OBJECTIVE: To investigate the effect of peripapillary retinoschisis (PPRS) on circumpapillary and macular retinal thickness and its correlation with longitudinal changes in the visual field. METHODS: A wide-field scan us...OBJECTIVE: To investigate the effect of peripapillary retinoschisis (PPRS) on circumpapillary and macular retinal thickness and its correlation with longitudinal changes in the visual field. METHODS: A wide-field scan using swept-source optical coherence tomography was performed to measure the circumpapillary retinal nerve fiber layer (cpRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) thickness. The relationship between longitudinal measurements of cpRNFL, mGCIPL thickness, and visual field index (VFI) was assessed using repeated-measures correlation. Pearson correlation analysis was used to evaluate the correlation between the VFI change rate and the change rates of cpRNFL or mGCIPL thickness. RESULTS: A total of 25 eyes were included in the final analysis. The cpRNFL thickness significantly increased with PPRS (P < .001) and decreased after the resolution of PPRS (P < .001), whereas the mGCIPL thickness did not change with PPRS (all P > .05). The longitudinal measurements of cpRNFL thickness did not show a significant correlation with VFI (P = .560), nor did its change rate correlate significantly with the progression rate of VFI (P = .294). In contrast, mGCIPL thickness exhibited a significant correlation with the VFI (P < .001), and its change rate also showed a significant correlation with the progression rate of the VFI (P = .035). CONCLUSIONS: The mGCIPL thickness could serve as a reliable marker for assessing progression in glaucomatous eyes with PPRS. Monitoring changes in each parameter across consecutive tests is essential to identifying the most appropriate marker for detecting glaucoma progression, given that structural alterations such as PPRS may occur in glaucomatous eyes.
BACKGROUND: The pattern electroretinogram (PERG) has been investigated as a potential functional biomarker for detecting retinal ganglion cell dysfunction in glaucoma. However, reported diagnostic performance appears to...BACKGROUND: The pattern electroretinogram (PERG) has been investigated as a potential functional biomarker for detecting retinal ganglion cell dysfunction in glaucoma. However, reported diagnostic performance appears to vary across disease stages and recording protocols. This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of PERG for glaucoma. METHODS: PubMed, Embase, and Web of Science were comprehensively searched up to March 2025. Studies assessing PERG accuracy against a clinical reference standard were included. Risk of bias was assessed using QUADAS-2. Data were synthesized using a hierarchical summary receiver operating characteristic model. Subgroup analyses were performed based on disease severity and International Society for Clinical Electrophysiology of Vision-standardized protocols. Sources of heterogeneity were explored through sensitivity analyses. RESULTS: Twenty-one studies involving 1 793 participants (2 580 eyes) were analyzed. Pooled sensitivity and specificity for manifest glaucoma were 0.79 (95% CI: 0.76-0.82) and 0.78 (95% CI: 0.75-0.80), respectively. Diagnostic performance for glaucoma suspects was comparable. The ocular hypertension subgroup exhibited moderate pooled sensitivity (0.54) with considerable heterogeneity. Sensitivity analysis suggested that this variation might stem from the higher sensitivity of the Hemifield protocol compared with standard full-field stimulation. Regarding temporal frequency, transient PERG appeared to demonstrate marginally higher diagnostic estimates than steady-state protocols. CONCLUSIONS: Current literature affirms the clinical viability of PERG; however, inconsistent performance metrics in the preperimetric phase suggest that standard full-field configurations may lack the requisite sensitivity to capture incipient localized damage. Preliminary findings suggest that protocol optimization-potentially involving Hemifield stimulation-may offer advantages for detecting early functional loss, warranting further validation in future studies.
