Ophthalmology[JOURNAL]

Sun 200 papers

Unilateral vision loss as the initial symptom of chronic myeloid leukemia with bilateral retinal infiltration: a case report.

Chen W, Qin B

BMC Ophthalmol · 2026 Jun · PMID 42321675 · Full text

BACKGROUND: Ophthalmic manifestations as the initial presentation of chronic myeloid leukemia (CML) are rare. CASE PRESENTATION: This case describes a 38-year-old man who presented with unilateral severe vision loss alon... BACKGROUND: Ophthalmic manifestations as the initial presentation of chronic myeloid leukemia (CML) are rare. CASE PRESENTATION: This case describes a 38-year-old man who presented with unilateral severe vision loss alongside bilateral ocular findings, including intraretinal hemorrhages, vascular tortuosity, cotton wool spots, and optic disc edema. Ophthalmic imaging, particularly optical coherence tomography (OCT), revealed bilateral retinal involvement, which was more severe in the left eye despite worse vision in the right eye. Systemic evaluation revealed critical hyperleukocytosis, splenomegaly, and Philadelphia chromosome positivity, confirming CML. The subsequent MRI during remission showed no abnormality. Treatment with hydroxyurea and nilotinib rapidly normalized white blood cell counts and reached major molecular response (MMR) along with complete visual recovery and normal retina and optic nerve. CONCLUSIONS: This case highlights the importance of recognizing ocular signs as potential indicators of life-threatening systemic diseases such as CML, warranting prompt diagnosis and intervention. Ocular signs not only help to confirm the primary diagnosis, but also may serve as a useful adjunctive marker for monitoring treatment response.

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Cortico-retinal decoupling in anisometropic amblyopia: OCTA-VEP multimodal biomarkers reveal neurovascular mismatch patterns.

Meng X, Wang Q, Zhang Y

BMC Ophthalmol · 2026 Jun · PMID 42321674 · Full text

BACKGROUND: To investigate the retinal microcirculation changes in children with anisometropic amblyopia through multimodal assessment and explore its correlation with neurophysiological dysfunction. METHODS: This prospe... BACKGROUND: To investigate the retinal microcirculation changes in children with anisometropic amblyopia through multimodal assessment and explore its correlation with neurophysiological dysfunction. METHODS: This prospective cross-sectional study recruited 68 treatment-naïve children (aged 4-14 years) with primary monocular anisometropic amblyopia. The fellow healthy eye served as the control. Macular microvascular parameters, including foveal avascular zone (FAZ) area and superficial capillary plexus (SCP) perfusion density, were quantified using optical coherence tomography angiography (OCTA). Pattern visual evoked potentials (P-VEP) assessed P100 latency and amplitude. Central macular thickness (CMT) and retinal nerve fiber layer (RNFL) thickness were measured. Correlations and multiple linear regression analyses were performed to identify predictors of best-corrected visual acuity (BCVA) in amblyopic eyes. RESULTS: Compared to fellow eyes, amblyopic eyes exhibited significant microcirculatory impairment: reduced SCP perfusion density (central: 0.27 vs. 0.29, P < 0.001; full: 0.44 vs. 0.46, P < 0.05), enlarged FAZ area (0.30 vs. 0.26 mm², P = 0.035), and increased CMT (141.00 vs. 131.50 μm, P < 0.05) and RNFL thickness (113.00 vs. 110.00 μm, P < 0.001). P-VEP revealed prolonged P100 latency (119.0 vs. 109.5 ms, P < 0.001) and decreased amplitude (12.8 vs. 19.25 µV, P < 0.001). SCP perfusion density correlated negatively with P100 latency (ρ=-0.341, P = 0.004), and SCP vessel density correlated negatively with CMT (ρ=-0.363, P = 0.002) and FAZ area (ρ=-0.424, P < 0.001). Multiple linear regression analysis (adjusted R²=0.625, P < 0.001) identified RNFL thickness (β = -0.546, P < 0.001) as a significant negative predictor of BCVA (logMAR), while SCP full perfusion density (β = 0.375, P < 0.001) and axial length (β = 0.237, P = 0.007) were significant positive predictors. CONCLUSION: Anisometropic amblyopia is marked by a neurovascular mismatch, manifested through simultaneous retinal hypoperfusion, paradoxical thickening of structures, and delayed neural conduction. The combined OCTA-P-VEP assessment provides a comprehensive biomarker framework. RNFL thickness, SCP perfusion density, and axial length emerge as key independent predictors of visual acuity, suggesting complex interplays between structure, perfusion, and function.

