Int Ophthalmol [JOURNAL]
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200 papers
Impact of glaucoma on quality of life: a systematic review and meta-analysis in Ethiopia.
Abdulwehab S, Tolesa K, Kedir F
Int Ophthalmol · 2026 Mar · PMID 41915101 · Publisher ↗
INTRODUCTION: Glaucoma is a leading cause of irreversible blindness worldwide, with profound physical and psychosocial effects. In Ethiopia, limited access to specialized eye care, delayed diagnosis, and low awareness ex...
INTRODUCTION: Glaucoma is a leading cause of irreversible blindness worldwide, with profound physical and psychosocial effects. In Ethiopia, limited access to specialized eye care, delayed diagnosis, and low awareness exacerbate its impact on patients' quality of life. This review aimed to synthesize existing evidence on the prevalence and determinants of poor QoL among glaucoma patients in Ethiopia. METHODS: Following the PRISMA 2020 guidelines, a systematic search was conducted across PubMed, Scopus, Web of Science, CINAHL, and Google Scholar up to March 2025 (PROSPERO: CRD420251018342). Eligible studies assessed QoL among adult glaucoma patients in Ethiopia using standardized instruments. Methodological quality was appraised using the Joanna Briggs Institute checklist, and a random-effects model was applied to estimate pooled prevalence. Heterogeneity was evaluated with I statistics, and certainty of evidence was assessed using the GRADE framework. RESULTS: Four hospital-based studies met the inclusion criteria. Three NEI-VFQ-25 studies were meta-analyzed, yielding a pooled prevalence of 47% (95% CI: 44-50; I = 19.6%). One additional WHOQOL-BREF study, which was not pooled because of tool heterogeneity, reported a comparable prevalence of 46.3%. Factors consistently associated with poorer QoL included older age, rural residence, low education, economic hardship, limited healthcare access, disease severity, and psychological distress. CONCLUSION AND RECOMMENDATIONS: Nearly half of Ethiopian glaucoma patients experience impaired QoL. The certainty of this evidence is low to very low due to cross-sectional study designs and limited representativeness. Strengthening early detection, equitable access to eye care, patient education, and psychosocial support is essential, while community-based longitudinal studies are needed to generate higher-quality evidence.
Comparative assessment of corneal biomechanical parameters in lactating versus non-lactating women: implications for refractive surgery candidates.
Kashfi A, Ghoreishi M, Pourazizi M … +4 more , Irajpour M, Mohammadinia M, Paknazar F, Kazemi H
Int Ophthalmol · 2026 Mar · PMID 41902983 · Publisher ↗
BACKGROUND: To assess and compare corneal biomechanical parameters between lactating and non-lactating women. METHODS: This analytical cross-sectional study included women aged 25-40 years with myopia or myopic astigmati...
BACKGROUND: To assess and compare corneal biomechanical parameters between lactating and non-lactating women. METHODS: This analytical cross-sectional study included women aged 25-40 years with myopia or myopic astigmatism. The case group comprised women who had been lactating for more than six months. The control group comprised healthy, non-pregnant, non-lactating refractive-surgery candidates in the same age range. Corneal biomechanical properties were measured with the Corvis ST. RESULTS: Fifty eyes from fifty lactating women (mean age: 31.28 ± 4.06 years) and a hundred eyes from one hundred non-lactating women (mean age: 30.68 ± 4.33 years) were included (P = 0.39). The median duration of breastfeeding was 12 months (range: 7-23 months). Initial analysis revealed significantly lower CCT, Radius, and stiffness parameter (SP-A1) in the lactating group compared to controls (P < 0.05). After adjusting for differences in CCT, no statistically significant differences were observed in any corneal biomechanical parameters (P > 0.05). CONCLUSIONS: Corneal biomechanical parameters in women who were lactating for over 6 months did not significantly differ from those of non-lactating women; these findings suggest that refractive correction surgery may be considered for such patients, pending further investigation.
Intravitreal sustained-release dexamethasone implant for the treatment of postoperative cystoid macular edema following vitrectomy.
Huynh E, Chronopoulos A, Langbein L … +1 more , Hattenbach LO
Int Ophthalmol · 2026 Mar · PMID 41886138 · Publisher ↗
AIM: Previous findings have demonstrated that intravitreal sustained-release dexamethasone (DEX) implants improve functional and anatomical outcomes in patients with cystoid macular edema (CME) following cataract surgery...
AIM: Previous findings have demonstrated that intravitreal sustained-release dexamethasone (DEX) implants improve functional and anatomical outcomes in patients with cystoid macular edema (CME) following cataract surgery; however, data on the influence of different surgical indications remain limited. This study aims to evaluate the efficacy of DEX implants in patients with persistent postoperative CME following vitrectomy, and to assess differences in treatment response regarding surgical indication, phakic status, and prior treatment received before DEX. METHODS: In this single-center study, we retrospectively reviewed data from 57 patients (57 eyes) who received a DEX implant for persistent postoperative CME following vitrectomy; main outcome measures were change in best corrected visual acuity (BCVA) and central retinal thickness (CRT). We then measured the effect of treatment outcomes across subgroups of patients according to surgical indication (rhegmatogenous retinal detachment vs. epiretinal membrane), phakic status, and prior receipt of subtenon triamcinolone. RESULTS: Patient eyes receiving a DEX implant achieved a significant improvement in both functional and anatomical outcomes: BCVA gain, 0.53 to 0.47 logMAR (p = 0.0180); CRT reduction, 453.5 µm to 381.6 µm (p < 0.0001). The mean number of DEX implants received was 1.74, with no significant differences observed between patient subgroups. Subgroup comparisons did not show any significant impacts on BCVA or CRT by either surgical indication or type of surgery. CONCLUSION: Sustained-release DEX implants provided immediate and lasting functional and anatomical benefits in patients with persistent postoperative CME. Outcomes such as the required number of DEX implants or treatment response were not significantly impacted by subgroup factors.
