Current Opinion In Ophthalmology[JOURNAL]
Sun
200 papers
AI-driven, low-cost aids for people with visual impairment.
Cappellani F, Snyder M, Pulido JS … +1 more , Ho AC
Curr Opin Ophthalmol · 2026 May · PMID 41766195 · Publisher ↗
PURPOSE OF REVIEW: The rapid integration of artificial intelligence (AI) into mainstream consumer devices has created new opportunities for accessible, low-cost support for individuals with visual impairment. This review...
PURPOSE OF REVIEW: The rapid integration of artificial intelligence (AI) into mainstream consumer devices has created new opportunities for accessible, low-cost support for individuals with visual impairment. This review examines emerging AI-driven tools that repurpose common hardware - such as smartphones and smart glasses - to deliver assistive functions traditionally reliant on costly, specialized devices. RECENT FINDINGS: Three representative technologies illustrate this shift: Ray-Ban × Meta smart glasses offering hands-free scene interpretation; Apple's iPhone Magnifier app with LiDAR-based Detection Mode providing spatial awareness and text recognition; and the Be My Eyes platform with its AI-powered virtual assistant enabling autonomous image interpretation. These tools emphasize affordability, discreet design, and seamless integration into daily life. Although widely adopted in real-world settings, formal clinical evaluation remains limited, with gaps in evidence regarding functional outcomes, safety, and performance across diverse environments. Online user-generated content has become a prominent source of practical guidance, often outpacing peer-reviewed research. SUMMARY: AI-enabled consumer devices are reshaping assistive technology by lowering financial barriers and enhancing usability. Clinicians should be aware of these rapidly evolving tools as patients increasingly adopt them independently. Rigorous studies are needed to assess their clinical impact, guide safe use, and inform integration into vision rehabilitation practice.
Complications and challenges of refractive surgery.
Bair H, Aguwa UT, Syed ZA
Curr Opin Ophthalmol · 2026 Jul · PMID 41766087 · Publisher ↗
PURPOSE OF REVIEW: This review provides an overview of possible complications of the most commonly performed refractive surgeries: laser-assisted in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), small i...
PURPOSE OF REVIEW: This review provides an overview of possible complications of the most commonly performed refractive surgeries: laser-assisted in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), small incision lenticule extraction (SMILE), and lens-based refractive surgery. While the vast majority of refractive surgeries are safe with successful outcomes, complications can still occur which requires surgeons to have an in-depth understanding of complication prevention and management. RECENT FINDINGS: Although overall rare, corneal laser refractive procedures and lens-based refractive surgeries are associated with a distinct set of potential complications. The most common complications from LASIK, PRK, and SMILE include flap issues, infectious keratitis, haze, dry eye disease, and corneal ectasia. Implantable collamer lenses (ICLs) come with a possible risk of intraocular pressure elevation and cataract formation. Refractive lens exchange (RLE) introduces younger patients to potential complications typically associated with cataract surgery, such as dysphotopsias, uveitis, and retinal detachment. SUMMARY: The elective nature of refractive surgery may raise expectations of patients for successful outcomes. This timely review provides relevant and detailed guidance to refractive surgeons on best practices to mitigate potential complications, and ultimately maximize patient safety and satisfaction.
Review of current management of submacular hemorrhage.
Martin J, Ortiz T, Zafar S … +1 more , Kuriyan AE
Curr Opin Ophthalmol · 2026 May · PMID 41766064 · Publisher ↗
PURPOSE OF REVIEW: Subretinal hemorrhage (SRH) is most commonly associated with neovascular age-related macular degeneration (nAMD) and can cause profound vision loss in the macula through mechanical, toxic, and inflamma...
