Pub Date : 2026-04-28Epub Date: 2026-02-07DOI: 10.1016/j.ajoint.2026.100234
Andrew Mihalache , Ryan S. Huang , Marko M. Popovic , Clara C. Chan
Purpose
To investigate whether smoking is associated with Fuchs endothelial corneal dystrophy (FECD).
Design
Retrospective cross-sectional study.
Subjects
Individuals with FECD in the All of Us Research Program were matched 1:10 to controls using propensity scores based on age, sex, self-reported race/ethnicity, and annual household income.
Methods
Self-reported smoking behaviour was obtained from survey data. Primary outcomes assessed cigarette-related smoking behaviour among individuals with FECD compared to matched controls, and secondary outcomes evaluated the use of other tobacco and nicotine products. Conditional logistic and fixed-effects linear regression models were applied to examine binary and continuous outcomes, respectively.
Results
The matched cohort included 13,409 participants (1,219 FECD cases and 12,190 controls). The odds of ever smoking ≥100 cigarettes did not differ between groups (OR=0.95, 95% CI=[0.85, 1.08], p=0.4). FECD cases reported a slightly shorter total duration of smoking (MD=-2.69, 95% CI=[-4.22, -1.15], p<0.01), although mean daily cigarette consumption did not differ significantly between groups (MD=-0.20, 95% CI=[-1.67, 1.27], p=0.8). Current smoking was less frequent among FECD cases (OR=0.58, 95% CI=[0.41, 0.81], p<0.01). No significant differences were observed for lifetime or current use of electronic nicotine products (p=0.4 and p=0.1), cigars or cigarillos (p=0.2 and p=0.4), hookah (p=1.0 and p=0.9), or smokeless tobacco (p=0.1 and p=0.9).
Conclusions
This cross-sectional analysis of a large, nationally diverse cohort did not find evidence of an association between smoking behaviour and FECD, supporting emerging evidence that challenges the strength of this purported relationship. Nonetheless, these findings should not detract from the well-established systemic harms of smoking.
{"title":"Association between self-reported smoking behaviour and Fuchs endothelial corneal dystrophy: A cross-sectional analysis","authors":"Andrew Mihalache , Ryan S. Huang , Marko M. Popovic , Clara C. Chan","doi":"10.1016/j.ajoint.2026.100234","DOIUrl":"10.1016/j.ajoint.2026.100234","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate whether smoking is associated with Fuchs endothelial corneal dystrophy (FECD).</div></div><div><h3>Design</h3><div>Retrospective cross-sectional study.</div></div><div><h3>Subjects</h3><div>Individuals with FECD in the <em>All of Us</em> Research Program were matched 1:10 to controls using propensity scores based on age, sex, self-reported race/ethnicity, and annual household income.</div></div><div><h3>Methods</h3><div>Self-reported smoking behaviour was obtained from survey data. Primary outcomes assessed cigarette-related smoking behaviour among individuals with FECD compared to matched controls, and secondary outcomes evaluated the use of other tobacco and nicotine products. Conditional logistic and fixed-effects linear regression models were applied to examine binary and continuous outcomes, respectively.</div></div><div><h3>Results</h3><div>The matched cohort included 13,409 participants (1,219 FECD cases and 12,190 controls). The odds of ever smoking ≥100 cigarettes did not differ between groups (OR=0.95, 95% CI=[0.85, 1.08], p=0.4). FECD cases reported a slightly shorter total duration of smoking (MD=-2.69, 95% CI=[-4.22, -1.15], p<0.01), although mean daily cigarette consumption did not differ significantly between groups (MD=-0.20, 95% CI=[-1.67, 1.27], p=0.8). Current smoking was less frequent among FECD cases (OR=0.58, 95% CI=[0.41, 0.81], p<0.01). No significant differences were observed for lifetime or current use of electronic nicotine products (p=0.4 and p=0.1), cigars or cigarillos (p=0.2 and p=0.4), hookah (p=1.0 and p=0.9), or smokeless tobacco (p=0.1 and p=0.9).</div></div><div><h3>Conclusions</h3><div>This cross-sectional analysis of a large, nationally diverse cohort did not find evidence of an association between smoking behaviour and FECD, supporting emerging evidence that challenges the strength of this purported relationship. Nonetheless, these findings should not detract from the well-established systemic harms of smoking.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100234"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-28Epub Date: 2025-12-22DOI: 10.1016/j.ajoint.2025.100215
Adriana Kaganovski , Anisha Kasi , Aliya Grinberg , Michael Kozlov , Riya Patel , Minwoo Kwon , Carolyn Lai , Inci Dersu
Purpose
To evaluate and compare the quality, accuracy, understandability, and actionability of responses generated by a health-specific AI chatbot (Health Answers by Pfizer) and a general-purpose AI chatbot (ChatGPT/GPT-5) to ophthalmology-related patient queries.
Methods
We input the top five Google Trends search queries on three leading causes of blindness worldwide — glaucoma, cataract, and age-related macular degeneration — into both chatbots. We evaluated each chatbot response with the Flesch Reading Ease test, Flesch-Kincaid Grade Level, Patient Education Materials Assessment Tool, and DISCERN tool to assess the quality, accuracy, understandability, and actionability of each response.