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Reactivation of retinopathy of prematurity after intravitreal bevacizumab: incidence, risk factors, and retreatment requirements.

Gül C, Özal E, Ermiş S … +3 more , Karapapak M, Bayraktar H, Özal SA

BMC Ophthalmol · 2026 Jun · PMID 42321667 · Full text

BACKGROUND: This study aimed to evaluate the incidence and risk factors of reactivation following intravitreal bevacizumab (IVB) treatment for retinopathy of prematurity (ROP) and to determine which cases required additi... BACKGROUND: This study aimed to evaluate the incidence and risk factors of reactivation following intravitreal bevacizumab (IVB) treatment for retinopathy of prematurity (ROP) and to determine which cases required additional treatment. METHODS: A retrospective cohort study was conducted including 62 premature infants (119 eyes) diagnosed with type 1 ROP or aggressive ROP (A-ROP) who received IVB monotherapy between September 2021 and July 2024. Demographic and clinical parameters such as gestational age, birth weight, disease zone and stage, duration of oxygen therapy, and timing of IVB administration were analyzed. Reactivation and retreatment rates were compared to identify potential risk factors. RESULTS: Reactivation occurred in 36 eyes (30.3%), and 31 of these eyes (86.1%) required additional treatment. The mean gestational age and birth weight in reactivated eyes were 24.4 ± 1.2 weeks and 643 ± 149 g, respectively. Reactivation was significantly associated with lower gestational age (p < 0.001), lower birth weight (p < 0.001), longer pre- and post-IVB oxygen therapy (p = 0.006 and p < 0.001), zone 1 disease (p < 0.001), and the presence of A-ROP (p < 0.001). Reactivation developed on average 9.4 weeks after IVB administration. Female infants showed a higher proportion of treatment-requiring reactivation (p = 0.031). CONCLUSIONS: Reactivation following IVB therapy is common among infants with low gestational age, low birth weight, prolonged oxygen exposure, and aggressive or zone 1 disease. Although most reactivations required retreatment, some resolved spontaneously, highlighting the importance of individualized and extended post-treatment monitoring.

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Efficacy and safety of ultrasound cycloplasty versus ahmed glaucoma valve for neovascular glaucoma.

Zhang S, Ji S, Li X … +2 more , Hu S, Fu Y

BMC Ophthalmol · 2026 Jun · PMID 42321652 · Full text

PURPOSE: To evaluate the efficacy and safety of Ultrasound Cycloplasty (UCP) versus Ahmed Glaucoma Valve (AGV) implantation in the treatment of neovascular glaucoma. METHODS: A total of 80 patients (80 eyes) were enrolle... PURPOSE: To evaluate the efficacy and safety of Ultrasound Cycloplasty (UCP) versus Ahmed Glaucoma Valve (AGV) implantation in the treatment of neovascular glaucoma. METHODS: A total of 80 patients (80 eyes) were enrolled and assigned to receive either UCP or AGV treatment (40 eyes each). Patients were followed up for 6 months postoperatively. Intraocular pressure (IOP), number of IOP-lowering medications, pain score, visual acuity, and complications were recorded. Complete surgical success was defined as an IOP reduction of ≥ 20% from baseline and maintained between 5 and 21 mmHg, without the need for additional medications or further surgery. RESULTS: Preoperative baseline characteristics showed no significant differences between the two groups. On postoperative day 1, the AGV group showed a greater reduction in IOP compared to the UCP group (p < 0.01). At 6 months postoperatively, the UCP group demonstrated better outcomes in terms of the IOP reduction rate (61.62% vs. 66.97%, p = 0.04) and pain score (0.13 vs. 0.43, p < 0.01) compared to the AGV group. There were no significant differences between the groups in the number of medications used or the rate of surgical success. The AGV group experienced more complications, commonly including tube blockage and plate exposure. CONCLUSION: Both UCP and AGV are effective in reducing IOP. However, UCP resulted in more stable postoperative IOP, fewer complications, and offered better safety and patient comfort.

