BMC Ophthalmology最新文献

{"title":"Keratoconus with two consecutive re-emergences: a case report.","authors":"Peicheng Zhang, Yanchao Wu, Lixiao Ma, Dong Wang","doi":"10.1186/s12886-025-03877-4","DOIUrl":"https://doi.org/10.1186/s12886-025-03877-4","url":null,"abstract":"<p><strong>Background: </strong>Keratoconus is a common disease in clinical practice, and deep anterior lamellar keratoplasty(DALK) is a conventional treatment for keratoconus, which is effective and not easy to recur after surgery.</p><p><strong>Case presentation: </strong>The author presents a rare case report involving a 21-year-old patient with Consecutive re-emergences of Keratoconus. He underwent DALK for keratoconus in his left eye in 2012 and experienced re-emergence 3 years later, followed by a second deep lamellar keratoplasty in the same year. In 2019, the patient experienced re-emergence of keratoconus and underwent a third deep lamellar keratoplasty in the same eye. Genetic testing was performed, and no abnormal genes were identified. Postoperative follow-up emphasized the management of chronic allergic conjunctivitis (CAC) and the correction of eye-rubbing habits. To date, he has not experienced any further re-emergence.</p><p><strong>Conclusions: </strong>Keratoconus is a complex disorder with a multifaceted etiology and pathogenesis, including genetic, environmental, biomechanical, and cellular factors. Its treatment usually requires multiple considerations, including the choice of surgical methods, anti-inflammatory therapy, and correction of eye rubbing habits to guide patients for subsequent treatment interventions.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"59"},"PeriodicalIF":1.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual, clinical and quality of life outcomes of a new multifocal IOL with optimized diffractive grating: a non-randomized clinical trial.","authors":"João Marcelo de Almeida Gusmão Lyra, Mariana Silva Gois de Almeida, Lucila de Albuquerque Barbosa Lira, Laís Oliveira Dos Santos, Mateus Lins Dos Santos, Jorge Artur Peçanha de Miranda Coelho","doi":"10.1186/s12886-025-03878-3","DOIUrl":"10.1186/s12886-025-03878-3","url":null,"abstract":"<p><strong>Background: </strong>Multifocal intraocular lenses (IOLs) are designed to reduce dependence on spectacles by providing multiple focal points. However, they are associated with photic phenomena such as halos and glare, and may reduce contrast sensitivity. The BIOS Trifocal is a single-piece acrylic diffractive IOL with a closed-loop haptic design, optimized for centration and stability. It features an aspheric, aberration-neutral surface and a precisely engineered diffraction grating for effective energy distribution across multiple distances. This study aims to evaluate the visual, clinical, and quality of life outcomes of the BIOS Trifocal IOL for treatment of cataract and presbyopia.</p><p><strong>Methods: </strong>Participants who met the inclusion criteria underwent implantation of the BIOS Trifocal IOL and were assessed at 30 and 90 days post-surgery. The evaluations included measurements of patient-reported outcomes using the NEI-VFQ 25 at postoperative day 30 and uncorrected and corrected distance visual acuity and defocus curves at postoperative day 90. Additionally, intraoperative and postoperative complications were documented. Visual acuity assessments were performed under photopic conditions, with a range of defocus from + 1.5 D to -3.0 D.</p><p><strong>Results: </strong>Significant improvements were observed in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and near visual acuity (UNVA) at both 30 and 90 days post-surgery (p < 0.001). The defocus curve demonstrated functional vision from + 1.5 D to -3.0 D, supporting the lens's efficacy for near, intermediate, and far distances. Quality of life, as assessed by the NEI-VFQ 25, showed marked improvement across all domains (p < 0.05), with no significant complications directly attributable to the IOL.</p><p><strong>Conclusions: </strong>The BIOS Trifocal IOL presented satisfactory effectivity in the treatment of cataract and presbyopia, providing functional vision across near, intermediate and far distances and maintaining good patient satisfaction.</p><p><strong>Trial registration: </strong>This trial was registered at the ReBEC (Registro Brasileiro de Ensaios Clínicos - Brazilian Registry of Clinical Trials)database under the registration code RBR-772s6y at April 6th, 2020.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"57"},"PeriodicalIF":1.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of crystalline lens decentration and tilt on visual performance in eyes implanted with bifocal or extended depth of focus intraocular lenses.","authors":"Yu Zhang, Jiaqing Zhang, Chen Liang, Yifan Xu, Jiaying Wu, Junming Wu, Yifan Zhang, Aixia Jin, Xuhua Tan, Lixia Luo","doi":"10.1186/s12886-025-03884-5","DOIUrl":"10.1186/s12886-025-03884-5","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the potential of crystalline lens decentration and tilt as indicators for screening cataract patients for presbyopia-correcting intraocular lens (IOL) implantation.