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

{"title":"Unilateral Orbital Lymphomas: A Structured Multidisciplinary Workflow for Diagnosis and Management.","authors":"Maria Angela Romeo, Alessandro Gaeta, Giuseppe Giannaccare, Silvia Ferraro, Giovanni Ottonelli, Sofia Manara, Caterina Giannitto, Ada Maria Antonella Lucia, Adriano Carnevali, Alessandra Di Maria","doi":"10.2147/OPTH.S607939","DOIUrl":"10.2147/OPTH.S607939","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a structured multidisciplinary workflow for the diagnosis and management of unilateral orbital lymphoma and to illustrate its clinical application through representative cases from a tertiary referral practice. Despite advances in orbital imaging and hematopathology, no standardized framework currently integrates clinical assessment, quantitative MRI parameters, immunohistochemical subtyping, and systemic staging into a reproducible diagnostic-therapeutic pathway.</p><p><strong>Patients and methods: </strong>A stepwise workflow integrating clinical assessment, MRI with diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) measurement, histopathologic confirmation with immunohistochemistry (IHC), and ¹⁸F-FDG PET/CT staging was developed at a tertiary referral center through multidisciplinary consensus. The workflow was applied to six patients with biopsy-confirmed unilateral orbital lymphoma (marginal zone, n=3; follicular, n=2; lymphoplasmacytic, n=1), selected to represent the clinical and radiologic spectrum encountered in practice.</p><p><strong>Results: </strong>The workflow facilitated systematic evaluation across all cases. MRI consistently demonstrated characteristic features: well-circumscribed, homogeneously enhancing lesions molding to orbital structures, with mean ADC values of 0.55-0.70 × 10^-3 mm²/s, supporting early biopsy decisions. IHC confirmed subtype-specific immunophenotypes guiding treatment selection. PET/CT identified systemic involvement in two patients (33%), modifying the therapeutic approach. Localized disease achieved remission with low-dose radiotherapy; disseminated cases responded to rituximab-based regimens. At a mean follow-up of 27 months, all patients were alive, with four achieving a complete response.</p><p><strong>Conclusions: </strong>The proposed workflow provides a reproducible framework for integrating clinical, radiologic, and histopathologic data in orbital lymphoma evaluation. Systematic application may support diagnostic accuracy, facilitate individualized staging, and inform evidence-based treatment selection, although prospective multicenter validation is needed before broader adoption. This methodology complements a recently accepted companion paper on unilateral orbital lesions, together providing a comprehensive resource for orbital disease assessment.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"607939"},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066525","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":"Comparison of the Outcomes of Implantable Collamer Lens Surgery Performed by Fellows and Consultants in a Tertiary Eye Care Hospital.","authors":"Rawan S Alshabeeb, Faisal Aljassar, Lojain M AlBathi, Khabir Ahmad","doi":"10.2147/OPTH.S600731","DOIUrl":"10.2147/OPTH.S600731","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the long-term outcomes and complication rates of implantable collamer lens (ICL) surgeries performed by fellows-in-training and consultant surgeons at a tertiary eye care hospital.</p><p><strong>Patients and methods: </strong>This was a retrospective cohort study. A chart review was performed for all patients who underwent ICL surgery for myopia and compound myopic astigmatism between January 2015 and December 2018 at King Khaled Eye Specialist Hospital and Reseach center, Riyadh, Saudi Arabia. Patients who underwent ICL implantation for hyperopia, keratoconus, or post-keratoplasty were excluded from the study. The outcomes and complication rates were compared based on whether the primary surgeon was a fellow (fellow group) or a consultant surgeon (consultant group). The primary outcome measure was the development of cataracts or endothelial cell loss, and the secondary outcome measure was visual acuity at each postoperative visit.</p><p><strong>Results: </strong>A total of 182 eyes (114 patients) underwent ICL surgery for myopia. Mean spherical equivalent was -9.74±3.51 D for the fellow group and -9.96 ± 3.77 D for the consultant group. A toric ICL was placed in 73 (86.9%) and 80 eyes(83.6%) in the fellow and consultant groups, respectively. The median postoperative follow-up (interquartile range) for patients operated on by fellows and consultants was 31.50 (32) months and 28 (33) months, respectively. There was no statistical difference in the median change in endothelial cell count (ECC) between the groups (p = 0.812). Postoperatively, cataract developed in six eyes during follow-up; two were ICL-related. The mean LogMAR uncorrected distance visual acuity was 0.11 ± 0.14(20/25) and 0.11 ± 0.16(20/25) in the fellow and consultant groups, respectively. Visual acuity outcomes and complication rates were comparable between groups.