搜索结果：Korean journal of ophthalmology : KJO

To evaluate the refractive accuracy of the European Society of Cataract and Refractive Surgeons (ESCRS) online intraocular lens (IOL) calculator for enhanced monofocal IOLs and to compare its performance with commonly used IOL formulas, including BUII, SRK/T, and Haigis. This retrospective case-series included 95 eyes from 95 patients who underwent uneventful phacoemulsification with ICB00 IOL. IOL power was calculated using the ESCRS calculator (Cooke K6, EVO 2.0, Hill-RBF 3.0, Hoffer QST, Kane, and Pearl DGS), and BUII, SRK/T, and Haigis formulas using IOLMaster 700. Prediction error (PE), mean absolute error (MAE), median absolute error (MedAE), the proportion of eyes with a PE within &#xb1; 0.50 D of target refraction, and the formula performance index (FPI) were evaluated at 3 months postoperatively with and without constant optimization. Without constant optimization, the Kane formula achieved the lowest MedAE (0.22 D) and the highest proportion of eyes with PE within &#xb1; 0.50 D (85.3%). With constant optimization, the Kane and Cooke K6 formulas showed the lowest MedAE (0.18 D each), and Kane and EVO 2.0 demonstrated the highest percentage of eyes within &#xb1; 0.50 D (85.3%). The proportion of eyes within &#xb1; 0.50 D showed statistically significant overall differences among formulas under both conditions (P < 0.05 each), although no significant pairwise differences were observed after optimization. The highest FPI values were observed for Cooke K6, Hill-RBF 3.0, and Kane, whereas SRK/T and Haigis consistently demonstrated the lowest performance. The ESCRS online IOL calculator demonstrated superior MedAE and FPI compared with traditional formulas (SRK/T and Haigis), while the accuracy in achieving a postoperative refraction within &#xb1;0.50 D was comparable among eyes implanted with enhanced monofocal IOLs. These results support the clinical utility of the ESCRS calculator for accurate and efficient IOL power calculation, regardless of constant optimization status.

To investigate long-term changes in retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) thickness in patients with posterior cerebral artery (PCA) infarction and homonymous visual field defects. This retrospective study included patients with PCA infarction and homonymous visual field defects with a minimum follow-up of 6 months. Retinal thinning was defined as a &#x2265;10% decrease from baseline to the final follow-up examination. Affected and non-affected sectors of the RNFL and GC-IPL were defined according to the retinotopic pattern of the homonymous visual field defect. The incidence of retinal thinning, retinal thickness changes, and time to retinal thinning were analyzed in the ipsilateral and contralateral eyes relative to the brain lesion. Of 142 screened patients, 29 30 were included. The incidence of thinning in affected sectors was 13.8% for the RNFL and 31.0% for the GC-IPL. The thinning ratio of GC-IPL was higher in affected sectors than in non-affected sectors (p = 0.008), whereas that of the RNFL was not significant (p = 0.983). The median time to thinning in affected sectors was 12.0 months for the RNFL and 18.0 months for the GC-IPL. Significant GC-IPL thinning was observed in the inferotemporal, inferior and superotemporal sectors of ipsilateral eyes, and in the inferonasal, superonasal, inferior, and superior sectors of contralateral eyes. Trans-synaptic retrograde degeneration TRD was observed after PCA infarction, with the incidence of 13.8% for RNFL thinning and 31.0% for GC-IPL thinning. The median time to GC-IPL thinning was 18.0 months during long-term follow-up. These findings suggest that long-term ophthalmic follow-up may be important for detecting chronic structural changes after post-geniculate visual pathway injury.

