AIM: To evaluate the effect of different lens constant optimization methods on the accuracy of intraocular lens(IOL) power calculation formulas for highly myopic eyes.METHODS: This study comprised 108 eyes of 94 conse...AIM: To evaluate the effect of different lens constant optimization methods on the accuracy of intraocular lens(IOL) power calculation formulas for highly myopic eyes.METHODS: This study comprised 108 eyes of 94 consecutive patients with axial length(AL) over 26 mm undergoing phacoemulsification and implantation of a Rayner(Hove, UK) 920H IOL. Formulas were evaluated using the following lens constants: manufacturer’s lens constant, User Group for Laser Interference Biometry(ULIB) constant, and optimized constant for long eyes. Results were compared with Barrett Universal II formula, original Wang-Koch AL adjustment method, and modified Wang-Koch AL adjustment method. The outcomes assessed were mean absolute error(MAE) and percentage of eyes with IOL prediction errors within ±0.25, ±0.50, and ±1.0 diopter(D). The nonparametric method, Friedman test, was used to compare MAE performance among constants.RESULTS: Optimized constants could significantly reduce the MAE of SRK/T, Hoffer Q, and Holladay 1 formulas compared with manufacturer’s lens constant, whereas the percentage of eyes with IOL prediction errors within ±0.25, ±0.50, and ±1.0 D had no statistically significant differences. Optimized lens constant for long eyes alone showed non-significant refractive advantages over the ULIB constant. Barrett Universal II formula and formulas with AL adjustment showed significantly higher accuracy in highly myopic eyes(P<0.001). CONCLUSION: Lens constant optimization for the subset of long eyes reduces the refractive error only to a limited extent for highly myopic eyes.展开更多
AIM: To investigate the phenotype and genotype of a family with X-linked recessive Lowe syndrome. METHODS: All the members in the Chinese pedigree underwent comprehensive ophthalmologic and systemic examinations. Geno...AIM: To investigate the phenotype and genotype of a family with X-linked recessive Lowe syndrome. METHODS: All the members in the Chinese pedigree underwent comprehensive ophthalmologic and systemic examinations. Genomic DNA was isolated from peripheral blood of the pedigree members and 100 unrelated healthy Chinese subjects. Direct sequencing was performed to screen the exons and intron boundaries of OCRL.RESULTS: The ophthalmological and systemic exami nations suggested that the affected individual had Lowe syndrome. The phenotype in the pedigree is severe and consistent among all the affected individuals except for an individual who additionally suffered from congenital heart disease and laryngeal cartilage dysplasia. Directio nal San ger sequenci ng identified a complex mutation c.(2368_2368delG;c.2370A>C) in the Rho-GTPase activating protein domain. This complex mutation causes termination of protein synthesis at amino acid 824 and result in a new peptide with 823 amino acids (p.Ala790ProfsX34). This mutation was not detected in 100 unrelated healthy Chinese subjects.CONCLUSION: Our findings expand the phenotypic and genotypic spectrum of Lowe syndrome.展开更多
AIM: To evaluate the visual outcomes and patient satisfaction of two multifocal intraocular lens implantation patterns, with the decision between the two patterns being guided by the patients' choice of visual zon...AIM: To evaluate the visual outcomes and patient satisfaction of two multifocal intraocular lens implantation patterns, with the decision between the two patterns being guided by the patients' choice of visual zones that best suited their lifestyle, or lifestyle zones. METHODS: This is a prospective non-randomized comparative study. The lifestyle zones. of 32 consecutive age-related cataract patients (64 eyes) were investigated individually to guide the surgical decision between two multifocal intraocular lens implantation patterns. The first group (MIX) received a combined implantation of a ReZoom NXG1 lens in the dominant eye and a Tecnis ZM900 lens in the other eye. The second group (MATCH) received bilateral ReZoom NXG1 lenses. One year postoperatively, the patients were assessed for binocular uncorrected visual acuity, reading visual acuity, reading speed and depth of focus under different luminance and were surveyed for visual disturbances, satisfaction and complete spectacle independence. ' RESULTS: According to the determination of lifestyle zones, 18 and 14 patients were included in the MIX and MATCH groups, respectively. One year postoperatively, each of the patients exhibited positive visual outcomes and lifestyle satisfaction, although there were still some differences between the two groups. Generally, patients in the MATCH group had better distance visual acuity than those in the MIX group. In contrast, patients in the MD( group had better near visual acuity, better reading acuity and better reading speed than those in the MATCH group. Between the two groups, there was no clear difference in intermediate visual acuity, and the depths of focus between the two groups were approximately equal. The results of the mean NEI-RQL-42 questionnaire score, overall satisfaction, and complete spectacle independence did not differ between the two groups. CONCLUSION: Different multifocal intraocular lenses implantation patterns can have differing advantages and disadvantages; however, the best results with respect to visual outcome and patient satisfaction can be achieved by taking individual lifestyle zones into account.展开更多
