OBJECTIVE:To evaluate the improvement in vision-related quality of life, as measured by validated patient-reported outcome measures (PROMs) (NEI-VFQ-14, NEI-VFQ-25) after cataract surgery, and to explore sources of variability in outcomes. METHODS:MEDLINE, EMBASE, and CINAHL were searched, with supplementary grey‑literature screening, for primary studies reporting preoperative and postoperative PROM scores following cataract surgery. Eligible instruments were the Visual Function Index (NEI-VFQ-14), National Eye Institute Visual Function Questionnaire (NEI‑VFQ‑25/‑14), Catquest‑9SF, and related tools. Two reviewers independently performed study selection, data extraction, and risk‑of‑bias assessment using design‑specific CLARITY/U.S. National Institutes of Health frameworks. Random-effects meta-analyses pooled mean change scores for NEI-VFQ-14 and NEI-VFQ-25. Heterogeneity (τ², I²), 95% prediction intervals, small-study effects (Egger's test), and trim-and-fill were assessed. Risk of bias used design-specific CLARITY/NIH tools. RESULTS:From 3473 records, 122 studies met inclusion criteria. Forty‑seven were prospective cohorts, 9 were randomized controlled trials, and 38 were case series; 52% were judged at moderate risk of bias. Fifty-six NEI-VFQ-14 cohorts (k = 56) and 33 NEI-VFQ-25 cohorts (k = 33) were pooled. Mean improvements were +21.8 points (95% CI: 17.4-26.3; I² = 99.9%; PI: -11.3 to 54.9) for NEI-VFQ-14 and +19.3 points (95% CI: 17.0-21.6; I² = 99.4%; PI: 6.5-32.1) for NEI-VFQ-25. For NEI-VFQ-25, Egger's test suggested small-study effects (p = .002); trim-and-fill imputed 3 studies, yielding +18.2 (95% CI: 16.0-20.4). CONCLUSIONS:Cataract extraction consistently enhances patient‑perceived visual function and quality of life. Unfortunately, high heterogeneity limits precision and suggests that gains in PROM score may vary by patient and procedural factors, and small-study effects may overestimate the true benefit recorded by NEI-VFQ-25. Routine integration of validated PROMs into cataract pathways will better capture outcomes that matter to patients, given that the very high heterogeneity, standardized reporting, and longer follow‑up are priorities.

Introduction Small pupils complicate cataract surgery and increase intraoperative risk. The Malyugin ring is a widely used mechanical pupil-expansion device lacking a comprehensive evidence synthesis. This review evaluated its efficacy and safety in adults. Methods A total of 4 databases (EMBASE, MEDLINE, CINAHL Plus, Web of Science) were searched from inception to October 21, 2024, with an updated search conducted on June 28, 2025. Randomized and observational studies involving adults undergoing cataract surgery with a Malyugin ring were eligible. The outcomes included dilation adequacy, surgical duration, intraoperative complications, endothelial cell loss, and visual acuity. Risk of bias was assessed using RoB 2 and ROBINS-I, and the certainty of evidence was evaluated using GRADE. A narrative synthesis was performed in accordance with PRISMA guidelines (PROSPERO CRD420251069562). Results Altogether 10 studies (3,233 eyes) were included. The Malyugin ring provided stable dilation (5.5–7.0 mm) in small pupils and in patients with pseudoexfoliation syndrome. Relative to iris hooks and manual stretching, it was associated with shorter phacoemulsification time (15.2 vs . 19.8 s) and lower endothelial cell loss (9.35% vs . 13.77%). The visual outcomes were favorable, although some studies reported higher rates of iris tears and pupil ovalization compared with those observed with comparator techniques. Discussion These findings suggest advantages in surgical efficiency and early visual recovery. However, the evidence comprises 2 randomized and 8 non-randomized studies with risk of bias ranging from low to serious, and no outcomes could be pooled; therefore, comparative conclusions remain tentative. Conclusion The Malyugin ring appears effective and generally safe in adult cataract surgery; reported complications were typically not visually significant. Certainty of evidence was low to very low (GRADE), and superiority over alternative devices is not established.

