Background: Large language models (LLMs) such as ChatGPT-4 and Google Gemini show potential for patient health education, but concerns about their accuracy require careful evaluation. This study evaluates the readability and accuracy of ChatGPT-4 and Google Gemini in answering questions about retinal detachment. Methods: Comparative study analyzing responses from ChatGPT-4 and Google Gemini to 13 retinal detachment questions, categorized by difficulty levels (D1, D2, D3). Masked responses were reviewed by ten vitreoretinal specialists and rated on correctness, errors, thematic accuracy, coherence, and overall quality grading. Analysis included Flesch Readability Ease Score, word and sentence counts. Results: Both Artificial Intelligence tools required college-level understanding for all difficulty levels. Google Gemini was easier to understand (p = 0.03), while ChatGPT-4 provided more correct answers for the more difficult questions (p = 0.0005) with fewer serious errors. ChatGPT-4 scored highest on most challenging questions, showing superior thematic accuracy (p = 0.003). ChatGPT-4 outperformed Google Gemini in 8 of 13 questions, with higher overall quality grades in the easiest (p = 0.03) and hardest levels (p = 0.0002), showing a lower grade as question difficulty increased. Conclusions: ChatGPT-4 and Google Gemini effectively address queries about retinal detachment, offering mostly accurate answers with few critical errors, though patients require higher education for comprehension. The implementation of AI tools may contribute to improving medical care by providing accurate and relevant healthcare information quickly.

Précis: After the open bleb revision following PreserFlo, the mean postoperative intraocular pressure (IOP) was lowered from 26.4 ± 9.9 mm Hg to 12.9 ± 5.6 mm Hg at 1 month and 15.9 ± 4.1 mm Hg at 12 months. Purpose: The purpose of this study was to evaluate the effectiveness and safety of an open bleb revision with mitomycin- C (MMC) for bleb fibrosis after PreserFlo MicroShunt implantation. Patients and Methods: We performed a retrospective analysis of 27 consecutive patients with bleb fibrosis after PreserFlo MicroShunt Implantation that underwent an open revision with MMC 0.2 mg/mL applied for 3 minutes at the Department of Ophthalmology of the Mainz, University Medical Center, Mainz, Germany. Demographic data, such as age, sex, glaucoma type, number of glaucoma medications, IOP before and after PreserFlo implantation and revision, complications, and reoperations within 12 months, were analyzed. Results: Twenty-seven patients (27 eyes) received an open revision after previous PreserFlo Microshunt implantation and consecutive bleb fibrosis. The mean preoperative IOP was 26.4 ± 9.9 mm Hg before revision, 7.0 ± 2.7 mm Hg ( P < 0.001) in the first week after the revision, and 15.9 ± 4.1 mm Hg at 12 months ( P = 0.02). Four patients needed IOP-lowering medication after 12 months. One patient had a positive Seidel test and needed a conjunctival suture. Four patients required a second procedure due to recurring bleb fibrosis. Conclusions: At 12 months, open revision with MMC for bleb fibrosis after failed PreserFlo implantation effectively and safely reduced IOP with a similar medication burden.

Purpose: Climate change, largely driven by greenhouse gas emissions, is a global threat. The healthcare sector contributes significantly − 4.4% of global and 5.2% of Germany’s CO ₂ emissions. Rhegmatogenous retinal detachment (RRD) is a common ophthalmic emergency requiring surgical intervention to prevent blindness. Fluorinated gases (FG) such as SF ₆ , C ₂ F ₆ , and C ₃ F ₈ are routinely used in pars plana vitrectomy (ppV) due to their expansive properties, but they have a strong greenhouse effect. With an European Union-wide ban under consideration, this study assesses the associated emissions from ppV for RRD in Germany. Methods: We analyzed DRG-coded ppV data for RRD (2013–2023) from the German Federal Statistical Office. A national survey of vitreoretinal surgeons provided information on endotamponade preferences. CO ₂ -equivalent emissions (CO ₂ EM) were calculated using GWP100 values from the IPCC report. Results: Between 2013 and 2023, 354,505 ppV for RDD were performed in Germany. Gas tamponade was used in 55.3% of cases, silicone oil in 27.7%, and air in 16.9%. FG resulted in 201.34 tons of CO ₂ EM. SF ₆ contributed 170.10 tons (84.5%), C ₂ F ₆ 26.84 tons (13.3%), and C ₃ F ₈ 4.40 tons (2.2%). This represents 18.3 tons of CO ₂ EM annually, corresponding to 0.000003% of Germany’s total CO ₂ EM and 0.00003% of healthcare sector emissions. Conclusion: This first comprehensive analysis of FG consumption and CO ₂ EM in ppV for RRD in Germany shows that FG contribute a negligible portion to Germany’s and healthcare-related CO ₂ EM. Gas tamponade remains crucial for the treatment of RDD and should therefore not be banned until proven alternatives exist. Further studies are needed to explore alternatives.

Background: Tamoxifen, a commonly used selective estrogen receptor antagonist for adjuvant therapy in hormone receptor-positive breast cancer, can cause ocular side effects due to estrogen receptors in ocular structures. This prospective study explores its impact on ocular morphology and function. Materials and methods: This prospective, non-interventional, cross-sectional study explores the effects of tamoxifen on ocular morphology, visual acuity, and quality. Examinations included objective refractometry, visual acuity, contrast sensitivity, color vision, visual field tests, corneal topography, optical coherence tomography, autofluorescence, and slit lamp biomicroscopy. Participants completed a health questionnaire. Statistical analysis, using linear or logistic (mixed) regression, compared tamoxifen’s effects to a control group. Results: A total of 102 patients were included: 90 in the study group and 12 controls. The duration of tamoxifen therapy showed a clinically relevant impact on the visual field, with a mean loss variance change of 0.045 dB² per week (95% CI [0.012 dB²; 0.079 dB²]). Corneal thickness decreased by −0.12 μm per week (95% CI [−0.20 μm; −0.031 μm]) with longer therapy duration. Fourteen patients received additional aromatase inhibitors, and this group showed clinically significant reductions in both visual acuity and contrast vision. No correlation was observed between tamoxifen intake and visual acuity, contrast vision, color vision, mean defect in visual fields, retinal thickness, macular morphology, or slit-lamp biomicroscopy findings. Conclusion: According to this study, tamoxifen intake influences corneal thickness and perimetry, which are two parameters associated with glaucoma development. Regular ophthalmological glaucoma controls could be useful in tamoxifen patients, especially if glaucoma is already known.