Dear Editor,Two cases of primary angle-closure glaucoma(PACG)with persistent shallow anterior chamber after phacoemulsification,intraocular lens(IOL)implantation and goniosynechialysis(GSL)were presented.PACG,which ma...Dear Editor,Two cases of primary angle-closure glaucoma(PACG)with persistent shallow anterior chamber after phacoemulsification,intraocular lens(IOL)implantation and goniosynechialysis(GSL)were presented.PACG,which mainly presents with mechanical obstruction of the trabecular meshwork,is clinically characterized by elevated intraocular pressure(IOP)secondary to the apposition of peripheral iris or a synechial closure of the angle[1].A previous study reported that angle-closure glaucoma eyes experienced widening and deepening of anterior chamber angles following cataract extraction and IOL implantation,which could probably normalize the IOP[2].A randomized controlled trial demonstrated that in comparison with laser peripheral iridotomy(LPI),clear-lens extraction showed greater advantages in efficacy and cost-effectiveness and could be proposed as the first-line initial treatment for PACG[3].展开更多
Extracapsular cataract extraction was performed combined with posterior chamber intraocular lens implantation on 120 inpatients (122 eyes) with traumatic cataract from 1992 to 1997. The results revealed that this comb...Extracapsular cataract extraction was performed combined with posterior chamber intraocular lens implantation on 120 inpatients (122 eyes) with traumatic cataract from 1992 to 1997. The results revealed that this combined operation can make most of them get useful visual acuity, although they were often accompanied with several comlicated eye injuries. We think the most important thing is to choose suitable opertion time, the reasonable operation method and take close followup after operation.展开更多
AIM: To evaluate the safety, quality and prospects of day-case cataract surgery performed in a Jiangsu public tertiary hospital METHODS: The general and clinical data for patients who underwent day-case cataract surge...AIM: To evaluate the safety, quality and prospects of day-case cataract surgery performed in a Jiangsu public tertiary hospital METHODS: The general and clinical data for patients who underwent day-case cataract surgery between August 1, 2014 and December 31, 2016 at this hospital were collected. The incidences of intraoperative and postoperative complications, preoperative and postoperative bestcorrected visual acuities(BCVAs), delayed discharge rate, rate of unplanned re-admission to hospital, and patient satisfaction were analyzed. RESULTS: A total of 4151 patients received cataract phacoemulsification surgery to correct age-related, congenital, traumatic, or complicated cataracts. Of these, age-related cataracts were the most frequently occurring. Patient age ranged from 18 to 101 y and the vast majority of patients were between 60 and 80 years old. Of the 4151 patients, 64.73%(2687/4151) had a systemic disease. The number of patients increased over the years, with the average number of patients per month being 90.4, 124.83, and 183.42 in 2014, 2015 and 2016, respectively. The average preoperative BCVA was 0.102±0.057 and average postoperative BCVAs at 1 d, 1 wk, and 1 mo post surgery were 0.453±0.264, 0.657±0.285, and 0.734±0.244, respectively. For intraoperative complications, 4.12%(171/4151) had posterior capsule rupture, 0.79%(33/4151) had iris or ciliary body injury, and 0.048%(2/4151) had suprachoroidal hemorrhage. For postoperative complications, 4.38%(182/4151) had cornea edema, 7.78%(323/4151) had intraocular hypertension, 0.096%(4/4151) had IOL toxicity syndrome, 0.28%(12/4151) had retained lens cortex, and 0.048%(2/4151) had hyphema. The delayed discharge rate was 0.82%(44/4151) and the unplanned re-admission to the hospital was 0(0/4151). The patient satisfaction rate was 91.42%(3795/4151). CONCLUSION: Day-case cataract surgery is safe and effective with good prospects for development.展开更多
AIM:To evaluate the efficacy and safety of the excimer laser correction of the residual refractive errors after cataract extraction with intraocular lens(IOL)implantation in uncommon cases.METHODS:Totally 24 patients ...AIM:To evaluate the efficacy and safety of the excimer laser correction of the residual refractive errors after cataract extraction with intraocular lens(IOL)implantation in uncommon cases.METHODS:Totally 24 patients with high residual refractive error after cataract surgery with IOL implantation were examined.Twenty-two patients had a history of phacoemulsification and IOL implantation,and two had extra-capsular cataract extraction with IOL implantation.Detailed examination of preoperative medical records was done to explain the origin of the post-cataract refractive errors.All patients underwent photorefractire keratectomy(PRK)enhancement.The mean outcome measures were refraction,uncorretted visual acuity(UCVA),best corrected visual acuity(BCVA)and corneal transparency and follow up ranged from 1 to 8 y.RESULTS:The principal causes of residual ametropia was inexact IOL calculation in abnormal eyes with high myopia and congenital lens abnormalities,followed by corneal astigmatism both suture induced and