</p><p><strong>Conclusion: </strong>ICL implantation provided good refractive outcomes and long-term stability. There were no significant differences in postoperative ECC loss, cataract development, or other complications according to different levels of surgical experience.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"600731"},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066467","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":"Advanced Glycation End Products and Metabolic-Mechanical Coupling in Diabetic Retinopathy.","authors":"Lifang Wang, Xudong Zhao, Yan Wang, Wei Chen","doi":"10.2147/OPTH.S635236","DOIUrl":"10.2147/OPTH.S635236","url":null,"abstract":"<p><p>Diabetic retinopathy (DR) is a major ocular microvascular complication of diabetes mellitus and one of the leading causes of vision loss among working-age populations worldwide. Hyperglycemia-induced metabolic dysregulation has been regarded as a central mechanism underlying DR; accumulating evidence indicates that biomechanical remodeling of the retinal microenvironment also plays an important role in disease progression. Advanced glycation end products (AGEs) serve as key mediators linking metabolic stress to alterations in mechanical signaling. Through non-enzymatic glycation and covalent crosslinking of long-lived proteins, AGEs promote extracellular matrix stiffening, basement membrane thickening, and retinal vascular rigidity. These mechanical alterations can be sensed by retinal vascular cells through mechanotransduction pathways such as Piezo1, YAP/TAZ, and RhoA/ROCK signaling. Aberrant mechanical signals may further exacerbate oxidative stress, inflammatory responses, blood-retinal barrier disruption, vascular dysfunction, and pathological neovascularization. This review summarizes the role of AGEs in DR from an integrated metabolic-mechanical perspective and discusses therapeutic strategies targeting AGEs, providing new insights into potential interventions aimed at biomechanical abnormalities.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"635236"},"PeriodicalIF":0.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066489","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":"Stereoscopic Projection of Cataract Surgery Video and Observer Perception of Intraocular Spatial Relationships.","authors":"Jonathan Clive Lake, Bernardo Kaplan Moscovici, Lincoln Lemes Freitas","doi":"10.2147/OPTH.S638131","DOIUrl":"10.2147/OPTH.S638131","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether stereoscopic projection of cataract surgery video changes ophthalmologists' perception of intraocular spatial relationships compared with nonstereoscopic projection, and whether such changes are scene-dependent.</p><p><strong>Methods: </strong>Prospective, paired, randomized, observer-masked comparative study, conducted in July 2006. A stereoscopic system was assembled from a conventional surgical stereomicroscope by coupling 2 synchronized cameras to its assistant optical paths and reprojecting the images through orthogonal polarizing filters and matching eyewear. Three lens procedures, 2 phacoemulsifications and 1 anterior vitrectomy with scleral-fixated intraocular lens (IOL) implantation, were edited into 22 scenes (11 situations, each in stereoscopic and nonstereoscopic form) shown in a single randomized order to 63 ophthalmologists. Responses were recorded on visual analog scales or as binary answers and compared between modes and against a surgeon-defined perceptual reference; paired mean differences, 95% CIs, effect sizes, numerical P values and Holm-adjusted P values are reported.</p><p><strong>Results: </strong>All 11 paired comparisons were based on 63 observations. Five of 11 situations differed between modes, and all 5 survived Holm correction. Stereoscopic projection moved responses toward the reference in deep-chamber capsulorhexis (mean difference 15.3 mm, 95% CI 8.2 to 22.3; P = 0.00005), in the subluxated lens (P = 0.0008), and for the vitrector tip relative to the IOL, where correct answers rose from 23.8% to 49.2% (paired risk difference 25.4%, 95% CI 13.0 to 37.8; P = 0.0004). In shallow-chamber capsulorhexis and the collapsed posterior capsule, the nonstereoscopic mean lay closer to the reference. Stereopsis was identified in 85.2% of stereoscopic scenes.</p><p><strong>Conclusion: </strong>Stereoscopic projection produced scene-dependent changes rather than uniform improvement, clearest when the judgment lay along the depth axis and monocular cues were degraded by transparency or overlap. These exploratory findings are specific to the scenes and system tested and do not establish an effect on learning or surgical performance.