PURPOSE OF REVIEW: Subretinal hemorrhage (SRH) is most commonly associated with neovascular age-related macular degeneration (nAMD) and can cause profound vision loss in the macula through mechanical, toxic, and inflammatory mechanisms. Submacular hemorrhage (SMH) lacks consensus on management. This review summarizes current treatment options, key comparative studies, and ongoing challenges, with emphasis on SMH management. RECENT FINDINGS: Antivascular endothelial growth factor (anti-VEGF) therapy remains central to SMH management, with outcomes comparable to surgery in small to moderate hemorrhages. Pneumatic displacement (PD) with or without recombinant tissue plasminogen activator (rtPA) shows the greatest comparative benefit in more extensive SMH. Adjunctive rtPA improves hemorrhage displacement rates, and meta-analyses support its efficacy with anti-VEGF therapy. Pars plana vitrectomy (PPV) remains an option for large or refractory hemorrhages but has not consistently shown superior visual outcomes compared to less invasive modalities. SUMMARY: Early intervention is consistently associated with improved outcomes, but there is no universally accepted treatment algorithm. Ongoing randomized trials and advances in multimodal imaging have the potential to refine patient selection and treatment strategies. Future efforts should focus on balancing efficacy, safety, and cost-effectiveness to establish evidence-based guidelines for SMH management.
Opportunities and challenges in leveraging multiomics and biobanks for vision science.
Padovani-Claudio DA, Bastarache L
Curr Opin Ophthalmol · 2026 May · PMID 41765918 · Publisher ↗
PURPOSE OF REVIEW: Emerging biobank resources allow large-scale integration of eye-specific phenotypes with clinical, genomic, and multiomic data. This convergence enables unprecedented opportunities to systematically di...
PURPOSE OF REVIEW: Emerging biobank resources allow large-scale integration of eye-specific phenotypes with clinical, genomic, and multiomic data. This convergence enables unprecedented opportunities to systematically dissect the genetic architecture, epidemiology, and mechanistic pathways of both rare monogenic and common polygenic diseases. The review aims to critically examine how contemporary data extraction, multiomics, and analytic methodologies are reshaping disease classification, genetic discovery, and translational research in ophthalmology, while highlighting the associated challenges in leveraging these advanced tools. RECENT FINDINGS: Recent literature demonstrates the utility of genome-wide and phenome-wide association studies, transcriptomic analyses, and artificial intelligence in uncovering novel risk loci, endophenotypes, and biomarkers relevant to eye diseases. Furthermore, advances in multiancestry sampling show substantial population-specific genetic variation, enriching disease models for conditions such as glaucoma and age-related macular degeneration. Finally. integrative approaches, including Mendelian randomization and enrichment analyses, are helping elucidate shared genetic architecture between ocular and systemic diseases, informing therapeutic target identification, and refining risk prediction models. SUMMARY: The convergence of biobank-derived multimodal data and sophisticated analytic techniques is catalyzing a path to personalized medicine in ophthalmology. For these approaches to fully translate into clinical practice ensuring scientifically robust and equitable outcomes, future research must address cohort diversity, mechanistic validation, and practical cost-effectiveness.
Impact of United States federal funding on equity and vision research: lessons from history, justice, and politics, 1968-2025.
Andoh JE, Fu J, Nwanyanwu KH
Curr Opin Ophthalmol · 2026 May · PMID 41765774 · Publisher ↗
PURPOSE OF REVIEW: Federal policy has long shaped the scope and inclusivity of vision research in the United States. This narrative review and opinion article evaluates the evolution of equity in vision research over tim...
PURPOSE OF REVIEW: Federal policy has long shaped the scope and inclusivity of vision research in the United States. This narrative review and opinion article evaluates the evolution of equity in vision research over time, from the landmark National Institutes of Health Revitalization Act of 1993 to the direct impact of federal policies in today's political landscape. RECENT FINDINGS: Equity in vision research originated from early epidemiologic studies identifying social and behavioral determinants of health in the 1970s. The post-2020 period accelerated attention to structural disparities in healthcare, catalyzed by the COVID-19 pandemic and a national conversation on race. However, recent executive orders have reversed equity oriented federal policies, restricted terminology and data access, and changed research funding operations. These ongoing developments pose risks to progress in all areas of research. SUMMARY: Equity in vision research in the United States remains vulnerable to federal priorities that serve to support or destabilize. The current political environment underscores the need for the ophthalmologic research community to safeguard data integrity, sustain diverse participation, and continue methodologically rigorous protocols to ensure continued progress toward equitable vision health.