AIM:To compare the visual outcomes of children with small(≤3 mm)posterior polar cataracts(PPC)and posterior lenticonus who had cataract extraction surgery with the visual outcomes of those who were managed conservati...AIM:To compare the visual outcomes of children with small(≤3 mm)posterior polar cataracts(PPC)and posterior lenticonus who had cataract extraction surgery with the visual outcomes of those who were managed conservatively.METHODS:Children who initially had small PPC and posterior lenticonus who were followed up over 1-year period were retrospective reviewed in the study.Patients receiving surgery were compared with those receiving conservative therapy.The axial length,keratometry,refraction,bestcorrected visual acuity(BCVA),and strabismus measurements were recorded.Lens morphology,i.e.,the location,size,and depth of the cataract lesion,was measured with a Scheimpflug imaging system.To help control for baseline differences in the groups,patients were matched with controls by propensity score methodology.RESULTS:The study evaluated 60 patients(30 in the surgery group and 30 in the conservative therapy group)after matching by propensity score.Patients who underwent cataract surgery showed greater BCVA improvements(0.36±0.24 logMAR)than patients who were treated without surgery(0.22±0.26 logMAR;P=0.036).Surgery was effective in patients with a rear projection length(RPL)less than 1.0 mm and a pretreatment BCVA worse than 0.52 logMAR.CONCLUSION:Children with small PPC and posterior lenticonus who undergo cataract surgery experience greater BCVA improvements than those managed conservatively.Certain patients presenting with a RPL less than 1.0 mm and a pretreatment BCVA of 0.52 logMAR or worse may benefit from surgery.展开更多
AIM: To study the change in ocular refraction in patients with pediatric cataracts(PCs) after lens extraction. METHODS: A total of 1258 patients who were undergoing cataract extraction with/without intraocular lens(IO...AIM: To study the change in ocular refraction in patients with pediatric cataracts(PCs) after lens extraction. METHODS: A total of 1258 patients who were undergoing cataract extraction with/without intraocular lens(IOL)implantation were recruited during preoperative examinations between Jan 2010 and Oct 2013. Patient ages ranged from 1.5 mo to 14y. Follow-ups were conducted at1 wk, 1, and 3 mo postoperatively and every 3 mo in the first year, then 6 mo thereafter. Ocular refraction [evaluated as spherical equivalent(SE)] and yearly myopic shift(YMS)were recorded and statistically analyzed among patients with age at surgery, baseline ocular refraction, gender,postoperative time and laterality(bilateral vs unilateral). RESULTS: By Dec 31st 2015, 1172 participants had been followed for more than 2y. The median follow-up period was 3y. The critical factors affecting the ocular refraction of PC patients were baseline ocular refraction, postoperative time for both aphakic and pseudophakic eyes. YMS grew most rapidly in young childhood and early adolescence. CONCLUSION: After lens surgeries, ocular refraction in PC patients shows an individual difference of change.Further concerns should be raising to monitor the rapid myopic shift at early adolescence of these patients.展开更多
AIM: To investigate the ocular development of patients who had unilateral congenital cataract(CC) combined with persistent fetal vasculature(PFV).METHODS: This cross-sectional, observational study included patients wh...AIM: To investigate the ocular development of patients who had unilateral congenital cataract(CC) combined with persistent fetal vasculature(PFV).METHODS: This cross-sectional, observational study included patients who had unilateral CC and PFV and those with isolated unilateral CC.Axial length(AL), keratometry, anterior chamber depth(ACD), lens thickness, and vitreous length were obtained.The ocular biometric parameters of the affected eyes of patients with CC and PFV were compared with the fellow eyes and with the affected eyes of patients with isolated CC.RESULTS: A total of 110 patients were included and divided into 4 groups: group 1(18 patients with CC and PFV, <24 mo), group 2(22 patients with CC and PFV, ≥24 mo), group 3(35 patients with CC, <24 mo), and group 4(35 patients with CC, ≥24 mo).The ALs of the affected eyes were shorter than those of the fellow eyes in group 1(20.02±1.06 vs 20.66±0.63 mm, P=0.025).While the ALs of the affected eyes were longer than those of the fellow eyes in group 2(23.18±2.00 vs 22.31±1.06 mm, P=0.044) and group 4(22.64±1.80 vs 22.02±1.01 mm, P=0.033).The keratometries of the affected eyes were steeper than those of the fellow eyes in group 2(44.78±1.66 vs 43.83±1.38 D,P=0.041) and group 4(43.76±1.91 vs 43.34±1.46 D, P=0.043).No difference of ACDs between two eyes was found in all groups(all P>0.05).CONCLUSION: Compared with the fellow eyes, the ALs of the eyes with unilateral CC and PFV are shorter in patients younger than 24 mo and longer in those older than 24 mo;the keratometries of the eyes with unilateral CC and PFV are steeper in patients older than 24 mo and similar with those younger than 24 mo.These findings provide further understanding of ocular development in patients with both CC and PFV.展开更多
AIM:To assess the effectiveness of core vitrectomyphacoemulsification-intraocular lens(IOL)implantationcapsulo-hyaloidotomy in treating phakic eye at least 1 mo after the onset of malignant glaucoma.METHODS:A retrospe...AIM:To assess the effectiveness of core vitrectomyphacoemulsification-intraocular lens(IOL)implantationcapsulo-hyaloidotomy in treating phakic eye at least 1 mo after the onset of malignant glaucoma.METHODS:A retrospective analysis were performed on malignant glaucoma patients treated in Zhongshan Ophthalmic Center between 2016 and 2018.Demographic and clinical data were described.The preoperative and postoperative visual acuity(VA),intraocular pressure(IOP),number of IOP-lowering medications used,and anterior chamber depth(ACD)of the case series were compared by Wilcoxon signed-rank test.RESULTS:Thirteen phakic eyes with long time intervals between onset and surgery were identified in this case series.Core vitrectomy-phacoemulsification-IOL implantation-capsulohyaloidotomy reduced the IOP(P=0.046)and the number of IOP-lowering medications used(P=0.004),deepened the ACD(P=0.005).Complete success was achieved in 38.5%of the eyes,and anatomical success was achieved in 100%of the eyes without any recurrence.The only postoperative complication observed is corneal endothelial decompensation.It occurred in two cases.CONCLUSION:Core vitrectomy-phacoemulsification-IOL implantation-capsulo-hyaloidotomy is safe and effective for treatment of long onset phakic malignant glaucoma.展开更多