Clinical profile and outcomes of endogenous endophthalmitis at the University of the Philippines-Philippine General Hospital: an eight-year retrospective study.
Sy PKT, Sosuan GMN, Lim Bon Siong R
Int Ophthalmol · 2026 Mar · PMID 41886132 · Publisher ↗
OBJECTIVES: To describe the clinical profile and outcomes of patients diagnosed with endogenous endophthalmitis at a national university hospital in the Philippines. METHODS: This single-center, 8-year retrospective, cro...
OBJECTIVES: To describe the clinical profile and outcomes of patients diagnosed with endogenous endophthalmitis at a national university hospital in the Philippines. METHODS: This single-center, 8-year retrospective, cross-sectional chart review examined the medical records of patients clinically diagnosed with endogenous endophthalmitis at the Philippine General Hospital Department of Ophthalmology and Visual Sciences from January 1, 2017 to December 31, 2024. The data included were patient demographics, clinical presentation, initial and final best corrected visual acuity, microbiological profile of intraocular and systemic infections, and management performed. RESULTS: Twenty-seven eyes of 25 patients were included in the study. The mean age was 50.2 ± 14.7 years old with majority (36%) of the patients in the 51-60 years-old age range. There was a slight male predilection (60%). Twenty-three patients had unilateral disease, while 2 patients had bilateral disease. The mean duration from symptom onset to consult was 10.1 ± 8.8 days and the mean duration of follow-up was 5.4 ± 4.6 months. The most common presenting symptoms were blurred vision (93%), eye redness (85%), and eye pain (70%). The most common presenting signs were vitritis (93%), absence of fundus view and anterior chamber inflammation (85%), and conjunctival injection (74%). Majority of patients (33%) had an initial best corrected visual acuity of hand movement. The most common risk factors identified were diabetes (64%), sepsis (32%), and chronic kidney disease (28%). The culture positivity rate was 44% for both intraocular and systemic cultures. The most common organism isolated from intraocular cultures (vitreous) was Klebsiella pneumoniae and the most common organism isolated from systemic cultures was Staphylococcus aureus, with majority without identified extraocular foci of infection at 48%. Among systemic cultures, Gram-positive organisms were usually seen in the setting of sepsis while Gram-negative organisms were all isolated from the urinary tract. Majority (56%) underwent pars plana vitrectomy as the primary management performed but the final best corrected visual acuity was most commonly no light perception (52%). Only 7% of patients had a final visual acuity better than counting fingers. CONCLUSION: Endogenous endophthalmitis is a severe disease with devastating consequences. Despite timely diagnosis and management, majority of patients still end up with poor nonfunctional vision. Gram-negative microorganisms are the most common etiologic agents of endogenous endophthalmitis consistent with studies in East Asia. However, none of the patient in this study had documented liver pathology.
Outcomes of vitreoretinal surgery for familial exudative vitreoretinopathy: a systematic review and meta-analysis of the current literature.
Tahoun M, Kiraly P, Tahoun R … +3 more , Ivanova T, Bakr A, Jalil A
Int Ophthalmol · 2026 Mar · PMID 41886127 · Publisher ↗
PURPOSE: To systematically review the anatomical and functional outcomes of vitreoretinal surgery for familial exudative vitreoretinopathy (FEVR)-associated retinal detachment (RD). METHODS: A systematic review and meta-...
PURPOSE: To systematically review the anatomical and functional outcomes of vitreoretinal surgery for familial exudative vitreoretinopathy (FEVR)-associated retinal detachment (RD). METHODS: A systematic review and meta-analysis were conducted following a PROSPERO-registered protocol. The Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Ovid, and Medline databases were searched for cohort studies and case series evaluating scleral buckling (SB), pars plana vitrectomy (PPV), or combined procedures for FEVR. Primary outcomes were retinal reattachment rates and postoperative best-corrected visual acuity (BCVA). Secondary outcomes included complication and reoperation rates. RESULTS: Nineteen studies involving a total of 682 eyes were included. The overall pooled primary retinal reattachment rate was 0.77 (95% Confidence Interval (CI): 0.71-0.83; I = 59.8%). Subgroup analysis demonstrated a pooled primary reattachment rate for SB of 0.90 (95% CI: 0.70-1.00; I = 12.7%) and for PPV of 0.71 (95% CI: 0.60-0.80; I = 49.1%). The pooled reoperation rate was 0.24 (95% CI: 0.08-0.45). Qualitative analysis showed that while BCVA outcomes were heterogeneously reported, they generally improved postoperatively. Surgical success was highly dependent on disease stage. CONCLUSION: Surgical management of FEVR-associated RD achieves high primary reattachment rates. While both SB and PPV yield favourable outcomes, the choice of procedure should be tailored to disease severity and patient characteristics. The evidence suggests SB may be preferred for uncomplicated rhegmatogenous detachments, while PPV is often necessary for more advanced and complex cases.
