Background. The aim of the current meta‐analysis was to compare the efficacy of microcatheter‐assisted circumferential trabeculotomy (Group 1) with that of conventional trabeculotomy (Group 2) for the treatment of childhood glaucoma. Methods. Published studies were systematically searched via the Web of Science, PubMed, Embase, and Cochrane Library databases. Odds ratios and 95% confidence intervals were calculated for dichotomous variables. Mean ± the standard deviation, mean difference, and 95% confidence intervals were calculated for continuous variables. Heterogeneity was assessed. Random effects modeling and RevMan version 5.30 were used to analyze the data. Results. Five eligible studies were included in the meta‐analysis. Mean postoperative intraocular pressures were significantly lower in Group 1 than in Group 2 at 3 months (P = 0.03), 6 months (P = 0.03), and 12 months (P = 0.007) postoperatively. The complete success rates were higher in Group 1 than in Group 2 at 3 months (P = 0.008), 6 months (P = 0.01), and 12 months (P = 0.004) postoperatively, as were the respective qualified success rates (P = 0.04, P = 0.0007, and P = 0.001). The pooled estimate indicated lower antiglaucoma medication use in Group 1, especially at 1 month postoperatively (P = 0.003). Conclusions. Microcatheter‐assisted circumferential trabeculotomy resulted in excellent intraocular pressure control, higher success rates, and the utilization of less medication than conventional trabeculotomy for childhood glaucoma. Therefore, microcatheter‐assisted circumferential trabeculotomy may be recommended as the initial procedure for the treatment of childhood glaucoma.

Background. This meta‐analysis is aimed at assessing the peripapillary vessel density (VD) and structural outcomes using optical coherence tomography angiography (OCTA) in patients with nonarteritic anterior ischemic optic neuropathy (NAION). Methods. A comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science databases for literature comparing VD and structural outcomes in patients with NAION and controls was performed. Mean differences (MDs) and its 95% confidence interval (CI) were calculated for continuous estimates. Review Manager (V5.30) was used for analysis. Results. Fourteen published studies met the requirement. The radial peripapillary capillary (RPC) whole enface VD measured by OCTA was significantly lower in patients with NAION compared to that of the controls (MD = −10.51, P < 0.00001). The RPC inside disc VD was significantly decreased in the NAION group than that in the control group (MD = −8.47, P < 0.00001). For RPC peripapillary VD, there was a statistically significant difference between patients with NAION and the controls (MD = −12.48, P < 0.00001). The peripapillary retinal nerve fibre layer (p‐RNFL) thickness was significantly lower in patients with NAION in comparison to the controls (MD = −22.18, P = 0.004). The ganglion cell complex (GCC) thickness in the macular zone of NAION patients was remarkably reduced compared to that in the controls (MD = −17.18, P = 0.0002). Conclusions. The findings suggested that the peripapillary VD and RNFL thickness were attenuated, and the macular GCC thickness was reduced in patients with NAION. OCTA, in the future, may facilitate the diagnosis and monitoring of patients with NAION.

Background. The aim of this meta-analysis was to compare morphological and functional outcomes between vitrectomy with the inverted internal limiting membrane (ILM) flap technique and vitrectomy with internal limiting membrane peeling in highly myopic eyes with macular hole- (MH-) induced retinal detachment (MHRD).Methods. The PubMed, Web of Science, Embase, and Cochrane Library databases were comprehensively searched from inception to November 10, 2019, for published studies comparing the two techniques for the treatment of MHRD. The outcomes in the collected articles included the postoperative MH closure rate, retinal reattachment rate, and best-corrected visual acuity (BCVA). Review Manager (version 5.3) was used for analyses.Results. In total, seven retrospective studies comparing the inverted ILM flap technique with ILM peeling for the treatment of MHRD were included. The MH closure rate was significantly higher in the inverted ILM flap group than in the ILM peeling group at 6 and 12 months after initial surgery (OR = 15.39; 95% CI: 6.68 to 35.43;P<0.00001and OR = 12.58, 95% CI: 3.51 to 45.08;P=0.0001), while the retinal reattachment rate was similar in both groups at 6 months after initial surgery (OR = 2.40; 95% CI: 0.89 to 6.50;P=0.08). Besides, the postoperative BCVA was significantly better in the inverted ILM flap group than in the ILM peeling group at 12 months after initial surgery (MD = −0.35; 95% CI: −0.52 to −0.18;P<0.0001).Conclusions. Thus, the MH closure rate and postoperative BCVA may be better with the inverted ILM flap technique than with ILM peeling for myopic MHRD, while the postoperative retinal reattachment rate appears to be similar with both techniques. Therefore, in the future, vitrectomy with the inverted ILM flap technique should be preferred over standard ILM peeling technique for the treatment of MHRD in highly myopic eyes.

