Search Results (930)

Intrabody cage augmentation has emerged as a minimally invasive technique for anterior column reconstruction in Kümmell disease and osteoporotic burst fractures. These osteoporotic conditions lead to progressive vertebral collapse, kyphosis, and instability. While cement augmentation provides rapid pain relief, it often fails to reliably restore sagittal balance or ensure biological integration in advanced stages of collapse. Although conventional anterior corpectomy with long-segment posterior fusion can achieve satisfactory deformity correction, these procedures are associated with substantial surgical morbidity. In contrast, screw fixation alone often fails to withstand anterior loading, resulting in loss of correction or hardware failure. By adapting standard interbody devices for off-label intravertebral use, this technique utilizes the intravertebral cleft as a natural cavity to restore vertebral height and sagittal alignment while preserving adjacent intervertebral discs and reducing stress on posterior instrumentation. The surgical technique involves transpedicular access, meticulous curettage of necrotic tissue, and insertion of a cage packed with osteoinductive material. This approach minimizes surgical trauma and operative time compared with conventional corpectomy procedures. Reported outcomes from retrospective series suggest promising pain relief, maintenance of correction, and low complication rates. Collectively, current evidence suggests that intrabody cage augmentation may serve as a potential, less invasive surgical option, acting as an intermediate approach between cement augmentation and corpectomy. However, as the existing evidence remains preliminary, high-quality prospective comparative studies are required to establish definitive indications and long-term efficacy. Full article

The aim of this study is to determine the optimal functional size of laser peripheral iridotomy (LPI) for anterior chamber parameter improvement in primary angle-closure disease (PACD). This study evaluated 109 eyes from 62 consecutive phakic patients. Baseline and one-week post-LPI anterior segment OCT were utilized to measure anterior chamber volume (ACV), anterior chamber angle (ACA), and iridotomy dimensions. Data was analyzed using linear mixed-effects models (LMMs), generalized additive models (GAMs), and receiver operating characteristic (ROC) curves. Post-LPI, significant increases occurred in ACA 500 (+7.54°), ACV (+11.09 mm³), and gonioscopic grade. LMMs confirmed a positive association between iridotomy size and anatomical expansion. GAMs demonstrated a saturation effect for ACV improvement, plateauing at 0.1 mm² (narrow area) and 0.25–0.30 mm² (superficial area), while the ACA relationship remained predominantly linear. ROC analysis identified preliminary superficial area cutoffs of 0.14 mm² and 0.12 mm² as discriminators of above-median volumetric and angular response, respectively. These findings suggest that LPI size is an independent determinant of anatomical response, beyond simple patency. As a preliminary, hypothesis-generating target, a superficial iridotomy area of approximately 0.12–0.14 mm² was associated with above-median volumetric and angular response in this cohort. Prospective validation is required before these thresholds can be incorporated into clinical practice. Full article

Myocardial bridging (MB) is a congenital coronary anomaly characterized by systolic compression of the intramyocardial arterial segment and delayed early diastolic artery relaxation, resulting in reduced vessel luminal diameter in diastole. Current evidence suggests that MB, particularly in the left anterior descending artery, may cause anginal symptoms and/or myocardial ischemia through several different pathophysiological and cellular mechanisms acting independently or synergistically: (1) delayed early diastolic relaxation of intramyocardial arterial segment; (2) impaired endothelial-dependent vasodilation with vessel smooth muscle cell hyperactivity in the coronary artery with MB, especially within the bridged segment; (3) focal (septal) ischemia due to “septal steal” phenomenon; and (4) development and progression of an atherosclerotic lesion in the coronary artery segment proximal to MB. Patients with isolated-MB may also experience anginal pain and/or myocardial ischemia due to concomitant structural and/or functional abnormalities of the coronary microcirculation. Both MB and coronary microvascular dysfunction refer to a subgroup of patients with angina and/or ischemia with non-obstructive coronary arteries (ANOCA/INOCA). Therefore, it may be challenging to determine whether MB is causing anginal pain and/or ischemia, particularly since both phenomena have also been reported without MB’s existence. Therefore, comprehensive coronary physiology testing should be encouraged in patients with this coronary anomaly to identify the underlying cause of anginal pain and/or myocardial ischemia, enabling optimal therapeutic strategies in these patients. This review is focused on different pathophysiological and cellular mechanisms of MB-related angina and/or ischemia and future perspectives in the functional assessment of MB severity, bearing in mind the complexity of coronary physiology in the presence of this anomaly. Full article

