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Fahmeeda Murtaza,1 Qayim Kaba,2 Sohel Somani,3– 5 Eric S Tam,3– 5 Darana Yuen3,4 1Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; 2Cardiff University, Cardiff, Wales, UK; 3Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada; 4Uptown Eye Specialists, Brampton, ON, Canada; 5Division of Ophthalmology, William Osler Health System, Brampton, ON, CanadaCorrespondence: Darana Yuen, Uptown Eye Specialists, 401-7900 Hurontario Street, Brampton, ON, L6Y 0P6, Canada, Tel +1 416-292-0330, Fax +1 416-292-0331, Email daranayuen2@gmail.comPurpose: To investigate the safety and effectiveness of micropulse transscleral cyclophotocoagulation (MPTSCPC) in non-incisional eyes with ocular hypertension (OHT) and early, moderate, and severe primary open-angle glaucoma (POAG).Methods: Retrospective cohort study of eyes that underwent MPTSCPC from 2016 to 2019 at an outpatient clinic in Canada. Eyes were excluded if any incisional procedures, except cataract surgery, were performed prior to MPTSCPC treatment. Laser power ranged from 900 to 2500mW.Results: A total of 153 eyes from 93 patients were included (OHT n=22; early POAG n=46; moderate POAG n=35; severe POAG n=50). The baseline IOP was 18.37 ± 4.76mmHg in the total cohort. All cohorts experienced a significant mean IOP reduction by final follow-up (total p< 0.001; OHT p=0.003; early POAG p< 0.001; moderate POAG p=0.022; severe POAG p=0.015). Overall, 52.9% of eyes achieved an IOP reduction of ≥ 20% from baseline to final follow-up (OHT 59.1%; early POAG 58.7%; moderate POAG 45.7%; severe POAG 50.0%). There was worsening in best-corrected visual acuity in the total cohort (mean difference=0.11 ± 0.36 logMAR, p=0.11), mostly attributable to cataract progression (34.1% of phakic eyes) and ocular surface disease (7.2%). The number of topical medications and drug classes remained unchanged in the total cohort (p=0.425 and p=0.791, respectively). Twenty-two eyes

Sohel Somani,1 Keyvan Koushan,2 Bijal Shah-Manek,3 Daniel Mercer,4 Thula Kanagenthiran,5 Changgeng Zhao,5 Ali Alobaidi5 1Department of Ophthalmology and Vision Sciences, University of Toronto and Uptown Eye Specialists, Brampton, Canada; 2Toronto Retina Institute, Toronto, Canada; 3Health Economics and Outcomes Research, Noesis Healthcare Technologies, Inc., Redwood City, CA, USA; 4Genesis Research, Hoboken, NJ, USA; 5Allergan, an AbbVie Company, Irvine, CA, USACorrespondence: Sohel Somani, Email sohel.somani@uptowneye.caPurpose: To understand the demographics, clinical characteristics, treatment patterns, visual and anatomic responses of patients with diabetic macular edema (DME) initially treated with anti-vascular endothelial growth factor (anti-VEGF) agents in the real-world clinical setting.Patients and Methods: This retrospective cohort study used electronic health records to identify consecutively presenting patients with DME who received their first documented anti-VEGF injection (index injection) on or after 1 October 2015 and before 30 September 2016 (index period) at 4 clinical sites in Ontario, Canada. Patients receiving anti-VEGF injections in the study eye were followed for ≥ 18 months. After the first 3 monthly injections, patients were classified as “responder” (≥ 20% reduction in central retinal thickness [CRT] from index date) or “nonresponder” (< 20% reduction in CRT) to anti-VEGF treatment.Results: At 12 months, change from baseline (CFB) in best visual acuity (BVA) of responders (n = 30) was mean (SD) 12.8 (13.00) letters; CFB in nonresponders (n = 56) was 3.2 (16.3) letters. Sensitivity analyses stratified by initial BVA were supportive. Mean (SD) change in CRT (μm) was − 160.4 (111.4) in responders and − 62.2 (98.6) in nonresponders. While changes in anti-VEGF therapy were lower in responders versus nonresponders (10.0% vs 23.2%), mean number of injections was similar (8.3 in each cohort).Conclusion: Despite receiving a sub

