bluuebunny/crossref_metadata_2025_split huggingface dataset:
LONG-TERM ANALYSIS OF INTRASCLERAL FIXATION OF INTRAOCULAR LENS
Authors: Byun Zeeyoon , Kim Dong IK , Kong Mingui 
Published: February 2023

Purpose:To compare the long-term outcomes of sutureless intrascleral fixation of the intraocular lens versus sutured scleral fixation.Methods:The authors retrospectively analyzed the medical records of patients who underwent intrascleral fixation of the intraocular lens using two different techniques: trocar–cannula–based sutureless fixation and sutured scleral fixation. Clinical outcomes were compared before and 1-, 3-, 6-, and 12-month follow-ups after the operation.Results:A total of 51 patients were followed over a 12-month period after the operation, including 28 eyes in the sutureless group and 23 eyes in the sutured group. Best-corrected visual acuity and spherical equivalent values reached targeted values faster in the sutureless scleral fixation of the intraocular lens. However, no significant difference was observed between the two groups. For intraocular lens capture, there was a statistically significant difference observed in the incidence of postoperative complications, which was demonstrated by one eye in the sutureless group and seven in the sutured group (P= 0.009). To exclude the effect of corneal astigmatism, surgically induced astigmatism was calculated based on the astigmatism value 1 year after surgery. It was found that the sutureless technique significantly reduced the occurrence of astigmatism (2.43 ± 1.42 vs. 1.65 ± 0.94,P= 0.031).Conclusion:In a 1-year follow-up period, the trocar–cannula–based sutureless technique was reliable and effective. Sutureless fixation was associated with fewer postoperative complications and lower surgically induced astigmatism values than those with sutured fixation.
COMPLEX HEMODYNAMICS OF INTERVORTEX VEIN ANASTOMOSES IN HIGHLY MYOPIC EYES
Authors: Lu Hongshuang , Xie Shiqi , Xiong Jianping , Chen Changyu , Wang Yining , Moriyama Muka , Kamoi Koju , Uramoto Kengo , Ohno-Matsui Kyoko 
Published: February 2023

Purpose:
To analyze the complex pattern of filling of the intervortex vein (IVV) anastomoses through large trunks in highly myopic eyes based on indocyanine green angiographic (ICGA) videos.

Methods:
The medical records of 1,060 consecutive highly myopic eyes that had undergone ICGA were studied. IVV anastomoses were identified in the ICGA images, and the ICGA images and videos were analyzed comprehensively to characterize their hemodynamic features.

Results:
Seven eyes with IVV anastomoses through large trunks were analyzed. In the ICGA videos of six eyes, laminar flow was observed in the IVV anastomotic vessels. The laminar flow started in the arterial phase in two eyes, with pulsatile fashion in 1 of them. The flow began in the early arteriovenous transition phase in four eyes. The laminar flow continued for a mean of 12.17 ± 3.06 seconds, and the remaining section was gradually filled slower than the surrounding veins. The anastomotic trunk for the remaining one eye was too narrow to be analyzed. Four eyes had longitudinal ICGA records, and two had significant attenuation and narrowing of the anastomotic vessels.

Conclusion:
The very early filling of part of the IVV anastomoses suggests that arteriovenous anastomoses are involved in the IVV of highly myopic eyes. However, this suggestion needs further study. There may be similar pathogenesis for IVV anastomoses either in thick or thin sclera.
Evaluation of Corneal Parameters and Meibomian Gland Alterations After Corneal Cross-Linking in Patients With Progressive Keratoconus
Authors: Balıkçı Ayşe Tüfekçi , Ulutaş Hafize Gökben 
Published: February 2023

Objectives:
The aim of the study was to evaluate the changes in corneal parameters and meibomian gland alterations after corneal cross-linking (CXL) for progressive keratoconus.

Methods:
Thirty nine eyes of 39 keratoconus patients were treated with CXL. Corneal topography, specular microscopy, the Ocular Surface Disease Index© (OSDI), noninvasive tear break-up time (NITBUT), and meibography indices were evaluated preoperatively and at the first, third, and sixth months after CXL.

Results:
The flattest keratometry (K1) (P=0.003), steepest keratometry (K2) (P<0.001), apex, central, and thinnest corneal thicknesses (P<0.001) showed significant differences after cross-linking, whereas the changes in the maximum keratometry (Kmax) were not significant (P=0.140). The endothelial cell density, coefficient of variation, and hexagonality were unchanged. The NITBUT values decreased after cross-linking; however, there was no significant change in OSDI index (P=0.313), meiboscore (P=0.392), and meibomian gland loss degrees (P=0.300). No change was detected in the morphology of the meibomian glands after CXL.