Editorial introduction.
Curr Opin Ophthalmol · 2026 Mar · PMID 41643047 · Publisher ↗
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Paraneoplastic syndromes and the retina.
Zhao CS, Mruthyunjaya P, Narala R
Curr Opin Ophthalmol · 2026 May · PMID 41608829 · Full text
PURPOSE OF REVIEW: Paraneoplastic diseases of the retina are rare. Diagnosis can be challenging, and studies on management strategies are limited. The purpose of this review is to summarize our current understanding of t...
PURPOSE OF REVIEW: Paraneoplastic diseases of the retina are rare. Diagnosis can be challenging, and studies on management strategies are limited. The purpose of this review is to summarize our current understanding of the presentation, diagnosis, and management for cancer associated retinopathy, melanoma associated retinopathy, paraneoplastic vitelliform maculopathy, and bilateral diffuse uveal melanocytic proliferation. RECENT FINDINGS: Multimodal imaging can aid in the diagnosis of paraneoplastic retinopathies since early fundus findings and symptoms can be nonspecific. No standardized treatment protocol exists with therapies having variable efficacy. Generally, systemic immunosuppression is used with possible concomitant local steroid treatment with improved visual outcomes in some cases. SUMMARY: Paraneoplastic syndromes affect the retina as an autoimmune response to tumor antigens or to circulating tumor-derived factors. Diagnosis hinges on maintaining high degree of clinical suspicion, and multimodal imaging can also be helpful. Once diagnosis is made, prompt systemic work-up for malignancy is necessary. Limited literature exists to suggest superiority of a single treatment, but management involves treatment of the underlying malignancy and local or systemic immunosuppression and/or antibody removal.
Trends in supply and demand of vitreoretinal fellowship positions in the United States.
Strong Caldwell A, Watane A, Bommakanti N
Curr Opin Ophthalmol · 2026 May · PMID 41580994 · Publisher ↗
PURPOSE OF REVIEW: To summarize trends in supply and demand for vitreoretinal fellowship positions in the United States, describe applicant characteristics and match outcomes, and discuss future workforce needs and diver...
PURPOSE OF REVIEW: To summarize trends in supply and demand for vitreoretinal fellowship positions in the United States, describe applicant characteristics and match outcomes, and discuss future workforce needs and diversity in the field. RECENT FINDINGS: Fellowship applications and positions have increased, with medical and surgical retina programs accounting for the largest share of positions. Despite this growth, match rates have declined, and a persistent portion of positions remain unfilled, likely concentrated among less established or non Association of University Professors of Ophthalmology (AUPO) programs. Predictors of matching include completing more interviews and ranking more programs as well as completing residency training in the United States. Women and individuals underrepresented in medicine remain markedly underrepresented in the vitreoretinal pipeline relative to need. Interest in vitreoretinal fellowship is driven by advanced surgical exposure, perceived prestige, financial considerations, and mentorship during residency. SUMMARY: Aligning supply with demand will require expanding high-quality, AUPO-compliant training; improving transparency about medical versus surgical positions; and targeted mentorship/sponsorship to diversify the pipeline. Given projected growth in retinal disease, strategic recruitment and training are essential to ensure equitable access to imaging, injections, laser, and surgery.
Management of persistent corneal epithelial defects: role of insulin.
Burgos-Blasco B, Perez-Garcia P, Diaz-Valle D
Curr Opin Ophthalmol · 2026 May · PMID 41580991 · Publisher ↗
PURPOSE OF REVIEW: PED are corneal epithelial defects that fail to heal after 2 weeks and pose a significant therapeutic challenge. In recent years, insulin has emerged as a promising and effective therapy for promoting...
