BMC Ophthalmology[JOURNAL]
Sun
200 papers
The influence of pterygium size on corneal refractive properties and higher-order aberrations.
Shen J, Chen Y, Chen Y … +2 more , Gou B, Cui H
BMC Ophthalmol · 2026 Jun · PMID 42249342 · Full text
OBJECTIVE: To evaluate associations between pterygium size parameters and corneal refractive properties and higher-order aberrations (HOAs). METHODS: In 41 patients with unilateral pterygium, thickness, length, and width...
OBJECTIVE: To evaluate associations between pterygium size parameters and corneal refractive properties and higher-order aberrations (HOAs). METHODS: In 41 patients with unilateral pterygium, thickness, length, and width were measured by anterior segment optical coherence tomography(AS-OCT). Corneal refractive parameters, irregularity indices, and HOAs were assessed using Pentacam HR. Correlation analyses evaluated relationships between pterygium dimensions and corneal parameters. RESULTS: Pterygium length and width significantly correlated with multiple corneal parameters in the 3-7 mm zone. Moderate correlations were found with K1 (length: |r| = 0.376-0.473; width: |r| = 0.361-0.415; all p < 0.05), and stronger correlations with corneal astigmatism (length: r = 0.582-0.642; width: r = 0.529-0.581; all p < 0.001) and irregularity indices (ISV, IVA, IHD) (length: r = 0.623-0.637; width: r = 0.566-0.596; all p < 0.001). Length positively correlated with total, third-, and fourth-order HOA RMS across the anterior and posterior surface, and entire cornea (r = 0.455-0.691, p < 0.05), primarily driven by vertical trefoil, vertical coma, and tetrafoil. Width also correlated with anterior and total corneal HOAs (r = 0.519 to 0.645, p < 0.05). Posterior surface correlations for width were weaker (r = 0.313 to 0.472, p < 0.05) but remained significant for total RMS, third-order RMS, and several specific aberrations. CONCLUSION: Pterygium length and width are key parameters associated with deteriorated corneal refractive status, irregularity, and HOAs. Width, being easily standardized, serves as a practical indicator for predicting pterygium-induced visual quality deterioration.
Early postoperative alignment as a predictor of recurrence after unilateral recession-plication for basic-type intermittent exotropia in children.
Ren Y, Jin K, Cao D … +4 more , Wang Y, Liu L, Li L, Jiang J
BMC Ophthalmol · 2026 Jun · PMID 42249332 · Full text
PURPOSE: This study aimed to identify clinical factors associated with early motor recurrence after unilateral lateral rectus recession with medial rectus plication (RP) in children with basic-type intermittent exotropia...
PURPOSE: This study aimed to identify clinical factors associated with early motor recurrence after unilateral lateral rectus recession with medial rectus plication (RP) in children with basic-type intermittent exotropia (IXT). METHODS: This retrospective cohort study enrolled children with basic-type IXT who underwent unilateral RP between January 2022 and December 2023. The primary outcome was early motor recurrence, defined as an exodeviation greater than 10 prism diopters (PD) at near at 6 months postoperatively. Early motor success was defined as horizontal exodeviation or esodeviation of 10 PD or less. Deviation at distance and near, fusion, and stereopsis were evaluated at predefined postoperative time points. Multivariable logistic regression and receiver operating characteristic (ROC) analyses were used to assess factors associated with early recurrence and final motor outcomes. RESULTS: Ninety-one patients were included (mean age, 8.10 ± 3.06 years; mean follow-up, 16.81 months). Thirty-one patients met criteria for early motor recurrence, and 60 achieved early motor success. The early recurrence group had significantly larger residual exodeviation at distance and near during the first postoperative week (P < 0.05). In adjusted logistic regression analyses, both near and distance deviations within the first postoperative week were independently associated with early motor recurrence at 6 months (near: OR = 0.738, 95% CI 0.609-0.895, P = 0.002; distance: OR = 0.736, 95% CI 0.606-0.893, P = 0.002) and with final motor failure (near: OR = 0.798, 95% CI 0.683-0.932, P = 0.004; distance: OR = 0.796, 95% CI 0.681-0.930, P = 0.004). Alignment at 6 months showed stronger adjusted associations with final motor outcome at both near and distance. ROC analysis showed moderate discriminative performance for near deviation within 1 week in identifying early recurrence (AUC = 0.7315) and stronger discrimination for near deviation at 6 months in identifying final motor outcome (AUC = 0.8461); these thresholds require external validation. At final follow-up, fusion was more frequent in the early motor success group (P = 0.011). CONCLUSIONS: Among children with basic-type IXT undergoing unilateral RP, early postoperative alignment at near and distance was associated with early motor recurrence and final motor failure. Alignment at 6 months showed stronger associations with final motor outcome and should be interpreted as a mid-term prognostic marker rather than an independent early predictor. These findings support careful monitoring of near and distance alignment during the first 6 postoperative months, while acknowledging that the proposed cutoff values require validation in larger, independent cohorts.
Mask-associated dry eye disease following short-term facemask wear with or without nasal bridge taping among health workers at a Nigerian tertiary care facility: a cross-over randomized clinical trial.
Amaefuna KP, Morgan RE, Bekibele CO
BMC Ophthalmol · 2026 Jun · PMID 42249316 · Full text
BACKGROUND: Mask-Associated Dry Eye disease (MADE) has been linked to facemask wear predominantly because of the upward flow of expired air towards the eyes. Taping the rim of the mask to the nasal bridge has been propos...