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The prevalence of refractive errors among patients with keratoconus attending Damascus hospital, Syria: a cross-sectional study.

Akwan R, Alhouri AN, Alhouri HN … +3 more , Aljaramani R, Olabi H, Issa S

BMC Ophthalmol · 2026 Jun · PMID 42321641 · Full text

BACKGROUND: Keratoconus (KC) is a progressive ectatic corneal disease characterized by corneal thinning and cone-like protrusion, leading to significant refractive errors. Despite its global impact, local data for the Sy... BACKGROUND: Keratoconus (KC) is a progressive ectatic corneal disease characterized by corneal thinning and cone-like protrusion, leading to significant refractive errors. Despite its global impact, local data for the Syrian population remains scarce. This study aimed to investigate refractive error patterns, prevalence, and disease grading among a sample of Syrian patients with KC. METHODS: This prospective cross-sectional study evaluated 173 eyes from 93 patients at Damascus Hospital. Corneal Tomography was performed using the Pentacam Scheimpflug system. Refractive status was determined via subjective refraction, and KC severity was graded using the Buxton keratometric classification. Statistical analysis included Chi-square tests and Pearson correlations. RESULTS: The mean age of participants was 29.7 ± 10.9 years, with most patients (34.4%) aged 19-30 years. Bilateral involvement was observed in 92.5% of patients. Mild and moderate disease were the most frequent grades, accounting for 45.1% and 43.9% of eyes, respectively. A significant association between KC grading and gender was identified (P = 0.04), whereas no significant association was found between grading and age. Oblique compound myopic astigmatism was the most prevalent refractive error (25.4%). Kmax showed a strong positive correlation with absolute spherical equivalent (r = 0.669, P < 0.001), whereas corneal thickness at the thinnest location showed a weak negative correlation (r = -0.393, P < 0.001). CONCLUSION: The clinical profile of KC in Syrian patients is comparable to reports from other regional and global populations, manifesting as bilateral mild-to-moderate disease in young adults, with compound myopic astigmatism as the hallmark refractive error. Future research should prioritize multicenter genetic and environmental studies within the Syrian population to optimize disease management strategies and early detection.

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Comparing national microinvasive glaucoma surgery procedure rates in response to Medicare and industry payment changes.