</p><p><strong>Methods: </strong>Prospective observational study. Patients undergoing phacoemulsification with bifocal (Tecnis ZMB00) or extended depth-of-focus (EDOF) (Tecnis ZXR00) IOL implantation were consecutively enrolled. The decentration and tilt of the crystalline lens and the IOL were quantified through the utilization of swept-source optical coherence tomography (SS-OCT, Casia2). Postoperative visual acuity (VA), contrast sensitivity (CS), objective optical quality, and patient-reported outcomes were assessed at a 3-month follow-up. A LOWESS (LOcally WEighted Scatterplot Smoothing) curve was employed to analyze the changes in VA, CS, and objective optical quality relative to the decentration or tilt of crystalline lenses. A further comparison of visual outcomes was conducted based on the inflection points suggested by the curves.</p><p><strong>Results: </strong>Eighty‑seven patients with ZMB00 IOL and 76 patients with ZXR00 IOL were included. Multiple 6-mm internal aberrations showed a nonlinear increase with greater crystalline lens decentration. The inflection points for the steep increase were observed to be 0.28 mm for the bifocal group and 0.35 mm for the EDOF group. Beyond these points, internal aberrations such as coma increased significantly (all P < 0.01). Patient satisfaction decreased (P < 0.01). Moreover, the bifocal group exhibited a decline in spectacle-independence from 98.67% to 83.33% (P = 0.049), along with a reduction in CS (P < 0.05).</p><p><strong>Conclusions: </strong>The increased decentration of crystalline lenses compromises specific visual quality aspects in eyes implanted with ZMB00 and ZXR00 IOLs, with cut-off values of 0.28 mm and 0.35 mm, respectively.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"58"},"PeriodicalIF":1.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of guanfacine treatment on ocular parameters in pediatric and adolescents patients with attention-deficit/hyperactivity disorder.","authors":"Işıl Merve Torun, Zeynep Vatansever Pinar, Şeyma İlhan","doi":"10.1186/s12886-025-03886-3","DOIUrl":"10.1186/s12886-025-03886-3","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the effects of guanfacine on the anterior and posterior segments of the eye.</p><p><strong>Methods: </strong>This prospective study included 32 children and adolescents with Attention-deficit/hyperactivity disorder (ADHD). The participants underwent a detailed ophthalmologic evaluation before and 6 months after the beginning of guanfacine treatment. The following data were recorded for each participant: refraction error, intraocular pressure (IOP), anterior chamber depth (ACD), central corneal thickness (CCT), corneal aberrations using corneal topography, retinal nerve fiber layer (RNFL) analysis of seven quadrants (central, nasal, naso-superior, naso-inferior, temporal, temporo-superior, temporo-inferior), central macular thickness (CMT), and choroidal thickness (CT). Assessments were made of these parameters obtained from images using an optical coherence tomography (OCT) instrument.</p><p><strong>Results: </strong>A significant increase in total root mean square (RMS) (p = 0.029*), RMS low-order aberration (LOA) (p = 0.014*), Coma 0° (p < 0.001*), and Coma 90° (p = 0.037*) corneal aberrations was observed at the sixth month of guanfacine treatment in comparison with the baseline examination. Other ocular parameters demonstrated no significant change from the baseline examination findings at the sixth month of guanfacine treatment. (p > 0.05, for each).</p><p><strong>Conclusion: </strong>Oral guanfacine in the treatment of ADHD had no effect on ocular structures such as the retina, choroid, optic nerve, refraction, or corneal thickness, although it increased corneal aberrations. The results require support through further studies with extended follow-up and a larger patient group.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"56"},"PeriodicalIF":1.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence and 6-year incidence of myopic tessellation in a Chinese rural adult population: the Handan Eye Study.","authors":"Caixia Lin, Jian Wu, Kai Cao, Bingsong Wang, Yuxin Fang, Ohno-Matsui Kyoko, Yunyun Sun, Jie Hao, Lixia Ma, Ye Zhang, Qing Zhang, Ningli Wang","doi":"10.1186/s12886-025-03874-7","DOIUrl":"10.1186/s12886-025-03874-7","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the prevalence and the cumulative 6-year incidence of fundus tessellation in a rural Chinese adult population.