To describe the clinical characteristics and evaluate the surgical outcomes of patients with acute secondary angle closure associated with lens subluxation who underwent phacoemulsification with secondary intraocular lens scleral fixation. A retrospective study was performed on patients with unilateral lens subluxation with angle closure who underwent phacoemulsification with secondary intraocular lens (IOL) scleral fixation using the single-loop four-point technique, and were followed up for at least 2 years. A total of 22 affected eyes from 22 patients were enrolled in this study. Preoperative ocular biometric parameters of affected eyes were compared with those of unaffected fellow eyes. Changes in intraocular pressure (IOP) were evaluated 2-year follow-up period. Among the affected eyes, 72.7% were in male patients and 63.6% involved the left eye. A history of ocular trauma was present in approximately 9.1% of patients. Preoperatively, affected eyes showed higher peak IOP (34.27 mmHg in the affected eye vs 16.05 mmHg in the fellow eye), shallower anterior chamber depth (1.90 mm in the affected eye vs 2.82 mm in the fellow eye), and more myopic spherical equivalent (-1.27 diopters in the affected eye vs 0.10 diopters in the fellow eye) compared to fellow eyes. Postoperative IOP remained stable for up to 2 years; however, 54.5% of patients required more than one antiglaucoma medication during this period. All affected eyes achieved the target IOP of <21 mmHg without requiring further glaucoma filtration surgery, although 54.5% of patients necessitated ongoing antiglaucoma medication (qualified success). In eyes with lens subluxation-associated secondary angle-closure, phacoemulsification with secondary IOL scleral fixation resulted in stable IOP control and anatomical restoration over a 2-year follow-up period in severe cases with extensive zonular dialysis.

To evaluate the impact of early residual fluid (ERF) following aflibercept loading on 12-month anatomical and functional outcomes in patients with neovascular age-related macular degeneration (nAMD). This retrospective study included 111 eyes of 107 treatment-na&#xef;ve nAMD patients. ERF was defined as the presence of intraretinal fluid (IRF) and/or subretinal fluid (SRF) observed after three loading doses of aflibercept. Patients were divided into ERF (n = 28) and ERF-free (n = 83) groups. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were assessed at baseline, post-loading, and at 12 months. Subgroup analyses were conducted based on fluid location within the ERF group. ERF was observed in 25.2% of eyes after loading. The ERF group exhibited significantly greater CMT at all time points (P < 0.050). Although BCVA did not differ significantly between groups, the ERF group required a significantly higher injection burden (7.36 &#xb1; 1.95 vs. 5.29 &#xb1; 1.44; P = 0.001). Subgroup analysis within the ERF group revealed that eyes with IRF had worse baseline BCVA (P = 0.038) and a higher rate of persistent IRF at 12 months (87.5%). Multivariate analysis identified post-loading ERF (OR: 3.41, P = 0.046), thicker post-loading CMT (OR: 1.01, P = 0.030), and higher injection frequency (OR: 1.31, P = 0.022) as independent predictors of residual fluid at 12 months. ERF after aflibercept loading is a significant independent predictor of long-term fluid persistence. While ERF signifies a more recalcitrant disease course, comparable visual outcomes can be achieved through proactive, individualized treatment.

To evaluate the effect of behavioral changes during the COVID-19 pandemic on myopia progression in children and to determine whether these changes modified the efficacy of low-concentration atropine (LAMP). This retrospective longitudinal study included children aged 7-15 years who underwent annual examinations from 2019 to 2023. A subset of participants completed a behavioral questionnaire in 2021. Annual spherical equivalent (SE) measurements from pre-COVID (2019), COVID (2020), and post-COVID (2021-2023) periods were analyzed using linear mixed-effects models. Changes in mobile device use and outdoor activity were assessed with repeated-measures ANOVA. Subgroup analyses were performed based on the degree of increase in device use and the duration of remote education. Seventy-seven children (140 eyes) were included in the refractive analysis, of whom 37 (69 eyes) completed the behavioral questionnaire and were included in behavioral analyses. Myopia progression during COVID increased compared with the pre-COVID period. A greater increase in mobile device use was significantly associated with faster progression between 2021 and 2022 (P=0.005). Longer duration of remote education showed a similar association (P=0.035). Changes in outdoor activity were not clearly associated with refractive outcomes. Low-dose atropine did not show a meaningful treatment effect in this cohort. Myopia progression accelerated during the pandemic and was strongly associated with increased screen time and prolonged remote education. These behavioral factors had a greater influence on progression than low-dose atropine, underscoring the importance of addressing visual habits in pediatric myopia management.

