American Journal of Ophthalmology最新文献

{"title":"The Safety of Office-Based Pterygium Surgery","authors":"Sandra Lora Cremers ,&nbsp;Adam G. Hidad ,&nbsp;Jenny Ha ,&nbsp;Matthew Joy ,&nbsp;Kishan Avaiya ,&nbsp;Emma Antall ,&nbsp;Elise Bolin ,&nbsp;Jesus Alberto Martinez","doi":"10.1016/j.ajo.2025.02.005","DOIUrl":"10.1016/j.ajo.2025.02.005","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Hospital and ambulatory eye surgical procedures continue to transition to the office setting. Pterygium surgery is the most commonly performed ocular surface surgical procedure in the world. No studies to date have evaluated its safety in the office-based surgical setting. Our study evaluates the safety, complication rate, cost-savings, and cosmetic satisfaction of office-based pterygiectomy.</div></div><div><h3>DESIGN</h3><div>Retrospective case series.</div></div><div><h3>METHODS</h3><div>A retrospective review was performed. Procedures were performed in an office-based suite with a Zeiss surgical microscope by two board-certified ophthalmologists under topical anesthesia and oral sedation. Over a 3 year period (2013-2016), 1071 office-based pterygiectomies were performed. Follow-up was performed via in-person office visits. Data collected included: date of service; location of pterygium (nasal, temporal, or both); primary or recurrent; use of mitomycin C, fibrin glue, and amniotic membrane; preoperative and postoperative refraction; intraocular pressure (IOP); endothelial cell density (ECD); patient-reported pain (as measured by an eleven-point visual analog scale, 0-10); cosmetic satisfaction; intraoperative surgical time; speculum width; incidence of ptosis (defined as a decrease in MRD1 by 2 mm) postoperatively at 12 weeks and 1 year and postoperative complications. Postoperative measures were checked at 1 day, 2 weeks, 1 month, 2 months, 3 months, 6 months, and 1 year. The average operational and procedural costs were compared between in-office and comparable surgical centers and academic hospital cases in our area.</div></div><div><h3>RESULTS</h3><div>A total of 1015 pterygia from 992 eyes were examined postoperatively. One case of central retinal artery occlusion due to peribulbar anesthetic injection with epinephrine at postoperative week 2 was noted, leading to the removal of epinephrine from the anesthetic regimen. At the 1-year follow-up, 393 pterygium cases in 343 eyes were assessed. One-year complication rates included overall recurrence (N = 8/393; 2.04%), dellen (N = 12/393; 3.05%), and granuloma (N = 15/393; 3.82%), ptosis 2.6% (N = 9/343). There were no cases of infection. Patient-reported pain scores remained less than 1.0 peri‑ and postoperatively, and cosmetic satisfaction was greater than 88% at 1 year. The average cost of office-based pterygium surgery was $1795 ($1700-$1890, depending on supplies used). In comparison, the costs at local surgical centers and hospitals were $3812.50 ($2625-$5000) and $5562 ($5095-$6029), respectively.</div></div><div><h3>CONCLUSION</h3><div>Office-based pterygiectomy is safe, cost-effective, and offers low recurrence rates and high patient satisfaction.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"273 ","pages":"Pages 82-91"},"PeriodicalIF":4.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Common Forms of Adult Esotropia Require Augmented Surgical Dosing","authors":"Veronika Yehezkeli ,&nbsp;Joseph L. Demer","doi":"10.1016/j.ajo.2025.02.007","DOIUrl":"10.1016/j.ajo.2025.02.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Age-related distance esotropia (ARDE) in older adults is commonly caused by sagging eye syndrome. Decompensated esophoria (DE) is a progressive esotropia in younger adults. We evaluated claims that dosing of medial rectus (MR) recession must appreciably exceed customary recommendations to avert surgical undercorrections in treatment of DE and ARDE.</div></div><div><h3>Study Design</h3><div>Comparative interventional case series.