Pub Date : 2023-10-09DOI: 10.1080/17469899.2023.2267763
Bharat Gurnani, Kirandeep Kaur
ABSTRACTIntroduction Ocular surface squamous neoplasia (OSSN) is a broad pathological entity that includes squamous neoplasm of conjunctival and corneal tissue. These various malignancies include conjunctival intraepithelial neoplasia (CIN), corneal epithelial dysplasia, squamous cell carcinoma (SCC), and mucoepidermoid carcinoma. OSSN diagnosis rests on exfoliative cytology, vital dyes, and imaging in the form of confocal microscopy and anterior segment optical coherence tomography. The medical management modalities are topical chemotherapy (Mitomycin C and 5 fluorouracil), immunotherapy (Interferon alpha 2b), and upcoming drugs, such as antivirals, anti-VEGF, and retinoic acid. Excision biopsy with no touch technique remains the gold standard for managing OSSN. However, surgery can lead to recurrence and unfavorable results in some cases.Areas Covered This article provides insights into the treatment aspects of OSSN with an overview of recent updates. The authors have discussed the current concept regarding the medical and surgical management of OSSN. The authors also dwell upon the recent updates along with the expert opinion.Expert Opinion- Although surgery remains the gold standard, topical drugs have revolutionized the management of OSSN. Patients should be closely followed up to look for any side effects. Cost, time duration, cosmesis, and side are the remaining major factors in deciding for medical versus surgical therapy.KEYWORDS: Ocular surface squamous neoplasiamitomycin C5-fluorouracilinterferon alpha 2bexcision biopsy Article highlights Ocular surface squamous neoplasia (OSSN) is a diverse ocular pathology that includes squamous neoplasm of conjunctival and corneal tissueThe important diagnostic modality includes exfoliative and impression cytology, vital dyes, high resolution anterior segment optical coherence tomography, and confocal microscopy.The medical management options of OSSN can be chemotherapeutic agents and immunotherapy.The gold standard for OSSN management is surgical excision biopsy by no touch technique and cryotherapy to the margins.The recent advances in OSSN management comprises human papilloma virus vaccine, light-activated belzupacap sarotalocan, verteporfin, cidofovir, bevacizumab, retinoic acid, and aloe vera.Declaration of interestsThe authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, or patents received or pending, or royaltiesReviewer disclosuresPeer reviewers on this manuscript have no relevant financial or other relationships to disclose.Additional informationFundingThis paper was not funded.
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Pub Date : 2023-10-07DOI: 10.1080/17469899.2023.2268285
Steffani Krista Someda, Yasuhiro Takahashi
KEYWORDS: dacryoadenitisidiopathic orbital inflammationimmunoglobulin G4-related diseaselacrimal gland biopsyorbital lymphoma
关键词:泪腺炎;特发性眼眶炎;免疫球蛋白g4相关疾病
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ABSTRACTIntroduction The management of keratoconus has been changed significantly due to the advancement of technology in the field of contact lens materials and designs and introduction of new surgical approaches that aim to avoid or postpone corneal transplantation until the advanced stage of the disease. Deep anterior lamellar keratoplasty (DALK) has the advantage of preserving the patient’s own endothelium and eliminating endothelial graft rejection. Since the recent trend is to perform corneal transplantation mainly for severe keratoconus that are not amenable to other less invasive approaches, this review aims to provide an update on the outcomes of DALK in eyes with the advanced stage of keratoconus.Areas covered A comprehensive literature review of studies in English was conducted using the following keywords: “deep anterior lamellar keratoplasty” or “anterior lamellar keratoplasty” or “DALK” and “keratoconus” and “severe” or “advanced.”Expert commentary DALK significantly improves vision and refraction in advanced keratoconus and provides favorable graft survival. Femtosecond laser seems to improve the technique of the DALK procedure, and future developments could improve the reproducibility of DALK even further. However, current data is inconclusive for the benefit of femtosecond laser-assisted DALK for advanced keratoconus.KEYWORDS: Keratoconusadvanced stagecorneal transplantationdeep anterior lamellar keratoplastyDALKDisclaimerAs a service to