To determine how cataract-related image-quality improvement and region of interest (ROI) definition affect the reproducibility of optical coherence tomography (OCT) radiomics features. This retrospective study included 50 eyes from 46 patients who underwent cataract surgery. Preoperative and postoperative OCT images were acquired using a standardized protocol. Radiomics features (n = 93) were extracted from two ROI configurations: retina ROI (Rr; retina only) and full ROI (Rf; retina, choroid, vitreous). Preoperative versus postoperative differences were tested with the Wilcoxon signed-rank test and Cohen's d; repeatability was assessed with the intraclass correlation coefficient (ICC). Agreement between ROIs was evaluated with Wilcoxon statistics, Spearman correlation, the concordance correlation coefficient (CCC) and Bland-Altman plots. The influence of signal strength was analyzed with paired t-tests and Spearman correlation. Postoperative signal strength significantly improved from 28.24 &#xb1; 3.16 to 31.40 &#xb1; 3.06 dB (p < 0.001). Significant preoperative/ postoperative changes occurred in 49 / 93 features (52.7%) within Rr and in 81 / 93 (87.1%) within Rf. ICC showed good-to-excellent repeatability in 51.6% of Rr features and 87.1% of Rf features, yet 29.0% of Rr features still demonstrated poor reliability. Across ROI methods, 94.6% of feature pairs differed significantly between Rr and Rf, and no feature achieved CCC &#x2265;0.85. Only two descriptors-first-order statistics 10th percentile and GLDM (gray level dependence matrix) gray level variance-showed no significant change with surgery and minimal dependence on signal strength. Radiomics features in OCT respond variably to media opacity, signal-to-noise ratio, and ROI definition: most are susceptible to these factors, yet a small subset remains stable across them. Limiting analysis to an anatomically precise retina- bounded ROI and enrolling eyes with comparable cataract status and signal-strength scores may therefore improve reproducibility. Implementing these standardizations will help future OCT-radiomics studies identify the most reliable biomarkers for clinical use.

Postoperative endophthalmitis is a sight-threatening intraocular infection requiring prompt treatment. This study aimed to compare the clinical outcomes of intravitreal 0.625% povidone-iodine (PI) injection with intravitreal antibiotic injection for the treatment of postoperative endophthalmitis. A retrospective review of 40 eyes diagnosed with postoperative endophthalmitis was conducted. Patients were divided into two groups: group 1 received intravitreal 0.625% PI injection (0.1 mL), while group 2 received intravitreal antibiotic injection. Clinical data, including best-corrected visual acuity (BCVA), intraocular pressure, the number of intravitreal injections, duration of anterior chamber hypopyon, and the need for pars plana vitrectomy (PPV), were analyzed. Group 1 (24 eyes) showed significant improvements in BCVA posttreatment (mean, 1.04 &#xb1; 0.95 logMAR; p < 0.001) compared to group 2 (16 eyes; mean, 1.26 &#xb1; 0.99 logMAR; p = 0.092). Severe visual impairment (BCVA < 10 / 100) was significantly less frequent in group 1 (25.0%) than in group 2 (62.5%) (p = 0.025). The mean duration of hypopyon was shorter in group 1 (2.6 &#xb1; 2.2 days) compared to group 2 (6.4 &#xb1; 7.3 days, p = 0.048). Fewer intravitreal injections (p = 0.002) and PPV (p = 0.002) were required in group 1. Intravitreal 0.625% PI injection was associated with fewer intravitreal injections, shorter hypopyon duration, and more favorable visual outcome-related measures, including significant visual improvement from baseline and a lower frequency of severe visual impairment, compared with intravitreal antibiotic treatment. These findings suggest that PI may be considered a safe and effective initial treatment option for postoperative endophthalmitis. Further prospective studies are needed to validate these results.