</div></div><div><h3>Methods</h3><div>We compared with Parks’ tables the actual dosing of strabismus surgery that included bilateral MR recession in consecutive patients with DE and ARDE from 2015 to 2024.</div></div><div><h3>Results</h3><div>Strabismus surgery was performed in 54 DE patients of mean age 31 ± 12 years (standard deviation) and 61 ARDE patients of age 70 ± 8 years. Preoperative esotropia was significantly greater in DE at 21 ± 10Δ than 14 ± 9Δ in ARDE (<em>P</em> = .0003). Although surgery initially produced orthotropia in most patients in both groups, esotropia gradually recurred in 10 DE patients (22%) after a mean of 3 ± 1.3 years, due to greater decline in surgical effect than in ARDE (<em>P</em> = .0022). There was no correlation between the use of adjustable sutures and reoperation (<em>P</em> = .73). Regression analysis indicated that the initial 4.6 mm MR recession in DE and 3.5 mm in ARDE had no effect on final alignment, but each additional mm total MR recession corrected 3Δ in DE and 2.4Δ in ARDE. These surgical effects are less than predicted by Parks tables.</div></div><div><h3>Conclusions</h3><div>Current recommendations for augmented MR recession in ARDE are appropriate, but dosing must be further augmented to achieve satisfactory alignment in DE to avoid undercorrections caused by early recurrences of esotropia.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"273 ","pages":"Pages 74-81"},"PeriodicalIF":4.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Cost Analysis of Secondary Intraocular Lens Surgeries Using Time-Driven Activity-Based Costing","authors":"Warren W. Pan ,&nbsp;Crystal Young ,&nbsp;David Portney ,&nbsp;Amanda Fowler ,&nbsp;Shahzad I. Mian ,&nbsp;Emily Eton ,&nbsp;Thomas J. Wubben","doi":"10.1016/j.ajo.2025.02.008","DOIUrl":"10.1016/j.ajo.2025.02.008","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the economics of secondary intraocular lens (IOL) surgeries, with a focus on variations in day-of-surgery costs based on surgical approach and number of surgeons involved.</div></div><div><h3>Design</h3><div>Retrospective, time-driven, activity-based costing study analyzing costs and reimbursement rates.</div></div><div><h3>Setting</h3><div>University of Michigan Kellogg Eye Center, analyzing procedures performed between January 1, 2014, and December 31, 2023.</div></div><div><h3>Participants</h3><div>Patients undergoing secondary IOL surgeries, including both single- and multi-surgeon cases and procedures without vitrectomy, with anterior vitrectomy, and with pars plana vitrectomy (PPV).</div></div><div><h3>Methods</h3><div>Data were obtained from the institution's Electronic Health Record and Revenue Department secondary IOL surgeries (Current Procedural Terminology [CPT] codes 66985 and 66986) performed over 10 years at a single academic institution. Time-driven activity-based costing was applied to calculate the costs associated with each procedure. Primary outcomes were the total cost, reimbursement, and net margins for secondary IOL surgeries. Secondary outcomes were surgical times, time-related costs, and material costs.</div></div><div><h3>Results</h3><div>A total of 391 cases were included in this analysis over a 10-year period, including 145 without vitrectomy, 56 with anterior vitrectomy, and 190 with PPV. There was no difference in primary or secondary outcome measures between IOL insertion (CPT 66985) and IOL exchange (CPT 66986). The total day-of-surgery costs were $4248.40 to $4447.15 for secondary IOL without vitrectomy, $4245.05 to $4600.36 for secondary IOL with anterior vitrectomy, $5518.52 to $5272.21 for single-surgeon secondary IOL with PPV, and $7769.22 to $8609.39 for multiple-surgeon secondary IOL with PPV. The calculated Medicare reimbursements were $2771.67 to $2901.81 for secondary IOL without vitrectomy, $3005.66 to $3155.75 for secondary IOL with anterior vitrectomy, and $4813.26 to $4861.62 for secondary IOL with PPV. Therefore, the net margins were –($1675.48-$1347.59) for secondary IOL without vitrectomy, –($1444.60-$1239.39) for secondary IOL with anterior vitrectomy, –($704.26-$410.59) for single-surgeon secondary IOL with PPV, and –($3796.13-$2907.60) for multiple-surgeon secondary IOL with PPV.