Gulani Y, Anderson GF, Johnson TV

Ophthalmol Glaucoma · 2026 Jun · PMID 42320867 · Publisher ↗

OBJECTIVE: To examine how changes in Medicare payments and industry transfers of value (TOVs) are associated with changes microinvasive glaucoma surgery (MIGS) procedure rates. DESIGN: Retrospective, observational cohort... OBJECTIVE: To examine how changes in Medicare payments and industry transfers of value (TOVs) are associated with changes microinvasive glaucoma surgery (MIGS) procedure rates. DESIGN: Retrospective, observational cohort study. SUBJECTS: Ophthalmologists who performed glaucoma surgery for Medicare beneficiaries from 2018-2023. METHODS: A 20% nationally representative sample of Medicare Part B Carrier claims from 2018-2023 identified trabecular meshwork bypass stent implantation, goniotomy, canaloplasty, and trabeculectomy procedures using Current Procedural Terminology codes. Procedures were aggregated at the physician-year level using National Provider Identifiers. Medicare payment changes for trabecular bypass stents implantation implemented on January 1, 2022 were examined alongside contemporaneous industry stent-related TOV payments from trabecular meshwork bypass stent manufacturers (Alcon and Glaukos), obtained from the Centers for Medicare & Medicaid Services Open Payments database. Annual and quarterly procedure volumes were compared before (2018-2021) and after (2022-2023) the policy change. Trabeculectomy served as a control procedure. MAIN OUTCOME MEASURES: Annual procedure volumes for trabecular stents, goniotomy, canaloplasty, and trabeculectomy; mean number of procedures performed per physician; association of CMS payment rates and industry TOV payments with individual procedure rates. RESULTS: Following a Medicare payment reduction for trabecular stents from approximately $500 to $34 per procedure, national trabecular stent utilization stably declined by 33%. Over the same period, goniotomy utilization increased by 61% and canaloplasty utilization increased by 19%, Total MIGS volume remained relatively stable. Industry stent-related TOV payments to ophthalmologists increased substantially in 2022 but subsequently declined in 2023. Stratified analyses demonstrated that reductions in trabecular stent utilization occurred across all levels of industry TOV payment recipients, including among physicians receiving the highest payment amounts. CONCLUSIONS: A large Medicare payment reduction for trabecular meshwork bypass stent implantation was associated with rapid declines in stent utilization and increased performance of alternative MIGS procedures. Concurrent increases in industry TOV payments did not offset these shifts, suggesting that Medicare payment policy exerted a stronger influence on procedural selection than industry financial incentives. These findings highlight the sensitivity of surgical practice patterns to payment policy and suggest that even substantial industry payments may have limited influence when insurer payments change dramatically.

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Investigating PRPH2-associated retinal degeneration patient-reported outcomes in vision-related quality of life.

Folk GA, Wagner NE, Walker EH … +1 more , Borooah S

BMC Ophthalmol · 2026 Jun · PMID 42316356 · Full text

BACKGROUND: PRPH2-associated retinal degeneration (PARD) is one of the most common causes of inherited retinal disease and can impair visual function and quality of life. While genetic and clinical features of PARD have... BACKGROUND: PRPH2-associated retinal degeneration (PARD) is one of the most common causes of inherited retinal disease and can impair visual function and quality of life. While genetic and clinical features of PARD have been described, patient-reported experiences of visual symptoms remain less well characterized. This study aims to evaluate self-reported visual function and quality of life among individuals with genetically confirmed PARD. METHODS: This cross-sectional study surveyed patients with confirmed PARD at a single academic center using the National Eye Institute Visual Function Questionnaire-25 (VFQ-25). The questionnaire was administered digitally and assessed 11 vision-related domains, including general vision, near and distance activities, and vision-related mental health. A composite score was calculated as the mean of all subscale scores excluding the general health item. Descriptive statistics were used to summarize responses, with higher scores indicating better perceived visual function. RESULTS: Twenty-two participants completed the VFQ-25. The median (IQR) composite score was 76.9 (16.4), reflecting moderate perceived visual dysfunction. The highest-rated domains were ocular pain (87.5 (37.5)) and color vision (100.0 (0.0)). Domains related to functional activities demonstrated greater impairment, including general vision (80.0 (20.0)), near activities (79.2 (39.6)), distance activities (75.0 (29.2)), and driving (75.0 (33.3)). The vision-specific mental health domain had the lowest score (59.4 (40.6)), underscoring the psychological impact of PARD. CONCLUSIONS: Individuals with PARD report significant challenges in visual function and emotional well-being. These results highlight the importance of incorporating patient-reported outcome measures into the clinical characterization of PARD and the design of future therapeutic studies.

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Early detection of tamoxifen-induced retinal injury: ellipsoid zone reflectivity as a sensitive structural marker.