AIM：To compare visual prognoses and postoperative adverse events of congenital cataract surgery performed at different times and using different surgical approaches.METHODS：In this prospective,randomized controlled ...AIM：To compare visual prognoses and postoperative adverse events of congenital cataract surgery performed at different times and using different surgical approaches.METHODS：In this prospective,randomized controlled trial,we recruited congenital cataract patients aged 3 mo or younger before cataract surgery.Sixty-one eligible patients were randomly assigned to two groups according to surgical timing：a 3-month-old group and a 6-month-old group.Each eye underwent one of three randomly assigned surgical procedures,as follows：surgery A,lens aspiration（I/A）;surgery B,lens aspiration with posterior continuous curvilinear capsulorhexis（I/A＋PCCC）;and surgery C,lens aspiration with posterior continuous curvilinear capsulorhexis and anterior vitrectomy（I/A＋PCCC＋A-Vit）.The long-term best-corrected visual acuity（BCVA） and the incidence of complications in the different groups were compared and analyzed.RESULTS：A total of 57 participants（114 eyes） with a mean follow-up period of 48.7 mo were included in the final analysis.The overall log MAR BCVA in the 6-month-old group was better than that in the 3-month-old group（0.81±0.28 vs 0.96±0.30;P=0.02）.The overall log MAR BCVA scores in the surgery B group were lower than the scores in the A and C groups（A：0.80±0.29,B：1.02±0.28,and C：0.84±0.28;P=0.007）.A multivariate linear regression revealed no significant relationships between the incidence of complications and long-term BCVA.CONCLUSION：It might be safer and more beneficial for bilateral total congenital cataract patients to undergosurgery at 6 mo of age than 3 mo.Moreover,with rigorous follow-up and timely intervention,the postoperative complications in these patients are treatable and do not compromise visual outcomes.展开更多
AIM: To investigate the behavioral and psychological disorders and the prevalence of parent ratings of attention deficit hyperactivity disorder(ADHD) symptoms among children with bilateral congenital cataracts(CCs). M...AIM: To investigate the behavioral and psychological disorders and the prevalence of parent ratings of attention deficit hyperactivity disorder(ADHD) symptoms among children with bilateral congenital cataracts(CCs). METHODS: This cross-sectional study investigated children with bilateral CC aged 3-8 y(CC group) using Conners’ Parent Rating Scale-48(CPRS-48) from July to December 2016. The abnormal rates of psychological symptoms in CC children and normal vision(NV) children were compared using the Chi-square test. The scores of CC children were compared with those of NV children and the Chinese urban norm using the independent samples t-test and one-sample t-test, respectively. RESULTS: A total of 262 valid questionnaires were collected. The ratio of CC children to NV children was 119:143. The overall rate of psychological symptoms in CC children was 2.28 times higher than that in NV children(46.22% vs 20.28%, Pearson’s χ2=20.062;P<0.001). CC children showed higher scores for conduct problems, learning problems, impulsiveness/hyperactivity, anxiety, and hyperactivity index than NV children and the Chinese urban norm, particularly between the ages of 3 and 5 y. Furthermore, male children aged between 6 and 8 y showed a higher impulsive/hyperactive score than females of the same age(t=6.083, P<0.001). CONCLUSION: Children with bilateral CCs have a higher rate of ADHD symptoms than children with NV. This study provides clinical evidence that screening for psychological symptoms and particularly for ADHD symptoms in children with bilateral CC are recommended for an early diagnosis and timely treatment.展开更多
The threading dislocations(TDs)in GaAs/Si epitaxial layers due to the lattice mismatch seriously degrade the performance of the lasers grown on silicon.The insertion of InAs quantum dots(QDs)acting as dislocation filt...The threading dislocations(TDs)in GaAs/Si epitaxial layers due to the lattice mismatch seriously degrade the performance of the lasers grown on silicon.The insertion of InAs quantum dots(QDs)acting as dislocation filters is a pretty good alternative to solving this problem.In this paper,a finite element method(FEM)is proposed to calculate the critical condition for InAs/GaAs QDs bending TDs into interfacial misfit dislocations(MDs).Making a comparison of elastic strain energy between the two isolated systems,a reasonable result is obtained.The effect of the cap layer thickness and the base width of QDs on TD bending are studied,and the results show that the bending area ratio of single QD(the bending area divided by the area of the QD base)is evidently affected by the two factors.Moreover,we present a method to evaluate the bending capability of single-layer QDs and multi-layer QDs.For the QD with 24-nm base width and 5-nm cap layer thickness,taking the QD density of 10^(11) cm^(-2) into account,the bending area ratio of single-layer QDs(the area of bending TD divided by the area of QD layer)is about 38.71%.With inserting five-layer InAs QDs,the TD density decreases by 91.35%.The results offer the guidelines for designing the QD dislocation filters and provide an important step towards realizing the photonic integration circuits on silicon.展开更多