A comprehensive review of management modalities for glaucoma and intraocular hypertension during pregnancy.
Anton N, Dohotariu FC, Armeanu T … +3 more , Lisă R, Bogdănici CM, Doroftei B
Int Ophthalmol · 2026 Mar · PMID 41880117 · Full text
INTRODUCTION: Glaucoma during pregnancy presents a complex clinical challenge, requiring a careful balance between effective intraocular pressure (IOP) control and fetal safety. BACKGROUND: This review examines the ocula...
INTRODUCTION: Glaucoma during pregnancy presents a complex clinical challenge, requiring a careful balance between effective intraocular pressure (IOP) control and fetal safety. BACKGROUND: This review examines the ocular changes that occur during pregnancy and their implications for glaucoma progression and management. METHODS: It synthesizes current evidence on IOP fluctuations, disease progression risks, and the safety profiles of pharmacologic, laser, and surgical interventions. Studies were included if they met the following criteria: (1) involved pregnant women diagnosed with glaucoma or ocular hypertension; (2) evaluated medical, laser, or surgical management strategies during pregnancy; and (3) reported outcomes related to intraocular pressure control, optic nerve evaluation, or visual field assessment. Studies focusing exclusively on other ocular complications of pregnancy were excluded. Particular attention is given to emerging trends in minimally invasive glaucoma surgeries (MIGS), diagnostic innovations, and pharmacotherapies tailored to the gestational period. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework was used to guide methodological rigor and transparency. RESULTS: From 257 initially identified records, 184 studies remained after duplicate removal. Following the title and abstract screening, 73 full text articles were assessed for eligibility. Ultimately, 54 studies met all inclusion criteria and were included in the final review. However, pregnancy introduces diagnostic challenges related to IOP assessment, variability in individual responses, and the possibility of paradoxical IOP elevation. The extent of IOP reduction during pregnancy may be influenced by physiological and demographic factors such as age, parity, systemic blood pressure, and central corneal thickness (CCT), all of which can modulate the degree of IOP change. For instance, multiparous women often exhibit greater IOP decreases than primigravidas. Beta-blockers remain among the most frequently prescribed agents during pregnancy; however, punctal occlusion is recommended to reduce systemic absorption. Alternative treatment options, including selective laser trabeculoplasty (SLT) and minimally invasive glaucoma surgery (MIGS), may be considered based on disease severity and gestational stage. CONCLUSIONS: The findings advocate for a patient-centered approach that integrates evidence-based strategies to preserve maternal vision while ensuring fetal well-being. Ongoing research and interdisciplinary collaboration will be essential in developing new approaches while safeguarding both maternal and fetal health.
Comparative accuracy of image-guided systems and smartphone applications for enhanced monofocal toric IOL alignment in cataract surgery.
Yang S, Song JY, Jeon Y … +3 more , Byun YS, Kim HS, Chung SH
Int Ophthalmol · 2026 Mar · PMID 41874809 · Publisher ↗
PURPOSE: To compare the clinical outcomes of cataract surgery with toric intraocular lenses (IOLs) using two different alignment methods: an image-guided system and a smartphone application-guided method, and to evaluate...
PURPOSE: To compare the clinical outcomes of cataract surgery with toric intraocular lenses (IOLs) using two different alignment methods: an image-guided system and a smartphone application-guided method, and to evaluate their efficacy, feasibility, and potential for improving accessibility. METHODS: This retrospective study analyzed 171 eyes of 120 patients undergoing cataract surgery with an enhanced monofocal toric IOL (Eyhance, Johnson & Johnson Inc., USA). Because some patients contributed both eyes, within-patient correlation was accounted for using generalized estimating equations (GEE). Outcomes included toric alignment error and refractive outcomes. RESULTS: Mean absolute alignment error was 1.37 ± 1.29° in the image-guided group and 1.84 ± 1.47° in the smartphone-guided group. In clustered GEE analysis, the smartphone workflow was associated with higher absolute alignment error (p = 0.04). Postoperative refractive cylinder and spherical equivalent prediction accuracy were similar between groups. CONCLUSION: Both systems demonstrated excellent refractive outcomes. The image-guided system provides superior accuracy in total absolute alignment error. While the smartphone application also provides comparable outcomes, it offers a cost-effective alternative, expanding accessibility in resource-limited settings.
Corneal thinning and perforation: a narrative review of diagnostic and stepwise management strategies.
Bin Helayel H, Bin Dakhil N, Alnutaifi R … +6 more , Alkathery F, Abukhaled Y, Alsaif BA, Aldayel A, Kirat O, Fairaq R
Int Ophthalmol · 2026 Mar · PMID 41874780 · Publisher ↗
PURPOSE: Corneal perforation is a sight-threatening ophthalmic emergency caused by trauma, infection, autoimmune disease, or ocular surface disorders. Early recognition and timely management are critical to maintain glob...