Background/Objectives: Fuchs endothelial corneal dystrophy (FECD) affects not only the corneal endothelium and Descemet membrane, but also the corneal thickness, shape, and optical quality. This study aimed to evaluate the quantitative and qualitative corneal changes after a Descemet membrane endothelial keratoplasty (DMEK) in patients with FECD and to compare the postoperative remodeling between eyes with subclinical corneal edema (F-SCE) and those with clinically evident corneal edema (F-CE). Methods: This retrospective observational study included 48 eyes of 40 patients with FECD who underwent DMEK between April 2023 and October 2025. The following parameters were assessed preoperatively and at 6 months postoperatively: central corneal thickness (CCT), mean pupillary power (MPP), anterior and posterior corneal astigmatism, total corneal higher-order aberrations (HOAs), anterior and posterior optical path difference (OPD), point spread function (PSF), anterior and posterior corneal surface regularity (RMS/A), and Gullstrand anterior/posterior (A/P) and posterior/anterior (P/A) ratios. The corneal data was obtained using a CSO MS-39 (Costruzione Strumenti Oftalmici, Firenze, Italy). Results: In the F-SCE subgroup, significant postoperative improvement was observed in the CCT (Δ = −84.6 ± 48.1 µm, p < 0.001), MPP (Δ = −1.010 ± 2.183, p < 0.001), posterior corneal regularity (posterior RMS/A) (Δ = −0.117 ± 0.229, p = 0.004), and both Gullstrand ratios (A/P: Δ = +0.111 ± 0.089, p < 0.001; P/A: Δ = −0.078 ± 0.064, p < 0.001). No significant change was detected in the anterior corneal regularity, anterior or posterior astigmatic metrics, total corneal higher-order aberrations, or PSF. In the F-CE subgroup, the postoperative response was greater, with significant improvement in the BCVA, CCT, thinnest corneal point, MPP, anterior and posterior corneal astigmatism, cylinder, total corneal HOAs, anterior and posterior corneal HOAs, PSF, anterior and posterior corneal regularity, and both Gullstrand ratios. Compared with the F-SCE eyes, the F-CE eyes showed significantly greater postoperative change in most structural and optical parameters, although most 6-month postoperative values were no longer significantly different between groups. Conclusions: DMEK induced significant corneal remodeling in both subclinical and clinically evident FECD. The eyes with subclinical edema demonstrated meaningful recovery in visual acuity, pachymetry, and posterior corneal regularity, supporting the presence of functional corneal impairment before a clinically visible edema. The eyes with clinically evident edema showed a broader and greater postoperative response, while the final postoperative values largely converged between groups. Full article

Background/Objectives: Multiple impacted teeth are defined as the sequential impaction of more than two teeth in the alveolar bone, whether unilateral or multilateral. Multiple impactions are an uncommon and rare phenomenon demanding thorough treatment planning and careful execution, but data on the prevalence of multiple impactions is scarce in the literature. In cases of multiple impactions, clinicians generally perform a 3D assessment using CBCT to determine tooth positions, establish a sequence of surgical exposures, implement suitable traction, and utilise appropriate biomechanics. A multidisciplinary approach between orthodontists and oral surgeons is essential to achieve optimal results. Methods: This case report presents non-syndromic multiple impactions of three upper left permanent anterior teeth—21, 22, and 23—along with a retained supernumerary tooth preventing their eruption and a fused primary tooth. The primary teeth and the impacted supernumerary tooth were surgically removed. A digitally designed transpalatal arch was used to preserve the space and to act as anchorage for the orthodontic traction. After an 8-month observational period without spontaneous eruption, surgical exposure was carried out using the closed exposure technique. Subsequently, elastic traction was performed, guiding the impacted teeth into the dental arch. Results: The multiple impacted teeth were successfully aligned in the dental arch, achieving symmetry in the frontal segment while preserving periodontal health. In order to ensure stability during the retention period, thermoformed retainers were used. Conclusions: Each complex and rare clinical case poses a challenge to orthodontists and is important for the scientific literature as it provides valuable clinical experience. Full article