OBJECTIVE: To identify risk factors for pentosan polysulfate (PPS) maculopathy. METHODS: Cross-sectional study of PPS-exposed individuals seen at Emory Eye Center from January 2018 to March 2024. Data from standardized q...OBJECTIVE: To identify risk factors for pentosan polysulfate (PPS) maculopathy. METHODS: Cross-sectional study of PPS-exposed individuals seen at Emory Eye Center from January 2018 to March 2024. Data from standardized questionnaires and fundus imaging were evaluated. Multivariate analyses were used to evaluate toxicity risk factors, and subgroup analysis was used to compare characteristics in low-exposure (<800 g) and high-exposure (>1500 g) groups. RESULTS: In total, 187 patients (mean age 59.5±13.8 years, 84.5% female) underwent screening. Risk of toxicity was dose-dependent, with those in the greatest exposure quartile (≥2000 g) showing the greatest risk (odds ratio [OR] 39.8, 95% confidence interval [CI] 10.6-205.1, P < .001). Other factors associated with risk included cumulative dose per body weight (OR 1.1, 95% CI 1.0-1.1, P < .001), female sex (OR 8.1, 95% CI 1.2-75.9, P = .04), older age (OR 1.03, 95% CI 1.02-1.1, P = .046), and inflammatory bowel disease or irritable bowel syndrome (OR 2.8, 95% CI 1.2-6.6, P = .02). In low-exposure cases (<800 g), those with maculopathy were older (67.1 vs 56.9 years, P = .01), had longer PPS exposure (11 vs 7.9 years, P = .03), a greater dose per body weight (9.7 vs 5.1 g/kg, P < .001), and lower body weight (63.9 vs 74.4 kg, P = .03). The prevalence of toxicity among PPS users at Emory is estimated as ranging between 3.8% and 24.5%. CONCLUSIONS: This comprehensive screening study corroborates that the risk of PPS maculopathy is primarily driven by cumulative PPS exposure but also suggests a possible role for other factors including age, sex, and body weight. These findings have global public safety implications and may help inform dosing guidelines and screening protocols.
OBJECTIVE: To investigate the accuracy of intraocular lens (IOL) calculations for patients with Fuchs' endothelial dystrophy (FED) undergoing Descemet stripping only (DSO) combined with cataract surgery. DESIGN: Retrospe...OBJECTIVE: To investigate the accuracy of intraocular lens (IOL) calculations for patients with Fuchs' endothelial dystrophy (FED) undergoing Descemet stripping only (DSO) combined with cataract surgery. DESIGN: Retrospective case series METHODS: All FED patients who underwent combined DSO and cataract surgery between August 2020 and January 2023 and met the following criteria were included: guttae in the central 4-5 mm of the cornea, no corneal edema, a clinically healthy peripheral endothelium, and a desired emmetropic target. IOL calculations were made using the Barrett Universal II formula. RESULTS: Eleven eyes were included in the study. The mean age was 68.3 ± 7.9 years. All patients achieved corneal clearance with no observed decompensation. Corrected distance visual acuity improved significantly with sustained improvement at the most recent follow-up (0.59 ± 0.48 vs 0.18 ± 0.16 logMAR; median follow-up 16.5 months). A mean refractive target of -0.64 ± 0.14 D was selected on the basis of prior experience with Descemet membrane endothelial keratoplasty. The mean difference between postoperative MRSE and target refraction was +0.33 ± 0.53 D with a median of +0.18 D. There was no significant change in astigmatism. CONCLUSIONS: In select FED patients, DSO combined with cataract surgery can provide significant improvements in vision. In this cohort, combined surgery induced a mean hyperopic shift of 0.33 D. When selecting an IOL power for this population, one should take this into account to achieve optimal visual outcomes.
