Li X, Cheung R, Nayeni M
… +4 more, Al-Burak SA, Dave P, Li B, Malvankar-Mehta MS
Can J Ophthalmol
· 2026 Jun · PMID 41651446
·
Publisher ↗
OBJECTIVE: Amid growing adoption of AI in ophthalmology, Hill-Radial Basis Function (Hill-RBF) 3.0 formula may improve refractive target prediction across diverse populations, transforming patient care. This systematic r...OBJECTIVE: Amid growing adoption of AI in ophthalmology, Hill-Radial Basis Function (Hill-RBF) 3.0 formula may improve refractive target prediction across diverse populations, transforming patient care. This systematic review and meta-analysis (PROSPERO: CRD42021231150) evaluated the predictive performance of the Hill-RBF 3.0 against other traditional and AI-based intraocular lens (IOL) power calculation formulas. DESIGN: Systematic review and meta-analysis. METHODS: EMBASE, MEDLINE, CINAHL, and Web of Science were searched on March 17, 2025. Eligible studies reported refractive or cataract surgeries using Hill-RBF 3.0 and at least 1 comparable formula (Barrett Universal II, EVO 2.0, Haigis, Hoffer Q, Hoffer QST, Holladay I, Ladas Super Formula AI, Kane, Olsen, Pearl-DGS, or SRK/T). Standardized mean difference (SMD) in mean absolute error (MAE) and odds ratio (OR) of achieving postoperative refraction within ±0.25, ±0.50, and ±1.00 diopters (D) were assessed. Meta-analyses were performed. RESULTS: Of 130 records screened, 31 studies were included qualitatively and 28 quantitatively. Hill-RBF 3.0 showed significantly lower MAE (SMD [95% CI]) compared to Haigis (-0.12 [-0.21 to -0.02]; p = 0.01), Holladay-1 (-0.08 [-0.15 to -0.01]; p = 0.04), and SRK/T (-0.07 [-0.14 to 0.00]; p = 0.04). Odds (odds ratio [OR; 95% CI]) of achieving ±0.50 D were higher versus Haigis (1.09 [1.01-1.19]; p = 0.03), Hoffer Q (1.11 [1.04-1.19]; p = 0.002), Holladay-1 (1.10 [1.02-1.18]; p = 0.02), and SRK/T (1.08 [1.01-1.16]; p = 0.02). Similarly, Hill-RBF outperformed these formulas within ±0.25 D, except in comparison with Holladay-1. CONCLUSIONS: Hill-RBF 3.0 achieved comparable or superior predictive accuracy over traditional and AI-based formulas, enhancing clinical workflows, refractive outcomes, and patient care.
Abumanhal M, Habaluyas CF, Umezawa N
… +1 more, Takahashi Y
Can J Ophthalmol
· 2026 Feb · PMID 41644100
·
Publisher ↗
OBJECTIVE: To examine the incidence and clinical characteristics of concurrent thyroid eye disease (TED) and myasthenia gravis (MG) and identify potential diagnostic clues for this rare coexistence. METHODS: A retrospect...OBJECTIVE: To examine the incidence and clinical characteristics of concurrent thyroid eye disease (TED) and myasthenia gravis (MG) and identify potential diagnostic clues for this rare coexistence. METHODS: A retrospective observational study included 15 patients diagnosed with both TED and MG between May 2013 and July 2025. The diagnosis of TED was based on Bartley's criteria, and MG was diagnosed using criteria from the Japanese Ministry of Health, Labour, and Welfare. Clinical data, including ocular alignment, eyelid position, thyroid function, antibody profiles, imaging findings, treatment, and outcomes, were reviewed. RESULTS: Of 6 576 TED patients, 15 (0.23%) were diagnosed with concurrent MG, and 12 (0.18%) had isolated ocular MG (OMG). Ptosis was observed in 9 patients (60.0%), and vertical strabismus was the most common pattern (53.3%). Exotropia, an unusual presentation in TED, was seen in 6 patients (40.0%). Extraocular muscle inflammation was confirmed on magnetic resonance images in 11 patients (73.3%). Steroid pulse therapy, administered to 8 patients (53.3%) for active TED, also improved MG symptoms. At a mean follow-up of 43.8 ± 36.6 months, 10 patients (66.7%) showed significant improvement in ptosis and/or diplopia. CONCLUSIONS: Concurrent TED and MG, while rare, present overlapping features that can complicate diagnosis. Atypical signs, such as ptosis with diurnal variability and exotropia with vertical misalignment in TED patients, should raise suspicion for MG.