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"638131"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042778","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":"Short-Term Changes in Persistent Ocular Discomfort After Add-On Motugivatrep in Patients with Dry Eye Disease: A Retrospective Observational Study.","authors":"Hisataka Fujimoto, Tomoaki Tanaka, Shinya Watanabe, Taiki Matsuoka, Fumi Gomi","doi":"10.2147/OPTH.S638367","DOIUrl":"10.2147/OPTH.S638367","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether motugivatrep improves persistent ocular discomfort in patients with dry eye disease who remain symptomatic despite ongoing conventional treatment.</p><p><strong>Patients and methods: </strong>This retrospective observational study included 41 eyes from 23 patients with dry eye disease who experienced persistent ocular discomfort for more than 2 months despite standard dry eye therapy, as defined by an Ocular Surface Disease Index (OSDI) total score of ≥13. A 0.3% motugivatrep ophthalmic solution was added to their existing treatment regimen. Subjective symptoms and objective ocular surface findings were assessed before treatment and 2 weeks after initiation. The primary outcome was a change in the total OSDI score. The secondary outcomes included changes in individual OSDI symptom items, fluorescein ocular surface staining scores, and tear film breakup time.</p><p><strong>Results: </strong>The OSDI total score significantly decreased from 44.9 ± 25.3 at baseline to 25.5 ± 21.9 at 2 weeks, with a mean paired change of -19.4 points (95% CI, -27.3 to -11.6; n=23; Wilcoxon signed-rank test, p = 1.8×10^-4). In the exploratory item-level analyses, nominal improvements were observed for several OSDI items. In linear mixed-effects models, the van Bijsterveld staining score decreased significantly (estimated change, -0.69; 95% CI, -1.22 to -0.15; p = 0.012), whereas tear film breakup time did not change significantly (estimated change, -0.78 s; 95% CI, -1.70 to 0.14; p = 0.096). No adverse events were observed during the 2-week observation period.</p><p><strong>Conclusion: </strong>Add-on motugivatrep was associated with an improvement in residual subjective ocular discomfort in patients with dry eye disease despite conventional therapy and may be a useful adjunctive treatment option.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"638367"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042811","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":"Characteristics of Patients Achieved Spectacle Independence After Enhanced Monofocal IOL Implantation Targeted at Distance Vision.","authors":"Naoki Tojo, Mitsuya Otsuka, Hiroshi Katayama, Atsushi Hayashi","doi":"10.2147/OPTH.S648393","DOIUrl":"10.2147/OPTH.S648393","url":null,"abstract":"<p><strong>Purpose: </strong>We investigated the percentage of patients achieving spectacle independence after bilateral implantation of enhanced monofocal IOLs targeted for distance vision.</p><p><strong>Patients and methods: </strong>This was a single-center cross-sectional study. We included consecutive patients who underwent cataract surgery with bilateral enhanced monofocal IOL (AMO Eyhance^TM; DIB00V) implantation. We excluded patients with conditions other than cataracts and patients with toric IOLs. The target refraction was set to the closest non-positive value to zero. One month after surgery, we surveyed patients to determine whether they could drive a car, watch TV, read a book, and operate a smartphone without glasses. Based on the survey results and verbal confirmation by the physician, patients were classified into glasses-free and glasses-required groups. We then compared refractive characteristics between the groups.</p><p><strong>Results: </strong>Of the 74 patients, 22 (29.7%) did not require glasses. In the glasses-free group, for the eye with the smaller refractive value, the mean target refractive value was -0.264±0.051, and the mean of postoperative refractive value was -0.602±0.414. These values were significantly smaller than those in the glasses-required group.</p><p><strong>Conclusions: </strong>Patients who underwent enhanced monofocal IOL implantation targeted for distance vision had an approximately 30% chance of achieving spectacle independence. These results suggest that patients for whom the target refraction of one eye could be set to a low value have a significantly higher likelihood of living without glasses.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"648393"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042476","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":"Characteristics, Mechanism and Surgical Outcomes of Funnel Shaped Retinal Detachment with Traumatic Vitreous Loss in Open Globe Injury.","authors":"Jiarui Yang, Jiayang Xu, Wenwen Lu, Zhizhong Ma, Changguan Wang, Huijin Chen","doi":"10.2147/OPTH.S623327","DOIUrl":"10.2147/OPTH.S623327","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the characteristics and mechanisms of funnel-shaped retinal detachment (FS-RD) with vitreous loss in open-globe injury (OGI) and assess the surgical outcomes after vitrectomy.