OBJECTIVE: To compare the effectiveness and safety of micropulse (MP-CPC) and continuous-wave cyclophotocoagulation (CW-CPC). DESIGN: A retrospective, comparative cohort study. PATIENTS: Patients with all types of glauco...OBJECTIVE: To compare the effectiveness and safety of micropulse (MP-CPC) and continuous-wave cyclophotocoagulation (CW-CPC). DESIGN: A retrospective, comparative cohort study. PATIENTS: Patients with all types of glaucoma and severity having received MP-CPC or CW-CPC between 2017 and 2021 followed for 2 years. METHODS: Complete success is defined as intraocular pressure (IOP) of 6-21 mm Hg and IOP reduction from baseline of 30% or higher with no additional glaucoma medications. Qualified success includes those with additional glaucoma medications. Safety outcomes include vision loss, visual field (VF), optical coherence tomography (OCT), CPC retreatment, additional glaucoma surgeries, and adverse events. RESULTS: 118 eyes and 114 eyes underwent CW-CPC and MP-CPC, respectively. There was a trend toward better survival in CW-CPC throughout the 24 months, notably at 6 and 18 months (p < 0.04). CW-CPC required significantly less glaucoma medication throughout the follow-up than MP-CPC (p = 0.049). Safety outcomes showed no difference in significant vision loss or change in VF and OCT. Ocular inflammation was more common in the CW-CPC group (33.1% vs 18.4%; p = 0.01), but similar rates of hypotony were observed in both groups (12% vs 9.6%; p = 0.73). The MP-CPC group needed additional incisional glaucoma surgeries sooner than the CW-CPC group (6.7 months vs 10.8 months; p = 0.002). CONCLUSION: CW-CPC demonstrated better IOP control with less use of glaucoma drops than MP-CPC. Early retreatment was more common and occurred sooner in the MP-CPC group. Ocular inflammation was more common with CW-CPC, but overall safety parameters were comparable between the 2 groups.
OBJECTIVE: To compare Canadian provincial cataract surgery "Wait Time 2" (WT2) between 2008 and 2023. WT2 refers to the interval between surgical booking and the date of surgery, with a national benchmark of ≤16 weeks in...OBJECTIVE: To compare Canadian provincial cataract surgery "Wait Time 2" (WT2) between 2008 and 2023. WT2 refers to the interval between surgical booking and the date of surgery, with a national benchmark of ≤16 weeks in Canada. DESIGN: A retrospective population-based analysis of the Canadian Institute for Health Information priority procedure database. PARTICIPANTS: Adults (≥18 years) undergoing publicly funded first-eye cataract surgery in Canada. METHODS: The analysis was limited to first-eye cataract surgeries. Metrics included surgical volume, median WT2, 90th percentile WT2, and the proportion of surgeries completed within the 16-week national benchmark. RESULTS: We identified 2,322,451 cataract procedures between 2008 and 2023. There was an increase in the national median income and 90th percentile cataract surgery WT2 by 3.04 days/year (p = 0.03) and 11.26 days/year (p < 0.01), respectively. Between 2008 and 2023, 6 provinces (Manitoba, New Brunswick, Newfoundland and Labrador, Ontario, Prince Edward Island, and Quebec) experienced significant average annual increases to their 50th and 90th percentile WT2, alongside reductions in the proportion of patients meeting the benchmark period. In the interprovincial analysis, Prince Edward Island and Manitoba had the greatest increase in median WT2 and the lowest benchmark achievement compared to other provinces. Quebec had the lowest WT2 and a higher proportion of cataract surgeries within the benchmark period. Provincially, greater ophthalmologist density, greater gross domestic product per capita, and a lower proportion of urban-dwelling residents were significantly associated with shorter WT2 times and higher rates of WT2 benchmark achievement. CONCLUSIONS: Between 2008 and 2023, WT2 and the proportion of patients missing WT2 benchmarks generally increased across Canada.