BACKGROUND: Mask-Associated Dry Eye disease (MADE) has been linked to facemask wear predominantly because of the upward flow of expired air towards the eyes. Taping the rim of the mask to the nasal bridge has been proposed to reduce MADE. This study compared dry eye disease rates following short-term face mask wear with or without taping the nasal bridge among health workers in National Hospital Abuja. METHODS: This was a cross-over randomized clinical trial conducted between February and July 2024 at National Hospital Abuja. It involved 77 health workers recruited according to their work environments (Open = 38 and Restricted = 39) using a stratified sampling method. Participants completed a modified MADE Questionnaire to assess MADE risk factors and symptoms. Dry eye symptom scores, Schirmer's test values, Tear Break-Up Time (TBUT), and Oxford ocular surface staining scores were measured before and after six hours of facemask wear, with and without nasal bridge taping, on two separate days. Participants were randomized into group A or B corresponding to facemask wear without taping or with taping on the 1st day. MADE was defined as presence of dry eye symptoms plus an abnormal TBUT, Schirmer's or Oxford corneal staining score post-facemask wear. Descriptive statistics, paired T-test, ANOVA, binary logistic regression and crossover analysis were used to analyze data using SPSS version 26, with statistical significance set at p < 0.05. RESULTS: The mean age of participants was 32.40 ± 9.14 years, with a male to female ratio of 1:2.21. There was a statistically significant difference in all outcome variables pre and post facemask wear with and without taping at the nasal bridge (p < 0.05). TBUT and Oxford scores showed greater improvement post-taped mask wear when compared with mask wear without taping (7.40 ± 2.24 s vs. 5.63 ± 1.82 s; and 0.23 ± 0.43 vs. 0.51 ± 0.70; p < 0.001). MADE developed in 14.3% of participants after facemask wear without taping, versus 3.9% with taping. Working in open environments was identified as a predictor of MADE in the non-taping group (OR: 0.111, p = 0.019). Crossover analysis showed significant carry-over effects in outcome variables. CONCLUSIONS: Short-term facemask wear can result in dry eye disease and taping facemasks at the nasal bridge can reduce these effects. TRIAL REGISTRATION: Retrospectively registered with the Pan African Clinical Trial Registry ( https://pactr.samrc.ac.za/ ) on August 1, 2025 PACTR202508721722676.
Early retinal, optic disc and choriocapillaris microvascular alterations in children with type 1 diabetes without clinical retinopathy: an OCTA-based case-control study.
Bolat S, Sönmez ÖA, Topuz HN … +1 more , Özbaş M
BMC Ophthalmol · 2026 Jun · PMID 42243767 · Full text
AIM: To assess retinal, optic disc, and choriocapillaris microvascular changes in children with type 1 diabetes mellitus (T1DM) using optical coherence tomography angiography (OCTA). MATERIALS AND METHODS: This cross-sec...
AIM: To assess retinal, optic disc, and choriocapillaris microvascular changes in children with type 1 diabetes mellitus (T1DM) using optical coherence tomography angiography (OCTA). MATERIALS AND METHODS: This cross-sectional study included 154 children, comprising 77 children with T1DM and 77 healthy controls. One eye from each participant was analyzed. OCTA was used to evaluate vessel density in the superficial and deep capillary plexuses, foveal avascular zone area, radial peripapillary capillary vessel density, and choriocapillaris non-perfused area (NPCA) ratios. Foveal thickness and subfoveal choroidal thickness were measured using optical coherence tomography. Age, sex, body mass index, and HbA1c levels were recorded for all participants, along with disease duration and daily insulin dose in the T1DM group. RESULTS: Superficial capillary plexus vessel density and foveal avascular zone parameters did not differ significantly between the T1DM and control groups (p > 0.05). Deep capillary plexus vessel density was also comparable between groups across most regions; however, superior hemi-area vessel density was higher in the T1DM group on unadjusted analysis (p < 0.05). Radial peripapillary capillary vessel density in the peripapillary region and whole-image analysis showed no significant differences between groups (p > 0.05). In contrast, intrapapillary vessel density was lower in children with T1DM (p < 0.05). Choriocapillaris NPCA ratio and foveal thickness were increased in the T1DM group (p < 0.05), while subfoveal choroidal thickness showed no significant difference between groups (p > 0.05). CONCLUSION: Children with T1DM without clinical retinopathy may show early microvascular alterations on OCTA, particularly increased central choriocapillaris non-perfusion and reduced intrapapillary vessel density. These findings support the potential value of OCTA in detecting preclinical ocular microvascular involvement in pediatric T1DM before clinically detectable retinopathy develops.
Central and peripheral optical quality after FS-LASIK, SMILE, and phakic ICL implantation for moderate to high myopia.
Lin Y, Wei X, Huang B … +3 more , Li Y, Su H, Huang M
BMC Ophthalmol · 2026 Jun · PMID 42243759 · Full text
BACKGROUND: FS-LASIK, small-incision lenticule extraction (SMILE), and phakic intraocular lens (ICL) implantation are widely used for correcting moderate to high myopia, yet their effects on peripheral optical quality re...
