Ocular Proteomics (United States)

To investigate the relationship between corneal sensitivity (CS), vision-related quality of life, ocular surface symptoms, and clinical severity in patients with Parkinson's disease (PwP). Prospective observational cohort study. CS was measured using a noncontact esthesiometer. Vision-related quality of life and ocular surface symptoms were assessed with the NEI VFQ-25 and OSDI questionnaires. Parkinson's disease severity was graded with the Hoehn and Yahr (HY) scale. Associations were analyzed using Pearson correlation and ANOVA. A total of 356 eyes from 178 PwP were included. Mean age was 62.77 ± 11.34 years, and 51.4% were male. Mean CS was 6.47 ± 2.24 mBar, NEI VFQ-25 score was 67.11 ± 9.35, and OSDI score was 25.17 ± 18.19. CS was significantly associated with the NEI VFQ-25 composite score (r = 0.449, P <0.001) but not with the OSDI score (r = 0.122, P = 0.141). NEI VFQ-25 and OSDI scores showed moderate correlation (r = 0.477, P <0.001). CS also correlated with general vision, near vision, distance vision, mental health, and peripheral vision subscales (P <0.05). CS varied across HY stages (P <0.001), with stages 3 to 4 demonstrating significantly reduced sensitivity compared with stages 1 to 2 (all P <0.001). CS correlates with vision-related quality of life but not directly with ocular surface symptoms in PwP. Its progressive reduction with advancing HY stages suggests potential as a surrogate marker of disease severity. CS measurements may complement quality-of-life assessments and aid in the early detection of ocular surface compromise in this population.

Kerato-lenticule extraction (KLEx) is a refractive surgery technique that, in contrast with femtosecond laser-assisted in situ keratomileusis (FS-LASIK), does not require the creation of a flap to correct refractive defects. The potential advantages of this technique are related to the absence of a flap and its complications. On the other hand, FS-LASIK is the most widely practised refractive surgery worldwide, as it offers excellent visual outcomes and is currently the gold standard of refractive surgery. The objective of this study is to compare the effectiveness and safety of KLEx versus FS-LASIK as a treatment option in patients with myopia or myopic astigmatism. This double-masked, parallel-group, single-centre randomised clinical trial will enrol 80 eyes from adults with myopia or compound myopic astigmatism within the ranges sphere -0.50 to -12.00 D and cylinder -0.50 to -6.00 D, recruited at the Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico. Participants will be allocated to KLEx or FS-LASIK and assessed at baseline and 1 day, 1 week, 1, 3, 6 and 12 months postoperatively. The primary outcome is uncorrected visual acuity at all postoperative visits. Secondary outcomes include postoperative spherical equivalent, best-corrected visual acuity (BCVA), loss of ≥2 BCVA lines, the proportion of eyes within ±0.50 D of the refractive target, corneal aberrations over a 5 mm pupil, epithelial changes and adverse events. Participants and outcome assessors will be masked to the assigned surgical technique. Participant confidentiality will be maintained with the publication of results. This study was approved by the research and ethics committee of the Instituto de Oftalmología Fundación de Asistencia Privada Conde Valenciana (CI-017-2024). The study results will be disseminated in scientific articles published in peer-reviewed journals and presented through research posters at national and international conferences. ClinicalTrials.gov registry (NCT06477081).

BackgroundPterygium is a wing-shaped fibrovascular growth over the cornea that may require surgical removal due to recurrence and cosmetic concerns. This randomized controlled trial compares the recurrence rate of conjunctival-limbal autograft (CLAu) with a modified mini-simple limbal epithelial transplant (mini-SLET) technique.Methods68 patients will be randomly assigned to two equally sized groups via simple randomization. Group I will undergo a pterygium excision with CLAu, while Group II will undergo a pterygium excision using a mini-SLET. Allocation concealment will be ensured using sealed envelopes, and procedures will be performed by two surgeons. Patients will be followed postoperatively at regular intervals for up to 12 months.DiscussionThis study builds on previous research by modifying the mini-SLET technique to enhance corneal stem cell viability and reduce recurrence. By refining this method, we aim to offer patients a more effective and minimally invasive alternative to the gold-standard procedure.Trial registrationClinicalTrials.gov, NCT06402643. Registered on April 15, 2024.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13063-025-09075-3.

Developmental dysplasia of the hip (DDH) poses challenges for component positioning during total hip arthroplasty (THA) secondary to abnormal bone morphology, soft-tissue contractures, and hip center migration. The objective of this study was to evaluate the radiographic and clinical outcomes of THA for DDH performed with robotic assistance versus manual (M) technique. A retrospective review identified 115 patients with Crowe II to IV dysplasia undergoing primary THA at a single institution from 2016 to 2022. There were 59 (51%) M-THAs and 56 (49%) RA-THAs. The median age was 49 years, the median body mass index was 28, and 94 (82%) patients were women. No difference was seen in Crowe classification between cohorts. The mean follow-up was two years. No difference was observed in mean surgical time between robotic-assisted THA (RA-THA) and manual THA (M-THA) cohorts (118 vs. 135 minutes, P = 0.23). Postoperatively, there was no difference in leg length discrepancy or hip center restoration. The RA-THA cohort had a lower rate of acetabular implant malposition (inclination and/or anteversion; n = 7, 15%) versus the M-THA (n = 16, 40%) cohort ( P = 0.01). There were two (3%) dislocations in the M-THA cohort versus no dislocations in the RA-THA cohort ( P = 0.17). There were three (5%) revision surgeries in the M-THA cohort, including one acetabular revision for recurrent instability, one femoral implant revision for aseptic loosening, and one femoral osteotomy with retrograde intramedullary lengthening nail for residual leg length discrepancy correction. There were no revision surgeries in the RA-THA cohort ( P = 0.09) or component revisions ( P = 0.17). In this series of primary THA for DDH, RA-THA was associated with decreased rates of acetabular implant malpositioning. In addition, RA-THA trended toward lower rates of dislocation and revision surgery with equivalent surgical times to M-THA, demonstrating its feasibility and efficacy in primary THA for DDH.

Dry eye disease (DED) is a prevalent and disabling condition. Artificial tears are commonly used but often inadequate for moderate-to-severe cases. Secretagogues such as pilocarpine, cevimeline, and diquafosol offer potential alternatives, though their comparative effectiveness remains unclear. To evaluate the safety and efficacy of these secretagogues versus artificial tears in adults with DED, we searched CENTRAL, PubMed, Scopus, LILACS, ClinicalTrials.gov, and WHO ICTRP without language restrictions. Randomized controlled trials (RCTs) comparing secretagogues to artificial tears were eligible. Data extraction and synthesis were conducted using Covidence and the Cochrane RoB 2 tool, and 19 RCTs (n = 2697) were included. Fifteen were analyzed quantitatively; however, only eight trials evaluating diquafosol were suitable for meta-analysis, as data for pilocarpine and cevimeline were insufficient for quantitative synthesis. GRADE was used to assess evidence certainty. PROSPERO registration: CRD42020218407. Diquafosol significantly improved rose bengal staining at 4 weeks and OSDI scores and TBUT in post-cataract patients at 4 and 12 weeks. However, it increased mild adverse events (RR, 1.81; 95% CI, 1.15–2.84). Evidence for pilocarpine and cevimeline was limited. Diquafosol 3% shows greater efficacy than artificial tears in post-cataract DED but with more side effects. Further research is needed for other secretagogues.

Purpose:To describe the surgical technique for implantation of a novel flexible, suturable, intrastromal synthetic cornea device.Methods:This report is a description of a novel surgical technique. Adult patients (≥18 years) with corneal edema who met specific inclusion criteria were enrolled. Intraoperative anterior segment optical coherence tomography was used to guide the surgery. The surgical procedure was performed under general anesthesia, utilizing a modified intrastromal pocket technique for secure implantation. First, a 4-mm partial-thickness trephination was created using a hand-held disposable metal trephine, followed by the manual dissection of a 360-degree intrastromal lamellar pocket at midstromal depth. After having completed the full-thickness trephination, the corneal button was removed and the device was carefully inserted into the pocket, rotated for proper positioning with the optical stem extending full thickness within the trephination wound and the skirt secured within the stromal pocket using 16 interrupted 10-0 nylon sutures.Results:A total of 8 surgeries were initiated. The procedure had to be aborted in only one patient because of anterior perforation of the cornea. Seven surgeries were completed satisfactorily without complications. Intraoperative AS-OCT confirmed the correct positioning of the device within the corneal stromal pocket and excellent apposition of the optical stem within the trephination wound.Conclusions:The intrastromal pocket implantation technique provides secure fixation and proper centration of this novel synthetic cornea device. The flexibility and suturability of the device eliminate the need for a carrier donor cornea.

IntroductionArtificial intelligence (AI) shows promise in ophthalmology, but its potential in tertiary care settings in Latin America remains understudied. We present a Mexican AI-powered screening tool and evaluate it against first-year ophthalmology residents in a tertiary care setting in Mexico City.MethodsWe analyzed data from 435 adult patients undergoing their first ophthalmic evaluation using an AI-based platform and first-year ophthalmology residents. The platform employs an Inception V3–based multi-output classification model with 512 × 512 input resolution to capture small lesions when detecting retinal disease. To evaluate glaucoma suspects, the system uses U-Net models that segment the optic disc and cup to calculate cup-to-disc ratio (CDR) from their vertical heights. The AI and resident evaluations were compared with expert annotations for retinal disease, CDR measurements, and glaucoma suspect classification. In addition, we evaluated a synergistic approach combining AI and resident assessments.ResultsFor glaucoma suspect classification, AI outperformed residents in accuracy (88.6% vs. 82.9%, p = 0.016), sensitivity (63.0% vs. 50.0%, p = 0.116), and specificity (94.5% vs. 90.5%, p = 0.062). The synergistic approach achieved a higher sensitivity (80.4%) than ophthalmic residents alone or AI alone (p < 0.001). AI’s CDR estimates showed lower mean absolute error (0.056 vs. 0.105, p < 0.001) and higher correlation with expert measurements (r = 0.728 vs. r = 0.538). In the retinal disease assessment, AI demonstrated higher sensitivity (90.1% vs. 63.0% for medium/high risk, p < 0.001) and specificity (95.8% vs. 90.4%, p < 0.001). Furthermore, differences between AI and residents were statistically significant across all metrics. The synergistic approach achieved the highest sensitivity for retinal disease (92.6% for medium/high risk, 100% for high risk).DiscussionAI outperformed first-year residents in key ophthalmic assessments. The synergistic use of AI and resident assessments showed potential for optimizing diagnostic accuracy, highlighting the value of AI as a supportive tool in ophthalmic practice, especially for early career clinicians.