OBJECTIVE: To identify U.S. Food and Drug Administration (FDA)-approved systemic drugs disproportionately associated with reported uveitis events using real-world pharmacovigilance data. DESIGN: A retrospective pharmacov...OBJECTIVE: To identify U.S. Food and Drug Administration (FDA)-approved systemic drugs disproportionately associated with reported uveitis events using real-world pharmacovigilance data. DESIGN: A retrospective pharmacovigilance study of a large spontaneous adverse event reporting database. PARTICIPANTS: All uveitis cases reported to the FDA Adverse Event Reporting System (FAERS) between the fourth quarter of 2003 and the third quarter of 2024. METHODS: FAERS data were analyzed using OpenVigil 2.1 data-mining software. Reports identifying FDA-approved drugs as primary suspects in uveitis cases were included. Disproportionality analyses were conducted by comparing drug-specific uveitis reports with the background reporting rate across all other drugs in the database. Reporting odds ratios (RORs) with 95% confidence intervals (CIs) were calculated. Bayesian confidence propagation neural network algorithms were applied to reduce false-positive associations and strengthen signal detection. RESULTS: A total of 7 301 uveitis events were identified. The strongest safety signals were observed for cidofovir (ROR = 103.8; 95% CI 53.0-203.2) and rifabutin (ROR = 77.4; 95% CI 50.5-118.7). Additional signals were detected for cobimetinib (ROR = 30.5), foscarnet (ROR = 29.0), infliximab (ROR = 18.1), dabrafenib (ROR = 16.4), vemurafenib (ROR = 16.2), trametinib (ROR = 15.5), brodalumab (ROR = 14.9), binimetinib (ROR = 11.3), encorafenib (ROR = 11.2), ipilimumab (ROR = 11.0), and moxifloxacin (ROR = 10.3). Implicated drug classes included antivirals, antibiotics, biologics, mitogen-activated protein kinase kinase inhibitors, and v-Raf murine sarcoma viral oncogene homolog B1 (or BRAF) inhibitors. CONCLUSIONS: Multiple systemic agents demonstrated disproportionate uveitis reporting in FAERS. Although these findings do not establish causality, they highlight potential safety signals that warrant continued pharmacovigilance, heightened clinical awareness, and further population-based studies to clarify absolute risk and underlying mechanisms.
OBJECTIVE: To identify, develop, and implement interventions that reduce the environmental impact of oculoplastic procedures. METHODS: Oculoplastic procedures performed in either office-based surgery suites or ambulatory...OBJECTIVE: To identify, develop, and implement interventions that reduce the environmental impact of oculoplastic procedures. METHODS: Oculoplastic procedures performed in either office-based surgery suites or ambulatory surgery centers at 2 sites were observed by an independent observer. Waste audits were performed to quantify the number of used and unused discarded items. Targeted interventions were developed from meetings with surgeons and staff, and procedure setups were adjusted accordingly. RESULTS: The study included 59 clinic procedures and 44 operating room procedures across 2 sites. Most waste was from textiles, plastics, and medications. The most commonly performed procedures were blepharoplasty, eyelid lesion excisions, and botulinum toxin injections. The most commonly opened yet discarded surgical supplies were cotton-tip applicators (12.8 ± 6) and gauze (9.5 ± 7). Our intervention consisted of reducing the preemptive opening of excess disposable items during oculoplastic procedures, with the option to open more as needed. We reduced preprocedure setups of cotton-tip applicators from 20 to 8 and 4 × 4 gauze squares from 10 to 8 for the office-based procedure, and reduced cotton-tip applicators from 20 to 10 and gauze from 20 to 10 for operating room procedures. These measures reduced wasted cotton tips from 12 to 3 per procedure and gauze squares from 10 to 3. CONCLUSIONS: Environmental waste in oculoplastic surgery can be significantly reduced with targeted interventions. We strongly recommend against the preemptive opening of excess cotton-tip applicators and gauze squares for procedures. Other potential interventions include multiuse of topical medications between cases, minimal surface area draping, and optimizing surgical supply packaging and instructions for use.