To describe the clinical characteristics, etiologies, management patterns, and visual outcomes of spontaneous corneal perforation. We retrospectively reviewed 18 eyes of 17 patients with spontaneous corneal perforation treated at a tertiary center in South Korea between 2014 and 2022 with follow-up through December 2024. Cases were classified as non-infectious, infectious, or mixed. Clinical features, interventions, and visual outcomes were analyzed. Univariate analyses were performed to examine associations between clinical and demographic variables and final visual acuity. The mean patient age was 58.0 &#xb1; 25.1 years. Non-infectious etiology accounted for 50.0% of cases; patients in this group were significantly younger than those with infectious or mixed etiologies (41.0 &#xb1; 26.8 vs. 73.1 &#xb1; 9.4 years, P = 0.036). Blepharokeratoconjunctivitis (BKC) was the most common cause in younger patients, while neurotrophic keratopathy with superimposed infection predominated in older patients. Primary surgical treatments included amniotic membrane transplantation (50%), corneal patch graft (38.9%), and penetrating keratoplasty (16.7%), with 38.9% requiring more than one procedure. Final best-corrected visual acuity was significantly better in the non-infectious group than in the combined infectious/mixed group (0.86 &#xb1; 1.14 logMAR vs. 2.19 &#xb1; 1.02 logMAR; P = 0.038). Final visual acuity was significantly correlated with age (Spearman's &#x3c1; = 0.738, P = 0.003); patients with systemic comorbidities also showed significantly worse outcomes (P = 0.008), a finding that may partly reflect confounding by age. Spontaneous corneal perforation shows distinct clinical patterns by etiology and age. Younger patients with non-infectious disease achieved more favorable visual outcomes, while older patients with infectious or mixed etiologies more often required repeated interventions focused on globe preservation. Early recognition and sustained management of BKC in younger patients and close monitoring of corneal integrity in older patients with neurotrophic keratopathy may reduce the risk of progression to perforation.

This study aimed to identify the predominant adenoviral genotypes responsible for epidemic keratoconjunctivitis (EKC) in Korea and to evaluate genotype distribution and associated clinical manifestations based on molecular confirmation. Sixty-seven conjunctival swabs were obtained from patients clinically suspected of epidemic keratoconjunctivitis between October 2016 and December 2019. Viral nucleic acids were extracted using the QIAamp&#xae; Viral Mini kit and processed via the QIAcube platform. Adenoviral genotypes were molecularly confirmed using polymerase chain reaction (PCR) and sequencing of the hexon gene. Of the 67 specimens, 45 (67.2%) showed positive genotyping results. Adenovirus types D8 (42.2%) and D37 (31.1%) were the predominant genotypes identified. From 2016 to 2018, D8 was the dominant genotype, whereas in 2019, additional genotypes, including B3, D53, D64, and E4, were newly detected during the study period. All patients with confirmed genotypes exhibited conjunctival hyperemia and follicular reaction. Pseudomembrane formation was observed in 68.4% of D8 cases and 57.1% of D37 cases. Corneal involvement, including epithelial defects and subepithelial infiltration, was frequently observed in genotypes D8, D37, D53, and D64, whereas genotypes B3 and E4 showed no corneal involvement, indicating potential trends toward genotype-associated clinical features. Adenoviral genotypes D8 and D37 were the predominant causes of epidemic keratoconjunctivitis in Korea. In 2019, additional genotypes, including B3, D53, D64, and E4, were newly detected, suggesting temporal changes in genotype distribution during the study period. Corneal involvement was more frequently observed in D8, D37, D53, and D64, whereas B3 and E4 showed no corneal involvement. These findings provide descriptive epidemiologic data on adenoviral genotypes in Korea and may serve as baseline information for future studies of genotype-associated clinical manifestations.

To evaluate the interobserver reproducibility of Goldmann applanation tonometry (GAT) among ophthalmologists with varying levels of experience and to assess the agreement between noncontact tonometry (NCT) and GAT in measuring intraocular pressure (IOP). This cross-sectional observational study, conducted prospectively at a tertiary care hospital, included 210 patients. IOP measurements were performed on the right eye using NCT followed by GAT. Observer 1 was a senior ophthalmologist, while observers 2 and 3 were a second-year and a first-year resident, respectively. The primary objective was to compare GAT-based IOP measurements between observer 1 and the residents; the secondary objective was to evaluate agreement between NCT and GAT. A statistically significant difference was observed between observers 1 and 2, and between observer 1 and NCT, but not between observers 1 and 3. The mean difference (MD) in IOP between observers 1 and 2 was 0.8 mmHg (95% limits of agreement [LoA], &#xb1;5.7 mmHg). Comparisons with observer 3 and NCT yielded MDs of 0.4 mmHg (95% LoA, &#xb1;6.5 mmHg) and -0.9 mmHg (95% LoA, &#xb1;7.3 mmHg), respectively. A higher percentage of observer 2 readings fell within &#xb1;4 mmHg of observer 1 compared to observer 3 and NCT. In the normotensive subgroup, MDs were 0.7, 0.4, and -1.4 mmHg, respectively, with a notably wide LoA for NCT (-8.1 to 5.3 mmHg). There was notable interobserver variability in GAT-based IOP measurements between residents and the senior ophthalmologist, exceeding the &#xb1;4 mmHg clinical acceptability benchmark. This variability suggests that less experienced observers may not yet have fully developed skills, impacting measurement accuracy. Over time, this range may narrow as experience and proficiency improve. Additionally, clinicians should interpret NCT results with caution-especially in postoperative assessments or when modifying treatment. Cross-checking with GAT and incorporating structured training protocols may enhance measurement consistency.