preexisting.After cataract surgery and before the laser enhancement the mean spherical equivalent(SE)was-0.56±3 D ranging from-4.62 to+2.25 D in high myopic patients,instead it was-1±1.73 D ranging from-3.25 to+3.75 D in the astigmatic eyes,with a mean cylinder of-3.75±0 ranging from-3 to+5.50 D.After laser refractive surgery the mean SE was 0.1±0.73,ranging from-0.50 to+1.50 in the myopic group,and it was-0.50±0.57 ranging from-1.25 to+0.50 in astigmatic patients,with a mean cylinder of-0.25±0.75.In myopic patients the mean UCVA and BCVA were 0.038±0.072 logMAR and 0.018±0.04 respectively,both ranging from 0.10 to 0.0.In astigmatic patients,the mean UCVA and BCVA were 0.213±0.132 and 0.00±0.0 respectively,UCVA ranging from 0.50 to 0.22 and BCVA was 0.00.All patients presented normal corneal transparency.No ocular hypertension was detected and no corneal haze was observed.All registered values remained stable also at the end line evaluation.CONCLUSION:The excimer laser treatment of residual refractive errors after cataract surgery with IOL implantation in abnormal eyes resulted in satisfactory and stable visual outcome with good safety and efficacy.展开更多
Purpose: To point out the indications for the use of the Anterior Chamber Maintainer (ACM) in order to facilitate cataract surgery in selective cases. Materials and Methods: In a time interval of 4 years the ACM was u...Purpose: To point out the indications for the use of the Anterior Chamber Maintainer (ACM) in order to facilitate cataract surgery in selective cases. Materials and Methods: In a time interval of 4 years the ACM was used in 28 special cataract cases 17 patients had high myopia (12 - 25 dpt, axial length 28 - 34 mm), 3 patients had vitreo-retinal pathology known pre-operatively and 8 cases were previously vitrectomized with silicon oil. In these cases the ACM was introduced either from the beginning or during the surgical procedure when excessive fluctuations of the Anterior Chamber (AC) were observed. Results: Though the new generation phaco machines tend to maintain the stability of the AC, the use of the ACM contributed to even greater stability during the insertion and the removal of probes and during the whole procedure, eliminating the risk of complications. All these risky cases were accomplished without intraoperative complications. The surgeons experienced a sense of increased safety during the procedure. Conclusions: The use of the ACM in cataract cases with high risk for complications offers a much greater stability of the AC, by eliminating the fluctuations of the posterior capsule and consequently prevents intraoperative and potentially postoperative complications.展开更多
Purpose: To investigate the epidemiology of strabismus in cases of pediatric cataracts. To assess visual outcome following orthoptic treatment for amblyopia in cases of cataracts in the pediatric age group. Methods: T...Purpose: To investigate the epidemiology of strabismus in cases of pediatric cataracts. To assess visual outcome following orthoptic treatment for amblyopia in cases of cataracts in the pediatric age group. Methods: This was a retrospective cohort study. We investigated a consecutive series of pediatric patients with congenital, developing, or traumatic cataracts who underwent surgery between January 1999 and April 2012 at our center. Patient demographics, cataract type, presenting symptoms, surgical intervention, postoperative visual acuity, and follow-up refractive changes were recorded. Results: In total, 1331 eyes of 1043 children were included: unilateral cataracts were present in 785 (59%) eyes. There were 605 (45.5%) traumatic and 726 (54.5%) non-traumatic cases. Ages at surgery ranged from 1 to 215 months. All eyes were examined for ocular alignment;66 (5%) were found to manifest strabismus. Deviation was significantly associated with age at intervention (p p < 0.001), and etiology of cataracts (p 0.001). We found significant differences in visual outcome following amblyopia therapy (p 0.001). Conclusions: Surgical treatment with intraocular lens implantation in children with congenital, developmental, or traumatic cataracts is effective for visual rehabilitation. Orthoptic treatment made a significant difference in visual outcome (p < 0.001).展开更多
Dear Editor,Descemet’s membrane detachment(DMD)is considered as a potential sight-threatening complication following various intraocular surgeries,particularly cataract surgery[1].The labile adhesion between the Desc...Dear Editor,Descemet’s membrane detachment(DMD)is considered as a potential sight-threatening complication following various intraocular surgeries,particularly cataract surgery[1].The labile adhesion between the Descemet’s membrane(DM)and the posterior corneal stromal layer can be easily separated with minimal mechanical force.Several risk factors have been associated with the development of DMD including old age,improper intraoperative operation,corneal ectatic disorders,and endothelial disorders and so on[1-4].展开更多