Pérez-Pérez M, de Sola-Llamas CG, Agostino A
… +9 more, Ruvolo M, Vilches-Arenas A, Relimpio-López MI, Macías-García L, De Miguel-Rodríguez M, Umbria-Jimenez S, García-Escudero A, Idoate MA, Ríos-Martín JJ
Can J Ophthalmol
· 2026 Jun · PMID 41644099
·
Publisher ↗
OBJECTIVE: To identify genetic variants with prognostic value in uveal melanoma (UM) using targeted next-generation sequencing (NGS) and evaluate their association with metastasis and histologic subtype. DESIGN: A retros...OBJECTIVE: To identify genetic variants with prognostic value in uveal melanoma (UM) using targeted next-generation sequencing (NGS) and evaluate their association with metastasis and histologic subtype. DESIGN: A retrospective observational study. METHODS: Targeted NGS was performed on tumour samples from 69 patients with choroidal melanoma treated by enucleation. Histopathological features and clinical outcomes were reviewed. Cox regression and multivariable logistic regression analyses were used to assess the relationship between genetic variants and metastatic risk and histological subtype, respectively. Internal model validation was performed using bootstrap resampling. RESULTS: A total of 231 pathogenic variants were identified across 28 genes. In multivariable Cox analysis, larger tumour size (HR = 3.07), and higher mitotic index (HR = 1.31) were significantly associated with increased metastatic risk, along with mutations in BAP1, CHEK2, and DICER1. Internal validation yielded a corrected Harrell's C-index score of 0.801. Logistic regression showed that BAP1 and LRP1B mutations were associated with epithelioid/mixed histology, while SF3B1 mutation was associated with spindle cell morphology. CONCLUSIONS: Mutations in BAP1, CHEK2, and DICER1 are independently associated with poorer prognosis in UM, while SF3B1 defines a distinct histologic subgroup. Routine mutational profiling by targeted NGS may aid in risk stratification and follow-up of UM patients.
Nahon-Estève S, Caujolle JP, Maschi C
… +12 more, Navaratnam J, Krohn J, Eide NA, Kiliç E, Brosens E, Bassil FL, Rospond-Kubiak I, Krasińska-Płachta A, Sonntag SR, Tura A, Grisanti S, Stålhammar G
Can J Ophthalmol
· 2026 Feb · PMID 41633531
·
Publisher ↗
OBJECTIVE: To validate a newly proposed anatomic staging system for choroidal and ciliary body melanoma, based on tumour volume estimated from routine clinical measurements, and compare its prognostic performance with th...OBJECTIVE: To validate a newly proposed anatomic staging system for choroidal and ciliary body melanoma, based on tumour volume estimated from routine clinical measurements, and compare its prognostic performance with the American Joint Committee on Cancer (AJCC) 8th edition classification. DESIGN: A retrospective, multicentre cohort study. PARTICIPANTS: A total of 5 410 consecutive patients diagnosed with choroidal and/or ciliary body melanoma at 6 European ocular oncology centres. METHODS: Tumours were staged according to both classifications. Prognostic performance was evaluated using competing risk regression, Cox regression, Kaplan-Meier survival analyses, and net reclassification improvement. RESULTS: The new classification showed better prognostic discrimination than the AJCC system, with a net reclassification improvement of 23%. In competing risk regression, it produced a higher Wald statistic (761 vs 628) and a subdistribution hazard ratio of 1.42 versus 1.22. Cox regression for melanoma-related mortality demonstrated higher hazard ratios, peaking at 24 for the new model compared with 13 for the AJCC classification. Cumulative incidence analyses revealed 15-year metastatic death rates ranging from 7% to 76% with the new system versus 11% to 69% with AJCC, widening the absolute range by 11 percentage points. CONCLUSIONS: This large international validation study demonstrates that the new volume-based classification provides more accurate prognostic stratification for choroidal and ciliary body melanoma. Its improved risk discrimination, using readily available clinical measurements, supports its applicability in clinical practice and potential utility for guiding follow-up and resource allocation.