To determine the 1-year, 3-year, and 5-year survival probabilities of patients with retinoblastoma in Malaysia and compare their overall survival according to various factors. A retrospective cohort study was conducted on patients diagnosed with retinoblastoma registered in hospitals with pediatric ophthalmology services in Malaysia from January 2004 to April 2023. The overall survival probabilities for patients with retinoblastoma at 1-year, 3-year, and 5-year were assessed using the Kaplan-Meier estimator. Additionally, differences in survival probabilities between various groups were analyzed through the log-rank test. The study included 402 patients diagnosed with retinoblastoma obtained from the Retinoblastoma Registry of the National Eye Database in Malaysia and patient's medical records using a standardized data collection form. A total of 22 (5.5%) patients died during the study period. The results showed that the 1-year, 3-year, and 5-year survival probabilities were 96.1% (95% CI: 93.4 to 97.7), 94.5% (95% CI: 91.3 to 96.6), and 92.6% (95% CI: 88.7 to 95.2), respectively. Patients with prolonged delay in diagnosis (p = 0.001), and non-compliance to follow-up (p = 0.001) were associated with differences in survival. This study provides important insights into the survival probabilities of patients with retinoblastoma in Malaysia, demonstrating high survival probabilities at 1-year, 3-year, and 5-year. Significant differences in survival time were observed related to delay in diagnosis, and non-compliance to follow-up indicating the importance of close monitoring and early detection strategies.

To characterize the epidemiology, microbiological spectrum, and antimicrobial resistance of infectious corneal ulcers in a Northern Portugal referral center and to identify predictors of severe structural outcomes in real-world practice. Retrospective observational cohort study of consecutive infectious corneal ulcer episodes undergoing microbiological sampling (2014-2025). Baseline demographics, ocular and systemic risk factors, clinical severity markers (ulcer location, hypopyon), microbiologic results, organism groups, antimicrobial susceptibility and initial empiric therapy were recorded. The primary outcome was severe structural failure (corneal perforation and/or evisceration). Secondary outcomes included central corneal scarring and hospitalization. Descriptive microbiological endpoints included culture positivity, pathogen distribution, and antimicrobial susceptibility patterns. Predictors of severe outcome were assessed using multivariable logistic regression. The study included 206 episodes (205 patients; mean age 54.6 &#xb1; 20.7 years). Microbiologic confirmation was obtained in 49.0% of episodes. Among microbiologically confirmed episodes, bacterial keratitis predominated (76.2%), followed by other/unspecified organisms (13.9%), polymicrobial infections (5.9%), and fungal keratitis (4.0%). The most frequent identified pathogens included Pseudomonas aeruginosa and Cutibacterium acnes, alongside PCR-detected HSV-1, coagulase-negative staphylococci, and Corynebacterium spp. Resistance was uncommon among isolates with available susceptibility data (fluoroquinolone 12%, aminoglycoside 9.1%, cephalosporin 5.9%); MDR occurred in 4.7%. Severe outcome occurred in 8.4% of episodes with available data. In multivariable analysis, hypopyon (aOR 6.85), systemic immunosuppression (aOR 4.89), and diabetes mellitus (aOR 2.50) independently predicted severe outcome. In this cohort, severe corneal ulcer outcomes were primarily driven by baseline inflammatory severity and host vulnerability (hypopyon, immunosuppression, diabetes), while antimicrobial resistance and MDR were infrequent. Early risk stratification using these clinical and systemic factors may guide escalation and monitoring, alongside ongoing local resistance surveillance.

