The Quinze-Vingts National Ophthalmology Hospital (Centre hospitalier national d’ophtalmologie des Quinze-Vingts) is France's national ophthalmology hospital located in Paris, in the 12th arrondissement. The hospital gave its name to the Quinze-Vingts quarter.
The goal of this review is to trace the history of refractive correction, from the earliest optical devices to modern refractive surgical techniques. Following the invention of spectacles in the Middle Ages, the first corneal procedures, such as Sato's and Fyodorov's keratotomies and Barraquer's keratomileusis, highlighted the limitations of early mechanical approaches. In the 1980s, the advent of the excimer laser revolutionized refractive surgery with the introduction of PRK (photorefractive keratectomy) and subsequently LASIK (Laser-Assisted In Situ Keratomileusis). The development of the femtosecond laser further enhanced precision and safety, while KLEx (keratorefractive lenticule extraction) provided an alternative minimally invasive procedure. In parallel, personalized treatments guided by corneal topography or wavefront analysis have significantly improved visual outcomes. When corneal surgery is not feasible, phakic intraocular lenses or refractive lens exchange offer effective alternatives. Current research is focused on artificial intelligence, new laser platforms, advanced "intelligent" intraocular implants, and ocular bioengineering. The evolution of refractive surgery thus exemplifies continuous progress toward increasingly safe, precise, and patient-tailored techniques.
BACKGROUND:Cystinosis is a multisystemic lysosomal storage disorder caused by pathogenic variants in CTNS, the gene encoding cystinosin, a lysosomal transmembrane cystine transporter. In patients with cystinosis, cystine accumulates within lysosomes in all organs. The cystine-depleting agent cysteamine delays but does not prevent disease progression. METHODS:In this phase 1-2, open-label, ongoing clinical study, we performed a preliminary assessment of CTNS-RD-04, which consists of autologous CD34+ cells transduced with lentiviral vectors carrying CTNS complementary DNA, in patients with cystinosis. The primary end points were the safety and the side-effect profiles of CTNS-RD-04. Secondary end points were measures of efficacy, including white-cell cystine levels and cystine storage depletion. Oral cysteamine was withdrawn before CTNS-RD-04 infusion, and cysteamine eyedrops were withdrawn 1 month after myeloablation. RESULTS:Six participants (20 to 46 years of age) received CTNS-RD-04 and were followed for 29 to 63 months. CTNS-RD-04 doses ranged from 3.63×106 to 9.59×106 CD34+ cells per kilogram of body weight, and vector copy numbers ranged from 0.59 to 2.91 copies per diploid genome. All the patients had sustained and highly polyclonal hematopoietic reconstitution; vector copy numbers at 24 months ranged from 0.51 to 2.67 copies per diploid genome. A total of 217 adverse events occurred, most of which were mild or moderate in severity and largely consistent with the procedures and underlying disease. No evidence of monoclonal expansion was noted. White-cell cystine levels decreased from baseline except in Patient 4, who had the lowest vector copy number. CONCLUSIONS:In this small study, CTNS-RD-04, an ex vivo gene therapy for cystinosis, had adverse effects that were largely consistent with the myeloablative regimen and underlying disease profile. White-cell cystine levels decreased after therapy. (Funded by the California Institute for Regenerative Medicine and others; ClinicalTrials.gov number, NCT03897361.).
Introduction:Earlier intervention in glaucoma has been suggested to slow disease progression and preserve visual function and quality of life. Consequently, minimally invasive glaucoma surgery (MIGS) is increasingly used in mild-to-moderate glaucoma. Although numerous techniques and devices are available, their comparative efficacy remains debated: most procedures lower intraocular pressure to the mid-teens in primary open-angle glaucoma, but without clear evidence of superiority. As these surgeries are now offered to younger, otherwise healthy patients, safety has therefore become a central criterion in technique selection. Methods:This PRISMA-based systematic review analyzed safety outcomes from peer-reviewed studies of the main MIGS procedures published between 2014 and 2024. Five databases were searched using current and historical device names. Non-clinical studies, case series, and nonstandard techniques were excluded from quantitative analysis but retained qualitatively to capture rare events. A total of 401 studies, representing 39,381 eyes and 68,917 eye-years of follow-up, were included. Highest reported and weighted mean complication rates were calculated by procedure type. Results:Safety profiles varied. Trabecular bypass implants and ab interno canaloplasty were associated with low rates of serious adverse events and minimal anatomical disruption. Suprachoroidal devices carried higher risks of hypotony, inflammation, and malposition. Across all categories, chronic changes to angle anatomy and occasionnal re-interventions highlighted the potential for long-term sequelae, with endothelial cell loss emerging as a key concern for certain procedures.However, heterogeneity in definitions and reporting limited comparability. Common events such as hyphema and IOP spikes were inconsistently documented, while late complications like endothelial cell loss or peripheral anterior synechiae were often overlooked. This underreporting risks conflicting conclusions and undermines comparisons. Conclusion:For patients with mild, stable disease or those undergoing opportunistic combined surgery, tissue-sparing procedures with the lowest observed complication rates may be preferable. Standardized definitions, long-term follow-up, and harmonized safety reporting are becoming essential.
IntroductionHealthcare contributes 4-6% of global CO2 emissions due to energy use, pharmaceuticals, and waste. Ophthalmology plays a significant role, particularly in managing dry eye disease (DED), which is a leading cause of eye care visits. DED affects up to 50% of people worldwide, with its incidence increasing with age, climate-related factors, and screen use. This study aims to gather insights from DED experts on their opinions toward sustainability in ophthalmic care.MethodsAn online survey was distributed to attendees of the European Dry Eye Society conference, running from June to September 2024. The survey consisted of 10 questions related to sustainability practices in DED management. Data on demographics were collected and analyzed using percentages.ResultsOf the 372 respondents, 83.7% expressed concerns about global warming, and 78.5% believed that ophthalmic care produces excessive waste. Most respondents (79.7%) considered that single-use preservative-free vials generate significantly more waste than multidose alternatives. Additionally, 89.2% supported recycling methods. Ophthalmologists also recognized the rising impact of digital eye strain and saw potential in using apps to manage DED more sustainably.ConclusionsThe survey highlights a strong consensus among DED experts about the need for more sustainable practices in ophthalmology. Key findings include concerns about waste, especially from single-use vials, and the potential for digital solutions to improve sustainability in DED management. The results suggest an opportunity to integrate environmentally friendly actions into ophthalmic care.
To evaluate the 12-month efficacy and safety of open bleb revision (OBR) for Preserflo® MicroShunt (PMS) (Santen, Osaka, Japan) bleb failure. All consecutive patients who underwent PMS OBR for primary bleb failure between April 2019 and July 2024 at the Hôpital National des Quinze-Vingts (Paris, France) were retrospectively included. The primary endpoint was assessed at 6 and 12 months as surgical success, defined as an intraocular pressure (IOP) ≤ 21 mmHg with a ≥ 20 What is new?