PURPOSE OF REVIEW: PED are corneal epithelial defects that fail to heal after 2 weeks and pose a significant therapeutic challenge. In recent years, insulin has emerged as a promising and effective therapy for promoting reepithelialization of the ocular surface, playing a role in the management of PED. The purpose of this article is to provide a summary of the role of topical insulin for persistent corneal epithelial defects (PED) management. RECENT FINDINGS: Based on current evidence, topical insulin merits an early placement within the therapeutic pathway and may be considered after conventional therapy, before the use of autologous serum. Several studies suggest that insulin eye drops can facilitate faster and more consistent epithelial healing, potentially offering greater efficacy than autologous serum in some cases. Moreover, patients who do not respond to insulin often require escalation to surgical interventions such as amniotic membrane transplantation. Overall, topical insulin appears to represent a well tolerated, cost-effective, and promising option that could serve as an intermediate step between standard medical treatments and surgical management in PED. SUMMARY: The evidence summarized in this review demonstrates that insulin shows considerable promise in managing PED, reinforcing the importance of further investigations to clarify its place in clinical practice. Ongoing clinical trials aim to validate the effectiveness of topical insulin for a range of ocular diseases and to benchmark its performance against other established treatment options.
Clinical and surgical approach to retinoschisis.
Swaminathan S, Starr MR
Curr Opin Ophthalmol · 2026 May · PMID 41578616 · Publisher ↗
PURPOSE OF REVIEW: To summarize the recent literature on the clinical and surgical management of retinoschisis. RECENT FINDINGS: Novel analyses of the existing imaging modalities, including ultra wide-field imaging, near...
PURPOSE OF REVIEW: To summarize the recent literature on the clinical and surgical management of retinoschisis. RECENT FINDINGS: Novel analyses of the existing imaging modalities, including ultra wide-field imaging, near-infrared imaging, blue light reflectance, and color Doppler ultrasound, can be adjuncts to existing diagnostic tools such as ocular coherence tomography (OCT) and clinical examination to differentiate between rhegmatogenous retinal detachment (RRD) and retinoschisis. SUMMARY: Degenerative retinoschisis can be challenging to differentiate from a RRD through clinical examination. Although ocular coherence tomography (OCT) is the typical approach to diagnosing retinoschisis, there have been many promising diagnostic developments to better prognosticate and differentiate between similar entities. Given the difficulty in managing these cases, medical and surgical management are typically at the discretion of the treating physician.
Central serous retinopathy: update on disease understanding and treatment.
Reeves MR, Talcott KE
Curr Opin Ophthalmol · 2026 May · PMID 41578611 · Publisher ↗
PURPOSE OF REVIEW: Investigations over the past 2 years involving novel genomics pathways, imaging techniques, risk factors, and therapeutic interventions have sought to better understand and manage central serous retino...
PURPOSE OF REVIEW: Investigations over the past 2 years involving novel genomics pathways, imaging techniques, risk factors, and therapeutic interventions have sought to better understand and manage central serous retinopathy (CSR). While most cases of acute CSR are self-resolving, chronic CSR remains a challenging condition to manage given response to therapy may be limited and the risk of permanent, severe vision loss. In this work, we present the latest insights on disease pathophysiology and management for acute and chronic cases of CSR, highlighting data from randomized control trials and meta-analyses to compare efficacy of treatment options. RECENT FINDINGS: There is no difference in best corrected visual acuity (BCVA) or resolution of subretinal fluid (SRF) in cases of chronic CSR that are treated with half-dose/half-fluence photodynamic therapy (PDT) versus full-strength/full-fluence therapy, making half-dose/half-fluence a reasonable option to avoid the atrophic retinal changes that may be more likely with full-strength treatment. Laser therapy could be considered as an alternative to PDT for treating chronic CSR in cases of verteporfin shortage; however, the statistically significant reduction in subretinal fluid seen on optical coherence tomography (OCT) does not translate to a significant improvement in BCVA after intervention. While there may be an early improvement in BCVA and SRF in cases of chronic CSR for which treatment with mineralocorticoid receptor antagonist is initiated, this effect does not appear to persist with extended follow up. SUMMARY: With ongoing extensive research on the disease process of CSR and a more nuanced understanding of the factors that increase risk of disease, observation remains the mainstay of management for acute CSR. For chronic CSR, PDT, laser, or anti-VEGF may be considered, with advances in imaging allowing OCTA to be a less invasive alternative method to dye angiography for detecting neovascularization.