OBJECTIVE: To assess the risk of developing ocular inflammation in the setting of sarcoidosis among non-Hispanic White (NHW) and Black/African American populations (BAA). DESIGN: Retrospective, population-based cohort st...OBJECTIVE: To assess the risk of developing ocular inflammation in the setting of sarcoidosis among non-Hispanic White (NHW) and Black/African American populations (BAA). DESIGN: Retrospective, population-based cohort study PARTICIPANTS: Participants were aged ≥18 years, diagnosed with sarcoidosis in the last 10 years, and divided into 2 cohorts of NHW and BAA descent. Propensity score matching was used to match for age and sex. METHODS: Using the TriNetX database, we determined the frequency of anterior uveitis, chorioretinal inflammation (CRI), optic neuritis (ON), and other disorders of the optic disc between the 2 cohorts using International Classification of Diseases, Tenth Revision, codes. Alternatively, the incidence of sarcoidosis was examined in patients diagnosed with ocular inflammation in the last 10 years, with sarcoidosis diagnosis occurring within 3 months after ocular inflammation. MAIN OUTCOME MEASURES: Risk ratio of the incidence of ocular inflammation between NHW and BAA populations, and the odds ratio of being diagnosed with sarcoidosis when presenting with ocular inflammation between NHW and BAA populations. RESULTS: After propensity score matching, each sarcoidosis cohort had 39 604 patients (mean age of 54.6 (± 13.4) years). Incidence of anterior uveitis was 1188 (3%) NHW and 1868 (4.7%) BAA with RR 0.636 (P < .0001, confidence interval [CI] 0.592-0.683). The incidence of CRI was 410 (1.0%) NHW and 309 (0.8%) BAA with RR 1.327 (P = .0002, CI 1.145-1.537). Incidence of ON was 538 (1.4%) NHW and 660 (1.7%) BAA with RR 0.815 (P = .0004, CI 0.728-0.913). Each anterior uveitis cohort had 32 780 patients (mean age 48.4 ± 18.3 years). Sarcoidosis was identified in 507 (1.5%) NHW and 1103 (3.4%) BAA with OR 0.451 (P < .0001, CI 0.406-0.502). Each CRI cohort had 4116 patients (mean age of 49.8 ± 17.7). Sarcoidosis was identified in 77 (1.9%) NHW and 190 (4.6%) BAA with OR 0.394 (P < .0001, CI 0.301-0.515). Each ON cohort had 22971 patients (mean age of 49.2 ± 17.9). Sarcoidosis was identified in 141 (0.6%) NHW and 483 (2.1%) BAA with OR 0.288 (P < .0001, CI 0.238-0.347). CONCLUSIONS: In those with sarcoidosis, BAA are at increased risk of developing anterior uveitis and optic neuropathy, while NHW are at increased risk of developing chorioretinal inflammation. BAA patients newly diagnosed with ocular inflammation are more likely to be diagnosed with sarcoidosis compared to their NHW counterparts.
OBJECTIVE: To evaluate the use, safety, and diagnostic accuracy of referrals sent through a direct access pathway for ophthalmic complaints from 2 emergency departments (EDs) to a tertiary emergency ophthalmology clinic....OBJECTIVE: To evaluate the use, safety, and diagnostic accuracy of referrals sent through a direct access pathway for ophthalmic complaints from 2 emergency departments (EDs) to a tertiary emergency ophthalmology clinic. DESIGN AND PARTICIPANTS: Cohort study of all referrals from two academic EDs to the Urgent Eye Care Clinic (UECC) at Kingston Health Sciences Centre between July 2, 2024, and March 21, 2025. METHODS: Referral data were extracted from electronic medical records, including patient demographics, referral details, and provisional diagnoses. Clinic notes were reviewed to identify the level of training of the primary assessor and the UECC diagnosis. Agreement between provisional and UECC diagnoses was assessed for both diagnostic accuracy and urgency. RESULTS: Two hundred forty-six referrals met the inclusion criteria. The mean ± SD time from referral to assessment was 1.15 ± 0.92 days, with 72% of patients seen within 1 calendar day. Among referrals containing a provisional diagnosis (n = 171), 85% were appropriately triaged as emergent or urgent. Agreement between provisional and final diagnoses occurred in 44% of the cases. ED physicians most accurately identified posterior segment pathology (97.5% agreement), whereas anterior segment disease was frequently misclassified. Overcalling of urgency was common (41%), while undercalling occurred in less than 5% of referrals. CONCLUSIONS: Overall, the direct referral pathway presents a safe and effective alternative to the fielding of ED referrals. Most referrals were appropriate, although some were for nonurgent concerns. Strengthening ophthalmic education and encouraging interdisciplinary communication might further optimize referral accuracy.
