Publications by authors named "Darby Miller"

Topical anesthetics for control of pain from corneal abrasions can cause drug-related toxicity that delays corneal healing. This report documents three cases where topical anesthetic drops were prescribed in the emergency department for pain control, after which patients developed persistent ocular pain, epithelial toxicity with impaired healing, and significant loss of vision. On consultation with the ophthalmology service, each patient was instructed to discontinue the topical anesthetic drops but to continue topical antibiotics.

View Article and Find Full Text PDF

Cataract surgery is one of the most performed procedures worldwide, and cataracts are rising in prevalence in our aging population. With the increasing utilization of artificial intelligence (AI) in the medical field, we aimed to understand the extent of present AI applications in ophthalmic microsurgery, specifically cataract surgery. We conducted a literature search on PubMed and Google Scholar using keywords related to the application of AI in cataract surgery and included relevant articles published since 2010 in our review.

View Article and Find Full Text PDF

Objective: To evaluate the published literature on the efficacy of amniotic membrane grafting (AMG) in the management of acute chemical and thermal ocular surface burns with respect to the rate of corneal re-epithelialization and improvement of visual acuity or corneal clarity.

Methods: Literature searches were conducted in the PubMed database in May 2023 and updated in January 2024 and were limited to the English language without date restrictions. The searches yielded 474 citations; 58 were reviewed in full text, and 9 met the inclusion criteria.

View Article and Find Full Text PDF

Purpose: To evaluate racial and ethnic differences in the use of microinvasive glaucoma surgery (MIGS) for the management of mild-moderate primary open-angle glaucoma (POAG) in the United States.

Design: Retrospective cohort study.

Participants: Patients with a diagnosis of mild or moderate POAG, as defined by Current Procedural Terminology (CPT) codes, were included.

View Article and Find Full Text PDF

Purpose: To compare the safety and effectiveness of standalone Kahook Dual Blade (KDB) excisional goniotomy to standalone ab-interno Xen gel stent implantation in eyes with moderate-to-severe open-angle glaucoma (OAG).

Methods: A single-center, retrospective study including eyes with moderate-to-severe OAG undergoing standalone KDB goniotomy or Xen gel stent implantation was conducted. Intraocular pressure (IOP), the number of antiglaucoma medications taken daily, and best-corrected visual acuity (BCVA) were recorded at baseline and for up to 36-months.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to assess the anatomical differences in eyes with Fuchs endothelial corneal dystrophy (FECD) versus eyes without this condition.
  • It involved a retrospective analysis of 404 eyes, using advanced imaging techniques to measure various eye characteristics before cataract surgery.
  • Results showed significant differences, including shallower anterior chamber depths and higher corneal volumes in FECD eyes, offering new insights for future research on this eye condition.
View Article and Find Full Text PDF

Purpose XEN45 Gel Stent and glaucoma drainage device (GDD) implantation is safe and effective for glaucoma treatment and should be taught during glaucoma fellowship training. However, complications may still occur, with potentially sight-threatening consequences. The purpose of this study is to describe the management of complications following a series of XEN45 Gel Stent and GDD surgeries performed over the course of glaucoma fellowship training.

View Article and Find Full Text PDF
Article Synopsis
  • This study evaluates the effectiveness of excisional goniotomy using the Kahook Dual Blade (KDB) for managing glaucoma over a period of 72 months.
  • It analyzed 90 eyes from 53 patients, comparing outcomes for those undergoing KDB alone versus those with concurrent phacoemulsification, measuring intraocular pressure (IOP) changes and medication use.
  • Results showed significant IOP reduction and less dependence on glaucoma medications, with successful outcomes for nearly half of the patients, highlighting the procedure's long-term efficacy and safety.
View Article and Find Full Text PDF
Article Synopsis
  • - The article reviews the safety and effectiveness of canaloplasty, a nonpenetrating surgical procedure for treating glaucoma, focusing on its ability to lower intraocular pressure and reduce medication needs in mild-to-moderate open-angle glaucoma patients
  • - After analyzing 60 studies, both ab externo and ab-interno canaloplasty methods demonstrated significant benefits, with ABiC showing a safety profile that is better than trabeculectomy and comparable to other minimally invasive surgeries
  • - The findings support the use of canaloplasty in clinical practice for glaucoma treatment, helping define the patient population and compare its outcomes with current minimally invasive options
View Article and Find Full Text PDF

Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in the Western world, with a higher prevalence among Europeans and North Americans than that in Africans, Hispanics, and Asians. Advanced AMD is categorized as atrophic (dry) or exudative (wet/neovascular age-related macular degeneration [nAMD]). Dry AMD is characterized by progressive geographic atrophy of the retinal pigment epithelium and outer retinal layers, whereas nAMD is characterized by new vessels that invade the subretinal and/or subretinal pigment epithelium spaces.

View Article and Find Full Text PDF
Article Synopsis
  • The text reviews the safety and effectiveness of epithelium-off corneal collagen cross-linking (CXL) as a treatment for progressive corneal ectasia, specifically keratoconus (KCN) and ectasia after refractive surgery.
  • A comprehensive literature search led to the inclusion of 6 high-quality randomized clinical trials, all showing positive outcomes, including decreased progression rates and improved visual acuity in patients undergoing treatment compared to controls.
  • The findings indicate that epithelium-off CXL is effective in managing KCN and post-refractive surgery ectasia with a low incidence of complications, suggesting a favorable safety profile.
View Article and Find Full Text PDF

Purpose: To evaluate the safety and effectiveness of the Ahmed ClearPath (ACP) 250 mm glaucoma drainage device (GDD) in managing refractory primary open-angle glaucoma (POAG).