Results
ChatGPT-5 produced responses that were easier to read (Flesch Reading Ease of 48.1 vs 39.0, p = 0.02) and written at a lower grade level (Flesch-Kincaid Grade Level of 8.9 vs 12.2, p = 0.003). ChatGPT-5 also scored higher for understandability (PEMAT-P understandability scores of 83.8% vs 80.5%, p = 0.024) and information quality (DISCERN scores of 41.3 vs 36.4, p = 0.047). In contrast, Health Answers by Pfizer produced content that was significantly more actionable (PEMAT-P actionability scores of 41.3% vs 23.3%, p = 0.004).
Conclusions
This study highlights the utility of Health Answers by Pfizer in producing content of higher actionability, compared to ChatGPT-5, which produced content of greater understandability, quality, and readability. It is paramount for effective patient education in ophthalmology to improve AI chatbots to balance clarity with actionability, especially given the critical nature of silently progressing diseases like glaucoma.
目的评估和比较健康专用AI聊天机器人(辉瑞公司的Health Answers)和通用AI聊天机器人(ChatGPT/GPT-5)对眼科相关患者查询产生的回答的质量、准确性、可理解性和可操作性。方法:我们在两个聊天机器人中输入关于全球三种主要致盲原因(青光眼、白内障和年龄相关性黄斑变性)的谷歌趋势搜索查询前五名。我们使用Flesch Reading Ease test、Flesch- kincaid Grade Level、Patient Education Materials Assessment Tool和DISCERN工具来评估每个聊天机器人的反应,以评估每个反应的质量、准确性、可理解性和可操作性。结果schatgpt -5产生的回答更容易阅读(Flesch Reading Ease为48.1 vs 39.0, p = 0.02),书写水平较低(Flesch- kincaid grade level为8.9 vs 12.2, p = 0.003)。ChatGPT-5在可理解性(PEMAT-P可理解性得分为83.8%比80.5%,p = 0.024)和信息质量(DISCERN得分为41.3比36.4,p = 0.047)方面得分也更高。相比之下,辉瑞公司的健康答案产生的内容更具可操作性(PEMAT-P可操作性得分为41.3%对23.3%,p = 0.004)。与ChatGPT-5相比,本研究突出了辉瑞公司的Health Answers在产生更高可操作性内容方面的效用,后者产生的内容更具可理解性、质量和可读性。对于有效的眼科患者教育来说,改进人工智能聊天机器人以平衡清晰度和可操作性是至关重要的,特别是考虑到青光眼等悄无声息发展的疾病的关键性质。
{"title":"Evaluating patient-facing eye disease information: ChatGPT-5 vs. Pfizer health answers","authors":"Adriana Kaganovski , Anisha Kasi , Aliya Grinberg , Michael Kozlov , Riya Patel , Minwoo Kwon , Carolyn Lai , Inci Dersu","doi":"10.1016/j.ajoint.2025.100215","DOIUrl":"10.1016/j.ajoint.2025.100215","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate and compare the quality, accuracy, understandability, and actionability of responses generated by a health-specific AI chatbot (Health Answers by Pfizer) and a general-purpose AI chatbot (ChatGPT/GPT-5) to ophthalmology-related patient queries.</div></div><div><h3>Methods</h3><div>We input the top five Google Trends search queries on three leading causes of blindness worldwide — glaucoma, cataract, and age-related macular degeneration — into both chatbots. We evaluated each chatbot response with the Flesch Reading Ease test, Flesch-Kincaid Grade Level, Patient Education Materials Assessment Tool, and DISCERN tool to assess the quality, accuracy, understandability, and actionability of each response.</div></div><div><h3>Results</h3><div>ChatGPT-5 produced responses that were easier to read (Flesch Reading Ease of 48.1 vs 39.0, <em>p</em> = 0.02) and written at a lower grade level (Flesch-Kincaid Grade Level of 8.9 vs 12.2, <em>p</em> = 0.003). ChatGPT-5 also scored higher for understandability (PEMAT-P understandability scores of 83.8% vs 80.5%, <em>p</em> = 0.024) and information quality (DISCERN scores of 41.3 vs 36.4, <em>p</em> = 0.047). In contrast, Health Answers by Pfizer produced content that was significantly more actionable (PEMAT-P actionability scores of 41.3% vs 23.3%, <em>p</em> = 0.004).</div></div><div><h3>Conclusions</h3><div>This study highlights the utility of Health Answers by Pfizer in producing content of higher actionability, compared to ChatGPT-5, which produced content of greater understandability, quality, and readability. It is paramount for effective patient education in ophthalmology to improve AI chatbots to balance clarity with actionability, especially given the critical nature of silently progressing diseases like glaucoma.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100215"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate pneumatic retinopexy (PnR) outcomes for primary rhegmatogenous retinal detachment (RRD) in a real-world North African cohort and identify factors associated with surgical failure.
Design
Retrospective observational case series.
Methods
A total of 112 eyes from 112 patients treated for primary RRD with PnR (January 2023–March 2025) were reviewed. Patient selection followed PIVOT trial criteria, including single retinal break or clustered breaks ≤1 clock hour, located within superior 8 clock hours (between 8 and 4 o'clock), with documented postoperative compliance. Preoperative demographics, ocular characteristics, and postoperative complications were systematically recorded. The primary anatomical outcome was defined as complete retinal reattachment without additional surgery at 6 months. Anatomical failure was defined as subretinal fluid persistence exceeding 4 weeks requiring secondary intervention. The primary visual outcome was best-corrected visual acuity (BCVA) at 6 months and its change over time. Logistic regression was used to identify factors associated with anatomical and visual failure.
