most commonly diagnosed cancer worldwide and represents the most common primary tumor metastasizing to the orbit. Herein, we present the largest review of the clinical features of orbital metastases from breast carcinoma reported in the literature and describe four additional patients.</p><p><strong>Methods: </strong>Case reports and case series of biopsy-proven orbital metastases from breast carcinoma published between 2011 and 2025 were identified through a MEDLINE search. Of 220 records screened, 63 articles (29%) met inclusion criteria. Titles, abstracts, and full texts were reviewed for eligibility. Data extracted included patient demographics, tumor subtype and receptor status, timing of breast cancer diagnosis relative to orbital presentation, clinical features, imaging findings, treatments, and survival outcomes.</p><p><strong>Results: </strong>Sixty-nine cases of breast carcinoma metastatic to the orbit from 63 articles were reviewed. The majority of patients were female (66 of 69, 96%). The average age at presentation of orbital symptoms was 60 years. Orbital metastasis was the presenting manifestation of breast cancer in 30/69 patients (43%). In 15 of 69 patients (22%), orbital metastasis was initially diagnosed as a different orbital process. Among the 49 patients for whom primary tumor type was reported, 25 of 49 (51%) had lobular carcinoma and 21 of 49 (43%) had ductal carcinoma. Two patients had independent lobular and ductal primaries, and one patient had a phyllodes tumor. The most common presenting orbital signs or symptoms were diplopia and/or limited motility (45 of 69, 65%) and decreased or blurry vision (33 of 69, 48%). Treatment of the primary breast carcinoma with orbital metastases varied widely and changed over time with near-equal representation of chemotherapy, hormonal therapy, and radiation therapy. Documentation of survival time was inconsistent.</p><p><strong>Conclusions: </strong>Breast carcinoma, including metastatic disease, is increasingly characterized by improved survival and prolonged disease control in selected patients with advances in systemic therapy. In patients with a history of breast cancer, metastatic disease should be considered in those presenting with orbital pathology. Conversely, unexplained orbital findings may warrant evaluation for occult malignancy.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1749352"},"PeriodicalIF":2.4,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392625","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":"Adjunctive ab-interno goniotomy in chronic angle-closure glaucoma: a retrospective proof-of-concept pilot study using doubly robust learning.","authors":"YuQi Ren, Xiaojing Zha, YiZheng Zhang, Jin Xuan, ZhiYong Meng, ChenMing Zhang","doi":"10.3389/fopht.2026.1846121","DOIUrl":"10.3389/fopht.2026.1846121","url":null,"abstract":"<p><strong>Purpose: </strong>To assess whether an anterior segment optical coherence tomography (AS-OCT)-informed causal framework could estimate the added benefit of adjunctive ab-interno goniotomy during phacoemulsification with goniosynechialysis (Phaco-GSL) in chronic angle-closure glaucoma (CACG).</p><p><strong>Design: </strong>Retrospective single-center comparative cohort pilot study.</p><p><strong>Methods: </strong>In a single-center development cohort of 102 eyes, 54 underwent phacoemulsification with goniosynechialysis alone and 48 underwent adjunctive ab-interno goniotomy. Marginal treatment effects were estimated using stabilized inverse probability of treatment weighting (IPTW) and augmented inverse probability weighting (AIPW). Medication-free complete success was defined as intraocular pressure (IOP) 5-18 mmHg with at least 20% reduction from baseline without IOP-lowering medications or additional glaucoma surgery; qualified success used the same IOP criteria with or without medications. Qualified failure was defined as loss of qualified success or need for additional glaucoma surgery. Time to qualified failure through 24 months was analyzed using stabilized IPTW-weighted Kaplan-Meier curves and weighted Cox models. Predicted individualized benefit estimates for 24-month medication-free complete success were derived from baseline clinical and AS-OCT features using a doubly robust learner with ridge regularization and 5-fold cross-fitting.</p><p><strong>Results: </strong>Adjunctive goniotomy was associated with higher 24-month qualified-failure-free survival under stabilized IPTW adjustment (0.682 vs 0.425; weighted hazard ratio 0.475, 95% CI 0.257-0.880; p=0.018). Doubly robust estimates favored adjunctive goniotomy for 24-month medication-free complete success (risk difference 0.291; 95% CI 0.105-0.478) and qualified success (risk difference 0.233; 95% CI 0.064-0.403). Adjusted mean IOP differences were modest, whereas medication-free complete success and medication burden showed more apparent separation. Hyphema occurred numerically more often with adjunctive goniotomy. Predicted individualized benefit estimates (model-predicted absolute probability differences) were variable and were not interpreted as clinically actionable recommendations.</p><p><strong>Conclusions: </strong>Adjunctive goniotomy was associated with more favorable 24-month surgical control in this retrospective pilot cohort. Imaging-informed doubly robust learning may support future studies of treatment-effect heterogeneity, but the current predicted individualized benefit estimates require external validation before clinical use.