PURPOSE: Corneal perforation is a sight-threatening ophthalmic emergency caused by trauma, infection, autoimmune disease, or ocular surface disorders. Early recognition and timely management are critical to maintain globe integrity and prevent complications. This review synthesizes current knowledge on the diagnosis and management of corneal perforations. METHODS: A narrative review of the literature was conducted using PubMed, Scopus, Web of Science, and Google Scholar through 2025. Keywords included "corneal perforation," "corneal thinning," "corneal melt," "ulcerative keratitis," "tissue adhesive," "amniotic membrane transplantation," and "keratoplasty." English-language original studies, case series, and reviews were included, and unrelated reports were excluded. Data were qualitatively synthesized due to heterogeneity in study designs. Illustrative clinical cases from King Khaled Eye Specialist Hospital were included to demonstrate real-world diagnostic and therapeutic approaches. RESULTS: Major causes of corneal perforation include infectious keratitis, autoimmune/inflammatory diseases, neurotrophic keratopathy, trauma (including iatrogenic), and degenerative or exposure-related conditions. Common clinical features are rapid vision loss, severe ocular pain, and tearing. Evaluation requires a careful, minimally manipulative examination with adjunctive imaging and systemic assessment when indicated. Management options include tissue adhesives, amniotic membrane grafts, platelet-rich plasma, lamellar or penetrating keratoplasty, and conjunctival flaps. Recent advances in biological adhesives, amniotic membrane techniques, and anterior segment imaging have expanded treatment options and improved outcomes. Follow-up is guided by slit lamp examinations and imaging. CONCLUSION: This review integrates recent evidence and evolving strategies to provide clinicians with a structured, stepwise framework for managing corneal perforations.
Timing of corneal cross-linking in eyes undergoing intracorneal ring segments for keratoconus: same-day versus staged CXL: a systematic review and meta-analysis.
Bonajmah H, Aljassar F, Taqi AA … +1 more , AlSabah DH
Int Ophthalmol · 2026 Mar · PMID 41874765 · Publisher ↗
BACKGROUND: In keratoconus managed with intracorneal ring segments (ICRS) plus corneal cross-linking (CXL), ICRS primarily reshapes the cornea while CXL provides biomechanical improvement and shape stabilization. However...
BACKGROUND: In keratoconus managed with intracorneal ring segments (ICRS) plus corneal cross-linking (CXL), ICRS primarily reshapes the cornea while CXL provides biomechanical improvement and shape stabilization. However, clinical practice varies regarding whether CXL should be performed on the same day as ICRS or delayed, and it remains uncertain whether CXL timing modifies the postoperative optical and topographic outcomes of ICRS. METHODS: We systematically searched PubMed, Web of Science, Scopus, and the Cochrane Library from inception to October 2025 and included seven comparative studies (2010-2025; 2 randomized trials, 5 cohorts) comparing same-day ICRS + CXL versus staged (typically CXL 3-6 months later). Outcomes covered ΔCDVA/ΔUDVA (logMAR), refractive cylinder and spherical equivalent (SE), keratometry (Kmax, K1, K2, Km), and adverse events; Common-effect models summarized pooled effects. RESULTS: Visual acuity improvements were equivalent between strategies with no heterogeneity (I = 0% for both ΔCDVA and ΔUDVA). Refractive changes (cylinder, SE) clustered near null, indicating comparable refractive normalization. Keratometry showed no difference in ΔKmax, while ΔKm trended toward slightly greater flattening with same-day surgery, narrowly missing significance; K1 and K2 showed similar, non-definitive flattening trends favoring simultaneous treatment. Safety was comparable overall; pooled adverse events did not differ meaningfully between strategies. CONCLUSIONS: Same-day and staged ICRS + CXL provide similar gains in vision and refraction with comparable safety at 6-12 months, addressing short-term outcome differences attributable to CXL timing rather than progression control. Small keratometric signals favoring simultaneous surgery are not conclusive. Either strategy is reasonable; larger, well-designed randomized trials with longer follow-up should test whether subtle keratometric differences translate into superior long-term stability.
Revealing the therapeutic potential of Laminaria japonica polysaccharides against cataract: evidence from transcriptomics, network pharmacology, and in vivo experiments.
Liao P, Yang T, Lin L … +4 more , Liang Y, Gan Q, Lan T, Liang H
Int Ophthalmol · 2026 Mar · PMID 41874747 · Full text
OBJECTIVE: To investigate the protective effects and underlying molecular mechanisms of Laminaria japonica polysaccharides (LPs) against cataract. METHODS: An integrated strategy combining transcriptomic analysis, networ...
OBJECTIVE: To investigate the protective effects and underlying molecular mechanisms of Laminaria japonica polysaccharides (LPs) against cataract. METHODS: An integrated strategy combining transcriptomic analysis, network pharmacology, machine learning, molecular docking, and in vivo validation was employed. Differentially expressed genes were identified from the GSE213546 dataset, and key targets were screened using WGCNA, protein-protein interaction analysis, and machine learning algorithms. Molecular docking was performed to evaluate interactions between major LPs components and core targets. A UVB-induced cataract model was established in 8-week-old male Sprague-Dawley rats to validate the protective effects of laminarin by assessing lens opacity, antioxidant activity, and apoptosis-related markers. RESULTS: XDH, ANPEP, and SNCA were identified as key targets associated with cataract and LPs intervention. Major LPs components, including Laminarin, Fucoidan, and Alginate, showed stable binding affinities with these targets. In vivo experiments demonstrated that Laminarin treatment significantly reduced lens opacity, increased superoxide dismutase (SOD) activity, upregulated SMP30 and FoxO4 expression, and modulated apoptosis-related markers by decreasing Bax and cleaved Caspase-3 while increasing Bcl-2 levels. CONCLUSIONS: These findings suggest that LPs may attenuate UVB-induced cataract by targeting XDH, ANPEP, and SNCA. In vivo evidence further indicates that this intervention enhances antioxidant defenses, as reflected by increased SOD activity and upregulation of SMP30 and FoxO4, while suppressing apoptosis, thereby contributing to protection against lens damage.
