BMC Ophthalmology最新文献

{"title":"Visual, refractive and patient-reported outcomes after two trifocal intraocular lens designs: a 12-month comparative cohort study.","authors":"Bora Deniz Argon, Enes Soyyiğit","doi":"10.1186/s12886-026-05426-z","DOIUrl":"10.1186/s12886-026-05426-z","url":null,"abstract":"<p><strong>Background: </strong>Trifocal intraocular lenses differ in how their optical architecture apportions incident light between foci, but comparative evidence combining acuity, defocus testing, contrast sensitivity and patient-reported outcomes in large routine-care cohorts is limited. We compared 12-month visual, refractive and patient-reported outcomes after implantation of two trifocal intraocular lens designs.</p><p><strong>Methods: </strong>This retrospective comparative cohort screened 432 patients and analysed one right eye from each of 340 patients (170 per group) implanted with a sinusoidal pupil-adaptive or a conventional diffractive trifocal lens. Allocation was non-randomised and individual selection reasons were unavailable. Primary outcomes, selected a priori before access to the study records, were 12-month uncorrected intermediate acuity at 65 cm and uncorrected near acuity at 40 cm. Assessment covered distance acuity, refractive accuracy, defocus curves, contrast sensitivity, dysphotopsia, spectacle independence and the National Eye Institute Visual Function Questionnaire-25. Models adjusted for baseline and operative-period differences, with propensity-score sensitivity analyses.</p><p><strong>Results: </strong>At 12 months the sinusoidal design showed better intermediate acuity (0.09 (0.05) vs. 0.12 (0.05) logMAR; adjusted difference - 0.025, 95% CI - 0.037 to - 0.013) and near acuity (0.10 (0.06) vs. 0.16 (0.05) logMAR; -0.066, 95% CI - 0.080 to - 0.053; both P < 0.001). Propensity-weighted and doubly robust estimates were almost identical (near-acuity E-value 5.4). Refractive predictability was equivalent (83.5% vs. 84.7% within ± 0.50 D; P = 0.88); all eyes were within ± 1.00 D. In exploratory unadjusted analyses, defocus area-under-the-curve, contrast sensitivity at most tested spatial frequencies, halo, glare and questionnaire outcomes also favoured the sinusoidal design; distance-acuity differences were clinically negligible.</p><p><strong>Conclusions: </strong>Both designs achieved excellent distance vision and refractive predictability. The sinusoidal design was associated with better intermediate and near function across several independent measures, and the estimates were robust to propensity-score weighting. Because allocation was not randomised and the groups differed at baseline, residual confounding cannot be excluded and prospective confirmation is required.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227086","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":"Intravitreal methotrexate as a prophylactic strategy for proliferative vitreoretinopathy in high-risk retinal detachment.","authors":"Adrian Konstantin Luyken, Claudia Brockmann, Valentin Junge, André Schulz, Thomas Armin Fuchsluger, Friederike Schaub","doi":"10.1186/s12886-026-05455-8","DOIUrl":"10.1186/s12886-026-05455-8","url":null,"abstract":"<p><strong>Background: </strong>Proliferative vitreoretinopathy (PVR) remains the major cause of surgical failure in rhegmatogenous retinal detachment (RRD). This study evaluates the anatomical and functional outcomes, as well as the safety, of a standardized intraoperative intravitreal methotrexate infusion protocol during pars plana vitrectomy (PPV) in eyes with early stage PVR (grade B) or with advanced PVR (grade C).</p><p><strong>Methods: </strong>A retrospective case series was conducted on 60 consecutive eyes of 59 patients with RRD and PVR grade B (n = 29) or grade C (n = 31) undergoing PPV with adjunct intraoperative methotrexate between November 2024 and February 2026 at a German tertiary center. Methotrexate 40 mg was administered via a 500 mL balanced salt solution infusion. Functional and structural testing included best-corrected visual acuity (BCVA), intraocular pressure, multifocal electroretinogram, perimetry, and spectral-domain optical coherence tomography. The primary outcome measure was single-surgery anatomical success (SSAS) at 12 weeks after primary surgery or after silicone oil removal. Secondary outcomes included BCVA changes and complication rates.