Current Issue : October-December Volume : 2026 Issue Number : 4 Articles : 5 Articles
Background/Objectives: Lower eyelid malposition is a recognized complication following eyelid tumor excision, trauma, or degenerative changes, and is frequently associated with laxity or disruption of the canthal ligaments. Conventional reconstruction techniques using autologous grafts such as fascia lata or auricular cartilage are effective but are associated with donor-site morbidity and increased surgical complexity. This study aimed to evaluate the feasibility and early outcomes of a novel technique for reconstruction and reinforcement of the lower eyelid canthal ligaments using a barbed suture system. Methods: A singleinstitution retrospective case series was conducted, including consecutive patients who required lower eyelid canthal ligament reconstruction or horizontal support reinforcement from April 2025 to November 2025. Margin reflex distance 2 (MRD-2) was measured from standardized photographs preoperatively and at final follow-up. Munk scale scores, surgically induced astigmatism (SIA), and postoperative complications were recorded. Results: Seven patients (median age 72 years; range 38–86) underwent the procedure. Indications included post-oncological eyelid reconstruction (n = 2), cicatricial ectropion (n = 2), paralytic ectropion (n = 1), involutional ectropion (n = 1), and cicatricial entropion (n = 1). The median follow-up was 189 days (range 105–280). MRD-2 at final followup was 5.4 mm in Case 1 (preoperative: 5.7 mm) and 4.1 mm in Case 2 (preoperative: 4.2 mm), indicating maintained eyelid position. Munk scale scores improved in four of five evaluated patients. No recurrence of ectropion or entropion was observed during follow-up. Transient linear skin indentation along the suture pathway was observed in all cases and resolved spontaneously in all patients by 3 months postoperatively. One patient experienced transient postoperative diplopia that resolved with conservative management. Conclusions: This study demonstrates the feasibility of lower eyelid canthal ligament reconstruction using a barbed suture system in a heterogeneous cohort of seven patients. Short-term results are encouraging, with maintained eyelid position and no recurrence of malposition observed during the follow-up period. These preliminary findings warrant further evaluation in larger, prospective, controlled studies with longer follow-up....
Background/Objectives: Artificial intelligence (AI) is increasingly being integrated into vascular surgery, particularly in diagnostic imaging, perioperative planning, intraoperative guidance, and postoperative surveillance. This literature review evaluates the current applications of artificial intelligence in vascular surgery and endovascular practice, with a particular focus on imaging technologies and their role in improving diagnostic precision, workflow efficiency, and patient outcomes. In addition, the review examines emerging AI applications in operative workflow optimization, endovascular navigation, postoperative surveillance, training platforms, and AI-assisted clinical decision support. Methods: A literature review was conducted using PubMed and Scopus with the search terms: (artificial intelligence OR AI OR neural network) AND (vascular surgery) AND (diagnosis OR treatment). Reference lists of included studies were manually screened, and additional recent studies were identified from relevant journals. Articles published in English up to April 2026 were included. Studies were assessed for their applications in vascular diagnostics, plaque characterization, endovascular workflow optimization, and postoperative surveillance. Results: AI demonstrated strong diagnostic performance across multiple imaging modalities. Deep learning systems achieved a sensitivity of 91.3% and specificity of 95.2% in peripheral arterial stenosis classification, while plaque characterization models showed accuracies up to 96% and substantial agreement with expert imaging interpretation. AI-assisted operative systems improved procedural efficiency through reductions in operative duration, radiation exposure, and contrast utilization. However, many studies were retrospective, single-center, and based on relatively small cohorts with heterogeneous endpoints. Conclusions: AI has significant potential to improve vascular surgical practice through enhanced image interpretation, procedural guidance, and individualized treatment planning. Despite promising outcomes, current evidence remains limited by methodological heterogeneity and insufficient external validation. Prospective multicenter studies and standardized evaluation frameworks are required before widespread clinical implementation can be achieved....