AIM:To report the clinical prognosis and pathological findings of accidental lens vacuolar changes in eyes with intraoperative exposure to a dispersive ophthalmic viscosurgical device(OVD).METHODS:Two patients who dev...AIM:To report the clinical prognosis and pathological findings of accidental lens vacuolar changes in eyes with intraoperative exposure to a dispersive ophthalmic viscosurgical device(OVD).METHODS:Two patients who developed transient lens vacuolar changes during uneventful persistent pupillary membrane(PPM)removal surgery were presented and followed up.This event was speculated to be associated with an intraoperative dispersive OVD DisCoVisc(hyaluronic acid 1.6%-chondroitin sulfate 4.0%)exposure.Then,to provide the pathological basis for our speculation,another four cataract patients were randomly exposed to different OVDs,and their anterior lens capsules were investigated with transmission electron microscopy(TEM).RESULTS:After months,the subcapsular vacuoles in both PPM cases were gradually disappeared without visual deterioration.For the cataract patients,similar lens changes were observed intraoperatively in those exposed to a dispersive DisCoVisc but not a cohesive OVD IVIZ(sodium hyaluronate gel 1.0%).In addition,marked ultrastructural changes,including chromatin condensation,extensive cytoplasmic vacuoles,and obvious intercellular space between lens epithelial cells in the anterior lens capsules of all eyes exposed to DisCoVisc,were observed by TEM.CONCLUSION:The lens vacuolar changes may be associated with a dispersive OVD exposure.Therefore,it is not preferable to use dispersive OVDs in patients with transparent lenses or without the intention of lens extraction.In addition,close follow-ups instead of immediate lens extraction are recommended for the occurrence of similar lens lesions.展开更多
·AIM: To introduce a new technique for iridoschisis management during phacoemulsification: “capsule drape wrap”.·METHODS: “Capsule drape wrap” technique was used for an 80-year-old man with idiopathic ir...·AIM: To introduce a new technique for iridoschisis management during phacoemulsification: “capsule drape wrap”.·METHODS: “Capsule drape wrap” technique was used for an 80-year-old man with idiopathic iridoschisis in the right eye during phacoemulsification. The inserted flexible nylon iris hooks to hold anterior capsule in place, the margin of the anterior capsule could act as drape wrap, tracking the fibrillary iris strands firmly from free floating and stabilizing the capsular bags simultaneously. ·RESULTS: The eye with iridoschisis was successfully treated. Iris fibrils remained immobile during the procedure, and despite the severity of iridoschisis, there were no intraoperative complications such as tear of the iris, hyphema, iris prolapse, loss of mydriasis, or rupture of the posterior lens capsule during phacoemulsification. The bestcorrected visual acuity was increased by 0.1(log MAR) 6mo after the surgery.·CONCLUSION: “Capsule drape wrap” for iridoschisis is easily manageable, prevents further disruption to the loose iris fibers and ensures the stability of capsule–iris complex simultaneously, consequently minimizing the risk of surgical complications in phacoemulsification.展开更多
Dear Editor,Glaucoma following cataract surgery(GFCS)is one of the most sight-threatening postoperative complications of pediatric cataract surgery,and often becomes refractory to medical treatment[1].Goniotomy has be...Dear Editor,Glaucoma following cataract surgery(GFCS)is one of the most sight-threatening postoperative complications of pediatric cataract surgery,and often becomes refractory to medical treatment[1].Goniotomy has been an increasingly popular procedure for primary open angle glaucoma and primary angle-closure glaucoma with 120-.展开更多
基金Supported by National Natural Science Foundation of China(No.81770905)
文摘AIM: To evaluate the effect of different lens constant optimization methods on the accuracy of intraocular lens(IOL) power calculation formulas for highly myopic eyes.METHODS: This study comprised 108 eyes of 94 consecutive patients with axial length(AL) over 26 mm undergoing phacoemulsification and implantation of a Rayner(Hove, UK) 920H IOL. Formulas were evaluated using the following lens constants: manufacturer’s lens constant, User Group for Laser Interference Biometry(ULIB) constant, and optimized constant for long eyes. Results were compared with Barrett Universal II formula, original Wang-Koch AL adjustment method, and modified Wang-Koch AL adjustment method. The outcomes assessed were mean absolute error(MAE) and percentage of eyes with IOL prediction errors within ±0.25, ±0.50, and ±1.0 diopter(D). The nonparametric method, Friedman test, was used to compare MAE performance among constants.RESULTS: Optimized constants could significantly reduce the MAE of SRK/T, Hoffer Q, and Holladay 1 formulas compared with manufacturer’s lens constant, whereas the percentage of eyes with IOL prediction errors within ±0.25, ±0.50, and ±1.0 D had no statistically significant differences. Optimized lens constant for long eyes alone showed non-significant refractive advantages over the ULIB constant. Barrett Universal II formula and formulas with AL adjustment showed significantly higher accuracy in highly myopic eyes(P<0.001). CONCLUSION: Lens constant optimization for the subset of long eyes reduces the refractive error only to a limited extent for highly myopic eyes.