Background/Objectives: While premature ventricular contraction (PVC) burden is clearly linked to cardiomyopathy in adults, its association with ventricular dysfunction in children remains less well established. This study investigated the myocardial effects of a PVC burden greater than 5% and its potential predictive factors in a pediatric population. Methods: The study enrolled 23 children aged 5–18 years with a PVC burden >5% on 24 h Holter monitoring, who had no chronic systemic illness, congenital or acquired heart disease, or known family history of cardiomyopathy or sudden cardiac death, along with 33 age-matched healthy controls. Data on demographic characteristics, anthropometric measures, clinical findings, and laboratory results were obtained. Twelve-lead electrocardiography, exercise testing using the Bruce protocol, 24 h Holter monitoring, and echocardiographic assessments—including conventional, tissue Doppler, and both segmental and global strain analyses—were performed and compared between the patient and control groups. Results: In the patient group, left ventricular isovolumetric relaxation time (IVRT) was prolonged, and the myocardial performance index (MPI) was higher compared with the controls (p < 0.001, p = 0.004). Longitudinal strain analysis revealed a significant reduction in global longitudinal strain (GLS) (p = 0.035). In addition, significantly lower segmental longitudinal strain values were observed in the basal anterolateral, basal inferolateral, and basal anterior segments, as well as a reduction in apical two-chamber GLS (p = 0.002, p = 0.002, p = 0.003, and p = 0.014, respectively). Circumferential strain was also significantly reduced in the basal anteroseptal, basal anterior, basal inferolateral, and mid anteroseptal segments, as well as in the basal, mid, and global averages (p = 0.003, p = 0.003, p = 0.026, p = 0.003, p = 0.006, p = 0.022, and p = 0.017, respectively). PVC burden on Holter monitoring was positively correlated with the global strain values, indicating less negative strain with increasing PVC burden. Conclusions: In children with structurally normal hearts and a PVC burden exceeding 5%, TDI and strain imaging revealed subtle alterations in diastolic function and myocardial deformation despite preserved ejection fraction. These findings suggest that frequent PVCs may be associated with early myocardial alterations and highlight the potential utility of advanced echocardiographic techniques in this population. Full article

Background/Objectives: To identify predictors of successful fusion and adjacent segment disease (ASD) following ALIF. Methods: Records of patients undergoing one- or two-level ALIF were queried for baseline and postoperative radiographic data, demographics, operative notes, and implant characteristics. All had ≥1 year of follow-up with CT, and multivariable Cox regression was used to identify predictors of radiographic fusion through the interbody, ASD, and ASD requiring reoperation. Results: In total, 177 patients (median 59 yr; 52.5% male) were treated at 245 unique levels, of which 193 fused (81.3% with posterior fixation and 59.6% with standalone), 43 had ASD (17.6%), and 14 had ASD requiring reoperation (5.7%). Fusion was predicted by anterior cage placement (HR 0.94/mm; 95% CI [0.90, 0.98]; p = 0.003) and BMP use (HR 1.92; [1.15, 3.18]; p = 0.012). Radiographic ASD was predicted by older age (HR 1.08 per year; [1.03, 1.14]; p < 0.001), undergoing a revision [vs. index] fusion operation (HR 3.51; [1.44; 8.59]; p = 0.006), lower preoperative disc height (HR 0.83/mm; [0.74, 0.94]; p = 0.003), and preoperative facet vacuum phenomenon (HR 2.46; [1.18, 5.15]; p = 0.017). None of the extracted variables predicted reoperation for ASD. Conclusions: BMP use along with anterior cage placement and posterior fixation may improve the odds of fusion through the interbody following one- or two-level ALIF. Adjacent segment pathology is more common in patients with greater preoperative degenerative pathology (vacuum sign; more collapsed disc) and advanced age. Pelvic fixation did not improve fusion odds, but the data highlight the benefits of supplementary posterior fixation vs. standalone ALIF. Full article

Background: Pectus excavatum (PE) is the most common anterior chest wall deformity in children and adolescents. It may lead to postural adaptations of the trunk and spine and can influence the distribution of the center of gravity. Methods: A total of 35 patients with PE, with a Haller index < 3.25, aged 5–17 years, followed a structured exercise program including postural correction exercises, thoracic mobility exercises, breathing retraining, and trunk extensor strengthening for three months after proper instruction by a specialist. Patients were assessed before and after the intervention. Postural alignment was evaluated laterally (right and left) using the GaitON Posture Analysis System, and static balance was assessed using the PoDATA 2.0 stabilometric platform (Chinesport, Italy), which analyzes plantar pressure distribution and center of pressure (COP) displacement during orthostatic stance. Statistical analysis was performed using paired t-tests and Pearson correlation coefficients. Results: Stabilometric analysis demonstrated a reduction in COP trajectory length, confidence ellipse area, and maximum velocity, indicating improved postural control and reduced sway. Postural analysis revealed statistically significant improvements in head and shoulder girdle alignment. Correlations suggest a potential relationship between segmental alignment and stabilometric parameters and a possible reduction in thoracic hyperkyphosis associated with PE. Conclusions: Postural and stabilometric assessment in PE highlights changes in the analyzed parameters and suggest that a structured exercise program may be associated with improvements in biomechanical function and neuromuscular control. These methods can be integrated into conservative management and therapeutic strategies. Full article