Conclusion:
In eyes with keratoconus, a flattening in keratometry readings and thinning in corneal thickness were observed after CXL. The corneal endothelium is protected by dextran-free riboflavin. Cross-linking procedure causes dry eye by changing the corneal structure without affecting the morphology of the meibomian glands.
Pediatric Phlyctenular Keratoconjunctivitis at a Tertiary Care Center in the United States
Authors: Kaufman Aaron R. , Chhadva Priyanka , Bontu Sneha , Bueno Carmen S. , Jain Sandeep , Tu Elmer Y. , D'Jalilian Ali R. , Sugar Joel , Cortina Maria Soledad 
Published: February 2023

Purpose:
The aim of this study was to evaluate characteristics and outcomes of pediatric phlyctenulosis at a tertiary care center in the United States.

Methods:
A retrospective cohort study of phlyctenulosis diagnosis in patients younger than 18 years was conducted. Demographics, presenting features, treatment regimens, and outcomes were analyzed.

Results:
Seventy patients (95 eyes) with phlyctenulosis were identified. Fifty-four patients (77.1%) were Hispanic, which was greater than the center's proportion of pediatric patients identifying as Hispanic (53.8%, P < 0.0001). Common comorbidities included adjacent external/lid disease (82.9%), allergic/atopic disease (18.6%), and viral infections (8.6%). Nine patients had tuberculosis testing which was negative in all cases. Five patients had vitamin A testing which revealed deficiency in 1 patient. Treatment regimens were diverse and included varying combinations of topical and systemic medications. Complications included corneal scarring (27.4%), corneal neovascularization (40.0%), amblyopia (16.8%), corneal perforation (3.2%), and severe limbal stem-cell deficiency (1.1%). 26.3% of affected eyes had final visual acuity worse than 20/40. Differences in rates of corneal complications between Hispanic and non-Hispanic patients were not statistically significant, although severe corneal complications including perforation occurred only in the Hispanic group.

Conclusions:
This study presents a modern cohort of phlyctenulosis at a tertiary center in the United States and includes a larger proportion of Hispanic patients than expected. Phlyctenulosis carries high corneal morbidity and may frequently result in reduced visual acuity. Similar rates of corneal complications were seen in Hispanic versus non-Hispanic patients, but severe corneal complications were seen only in the Hispanic group.
Mini-Conjunctival Limbal Autograft (Mini-CLAU) Using Platelet-Rich Plasma Eye Drops (E-PRP): A Case Series
Authors: Baradaran-Rafii Alireza , Heidari-Keshel Saeed , Behnaz Nazanin , Alemzadeh-Ansari Mohammadhasan , Feizi Sepehr , Hassanpour Kiana , Sadoughi Mohammad-Mehdi , Filutowski Oliver , Ghahari Mohammadreza 
Published: February 2023

Purpose:The purpose of this study was to introduce a new method of limbal stem cell transplantation using autologous platelet-rich plasma (E-PRP) eye drops for unilateral total limbal stem cell deficiency.Methods:Patients with total unilateral limbal stem cell deficiency due to chemical burn underwent mini-conjunctival limbal autograft using autologous E-PRP drops. One small limbal block, measuring 2 × 2 mm, was harvested from the patients' contralateral healthy eye and transplanted to the diseased eye. All patients received E-PRP drops until achieving complete corneal epithelialization. Subsequent corneal transplantation was performed in eyes with significant stromal opacification. Corneal buttons obtained during corneal transplantation underwent immunohistochemistry for the evaluation of limbal stem cell markers (ABCG2 and P63). Visual acuity, epithelial healing, corneal clarity, and regression of corneal conjunctivalization/vascularization were evaluated after surgery.Results:Ten patients with acid (n = 7) or alkali (n = 3) burn were included. The mean follow-up period was 21.7 ± 5.8 months (range, 12–32 months). Corneas were completely reepithelialized within 14.9 ± 3.5 days (range, 11–21 days). Corneal conjunctivalization/vascularization dramatically regressed 1 to 2 months after surgery in all cases, and corneal clarity considerably improved in 7 patients. In the 3 eyes with significant stromal opacification, subsequent optical penetrating keratoplasty was performed. The ocular surface was stable throughout the follow-up period in all eyes. BSCVA improved to 0.60 ± 0.0.32 and 0.46 ± 0.0.25 logMAR in eyes with and without corneal transplantation, respectively, at the final follow-up visit. ABCG2 and P63 markers were detected on corneal buttons after keratoplasty.Conclusions:Based on our clinical and laboratory findings, mini-conjunctival limbal autograft using E-PRP can be considered as a promising alternative to ocular surface reconstruction.
Cross-Linking Improves the Quality of Life of People With Keratoconus: A Cross-Sectional and Longitudinal Study From the Save Sight Keratoconus Registry
Authors: Kandel Himal , Chen Jern Yee , Sahebjada Srujana , Chong Elaine W. , Wiffen Steven , Watson Stephanie L. 
Published: February 2023

