The latest medical research on Ophthalmology

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about ophthalmology gathered by our medical AI research bot.

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Absence of Posterior Vitreous Detachment Is a Risk Factor of Severe Bleb-Related Endophthalmitis.

J Ophthalmol

Bleb-related endophthalmitis (BRE) after glaucoma surgery is an infection caused by bacteria in the avascular bleb gaining access into the eye. We report the clinical features and outcome of 10 consecutive eyes with severe BRE treated at our hospital.

Ten patients (10 eyes) with stage IIIb BRE after trabeculectomy diagnosed and treated at the Department of Ophthalmology, Tokyo Medical University, between April 2013 and May 2015, were studied. Patient background, type of glaucoma, interval from the first trabeculectomy, pretreatment bleb findings, causative microorganisms, surgical methods, status of posterior vitreous detachment (PVD), and postoperative visual acuity were examined.

The 10 patients comprised 8 males and 2 females, with mean age of 70.6 years at BRE onset. The types of glaucoma were open-angle glaucoma in 7 patients, neovascular glaucoma in 2, and secondary glaucoma in 1. All eyes underwent trabeculectomy combined with mitomycin C prior to the development of BRE. The interval from the first glaucoma surgery to onset of endophthalmitis was 8.5 ± 4.1 years. Examination of the bleb revealed leakage of aqueous humor from the avascular bleb in all eyes. Bacteria were isolated from intraocular samples of 8 eyes; namely, Viridans streptococci in 5 eyes, Staphylococcus epidermidis in 1, Branhamella catarrhalis in 1, and coagulase-negative Staphylococci in 1. BRE was treated by vitrectomy in 9 eyes and enucleation in 1 eye. PVD was produced intentionally during vitrectomy in 6 eyes. Histopathological examination of the enucleated eye showed no PVD. Visual acuity improved by 3 lines or more in 6 patients, while decimal visual acuity remained lower than 0.1 in 4 patients.

BRE developed frequently in eyes with no PVD. The absence of PVD may be a risk factor of severe BRE.

Intraoperative Complications of Cataract Surgery Using Intracameral Illumination in the Elderly over 75 Years.

J Ophthalmol

To evaluate intraoperative complications and utilization of adjunctive devices between microscope and intracameral illuminations during cataract surgery in the elderly over 75 years.

A retrospective, consecutive, interventional case series Participants. Two hundred eighty-six eyes of 184 patients older than 75 years who underwent cataract surgery using microscope and intracameral illuminations.

A chart review was performed on an advanced cataract surgery group of 141 consecutive cases in which the intracameral illumination was used and on a standard cataract surgery group of 145 consecutive cases in which the intracameral illumination was not used.

Intraoperative complications (posterior capsule rupture, radial tear of the anterior capsule, dropped nucleus, or sulcus-implanted/sclera-fixated IOL) and utilization of adjunctive devices (pupil expansion device or anterior capsule staining).

The frequency of use of the pupil expansion device was lower in the advanced cataract surgery group than that in the standard cataract surgery group (0.7% vs 6.9%; p=0.007). Furthermore, the rates of a posterior capsule rupture and at least one intraoperative complication were lower in the advanced cataract surgery group than those in the standard cataract surgery group (0.7% vs 4.8%; p=0.067) (0.7% vs 7.6%; p=0.004).

In the current cohort of patients over 75 years, the rate of intraoperative complications was lower when using the intracameral illumination than that when using the conventional method. Cataract surgery using intracameral illumination would be good option for elderly people.

Long-Term Clinical Outcomes after Mix and Match Implantation of Two Multifocal Intraocular Lenses with Different Adds.

J Ophthalmol

To compare long-term clinical outcomes between patients with bilateral implantation of +3.0 diopter (D) multifocal intraocular lenses (IOLs) and mix and match implantation of +2.5 D and +3.0 D multifocal IOLs.

This retrospective observer-masked cohort study comprised 66 eyes of 33 patients with two different strategies of binocular multifocal IOLs implantation: bilateral +3.0 D (17 patients) (bilateral group) and mix and match +2.5 D and +3.0 D (16 patients) (blended group). Patients were recruited 1 year (±3 months) after second-eye surgery. The primary effectiveness endpoint was binocular uncorrected intermediate visual acuity (UCIVA) at 70 cm. The secondary assessments included binocular visual quality tests and quality-of-vision questionnaire.