</p><p><strong>Results: </strong>SSAS was achieved in 81.7% of all eyes, with a significantly higher success rate in eyes with PVR grade B compared to PVR grade C (93.1% versus 71.0%; p = 0.043). At 12 weeks, BCVA improved significantly in macula-off cases (p < 0.001) and remained stable in macula-on cases. In an exploratory subset of 17 patients postoperative multifocal electroretinogram and perimetry demonstrated preserved central retinal function. No ocular or systemic adverse events related to methotrexate occurred.</p><p><strong>Conclusions: </strong>The standardized intraoperative intravitreal methotrexate infusion protocol was safe, feasible, and associated with high single-surgery reattachment rates, particularly in PVR grade B eyes. Anatomical outcomes in PVR grade C eyes were comparable to other complex PVR cohorts, without any drug-related local or systemic toxicity.</p><p><strong>Trial registration: </strong>Not applicable (retrospective observational study).</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223245","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":"Effects of systemic isotretinoin therapy on tear function and choroidal thickness in nodulocystic acne patients: a prospective comparative study.","authors":"Demet Mutlu, Berrin Uzunovalı","doi":"10.1186/s12886-026-05428-x","DOIUrl":"10.1186/s12886-026-05428-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This research intended to assess how systemic isotretinoin therapy influences subfoveal choroidal thickness (CT) along with superficial (SVD), deep (DVD), and choriocapillaris (CCD) vascular densities in nodulocystic acne patients, utilizing optical coherence tomography angiography (OCTA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective, non-randomized comparative study was conducted between April 2024 and July 2025. It included 32 patients with nodulocystic acne who completed a six month course of systemic isotretinoin (Group 1) and 28 patients with nodulocystic acne who did not receive systemic treatment (Group 2). In both groups, SVD, DVD, CCD and subfoveal CT data were obtained using OCTA. All patients underwent the Schirmer test. A post hoc power analysis was performed with G Power software. Data were analyzed with SPSS version 27.0. A p value below 0.05 was considered significant, and a Bonferroni corrected threshold of 0.01 was additionally applied across the five primary between group comparisons.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In Group 1, the average treatment duration was 5.66 ± 1.10 months, with a mean isotretinoin dose of 33.44 ± 10.66 mg/day, the mean cumulative dose was 98.6 ± 44.7 mg per kg. Mean CT was 314.75 ± 55.72 μm in Group 1 and 282.70 ± 48.46 μm in Group 2. This difference was statistically significant (p = 0.022) but did not meet a Bonferroni corrected threshold of 0.01 applied across the five primary comparisons. SVD, DVD, CCD did not differ significantly between groups (p &gt; 0.05). Within Group 1, cumulative isotretinoin dose showed a positive correlation with CT (Spearman rho = 0.403,p = 0.022), which also did not meet the stricter correction threshold used for the correlation analyses. Mean Schirmer values were 14.27 ± 6.76 mm in Group 1 and 20.38 ± 6.71 mm in Group 2. This difference was statistically significant and remained significant after Bonferroni correction (p &lt; 0.001). In Group 1, longer treatment duration was associated with lower Schirmer values within a multivariate model that also included age and drug dose (B=minus 2.96,p = 0.009), although the overall model approached but did not reach the conventional significance threshold (p = 0.055).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Systemic isotretinoin treatment was associated with a significant reduction in basal tear secretion. CT was significantly greater in the treated group at a conventional significance threshold, with a positive correlation to cumulative drug exposure, although neither finding survived correction for multiple comparisons. No significant differences were found in the retinal vascular density parameters assessed. The results of the study should be interpreted with appropriate caution and considered together with hypotheses for future confirmation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;(NCT07675460) (29.06.2026). Because this was a nonrandomized observational comparison rather than a clinical trial, regist","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223334","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":"Effects of complete suture removal on corneal topography, ocular