基金Supported by the National Natural Science Foundation of China(No.81700812)the Ph.D.Start-up Fund of Natural Science Foundation of Guangdong Province(No.2017A030310214)the Guangdong Provincial Foundation for Medical Scientific Research(No.A2017016)
文摘AIM: To investigate the phenotype and genotype of a family with X-linked recessive Lowe syndrome. METHODS: All the members in the Chinese pedigree underwent comprehensive ophthalmologic and systemic examinations. Genomic DNA was isolated from peripheral blood of the pedigree members and 100 unrelated healthy Chinese subjects. Direct sequencing was performed to screen the exons and intron boundaries of OCRL.RESULTS: The ophthalmological and systemic exami nations suggested that the affected individual had Lowe syndrome. The phenotype in the pedigree is severe and consistent among all the affected individuals except for an individual who additionally suffered from congenital heart disease and laryngeal cartilage dysplasia. Directio nal San ger sequenci ng identified a complex mutation c.(2368_2368delG;c.2370A>C) in the Rho-GTPase activating protein domain. This complex mutation causes termination of protein synthesis at amino acid 824 and result in a new peptide with 823 amino acids (p.Ala790ProfsX34). This mutation was not detected in 100 unrelated healthy Chinese subjects.CONCLUSION: Our findings expand the phenotypic and genotypic spectrum of Lowe syndrome.
基金Supported by the Fundamental Research Funds of State Key Laboratory of Ophthalmology and Guangdong Provincial Science and Technology Program,China (No.2009B080701017)
文摘AIM: To evaluate the visual outcomes and patient satisfaction of two multifocal intraocular lens implantation patterns, with the decision between the two patterns being guided by the patients' choice of visual zones that best suited their lifestyle, or lifestyle zones. METHODS: This is a prospective non-randomized comparative study. The lifestyle zones. of 32 consecutive age-related cataract patients (64 eyes) were investigated individually to guide the surgical decision between two multifocal intraocular lens implantation patterns. The first group (MIX) received a combined implantation of a ReZoom NXG1 lens in the dominant eye and a Tecnis ZM900 lens in the other eye. The second group (MATCH) received bilateral ReZoom NXG1 lenses. One year postoperatively, the patients were assessed for binocular uncorrected visual acuity, reading visual acuity, reading speed and depth of focus under different luminance and were surveyed for visual disturbances, satisfaction and complete spectacle independence. ' RESULTS: According to the determination of lifestyle zones, 18 and 14 patients were included in the MIX and MATCH groups, respectively. One year postoperatively, each of the patients exhibited positive visual outcomes and lifestyle satisfaction, although there were still some differences between the two groups. Generally, patients in the MATCH group had better distance visual acuity than those in the MIX group. In contrast, patients in the MD( group had better near visual acuity, better reading acuity and better reading speed than those in the MATCH group. Between the two groups, there was no clear difference in intermediate visual acuity, and the depths of focus between the two groups were approximately equal. The results of the mean NEI-RQL-42 questionnaire score, overall satisfaction, and complete spectacle independence did not differ between the two groups. CONCLUSION: Different multifocal intraocular lenses implantation patterns can have differing advantages and disadvantages; however, the best results with respect to visual outcome and patient satisfaction can be achieved by taking individual lifestyle zones into account.