As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL pow...As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL power calculation methods have evolved and innovated throughout time, from early theoretical and regression formulas to nonlinear formulas for estimating effective lens position (ELP), multivariable formulas, and innovative formulas that use optical principles and AI-based online formulas. This paper thoroughly discusses the development and iteration of traditional IOL calculation formulas, the emergence of new IOL calculation formulas, and the selection of IOL calculation formulas for different patients in the era of refractive cataract surgery, serving as a reference for “personalized” IOL implantation in clinical practice.展开更多
Cataract surgery is still the most common surgery performed worldwide.It has evolved tremendously in terms of incision,from 12 mm to 1.8 mm,in terms of capsulotomy from envelope type to automated capsulorhexis,and fro...Cataract surgery is still the most common surgery performed worldwide.It has evolved tremendously in terms of incision,from 12 mm to 1.8 mm,in terms of capsulotomy from envelope type to automated capsulorhexis,and from rigid intraocular lens to foldable intraocular lenses.Manual small incision cataract surgery(MSICS)remains a valuable technique,particularly in rural and underserved areas,due to its cost-effectiveness and simplicity.Its low logistics and favorable outcomes are particularly useful for managing the cataract backlog in developing countries.This review highlights the history and evolution of MSICS,and the reasons for the advent and popularity of this technique,especially in developing countries.It reviews the various recent modifications of the technique,for example,from a superior incision approach to temporal incision to customized MSICS,2 mm MSICS,and astigmatism-correcting MSICS.It provides an overview of its applicability in complicated scenarios(viz.,small pupil,compromised cornea,pseudoexfoliation,subluxated cataract,etc.).It briefly reviews the clinical trials on MSICS and its comparison with phacoemulsification.Finally,the review emphasizes why every ophthalmic surgeon must know MSICS,its relevance in postgraduate teaching,and the role of MSICS simulators for the same.Overall,the review presents a comprehensive picture of the present status of this technique in the surgical armamentarium of ophthalmology.展开更多
The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presu...The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presumed that lens has no source of immune cells as an avascular zone.Latest research has challenged the longstanding view of the lens as an immune-privileged tissue,revealing the presence of resident immune cells and active immune responses within the lens.Thus,we summarized the immune involvement in maintaining lens homeostasis,which may be a deleterious role in the induction of lens opacification if inappropriately activated.Furthermore,bioengineer-based immunomodulatory therapies to fine-tune the micro immune environment within lens may be future strategies for in situ lens regeneration,as a novel treatment for cataract.展开更多
Objective: To analyze the clinical manifestations of intraocular lens (IOL) opacity after cataract surgery through case reports, and to explore its pathogenesis and diagnosis and treatment ideas, so as to provide a ba...Objective: To analyze the clinical manifestations of intraocular lens (IOL) opacity after cataract surgery through case reports, and to explore its pathogenesis and diagnosis and treatment ideas, so as to provide a basis for the early diagnosis and correct treatment of IOL opacity. Methods: The clinical data of one patient diagnosed with IOL opacity and underwent intraocular lens replacement in the Department of Ophthalmology, Affiliated Hospital of Youjiang Medical College for Nationalities in December 2023 were reported. The characteristics of IOL opacity were observed, and the research progress and pathogenesis of IOL opacity were understood by consulting the literature. Results: This patient is the first case of IOL opacity in our hospital. The specific reason is unclear. It is considered to be related to the IOL material. Conclusion: Hydrophilic acrylic IOL is widely used in clinic because of its good histocompatibility. However, due to its hydrophilicity, there are more cases of IOL opacity than other types of IOL. At present, there is no unified conclusion on the etiology and mechanism of IOL opacity. IOL opacity can seriously affect vision and is easily misdiagnosed as a posterior cataract. We should fully disperse the large pupil and carefully observe under the slit lamp. The most effective treatment for this disease is IOL replacement.展开更多
Pediatric cataract,a leading cause of blindness in children globally,imposing a significant financial burden on both families and society.The extensive phenotypic heterogeneity of this condition means that the underly...Pediatric cataract,a leading cause of blindness in children globally,imposing a significant financial burden on both families and society.The extensive phenotypic heterogeneity of this condition means that the underlying mechanisms remain poorly understood,limiting the development of precise and effective treatments.The advent of omics technologies has provided potent tools for unraveling the pathogenesis of pediatric cataract.By mapping expression profiles across various molecular levels,these omics approaches enhance our understanding of the disease’s etiological mechanisms,aid in the identification of novel biomarkers and key pathways,and offer researchers new insights for the innovative strategies in disease diagnosis and targeted therapies.In this review,we summarize the application of omics approaches in clinical and basic research on pediatric cataract over the past decade,encompassing genomics,transcriptomics,proteomics,and metabolomics.Furthermore,we discuss the current challenges and future prospects of omics analyses in pediatric cataract studies.展开更多
