European Journal of Ophthalmology最新文献

Introduction: This study, part of a series, analyses the Swiss cohort from an EBO survey on cataract surgery training in Europe, focusing on Switzerland's unique program. The survey identifies two models: training all residents in surgery, and a "high-volume surgeon" model where only some learn CS post-residency.

Methods: This study analyses the survey results of Swiss participants in the EBO examinations (2018-2022) and compared them with the most important cohorts (Germany, France and Spain).

Results: Out of 251 respondents, 87 (34.7%) answered the questionnaire. Most (70.1%) had taken the EBO exam between 2021-2022, with the majority of study participants being men (55.2%) with a median age of 34 years and came from 12 different cantons. Two third (68.8%) of respondents had not performed any steps of cataract surgery on patients during their residency. Notably, 22.1% stated that they had carried out 10 or more training sessions on virtual reality simulator, 5.8% on synthetic eyes and 21% on animal eyes. A notable discrepancy was observed between participants with 10 or more training sessions and those without specific training in four key areas: self-assessed confidence and ability to perform cataract surgery (p = 0.006), management of challenging cases (p = 0.027), handling complications like posterior capsular tear (p = 0.031) and in performing corneal sutures (p = 0.023).

Discussion: Switzerland fits into the "high-volume surgeon" model group; extensive simulation-based training there significantly boosts self-confidence in performing CS, an effect less noticeable in countries offering hands-on training during residency.

Purpose: To report the case of a patient with ocular West Nile virus infection (WNVI) and to describe the demographics, eye characteristics, and treatment of patients with WNVI reported in the literature.

Methods: Systematic literature search using the PubMed MEDLINE database searching for all cases of ocular WNVI published from inception until October 14, 2023. Inclusion criteria were patients with serologic and/or cerebrospinal fluid diagnosis of WNVI with ocular involvement.

Results: A total of 60 patients (111 eyes), including the present case, were included. Most patients were males (57%), diagnosed in the United States (77%), and with a mean age at presentation of 54 years. The median time elapsed between the viral prodrome, and eye symptoms was 7 days. Neurologic involvement was present in 47 (78%) patients. Diabetes mellitus was the most frequent systemic comorbidity (45%). Posterior segment findings were present in 107 (96%) eyes. Multifocal chorioretinal lesions (86%), vitreous inflammation (51%), intraretinal hemorrhages (43%), and retinal vasculitis (21%) were the most frequent findings. Fluorescein angiography was performed in 88 (79%) eyes. Fifty-seven (51%) eyes did not receive treatment. Topical and systemic steroids were prescribed to 35% and 28% of eyes, respectively.

Conclusion: WNVI should be considered as a potential diagnosis in older patients who exhibit posterior uveitis, especially if they have recently experienced flu-like symptoms and have been exposed to mosquitoes. A comprehensive ocular assessment, which includes a dilated fundus examination and ocular imaging studies, can help raise suspicion for this condition even before serological confirmation is obtained.

X-linked retinoschisis (XLRS) is an inherited retinal disorder due to mutations in retinoschisin 1, characterized by impaired central vision secondary to parafoveal cystic cavities and visual field loss by splitting through the retinal nerve fibre layer in the peripheral retina. It is the leading cause of juvenile macular degeneration in males, and currently there is no approved treatment but carbonic anhydrase inhibitors can be used. A retrospective review of the medical records of 17 children with confirmed XLRS seen in the Paediatric Ophthalmology Department of La Paz University Hospital from the 1st of January 2009 to the 1st of June of 2023 was conducted. Complete ophthalmological studies, genetic testing and full-field electroretinogram were performed. Topical brinzolamide was given to patients with foveoschisis, adding oral acetazolamide in those who did not improve with topical treatment alone or with very extensive foveoschisis at diagnosis. Surgical treatment was performed in retinal detahment (RD) or in no clearing hemovitreous cases. Mean age at diagnosis was 5,86 years and the most common reason for consultation was strabismus, followed by RD. The most frequently affected retinal later on Optic coherence tomography was the inner nuclear layer and throughout the follow-up we observed a decrease in central macular thickness. We found some genotype-phenotype correlation in our series and more severe phenotypes if the first amino acid of the protein is affected or in frameshift mutations. We found that medical treatment (topical and oral) improves foveoschisis, and that surgery shows poor outcomes, especially in younger patients.

Methods: The authors performed a computerized search using PubMed, Embase, and Google Scholar. The search terms used were "chemotherapy AND surgery", "immunotherapy AND surgery", "radiotherapy AND surgery", "nutrition AND surgery", "(oculoplastic OR orbit OR eyelid OR lacrimal OR puncta) AND (chemotherapy OR immunotherapy OR radiotherapy)", "(facial OR facial plastic OR oculoplastic) AND (chemotherapy OR immunotherapy OR radiotherapy)", "(cancer OR malignancy) AND surgery", "(cancer OR malignancy) AND (surgery OR surgical) complications", "wound healing AND (cancer OR malignancy)", "infection AND (cancer OR malignancy)", "(bleeding OR blood loss) AND (cancer OR malignancy) AND surgery", "(chemotherapy OR immunotherapy OR radiotherapy) AND wound healing", "(chemotherapy OR immunotherapy OR radiotherapy) AND (bleeding OR blood loss)", "(chemotherapy OR immunotherapy OR radiotherapy) AND infection".

Results: A total of 89 articles, published from 1993 to 2023 in the English language or with English translations were included. Articles published earlier than 2000 were cited for foundational knowledge. References cited in the identified articles were also used to gather further data for the review.

