BMJ Open Ophthalmology最新文献

{"title":"Risk communication in cataract surgery.","authors":"Diana Lucia Martinez, Iqbal Ike K Ahmed, Matthew B Schlenker","doi":"10.1136/bmjophth-2023-001613","DOIUrl":"10.1136/bmjophth-2023-001613","url":null,"abstract":"<p><strong>Purpose: </strong>Risk communication is an integral aspect of shared decision-making and evidence-based patient choice. There is currently no recommended way of communicating risks and benefits of cataract surgery to patients. This study aims to investigate whether the way this information is presented influences patients' perception of how risky surgery will be.</p><p><strong>Methods and analysis: </strong>Two-arm parallel randomised study and patients referred for cataract surgery were assigned to receive information framed either positively (99% chance of no adverse effects) or negatively (1% chance of adverse effects). Subsequently, patients rated their perceived risk of experiencing surgical side effects on a 1-6 scale.</p><p><strong>Results: </strong>This study included 100 patients, 50 in each study group. Median (IQR) risk perception was 2 (1-2) in the positive framing group and 3 (1-3) in the negative framing group (p<0.0001). Risk framing was the only factor that was significant in risk perception, with no differences found by other patient clinical or demographic characteristics.</p><p><strong>Conclusion: </strong>Patients who received positive framing reported lower risk scores for cataract surgery than patients who received negative framing. Patient factors were not identified as significant determinants in patients' perceived risk. Larger longitudinal studies are warranted to further investigate.</p>","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11086490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140903618","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":"Nurse-led counselling programme on the adherence to eye patch application among children with amblyopia: a randomised control trial","authors":"Shivani ­, Sushma Kumari Saini, Mona Duggal, Srishti Raj, Savleen Kaur","doi":"10.1136/bmjophth-2021-000834","DOIUrl":"https://doi.org/10.1136/bmjophth-2021-000834","url":null,"abstract":"Objective To assess the impact of the nurse-led counselling programme on eye patch application for improvement of adherence to eye patch application and vision among children with amblyopia. Material and methods A randomised control trial was done at the paediatric clinic in the eye outpatient department of a tertiary care institute in North India. A total of 70 children with amblyopia were enrolled in the study by using total enumeration sampling techniques and randomised into experimental and control groups with 35 children in each group. Data were collected by interviewing the children with amblyopia and their parents as per the interview schedule. A protocol for nurse-led counselling on the adherence to eye patch application was developed. The intervention included counselling sessions, demonstrations and booklets for the experimental group. A performa for maintaining daily records of the time and duration of eye patch application was given to parents of the experimental group. Eight telephonic follow-ups were done with the experimental group of patients to motivate parents to adhere. Standard care was given to the children of the control group. Both groups were finally evaluated at third month on adherence to eye patch application and visual acuity. Result The adherence to eye patch application, vision (as per logMAR chart) knowledge and practices of eye patch application was significantly better in the experimental group as compared with the control group (p<0.01). Conclusion The nurse-led counselling programme demonstrated improvement in visual outcomes and adherence to eye patch application. Data are available on reasonable request.","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"13 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141259917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling molecular insights: in silico exploration of TLR4 antagonist for management of dry eye syndrome","authors":"Kothandan Sudhakar, Neeru Dugar, Srikanth Jupudi, Ravichandran Ashwin, Kuppusamy Gowthamarajan","doi":"10.1136/bmjophth-2023-001610","DOIUrl":"https://doi.org/10.1136/bmjophth-2023-001610","url":null,"abstract":"Background Dry eye disease is the most commonplace multifractional ocular complication, which has already affected millions of people in the world. It is identified by the excessive buildup of reactive oxygen species, leading to substantial corneal epithelial cell demise and ocular surface inflammation attributed to TLR4. In this study, we aimed to identify