Study of circulating MiRNA expression in myopic patients.
Kunceviciene E, Liutkeviciene R, Budiene B … +5 more , Smalinskiene A, Belickiene V, Grabauskyte I, Vilkeviciute A, Kucinskas L
Int Ophthalmol · 2026 Mar · PMID 41870798 · Publisher ↗
This study examines five circulating microRNAs (miRNAs) (miR-29a, let-7i, miR-204, miR-142, and miR-328) potentially relevant to the diagnostic and/or prognostic significance of myopia. miRNA expression was analyzed usin...
This study examines five circulating microRNAs (miRNAs) (miR-29a, let-7i, miR-204, miR-142, and miR-328) potentially relevant to the diagnostic and/or prognostic significance of myopia. miRNA expression was analyzed using StepOnePlus™ RT-PCR. miRNA expression was evaluated in whole blood samples collected and stored using Tempus™ Blood RNA Tubes. The expression of five miRNAs was analyzed in 88 participants: 45 in the myopia group and 43 in the control (emmetropic) group. Heatmap analysis revealed differences in the expression patterns of miR-29a, let-7i, miR-204, and miR-142 when comparing individuals with myopia and controls. The intensity of miR-328 expression was similar between the myopia and control groups. A significant correlation was observed between miR-204 ΔCt and spherical equivalent. However, comparison of median values between different degrees of myopia and the control group did not reveal significant differences. The simultaneous evaluation of multiple circulating miRNAs may help to better understand biological processes associated with myopia.
Perfluorohexyloctane eye drops in treating dry eye disease associated with meibomian gland dysfunction: a post hoc analysis by baseline severity.
Liu Z, Ma L, Li Y … +2 more , Tian L, Jie Y
Int Ophthalmol · 2026 Mar · PMID 41870723 · Full text
PURPOSE: This post hoc analysis aimed to explore the effect of perfluorohexyloctane on dry eye disease (DED) associated with meibomian gland dysfunction (MGD) by baseline disease severity. METHODS: Data from a randomized...
PURPOSE: This post hoc analysis aimed to explore the effect of perfluorohexyloctane on dry eye disease (DED) associated with meibomian gland dysfunction (MGD) by baseline disease severity. METHODS: Data from a randomized phase 3 trial (NCT05515471) were divided based on the baseline severity of DED signs (total corneal fluorescein staining [tCFS] score: < 6 or ≥ 6; tear film breakup time: < 3 or ≥ 3; MGD score: < 7 or ≥ 7) or symptoms (eye dryness scores [EDS]: < 70 or ≥ 70; ocular surface disease index score: < 60 or ≥ 60). The main outcomes of interest included response rates at day 57 of tCFS score, EDS, and tCFS and EDS, safety, and tolerability. RESULTS: Participants treated with perfluorohexyloctane had greater odds of achieving EDS (odds ratio [OR]: 2.25; 95% confidence interval [CI]: 1.34, 3.80), tCFS (OR: 2.21; 95% CI: 1.38, 3.55), and tCFS and EDS (OR: 2.56; 95% CI: 1.62, 4.04) responses than those treated with 0.6% sodium chloride in the overall population. No significant treatment interaction effect was observed by any DED signs or symptoms except for a significant effect of baseline tCFS score on EDS response, with a relatively large effect in participants with tCFS ≥ 6 versus tCFS < 6 (propensity score-weighted OR: 4.35 versus 1.26; P = 0.0317). The safety and tolerability profiles of perfluorohexyloctane stratified by baseline disease severity were generally consistent. CONCLUSION: Perfluorohexyloctane was well tolerated and improved the signs and symptoms of DED associated with MGD in patients with different baseline disease severity compared to saline control.
Candida pelliculosa cluster endophthalmitis: clinical profile and surgical outcomes in twelve eyes.
Kannan NB, Elamurugan V, Muthukrishnan V … +2 more , Babu VJS, Ramasamy K
Int Ophthalmol · 2026 Mar · PMID 41863673 · Publisher ↗
PURPOSE: To describe the clinical features and surgical outcomes of Candida pelliculosa cluster endophthalmitis following cataract surgery. METHODS: Twelve eyes of ten patients developed endophthalmitis after uncomplicat...
PURPOSE: To describe the clinical features and surgical outcomes of Candida pelliculosa cluster endophthalmitis following cataract surgery. METHODS: Twelve eyes of ten patients developed endophthalmitis after uncomplicated phacoemulsification with intraocular lens (IOL) implantation performed at a single hospital. All underwent core vitrectomy, IOL explantation, and intravitreal injections of vancomycin, ceftazidime, and voriconazole. Explanted IOL-bag complexes and vitreous samples were analyzed microbiologically. Secondary scleral-fixated IOL (SFIOL) implantation was performed after disease quiescence. Minimum follow-up was three months. RESULTS: The mean interval from cataract surgery to presentation was 28 days. Presenting symptoms included pain, redness, and mild vision loss. Mean presenting BCVA was 20/40 (0.3 LogMAR). All eyes showed mild congestion, keratic precipitates, fluffy capsular plaques, IOL deposits, and vitritis; three had corneal tunnel infiltrates and two had "string of pearls." Candida pelliculosa was isolated from all explanted IOL-bag complexes, while vitreous cultures were negative. All lenses were monofocal and from the same manufacturer. Mean post-vitrectomy BCVA was 20/60 (0.48 LogMAR; p = 0.718). Five eyes developed cystoid macular edema, one required sub-Tenon triamcinolone, and four developed epiretinal membranes. After a mean of 5.2 months, seven eyes underwent SFIOL implantation, achieving a final BCVA of 20/32 (p = 0.33). CONCLUSION: This first reported series of postoperative Candida pelliculosa cluster endophthalmitis underscores its subtle presentation and delayed onset. Early vitrectomy with IOL-bag explantation ensures infection control and favorable visual recovery.
