Clinical ophthalmology (Auckland, N.Z.)最新文献

{"title":"Patient-Reported Quality of Life and Treatment Experiences Among Patients with Neovascular Age-Related Macular Degeneration Receiving Intravitreal Aflibercept in Colombia: A Qualitative Study.","authors":"Maria Adelaida Piedrahita, Wanderley Augusto Arias-Ortiz, Claudia Patricia Acosta Cadavid, Eduardo Cadena Galvis, Fernando Yaacov Peña","doi":"10.2147/OPTH.S626968","DOIUrl":"10.2147/OPTH.S626968","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the experiences and perceptions of patients with neovascular age-related macular degeneration (AMD) receiving anti-VEGF therapy and understand how treatment influences their quality of life.</p><p><strong>Patients and methods: </strong>A qualitative study informed by a phenomenological perspective and employing a hybrid deductive-inductive thematic analysis was conducted at an ophthalmologic center in Medellín, Colombia. Fourteen patients with confirmed AMD undergoing intravitreal aflibercept treatment participated in semi-structured telephone interviews. Participants were selected through purposive sampling until meaning saturation was achieved, defined as the point at which no new experiential themes emerged. Interviews were transcribed verbatim and analyzed using a hybrid deductive-inductive thematic analysis guided by the Felce and Perry quality-of-life framework, supported by ATLAS.ti v24.</p><p><strong>Results: </strong>Patients described AMD as a condition strongly associated with fear, uncertainty, and emotional distress, particularly related to progressive visual loss and blindness. Intravitreal injections were initially perceived as invasive and anxiety-provoking; however, over time many participants associated treatment with hope, visual stability, and preservation of independence. Family support, religious beliefs, and trust in the treating ophthalmologist emerged as important factors for emotional coping and treatment adherence. Participants also reported subjective improvement in daily activities such as reading, mobility, self-care, and social interaction. Nevertheless, some continued to experience limitations related to transportation, dependence on others, and social isolation. Concerns about continuity of care and access to medication were frequently expressed.</p><p><strong>Conclusion: </strong>Quality of life in patients with AMD receiving anti-VEGF therapy extends beyond visual outcomes alone and is deeply influenced by emotional, social, and functional factors. Although treatment generated fear and discomfort at the beginning, it also represented an opportunity to maintain autonomy and social participation. These findings highlight the importance of patient-centered care strategies that integrate psychosocial support, clear communication, and continuous access to treatment.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"626968"},"PeriodicalIF":0.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963878","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":"Feeling Through the Patient's Eyes: Delivering the Diagnosis of Glaucoma as a Therapeutic Intervention.","authors":"Leticia A Checo, Syril Dorairaj","doi":"10.2147/OPTH.S609239","DOIUrl":"10.2147/OPTH.S609239","url":null,"abstract":"<p><p>Glaucoma is a chronic, progressive optic neuropathy; however, receiving the diagnosis represents more than a clinical event. For many patients, it is a psychological turning point associated with fear of blindness, loss of independence, and becoming a burden, regardless of disease stage. Psychological distress, health beliefs, communication, and treatment adherence are closely interconnected in glaucoma care, although the specific effect of the diagnostic conversation has not yet been prospectively established. In this Perspective article, we propose that delivering a glaucoma diagnosis should be approached as a therapeutic intervention. Adapting structured communication strategies such as the SPIKES protocol to glaucoma may support patient understanding, emotional processing, trust, and long-term engagement. The framework is applied to glaucoma-specific challenges, including asymptomatic disease, interpretation of optical coherence tomography and visual field findings, chronic topical therapy, and lifelong follow-up. It is presented as an evidence-informed clinical approach rather than a validated substitute for treatment. Recognizing the emotional and social dimensions of glaucoma offers a practical opportunity to strengthen patient-centered care in routine ophthalmic practice, while prospective studies are needed to evaluate its effect on distress, adherence, follow-up, and clinical outcomes.