Cnaan RB, Wengier A, Bez M
… +5 more, Harash L, Abumanhal M, Neiderman NC, Leibovitch I, Abergel A
Can J Ophthalmol
· 2026 Jun · PMID 41633530
·
Publisher ↗
OBJECTIVE: To evaluate whether age ≥80 years independently influences outcomes after endoscopic dacryocystorhinostomy (DCR) for primary acquired nasolacrimal duct obstruction (NLDO). DESIGN: A retrospective cohort study....OBJECTIVE: To evaluate whether age ≥80 years independently influences outcomes after endoscopic dacryocystorhinostomy (DCR) for primary acquired nasolacrimal duct obstruction (NLDO). DESIGN: A retrospective cohort study. PARTICIPANTS: Three hundred forty-six consecutive adults underwent standardized endonasal DCR between 2011 and 2023; 31 were ≥80 years. METHODS: Preoperative comorbidities, intraoperative variables and postoperative course were prospectively recorded. Outcomes-ostium patency, symptom relief, complications and revision-were assessed at a median of 12 months (IQR 6-24). Kaplan-Meier curves and multivariable Cox proportional-hazards models identified independent predictors. RESULTS: Octogenarians had more hypertension (64.5% vs 26.0%; p < 0.001) and hypothyroidism (25.8% vs 7.3%; p = 0.003). Silicone intubation was less common in this group (32.3% vs 54.0%, p = 0.021) but did not affect outcomes. Anatomical success was 83.9% in octogenarians versus 84.1% in younger adults (p = 0.97); functional success was 74.2 % versus 76.2% (p = 0.81). Complication (12.9 % vs 16.2 %; p = 0.64) and revision (3.2 % vs 4.1 %; p = 0.78) rates, as well as 24-month event-free survival, did not differ. Age ≥80 years was not an independent predictor of failure (Hazard Ratio: 0.93, 95% CI: 0.44-1.98). CONCLUSIONS: Despite greater systemic morbidity, very elderly patients achieved safety and efficacy equivalent to younger adults. Chronological age alone should not preclude endoscopic DCR; these real-world data support offering minimally invasive lacrimal surgery and -evidence-based counseling to an aging population.
Rhyno EM, Alim SI, Matheson KJ
… +5 more, Gupta RR, Dickinson JD, Samad A, O'Brien DM, Smith CA
Can J Ophthalmol
· 2026 Jun · PMID 41628896
·
Publisher ↗
OBJECTIVE: To measure the incidence and risk factors of rhegmatogenous retinal detachment (RRD) in a Canadian population from 2010 to 2023. DESIGN: A retrospective cohort study. PARTICIPANTS: Patients with ICD-10 diagnos...OBJECTIVE: To measure the incidence and risk factors of rhegmatogenous retinal detachment (RRD) in a Canadian population from 2010 to 2023. DESIGN: A retrospective cohort study. PARTICIPANTS: Patients with ICD-10 diagnostic code H33.0 (retinal detachment with retinal break) and controls who had cataract surgery but no prior history of detachment, age (±2 years) and sex-matched. METHODS: Patients reporting to the QEII Health Sciences Centre between January 1, 2010, to December 31, 2023, were included. The primary outcome was the incidence rate of RRD estimated using negative binomial regression. Generalized linear model was used to compare the risk of RRD and Cox-proportional hazards to model time to RRD following cataract surgery. RESULTS: Annual RRD incidence rates increased from 15.2 to 27.5 cases per 100,000 between 2010 and 2023. Mean axial length of RRD patients with prior cataract surgery was 25.0 (1.55) mm compared with the control population of 24.1 (1.60) mm. An increased risk of RRD was associated with each 1-mm increase in axial length (hazard ratio [HR] 1.31), male sex (HR 1.29), and per 1 year age increase (HR 1.03) post-cataract surgery. Time-to-event analyses identified that the mean time from cataract surgery to RRD was 9.43 years. CONCLUSIONS: Increases in RRD cases have been seen over the last 14 years. While the total risk for RRD is still small, male sex and a 1-2 mm increase in axial length can significantly change a patient's risk. Furthermore, the increased risk of RRD after cataract surgery is not only an early event.