AIM:To find out intraoperative and postoperative outcomes of congenital cataract surgery in eyes with microcornea.METHODS:This retrospective consecutive case series study compared outcomes after congenital cataract su...AIM:To find out intraoperative and postoperative outcomes of congenital cataract surgery in eyes with microcornea.METHODS:This retrospective consecutive case series study compared outcomes after congenital cataract surgery in eyes with/without microcornea.Infants(<1 year old)who underwent lensectomy surgery left aphakic were included.Microphthalmos was defined as an eye that has a horizontal corneal diameter less than or equal to 9.0 mm.RESULTS:There were 40 infants(54 eyes)in the microcornea group and 58(87 eyes)in the control group.The two groups were age-and sex-matched.The microcornea group showed significantly smaller corneal diameter(P<0.001),steeper corneal keratometry(P=0.001),thinner lens thickness(P<0.001),and shorter axial length(AL,P<0.001).And microcornea increased the incidence of poor pupil dilation(P<0.01).The two groups showed no significant differences in postoperative intraocular pressure(IOP),best-corrected visual acuity,central corneal thickness(CCT),AL,and the incidence of strabismus and nystagmus at the last follow-up.CONCLUSION:Although microcornea have different features from normal ones,the one-year follow-up after surgery has shown that early surgical intervention for congenital cataracts in eyes with microcornea can result in favourable outcomes with an acceptable rate of postoperative complications.Regular follow-up and timely management of postoperative complications are crucial for successful outcomes.展开更多
AIM:To compare health-related quality of life and vision-related quality of life between patients with cataracts and healthy controls.METHODS:This research was carried out as a cross-sectional study.Participants were ...AIM:To compare health-related quality of life and vision-related quality of life between patients with cataracts and healthy controls.METHODS:This research was carried out as a cross-sectional study.Participants were selected from Rasoul Akram Hospital in Tehran,Iran,comprised of two groups:healthy individuals and those diagnosed with cataracts,using a simple random sampling technique.Following the interviews,participants completed the SF-36 health-related quality of life questionnaire and the VFQ-25 vision-related quality of life questionnaire.Comprehensive optometric and ophthalmic assessments,were conducted for all participants.RESULTS:This research involved a selection of 130 healthy individuals and 154 cataract patients who were candidates for cataract surgery.The average ages of the healthy individuals and cataract patients were 69.7±3.5 and 69.5±6.5y,respectively(P=0.837),with 42.3%of the healthy individuals and 44.8%of the cataract male patients(P=0.672).According to the SF-36 questionnaire,the quality of life regarding physical functioning,role limitations due to physical health,social functioning,pain,and general health were significantly worse among cataract patients.The composite physical index for cataract patients and healthy individuals was 70.7±9.08 and 78.53±8.17,respectively(P<0.001;effect size=0.90,95%CI:0.66-1.15),while the mental index showed no significant difference between the two groups(P=0.112;effect size=0.19,95%CI:-0.04-0.42).All aspects of the VFQ-25 questionnaire were notably lower in cataract patients,with the mean final VFQ-25 scores being 56.49±14.81 for cataract patients and 92.9±4.64 for healthy individuals(P<0.001;effect size=3.21,95%CI:2.85-3.56).The VFQ-25 questionnaire indicated that the most significant effect size was associated with role difficulties and distance activities.More components from both questionnaires exhibited a substantial correlation with best-corrected visual acuity in cataract patients.CONCLUSION:Patients suffering from cataracts exhibit a significantly reduced health-related quality of life,especially concerning physical health and vision-related quality of life,compared to those without cataracts.Timely surgical treatment for these individuals can improve their overall quality of life.展开更多