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"609239"},"PeriodicalIF":0.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963917","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":"Patterns and Causes of Adult Blindness in a Tertiary Ophthalmic Center in Somalia: The Burden of Trauma-Related Visual Loss.","authors":"Kenan Calisir, Mohamed Salad Kadiye","doi":"10.2147/OPTH.S630147","DOIUrl":"10.2147/OPTH.S630147","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the patterns and causes of adult blindness in patients attending a tertiary ophthalmic center in Somalia, to examine age- and gender-related associations with major causes of blindness, and to assess the contribution of trauma-related visual loss.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted using medical records of all eligible patients aged 16 years and older evaluated at a tertiary ophthalmic center in Mogadishu, Somalia, between January and December 2025. Demographic characteristics, blindness laterality, and clinical causes were extracted from electronic medical records jointly by the two investigators and recorded in a Microsoft Excel spreadsheet. Descriptive analyses and multivariable logistic regression were performed to evaluate the distribution of blindness and age- and gender-related associations with major causes of blindness.</p><p><strong>Results: </strong>Of 10,000 patient records screened, 9740 met the eligibility criteria and were included in the analysis. Among these, blindness was identified in 1236 patients (12.7%), of whom 77.9% had unilateral blindness and 22.1% had bilateral blindness. Cataract was the leading cause of blindness overall, followed by trauma-related ocular disease, glaucoma, and corneal opacity. Trauma-related conditions predominated among younger adults, whereas cataract and glaucoma were more common in older age groups. Corneal opacity related to microbial keratitis or undetermined corneal scarring remained among the leading causes of unilateral blindness across age groups.</p><p><strong>Conclusions: </strong>Adult blindness in this hospital-based population reflected distinct age-related patterns, with trauma-related visual loss predominating among younger adults and age-related ocular diseases among older individuals. Corneal opacity remained an important cause of unilateral blindness across age groups. These findings have important implications for ophthalmic care in resource-limited settings.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"630147"},"PeriodicalIF":0.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963872","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":"Hospital-Based Reference Values for Hertel Exophthalmometry in Nepal.","authors":"Anup Subedi, Roshni Malla, Mario Cantó-Cerdán, Santosh Chhetri, Samriddhi Lamsal, Ravin Kumar Mishra, Umesh Belbase","doi":"10.2147/OPTH.S633842","DOIUrl":"10.2147/OPTH.S633842","url":null,"abstract":"<p><strong>Background: </strong>Population-specific reference values for Hertel exophthalmometry are limited in South Asian populations, including Nepal. This limits clinical interpretation of ocular protrusion in routine practice. This study aimed to establish hospital-based reference values for exophthalmometry, evaluate intra-session measurement repeatability, and examine demographic and anthropometric associations.</p><p><strong>Methods: </strong>Participants aged 6-85 years attending the outpatient department were enrolled using systematic sampling, with every fifth eligible attendee selected. Because recruitment was conducted within a tertiary eye hospital rather than through population-based sampling, the study was designed to provide hospital-based reference data rather than nationally representative estimates. Hertel exophthalmometry was performed by a single examiner with three repeated measurements per eye. Intra-session repeatability was assessed using intraclass correlation coefficient (ICC) and coefficient of variation. Group comparisons were performed using non-parametric tests, and multivariable linear regression identified independent correlates of right eye exophthalmometry value (EV).</p><p><strong>Results: </strong>This study provides the first hospital-based reference data for exophthalmometry in a Nepali clinical population with excellent intra-session repeatability. Provisional upper reference limits are 17.42 mm (95^th percentile) and 18.31 mm (mean plus 2SD). Inter-eye difference (IED) values exceeding 1.50 mm were uncommon in this sample (one participant, 0.2%). These findings are descriptive only; diagnostic thresholds for clinically significant asymmetry cannot be established from this study and require population-based investigations. Hertel base value (BV), age, ethnolinguistic ancestry, and geographical region were the independent associated with EV.