The importance of the microbiome in uveitis.
Lin P
Curr Opin Ophthalmol · 2026 Mar · PMID 41504254 · Publisher ↗
PURPOSE OF REVIEW: The purpose of this review was to summarize the literature on preclinical and clinical studies demonstrating the impact of the intestinal microbiome in noninfectious uveitis. RECENT FINDINGS: Preclinic...
PURPOSE OF REVIEW: The purpose of this review was to summarize the literature on preclinical and clinical studies demonstrating the impact of the intestinal microbiome in noninfectious uveitis. RECENT FINDINGS: Preclinical studies using the experimental autoimmune uveitis (EAU) model have shown commensals such as Desulfovibrio and Prevotella , as well as Ruminococcaceae , associated with uveitis, which overlap with some clinical studies in uveitis patients. Interventions that target the microbiome that can be developed for the treatment of uveitis include antibiotics, fecal metabolites or metabolite agonists that are protective in uveitis, probiotics, dietary interventions, or fecal microbial transplant. SUMMARY: There is significant data supporting the importance of the intestinal microbiome in noninfectious uveitis through enrichment or depletion of certain gut bacteria as well as their metabolites. Targeting the intestinal microbiome or their metabolites might be a viable option for the treatment of noninfectious uveitis.
Emerging applications of intraoperative and portable optical coherence tomography in glaucoma: a review of recent advances.
Gupta S, Ziari M, Blieden LS
Curr Opin Ophthalmol · 2026 Mar · PMID 41504250 · Publisher ↗
Glaucoma remains one of the leading causes of irreversible blindness worldwide with 80 million people affected and 3 million people blind from glaucoma [1] . Early diagnosis is critical for sight preservation and imaging...
Glaucoma remains one of the leading causes of irreversible blindness worldwide with 80 million people affected and 3 million people blind from glaucoma [1] . Early diagnosis is critical for sight preservation and imaging modalities such as optical coherence tomography assist with the identification and quantification of glaucomatous changes. While widely used in the clinical setting, optical coherence tomography (OCT) has only more recently been optimized for use intraoperatively, in both portable and microscope-integrated forms. Intraoperative OCT (iOCT) provides visualization of both anterior and posterior structures in the eye. Gaining prominence in corneal and vitreoretinal surgery, iOCT has been shown to enhance surgical decision-making and improve outcomes in these fields. In glaucoma, iOCT has uses during tube shunt placement, minimally invasive glaucoma surgery, and trabeculectomy. This review highlights recent updates in iOCT use for glaucoma surgery.
Surgical approach to ocular complications of Marfan syndrome.
Cohen SA, Kalavar M, Sridhar J
Curr Opin Ophthalmol · 2026 May · PMID 41496654 · Publisher ↗
PURPOSE OF REVIEW: Marfan syndrome is a connective tissue disorder with several vision-threatening ocular manifestations. This study synthesizes recent advances in the surgical approach to ocular complication of Marfan s...
PURPOSE OF REVIEW: Marfan syndrome is a connective tissue disorder with several vision-threatening ocular manifestations. This study synthesizes recent advances in the surgical approach to ocular complication of Marfan syndrome including ectopia lentis, early cataract, glaucoma, and retinal detachment. RECENT FINDINGS: Recent literature highlights advances in capsular support devices and alternative fixation methods for ectopia lentis, including long-term outcomes with modified capsular tension rings, suture-less scleral fixation, and iris-claw intraocular lenses. Pediatric cohorts underscore elevated risks of retinal detachment following lens removal, particularly when capsular remnants persist, emphasizing the importance of complete removal and vigilant follow-up. In highly myopic Marfan eyes, modern intraocular lens power calculation formulas demonstrate improved refractive predictability, though pediatric patients remain prone to progressive myopic shift. For glaucoma, tailored modifications to trabeculectomy and tube shunt techniques address the challenges of thin sclera and ocular surface fragility. Contemporary retinal detachment series reveal high lifetime risk, with surgical success often requiring multiple procedures, and outcomes closely tied to macular status and presence of proliferative vitreoretinopathy. SUMMARY: Advances across anterior and posterior segment surgery have improved visual outcomes for Marfan patients, but long-term risks remain substantial. Individualized surgical planning, early detection of complications, and long-term surveillance are essential to optimize outcomes in this high-risk population.