OBJECTIVE: To identify risk factors for ethambutol-induced optic neuropathy (EON). DESIGN: Systematic review and meta-analysis. METHODS: A literature search was conducted of PubMed, MEDLINE, EMBASE, and grey literature o...OBJECTIVE: To identify risk factors for ethambutol-induced optic neuropathy (EON). DESIGN: Systematic review and meta-analysis. METHODS: A literature search was conducted of PubMed, MEDLINE, EMBASE, and grey literature on February 5, 2024. Observational studies describing adults receiving ethambutol with optic neuropathy were included. Extracted data included patient demographics and comorbidities, dose, and duration of treatment with ethambutol, and the number of patients diagnosed with EON. A random-effects meta-analysis was performed for patients with hypertension, and patients with diabetes mellitus. Risk of bias was assessed using the Cochrane's RoB 2.0 tool and ROBINS-I tool. Certainty of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation. RESULTS: Eleven studies encompassing 370 patients diagnosed with EON were included. Longer duration of ethambutol therapy and the presence of comorbid renal disease were the most consistently associated risk factors. While non-weight-adjusted dosing did not significantly correlate with EON, patients receiving weight-adjusted doses had significantly higher daily dosages among EON cases. hypertension (odds ratio [OR] = 1.86; 95% CI 0.44-7.75; p = 0.11; k = 2) and diabetes mellitus (OR = 0.85; 95% CI 0.54-1.35; p = 0.27; k = 3), although neither reached statistical significance. The certainty of the evidence was low to very low, with wide confidence intervals and imprecise effects. CONCLUSIONS: EON is most strongly associated with longer ethambutol duration and renal impairment. The contribution of dosage, hypertension, and diabetes requires further investigation. Overall, judicious planning is required to monitor EON as a potential adverse event of antitubercular therapy.
OBJECTIVE: The aim of this study is to investigate the rates of infectious keratitis in patients using contact lenses (CL) post-keratoplasty and to determine associated risk factors that contribute to postoperative infec...OBJECTIVE: The aim of this study is to investigate the rates of infectious keratitis in patients using contact lenses (CL) post-keratoplasty and to determine associated risk factors that contribute to postoperative infection in contact lens users. DESIGN: A retrospective cohort study. PARTICIPANTS: Patients examined at the University of Minnesota Eye Clinic, a tertiary care referral center, between November 2012 and January 2023. METHODS: Parameters included demographic data, contact lens use, and ocular history. Statistical analyses comprised univariate and multivariate assessments. Only parameters that demonstrated significance in all analyses were considered significant. RESULTS: Seventy-six patients post-keratoplasty (74 penetrating keratoplasty and 2 deep anterior lamellar keratoplasty), who subsequently used CL, were included. Infectious keratitis occurred in 11.8% (n = 9) of cases, and all underwent penetrating keratoplasty. No statistically significant differences were found in age at CL fitting or duration of CL use between the infected and noninfected groups. Univariate analysis revealed higher rates of infection in patients with a history of limbal stem cell transplant (p = 0.003), prior infections (p = 0.02), persistent epithelial defects (p = 0.02), and redo keratoplasty (p = 0.03). Multivariate analysis confirmed these findings, with specific factors, including limbal stem cell transplant history, persistent epithelial defects, and redo keratoplasty history being significant contributors to infection risk. CONCLUSIONS: Caution is advised regarding CL use postkeratoplasty, particularly in patients with epithelial defects, a history of redo keratoplasty, or limbal stem cell transplant, as they exhibit increased susceptibility to infectious keratitis. These findings highlight the importance of postoperative management and personalized risk assessment to mitigate the risk of complications associated with CL use following keratoplasty.