</div></div><div><h3>Conclusions</h3><div>All secondary IOL surgeries result in net negative margins with single-surgeon PPV cases having the most favorable reimbursement that covers 87% to 92% of day-of-surgery costs and multiple-surgeon PPV surgeries having the least favorable with only 56% to 63% of costs reimbursed. Identifying these cost-intensive procedures offers insights for potential cost-reduction strategies, supporting both economic viability and patient access to necessary eye care.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"273 ","pages":"Pages 159-166"},"PeriodicalIF":4.1,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Cataract-Related Blindness in Brazil: 30 Years of Public Policy Evolution: A Review Article","authors":"Newton Kara-Junior,&nbsp;Silvana Rossi","doi":"10.1016/j.ajo.2025.01.023","DOIUrl":"10.1016/j.ajo.2025.01.023","url":null,"abstract":"<div><h3>Purpose</h3><div>This review evaluated the impact of various public policies on the number of cataract surgeries performed annually by the Public Health System (SUS) in Brazil and its regions. The goal was to provide insights for managers and the medical community to assess the effectiveness of strategies to prevent cataract-related blindness.</div></div><div><h3>Design</h3><div>Trend studies based on literature review.</div></div><div><h3>Methods</h3><div>This study was developed through a literature review, with a bibliographic survey conducted in databases such as PubMed, MEDLINE, Web of Science, Embase, LILACS, and SciELO.</div></div><div><h3>Results</h3><div>Until the early 2000s, approximately 130 000 cataract surgeries were performed annually in Brazil. In 2001, the National Cataract Campaign (CNC) was introduced, which significantly increased surgical volume by providing unrestricted federal funding. By 2003, the SUS had performed 430 000 surgeries, underscoring the critical role of funding in combating cataract blindness. However, the Ministry of Health discontinued the CNC in 2006, leading to a decline in surgeries in subsequent years. The annual surgical volume recovered to 430 000 only in 2011, following the adoption of new policies that involved directly contracting private companies through government tenders. In 2013, the SUS achieved the minimum number of surgeries required to prevent an accumulation of cataract blindness cases, conducting 530 000 procedures. By the early 2020s, parliamentary amendments directed to specific municipalities through Health Social Organizations became a primary funding source for cataract procedures. This approach proved effective, with approximately 860 000 surgeries performed in 2022 to prevent new accumulations and reduce overall cataract blindness. The COVID-19 pandemic disrupted progress, causing a 23% decline in surgeries in 2020. However, surgical rates surged with the relaxation of restrictions in 2021, exceeding prepandemic levels by 21%. By 2022, the number of cataract surgeries increased by 63% compared with the prepandemic average, fully addressing the backlog created during the health crisis.</div></div><div><h3>Conclusions</h3><div>The increase in surgeries was driven by unlimited federal funding, private contracts, and targeted parliamentary amendments. Despite these efforts, regional disparities persist, requiring equitable policies based on local epidemiologic data. Ensuring access to cataract surgery demands sustained public investment. The resilience of Brazil's SUS in the postpandemic era underscores the need for consistent investments to effectively address health care challenges.