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Background: Laser Peripheral Iridotomy (LPI) is a commonly performed procedure resulting in a reduction in the risk of progression to Acute Angle Closure and subsequent glaucoma. Whilst demand for LPI has varied over the previous 25 years, non-medical clinicians have been increasingly utilised in the delivery of ophthalmic laser procedures. There is, however, a paucity of safety and effectiveness of optometrist-performed LPI.

Method: This was a retrospective study. The success rate was determined by the presence of a patent LPI at the first appointment post-procedure. Adverse events were captured from electronic patient letters from the procedure until the first appointment post-procedure.

Results: Two optometrists performed LPI on 105 eyes. Presence of a patent iridotomy was documented in 93% and 89% for optometrist one and two, respectively (n = 95). Transient adverse events were reported in four patients. The remaining 10 eyes underwent a redo LPI.

Conclusion: Optometrists delivered a safe and effective LPI service with low rate of adverse events and high success rates.

Background: There is a growing burden that highlights the need for ophthalmology research to improve treatment outcomes and patient care. By promoting transparency, reproducibility, and collaboration, Data Sharing Statements (DSS) provide a formal declaration of whether and how data can be accessed, reused, or shared, ensuring that research findings can be validated. This study examines the prevalence, content, and implementation of DSS in ophthalmology journals from 2018 to 2023.

Methods: A comprehensive literature search in MEDLINE (PubMed) was conducted to evaluate clinical studies published in ten leading ophthalmology journals between January 1, 2018, and December 14, 2023. Data extraction was conducted via a standardized form in a masked, duplicate fashion. A hierarchical logistic regression was used to assess factors with potential influence on DSS inclusion. A qualitative analysis was performed to identify common themes in DSS.

Results: Of the 1385 articles analyzed, 326 (23.54%) included a DSS, with notable variability in DSS inclusion between journals. The British Journal of Ophthalmology had the highest DSS rate (152/228, 66.67%), while Investigative Ophthalmology and Visual Science had the lowest (4/103, 3.88%). Clinical trials were the most observed study design; however, DSS rates were low (183/667; 27%). Factors including study design, impact factor, funding type, and article access did not significantly influence DSS inclusion. The most common DSS themes were Conditional Data Availability (199/302, 65.89%) and Gatekeeper Role (87/302, 28.81%).

Conclusion: Implementing stronger mandates and adopting standardized data-sharing policies could address barriers to data-sharing practices, improving transparency and reproducibility in ophthalmology research.

Objective: A systematic review and meta-analysis evaluating the peer-reviewed literature describing the efficacy of the Paul glaucoma implant (PGI) in managing intraocular pressure (IOP) and its outcomes.

Methods: Comprehensive searches were conducted across major databases to identify relevant studies. The analysis focused on glaucoma patients who underwent PGI. The primary outcomes included failure rate, success rates (complete and qualified), reduction in IOP and post-operative complications. Reduction in medication use was assessed as secondary outcome. A random-effects model was applied for the meta-analysis, and pooled estimates were calculated using Comprehensive Meta-Analysis software.

Results: Out of the 255 articles screened, six studies met the eligibility criteria with a total sample of 267 eyes. In glaucoma patients receiving the PGI, complete (56.4%) and qualified success rates were 56.4 and 80.3% respectively. The mean reduction in IOP was 13.62 mmHg, demonstrating a significant difference vs baseline (p < 0.0001). Furthermore, there was a significant reduction in medications by 2.80 (p < 0.0001).The average rate of hypotony (all definitions) was 5.12%.

Conclusion: This meta-analysis provides evidence supporting the efficacy of PGI in controlling intraocular pressure and achieving good outcomes for glaucoma patients.

The Hydrus Microstent (HM) and iStent inject W are two widely used trans-trabecular bypass devices and can be combined with phacoemulsification for glaucoma patients undergoing cataract surgery.

Aim: To compare the efficacy and safety of the HM with triple iStent inject W devices (TiSW) devices combined with phacoemulsification in a real-world setting over 3 years of follow-up.

Methods: A prospective, consecutive, quasi-experimental, longitudinal study was conducted on open-angle glaucoma patients at a subspecialty cataract and glaucoma private practice in Brisbane, Australia. Outcomes included yearly changes from preoperative values in mean IOP and mean number of glaucoma medications; proportional shifts across IOP and number of glaucoma medication categories at preoperative and yearly time points, and hazard ratio for time to failure based on the American Academy of Ophthalmology combined minimally invasive glaucoma surgery criteria. Multi-level mixed effects regression modelling with inverse probability of treatment weighting was used to estimate the treatment effect while accounting for repeated measurements, clustering, confounding, and imbalances in baseline covariates.

Results: Of the 105 cases, 56 (53.3%) phacoemulsification cases were combined with the HM and 49 (46.7%) were combined with the TiSW. At 3 years, the mean IOP reduction in the HM was 2.6 mmHg (from 15.1 to 12.5 mmHg), while the TiSW showed a reduction of 2.0 mmHg (from 15.2 to 13.2 mmHg). No significant between-group differences in estimated changes in mean IOP from preoperative values were found at years 1, 2, and 3 (all Holm adjusted p = 1.00). Significant reductions in the estimated mean number of medications were observed in both groups at 3 years. The changes in mean number of medications from preoperative values at yearly timepoints were not statistically significant between groups (all Holm adjusted p = 1.00). The 3-year reduction was 1.3 medications in the HM (from a total of 2.3 to 1.0) and 1.4 medications in the TiSW (from a total of 2.2 to 0.8), resulting in a difference of 0.1 (95% CI: -0.6, 0.8). The proportions of eyes that were medication-free at 3 years were 54.3% in the HM group and 61.2% in the TiSW group. The intraoperative safety of the HM and TiSW was good, with no significant complications.

Conclusion: This study has shown that both HM and TiSW provide effective IOP reduction and medication reduction in glaucoma patients undergoing combined cataract surgery at up to 3 years follow-up. Both devices were well-tolerated. Surgeon preference may guide device selection, with specific considerations for patients such as extremes of ocular size or anticoagulation therapy.