Background:An alternative glaucoma treatment is selective laser trabeculoplasty (SLT) that can effectively reduce intraocular pressure (IOP) and decrease the burden of glaucoma management. With newly published randomized controlled trials (RCTs) comparing SLT and medication, an updated systematic review and meta-analysis was needed. Methods:A literature search of RCTs comparing SLT and medication in open-angle glaucoma patients was conducted until January 12, 2024 in CINAHL, Cochrane Library, EMBASE, MEDLINE, Web of Science, ClinicalTrials.gov, and Dissertations and Theses databases. Cochrane Risk of Bias 2 (ROB2) was used to assess the quality of the included RCTs. Results:The included 16 RCTs comprised 2412 patients. At 26 weeks, the combination treatment of SLT and medication had a significant IOP reduction (SMD = 0.78, 95% CI = [0.56, 1.01], p < 0.01, I 2 = 0.00%). At 52 weeks or longer, both the SLT group (SMD = 1.91, 95% CI = [1.55, I 2 = 73.99%) and the medication group (SMD = 1.70, 95% CI = [1.01, 2.38], p < 0.01, I 2 = 92.87%) had significant IOP reduction. At 6 months, the combination treatment significantly reduced the mean number of medications used by 0.78 (SMD = 0.78, 95% CI = [0.56, 1.01], p < 0.01, I 2 = 0.00%) where the medication treatment had no significant decrease (SMD = -0.01, 95% CI = [-0.23, 0.21], p = 0.93, I 2 = 0.00%). Quality of life between participants in the SLT and medication groups was found to be similar. Conclusion:Long-term IOP reduction was greater in the SLT treatment compared to medication. SLT treatment significantly reduced the number of medications used by participants whereas medication group had no significant change.

PURPOSE:Measure outflow resistance of the styrene-block-isobutylene-block-styrene (SIBS) microshunt when sutures of differing lengths, sizes, and materials partially occlude the lumen. DESIGN:In vitro experiment METHODS: The SIBS microshunt proximal end was connected to a gravity perfusion system. The distal tip was submerged within a fluid-filled covered collection-beaker. Microshunt flow was quantified through collection-beaker mass changes. Each 5-minute trial was replicated 4 times per condition. Various sutures were inserted into the distal end of the microshunt's lumen, and outflow resistance was measured in partly occluded states (4-mm or 8-mm suture length inserted, 9-0 or 10-0 suture diameters, Vicryl or nylon suture). The 4-mm 10-0 nylon condition was repeated with sutures from different lots to investigate the effects of suture manufacturing variability. MAIN OUTCOME MEASURE:Outflow resistance. RESULTS:Resistance of nonoccluded SIBS microshunts (n = 5) was 1.74 ± 0.06 mmHg/μl/minute, matching the theoretical 1.76 mmHg/μl/minute from the Hagen-Poiseuille formula. Partial occlusion with a 4-mm 10-0 suture increased resistance to 3.42 ± 0.13 mmHg/μl/minute for nylon and 3.55 ± 0.13 for Vicryl. Partial occlusion with an 8-mm 10-0 suture increased resistance to 4.66 ± 0.21 for nylon and 5.08 ± 0.23 for Vicryl. Partial occlusion with a 4-mm 9-0 suture increased resistance to 5.11 ± 0.28 for nylon and 5.00 ± 0.27 for Vicryl. Partial occlusion with an 8-mm 9-0 suture increased resistance to 7.24 ± 0.37 for nylon and 7.87 ± 0.55 for Vicryl. Resistance differed significantly between nonoccluded versus all partially occluded states (P < 0.0001), 4- versus 8-mm partially occlusion lengths (P < 0.0001), 10-0 versus 9-0 suture diameters (P < 0.0001), and 4-mm 10-0 nylon sutures from different lots (P < 0.0001). No difference was observed between suture materials (P > 0.05) or different microshunts (P > 0.05). CONCLUSIONS:Nonoccluded microshunt resistance measured by the perfusion model matched theoretical values. Partial occlusion with either suture material caused substantial resistance increases, depending on suture diameter and length, compared with nonoccluded microshunts. If desired, partial occlusion with 4-mm 9-0 nylon or 8-mm 10-0 nylon suture is recommended, producing resistance consistently above the hypotony threshold while maintaining optimal therapeutic efficacy. FINANCIAL DISCLOSURE(S):Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Objective Selective laser trabeculoplasty (SLT) has increasingly been used as a first-line glaucoma treatment. To better understand its impact on the Canadian patient and health care system, a cost-effectiveness analysis was performed to compare SLT against topical eye medications for patients with newly diagnosed open-angle glaucoma. Methods Using a Markov model with a 20-year horizon from a health care payer perspective, the incremental cost-effectiveness ratio (ICER) of treating newly diagnosed mild open-angle glaucoma with SLT and medication was calculated. A discount rate of 1.5% was applied to all costs and health outcomes. Sensitivity and probabilistic analyses were performed to test the uncertainty of the model. Results The base case analysis indicated that patients who received the SLT treatment had a lower health care system cost of $1,671.48 and a higher quality-adjusted life year of 0.09 per patient compared with the medication treatment. As a result, the SLT treatment dominates medication treatment. The one-way cost-effectiveness sensitivity analysis showed that SLT dominates the medication treatment at all discount rates between 0% and 3%. The largest effects on the ICER value were variations in medication utility of ocular hypertension and mild glaucoma state, and SLT utility of mild glaucoma state, based on the tornado diagram. Probabilistic sensitivity analyses also demonstrated that the SLT treatment dominated the medication treatment. Conclusions Our model suggests that SLT as the initial treatment strategy for glaucoma patients and investment in SLT could lead to improved clinical outcomes, costs, and resource utilization within the Canadian health care system.