BACKGROUND: FS-LASIK, small-incision lenticule extraction (SMILE), and phakic intraocular lens (ICL) implantation are widely used for correcting moderate to high myopia, yet their effects on peripheral optical quality remain incompletely understood. This study compared central and peripheral optical outcomes after these three procedures using on-axis and off-axis wavefront measurements. METHODS: This retrospective comparative study included 598 eyes (18-35 years) that underwent FS-LASIK, SMILE, or phakic ICL implantation. Wavefront aberrations were measured preoperatively and at 6 months postoperatively, both centrally and at ± 30° eccentric fixation, using a modified Shack-Hartmann aberrometer. The measurements were reconstructed over a 4.5-mm pupil, ensuring consistency across subjects.Second-, third-, and fourth-order RMS aberrations, peripheral relative defocus, astigmatic vector J0, and horizontal coma were analyzed pre- and postoperatively, with inter-group comparisons and correlations with preoperative spherical equivalent (SE). RESULTS: All procedures achieved high refractive accuracy with minimal surgically induced astigmatism. Second-order aberrations were substantially reduced in all groups. Third-order aberrations increased postoperatively, most prominently after FS-LASIK, followed by SMILE and then ICL implantation, while fourth-order changes were small and similar among groups. Peripheral relative defocus shifted toward hyperopia after all procedures, greatest after FS-LASIK. Induced higher-order aberrations and peripheral defocus were significantly correlated with preoperative SE, particularly in the FS-LASIK group. CONCLUSIONS: Although FS-LASIK, SMILE, and phakic ICL implantation all provided effective correction of moderate to high myopia, they were associated with different patterns of postoperative central and peripheral optical change. In this cohort, phakic ICL implantation showed relatively smaller changes in peripheral optical quality measures, whereas FS-LASIK was associated with greater spherical equivalent-dependent increases in higher-order aberrations and peripheral hyperopic defocus. Peripheral wavefront assessment may provide clinically relevant information beyond central aberrometry.
Serum microRNA-34a as a circulating biomarker for age-related macular degeneration and short-term anti-VEGF response in neovascular AMD.
Kong M, Jin R, Cheng T … +2 more , Sun L, Tong N
BMC Ophthalmol · 2026 Jun · PMID 42237272 · Full text
OBJECTIVE: To evaluate whether serum microRNA-34a (miR-34a) is associated with age-related macular degeneration (AMD) and whether baseline serum miR-34a has the potential to predict short-term response to anti-vascular e...
OBJECTIVE: To evaluate whether serum microRNA-34a (miR-34a) is associated with age-related macular degeneration (AMD) and whether baseline serum miR-34a has the potential to predict short-term response to anti-vascular endothelial growth factor (anti-VEGF) therapy in patients with neovascular AMD (nAMD). METHODS: In a cross-sectional cohort recruited at Qingdao Municipal Hospital between January and December 2024, serum miR-34a was quantified in 160 AMD patients and 122 age- and sex-matched healthy controls. AMD was staged according to Age-related Eye Disease Study (AREDS) criteria. Patients with nAMD received three consecutive monthly intravitreal anti-VEGF injections during the loading phase and were classified as good or poor responders according to prespecified anatomical and functional criteria based on optical coherence tomography (OCT) and best-corrected visual acuity (BCVA) after the loading phase. Peripheral blood samples were collected, and serum miR-34a expression was quantified using standard qPCR protocols. RESULTS: Serum miR-34a was significantly higher in patients with AMD than in controls (p < 0.001). Receiver operating characteristic (ROC) analysis yielded an area under the curve (AUC) of 0.740 (95% CI 0.681-0.799; p < 0.0001) for discriminating AMD from controls. Across AMD subgroups, serum miR-34a differed significantly overall; patients with geographic atrophy (GA) exhibited higher miR-34a levels than those with nAMD (p < 0.05). Among patients with nAMD, baseline serum miR-34a was remarkably higher in good responders than in poor responders after the loading phase (p < 0.001). ROC analysis showed an AUC of 0.772 (95% CI 0.687-0.857; p < 0.0001) for predicting treatment response, and multivariable logistic regression identified higher serum miR-34a as independently associated with lower odds of poor response (OR 0.143, 95% CI 0.042-0.489; p = 0.002). CONCLUSION: Elevated serum miR-34a is associated with AMD and may serve as a minimally invasive biomarker for distinguishing AMD from controls. In nAMD, baseline serum miR-34a also showed potential for predicting short-term response to loading-phase anti-VEGF therapy. These findings warrant validation in larger, longitudinal, and preferably multicenter cohorts.
Comparison of spectral-domain optical coherence tomography biometry measurements with partial coherence interferometry optical biometry.
Yakar K, Özgür G
BMC Ophthalmol · 2026 Jun · PMID 42237101 · Full text
PURPOSE: This study aimed to evaluate the agreement and interchangeability between a spectral-domain optical coherence tomography (SD-OCT)-based biometer (REVO FC) and a partial coherence interferometry (PCI) device (AL...
PURPOSE: This study aimed to evaluate the agreement and interchangeability between a spectral-domain optical coherence tomography (SD-OCT)-based biometer (REVO FC) and a partial coherence interferometry (PCI) device (AL Scan). METHODS: This prospective comparative cross-sectional study included 60 right eyes of 60 patients aged 40-82 years, diagnosed with senile cataracts. Measurements of axial length (AL), anterior chamber depth (ACD), keratometry (K1, K2), and astigmatism vector components (J0, J45) were conducted using both devices. Paired comparisons were performed using appropriate statistical tests. Agreement was evaluated using Bland-Altman analysis, while correlation and reliability were assessed using Pearson correlation coefficients and interclass correlation coefficients (ICC). RESULTS: No statistically significant differences were observed in AL (p = 0.507) or ACD (p = 0.218), with excellent correlations (AL: r = 0.998; ACD: r = 0.945). Bland-Altman analysis demonstrated excellent agreement for AL measurements, with a mean difference (bias) of - 0.01 mm and narrow 95% limits of agreement (LoA: -0.245 to 0.225 mm). For ACD, the mean difference was 0.02 mm, with a moderately wider LoA (- 0.244 to 0.288 mm), indicating an acceptable but less robust agreement compared to AL. The keratometric values were significantly higher with REVO FC (K1: +0.76 D; K2: +0.94 D; both p < 0.001), indicating a systematic bias. Despite strong correlations (K1: r = 0.980; K2: r = 0.924), the Bland-Altman analysis revealed wide limits of agreement. J0 exhibited no significant difference (p = 0.889), whereas J45 differed significantly (p = 0.028). Both vector components demonstrated moderate agreement, with relatively wide limits of agreement. CONCLUSION: REVO FC and AL Scan demonstrate excellent agreement for AL and ACD measurements and may be used interchangeably for these parameters. However, significant discrepancies in keratometric and astigmatic measurements limit their interchangeability.