Emerging solutions for neovascular age-related macular degeneration.
Franco JJ, Wubben TJ
Curr Opin Ophthalmol · 2026 May · PMID 41490387 · Publisher ↗
PURPOSE OF REVIEW: To summarize emerging therapeutic strategies for neovascular (wet) age-related macular degeneration (nAMD), with emphasis on recent translational and clinical developments. RECENT FINDINGS: The nAMD tr...
PURPOSE OF REVIEW: To summarize emerging therapeutic strategies for neovascular (wet) age-related macular degeneration (nAMD), with emphasis on recent translational and clinical developments. RECENT FINDINGS: The nAMD treatment landscape is rapidly evolving. Gene therapies (e.g. ABBV-RGX-314, ADVM-022, and 4D-150) have demonstrated sustained intraocular anti-VEGF expression with reduced injection burden in phase 2 and 3 programs, validating the 'biofactory' concept. Tyrosine kinase inhibitors delivered via intravitreal or suprachoroidal implants (e.g. EYP-1901, OTX-TKI, and CLS-AX) show potential for twice-yearly or less frequent dosing. Moreover, emerging therapeutic approaches increasingly target non-VEGF pathogenic pathways, reflecting a shift toward mechanistically diverse vascular stabilization and neuroprotection strategies. These include multitargeted biologics that couple anti-angiogenic and anti-inflammatory effects (e.g. KSI-501, IBI-302, and AG-73305), as well as agents modulating FGF2 signaling, Wnt activation, complement regulation, and cellular metabolism. SUMMARY: Therapeutic innovation in nAMD is transitioning from incremental refinements in intravitreal anti-VEGF delivery to strategies aimed at extending durability or targeting alternative contributory pathways. Long-term safety, efficacy, and durability will determine which of these candidates redefine standard care.
Systemic medications and their impact on age-related macular degeneration development and progression: a review of current evidence.
Yuan M, Alsoudi A, Alshaikhsalama A … +1 more , Rahimy E
Curr Opin Ophthalmol · 2026 May · PMID 41481850 · Publisher ↗
PURPOSE OF REVIEW: This review examines commonly prescribed systemic medications and their possible associations with age-related macular degeneration (AMD) development and progression. With the limitations and risks of...
PURPOSE OF REVIEW: This review examines commonly prescribed systemic medications and their possible associations with age-related macular degeneration (AMD) development and progression. With the limitations and risks of current intravitreal therapies, there is growing interest in oral pharmacotherapy for AMD management. The following review synthesizes observational studies, meta-analyses, and ongoing clinical trials to evaluate the potential effects of commonly used systemic medications on AMD. RECENT FINDINGS: Metformin demonstrates conflicting evidence, with several meta-analyses and large cohort study showing reduced AMD odds, while a recent randomized phase II trial found no effect on geographic atrophy progression. For statins, emerging evidence suggests that treatment duration exceeding 2 years and medium-intensity to high-intensity dosing may confer protection against AMD development. Aspirin demonstrates discordant results between different study designs: two large randomized controlled trials showed no benefit for AMD, while a 10-year observational study suggested protective effects.Fenofibrates show promise in preclinical models but require additional clinical investigation. Danicopan also shows modest effects in complement-related disorders and is currently undergoing a phase 2 trial to evaluate efficacy in patients with geographic atrophy. Finally, dopamine agonists appear to improve visual acuity and reduce subretinal fluid and central retinal thickness in newly diagnosed exudative AMD, as shown in an open-label pilot study, but require further investigation. SUMMARY: Multiple systemic medications have highlighted mixed or stage-dependent benefits on AMD development and progression. Some agents such as metformin and aspirin have shown conflicting findings, having been evaluated in randomized trials and large observational studies. Other medications including GLP-1 agonists, dopamine agonists, statins, fenofibrates, and danicopan show early promise in more limited studies, but require further clinical validation.
