{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T18:17:15Z","timestamp":1787854635348,"version":"build-2784847793"},"reference-count":14,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2026,8,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To create and clinically test the Lens Attachment Guard (LAG), a 3D-printed protective attachment for the prevention of incidental falls and breakage of ophthalmic lenses employed in laser treatments like pan-retinal photocoagulation (PRP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The LAG system was designed after several cases of lens damage in a busy clinical practice. It was created with Computer-Aided Design software and produced with thermoplastic polyurethane (TPU) through 3D printing. Iterative prototyping was done to maximise fit, optical compatibility and user-friendliness. The last prototype consisted of three primary elements: a winding clip, thread lock and 3D-printed lens holder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The LAG system ensured safe lens stabilisation without compromising laser delivery or visualisation. TPU had shock-absorption and was sterilisation compatible. There were no drops of lenses reported when used. Clinician input revealed enhanced procedural confidence and minimal interference with workflow. The system proved versatile for varied lens types and was readily cleaned and could be reused from case to case.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The LAG is a user-friendly, reusable and inexpensive innovation that satisfies a previously unmet need in ophthalmic practice. Its use can have a significant impact on reducing lens damage, increasing procedural safety and increasing clinical efficiency. Multicentre validation and increased lens compatibility testing are ongoing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2025-327899","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T17:20:24Z","timestamp":1787851224000},"page":"bjo-2025-327899","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Lens attachment guard (LAG): a novel protection system for lenses used in ophthalmology"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0483-7014","authenticated-orcid":false,"given":"Athul S","family":"Puthalath","sequence":"first","affiliation":[{"name":"Retina Vitreous Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kannan","family":"Naresh Babu","sequence":"additional","affiliation":[{"name":"Retina Vitreous Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muthukrishnan","family":"Vallinayagam","sequence":"additional","affiliation":[{"name":"Retina Vitreous Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Ramasamy","sequence":"additional","affiliation":[{"name":"Retina Vitreous Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"2026082710200872000_bjo-2025-327899v1.1","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/S0161-6420(83)34421-3","article-title":"Contact lenses for laser applications","volume":"Suppl","author":"Dieckert","year":"1983","journal-title":"Ophthalmology"},{"key":"2026082710200872000_bjo-2025-327899v1.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2013-001812"},{"key":"2026082710200872000_bjo-2025-327899v1.3","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1016\/S0002-9394(14)74389-2","article-title":"Potential laser hazards to the clinician during photocoagulation","volume":"103","author":"Sliney","year":"1987","journal-title":"Am J Ophthalmol"},{"key":"2026082710200872000_bjo-2025-327899v1.4","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.74.3.177"},{"key":"2026082710200872000_bjo-2025-327899v1.5","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1007\/s00417-019-04312-3","article-title":"Implementations of 3D printing in ophthalmology","volume":"257","author":"Sommer","year":"2019","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"2026082710200872000_bjo-2025-327899v1.6","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1007\/s40123-021-00379-6","article-title":"3D Printing in Eye Care","volume":"10","author":"Larochelle","year":"2021","journal-title":"Ophthalmol Ther"},{"key":"2026082710200872000_bjo-2025-327899v1.7","doi-asserted-by":"crossref","unstructured":"Viccica M , Giordano M , Galati M . Additive manufacturing of flexible thermoplastic polyurethane (TPU): enhancing the material elongation through process optimisation. Prog Addit Manuf 2024;1\u201313. doi:10.1007\/s40964-024-00790-y","DOI":"10.1007\/s40964-024-00790-y"},{"key":"2026082710200872000_bjo-2025-327899v1.8","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1016\/j.survophthal.2022.01.004","article-title":"Applications of three-dimensional printing in ophthalmology","volume":"67","author":"Tsui","year":"2022","journal-title":"Surv Ophthalmol"},{"key":"2026082710200872000_bjo-2025-327899v1.9","article-title":"Three-dimensional printing in ophthalmology and eye care: current applications and future developments","volume":"14","author":"Fakhoury","year":"2022","journal-title":"Ther Adv Ophthalmol"},{"key":"2026082710200872000_bjo-2025-327899v1.10","doi-asserted-by":"crossref","DOI":"10.1136\/bmjophth-2020-000685","article-title":"Novel open-source 3D-printed eye mount (TEMPO) for the ophthalmology wet lab","volume":"6","author":"Mak","year":"2021","journal-title":"BMJ Open Ophthalmol"},{"key":"2026082710200872000_bjo-2025-327899v1.11","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2016-308399"},{"key":"2026082710200872000_bjo-2025-327899v1.12","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1080\/09286586.2021.1980589","article-title":"Smartphone-based Anterior Segment Imaging: A Comparative Diagnostic Accuracy Study of a Potential Tool for Blindness Prevalence Surveys","volume":"29","author":"Kumar","year":"2022","journal-title":"Ophthalmic Epidemiol"},{"key":"2026082710200872000_bjo-2025-327899v1.13","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1177\/11206721241246187","article-title":"Design of a new 3D printed all-in-one magnetic smartphone adapter for fundus and anterior segment imaging","volume":"35","author":"Rubegni","year":"2025","journal-title":"Eur J Ophthalmol"},{"key":"2026082710200872000_bjo-2025-327899v1.14","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/j.jcrs.0000000000001635","article-title":"Disinfection of outpatient ophthalmic devices: a critique of \u201csemicritical\u201d designation","volume":"51","author":"Kuo","year":"2025","journal-title":"J Cataract Refract Surg"}],"container-title":["British Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjo-2025-327899","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T17:20:28Z","timestamp":1787851228000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjo.bmj.com\/lookup\/doi\/10.1136\/bjo-2025-327899"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":14,"alternative-id":["10.1136\/bjo-2025-327899"],"URL":"https:\/\/doi.org\/10.1136\/bjo-2025-327899","relation":{},"ISSN":["0007-1161","1468-2079"],"issn-type":[{"value":"0007-1161","type":"print"},{"value":"1468-2079","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,27]]}}}