biometry, and IOL power after keratoplasty: a comparative study of PK and DALK.","authors":"Eda Sahutoglu, Yusuf Kocluk, Burcu Kasim","doi":"10.1186/s12886-026-05451-y","DOIUrl":"10.1186/s12886-026-05451-y","url":null,"abstract":"<p><strong>Background: </strong>Complete suture removal after keratoplasty may substantially alter corneal shape and ocular biometric measurements, thereby affecting intraocular lens (IOL) power calculations. However, comparative data on these changes after penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK), as well as factors predicting the magnitude of IOL power change, remain limited. This study aimed to evaluate topographic and biometric changes after complete suture removal in eyes undergoing PK or DALK and to identify predictors of calculated IOL power change.</p><p><strong>Methods: </strong>This retrospective comparative study included 90 eyes of 90 patients who underwent PK (n = 44) or DALK (n = 46) at a tertiary referral ophthalmology center. Corneal topography and ocular biometry were assessed before and one month after complete suture removal. Anterior and posterior corneal curvature, corneal astigmatism, axial length, anterior chamber depth, and calculated IOL power were analyzed. Within-group and between-group comparisons were performed. Univariable and multivariable linear regression analyses were used to determine factors associated with change in calculated IOL power.</p><p><strong>Results: </strong>Complete suture removal caused significant anterior corneal steepening and increased anterior chamber depth in both groups. Calculated IOL power decreased significantly after suture removal in both PK and DALK eyes, with a greater mean reduction in the PK group than in the DALK group (- 4.67 ± 5.42 D vs. -2.49 ± 4.65 D, respectively; p = 0.019). Posterior corneal astigmatism decreased significantly after PK but remained stable after DALK. Axial length did not change significantly in either group. In multivariable analysis, pre-removal anterior mean keratometry and host-donor diameter disparity were independently associated with change in calculated IOL power.</p><p><strong>Conclusions: </strong>Complete suture removal after keratoplasty induces clinically meaningful changes in corneal topography and ocular biometry, with a substantial impact on IOL power calculations. These changes are more pronounced after PK than after DALK. Repeat biometric assessment after complete suture removal should be considered before cataract or refractive surgery planning, particularly in eyes with steeper corneas or greater host-donor diameter disparity.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191125","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":"Clinical and etiological profile of patients with bitemporal optic disc pallor visiting at a tertiary eye hospital.","authors":"Jyoti Mishra, Pawan Shrestha","doi":"10.1186/s12886-026-05436-x","DOIUrl":"10.1186/s12886-026-05436-x","url":null,"abstract":"<p><strong>Background: </strong>Bitemporal optic disc pallor may result from chiasmal compression as well as bilateral toxic, nutritional, hereditary, or inflammatory optic neuropathies. Data describing its clinical and etiological profile in Nepal are limited. This study was conducted with the aim to describe the clinical and etiological profile of patients with bitemporal optic disc pallor and to evaluate the relationship between clinical, visual-field, neuroimaging, and OCT findings.</p><p><strong>Methods: </strong>A hospital-based prospective, cross-sectional study was conducted among patients with clinically documented bitemporal optic disc pallor presenting to Biratnagar Eye Hospital, Nepal. The minimum calculated sample size was 49, and 50 participants were included in the final analysis. Demographic and clinical findings, Humphrey visual-field patterns, neuroimaging findings, optical coherence tomography-derived retinal nerve fibre layer (RNFL) and macular ganglion cell analysis (GCA) measurements, and relevant blood investigations were evaluated. Data were summarized using frequencies, percentages, means, and standard deviations.