Purpose:
The purpose of this study was to comprehensively evaluate the patient-reported quality-of-life (QoL) outcomes after corneal cross-linking for keratoconus.

Methods:
This Save Sight Keratoconus Registry study used cross-sectional and longitudinal designs. For the cross-sectional study, 532 patients with keratoconus (mean age 30.9 ± 11.9 years; 31.6% female) completed the Keratoconus Outcomes Research Questionnaire (KORQ) and 343 patients with keratoconus (mean age 28.3 ± 10.7 years; 32.7% female) completed the Impact of Vision Impairment (IVI) questionnaires. Similarly, for the longitudinal study, 39 patients (mean age 24.2 ± 8.4 years; 23.1% female) completed the KORQ and 16 patients (mean age 27.9 ± 17.1 years; 50.0% female) completed the IVI questionnaire before and after 6 months of cross-linking. The QoL data were analyzed using the Andrich Rating Scale Model of Rasch analysis.

Results:
For both cross-sectional and longitudinal studies, the KORQ and IVI scales demonstrated satisfactory psychometric properties [ordered and well-spaced categories, variance explained by the measure 52%–73%, person separation index 2.4–3.9, and fit statistics <1.3 (most cases)]. The patients who had not undergone corneal cross-linking had worse mean activity limitation than those with cross-linking (P = 0.008). However, the differences in symptoms and emotional scores between the groups were not statistically significant (both P > 0.05). The longitudinal study showed that cross-linking was associated with improved activity limitation, symptoms, and emotional scores.

Conclusions:
The KORQ and IVI are psychometrically robust tools to evaluate the QoL outcomes of corneal cross-linking. Cross-linking is associated with improved activity limitation, symptoms, and emotional status.
Incidence, Clinical Profile, and Management of Keratitis Caused by Uncommon Species of Pseudomonas at a Tertiary Eye Care Center
Authors: Thamizhselvi Sinouvassane , Pooja Andhare , Prajna Lalitha , Rameshkumar Gunasekaran , Prajna Numperumalsamy Venkatesh , Karpagam Rajarathinam 
Published: February 2023

Purpose:
The purpose of this study was to study the incidence, demographic features, clinical course, profiling, and management of uncommon species of Pseudomonas keratitis (other than Pseudomonas aeruginosa) at a tertiary eye care center.

Methods:
Thirty cases of culture-proven uncommon species of Pseudomonas keratitis between January 2017 and December 2021 were retrospectively studied. The incidence, demographic and clinical profile, predisposing factors, microbial results, treatment, and visual outcomes were analyzed. We evaluated the risk factors for poor treatment outcomes.

Results:
Among bacterial keratitis cases, uncommon species of Pseudomonas keratitis occurred at a rate of 2.2%. The mean age at presentation was 51.37 years, and the most common predisposing factor was corneal trauma (36.7%). The mean best corrected visual acuity (BCVA) [in log of minimum angle of resolution (logMAR)] at presentation was 1.99, and the mean ulcer size was 5.75 mm. On culture, 56.7% of the cases were identified as Pseudomonas putida, 26.7% as Pseudomonas stutzeri, 10% as Pseudomonas mendocina, and 3.3% each of Pseudomonas oryzihabitans and Pseudomonas alcaligenes. We recorded good treatment responses in 66.7% of cases with the medical therapy of a combination of broad-spectrum antibiotics, whereas 33.3% of cases required surgical intervention. The risk factors for poor clinical outcome were older age, ocular trauma, previous ocular surgeries, poor BCVA at presentation, large ulcer size, delayed treatment, hypopyon, and early complications such as perforation, limbal involvement, and total ulcer.