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1846121"},"PeriodicalIF":2.4,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392704","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":"Editorial: Imaging in the diagnosis and treatment of eye diseases.","authors":"Weihua Yang, Yalin Zheng, Shujun Wang","doi":"10.3389/fopht.2026.1899308","DOIUrl":"10.3389/fopht.2026.1899308","url":null,"abstract":"","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1899308"},"PeriodicalIF":2.4,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378433","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":"The traditional Chinese medicine bloodletting therapy at the Taiyang acupoint (No.EX-HN5) for the treatment of periorbital venous malformation: a case report.","authors":"Yanli Zhang, Xiaoyun Cao, Chunhong Chen, Zengfang Yu, Dan Li, Chaoqun Zhang, Man Kang","doi":"10.3389/fopht.2026.1787288","DOIUrl":"10.3389/fopht.2026.1787288","url":null,"abstract":"<p><strong>Background: </strong>This paper presents a case of periorbital venous malformation treated using appropriate Traditional Chinese Medicine interventions.</p><p><strong>Case presentation: </strong>A 27-year-old Asian Han female presented with prominent swelling of the right periorbital region that appeared when looking downward, accompanied by greenish skin discoloration, which resolved upon elevating the head. Initially, the patient did not seek medical attention, attributing the symptoms to fatigue and insufficient rest. However, the swelling recurred upon awakening, prompting the patient to seek medical evaluation at a hospital. Ocular ultrasound and orbital computed tomography (CT) were subsequently performed, resulting in a diagnosis of periorbital VM. Ocular ultrasound revealed the VM measured 2.0×1.28 cm. Additional ophthalmological findings were as follows: intraocular pressure-OD 14 mmHg, OS 16 mmHg; refraction-OD 0.00/-0.25, OS -1.00/-0.25; visual acuity-OD 1.0, OS 0.8. The patient was subsequently referred to the Departments of Traditional Chinese Medicine (TCM) and Ophthalmology, where management was overseen by a TCM ophthalmologist. The physician recommended bloodletting at the ear tips or Taiyang acupoints as part of the treatment and instructed the patient to adhere to this regimen for monitoring and further management. The patient complied with the physician's instructions, undergoing Taiyang acupoint bloodletting once weekly, with approximately 2 mL of blood removed per session. Six months later, follow-up ocular ultrasound demonstrated a reduction in VM size, although minor changes could be attributable to measurement variability. No evidence of lesion growth was observed, prompting further follow-up evaluations. The patient was instructed to abstain from meridian-based Taiyang acupoint bloodletting for two weeks. Serial ocular ultrasound examinations were performed to assess VM size and peripheral blood flow at multiple time points: pre-bloodletting, immediately post-procedure, and at 1, 2, 5, 7, 24 hours, and 3, 7, 12, and 14 days following the intervention. The results indicated the clinical efficacy of combined Chinese and Western interventions, including Taiyang acupoint meridian stabbing and bloodletting therapy, in managing periorbital VM.</p><p><strong>Conclusion: </strong>Taiyang acupoint meridian bloodletting therapy, when applied to a localized periorbital VM, may exert a therapeutic effect. The therapy temporarily reduces blood flow to the VM, alleviates swelling, improves patient comfort, and mitigates tissue compression associated with the lesion. However, this case report focuses exclusively on a localized periorbital VM during follow-up assessment and is intended solely for clinical reference. Medical guidance should be followed for the targeted and comprehensive management of VM.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1787288"},"PeriodicalIF":2.4,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371278","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":"Confidence in managing open-globe injuries and endophthalmitis: a pre- and postwet-lab training evaluation.","authors":"Vegard Asgeir Forsaa, Birger Lindtjørn","doi":"10.3389/fopht.2026.1740823","DOIUrl":"10.3389/fopht.2026.1740823","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate the effect of 2 days of wet-lab training on confidence in the management of open-globe injury (OGI) and endophthalmitis.</p><p><strong>Methods: </strong>In a porcine wet lab, 24 participants were trained on 12 surgical tasks, including pars plana vitreous sampling and corneal and scleral suturing. Participants anonymously rated their confidence in managing OGI and endophthalmitis on a scale from 1 to 10 before the course, immediately after its completion, and 6 months later.</p><p><strong>Results: </strong>Confidence in corneal suturing improved from a median of 1 (interquartile range [IQR] = 1) to 7 (IQR = 3) immediately after the course (<i>p</i> < 0.001), and to 3 (IQR = 2) six months later (<i>p</i> = 0.001). For scleral suturing, confidence improved from a median of 1 (IQR = 1) to 7 (IQR = 2) (<i>p</i> < 0.001), and to 3 (IQR = 3) 6 months later (<i>p</i> = 0.001). Confidence in endophthalmitis treatment improved from a median of 5 (IQR = 5) to 8 (IQR = 4) immediately after the course (<i>p</i> < 0.001), and remained at 8 (IQR = 2) 6 months later (<i>p</i> = 0.012).