Glaucoma tube shunts: 2026 Update.
Wuller AL, Patel H
Curr Opin Ophthalmol · 2026 Mar · PMID 41437526 · Publisher ↗
PURPOSE OF REVIEW: To provide an update on new glaucoma drainage devices and implants. RECENT FINDINGS: Glaucoma drainage implant devices are currently indicated for medically or surgically uncontrolled glaucoma, especia...
PURPOSE OF REVIEW: To provide an update on new glaucoma drainage devices and implants. RECENT FINDINGS: Glaucoma drainage implant devices are currently indicated for medically or surgically uncontrolled glaucoma, especially in eyes at high risk for trabeculectomy failure. The devices used can differ, but many offer similar long-term outcomes. Due to the differences in devices, some of the side effect profiles may differ. SUMMARY: Long-term outcomes show that nonvalved devices (Ahmed ClearPath, Baerveldt, Molteno, Paul Glaucoma Implant) achieve greater intraocular pressure reduction and lower medication burden than valved devices (Ahmed valved implant) but come with a higher risk of hypotony-related complications; all devices have similar overall complication rates and comparable surgical failure rates at 2-5 years. The most recent updates as of 2025 highlight that Ahmed ClearPath ST and Paul Glaucoma Implant (only available internationally) offer streamlined implantation and favorable safety profiles, and Molteno and Baerveldt continue to provide durable IOP control in refractory cases. Two more devices, Calibreye (Myra Vision) and VisiPlate (Avisi), are undergoing trials with promising initial outcomes. The Calibreye implant is showing promising short-term data, with less patients experiencing unwanted side effect of bleb needling and while offering the ability to titrate to maximize patient benefit. An upcoming device, GORE glaucoma drainage device implant is showing promises preclinical results and offer unique device material composition.
Novel surgical implants in the treatment of childhood glaucoma.
Elhusseiny AM, Shaarawy T
Curr Opin Ophthalmol · 2026 Mar · PMID 41431351 · Publisher ↗
PURPOSE OF REVIEW: Conventional glaucoma drainage devices (GDDs), such as the Ahmed Glaucoma Valve and Baerveldt Glaucoma Implant, are widely used in childhood glaucoma. Recently, newer surgical options, including the PR...
PURPOSE OF REVIEW: Conventional glaucoma drainage devices (GDDs), such as the Ahmed Glaucoma Valve and Baerveldt Glaucoma Implant, are widely used in childhood glaucoma. Recently, newer surgical options, including the PRESERFLO microshunt, Paul Glaucoma Implant (PGI), eyePlate-S, and ClearPath, have emerged with potential advantages to childhood glaucoma patients. This review summarizes current evidence regarding the design, outcomes, and safety profiles of these newer implants in childhood glaucoma patients. RECENT FINDINGS: The PRESERFLO offers a minimally invasive approach with favorable safety and intraocular pressure (IOP)-lowering outcomes in small pediatric case series, including eyes with prior GDD implantation. It is typically used with adjunctive mitomycin C. Technical modifications, such as ripcord insertion, reduce the risk of postoperative hypotony.The PGI features a valveless design that enables controlled flow via a 6-0 Prolene ripcord without external ligation. Additionally, its design reduces contact with the corneal endothelium and extraocular muscles. Retrospective series and early randomized data suggest good IOP control with an acceptable safety profile. The eyePlate-S features a valveless design that allows controlled flow through a 5-0 Prolene ripcord, eliminating the need for external ligation. Its tube has an external diameter comparable to the PGI (0.47 mm) but a larger internal diameter (0.18 mm in the eyePlate-S vs. 0.13 mm in the PGI). The eyePlate-200S can also be positioned between extraocular muscles, which may reduce the risk of postoperative diplopia. In addition, the thin, flexible silicone plate can be folded to facilitate implantation.The ClearPath enables flexible implantation in complex pediatric anatomy. Early multiyear results show sustained IOP reduction and decreased medication burden, with a success rate of 79% at 4 years. SUMMARY: Newer devices such as the PRESERFLO, PGI, and ACP demonstrate encouraging mid-term efficacy and safety in the management of childhood glaucoma, particularly in refractory cases or eyes with prior surgeries. While early outcomes are promising, larger comparative studies with extended follow-up are needed to better establish their long-term role relative to conventional GDDs in childhood glaucoma management.