Conclusions:
Uncommon species of pseudomonas keratitis was more closely related to predisposing factors such as corneal trauma and other factors such as previous ocular surgeries, older age, large ulcers, longer duration of treatment, early surgical intervention in complicated cases, and poor visual outcome.
Corneal Fourier and Belin–Ambrósio Enhanced Ectasia Analysis in Healthy 4-Year-Old White Children
Authors: Bajtl Dunja , Bjeloš Mirjana , Bušić Mladen , Ćurić Ana , Biuk Dubravka , Barać Josip 
Published: February 2023

Purpose:
The aim of this study was to provide normative databases of Fourier analysis (FA) and Belin–Ambrósio enhanced ectasia display (BAD) in healthy White 4-year-old emmetropic children.

Methods:
FA parameters analyzed were spherical component (SRmin), spherical eccentricity (SEcc), maximal decentration (MD), regular astigmatism at the center (Astigm. C) and periphery (Astigm. P), and irregularity (I). The parameters obtained by BAD included summary indicator BAD D, anterior corneal curvature (K1 and K2, D), maximal keratometry (Kmax, D), maximal Ambrósio relational thinnest (ART max), and pachymetric and BAD indices.

Results:
Eighty-nine eyes of eighty-nine 4-year-old children were included. The mean values of FA parameters were the following: SRmin 7.77, SEcc 0.600, MD 0.160, Astigm. C 0.070, Astigm. P 0.050, and I 0.019. The mean K1 and K2 in our study group were 42.92 ± 1.29 D and 43.75 ± 1.41 D, with the mean BAD D value 0.42 ± 0.67. The mean PPI min 0.629 ± 0.117, PPI max 1.059 ± 0.155, PPI avg 0.847 ± 0.103, Kmax 44.10 ± 1.39, and median of ART max 515.0 were recorded. No statistically significant differences between male and female sex in any of FA or BAD parameters were found.

Conclusions:
This is the first study providing large normative data on FA and BAD in 4-year-old White emmetropic children. We proposed a cutoff D value for early ectasia and clinical keratoconus in 4-year-old children.
Results from the Primary Tube Versus Trabeculectomy Study and translation to clinical practice
Authors: Gedde Steven J. , Vinod Kateki , Prum Bruce E. 
Published: February 2023

Purpose of review
The Primary Tube Versus Trabeculectomy (PTVT) Study is a multicenter randomized clinical trial comparing the safety and efficacy of tube shunt surgery and trabeculectomy with mitomycin C (MMC) in eyes without previous incisional ocular surgery. This article reviews results from the PTVT Study and suggests how they may be translated to clinical practice.

Recent findings
Tube shunt surgery had a higher failure rate than trabeculectomy with MMC in the PTVT Study, and the difference was statistically significant at 1 year but not at 3 years and 5 years. Both surgical procedures reduced intraocular pressure (IOP) to the low teens throughout 5 years of follow-up. Mean IOPs were lower after trabeculectomy with MMC compared with tube shunt implantation, and the differences were statistically significant during the first postoperative year and at 3 years. The greater IOP reduction after trabeculectomy with MMC was achieved with significantly fewer glaucoma medications relative to tube shunt placement. Surgical complications were common in the PTVT Study, but most were transient and self-limited. The incidence of early postoperative complications was significantly higher after trabeculectomy with MMC than tube shunt surgery. The rates of late postoperative complications, cataract progression, and vision loss were similar with both surgical procedures. Serious complications producing vision loss and/or requiring a reoperation to manage the complication developed more frequently after trabeculectomy with MMC compared with tube shunt surgery, and the difference was statistically significant at 1 year but not at 3 years and 5 years postoperatively.

Summary
Tube shunt implantation and trabeculectomy with MMC are both viable surgical options for managing glaucoma in patients without previous incisional ocular surgery. Results from the PTVT Study support further expansion of tube shunt use beyond refractory glaucomas.
Remdesivir Use in Pediatric Patients for SARS-CoV-2 Treatment: Single Academic Center Study
Authors: Samuel Allison M. , Hacker Larissa L. , Zebracki Jessica , Bogenschutz Monica C. , Schulz Lucas , Strayer Jill , Vanderloo Joshua P. , Cengiz Pelin , Henderson Sheryl 
Published: February 2023

Background:
Millions of children in the United States have been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with many infections leading to hospitalization. For pediatric patients, especially younger children, treatment options are limited. Remdesivir has demonstrated a positive safety and efficacy profile in adults, but little data is published regarding remdesivir use in pediatric patients. Additional data for SARS-CoV-2 treatments in pediatric patients is required to prevent further SARS-CoV-2–related morbidity and mortality. At a single pediatric academic medical center, the safety and efficacy of remdesivir was evaluated.

