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To identify real-world complications involving flanged scleral tunnel fixation of Zeiss CT Lucia 602 intraocular lenses, the Food and Drug Administration Manufacturer and User Facility Device Experience (FDA MAUDE) was searched by Manufacturer field for Zeiss with the terms "Ya-mane" and "scleral fixated". Reports containing these terms were reviewed to confirm technique and categorize adverse events. The search yielded 178 confirmed reports of lens malfunctions for CT Lucia 602 between 2013 to 2024, with 95% of reports in the last 3 years. The most common complication was lens tilt (94 reports), followed by breakage (53) comprised of haptic-optic disinsertion (31) and haptic breakage (22). Intraoperatively, 118 (66.3%) complications occurred, and 60 (33.7%) occurred postoperatively. Temporal analysis revealed that the number of reports to MAUDE has shown a ten-fold annual increase since 2020. Reports suggest haptic breakage is a noteworthy malfunction for CT Lucia 602 lenses. The occurrence of intraoperative breakage and lens tilt may be higher than previously expected in real-world settings. [ Ophthalmic Surg Lasers Imaging Retina 2024;55:XX-XX.] .

Deep learning has enabled breakthroughs in automated diagnosis from medical imaging, with many successful applications in ophthalmology. However, standard medical image classification approaches only assess disease presence at the time of acquisition, neglecting the common clinical setting of longitudinal imaging. For slow, progressive eye diseases like age-related macular degeneration (AMD) and primary open-angle glaucoma (POAG), patients undergo repeated imaging over time to track disease progression and forecasting the future risk of developing a disease is critical to properly plan treatment. Our proposed Longitudinal Transformer for Survival Analysis (LTSA) enables dynamic disease prognosis from longitudinal medical imaging, modeling the time to disease from sequences of fundus photography images captured over long, irregular time periods. Using longitudinal imaging data from the Age-Related Eye Disease Study (AREDS) and Ocular Hypertension Treatment Study (OHTS), LTSA significantly outperformed a single-image baseline in 19/20 head-to-head comparisons on late AMD prognosis and 18/20 comparisons on POAG prognosis. A temporal attention analysis also suggested that, while the most recent image is typically the most influential, prior imaging still provides additional prognostic value., (© 2024. The Author(s).)

Selective laser trabeculoplasty (SLT) has been in routine clinical use for over 20 years with millions of patients successfully treated and a low rate of clinically significant complications. The procedure requires the clinician to manually position the laser beam on the trabecular meshwork using a gonioscopy lens and to titrate the SLT laser energy based on the amount of pigmentation in the angle, as well as the observation of small bubbles produced by the laser effect. We propose that SLT energy titration is unnecessary either to achieve intraocular pressure (IOP) reduction or to minimize potential side effects. Ample evidence to support our proposal includes multiple clinical reports demonstrating comparable levels of IOP reduction resulting from different laser energies, a large variety of energy and other laser parameters used in commercially available SLT lasers, and the nature of the laser-induced changes in the trabecular meshwork tissue with respect to energy. Despite these variations in laser parameters, SLT consistently reduces IOP with a low complication rate. We propose that using low fixed energy for all patients will effectively and safely lower patients' IOP while reducing the complexity of the SLT procedure, potentially making SLT accessible to more patients., Competing Interests: Disclosure: S.V.T., G.S., and Y.S. are consultants to BELKIN Vision. Z.S., G.G, T.S., are consultants and hold options in BELKIN Vision. M.B. is the founder and holds shares of BELKIN Vision. The remaining authors declare no conflict of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Aim: To determine relationships between retinal nerve fiber layer (RNFL) thickness and nadir CD4 cell count in human immunodeficiency virus (HIV) positive patients evaluated for glaucoma suspicion., Methods: Data were reviewed for 329 HIV positive patients evaluated for glaucoma suspicion. High-definition optical coherence tomography (OCT) RNFL measurements were obtained at least 6mo apart. Analyses were performed to identify relationships between nadir CD4 count and RNFL thickness., Results: Totally 110 eyes of 55 patients met inclusion criteria, of which 46 eyes were from subjects with nadir CD4<200 cells/mm 3 and 64 had nadir CD4≥200 cells/mm 3 . Patients with nadir CD4<200 cells/mm 3 had significantly thicker superior (119.7±18.6 µm) and temporal (63.8±11.7 µm) quadrants at time of initial OCT compared to the superior (112.8±16.8 µm, P =0.048) and temporal (57.1±11.9 µm, P =0.004) quadrants of patients with higher nadir CD4. This trend toward thicker RNFL among subjects with lower nadir CD4 cell counts persisted at the time of follow up OCT where participants with nadir CD4<200 cells/mm 3 showed average RNFL thickness in the superior and temporal quadrants of 117.9±18.3 µm and 63.8±12.8 µm, respectively, compared to a superior thickness of 110.5±16.9 µm ( P =0.034) and temporal thickness of 57.3±11.6 µm ( P =0.007) among those with higher nadir CD4., Conclusion: Patients with lower nadir CD4 cell counts have thicker RNFL in the superior and temporal quadrants compared to those with higher nadir CD4 counts. RNFL thickness in HIV positive patients may be affected by historic HIV disease control and should be considered when evaluating HIV positive patients for glaucoma.

Aim: To compare the outcomes of dacryocystorhinostomy (DCR) using traditional Crawford tubes (TCT) and Crawford tubes with suture (CTS) in the lumen., Methods: Retrospective case series consisting of patients who underwent DCR between 2008 and 2013., Results: A total of 61 DCRs were performed on 50 patients. Patients who underwent DCR using CTS had higher rates of prolapse compared to the TCT group (50% vs 9.4%; P=0.003). Stent removal occurred earlier in patients who received CTS (3.3mo vs 5.1mo; P=0.004). Success rates were equivalent between the two groups (75% vs 81.1%; P=0.684)., Conclusion: CTS in the lumen increases the risk of prolapse, prompting earlier tube removal in patients following DCR for nasolacrimal duct obstruction (NLDO). Earlier removal of tubes does not appear to significantly decrease success rates.