Conclusions and relevance: Patients who are being treated for cancer or are undergoing current treatment for cancer require special considerations. Systemic therapies and radiotherapy impact the physiology of patients and the integrity of tissue in ways that significantly impact surgical interventions. It is imperative for the oculofacial plastic surgeon to have a complete understanding on how a previous or current diagnosis of cancer can influence surgical outcomes.

Purpose: To determine the relationship between the triglyceride-glucose-body mass index (TyG-BMI) and the incidence of myopia in United States (US) adolescents.

Methods: In this cross-sectional study, we utilized data from the National Health and Nutrition Examination Survey, with a focus on adolescents aged 12-19 years. Multivariate logistic regression models were used to determine the relationship between TyG-BMI and myopia. Furthermore, a restricted cubic spline function logistic regression model was used to explore the linear relationship between changes in TyG-BMI and myopia. Lastly, stratified analyses and interaction term tests were performed.

Results: The incidence of myopia was noted to be 42.17% among US adolescents. TyG-BMI was significantly and linearly associated with myopia in adolescents (p < 0.05). Compared with adolescents in the low TyG-BMI group, those in the high TyG-BMI group exhibited a 20% higher risk of developing myopia (OR = 1.20, 95% CI: 1.0-1.5, p for trend < 0.05).

Conclusions: TyG-BMI is significantly and positively associated with myopia incidence in US adolescents. The higher incidence of myopia in the high TyG-BMI group suggests the importance of metabolic health for myopia development. Controlling metabolic health factors is essential for preventing myopia in adolescents.

Purpose: To report the visual and refractive outcomes of trocar-assisted sutureless intrascleral three-piece intraocular lens (IOL) fixation, and to compare the accuracy of different IOL power formulas in this setting.

Methods: Twenty eyes of 20 patients who underwent trocar-assisted sutureless three-piece IOL scleral fixation were included. Two trocar-cannula systems were placed at 3 and 9 o'clock position creating 2.5 mm scleral tunnels. The haptics of a three-piece IOL were grasped with serrated retinal forceps, externalized through the scleral tunnels and fixed by making a flange. Prediction error (PE) was calculated as the actual postoperative spherical equivalent (SE) refraction minus the SE predicted refraction. The predicted SE was calculated using the Barret Universal II, Emmetropia Verifying Optical (EVO), Hoffer Q, Holladay 1, Holladay II, and SRK/T.

Results: At 6 months after surgery, corrected distance visual acuity improved from 0.66 ± 0.36 to 0.17 ± 0.13 logMAR (p < .001). The lowest median absolute PE was obtained by the Barrett formula (0.73D), followed by the EVO (0.81D), Holladay 1 (0.94D), SRK/T (0.98D), Hoffer Q (1.05D) and Haigis (1.64D) formulas. The highest percentage of eyes within ±1.00 D were obtained with the Barrett (60.0%), and EVO (55.0%) formulas.

Conclusion: Although trocar-assisted intrascleral three-piece IOL fixation yields good visual results, the predictability of refractive outcomes is lower than in standard cataract surgery. All formulas showed a slight tendency towards a hyperopic refractive surprise.

Introduction: To present a novel surgical technique for the treatment of a steep-walled filtering bleb following an Ahmed glaucoma valve implant. The primary aim was to alleviate the patient's discomfort and address associated corneal thinning, complications that can arise from this condition.

Methods: Case report and surgical technique. This case report describes a 29-year-old female who developed a dysesthesic filtering bleb following the implantation of a glaucoma drainage device. The employed surgical technique to address this complication involved the drainage of aqueous from the bleb using a 30-G needle, which effectively reduced its height. Subsequently, a compression suture was applied to maintain an appropriate bleb size.

Results: With the presented surgical technique, the ultimate control of an overhigh filtering bleb associated to a glaucoma drainage device was possible. Following the procedure, the patient's symptoms and the corneal thinning linked to the bleb's excessive size were successfully managed. Furthermore, the anatomy of the filtering bleb was preserved, and an optimal intraocular pressure outcome was achieved.

Conclusions: The removal of aqueous and the application of a compression suture are two surgical techniques traditionally used for managing the hypertensive phase of glaucoma drainage devices and for alleviating discomfort from blebs after classical filtering surgery, respectively. In the case presented, the combination of these two techniques effectively reduced the size of an excessively high filtering bleb associated with a glaucoma drainage device. This approach successfully resolved the patient's discomfort and corneal issues related to this complication.

Purpose: To investigate whether diurnal changes in biometric parameters at different times of the day are visible and to analyze whether the variations could have clinical significance in the process of intraocular lens (IOL) power calculation.

Methods: Phakic eyes measured by IOLMaster 700 above the age of 16 were included, with the exclusion of previous surgery. Measurements were taken between 7:00 and 15:00 and data were treated in hourly groups within this range. Data such as age, sex and biometric parameters (axial length (AL), anterior chamber depth, central corneal thickness, white-to-white distance, keratometry readings, lens thickness) were used besides the hour:minute time of the examination.

Results: Biometric data from 32,596 eyes were used (38.89% males). There were no statistically significant differences in age and biometric parameters between the office-hour groups (p > 0.05), excluding the AL. The AL at the end of the day was 0.198 mm longer for male and 0.197 mm longer for female compared to the beginning of the office day. Accordingly, the results of IOL power calculation varied between 21.0 and 20.0 D for male, and 21.5 D and 20.5 D for the female population.

Conclusion: The results suggest that the assessment of AL may be affected by the intraday time of the biometry. This variation is clinically significant and may have implications for the evaluation of AL.