基金Supported by the National Natural Science Foundation of China(No.81970813,No.81770967)the National Key R&D Program of China(No.2018YFC0116500)+1 种基金the Natural Science Foundation of Guangdong Province,China(No.2018A030313635)Science and Technology Program of Guangzhou,China(No.201904010062)。
文摘AIM:To compare the visual outcomes of children with small(≤3 mm)posterior polar cataracts(PPC)and posterior lenticonus who had cataract extraction surgery with the visual outcomes of those who were managed conservatively.METHODS:Children who initially had small PPC and posterior lenticonus who were followed up over 1-year period were retrospective reviewed in the study.Patients receiving surgery were compared with those receiving conservative therapy.The axial length,keratometry,refraction,bestcorrected visual acuity(BCVA),and strabismus measurements were recorded.Lens morphology,i.e.,the location,size,and depth of the cataract lesion,was measured with a Scheimpflug imaging system.To help control for baseline differences in the groups,patients were matched with controls by propensity score methodology.RESULTS:The study evaluated 60 patients(30 in the surgery group and 30 in the conservative therapy group)after matching by propensity score.Patients who underwent cataract surgery showed greater BCVA improvements(0.36±0.24 logMAR)than patients who were treated without surgery(0.22±0.26 logMAR;P=0.036).Surgery was effective in patients with a rear projection length(RPL)less than 1.0 mm and a pretreatment BCVA worse than 0.52 logMAR.CONCLUSION:Children with small PPC and posterior lenticonus who undergo cataract surgery experience greater BCVA improvements than those managed conservatively.Certain patients presenting with a RPL less than 1.0 mm and a pretreatment BCVA of 0.52 logMAR or worse may benefit from surgery.
基金Supported by National Natural Science Foundation of China (No.81873675 No.81770967)+2 种基金National Key R&D Program of China (No.2018YFC0116500 No.2017YFC1104600)Fundamental Research Funds for the Central Universities (No.16ykjc28)
文摘AIM: To study the change in ocular refraction in patients with pediatric cataracts(PCs) after lens extraction. METHODS: A total of 1258 patients who were undergoing cataract extraction with/without intraocular lens(IOL)implantation were recruited during preoperative examinations between Jan 2010 and Oct 2013. Patient ages ranged from 1.5 mo to 14y. Follow-ups were conducted at1 wk, 1, and 3 mo postoperatively and every 3 mo in the first year, then 6 mo thereafter. Ocular refraction [evaluated as spherical equivalent(SE)] and yearly myopic shift(YMS)were recorded and statistically analyzed among patients with age at surgery, baseline ocular refraction, gender,postoperative time and laterality(bilateral vs unilateral). RESULTS: By Dec 31st 2015, 1172 participants had been followed for more than 2y. The median follow-up period was 3y. The critical factors affecting the ocular refraction of PC patients were baseline ocular refraction, postoperative time for both aphakic and pseudophakic eyes. YMS grew most rapidly in young childhood and early adolescence. CONCLUSION: After lens surgeries, ocular refraction in PC patients shows an individual difference of change.Further concerns should be raising to monitor the rapid myopic shift at early adolescence of these patients.
基金Supported by the National Key R&D Program of China (No.2020YFC2008200)the National Natural Science Foundation of China (No.81970813+4 种基金No.81970778No.82000946)the Natural Science Foundation of Guangdong Province (No.2020A1515010987No.2021A1515012238)Guangzhou Municipal Science and Technology Project (No.201904010062)。
文摘AIM: To investigate the ocular development of patients who had unilateral congenital cataract(CC) combined with persistent fetal vasculature(PFV).METHODS: This cross-sectional, observational study included patients who had unilateral CC and PFV and those with isolated unilateral CC.Axial length(AL), keratometry, anterior chamber depth(ACD), lens thickness, and vitreous length were obtained.The ocular biometric parameters of the affected eyes of patients with CC and PFV were compared with the fellow eyes and with the affected eyes of patients with isolated CC.RESULTS: A total of 110 patients were included and divided into 4 groups: group 1(18 patients with CC and PFV, <24 mo), group 2(22 patients with CC and PFV, ≥24 mo), group 3(35 patients with CC, <24 mo), and group 4(35 patients with CC, ≥24 mo).The ALs of the affected eyes were shorter than those of the fellow eyes in group 1(20.02±1.06 vs 20.66±0.63 mm, P=0.025).While the ALs of the affected eyes were longer than those of the fellow eyes in group 2(23.18±2.00 vs 22.31±1.06 mm, P=0.044) and group 4(22.64±1.80 vs 22.02±1.01 mm, P=0.033).The keratometries of the affected eyes were steeper than those of the fellow eyes in group 2(44.78±1.66 vs 43.83±1.38 D,P=0.041) and group 4(43.76±1.91 vs 43.34±1.46 D, P=0.043).No difference of ACDs between two eyes was found in all groups(all P>0.05).CONCLUSION: Compared with the fellow eyes, the ALs of the eyes with unilateral CC and PFV are shorter in patients younger than 24 mo and longer in those older than 24 mo;the keratometries of the eyes with unilateral CC and PFV are steeper in patients older than 24 mo and similar with those younger than 24 mo.These findings provide further understanding of ocular development in patients with both CC and PFV.