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"273 ","pages":"Pages 205-211"},"PeriodicalIF":4.1,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which Test Is Best: Evaluation of Traditional and Contemporary Statistical Tests for Analysis of Spherical Equivalent Prediction Error","authors":"Nathan T. Cannon ,&nbsp;Giacomo Savini ,&nbsp;Seth M. Pantanelli ,&nbsp;Kenneth Hoffer ,&nbsp;Petros Aristodemou ,&nbsp;Kamran Riaz ,&nbsp;David Murphy ,&nbsp;David Griffin ,&nbsp;Christian Berry ,&nbsp;Guillaume Debellemanière ,&nbsp;Mathieu Gauvin ,&nbsp;Avi Wallerstein ,&nbsp;Woong-Joo Whang ,&nbsp;Kyungmin Koh ,&nbsp;Kazuno Negishi ,&nbsp;Ken Hayashi ,&nbsp;Diogo Hipólito-Fernandes ,&nbsp;David L. Cooke","doi":"10.1016/j.ajo.2025.01.022","DOIUrl":"10.1016/j.ajo.2025.01.022","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize the performance of traditional and contemporary statistics tests for analysis of spherical equivalent prediction error (SEQ-PE) after cataract surgery, with regard to test significance and self-consistency.</div></div><div><h3>Design</h3><div>Comparison of the utility of statistical tests.</div></div><div><h3>Methods</h3><div>Subjects: Eyes from 5 academic centers and 2 private practices that had cataract surgery and postoperative manifest refraction between March 2011 and December 2022. SEQ-PE data were randomly divided into subsets with sample sizes of 100, 300, 500, 700, and 2600 eyes. Mean absolute error (MAE), median absolute error (MedAE), SD, root mean squared absolute error (RMSAE), and the proportion of eyes within 0.50 diopters (D) of predicted were calculated for 6 power prediction formulas and analyzed using Friedman post hoc Dunn, Cochran <em>Q</em> post hoc McNemar, Eyetemis, and Wilcox-Holladay-Wang-Koch (WHWK) statistical tests. All tests were corrected for multiple comparisons using the Holm correction. Main outcome measures: The percentage of significant relationships (Percent Significance), proportion of inconsistencies (Inconsistency Ratio), and proportion of self-consistent significant relationships (Significance Index) for each statistical test.</div></div><div><h3>Results</h3><div>Analysis was performed on 7839 eyes of 7839 patients. WHWK.MAE (42%), WHWK.SD (41%), Eyetemis.MAE (40%), WHWK.RMSAE (39%), and Dunn.MAE (34%) were more robust, respectively, than the remaining 3 tests by Percent Significance (all <em>P</em> &lt; .001). Dunn.MAE had the best Inconsistency Ratio (0.11) in the 100-eye subsets. The same top 5 tests were most robust by Significance Index (0.39, 0.35, 0.35, 0.34, and 0.31, respectively; all <em>P</em> &lt; .02). WHWK.SD and WHWK.RMSAE had the best Significance Indices (both 0.77) in the 2600-eye subsets. McNemar had the poorest Significance Index overall (0.09).</div></div><div><h3>Conclusions</h3><div>The 5 high-performing tests produced significant results more often and were also self-consistent. WHWK.MAE and McNemar were highest and lowest performing overall, respectively. Dunn.MAE may be useful in sample sizes &lt;150 eyes.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"273 ","pages":"Pages 33-42"},"PeriodicalIF":4.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five- to Twelve-Year Outcomes of Autologous Simple Limbal Epithelial Transplantation: Long-Term Corneal Epithelial Imaging and Phenotypic Analysis","authors":"SWAPNA S SHANBHAG ,&nbsp;ANAHITA KATE ,&nbsp;SHAYERI GANGULY ,&nbsp;SAUMYA JAKATI ,&nbsp;RASHMI DESHMUKH ,&nbsp;SAYAN BASU","doi":"10.1016/j.ajo.2025.02.003","DOIUrl":"10.1016/j.ajo.2025.02.003","url":null,"abstract":"<div><h3>Purpose</h3><div>To objectively assess the long-term corneal epithelial recovery after autologous simple limbal epithelial transplantation (SLET) for ocular chemical burn (OCB)-induced unilateral limbal stem cell deficiency (LSCD).</div></div><div><h3>Design</h3><div>Prospective, fellow-eye controlled, cross-sectional imaging and diagnostic study.</div></div><div><h3>Subjects</h3><div>The study included 47 patients, who were 5 to 12 years postautologous SLET done for OCB-induced unilateral LSCD.</div></div><div><h3>Methods</h3><div>The donor and recipient eyes of all patients were assessed at a single follow-up visit with slit-lamp biomicroscopy (SLB), in vivo confocal microscopy (IVCM), impression cytology (IC), anterior segment optical coherence tomography (ASOCT), and Scheimpflug imaging (SI). The objective parameters that were assessed were corneal epithelial phenotype (CEP), thickness (CET), reflectivity (CER), and densitometry (CED). Median values with inter-quartile ranges were assessed for all parameters and analyzed using non-parametric tests.