PurposeCataract surgery is a fundamental procedure in ophthalmology, yet intraoperative complications such as anterior vitrectomy can compromise surgical outcomes. This systematic review and meta-analysis (CRD42025637001) aim to compare the incidence of anterior vitrectomy in cataract surgeries performed by ophthalmology residents versus experienced surgeons and assess factors contributing to surgical complications.MethodsA systematic search was conducted across EMBASE, MEDLINE, CINAHL Plus, Web of Science, ClinicalTrials.gov, PQDT Global, ARVO and AAO for studies published after 2000 that reported on anterior vitrectomy incidence in cataract surgery. Eligible studies included randomized controlled trials and observational studies. Meta-analysis was performed using STATA v. 18.0.ResultsOut of 1,190 screened studies, five studies (four retrospective cohort, one prospective cohort) involving phacoemulsification, extracapsular cataract extraction (ECCE), and femtosecond laser-assisted cataract surgery (FLACS) were included, encompassing a total of 4,918 cataract surgeries, and 208 anterior vitrectomy (AV) cases. The random-effects meta-analysis demonstrated a significant AV incidence for residents (ES = 0.04, 95% CI: [0.01, 0.06]), while the incidence for experienced surgeons was not statistically significant (ES = 0.03, 95% CI: [-0.03, 0.09]). High heterogeneity was observed among the included studies (I² = 92.1% for residents and I² = 96.7% for surgeons).ConclusionResidents may have a higher incidence of AV, highlighting the potential benefits of structured surgical training, early exposure, and mentorship in reducing intraoperative complications. Future research should explore simulation-based training and technology-assisted surgery to improve resident proficiency and patient outcomes.