Distinct retinal remodeling and visual prognostic factors in advanced epiretinal membranes with and without associated retinal break.
Valsecchi N, Rapezzi G, Elifani M … +4 more , Finzi A, Moramarco A, Fontana L, Mete M
BMC Ophthalmol · 2026 Jun · PMID 42237099 · Full text
PURPOSE: To compare retinal remodeling and predictors of visual outcomes in advanced epiretinal membranes with retinal break (RB + ERM) and without retinal break (RB - ERM). METHODS: Retrospective observational study con...
PURPOSE: To compare retinal remodeling and predictors of visual outcomes in advanced epiretinal membranes with retinal break (RB + ERM) and without retinal break (RB - ERM). METHODS: Retrospective observational study conducted on consecutive patients with stage 3 and 4 ERM who underwent pars plana vitrectomy with ERM peeling. Baseline and post-operative clinical and optical coherence tomography parameters-including ectopic inner foveal layer (EIFL) thickness, and presence of hyperreflective foci (HF)-were assessed. Multivariate analyses were conducted separately for the two conditions to examine the relationship between postoperative best-corrected visual acuity (BCVA) and a set of predictor variables. RESULTS: A total of 80 eyes from 80 patients were included: RB-ERM (n = 55) and RB + ERM (n = 25). At baseline, RB + ERM showed higher proportion of stage 4 ERMs compared to RB-ERM (p = 0.004), greater EIFL thickness (p = 0.003), and a higher number of HF in the EIFL (p = 0.042). After surgery, RB + ERM exhibited significantly greater reduction in EIFL thickness (p = 0.036) and in HF count within the EIFL compared to RB-ERM (p = 0.023). BCVA improvement was similar between the two groups (p = 0.917). In RB-ERM, multivariate regression identified older age, worse baseline BCVA, greater baseline EIFL and central macular thickness (CMT), and higher HF count within the EIFL as significant predictors of worse postoperative BCVA (p < 0.05), whereas in RB + ERM, presence of preoperative intraretinal cysts, and older age showed a significant association with worse BCVA after surgery (p < 0.05). CONCLUSIONS: RB + ERM demonstrated more pronounced retinal remodeling and distinct predictors of postoperative BCVA compared with RB-ERM, suggesting different underlying pathophysiology, despite similar improvements in visual outcomes. Further prospective and longitudinal studies incorporating histopathological analyses are warranted to confirm these observations.
Predictors of treatment response to subthreshold micropulse laser and oral spironolactone therapy for central serous chorioretinopathy.
Gao S, Zhang Y, Ge G … +1 more , Zhang M
BMC Ophthalmol · 2026 Jun · PMID 42237096 · Full text
OBJECTIVES: To identify the specific predictors of treatment response to subthreshold micropulse laser (SML) and oral spironolactone therapy in patients with central serous chorioretinopathy (CSC). METHODS: Patients diag...
OBJECTIVES: To identify the specific predictors of treatment response to subthreshold micropulse laser (SML) and oral spironolactone therapy in patients with central serous chorioretinopathy (CSC). METHODS: Patients diagnosed with CSC and treated with SML or spironolactone were included in this cohort study. Baseline characteristics, systemic factors, and various imaging characteristics were included as potential predictors of treatment response. Univariate and multivariate analysis was performed to identify predictive factors for the disease. RESULTS: A total of 103 eyes from 97 patients were included and divided into SML group (52 eyes) and spironolactone group (51 eyes). SRF resolution and OCT parameters, including CRT (p = 0.018) and SRF height (p < 0.001), decreased significantly in both groups, but SFCT decreased only in the spironolactone group. Regression analysis revealed that baseline SRF area was correlated with disease resolution in both SML (p = 0.005) and spironolactone (p = 0.016) groups, whereas changes in CRT and SFCT were correlated with a history of hyperuricemia (p = 0.047) and drinking (p = 0.035) only in the spironolactone group. CONCLUSION: Both SML and oral spironolactone are alternative therapies with similar efficacy. The SRF area at baseline can be a predictor of disease resolution. A history of hyperuricemia and drinking correlates with worse efficacy with spironolactone treatment. TRIAL REGISTRATION: The study was registered on Chinese Clinical Trial Registry (identifier: ChiCTR2100044356) at 17 March 2021.
Late-onset bullous keratopathy after iris-fixated phakic intraocular lens implantation: a case report.
Ferrand S, Bogdanova-Bennett A, Cornelius DT … +1 more , Ferrand RA
BMC Ophthalmol · 2026 Jun · PMID 42231248 · Full text
BACKGROUND: This article presents a case report of bullous keratopathy occurring 12 years after implantation of iris-fixated anterior chamber phakic intraocular lenses (AC pIOL), which eventually required Descemet Membra...
BACKGROUND: This article presents a case report of bullous keratopathy occurring 12 years after implantation of iris-fixated anterior chamber phakic intraocular lenses (AC pIOL), which eventually required Descemet Membrane Endothelial Keratoplasty (DMEK). This represents a much longer period of endothelial decompensation following implantation than that reported in other studies. CASE PRESENTATION: A 44-year-old woman presented with pain and reduced vision which was diagnosed as uveitis; it was unresponsive to topical steroids. Twelve years earlier, she had iris-fixated AC pIOLs (Myopia Artiflex 6 mm) implanted in both eyes for correction of myopia. Substantial endothelial loss with a bullous keratopathy was identified and both intraocular lenses were explanted. Owing to endothelial decompensation in the left eye, the patient required a left Descemet Membrane Endothelial Keratoplasty. CONCLUSIONS: As the same models of AC pIOLs are still in use today, clinicians should be aware of this serious complication when considering different refractive error correction procedures. Our report highlights that endothelial decompensation as a complication of AC pIOL implantation can occur many years after lens implantation, and emphasizes the need for long-term endothelial monitoring.