Kee AR, Weill Y, Bareket M
… +4 more, Agarwal M, Barequet D, Huertas-Bello M, Teichman JC
Can J Ophthalmol
· 2026 Jun · PMID 41621817
·
Publisher ↗
PURPOSE: To describe the clinical outcomes of combined Descemet stripping automated endothelial keratoplasty (DSAEK) and intraocular lens (IOL) exchange using the Yamane technique, and to review the literature. METHODS:...PURPOSE: To describe the clinical outcomes of combined Descemet stripping automated endothelial keratoplasty (DSAEK) and intraocular lens (IOL) exchange using the Yamane technique, and to review the literature. METHODS: This is a retrospective interventional case series. Included were patients with decompensated cornea and dislocated IOL, anterior-chamber IOL, or iris-claw IOL that underwent IOL exchange using the Yamane technique combined with suture pull-through DSAEK. Best-corrected visual acuity (BCVA), graft survival, and complications were evaluated at year 1. RESULTS: Twenty-four eyes from 24 patients were included. Mean age was 71 ± 14.2 years. All except 1 patient (95.8%) had concomitant issues that could limit visual outcome or success of surgery, such as glaucoma (62.5%, of which 47.0% had previously undergone glaucoma tube surgery). Mean BCVA improved from 20/590 to 20/93 1 year after surgery (p = 0.0001). Rebubbling was performed in 4 eyes (16.7%), and 2 eyes (8.3%) had graft failure requiring repeat DSAEK. None had graft rejection. Two eyes (8.3%) developed IOL issues (1 haptic-optic junction dislocation and 1 haptic-optic junction rotation), 6 eyes (25.0%) had ocular hypertension requiring topical treatment, and 1 eye had suprachoroidal hemorrhage. CONCLUSIONS: Combined DSAEK and IOL exchange using the Yamane technique was shown to be a safe and effective method for visual rehabilitation in patients with decompensated cornea and anterior chamber/iris-claw/dislocated IOL. Further studies are required to evaluate the long-term stability of the graft and the IOL.