Unlu BH, Koksaldı S, Durmaz Engin C … +1 more , Varol U

BMC Ophthalmol · 2026 Jun · PMID 42316354 · Full text

PURPOSE: To investigate early structural alterations in the outer retina and choroid of tamoxifen-treated patients without clinically detectable retinopathy by quantitatively assessing reflectivity changes of the externa... PURPOSE: To investigate early structural alterations in the outer retina and choroid of tamoxifen-treated patients without clinically detectable retinopathy by quantitatively assessing reflectivity changes of the external limiting membrane (ELM), ellipsoid zone (EZ), and retinal pigment epithelium (RPE), along with the choroidal vascularity index (CVI). METHODS: The study included 45 eyes of 45 tamoxifen-treated women and 50 eyes of 50 age- and sex-matched healthy female controls. ELM, EZ, and RPE reflectivity was measured along foveal, parafoveal, and perifoveal axes. CVI was derived using a standardized binarization method. Correlations between reflectivity metrics and tamoxifen exposure indices were analyzed. RESULTS: Tamoxifen users showed a marked reduction in EZ reflectivity at the central fovea and at the temporal perifovea (p = 0.005 and p = 0.037, respectively), accompanied by a corresponding decrease in relative EZ values at the central fovea and at the temporal parafovea (p = 0.012 and p = 0.039, respectively). In contrast, ELM and RPE reflectivity metrics remained stable across all evaluated regions (p > 0.05). CVI measurements revealed no significant differences between the patient and control groups (p > 0.05). Within the tamoxifen cohort, treatment duration demonstrated weak but significant positive associations with central foveal ELM reflectivity (r = 0.389, p = 0.008), whereas age was negatively correlated with EZ reflectivity in the nasal parafoveal region (r = - 0.331, p = 0.026). CONCLUSIONS: Early tamoxifen exposure appears to affect the EZ before detectable alterations become evident in the ELM, RPE, or choroid. These findings suggest that subtle EZ disruption may represent an early structural indicator of tamoxifen-related retinal involvement and could potentially aid in identifying patients who may require closer monitoring. However, longitudinal studies are needed to confirm these findings and clarify their clinical significance.

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The role of DNMT3B, GSK-3β and GJA3 in lens epithelial cell apoptosis and age-related cataract.

Chen X, Su D, Zhang G … +9 more , Xiang Z, Fu Y, Sun Z, Hu Y, Li S, Zhang Y, Ma X, Hu S, Wei Q

BMC Ophthalmol · 2026 Jun · PMID 42316121 · Full text

Age-related cataract (ARC) is a degenerative change following the aging of the lens, with its specific pathogenesis still unclear. This study investigates the expression of GSK-3β, DNMT3B, and GJA3 in ARC through in vivo... Age-related cataract (ARC) is a degenerative change following the aging of the lens, with its specific pathogenesis still unclear. This study investigates the expression of GSK-3β, DNMT3B, and GJA3 in ARC through in vivo and in vitro studies, elucidating the regulatory mechanisms among them. Additionally, it preliminarily explores the role of DNMT3B in the epigallocatechin gallate (EGCG)-mediated delay of apoptosis in lens epithelial cells (LECs). Immunohistochemistry and Western blot results showed that the protein expression level of DNMT3B was elevated, while the protein expression levels of GJA3 and p-GSK-3β (Ser9) were decreased in the ARC group and the aged mouse group (P < 0.05). CCK-8 and Hoechst 333,42 apoptosis assays indicated that DNMT3B, GJA3, and p-GSK-3β (Ser9) were involved in HO-induced apoptosis of LECs. Further investigation revealed that DNMT3B regulates lens epithelial cell apoptosis by modulating GJA3 expression, and the expression of DNMT3B is regulated by GSK-3β. Additionally, we found that EGCG effectively alleviates DNMT3B-mediated apoptosis of LECs (P < 0.05). In summary, our study indicates that p-GSK-3β, DNMT3B, and GJA3 play significant roles in ARC and oxidative stress-induced apoptosis of LECs, with interrelated regulatory mechanisms. EGCG can target DNMT3B to reduce apoptosis in LECs, offering a new direction for the development of cataract treatments.

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Indications and outcome of intravitreal bevacizumab injection in a Community Eye Hospital, Nepal.