Results
Single-operation anatomical success was 67 % (75/112 eyes); secondary procedures achieved 98 % final reattachment (110/112). Mean final BCVA was 0.12 logMAR, with 80 % of visual improvement occurring within the first postoperative month (0.62 logMAR gain; p < 0.001). Pseudophakia (OR=3.49, p < 0.001), high myopia (OR=1.82, p = 0.02), and prolonged symptom duration (OR=1.12 per day, p = 0.002) were independent factors associated with anatomical failure. New or missed retinal breaks (OR=2.16, p = 0.03) and proliferative vitreoretinopathy (PVR) (OR=1.96, p = 0.02) were independent postoperative factors of failure. For visual outcomes, pseudophakia (OR=3.2, p = 0.001), high myopia (OR=2.49, p = 0.004), worse preoperative BCVA (OR = 2.23, p = 0.002), and prolonged symptom duration (OR=1.35 per day, p = 0.002) were independent factors associated with poor outcomes. Postoperative complications (missed breaks OR=2.8; PVR OR=1.8) also independently contributed to poor visual recovery.
Conclusions
PnR achieves competitive anatomical and visual outcomes in real-world practice when rigorous patient selection and meticulous surgical technique are applied. Success depends equally on preoperative patient selection and surgical execution. Optimization through timely intervention, comprehensive preoperative examination, enhanced visualization, and rigorous surveillance may increase real-world success rates toward trial-level performance while maintaining procedural simplicity and cost-effectiveness in resource-limited settings.
目的评估北非现实世界人群中原发性孔源性视网膜脱离(RRD)的气压视网膜固定术(PnR)结果,并确定与手术失败相关的因素。设计回顾性观察病例系列。方法回顾性分析2023年1月~ 2025年3月收治的112例原发性RRD合并PnR患者的112只眼。患者选择遵循PIVOT试验标准,包括单个视网膜断裂或聚集性断裂≤1时钟小时,位于优越的8时钟小时内(8点至4点之间),并记录术后依从性。系统记录术前人口统计学、眼部特征和术后并发症。主要解剖结果被定义为6个月时视网膜完全复位,无需额外手术。解剖失败定义为视网膜下积液超过4周,需要二次干预。主要视力指标为6个月时的最佳矫正视力(BCVA)及其随时间的变化。使用逻辑回归来确定与解剖和视觉功能障碍相关的因素。结果单次手术解剖成功率为67%(75/112眼);二次手术最终复位率为98%(110/112)。平均最终BCVA为0.12 logMAR, 80%的视力改善发生在术后第一个月内(0.62 logMAR增益;p < 0.001)。假性近视(OR=3.49, p < 0.001)、高度近视(OR=1.82, p = 0.02)和症状持续时间延长(OR=1.12 /天,p = 0.002)是解剖衰竭的独立相关因素。新发或漏发视网膜断裂(or =2.16, p = 0.03)和增殖性玻璃体视网膜病变(or =1.96, p = 0.02)是术后失败的独立因素。对于视力结果,假性晶光(OR=3.2, p = 0.001)、高度近视(OR=2.49, p = 0.004)、术前BCVA恶化(OR= 2.23, p = 0.002)和症状持续时间延长(OR=1.35 /天,p = 0.002)是与预后不良相关的独立因素。术后并发症(漏断OR=2.8; PVR OR=1.8)也是导致视力恢复差的独立原因。结论通过严格的患者选择和细致的手术技术,spnr在实际应用中获得了良好的解剖和视觉效果。成功与否同样取决于术前病人的选择和手术的执行。通过及时的干预、全面的术前检查、增强的可视化和严格的监测进行优化,可以提高实际成功率,达到试验水平,同时在资源有限的情况下保持程序的简单性和成本效益。
{"title":"Anatomical and visual outcomes of pneumatic retinopexy in primary rhegmatogenous retinal detachment","authors":"Hassan Moutei, Meriem Abdellaoui, Fouad Chraibi, Idriss Benatiya","doi":"10.1016/j.ajoint.2025.100218","DOIUrl":"10.1016/j.ajoint.2025.100218","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate pneumatic retinopexy (PnR) outcomes for primary rhegmatogenous retinal detachment (RRD) in a real-world North African cohort and identify factors associated with surgical failure.</div></div><div><h3>Design</h3><div>Retrospective observational case series.</div></div><div><h3>Methods</h3><div>A total of 112 eyes from 112 patients treated for primary RRD with PnR (January 2023–March 2025) were reviewed. Patient selection followed PIVOT trial criteria, including single retinal break or clustered breaks ≤1 clock hour, located within superior 8 clock hours (between 8 and 4 o'clock), with documented postoperative compliance. Preoperative demographics, ocular characteristics, and postoperative complications were systematically recorded. The primary anatomical outcome was defined as complete retinal reattachment without additional surgery at 6 months. Anatomical failure was defined as subretinal fluid persistence exceeding 4 weeks requiring secondary intervention. The primary visual outcome was best-corrected visual acuity (BCVA) at 6 months and its change over time. Logistic regression was used to identify factors associated with anatomical and visual failure.</div></div><div><h3>Results</h3><div>Single-operation anatomical success was 67 % (75/112 eyes); secondary procedures achieved 98 % final reattachment (110/112). Mean final BCVA was 0.12 logMAR, with 80 % of visual improvement occurring within the first postoperative month (0.62 logMAR gain; <em>p</em> < 0.001). Pseudophakia (OR=3.49, <em>p</em> < 0.001), high myopia (OR=1.82, <em>p</em> = 0.02), and prolonged symptom duration (OR=1.12 per day, <em>p</em> = 0.002) were independent factors associated with anatomical failure. New or missed retinal breaks (OR=2.16, <em>p</em> = 0.03) and proliferative vitreoretinopathy (PVR) (OR=1.96, <em>p</em> = 0.02) were independent postoperative factors of failure. For visual outcomes, pseudophakia (OR=3.2, <em>p</em> = 0.001), high myopia (OR=2.49, <em>p</em> = 0.004), worse preoperative BCVA (OR = 2.23, <em>p</em> = 0.002), and prolonged symptom duration (OR=1.35 per day, <em>p</em> = 0.002) were independent factors associated with poor outcomes. Postoperative complications (missed breaks OR=2.8; PVR OR=1.8) also independently contributed to poor visual recovery.</div></div><div><h3>Conclusions</h3><div>PnR achieves competitive anatomical and visual outcomes in real-world practice when rigorous patient selection and meticulous surgical technique are applied. Success depends equally on preoperative patient selection and surgical execution. Optimization through timely intervention, comprehensive preoperative examination, enhanced visualization, and rigorous surveillance may increase real-world success rates toward trial-level performance while maintaining procedural simplicity and cost-effectiveness in resource-limited settings.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100218"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-28Epub Date: 2026-01-22DOI: 10.1016/j.ajoint.2026.100226