authors and researchers we are providing this version of an accepted manuscript (AM). Copyediting, typesetting, and review of the resulting proofs will be undertaken on this manuscript before final publication of the Version of Record (VoR). During production and pre-press, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal relate to these versions also. Article highlightsAs surgeons gain more experience and modify their techniques, DALK has emerged as an acceptable alternative to PK for advanced keratoconus when other less invasive approaches have failed to restore vision.Compared to PK, DALK has a superior safety profile as it eliminates the risk of endothelial graft rejection and preserves globe integrity against trauma.Despite improved safety, the visual and refractive outcomes after DALK can be inferior to those achieved after PK in advanced keratoconus eyes.Femtosecond laser has been used for the DALK procedure to increase the rate of successful big-bubble formation, decrease the rate of intraoperative Descemet membrane perforation, and provide better visual and refractive outcomes.Femtosecond laser-assisted DALK in the present form shows limited benefit, therefore, surgical design and parameters still need to be optimized.A medical economics study is required to assess the cost-effectiveness of laser-assisted DALK techniques in this particular subgroup of patients.AbbreviationsAS-OCT=Anterior segment optical coherence tomographyCDVA
由于隐形眼镜材料领域的技术进步，设计和引入新的手术方法，旨在避免或推迟角膜移植，直到疾病的晚期，圆锥角膜的治疗已经发生了重大变化。深前板层角膜移植术(DALK)具有保留患者自身内皮和消除内皮移植排斥反应的优点。由于最近的趋势是角膜移植主要用于严重圆锥角膜，而这些严重圆锥角膜无法采用其他侵入性较小的方法，因此本综述旨在提供晚期圆锥角膜DALK的最新结果。使用以下关键词:“深前板层角膜移植术”或“前板层角膜移植术”或“DALK”和“圆锥角膜”和“严重”或“进展”，对英文研究进行了全面的文献综述。专家评论DALK可显著改善晚期圆锥角膜患者的视力和屈光，并提供良好的移植物存活率。飞秒激光似乎改进了DALK过程的技术，未来的发展可以进一步提高DALK的可重复性。然而，目前的数据还不确定飞秒激光辅助的DALK对晚期圆锥角膜的益处。【关键词】角膜圆锥;晚期角膜移植;深前板层角膜成形术(dalk)免责声明:作为对作者和研究人员的服务，我们提供此版本的已接受稿件(AM)。在最终出版版本记录(VoR)之前，将对该手稿进行编辑、排版和审查。在制作和印前，可能会发现可能影响内容的错误，所有适用于期刊的法律免责声明也与这些版本有关。随着外科医生获得更多的经验和改进他们的技术，当其他侵入性较小的方法无法恢复视力时，DALK已成为晚期圆锥角膜患者PK的可接受替代方法。与PK相比，DALK具有更高的安全性，因为它消除了内皮移植排斥的风险，并保持了创伤的全球完整性。尽管安全性有所提高，但在晚期圆锥角膜患者中，DALK术后的视力和屈光效果可能不如PK术后。飞秒激光已被用于DALK手术，以提高大泡形成的成功率，降低术中网膜穿孔的发生率，并提供更好的视力和屈光效果。目前形式的飞秒激光辅助DALK的效益有限，因此，手术设计和参数仍需优化。需要一项医学经济学研究来评估激光辅助DALK技术在这一特定亚组患者中的成本效益。缩写as - oct =前段光学相干断层扫描cdva =矫正距离视力d =DiopterDALK=深前板层角膜成形术mm=毫米- μm=微孔soct =光学相干断层扫描ypk =穿透性角膜成形术udva =未矫正距离视力利益声明作者与任何组织或实体没有任何关联或经济参与与本文所讨论的主题或材料有经济利益或经济冲突手稿。这包括雇佣、咨询、酬金、股票所有权或期权、专家证词、获得或未决的赠款或专利，或特许权使用费。审稿人披露本文的每位审稿人没有相关的财务或其他关系需要披露。图1:描述筛选过程的文献检索流程图。附加信息本文未获得资助。
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Pub Date : 2023-10-06DOI: 10.1080/17469899.2023.2268289
Di Huang, Sam McLenachan, Fred K. Chen
ABSTRACTIntroduction ABCA4-associated Stargardt disease (STGD1) leads to bilateral central vision loss and is responsible for 12% of inherited retinal disease-related blindness.The lack of approved treatments highlights the urgent need for effective therapies.Areas covered This review explores personalized treatments for STGD1, focusing on therapeutic alternative splicing, genome editing, and translational read-through technologies. Literature searches as of July 2023 were undertaken via PubMed.Expert opinion Significant progress has been made in sequencing technology revealing the complexities of theABCA4 locus. Comprehensive functional assays now enable the determination of pathogenicity for ABCA4variants of uncertain significance. These breakthroughs facilitate the application of gene expression modulation technologies, ushering in a new era of personalized therapeutics. By targeting the ABCA4 gene and manipulating its expression, tailored treatments can address ABCA4-associated STGD1, offering enhanced efficacy and precise interventions based on the individual’s genetic profile. These advancements provide hope to those affected by STGD1, with improved treatment options and the potential to prevent vision loss. The convergence of genetic analysis breakthroughs and gene expression modulation technologies revolutionizes our understanding and treatment of inherited disorders, unlocking a promising frontier in personalized therapeutics. This transformative approach to STGD1 holds promise for similar breakthroughs in other inherited conditions.KEYWORDS: ABCA4inherited retinal diseasejuvenile macular dystrophypersonalized therapeuticsantisense oligonucleotidestherapeutic alternative splicinggene editingCRISPRbase editorprime editingDisclaimerAs a service to authors and researchers we are providing this