Functional and anatomical outcomes of Yamane technique-based scleral fixation after complicated cataract surgery versus IOL extraction.
Kahramanoğlu F, Albayrak MT, Ayas S
BMC Ophthalmol · 2026 Jun · PMID 42231235 · Full text
PURPOSE: To evaluate and compare the anatomical and functional outcomes of Yamane scleral-fixated intraocular lens (IOL) implantation in aphakic eyes following complicated cataract surgery (CCS) or prior IOL extraction (...
PURPOSE: To evaluate and compare the anatomical and functional outcomes of Yamane scleral-fixated intraocular lens (IOL) implantation in aphakic eyes following complicated cataract surgery (CCS) or prior IOL extraction (IE), using standardized outcome measures. METHODS: This retrospective study included 50 eyes of 50 patients who underwent Yamane scleral-fixated IOL implantation (CCS: n = 13; IE: n = 37). Best-corrected visual acuity (BCVA), intraocular pressure (IOP), refractive outcomes, endothelial cell density (ECD), and central macular thickness (CMT) were evaluated preoperatively and at 6 months postoperatively. Standardized changes (ΔlogMAR, ΔECD%, ΔCMT%) were calculated. RESULTS: BCVA and spherical equivalent improved significantly in both groups (p < 0.001), with no significant difference in visual gain between groups (p = 0.063). Absolute astigmatism decreased significantly in the IE group (p = 0.036) but not in the CCS group (p = 0.124). IOL-related astigmatism remained low and comparable between groups (p = 0.765). IOP decreased significantly in the CCS group (p = 0.036) but remained stable in the IE group (p = 0.476). ECD decreased significantly in both groups, with no between-group difference in percentage loss (p = 0.382). CMT remained stable, with no significant differences (p = 0.974). Complication rates were low, with no severe adverse events. CONCLUSION: Yamane scleral fixation provides safe and effective short-term anatomical and functional outcomes in aphakic eyes following both CCS and IE. Despite differences in surgical history, outcomes were largely comparable between groups across most parameters. Intraocular pressure decreased in eyes undergoing CCS and remained stable in previously operated eyes, reflecting expected physiological responses. These findings further support the Yamane technique as a reliable and versatile option for secondary IOL implantation, with outcomes largely independent of prior lens status. CLINICAL TRIAL NUMBER: This study is a retrospective study conducted using data obtained from patient records. It does not involve an interventional clinical trial; therefore, a clinical trial registration number is not applicable.
Phaco tip-chopper flip technique for epinucleus removal in cataract surgery.
Xie W, Tian T, Ying L
BMC Ophthalmol · 2026 Jun · PMID 42231217 · Full text
PURPOSE: To introduce the Phaco Tip-Chopper Flip Technique in removing epinucleus during phacoemulsification, and to report the preliminary clinical outcomes in patients who underwent this technique. METHODS: Sixteen eye...
PURPOSE: To introduce the Phaco Tip-Chopper Flip Technique in removing epinucleus during phacoemulsification, and to report the preliminary clinical outcomes in patients who underwent this technique. METHODS: Sixteen eyes with various conditions that underwent the Phaco Tip-Chopper Flip technique were retrospectively reviewed. The key steps of this technique consisted of retaining the phaco tip in the irrigation/aspiration (I/A) mode after nuclear fragment removal, using low-to-moderate vacuum to aspirate the folded portion of the epinucleus while the chopper was used to push the interior edge. The coordinated application of these forces flipped the epinucleus away from the capsular bag, enabling its rapid removal. RESULTS: All surgeries were completed successfully without any intraoperative or postoperative complications, notably without posterior capsule rupture. Thick and adherent epinucleus was smoothly aspirated in the vast majority of cases under I/A mode using a high vacuum (400 mmHg). Postoperative corrected distance visual acuity improved as expected in all cases at both 1-day and 1-week follow-ups. CONCLUSION: The Phaco Tip-Chopper Flip Technique appears to be a safe and efficient method for epinucleus removal based on this preliminary experience, and is suitable for various types of cataract scenarios.
Iridocorneal endothelial syndrome manifesting 4.5 years after toric implantable collamer lens implantation: a case report.
Wang K, Zhang Z, Wang J … +2 more , Zhang H, Fu M
BMC Ophthalmol · 2026 Jun · PMID 42231204 · Full text
BACKGROUND: Iridocorneal endothelial syndrome (ICE) is a rare unilateral disorder with subtle early manifestations and is therefore easily overlooked in clinical practice. Reports of ICE occurring after implantable colla...