Background: Finite element analysis (FEA) has become an important tool in restorative dentistry for investigating stress distribution in teeth and dental restorations. However, the accuracy of such analyses strongly depends on the anatomical fidelity of the underlying tooth models, which is often limited in simplified geometries. The objective of this study was to develop an anatomically accurate three-dimensional tooth model based on micro-computed tomography (micro-CT) data and to evaluate the biomechanical behaviour of sound and composite-restored teeth under clinically relevant loading conditions. Methods: A human tooth was scanned using high-resolution micro-CT imaging. Enamel, dentin, and pulp were segmented and reconstructed into three-dimensional geometries, which were further refined using computer-aided design (CAD) tools. The resulting models were imported into a finite element environment for mechanical simulation. Static loading conditions were applied to both sound and composite-restored tooth models, including a vertical load of 200 N and an oblique load of 200 N applied at a 45° angle to the tooth crown. Von Mises stress distributions were evaluated to characterize stress concentration patterns. Results: Finite element simulations revealed maximum von Mises stresses of approximately 140 MPa, predominantly localized in the coronal regions of the tooth. Oblique loading produced increased and more asymmetric stress concentrations than vertical loading, particularly in the anterior and posterior crown regions. While overall stress distributions were comparable between sound and composite-restored teeth, locally increased stress levels were observed in restored models under oblique loading. Conclusions: Anatomically accurate, micro-CT-based finite element tooth models provide a robust framework for biomechanical analysis in restorative dentistry. The presented workflow enables detailed evaluation of stress distribution in composite-restored teeth and may contribute to improved understanding and optimization of restorative materials and treatment strategies. Full article

Background. Despite technological innovations and improvements in stents and devices, sex-related discrepancies are still reported in the outcomes after ST-segment elevation myocardial infarction (STEMI), depending on biological and sex-specific pathophysiological differences, which have not been completely understood. The aim of the present study was to provide real-world data on the prognostic role of sex among patients with STEMI, enclosed into a recent up-to-date international registry. Methods. The ISACS-STEMI COVID-19 is a large-scale retrospective registry, including STEMI patients treated with mechanical reperfusion between 1 March and 30 June, 2019 and 2020. Patients, treated in 109 centers across Europe, Latin America, Southeast Asia, and North Africa, were grouped according to sex. Primary endpoint: In-hospital mortality; secondary endpoints: Time delay, 30-day mortality, and postprocedural Thrombolysis In Myocardial Infarction (TIMI) 3 flow. Results. We included 16,083 patients, 24.3% females (54.3% hospitalized in 2019, 45.7% in 2020). Women with STEMI were older, more often diabetic and hypertensive (p < 0.001), with a higher prevalence of hypercholesterolemia (p = 0.02), longer ischemia time (p = 0.01), ambulance referral (p = 0.03) and cardiogenic shock at presentation (p = 0.05), but less frequently smokers, with a previous cardiovascular event (p < 0.001) or anterior STEMI (p = 0.03) as compared to males. Preprocedural TIMI 0 flow, multivessel disease, need for thrombectomy (p < 0.001 and p = 0.001, respectively), use of Glycoprotein IIbIIIa inhibitors or cangrelor, radial access and implantation of drug-eluting stents (p < 0.001, p < 0.001 and p = 0.001, respectively) were also more common in men. Impaired postprocedural epicardial reperfusion (TIMI flow 0–2) was observed more frequently in females as compared to males (10% vs. 7.2%; adjusted OR [95% CI] = 1.30 [1.13–1.49], p = 0.01). In-hospital mortality was 5.8%, significantly higher among women (8.3% vs. 5%, p < 0.001, adjusted HR [95% CI] = 1.26 [1.06–1.5], p = 0.01). Similar data were observed for 30-day mortality (10.3% vs. 6.2%, p < 0.001, adjusted HR [95% CI] = 1.22 [1.06–1.38], p = 0.007). Conclusions. Among STEMI patients being treated with the most updated standard of care for primary percutaneous coronary intervention, female sex is still associated with higher complexity and impaired prognosis, displaying suboptimal epicardial reperfusion and increased in-hospital and 30-day mortality. Full article