version of an accepted manuscript (AM). Copyediting, typesetting, and review of the resulting proofs will be undertaken on this manuscript before final publication of the Version of Record (VoR). During production and pre-press, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal relate to these versions also. Article highlightsAutosomal recessive Stargardt disease (STGD1) is a common monogenic inherited retinal dystrophy that leads to bilateral central vision loss and is responsible for 12% of IRD-related blindness.The spectrum of retinopathy associated with STGD1 includes childhood-onset cone-rod dystrophy, late-onset STGD1 with foveal sparing, and rapid-onset chorioretinopathy phenotype.STGD1 is caused by bi-allelic variants in the ATP-binding cassette transporter subfamily A4 gene (ABCA4) gene, which encodes the ABCA4 protein responsible for importing specific retinoid compounds in photoreceptor cells.Variable accumulation of cytotoxic lipofuscin-related fluorophores, such as A2E, is determined by combined deleterious effect of the biallelic ABCA4 variants and contributes to phenotypic varia
{"title":"Advances towards personalized therapies for Stargardt disease","authors":"Di Huang, Sam McLenachan, Fred K. Chen","doi":"10.1080/17469899.2023.2268289","DOIUrl":"https://doi.org/10.1080/17469899.2023.2268289","url":null,"abstract":"ABSTRACTIntroduction ABCA4-associated Stargardt disease (STGD1) leads to bilateral central vision loss and is responsible for 12% of inherited retinal disease-related blindness.The lack of approved treatments highlights the urgent need for effective therapies.Areas covered This review explores personalized treatments for STGD1, focusing on therapeutic alternative splicing, genome editing, and translational read-through technologies. Literature searches as of July 2023 were undertaken via PubMed.Expert opinion Significant progress has been made in sequencing technology revealing the complexities of theABCA4 locus. Comprehensive functional assays now enable the determination of pathogenicity for ABCA4variants of uncertain significance. These breakthroughs facilitate the application of gene expression modulation technologies, ushering in a new era of personalized therapeutics. By targeting the ABCA4 gene and manipulating its expression, tailored treatments can address ABCA4-associated STGD1, offering enhanced efficacy and precise interventions based on the individual’s genetic profile. These advancements provide hope to those affected by STGD1, with improved treatment options and the potential to prevent vision loss. The convergence of genetic analysis breakthroughs and gene expression modulation technologies revolutionizes our understanding and treatment of inherited disorders, unlocking a promising frontier in personalized therapeutics. This transformative approach to STGD1 holds promise for similar breakthroughs in other inherited conditions.KEYWORDS: ABCA4inherited retinal diseasejuvenile macular dystrophypersonalized therapeuticsantisense oligonucleotidestherapeutic alternative splicinggene editingCRISPRbase editorprime editingDisclaimerAs a service to authors and researchers we are providing this version of an accepted manuscript (AM). Copyediting, typesetting, and review of the resulting proofs will be undertaken on this manuscript before final publication of the Version of Record (VoR). During production and pre-press, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal relate to these versions also. Article highlightsAutosomal recessive Stargardt disease (STGD1) is a common monogenic inherited retinal dystrophy that leads to bilateral central vision loss and is responsible for 12% of IRD-related blindness.The spectrum of retinopathy associated with STGD1 includes childhood-onset cone-rod dystrophy, late-onset STGD1 with foveal sparing, and rapid-onset chorioretinopathy phenotype.STGD1 is caused by bi-allelic variants in the ATP-binding cassette transporter subfamily A4 gene (ABCA4) gene, which encodes the ABCA4 protein responsible for importing specific retinoid compounds in photoreceptor cells.Variable accumulation of cytotoxic lipofuscin-related fluorophores, such as A2E, is determined by combined deleterious effect of the biallelic ABCA4 variants and contributes to phenotypic varia","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135351195","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 : 2023-10-04DOI: 10.1080/17469899.2023.2267179
