BMJ Open Ophthalmology最新文献

{"title":"Health economics of virtual versus face-to-face glaucoma clinics: a time-driven activity-based costing study.","authors":"Vishal Shah, Timothy L Jackson, Rhiannon Tudor Edwards, Joel Attlee, Obeda Kailani","doi":"10.1136/bmjophth-2024-001800","DOIUrl":"10.1136/bmjophth-2024-001800","url":null,"abstract":"<p><strong>Background/aims: </strong>Staffing represents the most significant cost to the National Health Service, and ophthalmology is its largest outpatient specialty. Value-based healthcare (VBH) focuses on care processes. Innovative models include a shift towards 'virtual' glaucoma services. We used VBH costing methodology to quantify personnel costs of virtual and face-to-face (F2F) glaucoma clinics.</p><p><strong>Methods: </strong>Virtual and F2F clinics were process-mapped to produce step-by-step pathways of patients in each setting. Real-world timings were then audited, and time-driven activity-based costing was used to calculate the personnel cost-per-patient for both settings.</p><p><strong>Results: </strong>Data were captured from 24 consecutive virtual glaucoma patients and 42 consecutive patients across two F2F clinics. The capacity cost rates in £/min were £0.24 for technicians and £1.16 for consultants. The average time taken to acquire clinical data in the virtual pathway was 39 min per patient (95% CI 36 to 43, range 27-61) with 14 min (95% CI 13 to 14, range 12-20) for their remote consultant review. The estimated personnel costs associated with a single virtual glaucoma clinic visit totalled £25.60 (95% CI £23.72 to £33.52). The average time taken to be seen in the F2F clinic was 50 min (95% CI 42 to 59 min, range 12-123 min) with a personnel cost of £31.08 (95% CI £19.70-£42.43).</p><p><strong>Conclusion: </strong>Staff costs associated with visits to the consultant-delivered virtual and F2F glaucoma clinics were similar (p value=0.14), supporting virtual clinics to provide service capacity. The main limitations were that our study involved a single site, small sample size and did not consider the severity of glaucoma.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754817","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":"Embryoid body-based differentiation of human-induced pluripotent stem cells into cells with a corneal stromal keratocyte phenotype.","authors":"Jie Chen, Qingjian Ou, Yifan Liu, Tingting Cui, Huimin Yang, Jiancen Tang, Lixia Lu, Guotong Xu, Hongping Cui, Caixia Jin, Qian Li","doi":"10.1136/bmjophth-2024-001828","DOIUrl":"10.1136/bmjophth-2024-001828","url":null,"abstract":"<p><strong>Objective: </strong>The transparency of the cornea is determined by the extracellular matrix, which is secreted by corneal stromal keratocytes (CSKs). Human-induced pluripotent stem cell (hiPSC)-derived keratocytes (hiPSC-CSKs) can be used in cell-based therapy for treating corneal blindness. Our goal was to develop an effective small molecule-based technique for differentiating hiPSCs into keratocytes.</p><p><strong>Methods and analysis: </strong>hiPSCs were cultured in chemically defined medium, and embryoid bodies (EBs) were generated; these EBs were induced into CSKs using keratocyte-differentiated medium. The expression of keratocyte-specific markers was assessed using quantitative RT-PCR, immunostaining and Western blotting.</p><p><strong>Results: </strong>We found that the expression of genes encoding keratocyte markers, including aldehyde dehydrogenase 1 family member A1 (ALDH1A1), lumican and keratocan, was upregulated. Immunostaining showed positive staining for ALDH1A1 and keratocan in the hiPSC-CSK samples. Similarly, western blot analysis indicated that ALDH1A1 and keratocan expression levels were significantly greater in the hiPSC-CSKs than in the control cells. In addition, hiPSC-CSKs were not transformed into fibroblasts or myofibroblasts.</p><p><strong>Conclusion: </strong>We established an innovative and effective method to generate CSKs via the EB-based differentiation of hiPSCs, which might be employed for cell-based therapy of corneal stromal opacities.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754813","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":"Investigation of choroidal vascular alterations in eyes with myopia using ultrawidefield optical coherence tomography angiography.","authors":"Xiangcheng Tang, Jia Liang, Lishi Luo, Fanglan Yuan, Keming Zhao, Xiaohua Zhuo, Wangting Li, Jiantao Wang, Shaochong Zhang, Kun Zeng","doi":"10.1136/bmjophth-2024-001839","DOIUrl":"10.1136/bmjophth-2024-001839","url":null,"abstract":"<p><strong>Background/aims: </strong>The study aims to evaluate choroidal vascular changes in younger patients with myopia using ultrawidefield swept-source optical coherence tomography angiography (SS-OCTA).