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Moderator
Kavitha R. Sivaraman, MD, ABO
Panelists
Marc G. Bodman, MD, ABO; Arsham Sheybani, MD, ABO
Viewing Papers
Expand a paper title to the right to view the paper abstract and authors. Use the video link to jump to that poster in the session.
Presenting Author
Jiwon Jeong, MD
Purpose
To compare corneal biomechanical properties between normal eyes and those with moderate to severe keratoconus (KC grade 2-4) using integrated tomographic, biomechanical, and refractive metrics, with primary emphasis on focal inhomogeneity assessed by Brillouin microscopy (BM) as a novel diagnostic discovery.
Methods
This retrospective study analyzed 1,548 normal eyes and 12 eyes with KC graded 2-4 by Pentacam's Topographic Keratoconus Classification. Parameters included Pentacam indices (e.g.,BAD-D,TP), Corvis biomechanical indices (e.g.,SP-A1, SSI, E_CBIF, E_Stage), refractive/visual acuity (VA) metrics (e.g.,CDVA), and comprehensive BM-derived values for focal analysis (e.g., central BM, minimum BM, maximum BM, BM9/10 for upper/lower cone regions, and Max-Min BM for spatial inhomogeneity/asymmetry; peripheral BM1 nasal, BM5 temporal, BM3 max superior, BM7 max inferior). Statistical comparisons used independent t-tests. Staging aligned with international standards (Belin ABCD, BEST staging system).
Results
BAD-D (1.00±0.68 vs. 11.02±7.26, p<0.0001),TP (550.74±30.11 μm vs. 471.69±66.59 μm, p<0.0001), maximum curvature (K2: 48.21±5.50 D vs. 43.79±1.55 D, p=0.0003), SP-A1 (121.31±15.37 mmHg/mm vs. 81.33±29.88, p<0.0001) and SSI (0.76±0.12 vs. 0.61±0.17, p<0.0001) shows significant value, The core novel discovery from BM focal analysis revealed pronounced cone-specific weakening: reduced central BM (2.86±0.06 vs. 2.84±0.04, p=0.0096), indicating overall cone softening; Min BM (2.82±0.05 vs. 2.80±0.05, p=0.038), highlighting the weakest focal point; BM9 (2.86±0.05 vs. 2.84±0.04, p=0.0559, borderline) and BM10 (2.86±0.05 vs. 2.84±0.04, p=0.0123), confirming upper/lower cone region vulnerability.
Conclusion
BM profiling offers new insights into cone-specific softening and inhomogeneity, with individual reductions (central/Min/BM9/10) revealing localized vulnerabilities and collective asymmetry (Max-Min) implying progressive ectatic instability–augmenting conventional metrics for precise early ectasia risk assessment
Presenting Author
Aishwarya Bhattacharya, BA, MPH
Co-Authors
Paul Kang (MD)
Purpose
The FDA recall of 39 artificial tears in 2023-24 has led to increasing patient fear around its use and doctor uncertainty around its recommendation. We examined all recalls of artificial tears from 2014-2024 to identify the most common types, classes of products, and associated reasons.
Methods
Artificial tear recalls from Jan 2014-Dec 2024 were identified through the FDA Enforcement Report. Data on country, classification (I, II, or III), ingredients, preservative use, type of product (branded/generic), and recall reason was analyzed retrospectively based on recall year. Recall reasons were classified as Lack of Assurance of Sterility (LAS), Confirmed Non-Sterility/microbial contamination (MC), common Good Manufacturing Practice (cGMP) Deviations, and Other (Mislabeling, Out of Specification, Presence of Particulate Matter). Descriptive statistics were used to quantify these categories and chi square test of independence was conducted with cross tabulated frequency tables.
Results
We identified 103 unique formulations of recalled tears. Most recalls were Class II (77) linked to LAS (61) and Class I (25) due to MC (24), ?� (6, N=103) = 96.6443, p<0.001. Preserved (47) and Preservative-free tears (54) were similarly implicated; preservative free recalls were mainly associated with LAS (35) while preserved tears were due to both LAS (27) and MC (21), ?� (3, N=103) =8.9331, p=0.030. Most recalls were generics (74) linked to LAS (49) and MC (18); branded tears (29) were mainly recalled due to LAS (13), ?� (3, N=103) =8.9351, p=0.030. Most tears were manufactured in the U.S. (78). A low concentration of NaCl (0.35-0.9%) was common across tears.
Conclusion
Most recalled tears were U.S. generics recalled due to lack of sterility. Preservative free and preserved tears had similar recalls. Given growing evidence on enhancing effects of low NaCl conc. on microbial growth, its effect in eye drops should be studied. Overall, adverse outcomes tied to confirmed microbial contamination of tears remain rare.