To evaluate 1-year clinical outcomes and response markers after implantation of a trabecular micro-bypass stent (iStent inject&#xae; W) in patients with moderate-to-severe open-angle glaucoma (OAG). This retrospective cohort study included 22 eyes of 22 patients with moderate-to-severe OAG who underwent standalone iStent inject&#xae; W implantation (n = 4) or combined phacoemulsification with iStent inject&#xae; W (n = 18). Qualified surgical success was defined as intraocular pressure (IOP) &#x2264;15 mmHg with glaucoma medications and either &#x2265;25% IOP reduction or final IOP &#x2264;12 mmHg if baseline IOP was &#x2264;15 mmHg. Kaplan-Meier analysis was used for cumulative probability of success; Cox proportional hazards regression analysis was used to identify response markers of surgical failure. Based on 19 eyes after censoring 3 eyes requiring additional surgery, IOP reduced from 22.09 &#xb1; 5.62 mmHg preoperatively to 12.37 &#xb1; 2.43 mmHg at 1 year (p < 0.001). Cumulative qualified success rates were 90.9% at 6 months and 72.7% at 12 months. No statistically significant changes were observed in the number of IOP-lowering medications. Higher postoperative IOP at 1 week and 1 month were independently associated with a higher surgical failure rate (1 week: hazard ratio [HR], 1.118; p = 0.007, 1 month: HR, 1.341; p = 0.031). Transient hyphema occurred in 7 eyes and resolved within 1 week; iStent iris plugging occurred in 2 eyes; and 3 eyes required subsequent trabeculectomy. iStent inject&#xae; W appeared to provide meaningful IOP reduction and may serve as an intermediate option in patients with moderate-to-severe OAG. Early higher postoperative IOP may be an early response marker associated with surgical failure.

To describe 4-year functional and structural outcomes of the first bilateral subretinal voretigene neparvovec-rzyl (VN) in Korean patient with molecularly confirmed RPE65-associated inherited retinal dystrophy, with a focus on the relationship between chorioretinal atrophy and visual function. This was an observational case-based study of a 29-year-old woman with biallelic RPE65 pathogenic variants. Both eyes underwent 25-gauge pars plana vitrectomy and subretinal VN injection 7 days apart. Standardized assessments were performed at baseline and 1 month, 3 months, 6 months, 1 year, 2 years, 3 years, and 4 years. Functional outcomes included best-corrected visual acuity (BCVA, ETDRS letters), kinetic visual fields, full-field stimulus threshold (FST, white light), and multi-luminance mobility test (MLMT). Structural changes were evaluated with spectral-domain optical coherence tomography, ultra-widefield color and autofluorescence imaging, and infrared reflectance. At baseline, BCVA was 9 and 8 ETDRS letters (right/left), with widespread ellipsoid zone loss but relatively preserved retinal pigment epithelium. BCVA improved to 34/33 letters at 1 year and remained higher than baseline in both eyes at 4 years. Goldmann III4e average visual field radius increased from 2.1/0.3&#xb0; at baseline to 8.8/15.0&#xb0; at 3 months, followed by partial contraction with paracentral scotomas after 1 year, yet fields remained wider than baseline at 4 years. FST improved from 0.10 log(cd&#xb7;s/m2) to -1.46 log(cd&#xb7;s/m2) at 1 month and remained stable at 3 months. MLMT performance improved from 150 lux at baseline to 10 lux binocularly and was maintained at 4 years. Perifoveal, fovea-involving chorioretinal atrophy developed between 3 and 6 months and enlarged mainly during the first year, then progressed slowly thereafter. In this Korean patient, VN provided large and durable functional gains over 4 years despite early, severe chorioretinal atrophy, illustrating structural-functional dissociation and underscoring the need for long-term multimodal monitoring in RPE65-associated disease.