Patients And Methods: This was a retrospective case series focused on adult patients diagnosed with severe POAG who underwent implantation of an ACP GDD. Over a 36-month follow-up period, data on intraocular pressure (IOP), the number of glaucoma medications, and complications were recorded.

View Article and Find Full Text PDF

Purpose: Although musculoskeletal involvement is the common presentation, studies have reported the incidence of sports related ocular trauma. Here we present the case reports of two patients who sustained injury in one of the fast growing sports - the pickleball, during play without eye protection.

Observations: Two patients with history of injury during pickleball play presented to our clinic with varying spectrum of ocular presentations.

View Article and Find Full Text PDF

Purpose: To review the published literature on the safety and outcomes of keratolimbal allograft (KLAL) transplantation and living-related conjunctival limbal allograft (lr-CLAL) transplantation for bilateral severe/total limbal stem cell deficiency (LSCD).

Methods: Literature searches were last conducted in the PubMed database in February 2023 and were limited to the English language. They yielded 523 citations; 76 were reviewed in full text, and 21 met the inclusion criteria.

View Article and Find Full Text PDF

Purpose: SCUBA diving exposes participants to a unique hyperbaric environment, but few studies have examined the effects of such an environment on intraocular pressure (IOP) and glaucoma. This systematic review aims to consolidate recent literature findings regarding the impact of increased atmospheric pressure on IOP and glaucoma.

Methods: Three online databases were searched to identify publications encompassing the subjects of diving or increased atmospheric pressure in conjunction with IOP or glaucoma.

View Article and Find Full Text PDF

Purpose: To report clinical outcomes of successful excisional goniotomy with the Kahook Dual Blade (KDB), through 60 months.

Patients And Methods: This was a noncomparative, single-surgeon, retrospective review of eyes receiving successful KDB goniotomy with or without concomitant phacoemulsification between October 2015 and January 2016 with five years of uninterrupted follow-up. Intraocular pressure (IOP), number of glaucoma medications, best corrected visual acuity (BCVA), and complications were recorded.

View Article and Find Full Text PDF

Purpose: To review the published literature on the diagnostic capabilities of the newest generation of corneal imaging devices for the identification of keratoconus.

Methods: Corneal imaging devices studied included tomographic platforms (Scheimpflug photography, OCT) and functional biomechanical devices (imaging an air impulse on the cornea). A literature search in the PubMed database for English language studies was last conducted in February 2023.

View Article and Find Full Text PDF

Importance: Recently, several states have granted optometrists privileges to perform select laser procedures (laser peripheral iridotomy, selective laser trabeculoplasty, and YAG laser capsulotomy) with the aim of increasing access. However, whether these changes are associated with increased access to these procedures among each state's Medicare population has not been evaluated.

Objective: To compare patient access to laser surgery eye care by estimated travel time and 30-minute proximity to an optometrist or ophthalmologist.

View Article and Find Full Text PDF

Purpose: To quantify differences in the age, gender, race, and clinical complexity of Medicare beneficiaries treated by ophthalmologists and optometrists in each of the United States.

Design: Cross-sectional study based on publicly accessible Medicare payment and utilization data from 2012 through 2017.

Methods: For each ophthalmic and optometric provider, demographic information of treated Medicare beneficiaries was obtained from the Medicare Provider Utilization and Payment Data from the Centers for Medicare and Medicaid Services (CMS) for the years 2012 through 2017.

View Article and Find Full Text PDF

Purpose: To comprehensively review the literature regarding recurrent corneal erosion (RCE) and to present treatment options and recommendations for management.

Overview: RCE usually presents with sharp, unilateral pain upon awakening, in an eye with an underlying basement membrane dystrophy, prior ocular trauma, stromal dystrophy or degeneration, or prior surgery for refractive errors, cataracts, or corneal transplantation. Making the correct diagnosis requires a careful slit-lamp examination of both eyes coupled with a high degree of suspicion.

View Article and Find Full Text PDF

Dry eye is one of the most commonly encountered problems in ophthalmology. Signs can include punctate epithelial erosions, hyperemia, low tear lakes, rapid tear break-up time, and meibomian gland disease. Current methods of diagnosis include a slit-lamp examination with and without different stains, including fluorescein, rose bengal, and lissamine green.

View Article and Find Full Text PDF

Purpose: To compare qualitatively and quantitatively Optos fundus camera fluorescein angiographic images of retinal vascular leakage with 9-field montage Topcon fluorescein angiography (FA) images in patients with uveitis. We hypothesized that Optos images reveal more leakage in patients with uveitis.

Design: Retrospective, observational case series.

View Article and Find Full Text PDF

Candidate HIV-1 vaccine regimens utilizing intramuscularly (i.m.) administered recombinant adenovirus (rAd)-based vectors can induce potent mucosal cellular immunity.

View Article and Find Full Text PDF