</p><p><strong>Methods: </strong>The Handan Eye Study was a population-based longitudinal study, with 6830 eligible subjects included in the baseline period, and 5394 subjects (follow-up rate: 85.3%) took part in the follow-up study. Participants had detailed eye examinations and physical examinations; a detailed questionnaire was also well administered. Fundus tessellation was defined as well-defined choroidal vessels that can be observed clearly around the fovea as well as around the arcade vessels.</p><p><strong>Results: </strong>Among 6830 subjects who participated in the baseline study, the prevalence of fundus tessellation was 9.89% (95%CI: 9.22-10.58%). The prevalence of fundus tessellation increased with age; that of subjects aged younger than 50 years and those aged 50 years or older was 2.5% and 14.5%, respectively. Six years later, the cumulative 6-year incidence of fundus tessellation was 1.21% (95%CI: 1.03-1.40%). Similarly, the incidence of fundus tessellation also increased with age; that of participants aged younger than 50 years and those aged 50 years or older was 0.20% and 1.86%, respectively. The progression rate of fundus tessellation in those with fundus tessellation at baseline was 1.5% (95% CI: 0.82%, 2.38%). By multivariable analysis, subjects being older (OR: 1.079, P < 0.001) and havingβ-parapapillary atrophy at baseline (OR: 2.657, P = 0.002) were associated with a higher risk of incidence of fundus tessellation.</p><p><strong>Conclusions: </strong>The prevalence and 6-year incidence of fundus tessellation were 9.89% and 1.21% in rural Chinese adults aged 30 + years, respectively. The progression rate in participants with fundus tessellation indicates the importance of regular follow-up for these patients.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"55"},"PeriodicalIF":1.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discriminatory power of trabeculectomy bleb internal reflectivity and morphology in surgical success using anterior segment optical coherence tomography.","authors":"Jeremy C K Tan, Matthew Roney, Matteo Posarelli, Abdus Samad Ansari, Mark Batterbury, Neeru A Vallabh","doi":"10.1186/s12886-024-03770-6","DOIUrl":"10.1186/s12886-024-03770-6","url":null,"abstract":"<p><strong>Background: </strong>The post-operative evaluation of trabeculectomy blebs has traditionally relied on subjective clinical grading systems performed at the slit-lamp. This study explores the use of swept source anterior-segment optical coherence tomography (AS-OCT) to objectively measure bleb internal reflectivity and morphology, and to distinguish blebs with surgical success vs. failure.</p><p><strong>Methods: </strong>Cross-sectional study of patients with glaucoma who had undergone trabeculectomy at least one year prior. Swept source AS-OCT was used to capture filtering blebs in the sagittal plane. Standardised regions of interests on the sagittal plane were segmented, and pixel intensity values and bleb height were measured. Receiver operating characteristic curves were used to examine the discriminatory ability of pixel intensity values and bleb morphology to classify blebs with surgical success or failure.</p><p><strong>Results: </strong>100 eyes of 65 patients were included, with a median post-operative follow up of 7.0 years (IQR 3.2-16 years). The proportion of complete success, qualified success and failure was 45%, 33%, and 22% respectively. The maximum bleb height was significantly greater in the blebs with complete success (1.74 vs. 1.25 vs. 1.23 mm in CS vs. QS vs. F, one-way ANOVA, p < 0.0001). Mean pixel intensity was significantly lower in blebs with complete success (150.8 vs. 157.4 vs. 167.4 in CS vs. QS vs. F, p = 0.0001). Bleb intensity standard deviation (AUC 0.81), maximal bleb height (AUC 0.76), mean pixel intensity (AUC 0.75) and minimum pixel intensity (AUC 0.75) offered the best discrimination between surgical success and failure.</p><p><strong>Conclusions: </strong>Swept-source AS-OCT can be used to quantify bleb internal reflectivity and morphology, which can be used to distinguish between well vs. poorly functioning blebs. These parameters may assist surgeons in the objective evaluation of post-operative bleb outcomes.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"52"},"PeriodicalIF":1.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of clinical outcomes and prognostic factors following membrane peeling in idiopathic epiretinal membrane using EIFL staging system: an optical coherence tomography angiography analysis.","authors":"Juan Li, Fangyuan Cheng, Zhaohui Li, Liang Wang","doi":"10.1186/s12886-025-03889-0","DOIUrl":"10.1186/s12886-025-03889-0","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the associations between anatomical changes and visual outcomes after membrane peeling in eyes with different stages of idiopathic epiretinal membrane (iERM) using optical coherence tomography angiography (OCTA).