</div></div><div><h3>Main outcome measures</h3><div>The primary outcome measure was successful restoration of normal CEP on SLB, IVCM, and IC. Secondary outcome measures were comparison of CET and CER on ASOCT, and CED on SI between the eyes with successful and failed CEP restoration, and donor eyes.</div></div><div><h3>Results</h3><div>The study analyzed 94 eyes of 47 patients, with a median follow-up of 5.75 years post-SLET. Successful restoration of CEP on SLB, IVCM, and IC was observed in 32 (68%) recipient eyes, while failure was seen in 15 (32%) eyes. The CEP was normal in all 47 (100%) donor eyes. The median CET was similar in healthy donor eyes, eyes with successful CEP restoration (55.9 microns, 50.3–59.2 vs. 57.8, 49.9–63.1; <em>P</em> = .47) and eyes with failure (57.7 microns, 50.9–66.2; <em>P</em> ≥ .59). Although, the median CER (100.72, 89.9–111.2 vs. 121.6, 109.7–139.8; <em>P</em> = .001) and CED (14.7, 13.4–17.1 vs. 26.5, 20.1–30.2; <em>P</em> = .02) values were significantly lower in eyes with successful CEP restoration as compared to eyes with failure, they were still significantly greater than corresponding values in the healthy donor eyes for CER (90.33, 84.9–96.9; <em>P</em> = .02), and CED (13.5, 11.4–15.1; <em>P</em> = .03), respectively.</div></div><div><h3>Conclusions</h3><div>Long-term 5–12 year successful restoration of the corneal epithelial phenotype was seen in two-thirds of eyes postautologous SLET. While corneal epithelial reflectivity, and densitometry were relatively better in eyes with successful outcomes, corneal epithelial thickness was similar in all eyes.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"273 ","pages":"Pages 107-118"},"PeriodicalIF":4.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Chemokine in Aqueous Humor and Primary Glaucoma: A Meta-Analysis","authors":"XIN SUN ,&nbsp;JING ZHOU ,&nbsp;XIANDONG ZENG ,&nbsp;YANHUA JIANG","doi":"10.1016/j.ajo.2025.02.002","DOIUrl":"10.1016/j.ajo.2025.02.002","url":null,"abstract":"<div><h3>Objective</h3><div>Glaucoma is a group of diseases characterized by optic nerve damage and corresponding visual field loss as clinical changes. A close relationship has been identified between chemokine in aqueous humor and primary glaucoma; however, this association remains controversial.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>The Web of Science, Wiley Online Library, PubMed, and Embase databases were searched. The title or abstract search term “glaucoma” was used together with “chemokine”. Meta-analysis results were presented as the standardized mean difference (SMD) with a corresponding 95% confidence interval (Cl).</div></div><div><h3>Results</h3><div>Twenty studies were included in this meta-analysis, which showed that patients with primary glaucoma had significantly elevated CCL2 (SMD: 0.48, 95% CI [0.11, 0.86]), CCL4 (SMD: 0.74, 95% CI [0.30, 1.17]), CCL5 (SMD: 0.97, 95% CI [0.07, 1.85]), CCL7 (SMD: 2.28, 95% CI [0.86, 3.71]), CXCL8 (SMD: 1.75, 95% CI [1.04, 2.46]), and CXCL10 (SMD: 1.45, 95% CI [0.46, 2.43]) levels in aqueous humor compared to the control group (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>This systematic review is the first to systematically and comprehensively evaluate chemokine levels in aqueous humor of patients with primary glaucoma. Clarifying the role of chemokines will be helpful for the treatment of glaucoma.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"273 ","pages":"Pages 1-12"},"PeriodicalIF":4.