</p><p><strong>Methods: </strong>Overall, 724 eyes of 362 participants (177 males, 185 females, age: 32.43±6.20 years) underwent SS-OCTA imaging (24×20 mm). The eyes were divided into normal, low myopia (LM), moderate myopia (MM), high myopia and superhigh myopia groups according to the spherical equivalent refraction (SER). Changes in choroidal vascular thickness (ChVT) and density (ChVD) in nine grids of the fundus were analysed using the latest version of the built-in analysis software.</p><p><strong>Results: </strong>Axial length (AL) showed a negative correlation with SER (<i>r</i>=0.822, p=0.000); ChVT and ChVD showed a negative correlation with AL (p≤0.001) in all nine grids. In group analysis, compared with normal eyes, myopia affects ChVT earlier than ChVD, as observed in the LM and MM groups, respectively. The decrease in ChVT was most evident in the macular grid (<i>β</i> = -34.20, p=0.000), whereas the decrease in ChVD was most evident in the optic disc grid (<i>β</i> = -2.19, p=0.001).</p><p><strong>Conclusion: </strong>Myopia has a significant impact on choroidal vascular structure, resulting in spatiotemporal differences. Using SS-OCTA with a new version of the built-in analysis software and a study with a larger sample cohort may aid in providing more authentic information on choroidal vascular changes in eyes with myopia.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680737","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":"Recent advances in the application of artificial intelligence in age-related macular degeneration.","authors":"Yundi Gao, Fen Xiong, Jian Xiong, Zidan Chen, Yucai Lin, Xinjing Xia, Yulan Yang, Guodong Li, Yunwei Hu","doi":"10.1136/bmjophth-2024-001903","DOIUrl":"10.1136/bmjophth-2024-001903","url":null,"abstract":"<p><p>Recent advancements in ophthalmology have been driven by the incorporation of artificial intelligence (AI), especially in diagnosing, monitoring treatment and predicting outcomes for age-related macular degeneration (AMD). AMD is a leading cause of irreversible vision loss worldwide, and its increasing prevalence among the ageing population presents a significant challenge for managing the disease. AI holds considerable promise in tackling this issue. This paper provides an overview of the latest developments in AI applications for AMD. However, current limitations include insufficient and unbalanced data, lack of interpretability in models, dependence on data quality and limited generality.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615229","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":"Network-based hub biomarker discovery for glaucoma.","authors":"Min Li, Shunming Liu, Shuo Ma, Xianwen Shang, Xiayin Zhang, Ha Jason, Yu Huang, Katerina Kiburg, Ke Zhao, Guang Hu, Lei Zhang, Honghua Yu, Mingguang He, Xueli Zhang","doi":"10.1136/bmjophth-2024-001915","DOIUrl":"10.1136/bmjophth-2024-001915","url":null,"abstract":"<p><strong>Objective: </strong>Glaucoma is an optic neuropathy and the leading cause of irreversible blindness worldwide. However, the early detection of glaucoma remains challenging, as chronic forms of glaucoma remain largely asymptomatic until considerable irreversible visual field deficits have ensued. Thus, biomarkers that facilitate early diagnosis and treatment for glaucoma patients with a high risk of progression are pressing.</p><p><strong>Methods and analysis: </strong>Human disease-biomarker interactions network and human disease-target-drug interactions network were first constructed based on multiomics data. The greedy search algorithm was used to search for the hub biomarkers and drug targets for glaucoma. Genome-wide association studies and epidemiological data from the UK Biobank were used to verify our results. Biological network and functional analysis was conducted to find common network features and pathways.</p><p><strong>Results: </strong>We identified 10 hub biomarkers/drug targets for the diagnosis, treatment and prognosis for glaucoma. These results were verified by text mining and genomic/epidemiology data. We also predicted the new application of BMP1 and MMP9 to diagnose glaucoma and confirm the theory of hub biomarkers with multiple clinical applications. Further, relevant pivotal pathways for these hub biomolecules were discovered, which may serve as foundations for future biomarker and drug target prediction for glaucoma.</p><p><strong>Conclusion: </strong>We have used a network-based approach to identify hub diagnostic and therapeutic biomarkers for glaucoma and detected relationships between glaucoma and associated diseases. Several hub biomarkers were identified and verified, which may play more important roles in the diagnosis and treatment of glaucoma.