Mark K Lukewich,1 Fahmeeda Murtaza,1 Sohel Somani,2– 4 Eric S Tam,2– 4 Hannah H Chiu2– 4 1Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; 2William Osler Health System, Brampton, Ontario, Canada; 3Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; 4Uptown Eye Specialists, Vaughan, Ontario, CanadaCorrespondence: Hannah H Chiu, Uptown Eye Specialists, 401-7900 Hurontario Street, Brampton, Ontario, L6Y 0P6, Canada, Tel +1 416 292-0330, Fax +1 416 292-0331, Email hannah.chiu@utoronto.caAim: To compare residual astigmatism prediction errors across Barrett toric calculations using predicted posterior corneal astigmatism (PCA) and PCA measured using the IOL Master 700 with total keratometry (IOLM).Methods: A retrospective cohort study was undertaken on patients with corneal astigmatism and no other ocular comorbidities that underwent uneventful refractive femtosecond laser-assisted cataract surgery with toric IOL implantation between May 2019 and November 2019. Toric calculations were performed using the Barrett toric calculator and the following values: predicted PCA with anterior corneal measurements from Pentacam, IOLM standard keratometry (SK), OPD scan, and median measurements from these devices; predicted PCA with IOLM total keratometry (TK); and measured PCA with IOLM SK or IOLM TK. Residual astigmatism prediction error was calculated for each device and method of calculation at postoperative month 1 and 3 using the astigmatism double angle plot tool.Results: A total of 24 eyes, 10 with-the-rule (WTR), 10 against-the-rule (ATR) and 4 oblique astigmatism, from 24 patients were included in this study. PCA ranged from 0.00 to 0.67 D with a mean of 0.24 ± 0.15 D in all eyes. PCA was significantly greater in WTR eyes (0.32 D) compared to ATR eyes (0.16 D; p < 0.05). In ATR eyes, calculations made using IOLM SK and measured PCA had significantly lower total corneal astigmatism and toric

Qayim Kaba,1 Felicia Tai,2 Ahmad Al-Awadi,3 Sohel Somani4– 6 1Cardiff University School of Medicine, Cardiff, UK; 2Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; 3Mayo Clinic School of Graduate Medical Education, Jacksonville, FL, USA; 4Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada; 5Uptown Eye Specialists, Brampton, Ontario, Canada; 6William Osler Health Centre, Brampton, Ontario, CanadaCorrespondence: Sohel Somani, Uptown Eye Specialists, 401-7900 Hurontario Street, Brampton, ON, L6Y 0P6, Canada, Email s.somani@utoronto.caPurpose: This prospective cohort study examined the relationship between diabetic macular edema (DME), diabetic retinopathy (DR) and obstructive sleep apnea (OSA) in patients after 1 year of treatment with anti-VEGF injection and/or continuous positive airway pressure (CPAP).Patients and Methods: The study included adults with type 1 or 2 diabetes mellitus with diabetic retinopathy. Polysomnography metrics were measured at baseline. Ophthalmologic metrics were measured at baseline, six-month (6m) and twelve-month (12m) follow-up. All DME+ patients received standard care, and all OSA+ patients were advised continuous positive airway pressure (CPAP). Logistic regression between DR severity and OSA severity was performed. Analysis of variance (ANOVA) was performed between subgroups.Results: Seventy-four eyes of 49 patients with DR were included. Prevalence of OSA was significantly higher in the DME+ group (70.7%) than DME- group (42.4%, p < 0.05). A significantly lower average minimum SaO2 was noted in OSA+DME+ (81.74%) than OSA+DME- eyes (88.23%, p < 0.05). Logistic regression analysis of ophthalmological and sleep metrics showed no correlation between DR and OSA severity. CPAP adherence was 20% (6/30) in the OSA+DME+ cohort and 36% (5/14) in the OSA+DME- cohort. At 12m, CPAP-adherent OSA+DME+ showed significantly lower DR severity score (1.00 ± 0.0) than CPAP non

Fahmeeda Murtaza,1 Dana Toameh,2 Saed Al-Habib,3 Raj Maini,2 Hannah H Chiu,2,4,5 Eric S Tam,2,4,5 Sohel Somani2,4,5 1Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; 2Uptown Eye Specialists, Brampton, Ontario, Canada; 3U Sculpt Plastic Surgery, Vaughan, Ontario, Canada; 4Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada; 5William Osler Health System, Brampton, Ontario, CanadaCorrespondence: Sohel SomaniUptown Eye Specialists, 401-7900 Hurontario Street, Brampton, Ontario, L6Y 0P6, CanadaTel +1 416 292-0330Fax +1 416 292-0331Email s.somani@utoronto.caBackground: BroadBand light intense pulsed light (BBL-IPL) therapy has shown to reduce hordeolum and blepharitis frequency. This study aims to evaluate the efficacy and safety of BBL-IPL therapy in patients with dry eye disease (DED) from meibomian gland dysfunction (MGD).Methods: This is a retrospective, consecutive case series of 48 patients with DED from MGD who underwent BBL-IPL therapy from October 2016 to January 2019 at a single, outpatient clinic in Ontario, Canada. Clinical outcomes included first and average non-invasive keratograph tear break-up times (NIKBUT), bulbar redness (BR) scores, tear meniscus heights (TMH), visual acuity (VA) and meibograph grades. Patient-reported outcomes included the Canadian dry eye assessment (CDEA) questionnaire and patient subjective assessment (PSA) scores. Outcomes were measured at baseline and after completion of 4 monthly BBL-IPL sessions.Results: The mean severity of dry eye symptoms as measured by the CDEA and PSA decreased significantly from 19.78 ± 9.62 to 12.08 ± 7.40 (p< 0.001) and from 7.65 ± 1.74 to 4.77 ± 2.03 (p< 0.001), respectively. Twenty-five percent of patients reported no dry eye symptoms after treatment. The meibograph grade improved significantly in both eyes (p< 0.001). Approximately 71.0% and 80.1% of patients had an improved meibograph grade in the right and left