Federico Rissotto, Riccardo Sacconi, Aurelio Apuzzo, Gloria Oldoni, Emanuele Fusi, Andrea Servillo, Francesco Bandello, Giuseppe Querques
ABSTRACTIntroduction Age-related Macular Degeneration (AMD) is one of the leading causes of irreversible visual acuity reduction among the elderly population. Dry AMD, the most frequent AMD form, is characterized by photoreceptor loss, Retinal Pigmented Epithelium (RPE) dysfunction and retinal degeneration. Although in the last years several clinical trials have been carried out and many therapeutic molecules have been examined to treat dry AMD, currently its treatment remains unsatisfactory.Areas covered In this review we report and analyze the most important molecules and treatment that have been studied and carried out till nowadays, and the future therapies that may be a hope in this complex and serious disease. We have provided a narrative review after having analyzed the literature and we have selected more than 120 papers to deliver this article.Expert opinion Although in 2023 has been carried out the first FDA approved drugs, there is still a long way to go in developing effective therapies for dry-AMD. In the future, a better understanding of its pathogenesis may lead to the development of targeted or genetic therapies that not only have an anatomical effect on the retina but also have a functional impact.KEYWORDS: Age related macular degenerationGeographic atrophydrusencomplement inhibitorsneuroprotectiongenetic therapyintravitreal injectionDisclaimerAs a service to authors and researchers we are providing this version of an accepted manuscript (AM). Copyediting, typesetting, and review of the resulting proofs will be undertaken on this manuscript before final publication of the Version of Record (VoR). During production and pre-press, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal relate to these versions also. Article highlightsIn this review we have summarized the most important molecules and trials that have been carried out till now in the attempt to treat dry-AMD.AREDS nutritional supplementation remains the standard of care for dry-AMD.In 2023 FDA has approved the first proven effect therapies for dry-AMD: Pegcetacoplan, and Avacincaptad Pegol.In the future, a genetic therapy focused on preventing and blocking the development of dry-AMD could be the most effective treatment, but at the present time, its development is at the embryonic stage.Declaration of InterestsR Sacconi has the following disclosures: Allergan Inc, Bayer Shering-Pharma, Medivis, Novartis, Zeiss.G Querques has the following disclosures: Alimera Sciences, Allergan Inc, Amgen, Bayer Shering-Pharma, Heidelberg, KBH, LEH Pharma, Lumithera, Novartis, Sandoz, Sifi, Sooft-Fidea, Zeiss.F Bandello has the following disclosures: Alcon (consultant), Alimera Sciences (consultant), Allergan Inc (consultant), Farmila-Thea (consultant), Bayer Shering-Pharma (consultant), Bausch and Lomb Genentech (consultant), Hoffmann-La-Roche (consultant), Novagali Pharma (consultant), Novartis (consultant), Sanofi-Aventis (consu
{"title":"What is on the horizon for dry age-related macular degeneration drug treatment?","authors":"Federico Rissotto, Riccardo Sacconi, Aurelio Apuzzo, Gloria Oldoni, Emanuele Fusi, Andrea Servillo, Francesco Bandello, Giuseppe Querques","doi":"10.1080/17469899.2023.2267179","DOIUrl":"https://doi.org/10.1080/17469899.2023.2267179","url":null,"abstract":"ABSTRACTIntroduction Age-related Macular Degeneration (AMD) is one of the leading causes of irreversible visual acuity reduction among the elderly population. Dry AMD, the most frequent AMD form, is characterized by photoreceptor loss, Retinal Pigmented Epithelium (RPE) dysfunction and retinal degeneration. Although in the last years several clinical trials have been carried out and many therapeutic molecules have been examined to treat dry AMD, currently its treatment remains unsatisfactory.Areas covered In this review we report and analyze the most important molecules and treatment that have been studied and carried out till nowadays, and the future therapies that may be a hope in this complex and serious disease. We have provided a narrative review after having analyzed the literature and we have selected more than 120 papers to deliver this article.Expert opinion Although in 2023 has been carried out the first FDA approved drugs, there is still a long way to go in developing effective therapies for dry-AMD. In the future, a better understanding of its pathogenesis may lead to the