potential compounds to treat of dry eye syndrome by exploring in silico methods. Methods In this research, molecular docking and dynamics simulation tests were used to examine the effects of selected compounds on TLR4 receptor. Compounds were extracted from different databases and were prepared and docked against TLR4 receptor via Autodock Vina. Celastrol, lumacaftor and nilotinib were selected for further molecular dynamics studies for a deeper understanding of molecular systems consisting of protein and ligands by using the Desmond module of the Schrodinger Suite. Results The docking results revealed that the compounds are having binding affinity in the range of −5.1 to −8.78 based on the binding affinity and three-dimensional interactions celastrol, lumacaftor and nilotinib were further studied for their activity by molecular dynamics. Among the three compounds, celastrol was the most stable based on molecular dynamics trajectory analysis from 100 ns in the catalytic pockets of 2Z63.pdb.pdb. Root mean square deviation of celastrol/2Z63 was in the range of 1.8–4.8 Å. Conclusion In particular, Glu376 of TLR4 receptor is crucial for the identification and binding of lipopolysaccharides (LPS), which are part of Gram-negative bacteria’s outer membrane. In our investigation, celastrol binds to Glu376, suggesting that celastrol may prevent the dry eye syndrome by inhibiting LPS’s binding to TLR4. No data are available.","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"373 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140841422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head rotation and the perception of eyelid height and contour","authors":"Stefania B Diniz, Elana Meer, John M Nesemann, Nicholas J Jackson, Daniel B Rootman","doi":"10.1136/bmjophth-2023-001557","DOIUrl":"https://doi.org/10.1136/bmjophth-2023-001557","url":null,"abstract":"Purpose Effective visual perceptual processing is one of the many components of surgical competence. Human face identification is most efficient when viewed upright. However, it is not yet clear how this perception sensitivity impacts eyelid symmetry. This study investigates surgeons’ and laypeople’s accuracy and efficiency in perceiving eyelid asymmetry from different spatial perspectives. Methods A prospective psychometric experiment was conducted where oculoplastic surgeons were recruited from the American Society of Ophthalmic Plastic and Reconstructive Surgery and the Brazilian Oculoplastic Surgery Society, and control participants were recruited via crowdsourcing (Amazon’s Mechanical Turk). Standard illustrations of the human face with varying degrees of eyelid abnormality, laterality, gender and rotation were presented to participants who were asked to judge whether the eyelids were symmetric or asymmetric. Results The survey was completed by 75 oculoplastic surgeons (49.33% male; mean age of 46.9±10.7) and 192 lay individuals (54.6% male; mean age 34.6±11.3 years). Among oculoplastic surgeons, deviation from upright was significantly associated with increased reaction time and decreased proportion correct (OR per 45° for peak 0.68, 95% CI 0.60 to 0.77, p<0.001; OR per 45° for ptosis 0.52, 95% CI 0.32 to 0.87, p=0.012; OR per 180° for aggregate responses 0.56, 95% CI 0.51 to 0.61, p<0.001). Oculoplastic surgeons demonstrated increasing accuracy and decreasing reaction time with additional trials for both peak and ptosis. Conclusion Oculoplastic surgeons perceive eyelid asymmetries more accurately and can better compensate for inverted sensory information. However, accuracy increases and reaction time decreases with additional trials, suggesting trainability and potential for improvement in inversion disability. Data are available on reasonable request. Raw data are available on reasonable request.","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"20 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140600297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripapillary atrophy area predicts the decrease of macular choroidal thickness in young adults during myopia progression","authors":"Menghan Li, Ya Shi, Qiuying Chen, Guangyi Hu, Jiamin Xie, Luyao Ye, Ying Fan, Jianfeng Zhu, Jiangnan He, Xun Xu","doi":"10.1136/bmjophth-2023-001555","DOIUrl":"https://doi.org/10.1136/bmjophth-2023-001555","url":null,"abstract":"Objective This study aimed to investigate the influence of peripapillary atrophy (PPA) area and axial elongation on the longitudinal changes in macular choroidal thickness (ChT) in young individuals with myopia. Methods and analysis In this longitudinal investigation, 431 eyes—342 categorised as non-high myopia (non-HM) and 89 as HM—were examined for 2 years. Participants