Latanoprostene bunod ophthalmic solution (LBN) 0.024% is a topical nitric oxide (NO)-donating prostaglandin F2α (PGF2α) analog first approved in November 2017 for reduction of intraocular pressure (IOP) in patients with ocular hypertension (OHT) or open-angle glaucoma (OAG). This narrative review describes the unique mechanism of action of LBN and summarizes available real-world data. Upon instillation, LBN is metabolized into latanoprost acid and butanediol mononitrate, which is further reduced to NO and an inactive metabolite. Latanoprost acid increases aqueous humor outflow primarily through the uveoscleral (unconventional) pathway, whereas NO increases outflow through the trabecular (conventional) pathway. Eight studies were identified: 2 studies in newly diagnosed, treatment-naïve patients with OHT or OAG, 4 studies of adjunctive therapy in patients with glaucoma receiving other IOP-lowering therapies, and 2 studies in which patients with glaucoma switched to LBN monotherapy or adjunctive therapy. Decreases in IOP after initiating LBN in newly diagnosed patients or adding/switching to LBN were generally consistent with reductions observed in clinical trials and sustained throughout the studies. Rates of discontinuation due to inadequate IOP lowering ranged from 12.2% to 17.1%. LBN was generally well tolerated in real-world studies; the most common adverse events were consistent with the known safety profile of LBN. Data from real-world studies provide important insights regarding the potential effectiveness and tolerability of LBN in the clinical setting and suggest that LBN is well tolerated and associated with significant, clinically meaningful, and durable reductions in IOP.

TOPIC:This review assesses the effectiveness of intravenous (IV) sedation compared with non-IV sedation for routine cataract surgery. CLINICAL RELEVANCE:Cataract surgery is a safe and routinely performed surgery. Sedation practices vary, with centers providing IV, oral, or no sedation for surgery. Improving sedation practices may have significant implications for patient safety, patient experience, and health system efficiency. METHODS:MEDLINE, Embase, Cochrane Library, BIOSIS, Web of Science, and CINAHL were searched from inception to July 2024 for relevant articles containing original data. Randomized controlled trials that compared IV with oral or no sedation and (1) used a validated pain scale to report on pain or (2) reported on perioperative complications were included. A random-effects meta-analysis was conducted. Odds ratios (ORs), standard mean differences (SMDs), 95% CIs, and I2 statistics were reported. The review was registered in PROSPERO (CRD42024582495), and PRISMA guidelines were followed. RESULTS:12 randomized controlled trials including 1130 patients were included in the meta-analysis. IV sedation was associated with significantly decreased pain compared with no sedation (SMD, -0.98; 95% CI, -1.68 to -0.29). Comparing IV and oral sedation, however, there was no difference in patient-reported pain (SMD, -0.54; 95% CI, -1.60 to 0.52). Analysis of intraoperative complications showed that there was no significant difference in complications between patients receiving IV and oral sedation (OR, 0.68; 95% CI, 0.27-1.73). CONCLUSIONS:For routine cataract surgery, IV sedation was associated with less pain than no sedation, but oral and IV sedation provided comparable pain control. Perioperative complications occur at similar rates regardless of sedation modality. These findings may help to inform sedation practices for cataract surgery.

PURPOSE:We conducted a cross-sectional study of sex, racial, and ethnic patient enrolment to glaucoma-related randomized controlled trials (RCTs) registered on ClinicalTrials.gov (to January 2023). METHODS:Trials were included if they were at least double-masked, completed, and had published results through the registry or a scholarly journal. Sex-based glaucoma disease burden was identified using the Global Burden of Disease database. Pooled population-to-prevalence ratios (PPRs) with 95% confidence intervals (CI) were calculated for female sex, with values between 0.8 and 1.2 constituting sufficient study enrolment. RESULTS:From 1061 records, we identified 177 trials (N = 38.475; 56.2% females) for inclusion in the study. The pooled female PPR was 1.05 [95% CI 1.02, 1.08]. Sub-group analysis revealed equitable female enrolment across study characteristics, although studies published prior to 1997 were indeterminate on whether they under-enrolled female participants. CONCLUSIONS:Overall, US-registered, glaucoma-related trials enrolled acceptable proportions of females based on real-world disease burden. Future trial enrolment should strive for equitable demographic representation.