development of targeted or genetic therapies that not only have an anatomical effect on the retina but also have a functional impact.KEYWORDS: Age related macular degenerationGeographic atrophydrusencomplement inhibitorsneuroprotectiongenetic therapyintravitreal injectionDisclaimerAs a service to authors and researchers we are providing this version of an accepted manuscript (AM). Copyediting, typesetting, and review of the resulting proofs will be undertaken on this manuscript before final publication of the Version of Record (VoR). During production and pre-press, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal relate to these versions also. Article highlightsIn this review we have summarized the most important molecules and trials that have been carried out till now in the attempt to treat dry-AMD.AREDS nutritional supplementation remains the standard of care for dry-AMD.In 2023 FDA has approved the first proven effect therapies for dry-AMD: Pegcetacoplan, and Avacincaptad Pegol.In the future, a genetic therapy focused on preventing and blocking the development of dry-AMD could be the most effective treatment, but at the present time, its development is at the embryonic stage.Declaration of InterestsR Sacconi has the following disclosures: Allergan Inc, Bayer Shering-Pharma, Medivis, Novartis, Zeiss.G Querques has the following disclosures: Alimera Sciences, Allergan Inc, Amgen, Bayer Shering-Pharma, Heidelberg, KBH, LEH Pharma, Lumithera, Novartis, Sandoz, Sifi, Sooft-Fidea, Zeiss.F Bandello has the following disclosures: Alcon (consultant), Alimera Sciences (consultant), Allergan Inc (consultant), Farmila-Thea (consultant), Bayer Shering-Pharma (consultant), Bausch and Lomb Genentech (consultant), Hoffmann-La-Roche (consultant), Novagali Pharma (consultant), Novartis (consultant), Sanofi-Aventis (consu","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135590464","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 : 2023-09-28DOI: 10.1080/17469899.2023.2264508
Nimesh C. Patel, Avinash Pathengay, Mudit Tyagi, Rajeev Reddy Pappuru, Vivek Pravin Dave
ABSTRACTIntroduction Cataract surgery is the most commonly performed intraocular surgery all over the world. Endophthalmitis is a sight-threatening complication subsequent to intraocular procedures, open-globe injuries, metastatic systemic infections, and systemic inflammatory diseases. The incidence of post-cataract surgery endophthalmitis is 0.012% to 1.3%.Areas covered Patients’ ocular surface flora, surgical instruments, and surgical complications like posterior capsule rupture with vitreous loss and anterior vitrectomy. The most common bacteria causing post-cataract endophthalmitis in the Western world are gram-positive coagulase-negative Staphylococci, followed by Streptococci and Pseudomonas aeruginosa. Povidone-iodine (PI) is the only topical prophylactic antiseptic known to reduce endophthalmitis perioperatively with a three to five times reduction rate within one minute of irrigation. The European Society of Cataract & Refractive Surgeons (ESCRS) study recommendations are also discussed.Expert opinion There are no randomized controlled trials of PI with endophthalmitis rate as the primary end point. Based on retrospective data, 5% PI applied to conjunctiva prior to surgery reduced endophthalmitis rates four-fold. Intracameral injection of either vancomycin, cefazoline, cefuroxime, or moxifloxacin has a prophylactic effect. We recommend using preoperative 5% povidone-iodine for 30 seconds in the cul-de-sac and intracameral moxifloxacin or cefuroxime as effective prophylaxis against post-operative endophthalmitis.KEYWORDS: Endophthalmitisprophylaxisintracameral antibioticsintracameral moxifloxacinpovidone-iodineDisclaimerAs a service to authors and researchers we are providing this version of an accepted manuscript (AM). Copyediting, typesetting, and review of the resulting proofs will be undertaken on this manuscript before final publication of the Version of Record (VoR). During production and pre-press, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal relate to these versions also. Declaration of interestThe authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.Reviewer disclosuresPeer reviewers on this manuscript have no relevant financial or other relationships to disclose.Table 2 Identified Risk factors and associationDownload CSVDisplay TableAdditional informationFundingThis paper was supported by funds from the Hyderabad Eye Research Foundation.