To develop a consensus-based photographic atlas tailored to East Asian patients to improve the consistency and clinical applicability of the Clinical Activity Score (CAS) in thyroid eye disease (TED), while maintaining compatibility with the established CAS framework. Under the auspices of the Korean Society of Ophthalmic Plastic and Reconstructive Surgery (KSOPRS), an expert Atlas Committee comprising eight TED specialists curated representative clinical photographs corresponding to the five sign-based CAS items: eyelid swelling, eyelid erythema, conjunctival redness, conjunctival swelling, and inflammation of the caruncle or plica. Images were categorized as CAS-positive or CAS-negative following multiple rounds of expert review and discussion. The finalized atlas was circulated to all KSOPRS members for consensus approval. The atlas provides standardized photographic panels and concise operational guidance for each sign-based CAS item. East Asian-specific considerations, including thicker eyelid skin, fuller preseptal and septal fat, and epicanthal folds, are incorporated to refine interpretation of inflammatory signs that may appear attenuated compared with photographic references derived from white populations of European ancestry. The atlas emphasizes pattern recognition, distribution of findings, and side-to-side comparison rather than absolute intensity of erythema or swelling, aiming to reduce false-negative judgments and improve inter-observer consistency. This ethno-specific standard photographic atlas enables endocrinologists and ophthalmologists to perform rapid and reproducible assessments in outpatient settings, facilitating the early identification of patients requiring referral or urgent treatment.

Previous studies had made efforts to find the optimal regimens to reduce xenogeneic rejection in corneal xenotransplantation. However, it had not been fully determined which immunosuppressive choice would be optimal for long-term graft survival. We aimed to compare clinical results in wild type pig-to rhesus corneal xenotransplantation with various immunosuppressive regimens. Medical records of 23 Chinese rhesus macaques who had received full thickness corneal transplantation with wild-type pigs were retrospectively analyzed. They were administered various immunosuppressants including steroid, tacrolimus, anti-CD20 antibody, co-stimulation blockade (CoB) or their combinations. Graft survival, central corneal thickness, changes in plasma anti-&#x3b1;Gal and donor-specific antibodies, aqueous complement levels, and blood effector and memory T/B cell subsets were compared between the groups with different regimens in the follow-up of 6 months. Graft survival time of anti-CD20 antibody (aCD20), anti-CD40 antibody (aCD40), or anti-CD154 antibody (aCD154)-based regimen group was significantly longer than that of steroid (S) or steroid/tacrolimus (S/T) group. INF-&#x3b3; T cell responses, both anti-&#x3b1;Gal IgG and donor-specific IgG levels, along with complement responses, were effectively managed under both the aCD20 and CoB regimens. Compared with aCD154 group, aCD40 group showed higher donor specific IgG responses and aqueous C3a level. B and activated B cell concentrations were significantly lower in aCD20 group than in S, S/T, or CoB group. It suggests that an aCD20-based regimen produces clinical outcomes comparable to those of an aCD154-based regimen in wild-type pig-to-rhesus corneal xenotransplantation, whereas an aCD40-based regimen does not.

To evaluate the clinical and immunological effects of systemic vitamin D supplementation in patients with dry eye disease (DED) and vitamin D deficiency, and to compare outcomes between topical therapy alone and combined topical plus oral vitamin D treatment over 6 months. This prospective, non-randomized comparative study enrolled 34 patients with DED and serum 25-hydroxyvitamin D [25(OH)D] levels <20 ng/mL. Participants received preservative-free artificial tears for three months (topical-only group, n=17) or combined topical therapy and oral cholecalciferol supplementation (50,000 IU weekly for 8 weeks; topical + vitamin D group, n=17). Clinical parameters (Schirmer I test, TBUT, Oxford-graded corneal staining, lid margin hyperemia) and tear cytokines (TNF-&#x3b1;, IL-1&#x3b2;, IL-4) were assessed at baseline and at 1, 3, and 6 months. The prespecified primary endpoint was TBUT at 3 months. Longitudinal analyses were performed using generalized estimating equations adjusted for age, baseline 25(OH)D level, and DED severity, with false discovery rate correction. At 3 months, the topical + vitamin D group demonstrated greater improvement in TBUT compared with the topical-only group (adjusted mean difference 1.25 seconds, 95% CI 0.62-1.88; p<0.001). Schirmer values also increased more in the topical + vitamin D group (adjusted mean difference 1.45 mm, 95% CI 0.73-2.17; p<0.001). Greater reductions in TNF-&#x3b1;, IL-1&#x3b2;, and IL-4 were observed at 3 months in the topical + vitamin D group, remaining significant after false discovery rate adjustment. At 6 months, partial attenuation of improvement was observed in both groups after discontinuation of topical therapy. In vitamin D-deficient DED, systemic vitamin D supplementation added to topical therapy was associated with greater improvement in tear film parameters and modulation of selected inflammatory cytokines compared with topical therapy alone. These findings warrant confirmation in adequately powered randomized controlled trials.

