Romanian journal of ophthalmology最新文献

{"title":"Acute Posterior Multifocal Placoid Pigment Epitheliopathy Presenting with Multiple Serous Retinal and Bacillary Layer Detachments: A Diagnostic Challenge.","authors":"Vipin Rana, Utkarsh Roodkee, Ranjit Goenka, Raihan Mondal, Mohit Dogra, Ashish Markan, Atul Arora, Jaya Kuashik","doi":"10.22336/rjo.2026.42","DOIUrl":"10.22336/rjo.2026.42","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a diagnostically challenging case of Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE) in a young girl, presenting with features mimicking Vogt-Koyanagi-Harada (VKH) syndrome.</p><p><strong>Methods: </strong>An 18-year-old Asian Indian girl presented with sudden bilateral visual diminution and metamorphopsia for three days. Clinical examination and multimodal imaging were performed, including Enhanced Depth Imaging Optical Coherence Tomography (EDI-OCT), Fundus Fluorescein Angiography (FFA), Indocyanine Green Angiography (ICG), and Optical Coherence Tomography Angiography (OCTA). Systemic evaluation included the Mantoux test, QuantiFERON-TB Gold, HRCT of the chest, abdominal ultrasonography, and routine blood work.</p><p><strong>Results: </strong>BCVA was 20/40 in both eyes. Fundus examination revealed mild vitritis, multiple serous retinal detachments (SRD), and yellowish placoid lesions at the posterior pole. EDI-OCT showed SRD with bacillary layer detachment and mild choroidal thickening in both eyes. FFA revealed early hypofluorescence with late staining; ICG showed persistent hypocyanescent lesions localized to the posterior pole. OCTA demonstrated choriocapillaris flow voids. Mantoux and QuantiFERON-TB Gold were strongly positive; other systemic investigations were unremarkable. Given the absence of VKH prodromal features and features on multimodal imaging, a diagnosis of APMPPE was made. The patient was observed without corticosteroid therapy, and complete resolution of SRD and bacillary layer detachment occurred within 1 week.</p><p><strong>Discussion: </strong>The initial presentation with bilateral SRDs and BALADs strongly suggested VKH syndrome. However, the absence of systemic prodromal symptoms, combined with characteristic angiographic features, led to a diagnosis of APMPPE. The rapid, spontaneous resolution of these atypical detachments without corticosteroid therapy further confirmed the self-limiting nature of APMPPE, in sharp contrast to the prompt immunosuppression typically required for VKH.</p><p><strong>Conclusion: </strong>APMPPE can rarely present with atypical clinical features such as SRD and BALAD. Clinicians must integrate multimodal imaging with systemic evaluations to accurately differentiate it from VKH syndrome, thereby preventing misdiagnosis and avoiding unnecessary treatment.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 2","pages":"316-321"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702961","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":"Endoscopic Endonasal Optic Nerve Decompression for Traumatic Optic Neuropathy: A Systematic Review.","authors":"Babak Ganjeifar, Seyed Reza Ahmadi Koupaei, Ali Moradi","doi":"10.22336/rjo.2026.28","DOIUrl":"10.22336/rjo.2026.28","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic optic neuropathy (TON) is an acute injury to the optic nerve caused by direct or indirect trauma, often resulting in vision loss. Endoscopic transsphenoidal optic nerve decompression (EOND) is a minimally invasive technique designed to relieve pressure on the optic nerve. This systematic review evaluates the efficacy, safety, and visual outcomes of EOND in patients with TON.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, and Google Scholar was conducted for articles published between 2014 and 2024. Keywords included \"optic nerve decompression\", \"traumatic optic neuropathy\", and \"endoscopic optic nerve decompression\". After screening 42 articles, 16 studies met the inclusion criteria and were analyzed.</p><p><strong>Results: </strong>All included studies used the endoscopic transsphenoidal approach. The mean visual recovery rate was 58.4%. All patients received postoperative corticosteroids. Study populations ranged from 11.7 to 68.1 years, including 24 females and 354 males. Postoperative complications were reported in 25% of studies, most commonly cerebrospinal fluid (CSF) leaks.</p><p><strong>Discussion: </strong>Our findings demonstrated that endoscopic endonasal optic nerve decompression (EOND) is a safe and effective option for traumatic optic neuropathy (TON) patients unresponsive to steroids, with a mean visual recovery rate of 58.4% and a low complication profile, most commonly CSF leaks. While EOND offers clear advantages over traditional approaches, including minimal invasiveness and excellent visualization, the heterogeneity of existing data and the limited number of high-quality studies underscore the need for standardized protocols and further prospective research to optimize patient selection and surgical timing.