Clinical efficacy and safety of anti-VEGF biosimilars compared to reference anti-VEGF agents for neovascular age-related macular degeneration: a systematic review, meta-analysis, and meta-regression.
Al-Shammari YM, AlDhafiri YM, Ahmad AK … +3 more , Alkharraz BB, Al-Awadhi MA, Alnabhan RM
Int Ophthalmol · 2026 Mar · PMID 41860622 · Publisher ↗
BACKGROUND: Neovascular age-related macular degeneration (AMD) is a leading cause of irreversible vision loss among the elderly. Current treatment options include intravitreal anti-VEGF therapy with ranibizumab and aflib...
BACKGROUND: Neovascular age-related macular degeneration (AMD) is a leading cause of irreversible vision loss among the elderly. Current treatment options include intravitreal anti-VEGF therapy with ranibizumab and aflibercept. These medications are very effective but expensive. Biosimilars of these expensive intravitreal medications have been proposed as less expensive treatment options. However, their clinical equivalence and safety are of concern. PURPOSE: The purpose of this study was to assess the efficacy, safety, and immunogenicity of biosimilars of ranibizumab and aflibercept, and their clinical equivalence with their reference biologics, in the treatment of neovascular AMD. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing biosimilar anti-VEGF agents with reference ranibizumab or aflibercept. A comprehensive search of PubMed, Scopus, and Cochrane Library (inception-September 2025) was performed following PRISMA guidelines. Outcomes included change in best-corrected visual acuity (BCVA) at 12 weeks and study endpoint, ≥ 15-letter responder rates, treatment-emergent anti-drug antibodies (ADAs), and ocular/serious ocular adverse events. Risk of bias was assessed using the Cochrane ROB-2 tool. RESULTS: Seventeen phase 3 RCTs including 6694 patients were analyzed. Pooled results showed no clinically meaningful differences in BCVA improvement at 12 weeks (MD = - 0.42, p = 0.17) or at study endpoint (MD = - 0.32, p = 0.23) between biosimilars and reference biologics. Responder rates (≥ 15-letter gain) were comparable (RR = 1.06, p = 0.36), as were rates of treatment-emergent ADAs (RR = 0.89, p = 0.40) and ocular adverse events (RR = 0.99, p = 0.86). The subgroup analysis did not demonstrate significant results for biosimilars of aflibercept compared with the reference aflibercept; however, biosimilars of ranibizumab had slightly less BCVA improvement at the end point (RR 0.53, p 0.02). Heterogeneity was low to moderate, and no publication bias was noted. CONCLUSION: Our analysis has demonstrated that biosimilars of ranibizumab and aflibercept have equivalent efficacy, safety, and immunogenicity profiles compared with the reference biologics. Future studies should focus on long-term outcomes, switching studies, and health economics to help determine the long-term success of biosimilar therapy.
The deviation between achieved net corneal thinning and predicted lenticule thickness after keratorefractive lenticule extraction surgery.
Aksoy M, Kilic D
Int Ophthalmol · 2026 Mar · PMID 41854952 · Publisher ↗
PURPOSE: The primary objective of this study was to assess the discrepancy between the achieved net corneal thinning following during Keratorefractive Lenticule Extraction (KLEx) surgery and the preoperatively predicted...
PURPOSE: The primary objective of this study was to assess the discrepancy between the achieved net corneal thinning following during Keratorefractive Lenticule Extraction (KLEx) surgery and the preoperatively predicted lenticule thickness. MATERIAL AND METHODS: This retrospective study included data from KLEx procedures performed at our institution between January 2022 and June 2024. Corneal pachymetry measurements obtained preoperatively and postoperatively using the Scheimpflug based imaging system (Pentacam), were reviewed. These findings were compared to the surgical read out parameters by the Visumax500 femtosecond laser system (Carl Zeiss Meditec). Statistical analysis was conducted using SPSS software (version 22.0, IBM). For data sets comparisons were made using the Paired Samples T-test. RESULTS: The analysis included 66 eyes from 66 patients, with a mean age of 29.4 years. The average preoperative central corneal thickness measured at the pupil center was 556.53 microns, which decreased to 484.92 microns postoperatively (p < 0.05). Similarly, the average apex corneal thickness changed from 557 microns to 486.53 microns following surgery (p < 0.05). The mean achieved reduction in corneal thickness was 70.47 microns, whereas the mean predicted reduction based on surgical parameters was 86.31 microns (p < 0.05). The average deviation between predicted and lenticule thickness and achieved net corneal thinning were calculated as 13.12 ± 7.86 microns. The difference was significantly higher in the patients with higher spherical eror but not correlated with corneal thickness or keratometric data. CONCLUSION: Post-KLEx measurements demonstrated that actual stromal tissue removal was consistently less than preoperative estimates from the VisuMax 500. The magnitude of refractive correction also differed from values reported in the literature, suggesting possible variability related to device characteristics and population differences.