BACKGROUND: Iridocorneal endothelial syndrome (ICE) is a rare unilateral disorder with subtle early manifestations and is therefore easily overlooked in clinical practice. Reports of ICE occurring after implantable collamer lens (ICL) implantation remain exceedingly rare. In the present case, localized peripheral anterior synechiae (PAS) were identified preoperatively, whereas corneal endothelial morphology and endothelial cell density (ECD) were essentially normal. The eye remained clinically stable throughout long-term follow-up until classic features of ICE became apparent 4.5 years later, underscoring the novelty and clinical significance of this case. CASE PRESENTATION: A 19-year-old woman with high myopia underwent bilateral toric implantable collamer lens (TICL) implantation in 2021. Preoperative examination revealed localized PAS and mild superior pupillary displacement in the right eye, while the cornea was clear and ECD was within the normal range. Early and intermediate postoperative follow-up was largely unremarkable. At 4.5 years after surgery, the patient presented with blurred vision in the right eye. Ophthalmic examination demonstrated corneal edema, segmental iris atrophy, progression of PAS, corectopia, and secondary ocular hypertension. In vivo confocal microscopy using the Heidelberg Retina Tomograph III with the Rostock Cornea Module (HRT-RCM) showed disorganized endothelial cell architecture, cellular enlargement, and a marked focal reduction in endothelial cell density. Based on these clinical findings, ICE syndrome of the right eye was diagnosed. The patient subsequently underwent viscocanalostomy, trabeculectomy, and peripheral iridectomy, after which intraocular pressure remained well controlled.Given the patient's history of extreme myopia, ICL explantation was deferred to avoid marked anisometropia and substantial impairment of visual function, and careful follow-up was continued. CONCLUSION: In patients with preoperative localized PAS or subtle iris abnormalities, underlying ICE cannot be definitively excluded, even when the cornea is clear and ECD is normal. This case suggests that ICE syndrome may exist in a subclinical stage before ICL implantation, with its characteristic features emerging only later in the disease course. Long-term follow-up after ICL implantation is therefore essential, with particular attention to serial assessment of the corneal endothelium, anterior chamber angle, and iris configuration, to enable early recognition of occult progressive disease.
Phacoemulsification with goniosynechialysis for nanophthalmos with secondary angle-closure or secondary angle-closure glaucoma: a 20-case series and stepwise management strategy.
Zhu H, Wu Z, Wang Y … +3 more , Zhan X, Lv J, Ye L
BMC Ophthalmol · 2026 Jun · PMID 42226170 · Full text
BACKGROUND: Nanophthalmos is a rare congenital ocular disorder characterized by a short axial length (AL), which predisposes to secondary angle-closure and secondary angle-closure glaucoma. Surgical management is challen...
BACKGROUND: Nanophthalmos is a rare congenital ocular disorder characterized by a short axial length (AL), which predisposes to secondary angle-closure and secondary angle-closure glaucoma. Surgical management is challenging due to high complication risks. This study aimed to evaluate the feasibility and efficacy of phacoemulsification with intraocular lens implantation and goniosynechialysis (Phaco + IOL+GSL) in nanophthalmos with secondary angle-closure or secondary angle-closure glaucoma, and to propose a stepwise complication management strategy. METHODS: This retrospective case series included 20 eyes of 20 patients diagnosed with nanophthalmos (AL < 20 mm) and PAC (2 eyes) or ACG (18 eyes) who underwent Phaco + IOL+GSL between January 2022 and Jun 2025. Patients were divided into three groups based on AL: Group A (14 mm ≤ AL < 16 mm, 9 eyes), Group B (16 mm ≤ AL < 18 mm, 4 eyes), and Group C (18 mm ≤ AL < 20 mm, 7 eyes). Preoperative and postoperative uncorrected visual acuity (UCVA, logMAR) and best-corrected visual acuity (BCVA, logMAR) were recorded, intraocular pressure (IOP), number of antiglaucoma medications, and intraoperative and postoperative complications were analyzed. RESULTS: At the final follow-up (6-12 months postoperatively), the median IOP significantly decreased from 25.5 [16.0, 35.0] mmHg to 16.0 [14.0, 19.0] mmHg (P < 0.05). The median number of antiglaucoma medications decreased from 2.5 [0.0, 4.0] to 0.0 [0.0, 0.0] (P < 0.05). UCVA improved from 1.30 [1.00, 1.70] to 0.40 [0.12, 1.10] (P < 0.05), and BCVA improved from 0.82 [0.40, 1.30] to 0.50 [0.30, 0.90] (P < 0.05).The qualified success rate was 95.0% (19/20), and the complete success rate was 80.0% (16/20). The intraoperative complication rate was 25.0% (5/20), primarily shallow anterior chamber. The postoperative complication rate was 40.0% (8/20), primarily shallow anterior chamber with elevated IOP. Complications were concentrated in Groups A and B. A stepwise management strategy-initiating with medical/laser therapy, escalating to cyclophotocoagulation, and reserving pars plana vitrectomy for refractory cases-achieved successful complication management. CONCLUSION: For nanophthalmos with secondary angle-closure glaucoma, Phaco + IOL+GSL appears to be a feasible and effective procedure, particularly when combined with a stepwise complication management strategy. It may serve as an initial surgical option before resorting to more invasive combined procedures. However, the high complication rate in eyes with AL < 16 mm warrants extreme caution and readiness for escalation. The retrospective design and small sample size limit the generalizability of our findings; larger prospective studies are needed to confirm these results.
Development and validation of a novel and graded colour saturation threshold test, the LSS-8.
Stepnicka K, Sarossy A, McGrath H … +1 more , Sarossy M
BMC Ophthalmol · 2026 May · PMID 42226163 · Full text
Colour vision changes are a key clinical feature of many acquired retinal and optic nerve disorders. Current clinical tests are often labour-intensive or designed for congenital defects. We introduce the novel LSS-8 test...
Colour vision changes are a key clinical feature of many acquired retinal and optic nerve disorders. Current clinical tests are often labour-intensive or designed for congenital defects. We introduce the novel LSS-8 test, which measures colour saturation thresholds across eight hues. Three cohorts with mixed ocular health underwent testing in a diagnostic crossover study. The reliability cohort was tested with LSS-4 on different days (n = 30 eyes). The screen independence cohort used LSS-8 with 11-inch versus 13-inch screens in random order (n = 27 eyes). Brightness independence testing used LSS-8 at 115 cd/m versus 230 cd/m (n = 19 eyes). Scores for each plate set and total scores were recorded. Intraclass correlation coefficients (ICC) and absolute difference frequency distributions were calculated. Data from 74 eyes (74 subjects; mean age 62.4 ± 19.1 years; range 20-85; 39% female) were analysed. LSS-4 test-retest reliability with ICC(2,1) was excellent (mauve 0.93, red 0.95, green 0.87, blue 0.91, total score 0.96). LSS-8 screen independence testing showed excellent reliability for mauve, green, pink and total scores (ICC(2,k) 0.74-0.98), and moderate to good reliability for other hues. Varying screen brightness did not produce significant score differences in most participants. The LSS is a simple, reliable test with potential for rapid quantification of acquired colour vision defects.