</p><p><strong>Results: </strong>The mean age of participants was 38.58 ± 15.20 years, and 58.0% were male. Diminution of vision was the predominant presenting complaint (88.0%). Central scotoma was the most common visual-field defect (48.0%), followed by cecocentral scotoma (26.0%) and bitemporal hemianopia (20.0%). Nutritional optic neuropathy was the most frequent etiology (26.0%), followed by toxic optic neuropathy (20.0%); Leber hereditary optic neuropathy and inflammatory optic neuropathy each accounted for 18.0%. Pituitary macroadenoma was present in 16.0% and Rathke cleft cyst in 2.0%. Bitemporal hemianopia was predominantly associated with sellar lesions. The combined pituitary macroadenoma/Rathke cleft cyst group had the lowest mean RNFL thickness (67.4 ± 10.7 μm). Temporal RNFL thinning was more prominent in toxic optic neuropathy and Leber hereditary optic neuropathy, with mean temporal RNFL values of 39.5 and 40.8 μm, respectively.</p><p><strong>Conclusions: </strong>Bitemporal optic disc pallor demonstrated a diverse etiological spectrum. Sellar lesions were predominantly associated with bitemporal hemianopia and greater overall RNFL loss, whereas non-sellar optic neuropathies were more frequently associated with central or cecocentral scotomas and temporal RNFL thinning. Combined clinical examination, visual-field assessment, neuroimaging, and optical coherence tomography may assist in differentiating the underlying causes.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191117","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":"Type 4 macular neovascularization in a consecutive age-related macular degeneration cohort: detected prevalence and multimodal imaging findings.","authors":"Mustafa Değer Bilgeç, Mustafa Kemal Özaslan, Ecenur Taş, Nazmiye Erol","doi":"10.1186/s12886-026-05443-y","DOIUrl":"10.1186/s12886-026-05443-y","url":null,"abstract":"<p><strong>Background: </strong>To determine the detected prevalence of type 4 macular neovascularization (MNV) within a retrospectively screened age-related macular degeneration (AMD) cohort and to characterize its clinical, structural, and angiographic features.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included 4658 structural OCT examinations from 962 eyes of 500 patients with age-related macular degeneration (AMD). Eyes with structural OCT findings suggestive of type 4 MNV underwent multimodal evaluation via structural OCT and available OCT angiography (OCTA). Cases were categorized as definite, probable, or non-type 4 MNV according to predefined multimodal imaging criteria. Detected prevalence within the screened cohort was calculated at the patient and eye levels with exact 95% Clopper-Pearson confidence intervals (CIs).</p><p><strong>Results: </strong>The detected prevalence of definite type 4 MNV within the entire consecutive AMD cohort was 2.00% (95% confidence interval [CI], 0.96-3.65%) at the patient level and 1.04% (95% CI, 0.50-1.90%) at the eye level. The hyperreflective oblique band (HOB), subretinal hyperreflective material (SHRM), and ellipsoid zone (EZ) loss were present in all the definite cases. Central posterior hyaloid fibrosis (CPHF) was observed in half of the definite cases, whereas the remaining eyes exhibited posterior hyaloid central hyperreflectivity (PHCH). By definition, the OCTA criterion of a continuous flow signal extending from the inner choroid to the preretinal space was fulfilled in all definite cases. During follow-up, HOB, CPHF, and PHCH remained stable, whereas exudative activity varied.</p><p><strong>Conclusions: </strong>Within this consecutive AMD cohort, type 4 MNV was an uncommon phenotype characterized by recognizable structural and angiographic features. Structural OCT was used to identify eyes suspicious for type 4 MNV, whereas designation as definite type 4 MNV required demonstration on OCTA of the continuous flow signal specified in the predefined criteria. Our findings further characterize the clinical, structural, and angiographic features of type 4 MNV in this retrospective cohort.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191164","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":"Success of femtosecond laser-assisted deep anterior lamellar keratoplasty (Femto-DALK): a clinical case series of 42 eyes using an intraoperative optical coherence tomography (iOCT)-guided laser-generated pre-descemet tunnel.","authors":"Nicola R Otto, Friedrich A Steindor, Gerd Geerling, Theo G Seiler","doi":"10.1186/s12886-026-05416-1","DOIUrl":"10.1186/s12886-026-05416-1","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the success of Femto-DALK with an iOCT-guided generated intrastromal pre-Descemet tunnel.