Argon laser demarcation of AIDS-related cytomegalovirus retinitis in resource-limited setting.
Hassman LM, Oo KT, Din ZM … +7 more , Larochelle M, Tun N, Hobbs R, Concepcion C, Holland G, Heiden D, Vitale AT
Int Ophthalmol · 2026 Mar · PMID 41854912 · Publisher ↗
PURPOSE: We evaluated outcomes associated with argon laser demarcation of cytomegalovirus (CMV) retinitis lesions to prevent retinal detachments amongst people with AIDS in a resource-poor setting. METHODS: We performed...
PURPOSE: We evaluated outcomes associated with argon laser demarcation of cytomegalovirus (CMV) retinitis lesions to prevent retinal detachments amongst people with AIDS in a resource-poor setting. METHODS: We performed a retrospective, longitudinal, observational cohort study of patients with AIDS-related CMV retinitis who were treated with laser demarcation to prevent retinal detachment during a 4-year period at a single facility in Yangon, Myanmar. The main outcomes were retinal detachment and loss of central visual acuity. We also evaluated a comparator group of patients who presented with AIDS-related CMV retinitis and concomitant retinal detachment. RESULTS: Laser demarcation was performed on 45 eyes (38 patients). All were receiving combination antiretroviral therapy (cART). All treated eyes had inactive CMV retinitis lesions involving ≥ 25% of the retinal area. No eye developed a retinal detachment or loss of central visual acuity during follow-up for 3 years. In contrast, eyes that presented with retinal detachments that were surgically repaired experienced further loss of vision (6 of 14 eyes [42%]) and recurrent detachments (4 of 14 eyes [28.6%]). CONCLUSIONS: Although laser demarcation of CMV retinitis lesions is not routinely performed in geographic regions where patients can be followed closely and have access to vitreoretinal surgeons, the procedure may be useful for some patients in resource-limited settings.
Differential associations of cataracts with somatic and cognitive-affective symptoms of depression: longitudinal findings from the English Longitudinal Study of Ageing.
Tu S
Int Ophthalmol · 2026 Mar · PMID 41854826 · Publisher ↗
BACKGROUND: Global population aging elevates the importance of identifying modifiable risk factors for late-life depression. This study uniquely investigates the prospective association between cataracts and incident dep...
BACKGROUND: Global population aging elevates the importance of identifying modifiable risk factors for late-life depression. This study uniquely investigates the prospective association between cataracts and incident depressive symptoms, specifically differentiating between somatic and cognitive-affective domains. METHODS: Using data from the English Longitudinal Study of Ageing (ELSA), we analyzed 4,584 participants. Cataract exposure was self-reported at wave 2, with incident depressive symptoms assessed at wave 4 using the CES-D-8 (cutoff ≥ 3). Multivariable logistic regression models adjusted sequentially for sociodemographics, health behaviors, and comorbidities were used to estimate associations, with sensitivity analyses (stratification, interaction tests) and multiple imputation for missing data. RESULTS: After multiple imputation, our cohort comprised 4,584 participants, of whom 581 (12.7%) developed incident depressive symptoms. In the fully adjusted model, baseline cataract was significantly associated with an increased risk of overall incident depression (OR 1.55, 95% CI 1.13-2.12; P = 0.007), which survived the Bonferroni-corrected threshold (P < 0.0167). Domain-specific analyses showed that cataract was associated with increased odds of somatic symptoms (OR 1.48, 95% CI 1.07-2.03; P = 0.018), whereas the association with cognitive-affective symptoms was not significant (OR 1.18, 95% CI 0.79-1.77; P = 0.420). Item-level analyses revealed that specific manifestations including 'could not enjoy life', 'restless sleep' and 'could not get going' reached nominal significance, though they did not survive strict multiple testing correction. CONCLUSION: Cataracts are independently associated with increased risk of incident depressive symptoms in older adults, particularly somatic manifestations. These findings highlight the importance of integrated ophthalmologic and mental healthcare pathways, suggesting that timely cataract treatment may represent a potential intervention point for mitigating depressive symptoms in aging populations.
New healthcare insights in ophthalmology: using a data integration center (DIC) to analyze the care of patients with corneal ulceration during the COVID-19 pandemic.
Stolze G, Engelmann K, Bartos M … +3 more , Nüßler F, Sedlmayr M, Weidner J
Int Ophthalmol · 2026 Mar · PMID 41854745 · Full text
PURPOSE: To leverage a novel Data Integration Centre (DIC) infrastructure and real-world data to analyze pandemic-driven changes in the incidence, demographics, and management of corneal ulceration (H16.0) in a tertiary...