</p><p><strong>Conclusion: </strong>This study provides hospital-based reference values for Hertel exophthalmometry in a Nepali population. Mean EV was approximately 13.5 mm, with a 95^th percentile upper limit of 17.42 mm. Measurement repeatability was excellent. EV was independently associated with age, Hertel base value, and demographic grouping variables, although clinical interpretation should consider the methodological limitations of hospital-based sampling. These findings may assist clinicians in interpreting exophthalmometry in Nepal; however, population-based studies are needed to establish definitive normative ranges.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"633842"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957529","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":"Corneal Biomechanics in Glaucoma: Current Evidence for Diagnosis, Risk Stratification, and Prognosis.","authors":"Xian Wu, Hongbo Luo, Huanping Chen, Rui Luo","doi":"10.2147/OPTH.S632529","DOIUrl":"10.2147/OPTH.S632529","url":null,"abstract":"<p><strong>Background: </strong>Corneal biomechanical measurements influence the interpretation of intraocular pressure and may also capture aspects of ocular-wall susceptibility that are not represented by central corneal thickness alone. Their diagnostic and prognostic relevance in glaucoma has therefore attracted increasing attention.</p><p><strong>Methods: </strong>A structured narrative search of PubMed/MEDLINE was performed from database inception through July 25, 2026, using combinations of terms related to glaucoma, ocular hypertension, corneal biomechanics, corneal hysteresis, the Ocular Response Analyzer, Corvis ST, dynamic Scheimpflug imaging, and emerging elastographic techniques. Reference lists of eligible publications and key reviews were also screened. Peer-reviewed clinical studies, systematic reviews, meta-analyses, authoritative reports, and selected foundational experimental studies were considered.</p><p><strong>Review findings: </strong>The Ocular Response Analyzer and Corvis ST provide device-specific measurements that are not directly interchangeable. Lower corneal hysteresis is consistently associated with glaucoma and with faster structural or functional progression, whereas the diagnostic performance of Corvis ST-derived parameters is more heterogeneous and varies by glaucoma subtype, intraocular pressure, central corneal thickness, axial length, and treatment exposure. Unlike previous broad overviews, this review explicitly separates diagnostic from prognostic evidence, contrasts findings across glaucoma phenotypes and devices, and examines the effect of major confounders. Brillouin microscopy and optical coherence elastography may eventually provide spatially resolved tissue measurements, but neither has been validated for routine glaucoma management.</p><p><strong>Conclusion: </strong>Corneal biomechanical measurements should currently be regarded as complementary biomarkers rather than stand-alone diagnostic endpoints in glaucoma. Future progress will depend on standardized acquisition and reporting, subtype-specific prospective validation, and multimodal integration with structural and functional glaucoma assessments.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"632529"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957524","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":"Methodological Limitations in \"Self-Reported Vision-Related Quality of Life and Functional Impact in Portuguese Patients with Uveitis: A Cross-Sectional Study\" [Letter].","authors":"Muneeba Iqbal, Abdullah Iftikhar","doi":"10.2147/OPTH.S640254","DOIUrl":"10.2147/OPTH.S640254","url":null,"abstract":"","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"640254"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957557","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":"The Effect of Varenicline Nasal Spray on the Signs and Symptoms of Dry Eye Disease and Tear Film Stability: A Randomized Controlled Trial.","authors":"P Dee Stephenson, Cynthia Matossian","doi":"10.2147/OPTH.S610688","DOIUrl":"10.2147/OPTH.S610688","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of varenicline nasal spray (VNS) 0.03 mg on the signs and symptoms of dry eye disease (DED) and tear film stability.