To compare the clinical outcomes of sutureless scleral-fixated posterior chamber intraocular lens (SFIOL) implantation performed with fibrin glue versus without fibrin glue in eyes with inadequate posterior capsular support. This prospective, randomized, comparative clinical study included 40 eyes of 40 patients requiring secondary intraocular lens implantation. Patients were randomly allocated into two groups: Group A (n = 20) underwent glued sutureless SFIOL implantation using fibrin glue, and Group B (n = 20) underwent non-glued sutureless SFIOL implantation. Preoperative evaluation included visual acuity, intraocular pressure (IOP), anterior segment assessment, corneal pachymetry, specular microscopy, and posterior segment examination. Outcome measures included surgical time, intra-operative complications, postoperative visual acuity, anterior segment parameters, IOP changes, scleral flap healing, pupillary abnormalities, and IOL centration. Patients were followed for a minimum of six months. Both groups demonstrated significant improvement in best-corrected visual acuity postoperatively (p < 0.001), with no significant intergroup difference at final follow-up (p = 0.853). Mean surgical time was longer in the glued IOL group but was not statistically significant (p = 0.361). A statistically significant postoperative rise in IOP was observed only in the glued IOL group (p = 0.049). Endothelial cell loss, corneal clarity, anterior chamber depth changes, and IOL centration were comparable between the two groups. Intra-operative and postoperative complications were generally mild and manageable. Both glued and non-glued sutureless scleral-fixated IOL techniques provide comparable visual and anatomical outcomes in eyes lacking capsular support. The non-glued technique offers a cost-effective alternative without compromising safety or efficacy and may be particularly advantageous in resource-limited settings.

This study evaluated the early outcomes of hyperopic small incision lenticule extraction (SMILE) using the VisuMax 800 femtosecond laser in a South Korean cohort, focusing on safety, efficacy, refractive predictability, and centration accuracy. This retrospective study included 11 eyes from seven patients who underwent hyperopic SMILE using the VisuMax 800 between December 1, 2024, and October 31, 2025, at Onnuri Eye Hospital in Jeonju, South Korea. All eyes completed at least 3 months of postoperative follow-up. Preoperative and postoperative evaluations included uncorrected and corrected distance visual acuity (CDVA), manifest refraction, tomography, and wavefront aberrometry. Outcomes were analyzed using the standard nine graphs for refractive surgery. Astigmatic changes were assessed using the Alpins vector method. Optical zone decentration was calculated using postoperative Placido-Scheimpflug topography. The median preoperative spherical equivalent (SEQ) was +2.50 diopters (D) (interquartile range [IQR], 1.94-4.12 D). At 3 months, eight eyes (72.7%) were within &#xb1;0.50 D and all eyes (100%) were within &#xb1;1.00 D of the residual SEQ. The median efficacy index was 0.90 (IQR, 0.80-0.95). CDVA was unchanged in 63.6% of eyes and decreased by one line in 36.4%; no eye lost two or more lines. The median safety index was 0.86 (IQR, 0.80-1.00). Root mean square higher-order aberrations (RMS HOA) increased by +0.38 &#x3bc;m (IQR, 0.09-0.52 &#x3bc;m). The median vertex-based decentration was 0.064 mm (IQR, 0.036-0.091 mm). Decentration demonstrated a significant positive correlation with RMS HOA (rho = 0.709, p = 0.014). Hyperopic SMILE using the VisuMax 800 produced favorable early clinical outcomes with high centration accuracy as well as shorter surgical time. Larger prospective studies with longer follow-up are necessary to determine long-term stability.