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographical Distribution of Ophthalmologists in the United States by Gender","authors":"Maya T. Harrington ,&nbsp;Sophie J. Bakri","doi":"10.1016/j.ajo.2025.02.006","DOIUrl":"10.1016/j.ajo.2025.02.006","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Female representation is growing each year in ophthalmology, but women are still underrepresented overall. Because of the potential impact of physician gender on the physician–patient relationship, this imbalance could affect patient outcomes and satisfaction. This study describes the geographic variation of gender disparities in ophthalmology throughout the United States.</div></div><div><h3>DESIGN</h3><div>Retrospective cross-sectional study.</div></div><div><h3>METHODS</h3><div>Physician characteristics were obtained from the 2023 Medicare Physician Compare National Database for physicians listing “ophthalmology” as their primary specialty. Duplicate physician entries were excluded. The remaining 17,503 physicians were grouped into states, allowing for analysis of gender distribution geographically.</div></div><div><h3>RESULTS</h3><div>Of the 17,503 ophthalmologists registered on the Medicare Physician Compare, 4,965 were female (28.37%). Gender distributions of ophthalmologists varied among states and regions, with the highest female representation in Massachusetts (41.25%) and the District of Columbia (38.37%). The lowest representation was in Wyoming (9.09%) and Utah (15.73%).</div></div><div><h3>CONCLUSIONS</h3><div>Geographical gender imbalances may be due to several factors including personal preference, state policies, and family choices. By identifying factors that contribute to where women geographically choose to practice, we can better guide approaches to increase female engagement in areas with the lowest representation to close potential healthcare disparities.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"273 ","pages":"Pages 56-61"},"PeriodicalIF":4.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autograft Donor Site Repair In Pterygium Surgery.","authors":"Minas T Coroneo, Ximena Masgoret, Vijay Reena Durai","doi":"10.1016/j.ajo.2025.01.025","DOIUrl":"10.1016/j.ajo.2025.01.025","url":null,"abstract":"","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Titaminates, a Biocompatible Titanium–Organic Hybrid Film, Support the Growth and Function of Conjunctival Epithelial Cells","authors":"Changrim Lee ,&nbsp;Veronica Anne-Line Kathrine Killi ,&nbsp;Ola Nilsen ,&nbsp;Darlene A. Dartt","doi":"10.1016/j.ajo.2025.02.004","DOIUrl":"10.1016/j.ajo.2025.02.004","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To find an ideal biosurface to regenerate conjunctival epithelium.</div></div><div><h3>DESIGN</h3><div>Experimental study.</div></div><div><h3>METHODS</h3><div>Pieces of human cadaveric conjunctival epithelium removed of connective tissues were randomly placed on 8 different biosurfaces to grow primary conjunctival epithelial cells for 9 to 14 days until the fastest growing cultures covered 80% to 90% of the film surface. Main outcome measures were growth, proliferation capacity, startification, mucin 5AC (MUC5AC) secretion, and compositional balance in cell types.</div></div><div><h3>RESULTS</h3><div>All titanium-based films (titaminates) supported the growth, stratification, proliferation, and MUC5AC secretion function of human primary conjunctival epithelial cells (HCjECs), but none of the zinc-based films grew cells at all. Although HCjECs’ ability to proliferate, stratify, and secrete MUC5AC per unit cell area was similar across all titaminates, titanium dioxide (TiO₂) and glycine titaminates (TiG) outperformed TiD and TiGD in terms of outgrowth, recapitulation of native conjunctival epithelium, and compositional balance in cell types. When goblet cells (a subtype of HCjECs) were predominantly grown on these films by using a different culture medium, the results were similar in all aspects.</div></div><div><h3>CONCLUSIONS</h3><div>Given the body-friendly nature and clinically proven safety and efficacy of titanium, titaminates TiO₂ and TiG have potential as an alternative bioactive substrate for conjunctival epithelium regeneration.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"273 ","pages":"Pages 62-73"},"PeriodicalIF":4.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}