Sheila K. West , Ian J. Saldanha , Fasika Woreta , Christina Ambrosino , Jay Maturi , Fekadu Ayalew , Jordan Kaplan , Annabelle Pan , Winnie Liu , Anna Kim , Emily Joseph , Andreas S. Mueller , Silvio P. Mariotti
Purpose
The World Health Organization (WHO) has specified a global target for “effective cataract surgery coverage” for monitoring progress towards tincreasing eye care quality across populations. The WHO is committed to providing evidence-based guidance for components of cataract surgerythat could lead to better outcomes. The first step is a scoping review of from existing guidelines, including the evidence base and gaps in the evidence for those guidelines.
Design
We developed a conceptual framework for the scoping review that compartmentalized stages of cataract surgery into pre-operative, operative, and postoperative phases and identified potential outcome indicators. A search strategy was developed.
Methods
In 2024, we used a multipronged approach to identify existing guidelines that support cataract surgery programs, reviewed known publicly available cataract surgery quality improvement programs, searched the Trip Medical Database, and reviewed materials sent to us directly from WHO. We noted the evidence-base of the guidelines.
Results
Of the 156 sources, 34 had guidelines. Seven guidelines were cited by multiple sources with good evidence; these include use of pre-operative povidone-iodine, a “time-out” checklist, intracameral antibiotics, and phacoemulsification. Some guidelines were inconsistent and require harmonization, such as the necessity for pre-operative medical visits and laboratory testing, and benchmarks for outcome assessment. Gaps in evidence were also found, such as details on what constitutes “accurate” biometry.
Conclusions
While these results are a reasonable starting point for WHO to begin the development of guidance for effective cataract surgery, there is an urgent need to generate data that will fill identified gaps in evidence and to harmonize inconsistencies going forward.
{"title":"A global scoping review of clinical practice guidelines for cataract surgery","authors":"Sheila K. West , Ian J. Saldanha , Fasika Woreta , Christina Ambrosino , Jay Maturi , Fekadu Ayalew , Jordan Kaplan , Annabelle Pan , Winnie Liu , Anna Kim , Emily Joseph , Andreas S. Mueller , Silvio P. Mariotti","doi":"10.1016/j.ajoint.2026.100226","DOIUrl":"10.1016/j.ajoint.2026.100226","url":null,"abstract":"<div><h3>Purpose</h3><div>The World Health Organization (WHO) has specified a global target for “effective cataract surgery coverage” for monitoring progress towards tincreasing eye care quality across populations. The WHO is committed to providing evidence-based guidance for components of cataract surgerythat could lead to better outcomes. The first step is a scoping review of from existing guidelines, including the evidence base and gaps in the evidence for those guidelines.</div></div><div><h3>Design</h3><div>We developed a conceptual framework for the scoping review that compartmentalized stages of cataract surgery into pre-operative, operative, and postoperative phases and identified potential outcome indicators. A search strategy was developed.</div></div><div><h3>Methods</h3><div>In 2024, we used a multipronged approach to identify existing guidelines that support cataract surgery programs, reviewed known publicly available cataract surgery quality improvement programs, searched the Trip Medical Database, and reviewed materials sent to us directly from WHO. We noted the evidence-base of the guidelines.</div></div><div><h3>Results</h3><div>Of the 156 sources, 34 had guidelines. Seven guidelines were cited by multiple sources with good evidence; these include use of pre-operative povidone-iodine, a “time-out” checklist, intracameral antibiotics, and phacoemulsification. Some guidelines were inconsistent and require harmonization, such as the necessity for pre-operative medical visits and laboratory testing, and benchmarks for outcome assessment. Gaps in evidence were also found, such as details on what constitutes “accurate” biometry.</div></div><div><h3>Conclusions</h3><div>While these results are a reasonable starting point for WHO to begin the development of guidance for effective cataract surgery, there is an urgent need to generate data that will fill identified gaps in evidence and to harmonize inconsistencies going forward.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100226"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To compare the one-year surgical outcomes of Tanito microhook Trabeculotomy combined with phacoemulsification (Phaco-TMH) and 5–0 prolene gonioscopy-assisted transluminal trabeculotomy combined with phacoemulsification (Phaco-GATT) in mild-moderate Open-angle glaucoma
Design
Prospective, comparative, non-randomised, interventional study
Subjects
Patients with mild-to-moderate POAG and visually significant cataract Methods:110 patients underwent Phaco-TMH (Group 1, N = 55) or Phaco-GATT (Group 2, N = 55). The primary outcome measures included changes in intraocular pressure (IOP), antiglaucoma medications (AGM), and best-corrected visual acuity (BCVA). Success was defined as a combination of at least 20%, 25%, or 30% reduction in IOP and an absolute IOP of less than 21, 18, or 15 mm Hg, respectively (Criteria 1, 2, and 3). Additionally, interventions and complications were compared between the groups.