Smartphone-based portable slit lamp microscopes are increasingly used as low-cost tools for anterior segment imaging in teleophthalmology, yet the literature combines heterogeneous study designs, comparator standards, and deployment contexts. Because the evidence base spans engineering reports, basic science, clinical validation studies, implementation research, and case-based telemedicine, we structured a narrative review rather than a pooled meta-analysis. We searched PubMed/MEDLINE, Embase, Scopus, Web of Science, Google Scholar, Cochrane Library, ScienceDirect, and DOAJ for literature available on or before 28 February 2026, supplemented by manual reference list screening and targeted retrieval of relevant technical standards. Peer-reviewed English original studies formed the core evidence base; contextual non-English and gray literature sources were retained only when explicitly labeled as non-core. To improve interpretability, the results were grouped by synthesis domain, clinical task, comparator standard, telemedicine scenario, and artificial intelligence (AI) dataset/validation characteristics. The highest-confidence evidence concerned nuclear cataract grading, tear film breakup time and corneal staining assessment, anterior chamber depth screening, tear meniscus height measurement, allergic conjunctival grading, and selected corneal disorders. Agreement with conventional slit lamp examination or anterior segment optical coherence tomography was generally moderate to high within task-specific comparisons, and telemedicine deployment was feasible for screening, follow-up, remote consultation, emergency triage, house visits, and outreach. However, illumination reporting remains inconsistent, explicit ISO-aligned dosimetry is sparse, and most AI studies remain retrospective, single-center, and device family-specific. Current evidence, therefore, supports smartphone-based portable slit lamp microscopes primarily as adjunctive teleophthalmology tools rather than replacements for comprehensive in-clinic microscopy. The synthesis clarifies where conclusions are supported by comparative validation data, where they remain exploratory, and which methodological gaps should be prioritized in future multicenter studies. Full article

Background: The Circle of Willis (CoW) is a key collateral pathway that enables communication between the anterior and posterior cerebral circulations. However, anatomical variations in the A1 segment of the anterior cerebral artery, such as hypoplasia or aplasia, can alter hemodynamics and may compromise this collateral function. While incomplete CoW configurations have been linked to aneurysm formation and altered patterns of hemorrhage, their role in the distribution of cerebral infarctions remains controversial. We aimed to explore the association between A1 segment hypoplasia/aplasia and infarct laterality across different etiological subtypes. Methods: We retrospectively analyzed patients with unilateral anterior circulation infarction admitted between April 2017 and March 2023. The CoW was assessed by magnetic resonance angiography (MRA). A1 segment hypoplasia was defined as a segment diameter <1 mm, and A1 aplasia was defined as non-visualization on MRA. The side with hypoplasia or aplasia was defined as the minor side, and the contralateral side as dominant. We assessed whether infarction occurred on the minor or dominant side. Results: Among 198 patients with unilateral anterior circulation infarction classified as lacunar, cardioembolic stroke (CES), or embolic stroke of undetermined source (ESUS), 30% had A1 hypoplasia or aplasia, with similar prevalence across subtypes. Infarcts occurred on the A1 dominant side in 53% of lacunar, 55% of ESUS, and 75% of CES cases. Although this difference did not reach statistical significance (p = 0.43), it should be interpreted with caution given the limited sample size. Conclusions: The rates of A1 hypoplasia and aplasia were similar across stroke types. No statistically significant association was identified. The findings remain inconclusive given the limited sample size. These results should be considered exploratory and hypothesis-generating. Full article