Martin GC, Huaulmé A, Cavaillé M
… +8 more, Cruz-Panesso I, Lacoste de Lamirande J, Trottier S, Kyrillos R, Hardy I, Jannin P, Tanoubi I, Mouriaux F
Can J Ophthalmol
· 2026 Mar · PMID 41895704
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OBJECTIVE: To evaluate whether incorporating contextual operating room (OR) elements into cataract surgery simulation influences cardiovascular responses, subjective stress, and surgical performance. DESIGN: A prospectiv...OBJECTIVE: To evaluate whether incorporating contextual operating room (OR) elements into cataract surgery simulation influences cardiovascular responses, subjective stress, and surgical performance. DESIGN: A prospective, within-subject crossover study. PARTICIPANTS: Ten ophthalmic surgeons (5 senior residents and 5 board-certified cataract surgeons) from the ophthalmology department and simulation laboratory at Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada. METHODS: Participants performed cataract surgeries under 3 conditions: real surgery (Real), standard virtual reality simulation on the EyeSi Surgical (LoFi), and simulated OR environment integrating the EyeSi simulator with surgical equipment, ambient sounds, and interactions with the patient and surgical staff (HiFi). Participants completed 3 procedures per condition. Physiological responses were assessed using heart rate (HR) and heart rate variability (HRV), and subjective stress ratings were collected. Technical performance was measured through expert video assessment using the Objective Structured Assessment of Cataract Surgical Skills and simulator-generated scores. RESULTS: Seventy-eight procedures were analyzed. The HiFi condition was associated with significantly higher average and peak HR compared with LoFi (92 ± 17 vs 82 ± 11 bpm; p < 0.0001; 112 ± 17 vs 103 ± 15 bpm; p = 0.01). The temporal HR pattern in the HiFi condition more closely resembled that observed during real surgery. Technical performance remained comparable between HiFi and LoFi. No significant differences were observed in HRV metrics or subjective stress ratings. CONCLUSIONS: Cataract surgery in a simulated OR environment was associated with increased cardiovascular activation and a heart rate pattern resembling real surgery, without impairing technical performance. This approach may support the training of both technical and nontechnical surgical skills in a controlled learning environment.
Can J Ophthalmol
· 2026 May · PMID 41833326
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OBJECTIVE: To evaluate the postmarketing ocular adverse events (AEs) reported for intravitreal antivascular endothelial growth factor (anti-VEGF) therapies, aflibercept (2 mg and 8 mg), and faricimab (6 mg). DESIGN: Retr...OBJECTIVE: To evaluate the postmarketing ocular adverse events (AEs) reported for intravitreal antivascular endothelial growth factor (anti-VEGF) therapies, aflibercept (2 mg and 8 mg), and faricimab (6 mg). DESIGN: Retrospective pharmacovigilance analysis. PARTICIPANTS: Food and Drug Administration Adverse Event Reporting System (FAERS) database. METHODS: We conducted a retrospective pharmacovigilance analysis of the FAERS database from the fourth quarter of 2023 to the first quarter of 2025. Descriptive statistics and reporting odds ratio (ROR) analysis were employed to evaluate and compare AEs between 2 mg aflibercept, 8 mg aflibercept, and faricimab. RESULTS: A total of 462 unique reports of AEs secondary to 2 mg aflibercept, 151 reports for 8 mg aflibercept, and 2 427 reports for faricimab were identified. Ocular AEs that were disproportionately over-reported for all of the 3 agents included intraocular injection complications, increased intraocular pressure, endophthalmitis, reduced visual acuity, eye inflammation, uveitis, visual impairment, and blurred vision. CONCLUSIONS: In this study, faricimab generally showed lower point estimates for ROR of ocular AEs compared to 2 mg and 8 mg aflibercept; however, the wider confidence intervals for some outcomes reflect the limited number of reports and highlight the need for continued safety monitoring, particularly given the inherent reporting biases and lack of detailed patient or dosing information in the FAERS database.