The blended group showed clinically better UCIVA (0.10 ± 0.07 logMAR) at 70 cm than the bilateral group (0.26 ± 0.09 logMAR) with a difference of 0.16 ± 0.08 logMAR (P < 0.001). Similar binocular visual acuities were achieved between the two groups at the near and far distance. The binocular defocus curves showed better performance in the blended group from 50 cm to 1 m. The mean binocular contrast sensitivities under the photopic conditions with or without glare and mesopic condition without glare were clinically better in the blended group. Both the groups reported low rate of visual phenomena, high rate of spectacle independence, and satisfaction.

Comparing with bilateral implantation of +3.0 D multifocal IOLs during the cataract surgery, mix and match implantation of +2.5 D and +3.0 D multifocal IOLs provides a wider depth of binocular focus, especially for intermediate distances, and better binocular visual quality.

The Association of Oxidative Stress Status with Open-Angle Glaucoma and Exfoliation Glaucoma: A Systematic Review and Meta-Analysis.

J Ophthalmol

To systematically evaluate the associations between oxidative stress status and different types of glaucoma.

Systematic review and meta-analysis.

We searched PubMed, EMBASE, and the Web of Science for randomized controlled trials written in the English language between January 1, 1990, and November 30, 2016. A random effects model was used to estimate oxidative stress status along with weighted mean differences and 95% confidence intervals (CIs). A funnel plot analysis and Egger's test were performed to assess potential publication bias.

Oxidative stress status was abnormal and different in patients with OAG (open-angle glaucoma) and EXG (exfoliation glaucoma).

Blood TAS (total antioxidant status) was lower in the OAG group than in the control group, with a mean difference of 0.580 mmol/L (p < 0.0001, 95% CI = -0.668 to -0.492). The aqueous humor SOD (superoxide dismutase), GPX (glutathione peroxidase), and CAT (catalase) levels were higher in the OAG group than in the control group, with mean differences of 17.989 U/mL (p < 0.0001, 95% CI = 14.579-21.298), 12.441 U/mL (p < 0.0001, 95% CI = 10.423-14.459), and 1.229 fmol/mL (p=0.042, 95% CI = 0.043-2.414), respectively. Blood TAS was lower in the EXG group than in the control group, with a mean difference of 0.262 mmol/L (p < 0.0001, 95% CI = -0.393 to -0.132). However, there were no differences in blood TOS and aqueous humor TOS between the EXG group and the control group.

This meta-analysis indicates that OAG patients had a lower TAS in the blood and higher levels of SOD, GPX, and CAT in the aqueous humor, while EXG patients only had a decreased TAS in the blood.

Early Macular Angiography among Patients with Glaucoma, Ocular Hypertension, and Normal Subjects.

J Ophthalmol

To evaluate early macular circulation in open-angle glaucoma (OAG), normal-tension glaucoma (NTG), ocular hypertension (OHT), and healthy subjects via optical coherence tomography angiography (OCTA).

A retrospective cross-sectional study was conducted. Medical records were reviewed, and the patients who received OCTA examinations were divided into the OAG, NTG, OHT, and normal groups. The ophthalmic data including best-corrected visual acuity, spherical equivalent, intraocular pressure, central corneal thickness, central foveal thickness, visual field deviation, retinal nerve fiber layers thickness, and ganglion cell complex thickness were obtained from medical documents. For the macular area, the superficial vessel density (VD), deep VD, foveal avascular zone (FAZ), flow area of the outer retina, and flow area of the choriocapillaris were measured via OCTA and analyzed using the default vascular density analysis program in the same OCTA device.

A total of 70 eyes from 70 patients were analyzed in the current study. Significant differences in the intraocular pressure, central corneal thickness, visual field deviation, retinal fiber layer thickness, and ganglion cell complex thickness were observed in the patients in the glaucoma group at their last visits. The OAG and NTG groups evinced a lower superficial VD than did the control group, while the NTG group had a lower deep VD than the control group. The NTG group also had a larger FAZ than did the OHT group. The flow area of the outer retina in the OAG group was low relative to those of the OHT and control groups. No difference in choriocapillaris perfusion was observed among the groups.

The OAG and NTG patients demonstrated impaired vasculature before significant disease development could be observed. Furthermore, the differences in macular circulation may be associated with differences in the courses of disease between the glaucoma and OHT patients.

The Effects of Diabetic Duration on Lacrimal Functional Unit in Patients with Type II Diabetes.

J Ophthalmol

To observe ocular surface changes in Type II diabetic patients with different disease durations and to understand the correlations between clinical parameters and diabetic durations.