Presenting Author
Pradipta N. Chowdhury, MBBS
Co-Authors
Mandeep Bindra (FRCOphth, MBBS, FRCSEd), Prakash Kumar Chowdhury (MS, DO), Anureet Kaur (MBBS)
Purpose
This study evaluates the environmental footprint of phacoemulsification within the UK National Health Service (NHS). It benchmarks this against a high-volume South Asian eye hospital to uncover how resource-lean surgical systems achieve comparable outcomes with dramatically lower carbon emissions.
Methods
This prospective study analysed 1,000 standalone phacoemulsification surgeries - 500 at Stoke Mandeville Hospital (Buckinghamshire Healthcare NHS Trust, UK) and 500 at Bangladesh Eye Hospital (BEH, Bangladesh). Complex or combined cases and capital infrastructure were excluded from the study. Surgical waste was recorded bin-by-bin; energy consumption for HVAC and lighting was obtained from estates departments; sterilization energy was sourced from CSSD logs. Emissions from travel were survey-based. EPA's TRACI 2.1 framework was used to calculate lifecycle CO?e. Patient satisfaction and post-operative infection rates were systematically assessed.
Results
Each NHS phacoemulsification generates 128.3 kg CO?e (primarily from disposable procurement) and 3.7 kg of solid waste. Averaging 12 cases/day, per-surgery energy use reaches 33.8 kWh (HVAC 30.4 kWh; autoclave 2.18 kWh) due to constant climate control and underfilled sterilisers. In contrast, Bangladesh Eye Hospital averages 37 cases/day, using just 8.4 kWh/case (HVAC 2.8 kWh; autoclave 0.093 kWh). BEH generates 17.1 kg CO?e and 0.45 kg waste per case - reductions of 86% and 87.84% respectively, compared to the NHS. This is achieved through reusable tools, batch sterilization, and multi-use medications. No endophthalmitis occurred. Patient satisfaction was 95.1% in the UK and 90.9% in BEH.
Conclusion
The UK NHS produced 55.6 tCO?e more than BEH after 500 cataract procedures. This is the same as 325,000 kilometres of driving. This study demonstrates that sustainability is a reproducible strategy for high-quality, low-carbon surgery rather than a compromise. Greener solutions exist; global ophthalmology can adapt.
Presenting Author
Tushar Talaparthy, BSc
Co-Authors
Abdelrahman Elhusseiny (MD)
Purpose
To examine the association between caregiver-reported pediatric vision impairment (VI) and household food insecurity (FI) using nationally representative U.S. data. This study aimed to determine whether families of children with VI experience significantly greater risk and severity of FI compared to those without VI.
Methods
We conducted a cross-sectional analysis of the 2021-2023 National Survey of Children's Health, including 154,912 U.S. children aged 0-17. The exposure was caregiver-reported VI; the outcome was household FI, measured using USDA-based categories. We applied survey-weighted multivariable logistic regression for binary FI and ordinal logistic regression to assess severity. Models were adjusted for age, sex, income-to-FPL ratio, parental education, household size, and marital status. All analyses accounted for complex sampling design using R v4.3.2 and the survey package. Statistical significance was defined as p<.05.
Results
Among respondents, 1.7% reported child VI. FI affected 50.0% of VI households, compared to 29.0% of non-VI households (p<.001). Full food security was observed in only 46.4% of VI households vs. 69.7% of non-VI. Adjusted odds of any FI were 55% higher among VI households (aOR=1.55; 95% CI, 1.25-1.91; p<.001). Ordinal regression showed a 77% increase in odds of more severe FI (aOR=1.77; 95% CI, 1.44-2.19; p<.001). Strong socioeconomic gradients and racial/ethnic disparities in FI were also observed, with income, education, single parenting, and race/ethnicity significantly associated with FI risk.
Conclusion
Children with vision impairment are at significantly increased risk of household food insecurity, even after adjusting for socioeconomic status. These findings identify pediatric VI as a distinct social determinant of health and call for integrated clinical, social, and policy strategies to reduce food insecurity and health disparities.
Presenting Author
Vasyl Shevchyk, MD, PhD
Co-Authors
Nataliia Molchaniuk (PhD), Andrii Romaniuk (MD)
Purpose
To evaluate the impact of different dispersive ophthalmic viscosurgical devices (OVDs) on the morphology of lens epithelial cells (LECs) within the capsulorhexis zone.