Thakali S, Shrestha M, Gauchan A … +1 more , Gurung HB

BMC Ophthalmol · 2026 Jun · PMID 42316110 · Full text

BACKGROUND: This study aimed to evaluate the indications and real-world treatment outcomes of intravitreal bevacizumab in a resource-limited community eye hospital setting. METHODS: This retrospective study included pati... BACKGROUND: This study aimed to evaluate the indications and real-world treatment outcomes of intravitreal bevacizumab in a resource-limited community eye hospital setting. METHODS: This retrospective study included patients who received IVB injection at Hetauda Community Eye Hospital between January 2019 and December 2022. INCLUSION CRITERIA: [Formula: see text]1 IVB injection; retinal diagnosis confirmed clinically and by Optical Coherence Tomography (OCT) where available. EXCLUSION CRITERIA: missing baseline Visual Acuity (VA) or OCT,[Formula: see text] month follow-up. Median visual acuity (VA) and central macular thickness (CMT) changes were compared using Wilcoxon signed‑rank test. RESULTS: A total of 418 injections were administered to 247 patients (260 eyes). After excluding those lost to follow‑up, 221 patients (234 eyes) were included in the analysis. Median baseline CMT was 366 μm and improved to 236 μm (p < 0.001). Most patients received one injection (57%) followed by two injections (30%). The median baseline VA was 0.78 log MAR and remained 0.78 log MAR overall (p = 0.108), but subgroup improvements were significant in DME, nAMD, BRVO, and central retinal vein occlusion (CRVO). CONCLUSION: IVB resulted in significant anatomical and functional improvements in patients with retinal diseases. The findings reflect real‑world outcomes in a community‑level eye hospital, where cost barriers limit repeated injections. The limitations of this study include its retrospective design, variable follow‑up, absence of control group, and limited numbers of injections.

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Rhythmic suture movement on gonioscopy after penetrating canaloplasty: a case report.

Liu S, Wu Z, Yu P … +1 more , Zeng L

BMC Ophthalmol · 2026 Jun · PMID 42316105 · Full text

BACKGROUND: Previous studies with advanced imaging like phase-sensitive optical coherence tomography suggest the trabecular meshwork-Schlemm's canal complex may show subtle motion related to intraocular pressure fluctuat... BACKGROUND: Previous studies with advanced imaging like phase-sensitive optical coherence tomography suggest the trabecular meshwork-Schlemm's canal complex may show subtle motion related to intraocular pressure fluctuations or cardiac rhythm. However, direct visualization of rhythmic motion in the Schlemm's canal region during routine gonioscopy has been undocumented. Here, we report an incidental finding during dynamic gonioscopy, where a retained 10 - 0 suture within Schlemm's canal exhibited subtle, regular back-and-forth movement at the 2-year follow-up after penetrating canaloplasty. CASE PRESENTATION: A 53-year-old man was diagnosed with chronic angle-closure glaucoma in both eyes and had a history of uveitis. His left eye had previously undergone trabeculectomy, but intraocular pressure remained poorly controlled, prompting a subsequent penetrating canaloplasty. During the procedure, a 10 - 0 suture was placed through Schlemm's canal to enhance the conventional outflow pathway. Postoperative follow-up remained stable, and no further glaucoma surgery was needed. At the 2-year postoperative visit, gonioscopy during slit-lamp examination revealed a 10 - 0 suture crossing Schlemm's canal at approximately 1 o'clock in the superior angle. Within a relatively stable visual field, the suture exhibited consistent, rhythmic back-and-forth movement, and this pattern was reliably observed throughout the same examination session. At that time, the anterior chamber was quiet and showed no signs of active inflammation. CONCLUSION: This case reports an incidental gonioscopic finding of subtle, rhythmic movement of a retained 10 - 0 suture within Schlemm's canal 2 years after penetrating canaloplasty. The retained suture may act as a visible marker of local dynamic behavior in Schlemm's canal.

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Effect of topical phenylephrine on aqueous flare levels and anterior scleral thickness in healthy adult eyes.