{"title":"Minimizing the risk of endophthalmitis following cataract surgery: Current antibiotic approaches","authors":"Nimesh C. Patel, Avinash Pathengay, Mudit Tyagi, Rajeev Reddy Pappuru, Vivek Pravin Dave","doi":"10.1080/17469899.2023.2264508","DOIUrl":"https://doi.org/10.1080/17469899.2023.2264508","url":null,"abstract":"ABSTRACTIntroduction Cataract surgery is the most commonly performed intraocular surgery all over the world. Endophthalmitis is a sight-threatening complication subsequent to intraocular procedures, open-globe injuries, metastatic systemic infections, and systemic inflammatory diseases. The incidence of post-cataract surgery endophthalmitis is 0.012% to 1.3%.Areas covered Patients’ ocular surface flora, surgical instruments, and surgical complications like posterior capsule rupture with vitreous loss and anterior vitrectomy. The most common bacteria causing post-cataract endophthalmitis in the Western world are gram-positive coagulase-negative Staphylococci, followed by Streptococci and Pseudomonas aeruginosa. Povidone-iodine (PI) is the only topical prophylactic antiseptic known to reduce endophthalmitis perioperatively with a three to five times reduction rate within one minute of irrigation. The European Society of Cataract & Refractive Surgeons (ESCRS) study recommendations are also discussed.Expert opinion There are no randomized controlled trials of PI with endophthalmitis rate as the primary end point. Based on retrospective data, 5% PI applied to conjunctiva prior to surgery reduced endophthalmitis rates four-fold. Intracameral injection of either vancomycin, cefazoline, cefuroxime, or moxifloxacin has a prophylactic effect. We recommend using preoperative 5% povidone-iodine for 30 seconds in the cul-de-sac and intracameral moxifloxacin or cefuroxime as effective prophylaxis against post-operative endophthalmitis.KEYWORDS: Endophthalmitisprophylaxisintracameral antibioticsintracameral moxifloxacinpovidone-iodineDisclaimerAs a service to authors and researchers we are providing this version of an accepted manuscript (AM). Copyediting, typesetting, and review of the resulting proofs will be undertaken on this manuscript before final publication of the Version of Record (VoR). During production and pre-press, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal relate to these versions also. Declaration of interestThe authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.Reviewer disclosuresPeer reviewers on this manuscript have no relevant financial or other relationships to disclose.Table 2 Identified Risk factors and associationDownload CSVDisplay TableAdditional informationFundingThis paper was supported by funds from the Hyderabad Eye Research Foundation.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135385927","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 : 2023-09-25DOI: 10.1080/17469899.2023.2263170
Jae-Chiang Wong, Jordan Safran, Shahin Hallaj, Eric Shiuey, Connie Wu, Daniel Lee
ABSTRACTIntroduction Trabeculectomy (TB) with mitomycin C (MMC) is a mainstay of glaucoma surgery for intraocular pressure reduction and visual field preservation, but surgical outcomes are often limited by episcleral and subconjunctival fibrosis leading to intraocular pressure (IOP) spikes.Research Design and Methods Retrospective case series presents seven eyes at a tertiary glaucoma center where open bleb needling was performed in combination with a collagen matrix implant and MMC following failed TB due to excessive fibrosis.Results Seven eyes of seven patients were included. Baseline IOP was 23.9 (±7.4) mmHg with a significant decrease on post-operative (post-op) day 1 to 4.6 mmHg. By post-op month 1, all eyes maintained a non-hypotonus IOP ≥ 5. Notably, four eyes (57%) had at least 1 unsuccessful open bleb needling without a collagen matrix implant prior. All eyes were complication-free by the latest visit without any complication-related visual decline, and six eyes (86%) were glaucoma medication-free at the most-recent post-op follow-up (12.4 ± 11.4 months). All cases were performed by one experienced glaucoma subspecialist (author DL).Conclusions Open bleb needling and MMC in combination with a collagen matrix implant may result in improved and sustained IOP control for encapsulated blebs following failed trabeculectomy, especially in those with prior unsuccessful bleb revisions.KEYWORDS: Ologenglaucomacollagen matrixbleb revisionfailed trabeculectomy Author contributionsAll authors made significant contributions to the research design and to the preparation of the manuscript. J.C. Wong, J. Safran, S. Hallaj and D. Lee were responsible for the execution of the research and data acquisition. J.C. Wong was responsible for the data analysis and interpretation.Declaration of interestD. Lee has received research support from Allergan, Equinox, Glaukos, Mati, Nicox, Olleyes, and Santan, lecture fees from Glaukos, and consulting fees from Quidel Eye Health. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.Reviewer disclosuresPeer reviewers on this manuscript have no relevant financial or other relationships to disclose.Additional informationFundingThis paper was not funded.