Methods
Anterior lens capsule samples (diameter 5.5 mm) were obtained during routine cataract surgery. Prior to capsulorhexis, the anterior chamber was filled for 1 minute with: A) in 5 eyes - 3% sodium hyaluronate OVD, B) in 5 eyes- 3% sodium hyaluronate and 4% chondroitin sulfate OVD and C) in 2 eyes- balanced salt solution (BSS). The LECs were analysed using light and transmission electron microscopy (PEM-100-01, Ukraine).
Results
Analysis revealed that LECs exposed to BSS experienced minimal alterations in their nuclear and cytoplasmic structures, suggesting that BSS has a neutral effect on cellular integrity. Conversely, exposure to the OVD containing 3% sodium hyaluronate and 4% chondroitin sulfate resulted in notable signs of coagulative necrosis, chromatin condensation, and a dense cytoplasm in many LECs. In case of the 3% sodium hyaluronate OVD, signs of liquefactive necrosis were observed, including cellular swelling, hydropic degeneration, and extracellular edema.
Conclusion
Dispersive OVDs in direct contact with the intact anterior lens capsule induce distinct patterns of cellular injury. The OVD with 3% sodium hyaluronate + 4% chondroitin sulfate causes cellular dehydration and coagulative necrosis, while 3% sodium hyaluronate alone leads to cellular swelling and liquefactive necrosis
Presenting Author
Pradipta N. Chowdhury, MBBS
Co-Authors
Prakash Kumar Chowdhury (MS, DO), Anureet Kaur (MBBS)
Purpose
Cataract blindness remains curable, yet surgery uptake in LMICs is strikingly low. This study reveals the hidden barriers: fear of surgery, financial strain, socio-cultural, and logistical barriers that continue to block vulnerable patients in both outreach and hospital settings from regaining sight.
Methods
A cross-sectional preoperative survey was conducted among 595 cataract patients attending hospital outpatient services (n = 222) and community outreach camps (n = 373) in Bangladesh from May to August 2025. Socio-demographic characteristics, awareness of cataracts and treatment, and barriers to surgery were assessed. To compare the baseline characteristics of the socio-demographic properties, chi-square tests were used for categorical variables, and the Mann-Whitney U test was applied for continuous variables. A linear regression was also used to examine the associations between patient characteristics and the number of reported barriers to accessing cataract surgery.
Results
The mean age was 62 years (50.3% female). Camp patients were predominantly rural (76.1%) and had lower education levels (43% with no schooling vs. 13% in OPD, p<0.001). 74% of the participants presented with bilateral cataracts. While 88.6% had heard of cataracts, only 41.3% were aware of the treatment options. Key barriers included affordability (72.3%), worry about the surgical outcome (27.1%), fear of surgery (25.9%), transportation (27.7%), lack of escort (22%) and time constraints due to work or family responsibilities (18.2%).
Conclusion
Cost of surgery, socio-cultural attitudes, low literacy & geographical access hinder cataract surgery uptake in Bangladesh. Innovative solutions such as subsidy models, gender sensitive counselling and mobile outreach are key to dismantling health inequities and protecting the vulnerable populations.
Presenting Author
Ana Laura C. Canedo, MD
Co-Authors
Edison Silva (PhD, MSc), Andre Sousa (BSc), Kaique Sbampato (PhD, MSc), Ricardo Clemente (MSc)
Purpose
To investigate the impact of the Tabia platform on reducing no-shows in ophthalmology appointments by analyzing real-world data on scheduling, confirmations, and attendance, and evaluating the relationship between patient response time and appointment presence.
Methods
A retrospective analysis was conducted on 3,112 appointments between July 28 and September 3, 2025, involving 2,285 unique patients. Confirmation, attendance, and absence rates were evaluated, along with patient responsiveness using TabiaScore, which classifies response time into six levels (A to F). A comparison between clinics using and not using Tabia allowed measurement of the platform's impact on no-show prevention.
Results
A total of 2,285 patients and 3,112 appointments were analyzed, with 2,108 confirmations. The overall no-show rate was 6.7%. Of all appointments, 2,059 were fulfilled, 835 canceled, and 209 resulted in no-shows. Clinics using Tabia reduced no-show rates from 6.78% to 6.72%, while non-Tabia clinics went from 7.15% to 6.78%. Among patients scored by TabiaScore, 43% responded within 5 minutes (grade A), 15% took over 1 hour (grades D/E), and 12.8% did not respond (grade F), showing strong correlation between response speed and attendance.
Conclusion
Tabia proved effective in reducing no-shows, especially in clinics with higher patient engagement. Metrics like TabiaScore help predict behavior and optimize confirmation strategies, enhancing operational efficiency and care quality.