</p><p><strong>Patients and methods: </strong>In this prospective, placebo-controlled study, 50 DED subjects were randomized to receive either VNS 0.03 mg nasal spray or its vehicle twice daily for 28 days. Study parameters included dry eye questionnaire score (DEQS), eye dryness score (EDS), corneal (CFS) and conjunctival fluorescein staining, non-invasive tear break-up time (TBUT), surface asymmetry index (SAI), and surface regularity index (SRI).</p><p><strong>Results: </strong>Post treatment, the improvement in mean symptom scores, including DEQS (23% vs 12%, p=0.022) and EDS (44% vs 27%, p = 0.012), was significantly higher in the VNS group compared to the vehicle group. The mean CFS and conjunctival staining scores also showed significantly higher improvement (~50% vs ~20%, p<0.001) in the VNS group compared to the vehicle. The mean change in non-invasive TBUT was higher in the VNS group (70% vs 30%, p = 0.680). The mean improvement in SAI and SRI were comparable between the two groups. There were no serious adverse events in either group.</p><p><strong>Conclusion: </strong>There was a statistically significant improvement in the symptoms and signs of DED in the VNS group. These results indicate that improving natural tear production using VNS nasal spray can help foster tear film stability and ocular homeostasis over time.</p><p><strong>Clinicaltrialsgov identifier: </strong>NCT05514041.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"610688"},"PeriodicalIF":0.0,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932150","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":"12-Month Visual and Clinical Outcomes After Implantation of a Monofocal Aspheric Hydrophobic Acrylic IOL: A Prospective Feasibility Study.","authors":"Oliver Hassel, Mustafa Kamal Hallak, Maximilian K Köppe, Ramin Khoramnia, Gerd U Auffarth","doi":"10.2147/OPTH.S617382","DOIUrl":"10.2147/OPTH.S617382","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate 12-month visual and clinical outcomes after implantation of a monofocal aspheric hydrophobic acrylic intraocular lens (IOL) delivered with a preloaded system.</p><p><strong>Methods: </strong>This investigator-initiated, prospective, single-center, uncontrolled feasibility study enrolled 30 patients undergoing unilateral or bilateral cataract surgery with implantation of the OPTIFLEX GENESIS COMFORT NY IOL. Twenty patients contributed 22 operative eyes to the per-treatment evaluable analysis at 12 months. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, contrast sensitivity, and intraocular pressure (IOP) were assessed postoperatively. Posterior capsule opacification (PCO), clinically detectable IOL tilt, decentration, discoloration, and higher-order aberrations were evaluated during follow-up.</p><p><strong>Results: </strong>Mean preoperative UDVA and CDVA were 0.64 ± 0.33 and 0.30 ± 0.23 logMAR, respectively. Mean UDVA improved to 0.12 ± 0.16 logMAR at 3 months and 0.19 ± 0.16 logMAR at 12 months. Mean CDVA improved to -0.01 ± 0.10 logMAR at 3 months and 0.01 ± 0.09 logMAR at 12 months. IOP remained stable, and no statistically significant change in spherical equivalent refraction was observed, although a numerical hyperopic trend was noted. At 12 months, PCO was absent in 15 eyes and minimal in 7 eyes. No clinically detectable IOL tilt, decentration, or discoloration was recorded. Contrast sensitivity was generally within or close to age-matched reference ranges.</p><p><strong>Conclusion: </strong>In this uncontrolled prospective feasibility cohort, implantation of the investigated monofocal aspheric hydrophobic acrylic IOL was associated with improved distance visual acuity and stable IOP through 12 months. The findings provide preliminary device-specific clinical data and should be confirmed in larger controlled studies with longer follow-up.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"617382"},"PeriodicalIF":0.0,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946326","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":"Determinants of Epithelial Healing Time and Cumulative Risk-Factor Burden in Eyes with Delayed Corneal Epithelialization After Routine Keratoplasty.","authors":"Dania Mohammed Jamal, Doaa Sofyan Milibari, Muhammad Ali Ahad","doi":"10.2147/OPTH.S608943","DOIUrl":"10.2147/OPTH.S608943","url":null,"abstract":"<p><strong>Background: </strong>Delayed epithelialization is a common complication after keratoplasty that can compromise graft survival and increase the economic burden.</p><p><strong>Purpose: </strong>To identify donor and recipient factors linked to extended epithelial healing time in eyes with delayed epithelialization after routine penetrating and lamellar keratoplasty.