Purpose: To conduct a systematic review investigating the efficacy of antibiotics used in irrigation fluid during cataract surgery on the incidence of post-operative endophthalmitis. Design: Systematic review of literature. Methods: Literature was searched through MEDLINE, EMBASE, CINAHL, ClinicalTrials.gov, and ProQuest Dissertations and Theses until February 17, 2024. Conferences held through the Association for Research in Vision and Ophthalmology and American Academy of Ophthalmology were searched until March 22, 2024. A total of 5341 records were screened leaving 13. One author independently reviewed them for quality and extracted data. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines were followed. Data on the types of antibiotics used, as well as the incidence of post-operative endophthalmitis and complications, were extracted. Results: A total of 608,064 eyes and 566,760 patients were included in the current study. Surgical procedures included phacoemulsification, manual small-incision, and extracapsular extraction. Results showed antibiotic additives reduced postoperative endophthalmitis and bacterial contamination. Vancomycin showed the lowest infection rates, with one study reporting 0 infections out of 220 patients using a concentration of 20 mg/L. Similarly, gentamicin, tobramycin, and cefuroxime also demonstrated reduced infection rates, with gentamicin achieving rates as low as 0.008 % at higher concentrations. Combination therapy with vancomycin and gentamicin further reduced bacterial contamination, with culture positivity rates as low as 2.73 %. In comparator groups without antibiotics, infection rates were significantly higher, ranging from 0.04 % to 0.07 %. No adverse events or complications were reported in those who received antibiotics in their irrigation fluid. Conclusions: Antibiotic additives in irrigation fluid reduce postoperative endophthalmitis and bacterial contamination in cataract surgery. These findings support their inclusion in surgical practice to improve patient outcomes. Based on the current systematic review, the overall quality of evidence is moderate, as findings are supported by a mix of randomized controlled trials and observational studies with some heterogeneity. Further high-quality RCTs are needed to determine optimal antibiotic concentrations and establish standardized guidelines.

Here we report the intraocular pressure (IOP) changes following treatment with latanoprostene bunod (LBN) 0.024

Purpose:Femtosecond laser-assisted cataract surgery (FLACS) has increasingly been adopted worldwide. Lagging behind is evidence-based consensus regarding optimal timing for intraocular pressure (IOP) measurement following FLACS. The purpose of this study was to determine if enough evidence currently exists to guide best practice. Methods:A comprehensive literature search was performed on MEDLINE and EMBASE until February 6th, 2023. Articles reporting IOP measurements following uncomplicated FLACS were screened. For change in IOP at various post-operative timepoints, standardized mean difference (SMD) was calculated as the mean difference in IOP from baseline. Risk of Bias Assessment was conducted following data extraction. Results:The meta-analysis incorporated six randomized clinical studies involving a total of 1356 eyes from 1032 participants. Post-operative day one was the only timepoint with a non-significant increase in IOP (SMD = -0.08 [95% CI: -0.41 to +0.24]) compared to the 7-days, 30-days, 60 to 90-days, and 180-days follow-up periods. All studies except one utilized an ophthalmic viscosurgical device (OVD) in their procedure; this was the only publication that reported a decrease in IOP from baseline within the 1-day follow-up period. Conclusion:The results suggest that the optimal time to measure IOP is within the first 24 hours after FLACS. However, these findings are limited by a small study sample. Future prospective clinical trials may be beneficial to determine if specific timepoints within the first 24 hours exist to optimize outcomes and patient reported experiences.

OBJECTIVE:The Glaucoma Research Society of Canada (GRSC) is Canada's only nonprofit organization dedicated to funding peer-reviewed glaucoma research. This study evaluates the impact of GRSC-funded projects using established research productivity metrics. DESIGN:Retrospective study. METHODS:GRSC-funded grants from 2010 to 2020 were analyzed, including project details and funding amounts. Research productivity was assessed by (1) the number of peer-reviewed publications and (2) the number of conference presentations at major North American meetings. Publications were identified via PubMed searches of grant recipients, ensuring alignment with GRSC-funded topics. Conference presentations were determined by reviewing accepted abstracts from 5 key ophthalmology meetings: the Canadian Ophthalmological Society, American Society of Cataract and Refractive Surgery, American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology. Research output was analyzed in relation to funding costs. RESULTS:Of 135 grants totaling $2,220,822, 84 (62%) led to at least one publication (92 total), while 67 (50%) resulted in conference presentations (85 total). The average research output per grant was 1.3, with costs of $12,547 per research output and $24,139 per publication. Research costs increased over time, with a slight decrease in 2019. CONCLUSIONS:GRSC-funded research consistently generates peer-reviewed knowledge, with over half of projects producing publications or presentations. Despite rising research costs, the high success rate in knowledge dissemination underscores GRSC's critical role in sustaining and advancing glaucoma research in Canada.