</p><p><strong>Methods: </strong>All iERM eyes were graded into four stages based on the presence of ectopic inner foveal layers (EIFL) and underwent 23-gauge vitrectomy combined with ERM and internal limiting membrane (ILM) peeling, while their fellow eyes were treated as the control group. OCTA was used to measure retinal thickness(RT), foveal avascular zone (FAZ)-related parameters and superficial and deep capillary plexus (SCP and DCP) layers using 6 × 6 mm scans before, 1 month and 3 months after surgery. In addition, best corrected visual acuity (BCVA), metamorphopsia and macular features were assessed.</p><p><strong>Results: </strong>Forty-six subjects were included in this study. In comparison to the preoperative data, visual acuity and metamorphopsia improvement was statistically significant in four stages(P < 0.05) and the higher stage (3 and 4) achieved more pronounced improvements (P = 0.002). For higher stage, RT reduced with an increase in stage(P < 0.001), superficial and deep foveal vessel density (SFVD and DFVD) and parafoveal vessel density (PRVD) in SCP declined remarkably, FAZ area was enlarged obviously, FAZ perimeter (PERIM), foveal vessel density (FD) and PRVD in DCP increased significantly after surgery (P < 0.05). Similar to high-stage patients, those with stage 2 iERMs demonstrated a decreasing trend in central macular thickness (CMT), paraRT (parafoveal thickness), SFVD, and DFVD(P < 0.05). Nevertheless, no notable alterations were observed in other indicators. Distinct from other groups, only CMT and FD increased slightly in stage 1 iERMs (P < 0.05). Post-LogMAR BCVA and LogMAR BCVA-d (pre-LogMAR BCVA -3-month post-LogMAR BCVA) were positively correlated with preoperative stages, CMT, pre-LogMAR BCVA, SFVD, and vascular tortuosity(P < 0.05). but negatively correlated with FAZ area and DFVD (P < 0.05). Preoperative and postoperative metamorphopsia had a certain positive correlation with preoperative CMT (P < 0.05).</p><p><strong>Conclusions: </strong>According to OCTA analysis, different EIFL stages of iERMs showed significantly functional and anatomic differences before and after membrane peeling. Low-stage patients have better post-op visual function, while high-stage patients benefit more from surgery. It also demonstrated EIFL staging system contribute doctors to manage iERMs.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"54"},"PeriodicalIF":1.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal nerve abnormalities in early-stage diabetic retinopathy evaluated by corneal confocal microscopy.","authors":"Yi Zhou, Xiangchen Li, Suhan Shi, Ziwei Guo, Beibei Shan, Linlin Xu, Yixiao Li, Jianxin Guo","doi":"10.1186/s12886-025-03880-9","DOIUrl":"10.1186/s12886-025-03880-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the correlation between the development of diabetic retinopathy (DR) and the changes in corneal sub-basal nerve plexus (SNP) and corneal dendritic cells (DCs).</p><p><strong>Methods: </strong>58 patients with type 2 diabetes mellitus (T2DM) and 30 age- and sex-matched healthy participants underwent assessment of the corneal nerve. The DR group was divided into no diabetic retinopathy (NDR) and 29 eyes with mild to moderate non-proliferative diabetic retinopathy (NPDR). We collected the clinical data (gender, age, body mass index), laboratory indicators (fasting blood glucose, glycosylated hemoglobin), and confocal laser scanning microscopy images for further analysis. Spearman rank correlation or Pearson correlation analyses were used to evaluate the relationships.</p><p><strong>Results: </strong>Compared to the control group, all parameters of corneal nerves in the case group were significantly reduced (all P < 0.001). Similarly, the density of immature dendritic cells (DCs) in the NDR group (70.40 [49.10-87.50]) was significantly higher than that in patients with DR (22.80 [14.30-34.50]), while the density of mature DCs (27.80 [17.70-39.60]) was significantly lower than that in patients with DR (70.80 [47.20-90.40]) (all P < 0.001). The morphological score of DCs in the NPDR group (2.6 [2.4-2.8]) was significantly higher than that in the NDR group (1.80 [1.80-2.20]) (all P < 0.001). As diabetes progresses to the stage of diabetic retinopathy, there were significant negative correlations between inferior whorl length (IWL) (rho = -0.802, P < 0.001) and average nerve fiber length ( ANFL) (rho = -0.487, P < 0.001) with the occurrence of DR. Additionally, there were significant positive correlations between the density of mature DCs (rho = 0.704, P < 0.001) and corneal dendritic morphology (DCM)(rho = 0.791, P < 0.001) with the occurrence of DR.</p><p><strong>Conclusion: </strong>Compared to patients with NDR, those with NPDR exhibited a reduction in corneal nerve fiber density (CNFD)and corneal nerve fiber length (CNFL), and the length of corneal nerves in the inferior whorl (IW) was also reduced and showed a significant negative correlation with the presence of fundus lesions. Patients with DR had an increased density and morphological score of mature DCs in the cornea. These findings suggest that we should focus on the changes in corneal nerves when screening and diagnosing DR, and treatment should be considered for better prognosis.