Results
In Group 1, mean IOP reduced significantly from 26.55±5.22mmHg to 14.60±3.87 mmHg, and in Group 2 from 25.45± 5.65mmHg to 12.80±3.12 mmHg at 12 months (p < 0.001), with a significant reduction in Group 2 than in Group 1 (p < 0.01). The percentage reduction of IOP in Group 1 was 37.5% and in Group 2 was 47.7%. AGM significantly reduced from 1.53±0.66 to 0.22±0.57 and from 1.64±0.73 to 0.09±0.29 in Groups 1 and 2, respectively (p < 0.001), with no significant difference between the groups (p = 0.1). The complete success rates by criteria 1, 2, and 3 in Group 1 were 74.6%, 69.1%, and 52.7%, respectively, and in Group 2 were 89.1%, 81.8%, and 65.4%, respectively. Higher baseline IOP(HR: 0.68, 95% CI: 0.54–0.87, p < 0.01) and higher age (HR: 0.93, 95% CI: 0.86–1.00, p = 0.05) were associated with a lower likelihood of surgical failure. Hyphema was seen in one patient in Group 1, 7 patients in Group 2, and two patients in Group 2 required anterior chamber wash. IOP spikes were seen in one patient in Group 1 and three patients in Group 2Conclusion: Tanito microhook trabeculotomy is safe, efficacious, and comparable to GATT combined with phacoemulsification. Phaco-GATT achieved greater intraocular pressure reduction at 12 months, with comparable postoperative complication rates between groups
{"title":"Comparison of outcomes of 180-degree Tanito Microhook trabeculotomy versus 360-degree gonioscopy-assisted transluminal trabeculotomy combined with phacoemulsification in open-angle glaucoma","authors":"Devendra Maheshwari , Madhavi Ramanatha Pillai , Nimrita Gyanchand Nagdev , Drishti Chautani , Davinder S Grover , Masaki Tanito , Mohammed Sithiq Uduman , Rengappa Ramakrishnan","doi":"10.1016/j.ajoint.2026.100229","DOIUrl":"10.1016/j.ajoint.2026.100229","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the one-year surgical outcomes of Tanito microhook Trabeculotomy combined with phacoemulsification (Phaco-TMH) and 5–0 prolene gonioscopy-assisted transluminal trabeculotomy combined with phacoemulsification (Phaco-GATT) in mild-moderate Open-angle glaucoma</div></div><div><h3>Design</h3><div>Prospective, comparative, non-randomised, interventional study</div></div><div><h3>Subjects</h3><div>Patients with mild-to-moderate POAG and visually significant cataract Methods:110 patients underwent Phaco-TMH (Group 1, <em>N</em> = 55) or Phaco-GATT (Group 2, <em>N</em> = 55). The primary outcome measures included changes in intraocular pressure (IOP), antiglaucoma medications (AGM), and best-corrected visual acuity (BCVA). Success was defined as a combination of at least 20%, 25%, or 30% reduction in IOP and an absolute IOP of less than 21, 18, or 15 mm Hg, respectively (Criteria 1, 2, and 3). Additionally, interventions and complications were compared between the groups.</div></div><div><h3>Results</h3><div>In Group 1, mean IOP reduced significantly from 26.55±5.22mmHg to 14.60±3.87 mmHg, and in Group 2 from 25.45± 5.65mmHg to 12.80±3.12 mmHg at 12 months (<em>p</em> < 0.001), with a significant reduction in Group 2 than in Group 1 (<em>p</em> < 0.01). The percentage reduction of IOP in Group 1 was 37.5% and in Group 2 was 47.7%. AGM significantly reduced from 1.53±0.66 to 0.22±0.57 and from 1.64±0.73 to 0.09±0.29 in Groups 1 and 2, respectively (<em>p</em> < 0.001), with no significant difference between the groups (<em>p</em> = 0.1). The complete success rates by criteria 1, 2, and 3 in Group 1 were 74.6%, 69.1%, and 52.7%, respectively, and in Group 2 were 89.1%, 81.8%, and 65.4%, respectively. Higher baseline IOP(HR: 0.68, 95% CI: 0.54–0.87, <em>p</em> < 0.01) and higher age (HR: 0.93, 95% CI: 0.86–1.00, <em>p</em> = 0.05) were associated with a lower likelihood of surgical failure. Hyphema was seen in one patient in Group 1, 7 patients in Group 2, and two patients in Group 2 required anterior chamber wash. IOP spikes were seen in one patient in Group 1 and three patients in Group 2Conclusion: Tanito microhook trabeculotomy is safe, efficacious, and comparable to GATT combined with phacoemulsification. Phaco-GATT achieved greater intraocular pressure reduction at 12 months, with comparable postoperative complication rates between groups</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100229"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-28Epub Date: 2025-12-10DOI: 10.1016/j.ajoint.2025.100212
Ngozi C. Chidi-Egboka , Chameen Samarawickrama , Fiona Stapleton , Laura E. Downie , Tanya Trinh , Maria Markoulli , Elsie Chan , Jern Yee Chen , Jason Holland , Stephanie L. Watson
Background
There is a need to translate evidence from randomised controlled trials (RCTs) into recommendations for prescribing topical ciclosporin A (CsA) in ocular surface disease (OSD), to inform clinicians and support improvements in Australian eyecare and research.