</p><p><strong>Methods: </strong>This retrospective cohort study included eyes undergoing penetrating or lamellar keratoplasty that developed delayed epithelialization, defined as complete epithelial closure occurring ≥8 days postoperatively. Recipient, donor, surgical, and postoperative variables were analyzed. Multivariable linear regression was used to quantify the effect of predictors on epithelial healing time (days). Time to epithelial closure was additionally analyzed using Kaplan-Meier estimates and Cox proportional hazards regression. A cumulative risk-factor burden model was constructed based on independent predictors.</p><p><strong>Results: </strong>A total of 146 eyes were included. In multivariable analysis, three independent predictors of prolonged epithelial healing were identified: recipient vernal keratoconjunctivitis (VKC) (β = +9.51 days, p < 0.001), female donor sex (β = +2.13 days, p = 0.030), and donor history of chemotherapy or radiotherapy (β = +3.28 days, p = 0.013). Cox regression confirmed slower epithelial healing associated with VKC (HR 0.38), female donor sex (HR 0.65), and donor chemotherapy/radiotherapy exposure (HR 0.64). Kaplan-Meier analysis demonstrated progressively delayed epithelial closure with increasing risk-factor burden (log-rank p < 0.001), with median healing times of approximately 10, 12, and 16 days for patients with 0, 1, and ≥2 risk factors, respectively.</p><p><strong>Conclusion: </strong>VKC, female donor sex, and donor history of chemotherapy or radiotherapy were independently associated with prolonged epithelial healing time in this single-center cohort of eyes that already exhibited delayed epithelialization after routine keratoplasty. The cumulative risk-factor burden model showed a stepwise association with slower epithelial closure; however, these findings are exploratory and require prospective external validation before integration into donor allocation strategies or routine clinical protocols.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"608943"},"PeriodicalIF":0.0,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932131","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":"Intraoperative Quantification of Incision-Site Descemet Membrane Detachment During Phacoemulsification: A Paired-Eye Comparison of Longitudinal and Torsional Ultrasound.","authors":"Petr Bulir, Pavel Studeny","doi":"10.2147/OPTH.S619853","DOIUrl":"10.2147/OPTH.S619853","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify the extent of clinically non-significant Descemet membrane detachment (DMD) at the clear corneal incision (CCI) during phacoemulsification and to compare its extent between longitudinal and torsional ultrasound modulation as a morphological marker of local tissue-instrument interaction.</p><p><strong>Methods: </strong>In this prospective contralateral-eye comparative randomized study, 14 patients (28 eyes) undergoing bilateral cataract surgery were included. One eye received longitudinal and the fellow eye torsional ultrasound (Constellation system, Alcon). DMD was assessed intraoperatively using microscope video recordings under red reflex illumination. Still images were analyzed, and DMD area (mm²) at the internal wound was measured. Correlations with cumulative dissipated energy (CDE) was evaluated.</p><p><strong>Results: </strong>Incision-site DMD was detected in all analyzed cases (100%) using intraoperative red reflex-based visualization. Mean DMD area was 1.33 ± 0.43 mm² (longitudinal) and 2.37 ± 0.67 mm² (torsional), with a mean difference of 1.04 mm² ± 0.74 mm² (95% CI, 0.60-1.48). The paired analysis demonstrated a highly significant difference (p < 0.001). No correlation was found between DMD extent and CDE.</p><p><strong>Conclusions: </strong>Clinically non-significant incision-site DMD appears to be a frequent intraoperative morphological phenomenon during phacoemulsification when assessed using sensitive visualization techniques. Torsional ultrasound was associated with a significantly greater DMD extent than longitudinal modulation. Rather than indicating greater clinical damage, DMD area may serve as a sensitive quantitative morphological marker of local tissue-instrument interaction at the corneal incision. Its potential value therefore lies primarily in the comparative evaluation and future refinement of phacoemulsification technologies, while the clinical significance of these subtle morphological differences remains to be established.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"619853"},"PeriodicalIF":0.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922169","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}