</p><p><strong>Conclusion: </strong>EOND is a safe and effective intervention for TON patients unresponsive to medical therapy, offering minimal scarring, improved visualization, and rapid recovery. However, the limited number of studies and the heterogeneity of data highlight the need for further high-quality research to optimize outcomes.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 2","pages":"199-203"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703233","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":"SMACH: A Rare, Non-Progressive Retinal Disorder - Key Insights into Its Clinical and Imaging Characteristics. A Case Report.","authors":"Mauricio Arango-Hurtado, Karol Quintero-Lizcano, Javier Andres Díaz-Vargas, Sara Turizo Mejía, Sarita Restrepo Velásquez","doi":"10.22336/rjo.2026.44","DOIUrl":"10.22336/rjo.2026.44","url":null,"abstract":"<p><strong>Objective: </strong>To report a case of a Stellate Multiform Amelanotic Choroidopathy (SMACH). A newly recognized, rare retinal disorder that remains largely underreported in the literature.</p><p><strong>Methods: </strong>Case report and review of literature.</p><p><strong>Results: </strong>We present the case of a 67-year-old asymptomatic woman with a nasal parafoveal hypopigmented lesion. Multimodal imaging, including Optical Coherence Tomography, Optical Coherence Tomography Angiography, and fluorescein angiography, revealed hyperreflective choroidal thickening, minimal subretinal fluid, and a digitiform pattern, with no signs of neovascularization.</p><p><strong>Discussion: </strong>SMACH is a rare, benign choroidal disorder whose variable clinical presentation can complicate accurate diagnosis. Understanding its non-progressive natural history is critical for differentiating it from vision-threatening pathologies, such as choroidal tumors, macular neovascularization, or pachychoroid spectrum diseases, reducing the risk of misdiagnosis and unnecessary therapeutic intervention.</p><p><strong>Conclusions: </strong>This case enhances our understanding of SMACH and underscores the value of multimodal imaging in identifying this rare condition, providing key insights into its diagnostic approach and natural course.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 2","pages":"326-329"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703259","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":"Optical coherence tomography-guided decision-making for Descemet stripping automated endothelial keratoplasty in Ahmed glaucoma valve-related corneal decompensation.","authors":"Vijay Kumar Sharma, Prabhjot Singh, Gaurav Kapoor, Vikas Ambiya, Sagrika Patyal","doi":"10.22336/rjo.2026.36","DOIUrl":"10.22336/rjo.2026.36","url":null,"abstract":"<p><strong>Objective: </strong>Ahmed glaucoma valve (AGV) implantation can lead to corneal decompensation in a significant proportion of patients. Anterior segment optical coherence tomography (ASOCT) evaluation may serve as a crucial tool for assessing AGV retention versus explantation and for planning Descemet stripping automated endothelial keratoplasty (DSAEK) in such cases. This study aims to evaluate the utility of ASOCT in guiding management decisions for AGV-related corneal decompensation.</p><p><strong>Materials and methods: </strong>In this prospective interventional study, 11 eyes with AGV-related corneal decompensation were evaluated using anterior segment 5-line raster-mode OCT measurements. Parameters assessed included stromal scarring, corneal thickness, and tube tip to endothelium (TTE) distance. ASOCT findings guided management decisions: four patients with nonfunctional AGVs underwent staged procedures (AGV removal with augmented trabeculectomy, followed by DSAEK), while seven patients underwent DSAEK alone (six with functional AGVs with TTE distance > 150 μm; one patient with a non-functional AGV refused consent for AGV explantation).</p><p><strong>Results: </strong>All patients demonstrated significant improvement in best-corrected visual acuity with well-controlled intraocular pressure. Graft attachment was successful in all cases except one patient who experienced detachment after one month. Based on our findings, we proposed a protocol for managing AGV-related corneal decompensation.</p><p><strong>Discussion: </strong>Tube shunt implantation effectively reduces intraocular pressure in eyes with uncontrolled glaucoma but can lead to significant endothelial cell loss and corneal decompensation. In this series, two major challenges were addressed: the decision regarding AGV tube removal and its risks, and the determination of a safe tube-tip-to-endothelium (TTE) distance to prevent graft damage after DSAEK. We considered a preoperative TTE greater than 150 μm to be safe for single-stage DSAEK without AGV modification, accounting for lenticule thickness and the anticipated reduction in corneal edema. ASOCT-guided measurement of TTE distance proved invaluable for predicting complications and guiding surgical decision-making, with outcomes that support our proposed management protocol.