</p><p><strong>Methods: </strong>This monocentric, retrospective study evaluated all patients treated with Femto-DALK between January 2020 and December 2023 at the Department of Ophthalmology at the University of Düsseldorf (Germany). The iOCT-guided tunnel was generated 30 microns anterior of Descemet's membrane. BB generation, surgery time and conversion to penetrating keratoplasty (PK) were analyzed.</p><p><strong>Results: </strong>A total of 42 eyes of 41 patients were identified. BB creation was successful in 78.6% of cases. Intraoperative conversion to PK was necessary in 28.6% of the eyes and microperforation of Descemet's membrane (DM) occurred in 16.7% of completed DALKs. Mean operation time was 118.6 ± 40.68 min. Among successful Femto-DALKs (n = 30), double anterior chamber was observed in 26.7%, and re-bubbling was needed in 23.3%. Re-keratoplasty was performed in one eye (3.3%).</p><p><strong>Conclusion: </strong>Femto-DALK with an iOCT-guided pre-Descemet tunnel generation is a feasible technique that achieves BB success rates comparable to the upper range reported for manual dissection, without a clear demonstrated improvement over manual technique.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179372","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":"Clinical and refractive outcomes of bilateral enhanced monofocal intraocular lens implantation with targeted mini-monovision.","authors":"Işıl Kefeli Kırcalı, Üzeyir Günenç, Canan Aslı Utine, Gül Arıkan","doi":"10.1186/s12886-026-05439-8","DOIUrl":"https://doi.org/10.1186/s12886-026-05439-8","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate visual and refractive outcomes, as well as patient satisfaction after bilateral implantation of an enhanced monofocal intraocular lens (IOL) with targeted mini-monovision.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of patients who underwent bilateral RayOne EMV IOL implantation during cataract surgery with targeted mini-monovision (-0.50 diopters [D] in the non-dominant eye). Patients' monocular and binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), distance-corrected intermediate visual acuity (DCIVA), and manifest refraction were assessed at the 1st and 6th months postoperatively. Binocular uncorrected and corrected near visual acuities, defocus curves, contrast sensitivity, spectacle independence, dysphotopsia, and patient-reported outcomes were evaluated at Month 6. Patient-reported visual function and satisfaction were assessed using the CatQuest-9SF questionnaire, while spectacle independence and dysphotopsia were evaluated separately using study-specific questions.</p><p><strong>Results: </strong>Fifty eyes of 25 patients were included. Mean age was 63.64 ± 10.53 years (range: 29-78 years), and the mean follow-up period was 14.52 ± 5.6 months (range: 6-24 months). At 6 months postoperatively, the mean spherical equivalent in dominant eyes was - 0.37 ± 0.29 D (range: -1.00 to + 0.38 D), whereas in non-dominant eyes, it was - 0.78 ± 0.46 D (range: -1.75 to + 0.25 D). The mean binocular UDVA was 0.02 ± 0.03 logMAR (range: 0.00- 0.10 logMAR), while binocular UIVA acuity was 0.21 ± 0.09 logMAR (range: 0.00- 0.40 logMAR) at month 6. Mean binocular uncorrected near visual acuity (UNVA) at 6 months was 0.24 ± 0.12 logMAR, whereas corrected near visual acuity (CNVA) was 0.14 ± 0.08 logMAR (P < 0.001). Binocular UDVA was 0.04 logMAR or better in 96% of patients, UIVA was 0.20 logMAR or better in 64%, and uncorrected near visual acuity was 0.3 logMAR or better in 80% of patients. All patients were spectacle independent for distance and intermediate vision; 10/25 patients (40%) were also spectacle independent for near vision, whereas 15/25 (60%) required a near addition. Twenty-four patients (96%) reported being very satisfied with their vision.</p><p><strong>Conclusion: </strong>Bilateral implantation of an enhanced monofocal IOL with targeted mini-monovision was associated with excellent visual outcomes at intermediate and distance vision with a high level of satisfaction.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179398","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":"Extensive recurrent pterygium following photorefractive keratectomy: a case report.","authors":"Sadegh Ghafarian, Alireza Mojarrad, Javad Sadeghi, Bijan Samavat","doi":"10.1186/s12886-026-05440-1","DOIUrl":"10.1186/s12886-026-05440-1","url":null,"abstract":"<p><strong>Background: </strong>To report an extensive recurrent pterygium following photorefractive keratectomy.