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"51"},"PeriodicalIF":1.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Graft-repositioning technique using infusion and small bubbles during Descemet's membrane endothelial keratoplasty.","authors":"Toshiki Shimizu, Itaru Oyakawa, Daisuke Tomida, Hideaki Yokogawa, Akira Kobayashi, Satoru Yamagami, Takahiko Hayashi","doi":"10.1186/s12886-025-03879-2","DOIUrl":"10.1186/s12886-025-03879-2","url":null,"abstract":"<p><strong>Background: </strong>Descemet's membrane endothelial keratoplasty (DMEK) is a highly effective procedure for corneal endothelial dysfunction; however, once a DMEK graft is deployed, repositioning can be challenging. Therefore, this study aimed to evaluate the efficacy of a technique that utilizes infusion and small air bubbles to reposition a misaligned deployed graft.</p><p><strong>Methods: </strong>This retrospective interventional case series enrolled patients who underwent DMEK between January 2022 and July 2023, including cases where the DMEK graft was attached and unfolded in off-center positions\". Experienced surgeons performed DMEK by inserting an infusion cannula and positioning a small bubble in the anterior chamber after the graft unfolded off-center. The eye was tilted in a deviated direction, and the cornea was massaged from the corneal limbus to the center using a 27-gauge blunt needle. Before and after DMEK, we measured the best spectacle-corrected visual acuity (BSCVA), central corneal thickness (CCT), and endothelial cell density (ECD). Additionally, we monitored the incidence of postoperative complications.</p><p><strong>Results: </strong>Six eyes of six patients were included in this study. Postoperatively, the overall BSCVA and CCT of the eyes improved (P < 0.001). However, one eye developed recurrent uveitis and required a sub-Tenon's capsule triamcinolone acetonide injection. No eyes required re-bubbling, and no instances of primary graft failure were observed.</p><p><strong>Conclusion: </strong>The described technique enables the safe and feasible repositioning and unfolding of the DMEK graft.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"53"},"PeriodicalIF":1.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post COVID glaucoma service redesign utilising electronic patient triage and community optometry clinics (Fife, Scotland 2020-2022).","authors":"Niharika Nalagatla, Shameela Parveen, Kelvin Kw Cheng, Caroline Styles, Andrew Blaikie, Peter Wilson, Bhavani Karri, David J Chinn, Roshini Sanders, Glaucoma Team, Lisa Wong, Alan Ramsay, Steven Halstead, Michelle Boulton, David Cummins, Colin Ferrier, Gavin Galloway, Elizabeth Embrey, Duncan Preston","doi":"10.1186/s12886-025-03882-7","DOIUrl":"10.1186/s12886-025-03882-7","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 caused a huge backlog of patients in glaucoma clinics. This study describes redesign of an entire glaucoma service with electronic patient triage to three levels and utilisation of the Scottish optometry infrastructure of upskilled optometrists.</p><p><strong>Methods: </strong>2276 patients in glaucoma clinics were identified and triaged to three levels in keeping with Glauc-strat-fast guidance with local amendments. Every patient detail was entered into a bespoke glaucoma database to include demographics, clinical findings and social deprivation scores. The database generated automatic patient, GP and optometrist letters. Level one patients (482) were discharged within the Scottish general optometry service contract. Level two patients (714) were discharged to glaucoma accredited community optometry clinics. The glaucoma consultants would discuss the optometry decision making through screen share once a week. Level three patients (1080) were retained in hospital. All outcomes were audited and analysed 24 months after the new service.</p><p><strong>Results: </strong>Statistically significant parameters were found between the three groups, to include more normal eyes, less mean deviation on visual fields and less social deprivation in level one patients. After 24 months level one patients had a return rate of 40.2%, mainly for other diseases with only 20.4% retained within hospital or level two. 9.4% of level two patients returned to hospital with retention of only 2.7% in hospital at 24 months.</p><p><strong>Conclusion: </strong>Glaucoma patients in Scotland can be appropriately triaged to glaucoma accredited community optometry clinics. This frees capacity within hospital to see patients with moderate and severe disease in a timely fashion, for best visual outcomes.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"50"},"PeriodicalIF":1.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}