摘要:小梁切除术(TB)联合丝裂霉素C (MMC)是青光眼手术中降低眼压和保护视野的主要方法，但手术结果往往受到导致眼压(IOP)峰值的膜外和结膜下纤维化的限制。研究设计和方法回顾性病例系列介绍了三期青光眼中心的7只眼睛，在由于过度纤维化导致结核病失败后，开放水泡针刺联合胶原基质植入和MMC。结果7例患者共7只眼。基线IOP为23.9(±7.4)mmHg，术后第1天显著下降至4.6 mmHg。术后1个月，所有眼保持非低张力IOP≥5。值得注意的是，有4只眼睛(57%)在没有胶原基质植入的情况下至少有1次不成功的开泡穿刺。术后随访(12.4±11.4个月)6只眼(86%)无青光眼药物治疗。所有病例均由一位经验丰富的青光眼专科医生(作者DL)进行手术。结论开放泡针和MMC联合胶原基质植入可改善小梁切除术失败后包裹性泡的IOP控制，特别是对先前不成功的泡修复患者。关键词:骨胶原青光眼胶原基质;修改;小梁切除术失败;作者贡献所有作者在研究设计和论文准备中都做出了重要贡献。J.C. Wong, J. Safran, S. Hallaj和D. Lee负责研究和数据采集的执行。J.C. Wong负责数据分析和解释。利益申报Lee获得了Allergan、Equinox、Glaukos、Mati、Nicox、Olleyes和Santan的研究支持，Glaukos的讲话费和Quidel Eye Health的咨询费。除了披露的内容外，作者与任何组织或实体没有其他相关关系或财务参与，这些组织或实体与稿件中讨论的主题或材料有经济利益或经济冲突。审稿人披露本文的每位审稿人没有相关的财务或其他关系需要披露。本文未获得资助。
{"title":"Clinical outcomes of collagen matrix as adjuvant to open bleb revision with mitomycin C following failed trabeculectomy","authors":"Jae-Chiang Wong, Jordan Safran, Shahin Hallaj, Eric Shiuey, Connie Wu, Daniel Lee","doi":"10.1080/17469899.2023.2263170","DOIUrl":"https://doi.org/10.1080/17469899.2023.2263170","url":null,"abstract":"ABSTRACTIntroduction Trabeculectomy (TB) with mitomycin C (MMC) is a mainstay of glaucoma surgery for intraocular pressure reduction and visual field preservation, but surgical outcomes are often limited by episcleral and subconjunctival fibrosis leading to intraocular pressure (IOP) spikes.Research Design and Methods Retrospective case series presents seven eyes at a tertiary glaucoma center where open bleb needling was performed in combination with a collagen matrix implant and MMC following failed TB due to excessive fibrosis.Results Seven eyes of seven patients were included. Baseline IOP was 23.9 (±7.4) mmHg with a significant decrease on post-operative (post-op) day 1 to 4.6 mmHg. By post-op month 1, all eyes maintained a non-hypotonus IOP ≥ 5. Notably, four eyes (57%) had at least 1 unsuccessful open bleb needling without a collagen matrix implant prior. All eyes were complication-free by the latest visit without any complication-related visual decline, and six eyes (86%) were glaucoma medication-free at the most-recent post-op follow-up (12.4 ± 11.4 months). All cases were performed by one experienced glaucoma subspecialist (author DL).Conclusions Open bleb needling and MMC in combination with a collagen matrix implant may result in improved and sustained IOP control for encapsulated blebs following failed trabeculectomy, especially in those with prior unsuccessful bleb revisions.KEYWORDS: Ologenglaucomacollagen matrixbleb revisionfailed trabeculectomy Author contributionsAll authors made significant contributions to the research design and to the preparation of the manuscript. J.C. Wong, J. Safran, S. Hallaj and D. Lee were responsible for the execution of the research and data acquisition. J.C. Wong was responsible for the data analysis and interpretation.Declaration of interestD. Lee has received research support from Allergan, Equinox, Glaukos, Mati, Nicox, Olleyes, and Santan, lecture fees from Glaukos, and consulting fees from Quidel Eye Health. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.Reviewer disclosuresPeer reviewers on this manuscript have no relevant financial or other relationships to disclose.Additional informationFundingThis paper was not funded.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135816186","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 : 2023-09-22DOI: 10.1080/17469899.2023.2262766
Alex Hui
{"title":"Antibiotic releasing contact lenses: the future of treatment for corneal infection and injury?","authors":"Alex Hui","doi":"10.1080/17469899.2023.2262766","DOIUrl":"https://doi.org/10.1080/17469899.2023.2262766","url":null,"abstract":"","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136060807","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 : 2023-09-14DOI: 10.1080/17469899.2023.2259613
Charles W McMonnies
ABSTRACTIntroduction Dryness symptoms in soft contact lens (SCL) wearers are common, especially at the end of the day, and are the most common reason for discontinuing wear.Areas covered With references to mechanisms for dry eye syndromes in non-SCL wearers, this review examines mechanisms whereby dryness symptoms are generated during SCL wear, including the significance of endogenous tear dysfunctions, pre-lens tear film instability, post-lens tear film volumes and stagnation, tear hyperosmolarity, blink inefficiency, SCL material dehydration, and front surface biocompatibility and wetness.Expert opinion Numerous efforts have been made to reduce dryness symptoms by improving SCL materials and surfaces, but the prevalence of dryness symptoms remains stubbornly high. It is possible that symptoms might be due to neuropathy and associated increases in corneal and/or lid wiper sensitivity that develops during SCL wear. For example, over time sensory thresholds for SCL awareness may be lowered and/or conditions that increase their perception sharpened. There are several mechanisms for contributions to thinner pre-lens tear films and reduced SCL