Zika virus (ZIKV) remains a significant global public health threat due to its association with severe neurological and ocular abnormalities, including microcephaly and congenital glaucoma in infants. Viruses often exploit host metabolic programs, such as energy and lipid metabolism, to support their replication. However, how ZIKV-driven metabolic reprogramming affects the anterior segment of the eye, especially trabecular meshwork (TM) cells, remains poorly defined. In this study, we investigated the roles of AMP-activated protein kinase (AMPK) signaling, fatty acid (FA) metabolism, and lipid droplet (LD) biogenesis in ZIKV-induced ocular pathogenesis using primary human TM cells and an IFNAR1-deficient mouse model. ZIKV infection triggered time-dependent activation of the LKB1-AMPK-ACC signaling axis and significantly increased LD accumulation. Pharmacological activation of AMPK suppressed viral replication, whereas its inhibition enhanced infection, highlighting an antiviral role for AMPK signaling. In contrast, ZIKV promoted LD biogenesis, and inhibition of DGAT1 reduced both LD formation and viral replication, indicating a proviral role for LDs. Modulation of FA metabolism further revealed differential effects on ZIKV infection: saturated FA (palmitate) enhanced viral replication, whereas inhibition of FA oxidation with etomoxir reduced infection. Conversely, unsaturated FAs (oleate and linoleate) suppressed viral replication, in part by impairing viral binding and entry. Collectively, these findings show that ZIKV reshapes host metabolic pathways in TM by differentially engaging AMPK signaling, FA metabolism, and LD biogenesis to promote viral replication and spread in ocular tissue. Targeting these metabolic pathways may offer promising therapeutic avenues for preventing and/or treating ZIKV-associated ocular complications. Full article

Ventricular repolarization abnormalities are among the most frequent electrocardiographic findings in pediatric athletes undergoing cardiovascular screening, yet their clinical significance remains a major source of diagnostic uncertainty. While most of them represent benign expressions of training-induced cardiac remodeling and developmental maturation, selected patterns may constitute the earliest phenotypic manifestation of cardiomyopathies or primary electrical disease. Distinguishing physiological adaptation from early pathology is therefore essential to prevent both sudden cardiac events and unnecessary restrictions on sports participation. This review integrates contemporary international electrocardiographic interpretation criteria with emerging pediatric evidence to provide a clinically oriented framework for evaluation and risk stratification of ventricular repolarization abnormalities in pediatric athletes. Early repolarization and anterior T-wave inversion are commonly benign when occurring within recognized age- and ethnicity-specific patterns and in the absence of symptoms, concerning family history, or structural abnormalities. Conversely, lateral or inferolateral T-wave inversion, atypical ST-segment morphology, complex ventricular arrhythmias, and abnormal imaging findings represent red flags requiring comprehensive investigation, including multimodality imaging when indicated. Due to the dynamic electrophysiological evolution during adolescence, longitudinal reassessment is crucial. A structured, risk-based approach integrating electrocardiographic features, demographic/familial context, clinical evaluation, imaging findings, and follow-up provides a pragmatic strategy to optimize risk detection while safeguarding appropriate athletic participation in young athletes. Full article

Background: Although minimally invasive glaucoma surgery (MIGS), including trabecular micro-bypass stent implantation, is safe, its surgical outcomes remain variable, with limited reliable success predictors. We evaluated whether preoperative trabecular meshwork (TM) thickness is associated with surgical outcomes after iStent inject^® W implantation. Methods: Patients with open-angle glaucoma (n = 28) who underwent iStent inject^® W implantation were included. Preoperative AS-SS-OCT was used to measure TM thickness and conventional angle parameters, including angle opening distance, angle recess area, trabecular–iris space area, and trabecular–iris angle. Surgical success was IOP ≤ 15 mmHg with ≥25% reduction or final IOP ≤ 12 mmHg under specified conditions. Logistic regression analyses were performed to identify factors associated with surgical outcomes. Results: At 12 months, 22 eyes (78.6%) achieved surgical success. Mean TM thickness was significantly greater in the unsuccessful than in the successful group (250.62 ± 32.05 μm vs. 180.75 ± 30.61 μm, p = 0.001), with similar findings for nasal and temporal TM thickness. Conventional angle parameters were not associated with surgical outcomes. In univariable analysis, both mean and nasal TM thickness were significantly associated with an increased risk of failure (per 10 μm increase; mean TM: OR = 2.77, 95% CI = 1.12–6.86, p = 0.027; nasal TM: OR = 1.64, 95% CI = 1.04–2.58, p = 0.034). Conclusions: Increased preoperative mean and nasal TM thickness was significantly associated with surgical failure following iStent inject^® W implantation. TM’s microstructural properties are more relevant than angular configuration in determining MIGS outcomes. Preoperative assessment of TM thickness using AS-SS-OCT may serve as a useful imaging biomarker for optimizing patient selection. Full article