Anterior capsule polishing prevents anterior capsule fibrosis after phacovitrectomy without intraocular lens implantation.
Liao X, Zhang Q, Huang Y … +3 more , Chen W, Grzybowski A, Chen H
BMC Ophthalmol · 2026 May · PMID 42218440 · Full text
OBJECTIVE: To investigate whether anterior capsule polishing can prevent the fibrosis of the anterior capsule in phacovitrectomy without intraocular lens (IOL) implantation. METHODS AND ANALYSIS: A retrospective study in...
OBJECTIVE: To investigate whether anterior capsule polishing can prevent the fibrosis of the anterior capsule in phacovitrectomy without intraocular lens (IOL) implantation. METHODS AND ANALYSIS: A retrospective study including seventy cases of phacovitrectomy without IOL implantation was conducted. Fifty cases received 360-degree anterior capsule polishing, and 20 cases did not receive polishing. The severity of anterior capsule fibrosis was calculated by adding the score (from 0 to 3) of each clock hour. The fibrosis severity was compared in the groups with and without polishing using Mann-Whitney U test. The risk factors of anterior capsule fibrosis were explored using single and multiple linear regression. The location of secondary intraocular lens implantation was compared between the polishing and non-polishing groups with Chi-square test. RESULTS: The median severity score of the polishing group was significantly less than that of the non-polishing group (6 vs. 24 out of 36, P < 0.001). Multiple regression showed that diabetes (b = 14.634, P = 0.001), silicone oil tamponade (b = 8.734, P < 0.001), and non-polishing (b = 13.731, P < 0.001) were the risk factors of anterior capsule fibrosis. Anterior capsule polishing was associated with a higher chance of secondary in-the-bag IOL implantation (OR = 4.889, P = 0.004). CONCLUSION: Polishing the anterior capsule is associated with reduced fibrosis of the anterior capsule in phacovitrectomy without primary IOL implantation, and more chance of secondary in-the-bag IOL implantation.
Timing of height growth peaks and axial elongation in atropine-treated myopic children.
Surl D, Han J, Seo Y
BMC Ophthalmol · 2026 May · PMID 42218416 · Full text
PURPOSE: To investigate the association between systemic height growth rate and ocular axial elongation rate in atropine-treated children with myopia, and to explore whether the timing of height growth provides clinicall...
PURPOSE: To investigate the association between systemic height growth rate and ocular axial elongation rate in atropine-treated children with myopia, and to explore whether the timing of height growth provides clinically relevant information regarding periods of axial elongation during treatment. METHODS: Children with myopia (< 15 years) who underwent serial ocular biometry and anthropometric measurements over ≥ 3 visits spanning > 1 year were included. Participants were classified into a control group (no atropine) and an atropine group (0.05% nightly, initiated for axial elongation ≥ 0.4 mm/year). Axial elongation and height growth rates were calculated for each inter-visit interval. Peak growth ages were defined as those with the greatest inter-visit changes. Subgroup analyses in the atropine group were based on the median peak height growth age (10.45 years) and median annual axial elongation rate (0.21 mm/year). RESULTS: A total of 139 eyes from 70 children were analyzed (56 control, 83 atropine-treated). Height growth rate and axial elongation rate were not significantly correlated in either group. In the control group, peak height growth age and peak axial elongation age showed similar unimodal distributions. In the atropine group, however, the distribution of peak height growth age showed a broadened pattern with marginal deviation from unimodality (P = 0.051) and associated strongly with peak axial elongation age (β = 0.91, P < 0.01). Children with earlier height growth peaks had greater annual axial elongation (0.27 ± 0.17 vs. 0.15 ± 0.12 mm/year; P < 0.01) despite identical dosing. CONCLUSIONS: Among atropine-treated children, earlier systemic growth peaks were associated with faster axial elongation. Monitoring height growth timing may help identify rapid ocular growth periods and optimize treatment strategies.
Choroidal watershed infarction due to medial posterior ciliary artery occlusion with hemi-retinal ischemia, a case report.
Alsakran WA, Alyousef N, Alenazi M … +2 more , Badawi AH, Magliyah MS
BMC Ophthalmol · 2026 May · PMID 42218413 · Full text
BACKGROUND AND PURPOSE: To describe a rare case of combined medial long posterior ciliary occlusion associated with nasal hemiretinal ischemia due to atherosclerotic disease and to outline the possible hemodynamic mechan...
BACKGROUND AND PURPOSE: To describe a rare case of combined medial long posterior ciliary occlusion associated with nasal hemiretinal ischemia due to atherosclerotic disease and to outline the possible hemodynamic mechanisms that can explain this association. CASE PRESENTATION: A 65-year-old female patient presented with iris neovascularization with angiographic evidence of watershed choroidal infarction in the setting of non-filling of the nasal choroid and the nasal half of the optic disc on fluorescein and indocyanine green angiography associated with superior and inferior amalric triangular infarcts. The nasal retinal arteries and veins showed significant filling delays. An extensive work-up was carried out, including neurovascular imaging, which was unremarkable except for the known atherosclerotic disease. CONCLUSIONS AND IMPORTANCE: The best explanation for this appearance is a sectoral hemodynamic failure across the standard watershed zone between the medial posterior ciliary artery (MPCA) and the nasal branches of the central retinal artery (CRA). MPCA obstruction most likely produced nasal choroidal and optic-disc ischemia, as well as subsequent hypoperfusion of adjacent nasal CRA branches. Recognizing this pattern emphasizes the intricate interconnectedness of the retinal and choroidal circulations and precludes misdiagnosis as abnormal CRA or venous blockage.