biocompatibility. Dryness symptoms may occur with bandage SCL, perhaps especially in a previous wearer of SCL.KEYWORDS: Dry eyecontact lensOcular surfaceCorneaTearssymptomsDisclaimerAs a service to authors and researchers we are providing this version of an accepted manuscript (AM). Copyediting, typesetting, and review of the resulting proofs will be undertaken on this manuscript before final publication of the Version of Record (VoR). During production and pre-press, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal relate to these versions also. Declaration of interestsThe author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.Reviewer disclosuresPeer reviewers on this manuscript have no relevant financial or other relationships to disclose.Article highlightsEvidence does not support the expectation that the division of the pre-corneal tear film into two layers by a SCL is a contributor to subsequent quantitative or qualitative aqueous, lipid or mucus deficiency and the risk of lens dehydration.Any SCL-related reduction in aqueous production, combined with increased rates of aqueous loss by evaporation (shorter TBUT), could explain lower tear meniscus heights during SCL wear.Insulation of the cornea from normal atmospheric blink stimuli by a SCL may contribute to aqueous production deficiency and/or blink inefficiency, with associated increased lens drying. For example, corneal insulation from blink stimuli such as exposure to air movement, dust and po
{"title":"Mechanisms for the symptoms of dryness in soft contact lens wearers","authors":"Charles W McMonnies","doi":"10.1080/17469899.2023.2259613","DOIUrl":"https://doi.org/10.1080/17469899.2023.2259613","url":null,"abstract":"ABSTRACTIntroduction Dryness symptoms in soft contact lens (SCL) wearers are common, especially at the end of the day, and are the most common reason for discontinuing wear.Areas covered With references to mechanisms for dry eye syndromes in non-SCL wearers, this review examines mechanisms whereby dryness symptoms are generated during SCL wear, including the significance of endogenous tear dysfunctions, pre-lens tear film instability, post-lens tear film volumes and stagnation, tear hyperosmolarity, blink inefficiency, SCL material dehydration, and front surface biocompatibility and wetness.Expert opinion Numerous efforts have been made to reduce dryness symptoms by improving SCL materials and surfaces, but the prevalence of dryness symptoms remains stubbornly high. It is possible that symptoms might be due to neuropathy and associated increases in corneal and/or lid wiper sensitivity that develops during SCL wear. For example, over time sensory thresholds for SCL awareness may be lowered and/or conditions that increase their perception sharpened. There are several mechanisms for contributions to thinner pre-lens tear films and reduced SCL biocompatibility. Dryness symptoms may occur with bandage SCL, perhaps especially in a previous wearer of SCL.KEYWORDS: Dry eyecontact lensOcular surfaceCorneaTearssymptomsDisclaimerAs a service to authors and researchers we are providing this version of an accepted manuscript (AM). Copyediting, typesetting, and review of the resulting proofs will be undertaken on this manuscript before final publication of the Version of Record (VoR). During production and pre-press, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal relate to these versions also. Declaration of interestsThe author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.Reviewer disclosuresPeer reviewers on this manuscript have no relevant financial or other relationships to disclose.Article highlightsEvidence does not support the expectation that the division of the pre-corneal tear film into two layers by a SCL is a contributor to subsequent quantitative or qualitative aqueous, lipid or mucus deficiency and the risk of lens dehydration.Any SCL-related reduction in aqueous production, combined with increased rates of aqueous loss by evaporation (shorter TBUT), could explain lower tear meniscus heights during SCL wear.Insulation of the cornea from normal atmospheric blink stimuli by a SCL may contribute to aqueous production deficiency and/or blink inefficiency, with associated increased lens drying. For example, corneal insulation from blink stimuli such as exposure to air movement, dust and po","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134970228","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 : 2023-09-03DOI: 10.1080/17469899.2023.2267757
Steffani Krista Someda, Yasuhiro Takahashi
{"title":"Applications of three-dimensional printing technology in Oculoplastic and Orbital Surgery: updates and trends","authors":"Steffani Krista Someda, Yasuhiro Takahashi","doi":"10.1080/17469899.2023.2267757","DOIUrl":"https://doi.org/10.1080/17469899.2023.2267757","url":null,"abstract":"","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134949742","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}
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