Background/Objectives: To evaluate the monocular and binocular visual outcomes for patients who underwent PRESBYOND Laser Blended Vision (LBV) surgery. Methods: A total of 46 patients participated in this study (mean age 47.5 yrs ± 4.7) with various refractive errors. Patients were treated using the MEL 90 excimer laser to correct their refractive errors. The patients were asked to attend follow-up sessions at intervals of 1, 3, and 6 months. A self-developed binary (Yes/No) satisfaction survey was then conducted at the end of the 6-month visit. Results: The mean preoperative spherical equivalent for the distance eyes was −0.42 ± 1.53, and for the near eyes was −0.4 ± 1.76. The mean logMAR for the uncorrected distance visual acuity after treatment and follow-up at one month, three months, and six months was 0.016, 0.037, and 0.028 (20/20 to 20/22 range), respectively. After treatment, 81% of patients achieved 20/22.5 vision or better, and 94% achieved 20/25 vision or better. For near vision, 100% of patients reached J2 print. After treatment, 97% of patients achieved 20/25 or better at distance and J2 or better at near. Patient satisfaction was 92%, with only 8% of patients reporting dissatisfaction. Conclusions: This protocol has demonstrated stable, well-tolerated, effective, and acceptable results in patients with presbyopia. The safety and efficacy of the procedure were demonstrated, with strong outcomes....
Background/Objectives: Mesh repair reduces hernia recurrence compared with suture repair, but permanent synthetic meshes are associated with chronic foreign-body complications. Biosynthetic poly-4-hydroxybutyrate mesh (Phasix™) provides temporary reinforcement with gradual resorption; however, short-term real-world outcomes across different hernia types remain limited. This study evaluated short-term outcomes after Phasix™ hernia repair and identified factors associated with baseline recurrent hernia at presentation. Methods: This retrospective cohort included patients ≥ 16 years who underwent open or laparoscopic hernia repair with Phasix™ at King Abdulaziz Medical City (2020–2023). Patients receiving other mesh types were excluded. Demographic, operative, and postoperative data were analyzed. Multivariable logistic regression identified factors associated with baseline recurrent hernia. Results: Among the 228 patients (51.8% female; mean age 55 years), hernia types were incisional (36.0%), paraumbilical (26.3%), and inguinal (24.6%). Early complications were uncommon: seroma in 2.2% and surgical site infection in 1.8% at 1 month. One-year recurrence occurred in 1.3% (3/228). Female sex, prior incisional hernia repair, previous mesh removal, and open repair independently predicted baseline recurrent hernia, while laparoscopic repair was protective. Conclusions: Phasix™ repair demonstrated low short-term complication rates and rare 1-year recurrence across ventral and inguinal hernias. Short-term outcomes were driven mainly by patient and procedural factors rather than mesh-specific effects....
Objectives: Tandem spinal stenosis (TSS) is often underdiagnosed and traditionally managed with multi-stage surgery (MSS). Single-stage surgery (SSS) is an alternative, but prior studies largely emphasize younger, healthier patients. This study evaluated perioperative and functional outcomes after SSS for TSS in a surgically diverse cohort. Methods: A retrospective chart review included 20 patients who underwent SSS for TSS at a single academic institution. Mean age was 63.75 years, and median modified frailty index was 2. Etiologies included degenerative, traumatic, and neoplastic disease across cervical, thoracic, and lumbar regions. Outcomes included operative characteristics, complications, readmissions, and functional recovery measured by Visual Analog Scale (VAS) pain and modified Japanese Orthopaedic Association (mJOA) scores. Results: The mean number of operated levels was 5.2, mean operative time was 232.4 min, total OR time was 355.1 min, and length of stay was 6.9 days. Surgical complications occurred in 15% of patients, medical complications in 25%, and 90-day readmission in 15%, with no 30-day mortality. Mean mJOA improved from 12.86 at baseline to 16.08 at first follow-up and 16.46 at 3 months; REML mixed-effects modeling showed a significant timepoint effect (F (4, 34.55) = 9.15, p < 0.001), with significant Sidak-adjusted improvement at both timepoints. VAS pain showed no significant longitudinal effect. Conclusions: SSS for TSS appears feasible in a real-world, surgically diverse cohort including older and moderately frail patients. These findings support individualized SSS candidacy assessment....
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