INTRODUCTION:Here we report the intraocular pressure (IOP) changes following treatment with latanoprostene bunod (LBN) 0.024% in patients in Canadian ophthalmology practices. METHODS:This real-world, open-label, 6-week, observational study collected data from 59 Canadian ophthalmologists and a total of 653 patients. Eligibility was open to all patients treated with LBN 0.024% instilled once daily for open-angle glaucoma or ocular hypertension. IOP was assessed prior to initiating LBN and after a planned 6 weeks of treatment. Patient demographics, prior treatment(s), IOP, and patient/physician satisfaction ratings were recorded. Subgroup analyses included (1) patients naïve to prior IOP-lowering medication (with or without prior selective laser trabeculoplasty [SLT]) initiating LBN; (2) patients switching from a pre-existing medication to LBN; and (3) patients adding LBN to existing medications. RESULTS:Of 653 patients included, 251 were naïve to previous medical antihypertensive therapy, 369 were switched to LBN from a previous medication, and 26 added LBN on top of existing medications (seven patients did not indicate status). Mean baseline IOP was 19.5 mmHg in the overall cohort and follow-up occurred over a period of 37.9 ± 7.9 days. Mean IOP was reduced by 16.3% (95% confidence interval 14.9-17.7) across all included patients. Overall IOP reduction from baseline was largest for naïve patients with no prior SLT (29.3%), with age and baseline IOP key determinants of outcomes in this group. Patient and physician satisfaction scores were high. CONCLUSION:This initial Canadian clinical experience of LBN in diverse patient and physician populations reflected its use in a real-world context, and demonstrated a significant IOP-lowering effect with LBN across patient groups seen in routine practice. Patient and physician satisfaction scores were high and in notable agreement.

Background To investigate the effect of perioperative intraocular pressure (IOP) lowering medications on controlling postoperative IOP following uncomplicated phacoemulsification. Methods Ovid MEDLINE, EMBASE, and Cochrane CENTRAL databases were searched up until November 2022. Randomised controlled trials (RCTs) that assessed IOP change via applanation tonometry in medicated and control arms following uncomplicated cataract surgery in healthy eyes were included. The primary outcome was the weighted mean difference (WMD) of IOP at 2–8 h, 12–24 h, and 1–7 days postoperatively within each medication class or common fixed-combination formulations. Risk of bias was assessed using the revised risk of bias in randomised trials (RoB-2). Level of evidence was rated using the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) Results From 702 screened articles, 30 RCTs involving 2986 eyes were included. There was a statistically significant reduction in IOP favouring treatment arms at 2–8 h (WMD = −3.87 mmHg; 95% CI [−4.75, −3.00]; p < 0.001) and 12–24 h (WMD = −2.69 mmHg; 95% CI [−3.36, −2.02]; p < 0.001), with the effect wearing off beyond 1 day ( p = 0.18). Between medication classes, the largest effect at both 2–8 h and 12–24 h was observed with intracameral cholinergics or fixed-combination carbonic anhydrase inhibitor-beta-blocker (FCCB) formulations. Conversely, the smallest effect was observed with prostaglandin analogues, alpha-agonists, and topical carbonic anhydrase inhibitors (CAIs). Conclusion Prophylaxis against acute IOP elevations following uncomplicated cataract surgery is effective. FCCB and intracameral cholinergics are the most effective ocular antihypertensive agents, while alpha-agonists, prostaglandin analogues, and topical CAIs were found to be the least effective. These findings may inform future surgical guidelines.