were examined with swept-source optical coherence tomography. The macular ChT, PPA area and axial length (AL) were measured at baseline and follow-up visits. Multiple regression analysis was performed to identify factors associated with ChT changes. The areas under the receiver operating characteristic curves were analysed to ascertain the predictive capacity of the PPA area and axial elongation for the reduction in macular ChT. Results Initial measurements revealed that the average macular ChT was 240.35±56.15 µm in the non-HM group and 198.43±50.27 µm in the HM group (p<0.001). It was observed that the HM group experienced a significantly greater reduction in average macular ChT (−7.35±11.70 µm) than the non-HM group (−1.85±16.95 µm, p=0.004). Multivariate regression analysis showed that a greater reduction of ChT was associated with baseline PPA area (β=−26.646, p<0.001) and the change in AL (β=−35.230, p<0.001). The combination of the baseline PPA area with the change in AL was found to be effective in predicting the decrease in macular ChT, with an area under the curve of 0.741 (95% CI 0.694 to 0.787). Conclusion Over 2 years, eyes with HM exhibit a more significant decrease in ChT than those without HM. Combining the baseline PPA area with the change in AL could be used to predict the decrease of macular ChT. Data are available on reasonable request. The data analysed during the current study are available from the corresponding author on reasonable request.","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"176 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140560177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of lens autofluorescence and opacification on retinal imaging","authors":"Leon von der Emde, Geena C Rennen, Marc Vaisband, Jan Hasenauer, Raffael Liegl, Monika Fleckenstein, Maximilian Pfau, Frank G Holz, Thomas Ach","doi":"10.1136/bmjophth-2023-001628","DOIUrl":"https://doi.org/10.1136/bmjophth-2023-001628","url":null,"abstract":"Background Retinal imaging, including fundus autofluorescence (FAF), strongly depends on the clearness of the optical media. Lens status is crucial since the ageing lens has both light-blocking and autofluorescence (AF) properties that distort image analysis. Here, we report both lens opacification and AF metrics and the effect on automated image quality assessment. Methods 227 subjects (range: 19–89 years old) received quantitative AF of the lens (LQAF), Scheimpflug, anterior chamber optical coherence tomography as well as blue/green FAF (BAF/GAF), and infrared (IR) imaging. LQAF values, the Pentacam Nucleus Staging score and the relative lens reflectivity were extracted to estimate lens opacification. Mean opinion scores of FAF and IR image quality were compiled by medical readers. A regression model for predicting image quality was developed using a convolutional neural network (CNN). Correlation analysis was conducted to assess the association of lens scores, with retinal image quality derived from human or CNN annotations. Results Retinal image quality was generally high across all imaging modalities (IR (8.25±1.99) >GAF >BAF (6.6±3.13)). CNN image quality prediction was excellent (average mean absolute error (MAE) 0.9). Predictions were comparable to human grading. Overall, LQAF showed the highest correlation with image quality grading criteria for all imaging modalities (eg, Pearson correlation±CI −0.35 (−0.50 to 0.18) for BAF/LQAF). BAF image quality was most vulnerable to an increase in lenticular metrics, while IR (−0.19 (−0.38 to 0.01)) demonstrated the highest resilience. Conclusion The use of CNN-based retinal image quality assessment achieved excellent results. The study highlights the vulnerability of BAF to lenticular remodelling. These results can aid in the development of cut-off values for clinical studies, ensuring reliable data collection for the monitoring of retinal diseases. Data are available upon reasonable request. Data are available from the corresponding author upon reasonable request.","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"293 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140841692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of first-line or second-line selective laser trabeculoplasty for normal-tension glaucoma: a multicentre cohort study","authors":"Koji Nitta, Kae Sugihara, Akiko Narita, Tomoko Naito, Takako Miki, Maki Katai, Shiro Mizoue, Keiji Yoshikawa, Masaki Tanito, Kazuhisa Sugiyama","doi":"10.1136/bmjophth-2023-001563","DOIUrl":"https://doi.org/10.1136/bmjophth-2023-001563","url":null,"abstract":"Background/aims This study aimed to investigate and compare the efficacy and safety of first-line and second-line selective laser