Current Issue : October-December Volume : 2026 Issue Number : 4 Articles : 5 Articles
Background/Objectives: Uncorrected refractive errors (UREs) are a primary cause of preventable visual impairment in children globally, impacting education and quality of life. In Jakarta, prevalence has surged to 40% post-pandemic, categorizing it as a serious public health problem. This study aimed to develop and validate the CIPSEL questionnaire as a rapid, culturally adapted screening tool for identifying visual impairment consistent with possible UREs among Indonesian school-aged children. Methods: A cross-sectional study was conducted in South Jakarta with 131 students aged 8–12 years. The 10-item CIPSEL questionnaire, exploring visual behaviors and symptoms, was administered via face-toface interviews. Visual acuity was assessed using a standard Snellen chart by medical personnel blinded to the questionnaire results. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curve analysis, with optimal thresholds determined via the Youden Index and the shortest distance to (0, 1). Results: Visual impairment was identified in 26 students (19.8%). Mean CIPSEL scores were significantly higher in students with visual impairment (4.73) compared to those with normal vision (1.95). ROC analysis showed considerable diagnostic accuracy with an AUC of 0.887 (95% CI: 0.829–0.946). A safety-first cutoff of 2.5 prioritized sensitivity (96.2%), while a balanced cutoff of 3.5 provided 80.8% sensitivity and 79.0% specificity. A tiered risk system (Low, Medium, and High) demonstrated a robust statistical association with actual clinical findings (Cramer’s V = 0.534, p < 0.001). Conclusions: CIPSEL is a reliable and scalable screening tool for the early detection of visual impairment in Indonesian children. Its tiered risk stratification framework facilitates nuanced clinical decision-making and efficient resource allocation in school-based settings. Its accessibility for non-medical personnel and potential for digital integration support national efforts toward universal eye health....
Background and Objectives: Pediatric cataract comprises a heterogeneous group of disorders with varying etiologies, laterality patterns, age and gender distributions, and contemporary data from Central Asia remain limited. The study aimed to describe the etiologic spectrum, laterality, age, and gender distribution of pediatric cataract from a two-center tertiary cohort from Kazakhstan. Materials and Methods: This retrospective two-center cohort study included all consecutive children aged ≤17 years who underwent cataract surgery between January 2022 and December 2024 at the Astana and Almaty branches of the Kazakh Eye Research Institute. Recorded variables included age at surgery, gender, cataract laterality, and etiology. Etiologies were classified as congenital, traumatic, ectopia lentis-associated, and complicated cataract. No formal hypothesis-testing framework was predefined; analyses were primarily descriptive. Results: A total of 528 children (782 eyes) were included. Median age at surgery was 6.5 years (IQR 4.3–9.9 years). Children were distributed as ≤6 years: 294 (55.68%), 7–11 years: 156 (29.55%), and 12–17 years: 78 (14.77%). Operated eyes were distributed as 466 (59.59%), 216 (27.62%), and 100 (12.79%), respectively. Congenital cataract was the predominant etiology, accounting for 412/528 children (78.03%) and 645/782 eyes (82.48%), and was predominantly bilateral (233/412 children, 56.55%). Traumatic cataract accounted for 68/528 children (12.88%) and was uniformly unilateral, with male predominance (53/68, 77.94%). Ectopia lentis-associated cataract accounted for 24/528 children (4.55%) and was more often bilateral (14/24, 58.33%). Complicated cataracts accounted for 24/528 children (4.55%). Conclusions: Overall, these findings demonstrate that the etiologic profile of pediatric cataract surgery varies substantially by age, gender, and laterality....