Purpose: To compare early clinical outcomes, centration accuracy, and optical quality–related parameters after small incision lenticule extraction (SMILE) performed using the VisuMax 800 and VisuMax 500 platforms in a Chinese population with myopia and low-to-moderate astigmatism. Methods: This retrospective, single-center comparative study included 200 patients (200 eyes) who underwent SMILE between May and August 2025. Patients were grouped according to the laser platform used in routine clinical practice: the SMILE group (VisuMax 500, n = 100) and the SMILE Pro group (VisuMax 800, n = 100). To avoid inter-eye correlation, one eye per patient was included in the analysis. Baseline characteristics were comparable between groups. At 3 months postoperatively, outcomes assessed included visual acuity, refractive outcomes, optical zone decentration, corneal higher-order aberrations, astigmatism vector parameters using the Alpins method, and exploratory correlation analyses between centration metrics and postoperative optical and astigmatic outcomes. Results: No significant between-group differences were observed in postoperative uncorrected or corrected distance visual acuity, safety index, or efficacy index (all p > 0.05). Compared with the SMILE group, the SMILE Pro group showed significantly shorter lenticule creation time (9.47 ± 0.88 s vs. 27.43 ± 2.26 s, p < 0.01), lower absolute Y-axis decentration and total optical zone decentration (both p < 0.01), and lower postoperative vertical coma ( p = 0.004). Postoperative residual cylindrical error was also lower in the SMILE Pro group ( p = 0.048), although the absolute between-group difference was small. In astigmatism vector analysis, the SMILE Pro group showed lower magnitude of error and index of success values (both p < 0.05). Exploratory correlation analysis showed a significant positive association between vertical decentration and postoperative vertical coma in both groups, whereas total decentration was significantly associated with the index of success only in the SMILE group. Conclusion: At 3 months postoperatively, both VisuMax 500-and VisuMax 800-based SMILE showed favorable safety and efficacy for the correction of myopia and low-to-moderate astigmatism. Compared with conventional SMILE (VisuMax 500), SMILE Pro (VisuMax 800) was associated with shorter laser scanning time, lower optical zone decentration, lower postoperative vertical coma, and more favorable astigmatic vector outcomes. These findings represent early postoperative results and should be interpreted cautiously. Further prospective, multicenter studies with larger sample sizes and longer follow-up are warranted.

Purpose: To evaluate vector outcomes and higher-order aberrations (HOAs) in eyes with high astigmatism (HA) and their contralateral eyes with moderate-to-low astigmatism (MLA) after small-incision lenticule extraction (SMILE Pro) with automated cyclotorsion compensation. Methods: This single-center retrospective study included 30 patients (60 eyes) who underwent bilateral SMILE Pro using the VISUMAX 800 platform with OcuLign iris registration. The eyes were classified as HA [> 2.00 diopters (D)] or MLA (≤ 2.00 D) according to their preoperative cylinder magnitude. Visual acuity, refractive outcomes, Alpins vector parameters, intraoperative decentration, and HOAs were compared at 6 months after surgery. Results: The mean preoperative manifest cylinder was 2.38 ± 0.25 D in HA eyes and 1.41 ± 0.49 D in MLA eyes. At 6 months, uncorrected distance visual acuity was comparable between eye groups ( p = 0.40). The correction index (0.95 ± 0.10 vs. 0.96 ± 0.12; p = 0.52), absolute angle of error (2.42 ± 2.49° vs. 1.99 ± 2.34°; p = 0.46), and index of success were similar between HA and MLA eyes. Residual cylinder and difference vector were nominally higher in HA eyes in the unadjusted analyses, but the paired differences were small (both 0.13 D) and did not remain statistically significant after false discovery rate correction. Horizontal intraoperative decentration and trefoil also showed nominal unadjusted differences that did not remain significant after FDR correction. Postoperative total HOAs, spherical aberration, and coma were comparable between groups. Conclusion: In this small retrospective contralateral-eye cohort, SMILE Pro with OcuLign-assisted cyclotorsion compensation showed favorable 6-month visual, refractive, and vector outcomes in eyes with astigmatism slightly above 2.00 D. These findings should be interpreted cautiously given the modest sample size, narrow HA range, and absence of a non-inferiority design.

Introduction This study aims to evaluate the short-term safety and efficacy of the Loong Crystal^®PR lens, a novel posterior chamber phakic intraocular lens (PIOL) that utilizes advanced optical and material designs. Methods The single-center retrospective case series included 67 eyes of 34 patients with moderate and high myopia who underwent the PR implantation from February to July 2025. Corrected distant visual acuity (CDVA) and anterior chamber depth (ACD) were measured preoperatively. Uncorrected distant visual acuity (UDVA), refractive errors, higher-order aberrations (HOAs), intraocular pressure (IOP), and endothelial cell density (ECD) were measured preoperatively, at 1 week, and at 1 month postoperatively. The central and peripheral vault were measured on the operating day, at 1 week, and at 1 month after surgery. Results At 1 month postoperatively, 95.5% of eyes achieved UDVA equal to or better than the preoperative CDVA. The efficacy index was 1.17 ± 0.19 at 1 month postoperatively. Also, 94.0% of eyes achieved UDVA of 20/20 or better and 94.0% of eyes had residual spherical equivalent (SE) refraction within ± 1.00 D at 1 month postoperatively, demonstrating excellent visual outcomes and refractive predictability. No significant difference in ECD was observed 1 month postoperatively (3118.27 ± 180.95 cells/mm²) compared to the preoperative value (3081.12 ± 288.08 cells/mm²). Stable central and peripheral vaults remained at 376.27 ± 168.95 μm and 485.72 ± 179.62 μm, at postoperative 1 month, respectively, compared to the surgery-day values of 373.51 ± 182.41 μm and 486.24 ± 172.41 μm, respectively. There were no significant differences of HOAs at postoperative 1 month compared to the preoperative outcomes. Conclusions The Loong Crystal^® PR lens demonstrates good, predictable efficacy and stability in correcting myopia, with a low risk of adverse events and complications at 1 month postoperatively, indicating its short-term safety and efficacy.