基金Supported by the National Natural Science Foundation of China(No.81700812)。
文摘AIM:To assess the effectiveness of core vitrectomyphacoemulsification-intraocular lens(IOL)implantationcapsulo-hyaloidotomy in treating phakic eye at least 1 mo after the onset of malignant glaucoma.METHODS:A retrospective analysis were performed on malignant glaucoma patients treated in Zhongshan Ophthalmic Center between 2016 and 2018.Demographic and clinical data were described.The preoperative and postoperative visual acuity(VA),intraocular pressure(IOP),number of IOP-lowering medications used,and anterior chamber depth(ACD)of the case series were compared by Wilcoxon signed-rank test.RESULTS:Thirteen phakic eyes with long time intervals between onset and surgery were identified in this case series.Core vitrectomy-phacoemulsification-IOL implantation-capsulohyaloidotomy reduced the IOP(P=0.046)and the number of IOP-lowering medications used(P=0.004),deepened the ACD(P=0.005).Complete success was achieved in 38.5%of the eyes,and anatomical success was achieved in 100%of the eyes without any recurrence.The only postoperative complication observed is corneal endothelial decompensation.It occurred in two cases.CONCLUSION:Core vitrectomy-phacoemulsification-IOL implantation-capsulo-hyaloidotomy is safe and effective for treatment of long onset phakic malignant glaucoma.
基金Supported by the 973 Program(No.2015CB964600)National Natural Science Foundation of China(No.91546101+3 种基金No.81300750)the Guangdong Provincial Natural Science Foundation for Distinguished Young Scholars(No.2014A030306030)the Tip-top Scientific and Technical Innovative Youth Talents of Guangdong Special Support Program(No.2014TQ01R573)the Clinical Research and Translational Medical Center of Pediatric Cataracts in Guangzhou(No.201505032017516)
文摘AIM：To compare visual prognoses and postoperative adverse events of congenital cataract surgery performed at different times and using different surgical approaches.METHODS：In this prospective,randomized controlled trial,we recruited congenital cataract patients aged 3 mo or younger before cataract surgery.Sixty-one eligible patients were randomly assigned to two groups according to surgical timing：a 3-month-old group and a 6-month-old group.Each eye underwent one of three randomly assigned surgical procedures,as follows：surgery A,lens aspiration（I/A）;surgery B,lens aspiration with posterior continuous curvilinear capsulorhexis（I/A＋PCCC）;and surgery C,lens aspiration with posterior continuous curvilinear capsulorhexis and anterior vitrectomy（I/A＋PCCC＋A-Vit）.The long-term best-corrected visual acuity（BCVA） and the incidence of complications in the different groups were compared and analyzed.RESULTS：A total of 57 participants（114 eyes） with a mean follow-up period of 48.7 mo were included in the final analysis.The overall log MAR BCVA in the 6-month-old group was better than that in the 3-month-old group（0.81±0.28 vs 0.96±0.30;P=0.02）.The overall log MAR BCVA scores in the surgery B group were lower than the scores in the A and C groups（A：0.80±0.29,B：1.02±0.28,and C：0.84±0.28;P=0.007）.A multivariate linear regression revealed no significant relationships between the incidence of complications and long-term BCVA.CONCLUSION：It might be safer and more beneficial for bilateral total congenital cataract patients to undergosurgery at 6 mo of age than 3 mo.Moreover,with rigorous follow-up and timely intervention,the postoperative complications in these patients are treatable and do not compromise visual outcomes.
基金Supported by the National Natural Science Foundation of China (No.81770967 No.91546101)+4 种基金National Key R&D Program (No.2018YFC0116500)the Fundamental Research Funds for the Central Universities (No.18ykpy33 No.16ykjc28)the Youth Pearl River Scholar Funded Scheme(2016-2018)the Fundamental Research Funds of the State Key Laboratory of Ophthalmology (2018-2019)
文摘AIM: To investigate the behavioral and psychological disorders and the prevalence of parent ratings of attention deficit hyperactivity disorder(ADHD) symptoms among children with bilateral congenital cataracts(CCs). METHODS: This cross-sectional study investigated children with bilateral CC aged 3-8 y(CC group) using Conners’ Parent Rating Scale-48(CPRS-48) from July to December 2016. The abnormal rates of psychological symptoms in CC children and normal vision(NV) children were compared using the Chi-square test. The scores of CC children were compared with those of NV children and the Chinese urban norm using the independent samples t-test and one-sample t-test, respectively. RESULTS: A total of 262 valid questionnaires were collected. The ratio of CC children to NV children was 119:143. The overall rate of psychological symptoms in CC children was 2.28 times higher than that in NV children(46.22% vs 20.28%, Pearson’s χ2=20.062;P<0.001). CC children showed higher scores for conduct problems, learning problems, impulsiveness/hyperactivity, anxiety, and hyperactivity index than NV children and the Chinese urban norm, particularly between the ages of 3 and 5 y. Furthermore, male children aged between 6 and 8 y showed a higher impulsive/hyperactive score than females of the same age(t=6.083, P<0.001). CONCLUSION: Children with bilateral CCs have a higher rate of ADHD symptoms than children with NV. This study provides clinical evidence that screening for psychological symptoms and particularly for ADHD symptoms in children with bilateral CC are recommended for an early diagnosis and timely treatment.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.61874148,61974141,and 61674020)the Beijing Natural Science Foundation,China(Grant No.4192043)+3 种基金the National Key Research and Development Program of China(Grant No.2018YFB2200104)the Fund from the Beijing Municipal Science&Technology Commission,China(Grant No.Z191100004819012)the Project of the State Key Laboratory of Information Photonics and Optical Communications,Beijing University of Posts and Telecommunications,China(Grant No.IPOC2018ZT01)the 111 Project of China(Grant No.B07005).