</p><p><strong>Conclusion: </strong>While performing DSAEK in patients with AGV-related corneal decompensation presents significant challenges, ASOCT is an essential modality for guiding surgical decision-making regarding AGV explantation versus retention and subsequent DSAEK.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 2","pages":"272-278"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703237","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":"SIA Vector Analysis and Keratometry Prediction in Temporal SICS with 350 µm Scleral Incision Depth.","authors":"Prabhakar Srinivasapuram Krishnacharya, Kedar Janardhan Prabhu, Shreya Nataraj, Anisha Cyprian, Preethi Prasanna Belagutti","doi":"10.22336/rjo.2026.34","DOIUrl":"10.22336/rjo.2026.34","url":null,"abstract":"<p><strong>Objectives: </strong>The magnitude and axis of surgically induced astigmatism depend on the sclera-corneal tunnel dimensions. Often, the incision depth is subjective, and standardization is rarely emphasized. This study attempts to evaluate a fixed scleral incision depth of 350 µm at 1-week post-op. The aim is to determine the SIA vector and centroid using the Pythagorean theorem and keratometric measurements.</p><p><strong>Materials and methods: </strong>This study was conducted from January to July 2025 and recruited 42 patients at a tertiary health institution. All patients received scleral incisions to a depth of 350 µm after preoperative auto-keratometry measurements. Preoperative astigmatism was classified into WTR, ATR, and oblique types.</p><p><strong>Results: </strong>The overall mean age was 67.14 (± 9.23) years, with 27 (64.29%) males and 15 (35.71%) females. A positive correlation (r = 0.93, 0.69) was found for pre- and post-operative keratometry. T-test for pre- and post-operative vertical keratometry revealed statistical significance (p < 0.0009). The mean SIA magnitude and axis were 2.05 (± 1.75) D and 77.94º (± 59.68º), respectively. The Wilcoxon signed-rank test showed statistical significance for SIA magnitude (p=0.0003). The centroid was at 22.3º. A 28.57% conversion rate from ATR to WTR was observed, with 71.43% remaining unchanged postoperatively. High prediction accuracy was observed for preoperative horizontal and vertical keratometry (R² values of 0.93 and 0.74, respectively).</p><p><strong>Discussion: </strong>This work adds a unique dimension to the literature by explicitly linking a fixed tunnel depth to the SIA vector and keratometric prediction. These results provide a platform for future research exploring scleral incision depth as a determinant of astigmatic outcomes.</p><p><strong>Conclusions: </strong>This study finds a statistically significant difference in vertical keratometry with moderate SIA magnitude. Astigmatic axis transition was unchanged in most patients, likely due to a standardized scleral incision depth. Centroid demonstrated a minimal SIA magnitude on horizontal keratometry. An excellent postoperative keratometry prediction was determined.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 2","pages":"259-266"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703274","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":"Spontaneous late-onset pupillary block in a pseudophakic, vitrectomized eye despite prior Nd:YAG capsulotomy: a diagnostic challenge.","authors":"Batuhan Aksoy, Cansu Yüksel Elgin","doi":"10.22336/rjo.2026.46","DOIUrl":"10.22336/rjo.2026.46","url":null,"abstract":"<p><strong>Objective: </strong>To report a rare case of spontaneous, delayed-onset pupillary block in a pseudophakic, vitrectomized eye with a prior Nd: YAG posterior capsulotomy, and to emphasize the importance of maintaining a high index of suspicion even in anatomically protected eyes.</p><p><strong>Methods: </strong>We describe the clinical presentation, imaging findings, differential diagnosis, and management of a 78-year-old female with well-controlled primary open-angle glaucoma who presented with acute angle-closure symptoms in a previously vitrectomized, pseudophakic eye. Multimodal imaging, including anterior segment optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM), was utilized to rule out malignant glaucoma and aqueous misdirection.</p><p><strong>Results: </strong>Slit-lamp examination revealed iris bombe and appositional angle closure in the left eye. Anterior segment OCT confirmed a shallow anterior chamber, while UBM excluded ciliochoroidal effusion and anterior rotation of the ciliary body. A diagnosis of acute pupillary block was established. Nd: YAG laser peripheral iridotomy (LPI) resulted in immediate resolution of symptoms and normalization of intraocular pressure.</p><p><strong>Discussion: </strong>Although pupillary block is generally considered unlikely in pseudophakic and vitrectomized eyes, this case demonstrates that it may still occur despite prior Nd:YAG posterior capsulotomy. Progressive anatomical changes may contribute to delayed obstruction of aqueous flow. Careful clinical examination, combined with anterior segment OCT and UBM, is essential for distinguishing pupillary block from other causes of secondary angle closure, particularly malignant glaucoma and aqueous misdirection.