Post-operative increases in intraocular pressure (IOP) are a frequent complication following phacoemulsification cataract surgery. Assessment of IOP is an essential element in post-operative checks. Despite this, guidance regarding the optimal timing remains vague. The purpose of this meta-analysis was to determine the current status of evidence that may help guide best practice regarding the optimal time following phacoemulsification cataract surgery to measure IOP. A comprehensive literature search was performed on MEDLINE and EMBASE. In two stages, independent reviewers screened articles that reported IOP measurements following uncomplicated cataract surgery. Risk of Bias Assessment was conducted following data extraction. The meta-analysis incorporated 57 randomized clinical studies involving a total of 6318 participants and 7089 eyes. Post-operative hour one had a significant decrease in IOP from baseline, while hour two had a non-significant increase. Post-operative hours four, six, and eight were the only timepoints to have a significant increase in IOP. Finally, post-operative day one had no significant change in IOP, while day two had a non-significant decrease. These results suggest that the optimal time to measure IOP is within the first 4–8 h following phacoemulsification cataract extraction. Taking measurements too soon or too late could result in missed IOP spikes.

OBJECTIVE:This study aimed to assess whether the research output of medical students who matched into a Canadian ophthalmology residency program influences their subsequent research productivity during residency, decision to pursue a fellowship, or engagement in academic practice. DESIGN:Retrospective database review. PARTICIPANTS:A total of 369 trainees commencing ophthalmology residency from 2004 to 2015 at 15 residency programs. METHODS:Each trainee's publication record was queried in Scopus before and after the date they started residency. Multiple public sources were searched to identify fellowship placement and the type of subsequent practice (i.e., academic or community). Predictors of research productivity during residency, fellowship, and practice setting were assessed using multivariable regression analyses. RESULTS:Trainees with pre-residency publications (n = 187) demonstrated significantly higher research productivity during residency than those without pre-residency publications (n = 182), with a mean of 5.17 ± 5.97 versus 1.60 ± 2.38 publications on any topic (p < 0.001). Pre-residency research output was a predictor of research productivity during residency (relative risk = 1.17; 95% CI, 1.09-1.27; p < 0.001), pursuing fellowship (odds ratio, 2.9; 95% CI, 1.74-4.83), and an academic career (odds ratio = 1.85; 95% CI, 1.07-3.2). CONCLUSION:Pre-residency research output is a significant predictor of research productivity during residency and subsequent career choices, suggesting that pre-residency publishing reflects a propensity toward an academic trajectory. Residency publication count moderates this association, underscoring the role of the residency program environment in fostering research productivity. Addressing barriers such as mentorship, funding, and curriculum may be key to incentivizing trainees to pursue academic medicine.

The current clinical application of glaucoma drainage devices is made of non-degradable materials. These non-degradable drainage devices often trigger inflammatory responses and scar proliferation, possibly leading to surgical failure. We developed a biodegradable material hydroxyapatite-coated magnesium (HA-Mg) as a glaucoma drainage device. Twelve New Zealand white rabbits were randomly assigned to three groups: HA-Mg drainage plate group (6 right eyes), trabeculectomy group (6 right eyes), and control group (12 left eyes). Results showed that all HA-Mg drainage plates were completely degraded ~4 months postoperatively. At the 5th month postoperatively, there was no statistical difference in the corneal endothelium density between the HA-Mg drainage plate group and the control group (p = 0.857). The intraocular pressure (IOP) level in the HA-Mg drainage plate implantation group was lower than in the other two groups. The trypan blue dye still drained from the anterior chamber to the subconjunctiva 5 months after HA-Mg drainage plate implantation. HE staining revealed the scleral linear aqueous humor drainage channel and anterior synechia were observed after drainage plate completely degraded, with no obvious infiltration with the inflammatory cells. This study showed the safety and efficacy of HA-Mg glaucoma drainage plate in controlling IOP after implantation into the anterior chamber of rabbit eyes.