The association between intravitreal injections and glaucoma: an update.
Phan C, Qiu M, Zhang AY
Curr Opin Ophthalmol · 2026 Mar · PMID 41431277 · Publisher ↗
PURPOSE OF REVIEW: Intravitreal antivascular endothelial growth factor (VEGF) injections are the cornerstone of retinal disease management but raise concern for intraocular pressure (IOP)-related complications. This revi...
PURPOSE OF REVIEW: Intravitreal antivascular endothelial growth factor (VEGF) injections are the cornerstone of retinal disease management but raise concern for intraocular pressure (IOP)-related complications. This review summarizes recent evidence on transient and sustained IOP elevation, structural and vascular effects, and management strategies. RECENT FINDINGS: Acute IOP spikes occur in nearly all eyes, typically resolving within an hour, but recovery is delayed in glaucoma and ocular hypertension (OHT), increasing optic nerve risk. Spike magnitude depends on patient factors (age, diabetes, vitreous volume, lens status) and technical factors (needle gauge, reflux, injection volume). Sustained IOP elevation is less predictable, with higher rates for bevacizumab and ranibizumab than aflibercept, and cumulative injection burden correlating with reduced outflow facility, retinal nerve fiber layer (RNFL) thinning, and greater need for glaucoma surgery. Acute spikes cause immediate RNFL thinning, while long-term loss is uncommon in nonglaucomatous patients. Prophylactic IOP-lowering therapy, paracentesis in high-risk eyes, and agent or delivery selection may mitigate risk. SUMMARY: Uniform protocols inadequately address patient-specific factors, warranting individualized management strategies. Prophylactic measures, careful agent selection, and multidisciplinary management can mitigate IOP-related complications in susceptible patients.
Anterior segment optical coherence tomography imaging in angle closure: advances in diagnosis and care.
Namba M, Xu BY
Curr Opin Ophthalmol · 2026 Mar · PMID 41431253 · Publisher ↗
PURPOSE OF REVIEW: To highlight emerging applications of anterior segment optical coherence tomography (AS-OCT) in the diagnosis, risk stratification, and management of angle closure glaucoma, with particular emphasis on...
PURPOSE OF REVIEW: To highlight emerging applications of anterior segment optical coherence tomography (AS-OCT) in the diagnosis, risk stratification, and management of angle closure glaucoma, with particular emphasis on the integration of artificial intelligence. RECENT FINDINGS: AS-OCT enables objective and reproducible quantification of anterior chamber angle parameters, overcoming the subjective and qualitative nature of traditional gonioscopy. Recent studies also suggest that AS-OCT can better predict angle closure disease and treatment outcomes than gonioscopy. Furthermore, advances in artificial intelligence-based image analysis have achieved expert-level accuracy in detecting angle closure and related anatomical features, facilitating personalized risk stratification and treatment planning. Overall, these advancements show strong potential for broad adoption to enhance clinical care and workflows. SUMMARY: High-resolution AS-OCT imaging combined with artificial intelligence-driven analytics is transforming the evaluation and management of angle closure disease. This noninvasive, objective approach has the potential to augment traditional methods, paving the way for more precise, personalized, and evidence-based care. Broad clinical adoption requires further rigorous prospective validation across large and diverse patient populations.
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