Journal of Clinical & Translational Ophthalmology

Objective: The purpose of this study is to investigate the effect of low-dose atropine and dual-focus MiSight contact lenses on myopia control. Methods: This study included a retrospective review of patients (5–13 years old) started on MiSight contacts or 0.05% atropine with a ≥1-year follow-up. Outcomes included cycloplegic refraction, axial length measurement, and side effects. The right eyes were included in analyses. Results: One hundred children were treated with MiSight lenses (n = 55) or 0.05% atropine (n = 45) at an average age of 10.4 ± 2.1 years and 8.4 ± 2.5 years, respectively. At the 1-year follow-up, there was no difference from baseline in spherical equivalent or axial length in the MiSight group (p = 0.61, p = 0.98) or in the atropine group (p = 0.78, p = 0.97). Further, subgroup analysis based on age at treatment initiation (<9.5 years vs. ≥9.5 years) showed no age difference in baseline or final spherical equivalent and axial length in either the MiSight group or the atropine group. Linear regression analysis demonstrated no association between initial age and baseline spherical equivalent, baseline axial length, or the change in spherical equivalent in either the MiSight or atropine group. Conclusions: There was no significant difference in spherical equivalent or axial length after 1 year of treatment with either the MiSight contact lenses or 0.05% atropine eye drops. However, the limited sample size, the difference in age and ethnicity, and baseline refraction prevent a direct comparison between the two treatment groups.

Background: Trabeculectomy and minimally invasive glaucoma surgery (MIGS) such as goniotomy aim to reduce intraocular pressure (IOP) and medication burden but are often performed in patients with differing disease severity. Methods: We retrospectively reviewed 100 eyes from 76 adults with glaucoma that underwent either goniotomy (n = 50; Kahook Dual Blade = 42, OMNI = 8) or trabeculectomy ab externo (n = 50) at a tertiary center between May 2022 and June 2023, with at least six months of follow-up. Baseline and six-month IOP, number of medications, and postoperative complications were recorded. Eyes undergoing trabeculectomy had higher preoperative IOP than those undergoing goniotomy (22.6 ± 7.7 vs. 19.1 ± 5.9 mmHg). Results: At six months, trabeculectomy achieved a greater absolute IOP reduction (8.8 ± 0.8 vs. 5.4 ± 0.8 mmHg; p = 0.004), likely reflecting higher baseline IOP, while goniotomy yielded a larger medication reduction (1.47 ± 0.30 vs. 0.72 ± 0.20; p = 0.041). Hyphema occurred more often after trabeculectomy, and the small number of OMNI cases precluded device comparison. Conclusions: In this short-term retrospective series, trabeculectomy achieved larger absolute IOP reduction whereas goniotomy offered greater medication reduction, highlighting the need to individualize surgical choice and confirm these findings in larger prospective studies.

Background: This study evaluates the incidence and outcomes of patients with dropped nucleus/nuclear fragment during phacoemulsification surgery; Methods: Retrospective review of continuous cases with dropped nucleus/nuclear fragment during phacoemulsification cataract surgery from January 2020 to December 2024. Demographic and perioperative data were collected and analysed. A good visual outcome was defined as a postoperative best-distance visual acuity of ≥6/12; Results: A total of 91,883 cases of planned phacoemulsification cataract surgery were identified, of which 175 (0.19%) were complicated by a dropped nucleus/lens fragment. Mean age was 71 years and median number of days from primary procedure to secondary fragmatome was 5 days. Good visual outcomes were achieved in 127 cases (73%). Median final intraocular pressure was 13 mmHg. Most patients required two (63%) or three (29%) operations in total and none developed endophthalmitis. Hypermature cataracts were present in 70 cases (40%) and were significantly associated with poor visual outcomes (p = 0.003). Surgeon grade and other pre-existing ocular co-pathologies known to increase posterior capsular rupture risk were not significantly associated with poor visual outcomes; Conclusions: Overall incidence and outcomes of cases complicated with dropped nucleus/fragment were favourable despite the presence of pre-existing risk factors. Emergent management is paramount to ensure good outcomes in patients.