</p><p><strong>Conclusions: </strong>This case demonstrates that pupillary block can occur spontaneously even in eyes with prior vitrectomy and YAG capsulotomy. Progressive anatomical changes may lead to delayed iris-lens apposition. Early diagnosis and treatment with LPI can reverse the condition and preserve vision. Clinicians should consider pupillary block in the differential diagnosis of acute angle closure, regardless of prior surgical history.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 2","pages":"334-337"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703280","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":"Retinal Changes in Chronic Kidney Disease: A Spectral-Domain Optical Coherence Tomography Study Correlated with Biochemical Parameters.","authors":"Sanagama Bhargav, Priyanka Pantola, Avadhesh Oli","doi":"10.22336/rjo.2026.38","DOIUrl":"10.22336/rjo.2026.38","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic Kidney Disease (CKD) is a significant public health problem associated with considerable morbidity and mortality. It is known to cause retinal vascular changes and retinopathy that reflects changes occurring in the kidneys. Optical coherence tomography (OCT) is a promising biomarker for assessing retinal changes associated with CKD. This study was conducted to evaluate retinal alterations in patients with CKD using spectral-domain optical coherence tomography (SD-OCT), correlate these findings with biochemical parameters to facilitate early screening and timely detection, and assess disease progression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This single-centre, cross-sectional study included 60 eyes of 60 patients with stage 3, 4, or 5 CKD. Data collected included age, sex, glycaemic status, serum electrolytes, blood urea nitrogen (BUN), and serum creatinine. Fundus examination and various OCT parameters were measured. Central retinal thickness (CRT) and central choroidal thickness (CCT) were measured manually at the subfoveal region. Automated segmentation was used to measure retinal nerve fibre layer (RNFL) and ganglion cell complex (GCC) thicknesses across all quadrants and sectors using SD-OCT. Descriptive and inferential statistical analyses were applied to assess significance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Most patients were in Stage 3 CKD, with the majority having a disease duration of 1-3 years. Mean retinal thickness reduced from stage 3 to 5 with no statistical significance, while choroidal thickness remained preserved. Inferior RNFL thickness declined significantly with worsening CKD, whereas temporal RNFL and GCC showed borderline significance. Retinal parameters did not differ by CKD duration. Elevated HbA1c was associated with increased retinal thickness and thicker inferior RNFL. Both hypernatremia and hyperkalemia were associated with reduced retinal thickness. A higher glomerular filtration rate (GFR) was positively correlated with inferior RNFL thickness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The findings of this study suggest that chronic kidney disease is associated with progressive neuroretinal changes, particularly thinning of the inferior retinal nerve fibre layer, which may reflect underlying microvascular and neurodegenerative processes occurring in CKD. The preservation of choroidal thickness despite declining renal function indicates that neuroretinal alterations may precede detectable choroidal changes. The observed associations between OCT parameters and biochemical markers, including HbA1c, serum sodium, potassium, and GFR, further support the influence of systemic metabolic and renal status on retinal structure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The study highlights that chronic kidney disease is associated with neuroretinal alterations that become more pronounced as disease severity increases. Optical Coherence Tomography has emerged as an important biomarker for evalu","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 2","pages":"286-294"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703298","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":"Evaluation of Ocular Higher-Order Aberrations in Patients with Migraine: A Comparative Study.","authors":"Ashutosh Kumar Mishra, Ruchi Shukla, Pragati Garg, Aparajita Shukla, Mukesh Shukla, Nilakshi Banerjee","doi":"10.22336/rjo.2026.31","DOIUrl":"10.22336/rjo.2026.31","url":null,"abstract":"<p><strong>Objective: </strong>To assess and compare higher-order aberrations (HOAs) in migraine patients versus healthy controls, and to explore potential correlations between aberrometric parameters and migraine characteristics.