PURPOSE: To leverage a novel Data Integration Centre (DIC) infrastructure and real-world data to analyze pandemic-driven changes in the incidence, demographics, and management of corneal ulceration (H16.0) in a tertiary care setting. METHODS: We conducted a retrospective single-center analysis of 3029 cases (2016-2024), stratified into pre-pandemic, pandemic, and post-pandemic periods. Data were sourced via the institutional DIC. We employed descriptive statistics and regression models to evaluate temporal trends, age/sex distributions, length of stay (LOS), and surgical interventions. RESULTS: A significant structural shift from inpatient to outpatient care was observed, with outpatient cases rising by 70% during the pandemic while inpatient numbers declined. A notable demographic shift occurred, with a higher proportion of younger male patients (aged 30-40) affected during and after the pandemic. Mean LOS decreased progressively from 6.27 (pre-pandemic) to 4.13 days (post-pandemic). Despite an overall decline in surgical procedures, the rate of keratoplasties per 1000 patients increased significantly in the post-pandemic phase. CONCLUSION: The COVID-19 pandemic precipitated a marked restructuring of care for corneal ulcers towards outpatient management and was associated with a distinct demographic shift. The increase in keratoplasty rates for the diagnosis of corneal ulcer after the pandemic could be due to a significantly changed local care structure during the pandemic and the prioritization of follow-up treatment for more difficult cases. This study demonstrates the practical utility of DIC-derived real-world data for health services research, providing robust evidence on evolving care patterns and disease burden. CLINICAL TRIAL REGISTRATION NUMBER: The study was approved by the Ethics Committee of the Saxony Medical Association under reference number EK-BR-102/23-1 in accordance with the ICH-GCP-Guidelines.
Incidences and outcomes of retinal re-detachment in vitrectomised eyes following cataract extraction.
Shah PA, Shah N, Ahmed S … +3 more , Casswell EJ, Ionides A, Balal S
Int Ophthalmol · 2026 Mar · PMID 41848930 · Publisher ↗
PURPOSE: Pars plana vitrectomy (PPV) with gas tamponade is known to precipitate cataract progression, particularly when performed for retinal detachment (RD). While cataract surgical complications in previously vitrectom...
PURPOSE: Pars plana vitrectomy (PPV) with gas tamponade is known to precipitate cataract progression, particularly when performed for retinal detachment (RD). While cataract surgical complications in previously vitrectomised eyes are well-studied, limited literature exists on the rate of retinal re-detachment following cataract extraction (CE) in eyes with prior PPV for RD. METHODS: A retrospective review was conducted on consecutive CE's at Moorfields Eye Hospital NHS Foundation Trust between January 1, 2015, and March 15, 2022. Included were patients with prior PPV for RD. Exclusion criteria included multiple vitrectomies before CE, combined procedures with phacoemulsification, and non-phacoemulsification CE's. Data on demographics, the interval from PPV to CE, and subsequent retinal detachment were collected, with a minimum of one-year follow-up post CE. Statistical analysis was performed using logistic regression. RESULTS: Out of 110,670 patients who had CE, 1,808 had prior RD repair. Within this group, 44 patients (2.4%) experienced re-detachment following CE. This rate was significantly higher than the 0.34% incidence of first RD after CE (χ = 203.61, p < 0.01). The mean final logMAR BCVA for patients with RD repair pre-CE was 0.15, compared to 0.5 for those who had RD repair post-CE. The mean interval from CE to re-detachment was 573 days. CONCLUSION: This study highlights that the rate of re-detachment following CE is still significant despite eyes having undergone previous vitrectomy and RD repair. Final visual acuity was notably lower in those patients who had RD post CE compared to those with RD repair before CE.
Two current biomarkers in major depressive disorder: peripapillary and subfoveal choroidal vascular indexes.
Icoz M, Yalvac T, Erkan E
Int Ophthalmol · 2026 Mar · PMID 41848894 · Publisher ↗
PURPOSE: To investigate the peripapillary (p) and subfoveal (sf) choroidal vascular index (CVI) parameters in newly diagnosed major depressive disorder (MDD). METHODS: This prospective comparative study was conducted on...
PURPOSE: To investigate the peripapillary (p) and subfoveal (sf) choroidal vascular index (CVI) parameters in newly diagnosed major depressive disorder (MDD). METHODS: This prospective comparative study was conducted on 50 patients with newly diagnosed MDD and 50 age- and sex-matched healthy participants. All participants underwent an ophthalmological examination, and their demographic characteristics were recorded. Choroidal images obtained from the HD-line optical coherence tomography sections of both groups were analyzed in both the foveal and peripapillary regions.Choroidal thickness measurements were obtained, and choroidal vascular parameters were determined using a specialized free software program.These parameters included the luminal choroidal area (LCA), stromal choroidal area (SCA), and total choroidal area (TCA).The ratio of LCA to TCA was defined as CVI. RESULTS: No statistically significant differences were found between the groups concerning choroidal thickness, optic disc head measurements, or peripapillary retinal nerve fiber layer thickness (p > 0.05 for all).In the MDD group, the sfLCA was 0.11 ± 0.04 mm and the pLCA was 0.12 ± 0.03 mm, whereas in the control group, these measurements were 0.16 ± 0.05 mm and 0.16 ± 0.02 mm, respectively (p = 0.003 and p = 0.005,respectively).The sfCVI values were 0.61 ± 0.03 in the MDD group and 0.74 ± 0.03 in the control group, while the pCVI values were 0.64 ± 0.04 in the MDD group and 0.71 ± 0.03 in the control group (p < 0.001).The TCA and SCA values were similar between the two groups (p > 0.05 for both). CONCLUSION: The findings highlight the significance of these current, non-invasive, rapid, and reproducible indices obtained through choroidal imaging for elucidating the etiopathogenesis and diagnosis of MDD,a disorder considered to have a neurodegenerative component.
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