</p><p><strong>Methods: </strong>A total of 1026 patients with OGI were prospectively enrolled, of whom 37 eyes with diagnosed with FS-RD. Data were collected before and after vitrectomy. The characteristics and mechanisms of FS-RD were described, and one-year outcomes of the eyes were evaluated, including retinal reattachment rate, best corrected visual acuity (BCVA, in LogMAR), proportion of light perception (LP) recovery, and intraocular pressure (IOP). Group and subgroup comparisons were conducted using the chi-square test, paired <i>t</i>-test, or Wilcoxon signed-rank test according to data distribution, and a two-sided P < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>FS-RD occurred early after the injury, with 81.8% having wounds >10mm and 73% in zone II. All eyes had vitreous loss and 91.9% with total loss. Proliferative vitreoretinopathy (PVR) occurred in 32.4% eyes. Retinal reattachment was achieved in all eyes, while 86.5% of patients remained dependent on silicone oil. BCVA improved from 3.41 ± 0.66 preoperatively to 2.48 ± 0.86 at final follow-up (P < 0.05). NLP decreased from 54.1% preoperatively to 18.9%. IOP increased from 6.4 ± 3.9 mmHg preoperatively to 9.3 ± 3.6 mmHg.</p><p><strong>Conclusions: </strong>FS-RD with traumatic vitreous loss in OGI differs from traditional FS-RD in eyes with chronic RD. A large anterior wound causing total or subtotal vitreous loss is the most prominent feature and the prerequisite of FS-RD. Anatomical and functional outcomes in this cohort were relatively good, however, larger multicenter studies are warranted to confirm these findings and their generalizability.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"623327"},"PeriodicalIF":0.0,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042500","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":"Comparative Visual Outcomes and Complications of Light Adjustable Intraocular Lens Technology: A Scoping Review.","authors":"Anita B Chander, Eric Tam, Sohel Somani","doi":"10.2147/OPTH.S628839","DOIUrl":"https://doi.org/10.2147/OPTH.S628839","url":null,"abstract":"<p><strong>Purpose: </strong>A scoping review was completed to evaluate visual outcomes of the light adjustable lens (LAL) relative to alternative intraocular lenses (IOLs) and post-operative adverse events associated with the LAL.</p><p><strong>Methods: </strong>A structured search of MEDLINE, EMBASE, and CENTRAL was completed to identify primary studies of cataract surgery with LAL implantation.</p><p><strong>Results: </strong>Twenty studies (1743 eyes) were included. Six studies (30%) compared the visual performance of LAL to another IOL, reporting sphere (n = 2 studies), spherical equivalent (SE; n = 5), and residual cylinder (n = 6). Residual cylinder was lower with the LAL across all 6 studies, whereas comparative SE outcomes were variable. Uncorrected visual acuity (UCVA) was reported in 4 studies, with all 4 studies demonstrating improved UCVA with the LAL. Adverse events were reported in 18 studies (90%). Posterior capsular opacification or YAG capsulotomy was reported in the largest number of studies (n = 8 studies), with study-level proportions ranging from 0.7% to 28.6% of eyes. Macular edema was reported in 6 studies (0.6% to 10.9% of eyes) and secondary surgical interventions in 5 studies (1.0% to 12.5% of eyes). The first light delivery device (LDD) treatment was performed 17 to 24 days after surgery in 7 studies (35%).</p><p><strong>Conclusion: </strong>LAL technology is associated with reduced residual refractive cylinder and improved UCVA compared to monofocal IOLs. The small number of comparative studies and heterogeneity across sources limit the strength of this evidence. The potential for UV light contamination with first generation models and LDD treatment delays warrant consideration.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"628839"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042704","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":"Risk Factors of Residual Exotropia After Surgery in Patients with Intermittent and Sensory Exotropia: A Systematic Review and Meta-Analysis.","authors":"Yara S Alhenaki, Mohammed A Alanazi, Amirah A Alanazi, Munira M Albeshr, Faeeqah Almhmoudi, Mohammed A Salawi, Hanan T Aljadani, Eyad M Albarrati, Nawaf I Almaiman","doi":"10.2147/OPTH.S598091","DOIUrl":"10.2147/OPTH.S598091","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Residual exotropia remains a common challenge following surgical correction of intermittent exotropia (IXT) and sensory exotropia (SX). Identifying prognostic factors associated with postoperative misalignment is essential to improve surgical planning and long-term outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To systematically review and evaluate patient- and surgery-related risk factors for residual exotropia after surgical correction, and to compare these factors between intermittent and sensory