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615210","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":"Investigating the effects of simulated high altitude on colour discrimination.","authors":"Siru Liu, Yuchen Wang, Xinli Yu, Jiaxi Li, Jun Zhou, Yuanhong Li, Zesong Wang, Chengkai Zhou, Jiaxing Xie, Anqi Guo, Xinzuo Zhou, Yi Ding, Xuemin Li, Li Ding","doi":"10.1136/bmjophth-2024-001894","DOIUrl":"10.1136/bmjophth-2024-001894","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify changes in colour vision immediately after exposure to different altitudes of low-pressure hypoxia.</p><p><strong>Methods: </strong>The study involved 35 healthy participants (ages 20-26). Colour vision was assessed using the Farnsworth-Munsell 100-Hue test at eight different altitudes (condition 1: ground, condition 2: 3500 m, condition 3: 3500 m after 40 min, condition 4: 4000 m, condition 5: 4000 m after 40 min, condition 6: 4500 m, condition 7: 4500 m after 40 min, condition 8: back to the ground). Data were analysed using Analysis of Variance (ANOVA), paired t-test, and χ² test .</p><p><strong>Results: </strong>Total Error Score (TES) increased with altitude and hypoxia duration, with higher TES in condition 8 than in condition 1. There were significant TES differences between conditions 3 and 7, as well as 4 and 7. Friedman and repeated ANOVA tests revealed significant sector differences, with Blue-Yellow Partial Error Score (PES) greater than Red-Green PES, particularly on conditions 4, 5 and 8. Significant Red-Green PES differences were found between conditions 4 and 7, and Blue-Yellow PES between conditions 3 and 5, 7, 8. Tritan (Blue-Yellow) shift was most pronounced at high altitudes.</p><p><strong>Conclusions: </strong>This experiment investigated acute low-pressure hypoxia's effects on colour vision, supplementing chronic hypoxia research. Increased altitudes and exposure duration worsen colour vision, with effects persisting post-recovery. Tritan axis loss is most significant under hypoxia.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602288","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":"Total retinal thickness is an important factor in evaluating diabetic retinal neurodegeneration.","authors":"Noor-Us-Sabah Ahmad, Kristen Staggers, Kyungmoo Lee, Nitish Mehta, Amitha Domalpally, Benjamin J Frankfort, Yao Liu, Roomasa Channa","doi":"10.1136/bmjophth-2024-001791","DOIUrl":"10.1136/bmjophth-2024-001791","url":null,"abstract":"<p><strong>Objective: </strong>Macular retinal nerve fibre layer (mRNFL) and ganglion cell-inner plexiform layer thickness (GC-IPL) measurements are important markers of diabetic retinal neurodegeneration (DRN). In this cross-sectional study, we aimed to quantify the contribution of total retinal thickness (TRT) and other factors in the variation of mRNFL and GC-IPL thickness among participants with diabetes.</p><p><strong>Methods and analysis: </strong>We used macular-centred spectral domain-optical coherence tomography scans from participants with diabetes in the UK Biobank. Two multiple linear regression models (prior to and after adjusting for TRT) were used to determine factors associated with mRNFL and GC-IPL thicknesses. A p value of less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 3832 eyes from 3832 participants with diabetes were analysed. Factors that explained the greatest variation in thickness were TRT (20.9% for mRNFL and 57.2% for GC-IPL), followed by spherical equivalent (8.0% for mRNFL only), gender (2.2% for mRNFL only) and age (1.4% for GC-IPL only). Other factors significantly associated with mRNFL and/or GC-IPL thickness explained less than 1% of the variation in their thicknesses. Self-reported ancestral background was not significantly associated with mRNFL thickness after accounting for TRT.</p><p><strong>Conclusions: </strong>Although many factors were significantly associated with mRNFL and GC-IPL thickness in participants with diabetes, they accounted for a fraction of the variation in the thickness of both layers. TRT explained most of the variation in these measurements, hence accounting for TRT is needed when using these metrics to evaluate DRN.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602291","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":"Factors affecting outcome of acquired comitant esotropia with restricted use of digital devices: ACEDD Study 3.","authors":"Noriko Nishikawa, Hirohito Iimori, Reiko Kinouchi, Sachiko Nishina, Tomoyo Yoshida, Akiko Hikoya, Miwa Komori, Osamu Hieda, Toshiaki Goseki, Takafumi Mori, Takeshi Morimoto, Takashi Negishi, Tamami Shimizu, Yukiko Shimizu, Shion Hayashi, Yoshiko Sugiyama, Yoshimi Yokoyama, Akiko Kimura, Hiroko Suzuki, Sadao Suzuki, Noriyuki Azuma, Miho Sato","doi":"10.1136/bmjophth-2024-001713","DOIUrl":"10.1136/bmjophth-2024-001713","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to investigate factors associated with outcomes after 3 months of instructed usage of hand-held digital devices (DD) in patients with acquired comitant esotropia (ACE).