Suprachoroidal effusion with angle-closure glaucoma in a patient with active systemic lupus erythematosus: a case report.
Guo X, Li Y, Wang J … +2 more , Zhang Y, Wu P
BMC Ophthalmol · 2026 May · PMID 42218403 · Full text
BACKGROUND: Systemic lupus erythematosus (SLE) uncommonly presents with ocular manifestations as the initial feature. Uveal effusion syndrome (UES) is typically described in eyes with nanophthalmos and scleral abnormalit...
BACKGROUND: Systemic lupus erythematosus (SLE) uncommonly presents with ocular manifestations as the initial feature. Uveal effusion syndrome (UES) is typically described in eyes with nanophthalmos and scleral abnormalities. This case is noteworthy for two reasons. First, the patient had normal axial length and no marked diffuse scleral thickening on ultrasound biomicroscopy(UBM), with a massive annular uveal/suprachoroidal effusion resembling a type III UES-like phenotype; however, concurrent active SLE, hypoalbuminaemia and polyserositis suggested a secondary systemic trigger. Second, ocular recovery appeared to accelerate after periocular corticosteroid therapy, despite inadequate response to systemic immunosuppression. CASE PRESENTATION: A 38-year-old woman presented with three days of bilateral ocular pain and visual deterioration. Initial examination revealed intraocular pressure of 38.7 mmHg in the right eye and 32.7 mmHg in the left, shallow anterior chambers, and axial length of 21.85 mm bilaterally. Bilateral angle-closure glaucoma was diagnosed, and laser peripheral iridotomy was performed along with topical antiglaucoma agents and corticosteroids. One week later, systemic symptoms including fever and polyarthralgia developed. Laboratory tests showed strongly positive autoimmune markers (ANA: antinuclear antibody, ANSA༚anti-nucleosome antibody, ARPA༚anti-ribosomal P protein antibody), low complement levels (C3༚complement 3, C4༚complement 4). Inflammatory markers were elevated (CRP༚C-reactive protein 84.08 mg/L, ESR༚erythrocyte sedimentation rate 83 mm/h), severe hypoalbuminaemia (27.4 g/L). Imaging revealed pleural, pericardial, and peritoneal effusions. Active SLE with polyserositis and lupus nephritis was diagnosed. Intravenous methylprednisolone, cyclophosphamide, hydroxychloroquine and telitacicept were initiated. However, ultrasonography showed progressive 360-degree annular choroidal detachment with anterior displacement of the lens-iris diaphragm. Bilateral periocular triamcinolone acetonide 20 mg was administered, followed by periocular dexamethasone 5 mg. Choroidal detachment rapidly resolved, anterior chamber depth increased from 1.57 mm to 2.93 mm, and the retina reattached spontaneously. One month later, best-corrected visual acuity improved from 20/500 to 20/50 in both eyes, and intraocular pressure normalised. CONCLUSIONS: This case illustrates that systemic serous leakage in SLE can cause massive suprachoroidal effusion with secondary angle-closure glaucoma, even in eyes with normal axial length. Periocular corticosteroid therapy may serve as a useful adjunct by increasing local ocular drug exposure and promoting fluid resorption.
Comparative analysis of optical coherence tomography angiography metrics in primary open-angle glaucoma and ocular hypertension.
Karadağ B, İzgi B, Bayraktar Ş
BMC Ophthalmol · 2026 May · PMID 42216126 · Full text
PURPOSE: To evaluate macular ganglion cell complex (GCC) thickness and parafoveal vessel density (pfVD) using optical coherence tomography angiography (OCT-A) in patients with ocular hypertension (OHT) and early- to inte...
PURPOSE: To evaluate macular ganglion cell complex (GCC) thickness and parafoveal vessel density (pfVD) using optical coherence tomography angiography (OCT-A) in patients with ocular hypertension (OHT) and early- to intermediate-stage primary open-angle glaucoma (POAG). MATERIAL AND METHODS: This cross-sectional study included 150 eyes from 56 patients with POAG and 32 patients with OHT who were under regular follow-up at the Glaucoma Unit of Istanbul University Faculty of Medicine, Department of Ophthalmology. Evaluations were conducted between November and December 2022. Additionally, 50 eyes from 25 healthy individuals were included as a control group. OCT-A imaging was performed using the Topcon DRI OCT Triton system (Topcon Corporation, Japan). Macular GCC thickness and pfVD in the superficial and deep capillary plexuses were measured and compared among groups. RESULTS: A total of 113 participants (74 females, 39 males) were included. No significant differences in macular GCC thickness or pfVD were observed between the control and OHT groups. In contrast, both parameters were significantly reduced in POAG eyes, with greater reductions observed in more advanced disease stages. The decrease in pfVD was more pronounced in the superficial capillary plexus compared to the deep plexus. In early-stage POAG, GCC thinning appeared more prominent than pfVD reduction. CONCLUSıON: Our findings suggest that macular GCC thickness and pfVD assessed by OCT-A are associated with glaucomatous changes. In particular, structural alterations in macular GCC may be more pronounced than vascular changes in early-stage POAG. These results indicate that macular GCC assessment may provide complementary information in the evaluation of early glaucomatous damage. However, due to the cross-sectional design of the study, no conclusions can be drawn regarding the temporal relationship between structural and vascular changes.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe