Moderator
Kevin M. Miller, MD
Panelists
Kendrick M Wang, MD
Ali Nowrouzi, MD, FEBO, FRCS
Viewing Papers
Expand a paper title to the right to view the paper abstract and authors. Use the video link to jump to that poster in the session.
Presenting Author
Sarah Rahman, MD
Co-Authors
Kevin Everett MD, David Oh MD
Purpose
To compare outcomes of Vivity intraocular lens implantation in post-myopic LASIK or PRK patients with patients with no history of myopic laser correction
Methods
Retrospective chart review of patients who underwent Vivity intraocular lens implantation by a single surgeon at one institution from September 2020-August 2024. Exclusion criteria were history of radial keratotomy or hyperopic LASIK. A total of 183 eyes were included, 34 were post-myopic refractive surgery and 149 had not undergone any myopic laser correction. Primary outcome was uncorrected visual acuity at distance and intermediate at the 1 month postoperative visit. Secondary outcome was uncorrected visual acuity at near. Uncorrected visual acuity was compared between the two study groups.
Results
Distance logMAR vision was average of 0.11 in naive eyes and 0.13 in post-refractive eyes (p-value=.0.515). Intermediate logMAR visionwas an average of 0.16 in naive eyes and 0.21 in post-refractive eyes (p-value=0.11, n=114 naive and 26 post-refractive). Near logMAR vision was an average of 0.29 in naive eyes and 0.24 in post-refractive eyes (p=value=0.36).
Conclusion
There is no statistically significant difference in vision outcomes and distance, intermediate or near between eyes who have underwent post-myopic refractive surgery and eyes who have not undergone any myopic laser correction. This suggests that Vivity intraocular lens implantation has non-inferior outcomes after post-myopic refractive correction.
Presenting Author
Xiteng Chen, MD
Purpose
Oxidative stress results in lens inflammation, thus promoting the occurrence of cataract. This study aimed to investigate the impact of insulin on oxidative stress-induced inflammation in Human Lens Epithelial Cells (HLE-B3) and elucidate the underlying mechanism through which insulin exerts its anti-inflammatory effects.
Methods
Human anterior capsule membrane of lens including non-insulin group (I -) and insulin group(I+) were collected for Immunohistochemical staining (IHC) and immunofluorescence staining (IF) and the expression of inflammatory factors (CXCR1, CXCR2, and IL6) and ferroptosis-related protein (GPX4 and FTH1) were detected. In vitro, Western Blot, RT-qPCR, and IF were used to evaluate the effect of insulin on the expression of CXCR1, CXCR2, IL6, GPX4, and FTH1. Oil red O staining and Lipi-Green staining were utilized to measure lipid peroxide content, while FerroOrange staining was employed to determine Fe2+ content.
Results
Insulin decreased the expression of CXCR1, CXCR2, and IL-6 in HLE-B3 cells and increased the expression of GPX4 and FTH1. Additionally, insulin reduced the content of lipid peroxide and Fe2+ in HLE-B3 cells. More importantly, the reduction of ferroptosis reversed the inhibitory effect of insulin on the expression of inflammatory factors.
Conclusion
Insulin downregulates the expression of inflammatory and ferroptosis-related factors in HLE-B3 cells, potentially exerts its anti-inflammatory effect by inhibiting ferroptosis in HLE-B3 cells.
Presenting Author
Andreas F. Borkenstein, MD
Purpose
Pinhole intraocular lenses (IOLs) are presbyopia correcting IOLs that combine the proven principle of small aperture optics with an aspheric monofocal lens to deliver a continuous range of vision. Posterior capsule opacification is treated by Nd:YAG laser capsulotomy. If the laser beam is incorrectly focused, the IOL can be permanently damaged.
Methods
In this experimental study YAG-pits/damages were created on purpose. All defects were made with the exact same settings/energy levels (2.6mJ). Defects were analyzed and compared peripherally of the ring in the clear area of the hydrophobic acrylic lens and at the carbon black (CB)-polyvinylidene fluoride (PVDF) filtering component (FilterRing�) of the pinhole lens. The damage induced to the pinhole IOL was examined by low magnification images, light microscopy, scanning electron microscopy and micro-computed tomography. A video analysis and 3D-reconstruction was made to study the defects in detail.
Results
YAG-defects in the carbon black filter ring were much more severe than in the clear zone due to the high absorption of the carbon black. Massive defects and destruction of the lens with tearing out of fragments and particles was observed. The missing volume, calculated from the micro-CT reconstruction was 0.266 mm�, which is 1.6 % of the entire IOL-volume. This is more than 1000 times the volume damaged in the largest shots in the clear area in the periphery.
Conclusion
We highly recommend to use lowest possible energy levels, posterior offset setting and circular pattern for maximum safety when performing Nd:YAG capsulotomy with pinhole implants. It should be avoided to create irreversible defects that may affect overall quality. The safest area seems to be the clear area peripherally of the ring segment.
Presenting Author
Ritu R Sampige, BSc
Co-Authors
Aretha Zhu BSc, MD, Amisha Dave MD, Jennifer Ling BA, Dagny Zhu MD
Purpose
To evaluate the quality of refractive surgery content including the degree of misinformation on TikTok, a popular video-based social media platform.
Methods
The top 20 most-liked TikTok videos under each of the following hashtags, #lasik, #lasikeyesurgery, #prk, and #prksurgery, were identified in August 2024. Duplicate, irrelevant, and non-English videos were excluded. Each video was evaluated for creator type (e.g., healthcare provider versus non-healthcare provider), content purpose (i.e., education, promotion, personal/patient experience, or entertainment), engagement metrics (i.e., views, likes, comments, bookmarks, and reshares), overall sentiment (i.e., positive, neutral, or negative), and degree of misinformation. IBM SPSS Statistics 29.0 was used to run descriptive and comparative statistical analyses, including Mann�Whitney U tests.
Results
Sixty-two videos encompassing 189,678,034 total views with an average of 3,059,323 views per video were included. Ophthalmologists and patients created 25.8% and 64.5% of videos, respectively. A majority of videos (62.9%) fell under �personal experience," followed by education (24.2%). Most videos (43.5%) were in favor of refractive surgery while 16.1% were against. A significant proportion of videos contained misinformation (12.9%) and were more likely to come from non-healthcare providers (p < 0.05). Videos with misinformation garnered a significantly higher number of comments and reshares compared to videos without (p < 0.05). Additional hashtag and DISCERN analyses are pending.
Conclusion
Refractive surgery-related content is popular on social media, but a significant proportion of videos contain misinformation and are more likely to be reshared. There is a need for ophthalmologists to improve the quality of refractive-surgery content on social media by creating educational evidence-based information.
Presenting Author
Patrick Gooi, MD
Co-Authors
Abdullah Al-Ani PhD, Derek Waldner MD, PhD, Alison Banwell MD
Purpose
The purpose of this study is to validate a custom 3D-printed simulation handpiece for phacoemulsification, focusing specifically on nucleus disassembly and teaching chopping techniques. This tool aims to enhance tactile feedback and skill development in novice surgeons.
Methods
We designed the simulation handpiece by scanning a standard phacoemulsification handpiece and adding customized notches around the phaco tip. These notches represent desirable contact points, between the phaco tip and the chopper. The design�s purpose is to provide trainees with appropriate tactile feedback and proprioceptive cues when performing chopping maneuvers for nucleus disassembly in the closed, confined environment of the anterior chamber. The handpiece was then printed using 3D printing technology and tested for effectiveness in surgical simulation scenarios.
Results
We successfully replicated the phaco handpiece with the customized notches using 3D printing. The handpiece was trialed with several residents at the University of Calgary�s residency program. Using a previously validated questionnaire, we assessed the device�s face and content validity. Feedback from residents indicated that the handpiece provided acceptable and favorable tactile feedback, simulating the realistic feel of nucleus disassembly and chopping techniques. The custom notches effectively enhanced the training experience by offering precise contact cues, contributing to improved skill development in a safe, simulated setting.
Conclusion
This 3D-printed simulation handpiece offers an accessible, cost-effective way for novice phaco surgeons to practice nucleus disassembly techniques, specifically chopping. Implementing a 15-minute dry-fire session with this handpiece at the beginning of a trainee�s operating room day could enhance surgical readiness and confidence.
Presenting Author
Elad Ziv-On, MD, MPH
Purpose
The aim of this study was to examine public awareness of ophthalmic emergencies, as increased awareness and prompt seeking of medical attention can potentially improve patient prognosis.
Methods
This cross-sectional study (March-July 2023) used a questionnaire for patient companions in Shaare Zedek Medical Center's emergency department, Jerusalem. Available in Hebrew, English, and Arabic, it gathered demographics and presented 14 ophthalmic scenarios (11 emergencies, 3 non-urgent), including corneal foreign body/penetrating injury, chemical burns, and acute angle closure glaucoma. Scenarios were rated on a 1-5 urgency scale. Demographics covered age, gender, marital status, language, birth country, residence, education, medical occupation, smoking, eye health history, comorbidities, mental health, and recent doctor visits.
Results
Of 306 survey respondents, 55.9% were female, with a mean age of 45.15 years (SD 16.8). 38.6% had academic degrees and 15.03% reported eye diseases. The mean score for emergency conditions was 3.45 (SD 0.73), significantly higher than non-urgent conditions at 3.27 (SD 0.85; p < 0.001). No significant differences were found between genders or age groups in emergency question responses. However, higher average responses were associated with medical background, ophthalmic history, previous eye surgeries, higher education, and recent ophthalmologist visits. The more recent the eye doctor visit, the higher the average response. Notably, not all variables showed statistical significance.
Conclusion
This study reveals a significant gap in public awareness of ophthalmic emergencies. Medical background, eye health history, and education correlate with higher urgency ratings. Addressing this gap through targeted public education is crucial for enhancing timely care-seeking behavior, patient outcomes, and reducing preventable vision loss.
Presenting Author
Fatma Shakarchi, MD, MSc
Purpose
To evaluate cataract surgical coverage (CSC) and effective CSC (eCSC) in Rusafa district and develop strategies to improve these indicators by 15% within one year.
Methods
This prospective study aimed to improve cataract surgical indicators in Rusafa, Baghdad, Iraq, over one year. Interventions included integrating an electronic data system at Ibn Al-Haitham Hospital and training staff on outcome documentation. Public health campaigns raised awareness, and steps were taken to reduce patient and surgeon delays. Data on cataract surgical coverage (CSC) and effective CSC (eCSC) were collected at baseline, 3, 6, and 12 months to assess the impact of these strategies.
Results
At the end year one, the study observed a 17% increase in CSC, exceeding the initial target of 15%. The eCSC also improved significantly, with 84% of patients achieving a postoperative visual acuity of 6/18 or better, compared to 70% at baseline. The integration of the electronic data system resulted in a 95% compliance rate for documenting surgical outcomes. Public health campaigns contributed to a 12% increase in cataract-related outpatient visits, and the introduction of disincentives for delays reduced the average wait time for cataract surgeries by 20%. These improvements demonstrate the effectiveness of the implemented strategies in enhancing cataract surgical care.
Conclusion
The implementation of targeted strategies in the Rusafa district improved cataract surgical indicators, demonstrating the potential for similar interventions to enhance eye care outcomes in comparable settings.
Presenting Author
Robert K. Maloney, MD, MA, ABO
Co-Authors
Sloan Mahone PhD
Purpose
2025 is the 75th anniversary of the first implantation of an IOL by Harold Ridley. The widely accepted narrative is that Ridley and his invention received a hostile reception from Stewart Duke-Elder and other ophthalmic thought leaders. Ridley suffered greatly but was eventually vindicated as later IOL designs were widely accepted.
Methods
We argue that this narrative is biased because it was told by Ridley himself and amplified by his biographer and close friend, David Apple. Our argument is based on archival research at the Institute of Ophthalmology in London, interviews with survivors who knew Harold Ridley and a review of the literature.
Results
There were good reasons to be skeptical of Ridley�s invention. Ridley had not done pre-clinical studies, so his early patients suffered avoidable complications. His first patient had a postop spherical equivalent refraction of -21D because of an error in calculating the lens power. The implanted eyes developed severe inflammation from the sterilization chemical, cetramide. 21% of Ridley's patients suffered irreversible visual loss from glaucoma or corneal decompensation. He worked in secret at a time when openness was the norm. The cautious approach that Duke-Elder and others had towards IOLs is understandable.
Conclusion
The true history is a story of a clash of worldviews between an inventor who was focused on innovating quickly to solve a major clinical problem and established leaders who were concerned about the harm to patients from a flawed invention. The skepticism of established thought leaders remains a valuable check on overly aggressive innovation today.
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