Methods:
A retrospective review of patients admitted to a pediatric academic medical center who received remdesivir over a 17-month period was completed. All pediatric patients who received at least 1 dose of remdesivir were included. Safety and efficacy were assessed using national organization’s definitions of clinical improvement, bradycardia, hypertension, acute kidney injury and drug-induced liver injury.

Results:
There were 48 pediatric patients included in this study with 29% of patients admitted to the pediatric intensive care unit. Less than one-third of patients received the full treatment course of remdesivir, with over half of patients not completing therapy due to symptomatic improvement or hospital discharge. Majority of patients required some level of supplemental oxygen support. The median World Health Organization score was consistent throughout all 5 days of therapy. No patients experienced significant bradycardia, hypertension, acute kidney injury, or drug-induced liver injury.

Conclusions:
Remdesivir may correlate with clinical stability or improvement and demonstrates safety when used in pediatric patients. A randomized controlled trial is needed to confirm these findings.
To Evaluate the Efficacy of Diagnostic Periocular Punch Biopsy: Using a 4-mm Dermatology Punch
Authors: Burgess Nada R. , Rathore Deepa , Gao Anna , Johnson Andria , Ahluwalia Harpreet S. 
Published: February 2023

Purpose:
The dermatological punch biopsy is a minimally invasive procedure that provides conclusive diagnosis when managing periocular lesions. It aids with establishing histological diagnosis and subtype thereby facilitating management planning and eliminates the risk of unnecessary tissue sacrifice. The present literature provides limited evidence evaluating the value of punch biopsy in diagnosing periocular lesions.

Methods:
A retrospective case note analysis of 400 consecutive 4-mm periocular punch biopsies performed between 2005 and 2016, from 353 patients was undertaken at a single institution. Three hundred fifty-nine lesions had an initial definite clinical diagnosis of malignancy (group A) and the remaining 41 lesions had an uncertain clinical diagnosis with enough suspicion to merit a biopsy (group B).

Results:
In group A, 75.5% (n = 271) of the biopsies verified the clinical diagnosis of malignancy and 24.5% (n = 88) were benign. In group B, 70.7% (n = 29) of the lesions were benign and 29.3% (n = 12) were malignant and were subsequently treated as group A. Only 4, group A biopsies, which underwent formal excision, did not initially diagnose a malignancy (punch biopsy was repeated) providing a sensitivity of 98.6% and a specificity of 100%. One hundred seventeen were found to be benign avoiding unnecessary tissue sacrifice in 29.25% of cases.

Conclusion:
Our study provides the largest sample size in the literature that evaluates a 4-mm diagnostic periocular punch biopsy in managing eyelid lesions. In 29.5% of punch biopsies, unnecessary tissue sacrifice was avoided as they were histologically benign. The authors found that punch biopsies for lesions <7 mm carry a risk of inadvertent excision of lesion.
Automated Precision Pulse Capsulotomy Versus Manual Capsulorhexis In White Cataracts: Reduction In Procedural Time And Resource Utilization
Authors: Ifantides Cristos , Sretavan David 
Published: February 2023

Abstract

Purpose:
To compare the utility of Precision Pulse Capsulotomy (PPC) with manual capsulorhexis for capsulotomy in white cataracts.

Setting:
Hospital-based academic practice.

Design:
Retrospective analysis of surgical case records and surgical videos from a single surgeon.

Methods:
Cases involving intumescent and non-intumescent white cataracts were identified. Capsulotomy outcomes, surgical outcomes, procedural time, and resource utilization as well as patient demographic and health data were analyzed and subjected to statistical testing.

Results:
15 cases of white cataract (10 Intumescent, 5 non-intumescent) performed using Continuous Curvilinear Capsulorhexis (CCC) were compared to 20 cases (9 Intumescent, 11 non-intumescent) performed using PPC. The cases covered a period of 14 months prior to and 30 months following surgeon adoption of PPC. There were no significant differences between the 2 groups in subject age, sex, ethnicity, ocular history, medical history and medications. PPC resulted in complete capsulotomies without tags or tears and intracapsular IOL implantation with 360-degree capsular overlap in all 20 cases. There was one CCC case resulting in the Argentinian Flag sign. Compared to CCC, PPC white cataract cases also demonstrated significant advantages in capsulotomy time, reduced use of trypan blue and ophthalmic viscosurgical device (OVD), and less overall procedural time.

Conclusions:
PPC is a safe and highly effective method to create consistent capsulotomies in both intumescent and non-intumescent white cataracts. The use of PPC provides benefits of significant reductions in capsulotomy time, overall procedural time and resource utilization resulting in a streamlined treatment of these complex cataract surgery cases.