</p><p><strong>Conclusions: </strong>Wet-lab training effectively increased participants' confidence in managing OGI. Key elements of the ophthalmic surgeon's learning curve can be addressed in a porcine wet lab, thereby reducing the risk of poor patient outcomes. Six months later, the positive effect on confidence remained significant, despite the expected decline over time. Nonetheless, there remains scope for further improvement in these essential surgical skills.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1740823"},"PeriodicalIF":2.4,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371298","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":"Health-related quality of life and tobacco and alcohol consumption in Leber hereditary optic neuropathy in Sweden.","authors":"Johan Hedström, Maria Nilsson, Martin Engvall, Pete A Williams, Abinaya Priya Venkataraman","doi":"10.3389/fopht.2026.1791334","DOIUrl":"10.3389/fopht.2026.1791334","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate health-related quality of life (HRQoL), tobacco and alcohol consumption in Leber hereditary optic neuropathy (LHON) affected and carriers in Sweden.</p><p><strong>Methods: </strong>This cross-sectional case-control study included LHON affected and carriers from the Swedish LHON research registry. Age and sex matched healthy control (HC) references and references with other eye diseases were also included. Validated questionnaires on HRQoL, alcohol, smoking and smokeless-tobacco (snus) consumption were administered. The differences between groups and sub-groups (stratified for sex) were analyzed with ANOVA and independent samples t-test. Differences in prevalence of tobacco and alcohol consumption were evaluated with chi-square test.</p><p><strong>Results: </strong>32 LHON affected and 32 carriers were included. Mean age at inclusion were 49.1 ± 19.7 years and 48.2 ± 17.7 years respectively. LHON affected and carriers did not show any significant difference in HRQoL compared to HC reference group. However, the affected males had significantly lower scores for role limitation due to physical health than affected females (67.1 ± 36.4 vs. 95.0 ± 15.8, p = 0.019). A higher prevalence of smoking (20%) and snus-use (33%) was seen among LHON affected. One-fourth of LHON affected had harmful or hazardous alcohol consumption risk classification.</p><p><strong>Conclusions: </strong>The HRQoL was similar among the Swedish LHON cohort compared to HC references. Swedish LHON cohort showed a higher prevalence of smoking. Snus usage, and harmful or hazardous alcohol consumption were higher among LHON affected individuals.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1791334"},"PeriodicalIF":2.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354894","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":"Primary posterior optic buttonholing as a new standard-of-care: rationale, technique, advantages, and special indications.","authors":"Rupert Menapace","doi":"10.3389/fopht.2026.1757735","DOIUrl":"10.3389/fopht.2026.1757735","url":null,"abstract":"<p><strong>Introduction: </strong>Posterior capsule opacification (PCO) is still frequent in spite of sharp-edged optic IOLs. With primary posterior capsulorhexis (PPCCC), lens epithelial cells (LECs) may still access the central posterior optic surface. Additional posterior optic buttonholing (POBH) deviates migrating LECs towards the anterior optic surface, thus excluding retro-optical opacification.</p><p><strong>Methods: </strong>In 2004 the author started investigating POBH as a standard procedure for adult cataracts. 1000 consecutive POBH cases were evaluated and compared to standard in-the-bag IOL placement and sole PPCCC. Additional anterior capsule polishing (ACP) and capsule tension ring (CTR) implantation were also performed in sub-series.</p><p><strong>Results: </strong>In all eyes, retro-optical opacification was eradicated, and capsular fibrosis largely reduced. CTR implantation facilitated PPCCC with loose zonules or flaccid capsule bags. Postoperative refractive and rotational stability were immediate. No pressure rises or inflammatory response was observed. Retinal detachment and macular edema were not increased.</p><p><strong>Discussion: </strong>With POBH the IOL optic is placed in Berger´s space outside of instead of in the capsular bag. POBH is controlled, safe, and effective including costs. POBH is compatible with many open-loop IOL models independent of material properties. It avoids dysphotopsia as round-edged optic IOL may also be used. Planned POBH may be converted into sulcus or anterior capsule IOL fixation in case of posterior capsular complications. It provides immediate refractive and perfect rotational stability. POBH improves the performance of trifocal IOLs and facilitates delayed exchange if needed. It combines with Add-On IOLs and translimbal floaterectomy. POBH could therefore replace in-the-bag IOL implantation as standard of care.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"6 ","pages":"1757735"},"PeriodicalIF":2.4,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13303034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347456","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}