Shlomov T, Nitzan I, Pollack R
… +2 more, Zloto O, Gur Z
Can J Ophthalmol
· 2026 Jun · PMID 41620207
·
Publisher ↗
OBJECTIVE: To evaluate whether semaglutide use is associated with thyroid eye disease (TED)-related outcomes among patients with autoimmune thyroiditis and type II diabetes mellitus (T2DM). METHODS: Adults with thyrotoxi...OBJECTIVE: To evaluate whether semaglutide use is associated with thyroid eye disease (TED)-related outcomes among patients with autoimmune thyroiditis and type II diabetes mellitus (T2DM). METHODS: Adults with thyrotoxicosis (International Classification of Diseases [ICD-10]: E05) and T2DM were identified from the TriNetX US Collaborative Network. T2DM was defined by ICD-10 (E11) or laboratory criteria. The exposed cohort included individuals prescribed semaglutide on or after its Foood and Drug Administration approval (December 5, 2017). The control cohort included patients treated with non-glucogon-like peptide-1 receptor agonist antihyperglycemic agents without prior glucagon-like peptide-1 receptor agonist exposure. Propensity score matching (1:1) was performed using demographics, comorbidities, medications, and health care utilization variables. Five-year outcomes included: (1) TED-related diagnoses; (2) systemic corticosteroid use; (3) TED-related surgical interventions; (4) radiation treatment; and (5) teprotumumab use. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated. RESULTS: After matching, 23,279 patients were included per group (mean age: 60.1 years; 75% female). At 5-year, semaglutide users had lower rates of TED-related diagnoses (2.16% vs 2.82%; RR: 0.76; 95% CI: 0.68-0.86), systemic corticosteroid use (22.71% vs 26.39%; RR: 0.86; 95% CI: 0.82-0.90), TED-related surgical interventions (0.30% vs 0.42%; RR: 0.70; 95% CI: 0.51-0.96), and radiation treatment (1.17% vs 2.05%; RR: 0.57; 95% CI: 0.49-0.67). Teprotumumab use was rare and similar between groups (0.08% vs 0.08%; RR: 1.00; 95% CI: 0.52-1.92). CONCLUSIONS: Semaglutide use was associated with fewer TED-related diagnoses and treatments over 5 years, supporting a potential protective role. Further studies are warranted to confirm these associations and clarify underlying mechanisms.
Zhao HQ, Zhou WD, Shao L
… +4 more, Zhang RH, Yang YH, Dong L, Wei WB
Can J Ophthalmol
· 2026 Jun · PMID 41620203
·
Publisher ↗
PURPOSE: Proliferative diabetic retinopathy causes severe vision loss. Although anti-vascular endothelial growth factor (VEGF) injections aid surgery outcomes, optimal timing is unclear. We evaluated the efficacy and saf...PURPOSE: Proliferative diabetic retinopathy causes severe vision loss. Although anti-vascular endothelial growth factor (VEGF) injections aid surgery outcomes, optimal timing is unclear. We evaluated the efficacy and safety of anti-VEGF injections at various perioperative time points. METHOD: This network meta-analysis comprehensively searched PubMed, Cochrane Library, Web of Science, Embase, ClinicalTrials.gov, and WHO ICTRP from inception to November 2024 for randomized controlled trials examining perioperative anti-VEGF injection. Two authors independently screened the studies, collected the data, and assessed the risk of bias. The protocol was registered with PROSPERO (CRD42024614758). RESULTS: Thirty studies involving 2 646 eyes were analyzed. Perioperative anti-VEGF treatment significantly improved postoperative best-corrected visual acuity (preoperatively >7 days: standardized mean difference [SMD] = 0.57, 95% CI: 0.01-1.13; preoperatively 3-7 days: SMD = 0.50, 95% CI: 0.29-0.70; intraoperative: SMD = 0.34, 95% CI: 0.10-0.66). It also reduced recurrent vitreous hemorrhage (intraoperative: odds ratio [OR] = 0.28, 95% CI: 0.09-0.87), and intraoperative bleeding (preoperatively >7 days: OR = 0.11, 95% CI: 0.03-0.39; preoperatively 3-7 days: OR = 0.22, 95% CI: 0.04-1.13). Additionally, it shortened surgical time (preoperatively >7 days vs preoperatively 1-3 days: WMD = -17.90, 95% CI: -29.99 to -5.81). No significant effects on silicone oil use or recurrent retinal detachment were observed. The safety profile of anti-VEGF has been found to be favourable. CONCLUSIONS: The combination of perioperative anti-VEGF injections provides several advantages. Clinicians may select the optimal timing based on individualized treatment objectives. However, because of the variability in evidence quality and the heterogeneity among the included studies, these conclusions should be approached with caution.