trabeculoplasty (SLT) in Japanese patients with normal-tension glaucoma (NTG). Methods 100 patients with NTG were enrolled in this study. Patients were treated with SLT as a first-line or second-line treatment for NTG. Main outcome measures were intraocular pressure (IOP) reduction rate, outflow pressure improvement rate (ΔOP), success rate at 1 year and complications. Success was defined as ΔOP≥20% (criterion A) or an IOP reduction ≥20% (criterion B) without additional IOP-lowering eye-drops, repeat SLT or additional glaucoma surgeries. The incidence of transient IOP spike (>5 mm Hg from the pretreatment IOP), conjunctival hyperaemia, inflammation in the anterior chamber and visual impairment due to SLT were assessed. Results A total of 99 patients (99 eyes) were initially enrolled in this study, including 74 eyes assigned to the first-line SLT group and 25 eyes to the second-line SLT group. The mean IOP of 16.3±2.1 mm Hg before SLT decreased by 17.1%±9.5% to 13.4±1.9 mm Hg at 12 months after SLT in the first-line group (p<0.001), and the mean IOP of 15.4±1.5 mm Hg before SLT decreased by 12.7%±9.7% to 13.2±2.0 mm Hg at 12 months after SLT (p=0.005) in the second-line group. Both groups showed significant reductions in IOP. Higher pre-SLT IOP and thinner central corneal thickness were associated with greater IOP reduction. The success rate at 1 year was higher in the first-line compared with the second-line group, with lower pretreatment IOP and the use of IOP-lowering medication before SLT being associated with treatment failure. Most post-treatment complications were minor and transient. Conclusions SLT may be an effective and safe treatment option for NTG, as either a first-line or second-line treatment. Trial registration number The study was registered in the UMIN-CTR (UMIN Test ID: UMIN R000044059). Data are available on reasonable request.","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"2010 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140600027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and associated factors of corneal opacity among adults in Kolladiba town, Northwest Ethiopia: a cross-sectional study","authors":"Endalew Mulugeta Worku, Sofonias Addis Fekadu, Bersufekad Wubie Alemie, Merkineh Markos Lorato","doi":"10.1136/bmjophth-2024-001665","DOIUrl":"https://doi.org/10.1136/bmjophth-2024-001665","url":null,"abstract":"Objective This study aimed to assess the prevalence and associated factors of corneal opacity among adults in Kolladiba town, Northwest Ethiopia. Methods and analysis A community-based cross-sectional study was conducted using a systematic random sampling technique. A total of 846 adult individuals were recruited for the study. Ethical approval was obtained from the University of Gondar School of Medicine Ethical Review Committee. A standardised, semistructured questionnaire plus an ocular examination were used to collect the data. The data were entered into Epi Info V.7 and cleaned and analysed using SPSS V.26. Binary and multivariable logistic regression analyses were performed to select candidate variables and identify statistically significant factors. Variables with a p value of less than 0.05 according to the multivariable logistic regression analysis were considered to be statistically significant. Results and conclusion The prevalence of corneal opacity among the study participants was 27.2% (95% CI 24.4% to 30.4%). In this study, age 49–60 years (adjusted OR (AOR): 1.90; 95% CI 1.03 to 3.32), age ≥61 years (AOR=2.12; 95% CI 1.17 to 3.87), inability to read and write (AOR=2.65; 95% CI 1.68 to 4.16), middle-income level (AOR=2.12; 95% CI 1.30 to 3.47) and poor income level (AOR=4.96; 95% CI 3.04 to 8.09) were factors that were significantly associated with corneal opacity. In this study, the prevalence of corneal opacity was considerably high. Being poor and unable to read and write were the primary factors significantly associated with corneal opacity. Hence, concerned stakeholders should strive to reverse the effects of corneal opacity on the quality of life of the study and causal studies should be considered in the future. Data are available upon reasonable request. All the necessary data are included in the manuscript, and if needed, further information is available upon reasonable request to the corresponding author.","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"300 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140600028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified sutureless and glue-free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery: a systematic review and meta-analysis","authors":"Faisal Aljahdali, Waleed Khayyat, Abdulelah T BinYamin, Sultan A