Esen Baris M, Guclu A, Guven S … +1 more , Palamar M

BMC Ophthalmol · 2026 Jun · PMID 42316074 · Full text

BACKGROUND: Phenylephrine is widely used for pharmacological mydriasis in routine ophthalmic practice. While its vascular and pupillary effects are well established, its influence on anterior segment structures and intra... BACKGROUND: Phenylephrine is widely used for pharmacological mydriasis in routine ophthalmic practice. While its vascular and pupillary effects are well established, its influence on anterior segment structures and intraocular inflammatory parameters remains unclear. This study aimed to evaluate the effects of topical phenylephrine on anterior scleral thickness (AST) and aqueous humor flare levels in healthy eyes. METHODS: This prospective study included the right eyes of 20 healthy volunteers. Topical phenylephrine 2.5% was administered three times at 5-minute intervals. Measurements were obtained 45 min after the final instillation. Nasal and temporal AST were measured at the scleral spur (AST-0) and at 1000 μm (AST-1) and 2000 μm (AST-2) posterior to the scleral spur using anterior segment optical coherence tomography. Aqueous flare levels were assessed using laser flare photometry. Fellow untreated eyes served as controls. RESULTS: At the scleral spur level (AST-0), scleral thickness increased significantly in both nasal and temporal regions following phenylephrine administration (p = 0.0003 and p = 0.01, respectively). At 1000 μm posterior to the scleral spur, temporal AST decreased significantly (p = 0.005), while other changes in AST-1 and AST-2 were not statistically significant. Aqueous flare levels showed an increase after phenylephrine instillation; however, this change was not statistically significant (p = 0.2). No significant changes were observed in the fellow control eyes. CONCLUSIONS: Topical phenylephrine was associated with localized changes in anterior scleral thickness, characterized by thickening at the scleral spur and relative thinning posteriorly. Although aqueous flare levels tended to increase, this effect was not statistically significant and likely reflects a minimal effect size. These findings suggest that phenylephrine may be associated with alterations in scleral configuration without a clinically meaningful impact on intraocular inflammatory status in healthy eyes.

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Experimental knotless scleral fixation with expanded polytetrafluoroethylene (ePTFE): dynamics of anchoring strength in the early postoperative period.

Hatlova V, Cendelin J, Stefkova M … +6 more , Hecova L, Vankova L, Klein P, Rusnak S, Krizkova V, Studeny P

BMC Ophthalmol · 2026 Jun · PMID 42316071 · Full text

PURPOSE: To investigate short-term scleral response to expanded polytetrafluoroethylene (ePTFE) sutures using the dynamics of its mechanical stabilization in an animal model. METHODS: Ten rabbits underwent unilateral len... PURPOSE: To investigate short-term scleral response to expanded polytetrafluoroethylene (ePTFE) sutures using the dynamics of its mechanical stabilization in an animal model. METHODS: Ten rabbits underwent unilateral lens extraction followed by implantation of two knotless scleral fixation techniques using ePTFE (Gore-Tex CV-8): Z-suture and chain-of-knots. Both techniques were implanted in each eye. At postoperative days 1, 5, 10, 20, and 30, two rabbits were analyzed per time point (n = 10), each contributing one independent dynamometric measurement per technique. The tensile force required to disinsert the implanted material from the sclera was quantified using a dynamometer. RESULTS: Dynamometric evaluation of tensile force of the Z-suture ranged from 0.12 to 0.32 N, whereas the chain-of-knots scleral fixation ranged from 0.07 to 0.27 N. Both techniques showed an increase in the force required to disinsert fibers from the sclera in the early postoperative period. CONCLUSIONS: In this rabbit model, knotless ePTFE scleral fixation demonstrated increasing early mechanical stabilization. The differences between the two fixation techniques may be caused by a combination of mechanical factors and tissue adaptation, although these findings remain exploratory. Both techniques may provide sufficient early fixation strength in an experimental setting and support further preclinical and clinical evaluation.

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