</p><p><strong>Case presentation: </strong>A healthy 39-year-old male presented with an extensive recurrent pterygium three months after uneventful photorefractive keratectomy. The patient had undergone primary pterygium surgery two months earlier. On presentation, his best-corrected visual acuity was 20/60, and the recurrent pterygium extended across the visual axis. Surgical management included pterygium excision, application of mitomycin C, and free conjunctival autografting. At six-month's postoperative follow-up, uncorrected visual acuity and best-corrected visual acuity improved to 20/32 and 20/25, respectively, with a manifest refraction of +3.25 - 3.5*90. A mild corneal sub-epithelial haziness was observed in the right eye, but no pterygium recurrence was noted. At 33 months postoperative visit, best-corrected visual acuity improved to 20/20 with manifest refraction of Plano - 1.5*110. There was no sign of pterygium recurrence.</p><p><strong>Conclusions: </strong>The excimer laser, operating within the ultraviolet spectrum, combined with the inflammatory cascade triggered by photorefractive keratectomy, may contribute to pterygium recurrence. In patients with pterygium who are candidates for keratorefractive surgery, selecting a surgical technique with the lowest recurrence rate and ensuring an adequate follow-up period-at least six months-to allow for refractive stabilization and confirm the absence of recurrence is crucial before proceeding with corneal refractive surgery.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179383","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":"Magnesium sulfate versus dexmedetomidine as adjuvants for peribulbar block: a GRADE-assessed systematic review and meta-analysis.","authors":"Fahad Amin, Moazam Ali, Tarooba Khan, Muhammad Shoaib Bilal, Roshan Zahra, Hamza Sajid, Syed Zakria Ali Shah, Sanjeet Kumar, Saqib Rehman, Momna Ubaidullah, Ayesha Mudassar, Enas Kamal Abdalaziz Seyed","doi":"10.1186/s12886-026-05429-w","DOIUrl":"10.1186/s12886-026-05429-w","url":null,"abstract":"<p><strong>Background: </strong>Regional anesthesia is widely used for ophthalmic surgery, but peribulbar block may have slower onset and variable akinesia. Dexmedetomidine and magnesium sulfate are used as adjuvants, yet their comparative effects remain uncertain.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed PRISMA 2020 and Cochrane guidance (PROSPERO CRD420261435378). PubMed, Embase, Scopus, ScienceDirect, Cochrane and Google Scholar were searched from inception to May 2026 for randomized controlled trials comparing magnesium sulfate with dexmedetomidine as adjuvants to peribulbar local anesthetic. Random-effects meta-analysis used REML, conventional and Hartung-Knapp confidence intervals, prediction intervals, leave-one-out sensitivity analyses, dosage and surgery-based subgroup analyses, and GRADE assessment.</p><p><strong>Results: </strong>Six randomized controlled trials were included. Most pooled outcomes showed no statistically significant between-group differences, including sensory-block onset (MD - 0.04 min, 95% CI - 0.15 to 0.06), globe-akinesia onset (MD - 0.33 min, 95% CI - 1.61 to 0.96), globe-akinesia duration (MD - 11.46 min, 95% CI - 29.68 to 6.77), time to block adequacy (MD 0.10 min, 95% CI - 0.92 to 1.12), IOP at 5 and 10 min, akinesia scores, supplementary injection, and satisfaction. Dexmedetomidine was associated with faster lid-akinesia onset in the conventional analysis (MD 0.32 min, 95% CI 0.15 to 0.50; P = 0.0003), but the HK-adjusted CI crossed the null (- 0.31 to 0.95). Conventional analyses also favored dexmedetomidine for lid-akinesia duration (MD - 12.20 min, P = 0.0188) and time to first analgesia (MD - 18.22 min, P = 0.0101), but both lost statistical significance after HK adjustment. Heterogeneity was substantial for several outcomes, and GRADE certainty ranged from high to very low, with most outcomes rated very low.</p><p><strong>Conclusion: </strong>Current evidence does not establish a clear efficacy or safety advantage of magnesium sulfate or dexmedetomidine as a peribulbar adjuvant. Apparent benefits for lid-akinesia onset, lid-akinesia duration, and time to first analgesia are sensitive to conservative statistical adjustment and should not be interpreted as definitive. The evidence base is small, heterogeneous, geographically concentrated, and generally low or very low certainty; adequately powered multicenter trials with standardized dosing and outcome assessment are needed.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164308","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}