In this cross-sectional, prospective study, 51 healthy controls and 91 patients with Type II diabetes were enrolled. The diabetics were divided into 3 subgroups according to the disease duration, including duration <10 y group, 10 to 20 y group, and ≥21 y group. All subjects underwent clinical ocular examinations, including lipid layer thickness (LLT), blinking rate, tear meniscus height (TMH), noninvasive tear film break-up time (NI-BUT), meibography, superficial punctate keratopathy (SPK) scoring, corneal sensitivity, and Schirmer I test. They were also evaluated using the standard patient evaluation of eye dryness (SPEED) questionnaire.

SPEED score, meiboscore, SPK score, LLT, Schirmer I test, and corneal sensitivity differed significantly between the diabetic and healthy control groups. Further, SPEED score, Schirmer I test, corneal sensitivity, meiboscore, and blink rate significantly differed among the 3 diabetic subgroups and the control group. In diabetics, the SPEED score correlated with the SPK score, blink rate, TMH, and LLT; NI-BUT with TMH, LLT, and blink rate; TMH with the SPK score; Schirmer I test with the SPK score; and corneal sensitivity with the meiboscore. More importantly, the Schirmer I test, corneal sensitivity, and SPEED score negatively correlated with diabetic duration.

Diabetic duration is an important factor that affects functions of the lacrimal functional unit in patients with Type II diabetes. The trends of changes in the ocular parameters vary along the course of diabetes.

Epiretinal Membrane Surgery in Daily Clinical Practice: Results of a Proposed Management Scheme.

J Ophthalmol

To report the results of the epiretinal membrane (ERM) management guidelines followed in our center.

Patients with ERM seen between 2014 and 2015, with ≥2 years follow-up or who had undergone ERM surgery, were included. Corrected visual acuity (VA), lens status, and ERM configuration were recorded at each visit. Our guidelines for ERM are if VA is ≥20/30, observation is recommended unless there is moderate/intense metamorphopsia. Vitrectomy is recommended during follow-up if there is a drop >one line in VA with changes in ERM configuration. If VA at diagnosis is <20/30, vitrectomy is recommended. If visual loss is thought to be due to cataract, phacoemulsification is performed first and visual status reevaluated.

Ninety-nine eyes of 94 patients were included; 52 eyes underwent vitrectomy, and 47 eyes were monitored. From eyes with VA at diagnosis <20/30 (41 eyes), 8 eyes underwent isolated phacoemulsification: VA improved to ≥20/30. Vitrectomy was recommended but refused by 4 patients. The other 29 eyes underwent vitrectomy. Of the 58 eyes with VA at diagnosis ≥20/30, 5 underwent surgery due to metamorphopsia. Eighteen eyes underwent vitrectomy during follow-up. VA improved a mean of 0.13 logMAR (SD 0.30) after vitrectomy. There were no differences in mean VA improvement between eyes that underwent vitrectomy within six months of diagnosis (0.24, SD 0.32) and those that underwent surgery more than six months after diagnosis (mean 0.17, SD 0.17), p=0.106. Three eyes developed postsurgical complications with visual loss: persistent macular edema in one eye, two consecutive retinal detachments in one eye, and a central visual defect in another eye. At the end of follow-up, VA was similar in the observation group (0.14, SD 0.14) and in the vitrectomy group (0.16, SD 0.28), p=0.528.

Our proposed guidelines lead to visual preservation in most patients while limiting surgery and its possible complications.

Factors responsible for the development of carbon granuloma post transoral laser cordectomy.

Lasers in Medical Science

Our study was performed with an aim to analyse the factors responsible for the formation of a carbon granuloma (CG) following transoral laser micro...

Lasers for Becker's nevus.

Lasers in Medical Science

Becker's nevus is a common pigmented dermatosis, usually featured by ipsilateral pigmented patch with hypertrichosis. Becker's nevus is often treat...

Posterior laryngofissure using a surgical contact diode laser: an experimental feasibility study.

Lasers in Medical Science

To evaluate the feasibility of a 980-nm contact diode laser (CDL) as a method for creating a posterior laryngofissure in live pigs. Twenty-eight La...

Influence of Er:YAG laser pulse duration on the long-term stability of organic matrix and resin-dentin interface.

Lasers in Medical Science

The purpose of this study was to explore the influence of Er:YAG laser irradiation with different pulse durations on the organic matrix, micromorph...