Methods
A systematic review with meta-analysis, review of the Therapeutic Goods Administration approvals, Pharmaceutical Benefit Scheme (Australia) and evaluation of the quality of available evidence with expert-led consensus was used to develop practical recommendations for the use of topical CsA for OSD.
Results
Most RCTs of topical CsA for OSD were available for aqueous-deficient dry eye disease (DED). In the RCTs, prior to prescribing topical CsA, patients were assessed for symptoms (e.g., Ocular Surface Disease Index) and signs (e.g., tear secretion, corneal fluorescein staining). In Australia, topical CsA was available as Ikervis® (CsA 0.1 % cationic nanoemulsion), Cequa® (CsA 0.09 % nanomicellar solution), Restasis® (CsA 0.05 % oil-in-water emulsion) and compounded products (CsA 0.02 %, 0.05 %, 0.2 %, 0.5 %, 1.0 %). Recommendations for prescribing topical CsA included that it could be considered when DED symptoms and/or signs were not adequately controlled by preservative-free artificial tear monotherapy. Timeline for an improvement with CsA treatment was noted as within 4 to 12 weeks, to inform follow-up schedules. Potential ocular side effects associated with topical CsA included stinging and irritation on instillation. Evidence was limited for topical CsA use in individuals <18 years and it was not recommended for patients planning a pregnancy, or who are pregnant or lactating.
Conclusion
Topical CsA may be used to treat OSD, with most evidence supporting its efficacy for aqueous-deficient DED. Treatment in adults, aside from pregnant or lactating patients or those planning pregnancy, was generally safe with no serious adverse events reported.
{"title":"Evidence- and consensus-based practical recommendations for use of topical ciclosporin to treat ocular surface disease in Australian clinical practice","authors":"Ngozi C. Chidi-Egboka , Chameen Samarawickrama , Fiona Stapleton , Laura E. Downie , Tanya Trinh , Maria Markoulli , Elsie Chan , Jern Yee Chen , Jason Holland , Stephanie L. Watson","doi":"10.1016/j.ajoint.2025.100212","DOIUrl":"10.1016/j.ajoint.2025.100212","url":null,"abstract":"<div><h3>Background</h3><div>There is a need to translate evidence from randomised controlled trials (RCTs) into recommendations for prescribing topical ciclosporin A (CsA) in ocular surface disease (OSD), to inform clinicians and support improvements in Australian eyecare and research.</div></div><div><h3>Methods</h3><div>A systematic review with meta-analysis, review of the Therapeutic Goods Administration approvals, Pharmaceutical Benefit Scheme (Australia) and evaluation of the quality of available evidence with expert-led consensus was used to develop practical recommendations for the use of topical CsA for OSD.</div></div><div><h3>Results</h3><div>Most RCTs of topical CsA for OSD were available for aqueous-deficient dry eye disease (DED). In the RCTs, prior to prescribing topical CsA, patients were assessed for symptoms (e.g., Ocular Surface Disease Index) and signs (e.g., tear secretion, corneal fluorescein staining). In Australia, topical CsA was available as Ikervis® (CsA 0.1 % cationic nanoemulsion), Cequa® (CsA 0.09 % nanomicellar solution), Restasis® (CsA 0.05 % oil-in-water emulsion) and compounded products (CsA 0.02 %, 0.05 %, 0.2 %, 0.5 %, 1.0 %). Recommendations for prescribing topical CsA included that it could be considered when DED symptoms and/or signs were not adequately controlled by preservative-free artificial tear monotherapy. Timeline for an improvement with CsA treatment was noted as within 4 to 12 weeks, to inform follow-up schedules. Potential ocular side effects associated with topical CsA included stinging and irritation on instillation. Evidence was limited for topical CsA use in individuals <18 years and it was not recommended for patients planning a pregnancy, or who are pregnant or lactating.</div></div><div><h3>Conclusion</h3><div>Topical CsA may be used to treat OSD, with most evidence supporting its efficacy for aqueous-deficient DED. Treatment in adults, aside from pregnant or lactating patients or those planning pregnancy, was generally safe with no serious adverse events reported.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100212"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145798446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-28Epub Date: 2026-01-27DOI: 10.1016/j.ajoint.2026.100230
Andy Asare Antwi , Agnes Danso Mensah , Pascal Michel Tchiakpe , Onakhe Emmanuel Ojo
Purpose
To determine the knowledge, awareness and use of ocular nutritional supplements (ONS) among adults in the New Juaben South Municipality, Ghana.
Design
Exploratory, clinic-based cross-sectional study.