Rauchegger T, Seifert F, Krause SM
… +6 more, Pattinger C, Nowosielski Y, Willeit P, Rehak M, Schmid E, Teuchner B
Can J Ophthalmol
· 2026 Jun · PMID 41620201
·
Publisher ↗
OBJECTIVE: To compare in detail the clinical outcome and safety of PreserFlo MicroShunt implantation versus trabeculectomy in patients with secondary open-angle glaucoma (SOAG). DESIGN/PARTICIPANTS: A retrospective study...OBJECTIVE: To compare in detail the clinical outcome and safety of PreserFlo MicroShunt implantation versus trabeculectomy in patients with secondary open-angle glaucoma (SOAG). DESIGN/PARTICIPANTS: A retrospective study of patients with SOAG and uncontrolled intraocular pressure (IOP) who underwent PreserFlo MicroShunt implantation (PreserFlo) or trabeculectomy (TRAB) at the Medical University of Innsbruck. METHODS: We analyzed changes in IOP, use of IOP-lowering medications, complete surgical success (IOP ≤21 to ≤12 mm Hg and >6 mm Hg without medication), best-corrected visual acuity, and visual field outcomes up to 12 months postoperatively. RESULTS: Between 2014 and 2023, PreserFlo was performed in 85 eyes and TRAB in 55 eyes. Mean IOP decreased from 26.8 to 10.8 mm Hg (mean reduction 56%, 95% confidence interval 52-61%; p < 0.001) in the PreserFlo group and from 27.3 to 10.9 mm Hg (mean reduction 55%, 46-65%; p < 0.001) in the TRAB group. IOP was significantly lower in the PreserFlo group at 1-3 days and 1 week (p < 0.001 and p = 0.007, respectively). At 12 months, both groups showed similar rates of medication use (18.8% vs 11.4%; p = 0.334) and complete surgical success (e.g., ≤18 mm Hg: 76.8% vs 75.7%; p = 0.864). PreserFlo was associated with fewer needlings (hazard ratio 0.33; 0.12-0.90; p = 0.0031) and worse BCVA at month 12 (p = 0.036). CONCLUSIONS: Both PreserFlo and trabeculectomy significantly lowered IOP and reduced medication use over 12 months. PreserFlo was associated with fewer postoperative interventions, while TRAB yielded better visual acuity outcomes. Both procedures appear comparably safe and effective for treating SOAG.
Ozer F, Sener H, Unlu M
… +3 more, Sönmez HK, Horozoglu F, Evereklioglu C
Can J Ophthalmol
· 2026 Jun · PMID 41592742
·
Publisher ↗
PURPOSE: To systematically review the extant literature on pediatric endoscopic dacryocystorhinostomy (endoDCR) and to perform a meta-analysis of the pooled success rate and complication profile. METHODS: A comprehensive...PURPOSE: To systematically review the extant literature on pediatric endoscopic dacryocystorhinostomy (endoDCR) and to perform a meta-analysis of the pooled success rate and complication profile. METHODS: A comprehensive literature search was conducted using PubMed, Cochrane Library, and Web of Science databases in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they reported the pediatric endoDCR success rate with a minimum follow-up of 3 months and at least 10 patients. Data on success rates, complications, age, follow-up time, and silicone stent removal time were extracted. Statistical analyses were performed using comprehensive meta-analysis software. RESULTS: Twenty-nine studies comprising 1502 pediatric eyes were included. The pooled success rate was 87% (95% CI: 0.83-0.90). The I² statistic was 58.47%, indicating moderate to substantial heterogeneity. Egger's test indicated significant publication bias (p < 0.00001). Complication rates varied considerably: while some studies reported minor complications in up to 60% of cases, others documented serious, but rare, events such as cerebrospinal fluid rhinorrhea (0.28%). The most common complications included bleeding/epistaxis, tube prolapse, adhesions/synechiae, and granulation tissue. CONCLUSION: EndoDCR is an effective and generally safe surgical option for pediatric nasolacrimal duct obstruction, with a high pooled success rate and acceptable variability in outcomes. However, variation in complication reporting and methodological heterogeneity across studies highlights the need for standardization in future research.