Presenting Author
Victoria Leung, BSc
Co-Authors
James Armstrong (MD, PhD), Cindy Hutnik (MD, PhD), Matthew Fung (MD)
Purpose
The success of bleb-forming glaucoma surgery depends on sustained aqueous humour outflow through subconjunctival tissues, which can be impaired by fibroblast-driven scarring triggered by TGF? and flow stress. This study examines whether netarsudil, a Rho kinase inhibitor, can reduce fibroblast-mediated increases in outflow resistance in vitro.
Methods
This study used an in-vitro microfluidic model to assess afferent perfusate pressure across a 3D collagen matrix containing human Tenon's capsule fibroblasts simulating the subconjunctival outflow tract. Matrices were perfused with culture media at 2.6 µL/min for 72 hours. TGF?1-spiked culture media modeled the post-surgical milieu, and was co-treated with netarsudil to test whether said pro-inflammatory mechanisms could be attenuated. At the endpoint, tissues were stained for F-actin and alpha-smooth muscle actin (?-SMA) to assess fibroblast transdifferentiation, which was analyzed via confocal microscopy. Pressure trends were compared using repeated measures ANOVA.
Results
At 72 hours, mean ± SD perfusion pressures were highest in the TGF?1 group (55.0 ± 7.3 mmHg), compared to vehicle control (24.1 ± 5.9 mmHg) and netarsudil (12.4 ± 3.4 mmHg) groups. Netarsudil co-treatment attenuated TGF?1-induced expression of F-actin and ?-SMA (52.3% and 38.1% respectively).
Conclusion
Netarsudil attenuated TGF?1-induced increases in outflow resistance and fibroblast morphological changes, suggesting it may preserve subconjunctival tissue porosity post-surgery, potentially improving surgical outcomes.
Presenting Author
Jamie L Surgent-Nahay, BA
Co-Authors
Muhammad Chauhan (MD, MS), Jawad Muayad (BSc), Paul Phillips (MD), Ahmed Sallam (MD, PhD, FRCOphth)
Purpose
To quantify the research and clinical output across U.S. ophthalmologists and evaluate any discrepancies in productivity outcomes among subspecialty, gender, career stage, and institutional or geographical concentration.
Methods
Cross-sectional analysis of approximately 2,900 U.S. ophthalmologists with ?1 PubMed-indexed article (2021-2023), matched by National Provider Identifier to a 5% Medicare Part B claims sample. Research output was measured with a fractional publication score weighted by authorship placement and journal impact factor; clinical productivity was estimated using annualized Part B work relative value units (RVUs). A composite metric (Score � RVU) reflected combined productivity. Ophthalmologists were classified into 10 subspecialties. Nonparametric statistical tests (Kruskal-Wallis, Wilcoxon rank-sum) compared subgroups, and Spearman's rho assessed correlation.
Results
Publication score and RVUs showed a weak inverse correlation across the cohort (Spearman r=??0.13; 95?%?CI??0.16 to??0.10). Ocular oncology led in publication scores, retina led in clinical RVUs, and corneal specialists ranked among the most balanced subspecialty across all domains (each p<0.001). Publication scores showed little variability between genders, with female ophthalmologists lagging by 50% in median RVUs (p<0.001). Overall productivity peaked at 21-30 years in practice, with the mid-career cohort achieving the highest Score � RVU (p < 0.001). Top research performance concentrated among a few institutions, with clinical output dominating among private practices (p<0.05).
Conclusion
Differences in clinical and research performance exist, reflecting the challenges to excel in both areas among ophthalmologists. Building support for physician-scientists with mentorship, protected time, and funding may enable more ophthalmologists to reach their full potential while ensuring sustainability and innovation in the field.
Presenting Author
Kevin Yang Wu, MD
Co-Authors
Michael Marchand (MD, FRCSC)
Purpose
This review aims to bridge this gap by summarizing the relevant anatomical connections between the oral and ocular regions, exploring the mechanisms through which dental procedures may lead to ophthalmic complications, and detailing their clinical presentations, progression, and potential management and preventive strategies.
Methods
Published case reports and case series from 1950 to October 2024 that described ophthalmic complications in human patients following dental procedures were included in this scoping review.
Results
Dental procedures can give rise to a variety of ophthalmological complications, whether neuro-ophthalmic (e.g., diplopia, ptosis, or vision loss), vascular (e.g., retrobulbar hemorrhage or cervical artery dissection), infectious (e.g., orbital cellulitis or abscess), mechanical (e.g., orbital trauma or fractures), or air-related (e.g., orbital and subcutaneous emphysema).
Conclusion
Most of the ophthalmological complications following dental procedures are often reversible, but some can be vision-threatening or lead to permanent sequelae if not promptly recognized and managed. Prevention through multidisciplinary collaboration are crucial to minimizing risks and ensuring better patient outcomes.