Participants
Two hundred and eighteen (218) adults aged ≥40 years were recruited using a convenience sampling technique as they presented for care. This approach was intended to characterize beliefs among clinic-attending adults rather than to generate population-representative estimates.
Methods
Participants completed a semi-structured, self-administered questionnaire covering demographics, knowledge regarding ONS components and benefits, awareness of products, and self-reported usage. Primary outcomes included the prevalence of knowledge, awareness, and use, with the statistical association between demographic variables (age, gender, ethnicity, education) and outcomes analyzed using Chi-square tests.
Results
The mean age was 52.9 ± 9.5 years; 55% were female, and 45% were male. A majority (64.7%) reported no knowledge of ONS, while 35.3% reported some knowledge (58.4% basic, 39.0% average, and 2.6% expert). Awareness of nutritional supplements for eye health was reported by 48.0% of respondents, primarily from healthcare professionals. ONS use was reported by 19.7% of participants, while 80.3% reported no prior or current use. Among users, 76.7% reported a perceived subjective benefit from ONS for their intended purpose. Self-reported adverse effects were uncommon, with 97.7% of users reporting none. Educational attainment was significantly associated with knowledge (p < 0.001), awareness (p < 0.001), and use (p = 0.007).
Conclusions
Adults aged ≥40 years attending eye clinics in the New Juaben South Municipality had limited knowledge and awareness of ONS, with low utilization. These findings support the clinical relevance of ONS in ocular conditions where there is a demonstrated benefit, and highlight the need for educational interventions promoting appropriate, evidence-based use rather than routine supplementation.
{"title":"A survey on ocular nutritional supplement among adults: A cross-sectional study in the new Juaben south municipality, Ghana","authors":"Andy Asare Antwi , Agnes Danso Mensah , Pascal Michel Tchiakpe , Onakhe Emmanuel Ojo","doi":"10.1016/j.ajoint.2026.100230","DOIUrl":"10.1016/j.ajoint.2026.100230","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the knowledge, awareness and use of ocular nutritional supplements (ONS) among adults in the New Juaben South Municipality, Ghana.</div></div><div><h3>Design</h3><div>Exploratory, clinic-based cross-sectional study.</div></div><div><h3>Participants</h3><div>Two hundred and eighteen (218) adults aged ≥40 years were recruited using a convenience sampling technique as they presented for care. This approach was intended to characterize beliefs among clinic-attending adults rather than to generate population-representative estimates.</div></div><div><h3>Methods</h3><div>Participants completed a semi-structured, self-administered questionnaire covering demographics, knowledge regarding ONS components and benefits, awareness of products, and self-reported usage. Primary outcomes included the prevalence of knowledge, awareness, and use, with the statistical association between demographic variables (age, gender, ethnicity, education) and outcomes analyzed using Chi-square tests.</div></div><div><h3>Results</h3><div>The mean age was 52.9 ± 9.5 years; 55% were female, and 45% were male. A majority (64.7%) reported no knowledge of ONS, while 35.3% reported some knowledge (58.4% basic, 39.0% average, and 2.6% expert). Awareness of nutritional supplements for eye health was reported by 48.0% of respondents, primarily from healthcare professionals. ONS use was reported by 19.7% of participants, while 80.3% reported no prior or current use. Among users, 76.7% reported a perceived subjective benefit from ONS for their intended purpose. Self-reported adverse effects were uncommon, with 97.7% of users reporting none. Educational attainment was significantly associated with knowledge (<em>p</em> < 0.001), awareness (<em>p</em> < 0.001), and use (<em>p</em> = 0.007).</div></div><div><h3>Conclusions</h3><div>Adults aged ≥40 years attending eye clinics in the New Juaben South Municipality had limited knowledge and awareness of ONS, with low utilization. These findings support the clinical relevance of ONS in ocular conditions where there is a demonstrated benefit, and highlight the need for educational interventions promoting appropriate, evidence-based use rather than routine supplementation.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100230"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-28Epub Date: 2025-12-18DOI: 10.1016/j.ajoint.2025.100214
Justus Zemberi , Julian Peregoff , Matthew Santos
Purpose
To evaluate whether a recent history of intravitreal injection is associated with postoperative complications after cataract surgery in a large, real-world cohort.
Adults undergoing cataract surgery with or without at least one intravitreal injection within 90 days before surgery were identified from the U.S. TriNetX research network. Cohorts were matched for demographic characteristics and ocular and systemic comorbidities. Postoperative complications at 14, 30, and 90 days were compared using risk ratios with 95% confidence intervals.
Results
After matching, 10,107 patients with recent intravitreal injection and 10,107 controls were included. A recent intravitreal injection history was associated with higher rates of postoperative macular edema at 14, 30, and 90 days (RR range 2.07–2.69) and vitreous hemorrhage at 90 days (RR 1.74). Absolute risk differences were modest. No significant associations were observed for infection, retinal detachment, anterior vitrectomy, lens dislocation, anterior uveitis, or secondary lens procedures.
Conclusion
In this large retrospective analysis, patients undergoing cataract surgery with a recent history of intravitreal injection had higher observed rates of postoperative macular edema and vitreous hemorrhage, while other major complications were not increased. These associations likely reflect the presence of underlying retinal disease rather than a direct effect of the injection procedure itself and should be interpreted as non-causal.