Carter W Lim,1– 3 Sohel Somani,3– 5 Hannah H Chiu,3– 5 Raj Maini,3– 5 Eric S Tam3– 5 1Faculty of Medicine, University of Ottawa, Ottawa K1H 8M5, Canada; 2Eye Foundation of Canada, Toronto M3N 2V6, Canada; 3William Osler Health System, Brampton L6R 3J7, Canada; 4Uptown Eye Specialists, Brampton L6Y 0P6, Canada; 5Faculty of Medicine, University of Toronto, Toronto M5S 1A8, CanadaCorrespondence: Eric S TamUptown Eye Specialists, 401-7900 Hurontario Street, Brampton L6Y 0P6, ON, CanadaTel +1416-292-0330Email ericstam@gmail.comPurpose: To determine astigmatic changes of intrastromal limbal-relaxing incisions (LRIs) performed during femtosecond laser-assisted cataract surgery (FLACS).Design: Retrospective case series.Patients and Methods: Patients undergoing FLACS with adjunctive astigmatism management with intrastromal LRIs were included. All eyes had preoperative corneal cylinder (Kcyl) ≥ 0.20 D on ocular biometry. An intrastromal LRI nomogram of single, non-paired LRIs placed at the 9 mm optical zone was used. Keratometry was measured preoperatively, and postoperatively at 1 week, 1 month, and 3 months (POM3). Alpins astigmatism analysis was used to calculate target-induced astigmatism (TIA, equivalent to preoperative Kcyl), surgically induced astigmatism (SIA), difference vectors (DV), and correction indices (CI). Secondary analysis included multivariable binary logistic regression to determine clinical factors associated with corrections > 125% (CI >  1.25).Results: A total of  154 eyes (125 patients) were studied. Mean preoperative Kcyl was 0.87± 0.42 D (SD), which did not significantly differ from POM3 Kcyl (0.87± 0.51 D, p=0.470). Only the against-the-rule (ATR) subgroup demonstrated a small but significa

Nadeem Ali Dhirani,1 Yelin Yang,2 Sohel Somani2–4 1Wayne State University School of Medicine, Detroit, MI, USA; 2Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, 3William Osler Health System, Brampton, ON, 4Uptown Eye Specialists, Brampton, ON, Canada Objective: To evaluate the short- and long-term outcomes of half-dose verteporfin with photodynamic therapy (PDT) in the treatment of chronic central serous retinopathy (CSR). Design: Retrospective case series.Participants: 45 eyes in 39 patients with chronic CSR were included. Diagnosis of chronic CSR was confirmed by fluorescein angiography and persistence of subretinal fluid by optical coherence tomography for a minimum of 3 months duration.Methods: Each patient underwent treatment with half-dose verteporfin with full-fluence PDT; initial follow-up was defined as a 6–8 week visit following the treatment, and final follow-up ranged from 5 to 70 months.Results: The average follow-up period for treatment was 19.3 months. Best-corrected visual acuity increased from logMAR means of 0.52 to 0.42 (p<0.05). Central retinal thickness and choroidal thickness also significantly decreased at last follow-up (p<0.05). Eight of 45 eyes (18%) demonstrated a recurrence of CSR following treatment within the follow-up period. At the final follow-up, 41 out of the 45 eyes (91%) had complete resolution of subretinal fluid accumulation.Conclusion: Half-dose PDT is an effective treatment option for chronic CSR in a Canadian population, and it is both safe and durable. The positive treatment effect is realized rapidly, with the initial 6-week result highly correlated with the final follow-up result. Keywords: central serous chorioretinopathy, photodynamic therapy, verteporfin, half-dose verteporfin&nbsp