Al-Qahtani, Mohammed D Alghamdi, Ali Saleh Alsudais, Husain A Alalgum, Halah Bin Helayel, Mohammed AlMutlak","doi":"10.1136/bmjophth-2023-001621","DOIUrl":"https://doi.org/10.1136/bmjophth-2023-001621","url":null,"abstract":"Background Pterygium is a common ocular surface disorder that requires surgical intervention for treatment. Conjunctival autografts are preferred over simple excision due to lower recurrence rates. This systematic review and meta-analysis compared the modified sutureless glue-free (MSGF) method with conventional sutures (CS) for conjunctival autograft fixation in primary pterygium surgery. Methods A comprehensive search was conducted in MEDLINE, Embase, CENTRAL, Google Scholar and ClinicalTrials.gov for randomised controlled trials (RCTs) comparing MSGF and CS conjunctival autografts. Outcome measures included operation time, recurrence and postoperative complications. Standardised mean difference (SMD) and risk ratio (RR) were used for continuous and dichotomous outcomes, respectively. Results 11 RCTs involving 833 participants were included. The analysis revealed that MSGF had a significantly shorter operation time compared with CS (SMD −3.704, 95% CI −5.122 to −2.287, p<0.001). CS was associated with a higher risk of foreign body sensation (RR 0.22, 95% CI 0.06 to 0.74, p=0.01). MSGF was associated with a higher risk of graft dehiscence (RR 9.01, 95% CI 2.74 to 29.68, p=0.000) and graft retraction (RR 2.37, 95% CI 1.17 to 4.77, p=0.02). No significant differences were found in recurrence, graft haemorrhage, granuloma, Dellen and conjunctival oedema. Conclusion Using the MSGF technique in conjunctival autograft fixation for pterygium surgery reduces operation time by relying solely on the patient’s blood for fixation. However, it increases the risk of graft dehiscence and retraction. However, CS is linked to a higher likelihood of experiencing foreign body sensations. Understanding the learning curve and surgeon familiarity with novel techniques is crucial for optimising patient care and surgical outcomes, while individualised decision-making is necessary considering the advantages and disadvantages of each approach. Further research is warranted to minimise complications and optimise surgical outcomes. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"53 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140600259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image-guided orbital surgery: a preclinical validation study using a high-resolution physical model","authors":"Rizwana I Khan, Kealan McElhinney, Andrew Dickson, Ronan P Kileen, Conor Murphy, Donncha F O’Brien","doi":"10.1136/bmjophth-2023-001568","DOIUrl":"https://doi.org/10.1136/bmjophth-2023-001568","url":null,"abstract":"Objective Preclinical validation study to assess the feasibility and accuracy of electromagnetic image-guided systems (EM-IGS) in orbital surgery using high-fidelity physical orbital anatomy simulators. Methods EM-IGS platform, clinical software, navigation instruments and reference system (StealthStation S8, Medtronic) were evaluated in a mock operating theatre at the Royal Victoria Eye and Ear Hospital, a tertiary academic hospital in Dublin, Ireland. Five high-resolution 3D-printed model skulls were created using CT scans of five anonymised patients with an orbital tumour that previously had a successful orbital biopsy or excision. The ability of ophthalmic surgeons to achieve satisfactory system registration in each model was assessed. Subsequently, navigational accuracy was recorded using defined anatomical landmarks as ground truth. Qualitative feedback on the system was also attained. Results Three independent surgeons participated in the study, one junior trainee, one fellow and one consultant. Across models, more senior participants were able to achieve a smaller system-generated registration error in a fewer number of attempts. When assessing navigational accuracy, submillimetre accuracy was achieved for the majority of points (16 landmarks per model, per participant). Qualitative surgeon feedback suggested acceptability of the technology, although interference from mobile phones near the operative field was noted. Conclusion This study suggests the feasibility and accuracy of EM-IGS in a preclinical validation study for orbital surgery using patient specific 3D-printed skulls. This preclinical study provides the foundation for clinical studies to explore the safety and effectiveness of this technology. Data are available upon reasonable request.","PeriodicalId":9286,"journal":{"name":"BMJ Open Ophthalmology","volume":"45 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140600301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}