</p><p><strong>Methods: </strong>A cross-sectional study was conducted involving 99 migraine patients (32 episodic and 67 chronic) and 99 age- and sex-matched controls. Comprehensive ophthalmologic examinations and wavefront aberrometry (using Huvitz HRK-8000A Autorefractor/Keratometer based on a Hartmann-Shack principle) were performed on all participants. HOAs, including spherical aberration, coma, trefoil, and quadrafoil, were quantified. Statistical analyses examined differences between groups and correlations with clinical migraine data.</p><p><strong>Results: </strong>Migraine patients exhibited higher total HOAs, but the result was not statistically significant compared to controls. Coma and oblique trefoil aberrations were notably elevated in the migraine patients. Oblique trefoil was significantly higher in cases than in controls. However, no correlation was found between HOA magnitude and migraine disease duration. Statistically significant correlation was found when comparing episodic versus chronic migraine cases.</p><p><strong>Discussion: </strong>Increased higher-order aberrations, especially oblique trefoil, are linked to chronic migraine, indicating that even with normal acuity, small optical variables may cause visual disruptions. Although more long-term research is required to establish causality, these results point to a combination of ocular and neurological mechanisms.</p><p><strong>Conclusions: </strong>Migraine patients demonstrate increased higher-order ocular aberrations, which may contribute to their visual symptoms. Aberrometry may serve as a valuable tool in identifying visual triggers and customizing optical interventions for migraine management.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 2","pages":"225-232"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703227","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":"Scleral suture fixation of a foldable intraocular lens without a scleral flap or groove.","authors":"Hasan Burhanettin Kaptı, Kader Kasar","doi":"10.22336/rjo.2026.37","DOIUrl":"10.22336/rjo.2026.37","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the surgical and visual outcomes of a sutured intraocular lens (IOL) fixation approach performed without creating a scleral flap or tunnel in aphakic eyes without posterior capsule support.</p><p><strong>Methods: </strong>In this retrospective study, we evaluated aphakic patients who underwent surgery using the ab externo scleral fixation technique that involved tying IOL fixation sutures on the sclera and placing the suture ends under the Tenon's capsule without opening the scleral flap. Preoperative and postoperative visual acuity, refraction values, intraocular lens centralization, and operation-related complications were analyzed.</p><p><strong>Results: </strong>In the study involving 38 patients with an average follow-up period of 8.2 months, the best-corrected visual acuity (BCVA) improved from an average of 1.00 logMAR to 0.10 logMAR. Spherical equivalent refraction decreased from +10.03 D to +0.96 D. Intraocular lens decentration was observed in 7.9% of cases. No intraoperative complications were observed, while 5.2% of patients experienced postoperative corneal edema and 2.6% experienced macular edema.</p><p><strong>Discussion: </strong>The results of this study demonstrate that the ab externo scleral fixation technique without a scleral flap or groove is a safe and effective approach for secondary IOL implantation in aphakic eyes. The significant improvement in BCVA (from 1.00 to 0.10 logMAR) and the substantial reduction in spherical equivalent refraction confirm the technique's optical efficacy. The low rates of intraoperative and postoperative complications, along with satisfactory IOL centration in 92% of cases, support the safety profile of this method. By positioning the suture ends beneath Tenon's capsule rather than creating a scleral flap or tunnel, this technique reduces operative complexity. It minimizes the risk of suture exposure and conjunctival erosion, while maintaining reliable IOL fixation.</p><p><strong>Conclusions: </strong>Due to its short surgical length, low complication rate, and satisfactory visual results, this simplified sutured IOL fixing technique without a scleral flap or tunnel is safe and effective. Suture exposure is reduced, and the procedure is less invasive, with the suture ends under Tenon's capsule. Larger, comparable, and prospective research is needed to assess the method's long-term effects.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 2","pages":"279-285"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703292","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":"Consumer Decision-Making and Ophthalmic Conditions: A Novel Area of Marketing Research.","authors":"Consuela-Mădălina Gheorghe","doi":"10.22336/rjo.2026.26","DOIUrl":"https://doi.org/10.22336/rjo.2026.26","url":null,"abstract":"","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"70 2","pages":"189-190"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703128","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}