{"title":"Intravitreal injection history and cataract surgery complications: A multicenter retrospective cohort","authors":"Justus Zemberi , Julian Peregoff , Matthew Santos","doi":"10.1016/j.ajoint.2025.100214","DOIUrl":"10.1016/j.ajoint.2025.100214","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate whether a recent history of intravitreal injection is associated with postoperative complications after cataract surgery in a large, real-world cohort.</div></div><div><h3>Design</h3><div>Retrospective, propensity score–matched cohort study.</div></div><div><h3>Methods</h3><div>Adults undergoing cataract surgery with or without at least one intravitreal injection within 90 days before surgery were identified from the U.S. TriNetX research network. Cohorts were matched for demographic characteristics and ocular and systemic comorbidities. Postoperative complications at 14, 30, and 90 days were compared using risk ratios with 95% confidence intervals.</div></div><div><h3>Results</h3><div>After matching, 10,107 patients with recent intravitreal injection and 10,107 controls were included. A recent intravitreal injection history was associated with higher rates of postoperative macular edema at 14, 30, and 90 days (RR range 2.07–2.69) and vitreous hemorrhage at 90 days (RR 1.74). Absolute risk differences were modest. No significant associations were observed for infection, retinal detachment, anterior vitrectomy, lens dislocation, anterior uveitis, or secondary lens procedures.</div></div><div><h3>Conclusion</h3><div>In this large retrospective analysis, patients undergoing cataract surgery with a recent history of intravitreal injection had higher observed rates of postoperative macular edema and vitreous hemorrhage, while other major complications were not increased. These associations likely reflect the presence of underlying retinal disease rather than a direct effect of the injection procedure itself and should be interpreted as non-causal.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100214"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-28Epub Date: 2025-12-23DOI: 10.1016/j.ajoint.2025.100219
Prashant Ramdas Kokiwar , Amit Singh Pawaiya , Ranjana Roy , Reenoo Jauhari
{"title":"Comment on “Effectiveness of intracameral antibiotics in reducing postoperative endophthalmitis risk after cataract surgery: A meta-analysis”","authors":"Prashant Ramdas Kokiwar , Amit Singh Pawaiya , Ranjana Roy , Reenoo Jauhari","doi":"10.1016/j.ajoint.2025.100219","DOIUrl":"10.1016/j.ajoint.2025.100219","url":null,"abstract":"","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100219"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transpupillary thermotherapy (TTT) is used as a focal treatment modality for smaller retinoblastoma tumors, however its efficacy in thicker tumors is limited. This study evaluated whether indocyanine green (ICG) augmentation of TTT (ICGeTTT) improves tumor regression compared to TTT alone for residual chemoreduced retinoblastomas >2 mm in height.
Methods
In this randomized controlled trial, simple randomisation table was used to allocate 28 chemoreduced tumors to treatment with either TTT (group 1) or ICGeTTT (group 2). Treatment was administered every 3–4 weeks until tumor height was <2 mm or a maximum of four sessions were completed.
Results
The baseline tumor height was higher for the ICGeTTT group. Adjusted analysis for this baseline difference showed a statistically significant greater reduction in tumor height for group 2 (44 %) as compared to group 1 (21 %) (p = 0.018). The percentage of tumors achieving complete regression was higher in group 2 but this difference did not reach statistical significance. The cumulative energy used and side effects from treatment were similar between the groups.
Conclusion
Despite the limitations of the study including the small sample size and the baseline difference, the study still demonstrated a greater tumor height reduction with the use of ICGeTTT as compared to TTT in chemoreduced thick residual tumors and hence ICGeTTT may be preferred in such cases.
{"title":"“Indocyanine green enhanced TTT Vs TTT for treatment of thicker tumors in Retinoblastoma- a randomised control trial”","authors":"Ipsita Barman , Rachna Meel , Neelam Pushker , Vinod Kumar , Neiwete Lomi , Anjolie Chhabra , Mandeep S. Bajaj","doi":"10.1016/j.ajoint.2025.100213","DOIUrl":"10.1016/j.ajoint.2025.100213","url":null,"abstract":"<div><h3>Background</h3><div>Transpupillary thermotherapy (TTT) is used as a focal treatment modality for smaller retinoblastoma tumors, however its efficacy in thicker tumors is limited. This study evaluated whether indocyanine green (ICG) augmentation of TTT (ICGeTTT) improves tumor regression compared to TTT alone for residual chemoreduced retinoblastomas >2 mm in height.</div></div><div><h3>Methods</h3><div>In this randomized controlled trial, simple randomisation table was used to allocate 28 chemoreduced tumors to treatment with either TTT (group 1) or ICGeTTT (group 2). Treatment was administered every 3–4 weeks until tumor height was <2 mm or a maximum of four sessions were completed.</div></div><div><h3>Results</h3><div>The baseline tumor height was higher for the ICGeTTT group. Adjusted analysis for this baseline difference showed a statistically significant greater reduction in tumor height for group 2 (44 %) as compared to group 1 (21 %) (<em>p</em> = 0.018). The percentage of tumors achieving complete regression was higher in group 2 but this difference did not reach statistical significance. The cumulative energy used and side effects from treatment were similar between the groups.</div></div><div><h3>Conclusion</h3><div>Despite the limitations of the study including the small sample size and the baseline difference, the study still demonstrated a greater tumor height reduction with the use of ICGeTTT as compared to TTT in chemoreduced thick residual tumors and hence ICGeTTT may be preferred in such cases.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100213"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}