ArticleClinical ophthalmology (Auckland, N.Z.)2025
Proposing a New Classification for Managing Prostaglandin-Induced Enophthalmos in Glaucoma Patients.
Article in Clinical ophthalmology (Auckland, N.Z.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Ocular Surface Recovery Following Corrective Eyelid Surgery: Course, Predictors, and Perioperative Management Implications.Diagnostics (Basel, Switzerland) · 2026Article
- Epithelial and Topographic Corneal Remodeling After Ptosis and Ectropion Surgery: An MS-39-Based Study.Diagnostics (Basel, Switzerland) · 2026Article
- Ocular Surface Parameters in Glaucoma Patients Treated with Topical Prostaglandin Analogs and the Importance of Switching to Preservative-Free Eye Drops-A Systematic Review.Life (Basel, Switzerland) · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: Glaucoma is commonly treated with prostaglandin analogs (PGAs), which effectively reduce intraocular pressure. However, PGAs can cause ocular side effects, including prostaglandin-associated periorbitopathy syndrome (PAPS), characterized by fat loss, enophthalmos and increased orbital structure prominence. The underlying mechanism is believed to involve adipocyte apoptosis, altered lipid metabolism, and changes in soft tissue dynamics. Currently, there is no standardized grading for enophthalmos, complicating its management. This study aimed to classify prostaglandin-induced enophthalmos and explore surgical or minimally invasive treatments, focusing on Italian Caucasian patients. Materials and Methods: The study, conducted at IRCCS Humanitas Research Hospital between 2005 and 2023, assessed PAPS in primary open-angle glaucoma patients. It included a two-phase approach: (1) classification of enophthalmos using clinical and radiological measures to create a composite PAPS score; and (2) evaluation of treatment options, including Calcium Hydroxylapatite (CAHY) injections and autologous fat grafting. Results: A retrospective analysis of 120 glaucoma patients with prostaglandin-induced enophthalmos identified severity levels using the PAPS classification. The proposed therapeutic algorithm stratifies treatment: mild cases benefit from conservative management or fillers, moderate cases from calcium hydroxyapatite (CAHY) injections, and severe cases from combined CAHY and autologous fat grafting. Conclusion: A lack of a standardized grading system hinders consensus on management of PAPS. We propose a novel composite scoring system integrating six clinical parameters to stratify patients and tailor a minimally invasive therapeutic approach using calcium hydroxyapatite fillers and autologous fat grafting to restore orbital volume, improve eyelid aesthetics, and reduce complications. This classification system may serve as a clinical tool in patients with persistent or advanced PAPS who seek cosmetic correction or relief from functional symptoms.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.