文摘The threading dislocations(TDs)in GaAs/Si epitaxial layers due to the lattice mismatch seriously degrade the performance of the lasers grown on silicon.The insertion of InAs quantum dots(QDs)acting as dislocation filters is a pretty good alternative to solving this problem.In this paper,a finite element method(FEM)is proposed to calculate the critical condition for InAs/GaAs QDs bending TDs into interfacial misfit dislocations(MDs).Making a comparison of elastic strain energy between the two isolated systems,a reasonable result is obtained.The effect of the cap layer thickness and the base width of QDs on TD bending are studied,and the results show that the bending area ratio of single QD(the bending area divided by the area of the QD base)is evidently affected by the two factors.Moreover,we present a method to evaluate the bending capability of single-layer QDs and multi-layer QDs.For the QD with 24-nm base width and 5-nm cap layer thickness,taking the QD density of 10^(11) cm^(-2) into account,the bending area ratio of single-layer QDs(the area of bending TD divided by the area of QD layer)is about 38.71%.With inserting five-layer InAs QDs,the TD density decreases by 91.35%.The results offer the guidelines for designing the QD dislocation filters and provide an important step towards realizing the photonic integration circuits on silicon.
基金Supported by the National Key R&D Program of China(No.2020YFC2008200)the National Natural Science Foundation of China(No.81970778,No.82271066,No.81970813)+1 种基金the Natural Science Foundation of Guangdong Province(No.2023A1515011198)Guangzhou Municipal Science and Technology Project(No.SL2022A03J00553).
文摘AIM:To report the clinical prognosis and pathological findings of accidental lens vacuolar changes in eyes with intraoperative exposure to a dispersive ophthalmic viscosurgical device(OVD).METHODS:Two patients who developed transient lens vacuolar changes during uneventful persistent pupillary membrane(PPM)removal surgery were presented and followed up.This event was speculated to be associated with an intraoperative dispersive OVD DisCoVisc(hyaluronic acid 1.6%-chondroitin sulfate 4.0%)exposure.Then,to provide the pathological basis for our speculation,another four cataract patients were randomly exposed to different OVDs,and their anterior lens capsules were investigated with transmission electron microscopy(TEM).RESULTS:After months,the subcapsular vacuoles in both PPM cases were gradually disappeared without visual deterioration.For the cataract patients,similar lens changes were observed intraoperatively in those exposed to a dispersive DisCoVisc but not a cohesive OVD IVIZ(sodium hyaluronate gel 1.0%).In addition,marked ultrastructural changes,including chromatin condensation,extensive cytoplasmic vacuoles,and obvious intercellular space between lens epithelial cells in the anterior lens capsules of all eyes exposed to DisCoVisc,were observed by TEM.CONCLUSION:The lens vacuolar changes may be associated with a dispersive OVD exposure.Therefore,it is not preferable to use dispersive OVDs in patients with transparent lenses or without the intention of lens extraction.In addition,close follow-ups instead of immediate lens extraction are recommended for the occurrence of similar lens lesions.
基金Supported by the National Key R&D Program of China (No.2020YFC2008202)the National Natural Science Foundation of China (No.81970813)+1 种基金the Natural Science Foundation of Guangdong Province (No.2023A1515011198)Guangzhou Municipal Science and Technology Project (No.SL2022A03J00553)。
文摘·AIM: To introduce a new technique for iridoschisis management during phacoemulsification: “capsule drape wrap”.·METHODS: “Capsule drape wrap” technique was used for an 80-year-old man with idiopathic iridoschisis in the right eye during phacoemulsification. The inserted flexible nylon iris hooks to hold anterior capsule in place, the margin of the anterior capsule could act as drape wrap, tracking the fibrillary iris strands firmly from free floating and stabilizing the capsular bags simultaneously. ·RESULTS: The eye with iridoschisis was successfully treated. Iris fibrils remained immobile during the procedure, and despite the severity of iridoschisis, there were no intraoperative complications such as tear of the iris, hyphema, iris prolapse, loss of mydriasis, or rupture of the posterior lens capsule during phacoemulsification. The bestcorrected visual acuity was increased by 0.1(log MAR) 6mo after the surgery.·CONCLUSION: “Capsule drape wrap” for iridoschisis is easily manageable, prevents further disruption to the loose iris fibers and ensures the stability of capsule–iris complex simultaneously, consequently minimizing the risk of surgical complications in phacoemulsification.
基金Supported by the National Key R&D Program of China (No.2020YFC2008200)the National Natural Science Foundation of China (No.81970778,No.82271066)。
文摘Dear Editor,Glaucoma following cataract surgery(GFCS)is one of the most sight-threatening postoperative complications of pediatric cataract surgery,and often becomes refractory to medical treatment[1].Goniotomy has been an increasingly popular procedure for primary open angle glaucoma and primary angle-closure glaucoma with 120-.