</p><p><strong>Methods and analysis: </strong>This prospective multicentre observational study included patients with ACE, aged 5-35 years, who used DD within 1 year of onset and were followed up for clinical findings and instructed use of DD. The outcomes were classified into four groups: cured, improved, unchanged and worsened. After the analysis of group differences in the clinical and DD use-related factors by univariate analysis, we used ordinal logistic regression models to identify factors associated with favourable outcomes.</p><p><strong>Results: </strong>Of 156 patients (mean age (SD): 16.4 (7.4) years), 10 (6%), 58 (37%), 67 (43%) and 21 (14%) were classified into the cured, improved, unchanged, and worsened, respectively. In the univariate analysis, consultation within 3 months of onset, small-angle strabismus at distance and good stereoacuity were associated with good outcomes. Ordinal logistic regression analysis on adjusting for age with stereoacuity or successful DD-use time halving showed that small-angle strabismus at distance (OR: 1.02, 95% CI 1.00 to 1.03, p=0.023), good stereoacuity (OR: 1.31; 95% CI 1.10 to 1.56; p=0.003) and successful halving of DD-use time (OR: 0.63; 95% CI 0.43 to 0.92; p=0.016) influenced favourable outcomes.</p><p><strong>Conclusion: </strong>Patients with small-angle esotropia, good stereoacuity on consultation and success in halving DD-use time had a higher chance of recovery through instructional DD usage. Further studies using objectively measurable systems are needed to ensure the accuracy of DD-use time.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563995","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":"Clinical outcomes and prognostic factors in patients with nasolacrimal duct obstruction or stenosis using dacryoendoscopy.","authors":"Hongxun Li, Jiagen Li, Lei Zhang, Lihong Yang, Yun Zhao, Hong Zhao, Ye Pan","doi":"10.1136/bmjophth-2024-001743","DOIUrl":"10.1136/bmjophth-2024-001743","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of dacryoendoscopic-assisted laser dacryoplasty with silicone intubation (DLDI) for the management of nasolacrimal duct obstruction (NLDO) or stenosis, and to identify the factors associated with DLDI failure.</p><p><strong>Methods and analysis: </strong>This study was designed as a prospective, single-centre cohort study. Patients with NLDO or stenosis who underwent DLDI from December 2019 to December 2021 at Tianjin Eye Hospital were considered for enrolment. The Kaplan-Meier estimator was used to assess the anatomical and functional success rate of DLDI within 2 years follow-up after removal of the silicone stent. Cox proportional hazards regression models were used to identify risk factors for treatment failure.</p><p><strong>Results: </strong>170, 174 and 178 eyes were included in Groups A (proximal NLDO), B (distal NLDO) and C (nasolacrimal duct stenosis), respectively. The overall anatomical success rate was 84.8% for the entire cohort at the 2-year follow-up. The cumulative anatomical or functional success rate for Groups B and C was significantly higher than that for Group A. In the multivariable model, a higher risk of failed DLDI surgery was associated with a history of chronic dacryocystitis (HR=3.07; p<0.001) and a longer duration of epiphora than 1 year (HR=2.67; p<0.001). Of the 522 eyes, 37 patients (7.1%) had surgery-related complications.</p><p><strong>Conclusions: </strong>DLDI is an effective minimally invasive technique for treatment in patients with distal NLDO or stenosis. Factors associated with a higher risk of reoperation include a longer duration of epiphora and a history of chronic dacryocystitis.</p><p><strong>Trial registration number: </strong>NCT05999058.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563984","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":"Keratoplasty: are children missing out on the lamellar revolution-the 2023 Bowman Club, David L. Easty Lecture.","authors":"Yuan-Yuh Leong, Jodhbir S Mehta","doi":"10.1136/bmjophth-2024-001804","DOIUrl":"10.1136/bmjophth-2024-001804","url":null,"abstract":"<p><p>There has been a growing interest in lamellar keratoplasty over penetrating keratoplasty in the treatment of cornea diseases. Children, in particular, may benefit from lamellar keratoplasty due to faster visual recovery, better outcomes, fewer eye drops and earlier amblyopia treatment. This review aims to examine the trends, surgical techniques and outcomes in paediatric lamellar keratoplasty. Additionally, alternative treatment modalities to keratoplasty such as selective endothelium removal in Peters anomaly and ophthalmic non-steroidal anti-inflammatory drugs eyedrops in congenital hereditary endothelial dystrophy are also discussed.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495532","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}