exotropia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar were searched from January 2010 to 2025. Eligible studies included patients undergoing surgery for intermittent or sensory exotropia with reported postoperative alignment outcomes. Data extraction and risk-of-bias assessment were performed independently by multiple reviewers, using the MINORS tool for non-randomised studies and the Cochrane RoB 2 tool for randomised trials. The primary synthesis was narrative; where studies were sufficiently comparable, random-effects meta-analyses were additionally performed (single-arm success proportions were pooled with a random-intercept logistic model using maximum-likelihood estimation, and the between-technique odds ratio was pooled by the inverse-variance method with the DerSimonian-Laird estimator).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 53 studies (approximately 7470 patients) were included. Reported surgical success ranged widely, from approximately 38% to 91.6%, depending on the success criterion and follow-up duration. Residual exotropia and postoperative exodrift were consistently reported across studies. Larger preoperative deviation, poor preoperative control, amblyopia, reduced stereoacuity, and sensory exotropia were associated with higher rates of residual deviation and recurrence. Early postoperative alignment emerged as one of the strongest predictors of long-term success, with early overcorrection associated with improved stability. Patients with intermittent exotropia demonstrated better sensory recovery than those with sensory exotropia. The predictive value of risk factors differed by subtype: poor preoperative visual acuity and the chronicity of visual loss dominated in sensory exotropia, whereas fusional control, stereoacuity, and the early postoperative target angle dominated in intermittent exotropia. No statistically significant difference between surgical techniques was detected. On meta-analysis, the pooled surgical success rate was 68.7% (95% CI 63.8-73.2; I&lt;sup&gt;2&lt;/sup&gt; = 89%) and was similar in intermittent (68.3%) and sensory (67.6%) exotropia (test for subgroup differences, P = 0.42), and bilateral lateral rectus recession and recession-resection did not differ in success (pooled odds ratio 0.88, 95% CI 0.51-1.52).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: ","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"598091"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042644","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":"One-Year Outcomes and Satisfaction Following Non-Linear Aspheric Micro-Monovision LASIK (PRESBYOND) for Myopic and Hyperopic Presbyopia.","authors":"Zofia Pniakowska, Barbara Czarnota-Nowakowska, Nabila Jones, Joanna Wierzbowska","doi":"10.2147/OPTH.S614420","DOIUrl":"10.2147/OPTH.S614420","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate clinical outcomes and satisfaction following non-linear aspheric micro-monovision LASIK for presbyopia.</p><p><strong>Patients and methods: </strong>Retrospective single-center study of myopic and hyperopic presbyopic patients treated with LASIK-induced micro-monovision combined with non-linear aspheric ablation profiles (PRESBYOND® Laser Blended Vision, Carl Zeiss Meditec AG) at Optegra Eye Clinic, Poland, between January 2019 and December 2023. Dominant eyes were targeted for plano; non-dominant eyes were targeted for -0.40 to -2.00 diopters (D). Visual acuity (VA) was assessed at 1, 3, and 12 months. Patients completed a purpose-made (non-validated) questionnaire assessing subjective experience and satisfaction at 3-6 months and 12 months postoperatively.</p><p><strong>Results: </strong>The study included 638 eyes of 319 patients (442 myopic eyes and 196 hyperopic eyes). At 12 months, binocular uncorrected distance VA was 20/20 or better in 98% of myopic patients and 93% of hyperopic patients. Binocular uncorrected near VA was N6 or better in 99% of myopic patients and 96% of hyperopic patients. All eyes were within ±1.00 D of intended spherical equivalent in both groups. No eyes in the myopia group and one eye in the hyperopia group lost two or more lines of corrected distance VA. Seventy out of 100 respondents at the 12-month visit (70%) experienced an improvement in vision within hours to a few days. Vision quality was rated satisfactory to excellent by 92% of patients and 89% were happy with the procedure.</p><p><strong>Conclusion: </strong>The findings of this retrospective study suggest that non-linear aspheric micro-monovision LASIK can achieve safe and effective correction of myopic and hyperopic presbyopia with high patient satisfaction up to one year postoperatively. Prospective studies using validated questionnaires are required to further characterize patient-reported outcomes with this procedure.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"20 ","pages":"614420"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019012","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}