Purpose: To determine the optimal treatment sequence for combination therapy using intravitreal faricimab (IVF) and direct photocoagulation (PC) in eyes with non-centerinvolved diabetic macular edema (DME). Methods: This retrospective study included 35 eyes with focal DME treated with IVF and PC targeting microaneurysms (MAs). Treatment success was defined as resolution of focal edema, indicated by disappearance of the white area (WA) on optical coherence tomography. Eyes were assigned to a PC-IVF group (initial PC followed by IVF if edema persisted after 2 months; n = 20) or an IVF-PC group (initial IVF followed by PC for residual edema; n = 15). Additional PC was performed every 2 months as needed. Results: Cumulative success rates at 2, 4, and 6 months were 35.0%, 70.0%, and 90.0% in the PC-IVF group and 60.0%, 93.3%, and 100% in the IVF-PC group, respectively. Macular volume significantly decreased at all time points in the IVF-PC group (all p < 0.01), whereas a significant reduction was observed only after 6 months in the PC-IVF group (p < 0.01). The number of MAs and the extent of edema were significantly reduced after 2 months in both groups, with greater reductions in the IVF-PC group (p < 0.05). The number of laser shots required for initial PC was significantly lower in the IVF-PC group (p < 0.0001), and the mean number of PC sessions was also reduced (0.6 vs. 1.8). In the PC-IVF group, baseline edema size was significantly smaller in successfully treated eyes (p < 0.001). Conclusions: Initiating treatment with IVF prior to PC may be advantageous in focal DME, particularly in eyes with larger edema, enabling faster anatomical improvement and reducing the need for laser treatment. Direct PC alone may be sufficient for small focal lesions with limited edema, supporting an individualized treatment strategy....
Purpose: To evaluate the 3-year effectiveness and safety of the XEN63 Gel Stent, both as a standalone procedure and combined with phacoemulsification, in patients with primary open-angle glaucoma (POAG). Methods: This prospective, multicenter, non-randomized study included 85 eyes (85 patients) with medically-uncontrolled POAG. Subjects underwent either XEN63-standalone implantation (n = 46) or combined XEN63 + Phacoemulsification (n = 39). The primary endpoint was the cumulative probability of complete success (IOP ≥ 6 and ≥18 mmHg and reduction in IOP ≥ 20% from baseline without ocular-hypotensive medications) at 36 months. Results: At 36-months, the overall surgical success rate was 67.1% (95% CI: 50.8–86.9%), with significant differences between the standalone (78.3%) and combined groups (53.9%; p = 0.0173). Complete success was achieved in 45.9% of the total cohort. Preoperative mean IOP decreased significantly from 21.3 ± 4.7 mmHg to 14.3 ± 4.3 mmHg at the last-follow-up visit (LFUV) (p < 0.0001). Correspondingly, the mean number of medications was significantly reduced from 2.3 ± 0.8 to 0.7 ± 1.0 (p < 0.0001). Multivariable analysis showed that surgical strategy did not significantly influence IOP reduction. Numerical hypotony (IOP < 6 mmHg) occurred in 23.5% of eyes at Day 1 but resolved in 95% of cases by Month 1. One case of hypotonic maculopathy required device explantation. Serious late-onset events included one endophthalmitis (Month 30) and one retinal detachment (Month 26). Secondary needling was required in 8.2% of eyes. Conclusions: The XEN63 Gel Stent provided sustained IOP reduction and a significantly decreased medication burden over 36 months. Outcomes remained consistent regardless of whether the stent was implanted as a standalone procedure or combined with cataract surgery....
Background/Objectives: The purpose of this study was to investigate the variation in subjective manifest refraction measures in a patient cohort screened for myopic refractive surgery. Methods: In this retrospective non-randomised cross-sectional single-centre study, we evaluated a dataset containing sequences of three refraction measurements performed by four experienced optometrists in 175 eyes screened for refractive corneal or lens surgery for myopia or myopic astigmatism. Refraction was converted from sphere (SPH), cylinder (CYL) and axis to power vector components (spherical equivalent SEQ and cylinder projections C0 and C45). The mean power vectors of the three repeat measurements (MEAN) and the deviations (DEV) of the repeat measurements from the MEAN were evaluated. Results: MEAN values for SPH/CYL/SEQ/C0/C45 were −5.93/0.99/−5.44/−0.47/0.02 D and the corresponding standard deviations were 0.20/0.16/0.17/0.17/0.16 D. DEV of both SEQ and CYL correlated significantly with patient age (Spearman R = 0.16 and 0.20). DEV of CYL correlated with mean (myopic) SEQ (R = −0.22) and CYL (R = 0.27) whereas DEV of SEQ showed no significant correlation with mean SEQ or CYL. Conclusions: The variation in subjective manifest refraction with repeat measurements is in a range of ±0.16 to ±0.20 D for SPH, CYL and the power vector components SEQ, C0 and C45. If reliable subjective refraction measurements are mandatory, e.g., for planning refractive surgery procedures or for formula constant optimisation, repeat refractometry measures could help to ensure representative data and to estimate the intraindividual variations....
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