Malaria remains a major public health challenge necessitating accurate predictive models to inform effective intervention strategies in Sierra Leone. This study compares the performance of Holt-Winters’ Exponential S...Malaria remains a major public health challenge necessitating accurate predictive models to inform effective intervention strategies in Sierra Leone. This study compares the performance of Holt-Winters’ Exponential Smoothing, Harmonic, and Artificial Neural Network (ANN) models using data from January 2018 to December 2023, incorporating both historical case records from Sierra Leone’s Health Management Information System (HMIS) and meteorological variables including humidity, precipitation, and temperature. The ANN model demonstrated superior performance, achieving a Mean Absolute Percentage Error (MAPE) of 4.74% before including climatic variables. This was further reduced to 3.9% with the inclusion of climatic variables, outperforming traditional models like Holt-Winters and Harmonic, which yielded MAPEs of 22.53% and 17.90% respectively. The ANN’s success is attributed to its ability to capture complex, non-linear relationships in the data, particularly when enhanced with relevant climatic variables. Using the optimized ANN model, we forecasted malaria cases for the next 24 months, predicting a steady increase from January 2024 to December 2025, with seasonal peaks. This study underscores the potential of machine learning approaches, particularly ANNs, in epidemiological modelling and highlights the importance of integrating environmental factors into malaria prediction models, recommending the ANN model for informing more targeted and efficient malaria control strategies to improve public health outcomes in Sierra Leone and similar settings.展开更多
This review is to elucidate the retinal toxicity following intraocular injections of cefuroxime,including possible risk factors,clinical manifestations,visual prognosis and treatment.Refereed publications were retriev...This review is to elucidate the retinal toxicity following intraocular injections of cefuroxime,including possible risk factors,clinical manifestations,visual prognosis and treatment.Refereed publications were retrieved from PubMed,the Cochrane Library,and EMBASE databases,using the search terms cefuroxime,retina,macular edema,serous retinal detachment,toxic,cataract surgery.The screening was not limited by publication date,country or study type.We screened out 51 articles out of which 32 met the inclusion criteria for this systematic review.Data regarding sample size calculation reporting and trial characteristics were extracted for each trial.Retinal toxicity can be caused by both high and standard doses of cefuroxime injections in different ethnic groups,with risk factors including overdose,blood-retinal barrier disruption,anterior and posterior chamber connection.The typical clinical manifestations of retinal toxicity are cystoid macular edema and extensive serous retinal detachment,mainly involving the outer nuclear and outer plexiform layers,with a good prognosis for visual acuity in most cases,but in a small number of cases,the prognosis is not satisfactory.In conclusion,though the current use of intracameral injection antibiotics in cataract surgery is gradually increasing,the potential risks should not be ignored.Unexplained poor vision on the first day after cataract surgery can be supplemented with macular optical coherence tomography to rule out cefuroxime-related retinal toxicity.展开更多
Background To comprehensively evaluate the agreement of component corneal aberrations from the newly updated wavefront analysis software of a swept-source optical coherence tomographer(SS-OcT)and a referential Placido...Background To comprehensively evaluate the agreement of component corneal aberrations from the newly updated wavefront analysis software of a swept-source optical coherence tomographer(SS-OcT)and a referential Placido-topography combined OcT device in elderly cataract patients.Methods Retrospective study including 103 eyes from 103 elderly patients scheduled for cataract surgery that were measured on the same day with a SS-OcT(Heidelberg Engineering,Germany)device and a Placido-topography combined OCT device(CsO,Italy).Anterior,total,and posterior corneal wavefront aberrations were evaluated for their mean differences and limits of agreement(LoA)via Bland-Altman plots.Vector analysis was additionally employed to compare corneal astigmatism measurements in dioptric vector space.Results Mean differences of all corneal aberrometric parameters did not exceed O.05 um.Total corneal aberrations were not significantly different from 0 except for vertical coma(-0.04μm;P=0.003),spherical aberration(-0.01μm,P<0.001),and root mean square(RMS)higher-order aberration(HOA)(0.03μm,P=0.04).The 95%LoA for total corneal aberration parameters between both devices were-0.46 to 0.42μm for horizontal astigmatism,-0.37 to 0.41μm for oblique astigmatism,-0.19 to 0.17μm for oblique trefoil,-0.33 to 0.25μm for vertical coma,-0.20 to 0.22μm for horizontal coma,-0.22 to 0.20 um for horizontal trefoil,-0.11 to 0.08μm for spherical aberration,and-0.22 to 0.28 um for RMs HOA.Vector analysis revealed no statistically significant mean differences for anterior,total,and posterior corneal astigmatism in dioptric vector space.Conclusion In eyes undergoing cataract surgery with a regular elderly cornea,corneal wavefront analysis from the SS-OcT device showed functional equivalency to the reference device.Nevertheless,clinically relevant higher-order aberration parameters should be interpreted with caution for surgical decision-making.展开更多
AIM:To investigate the optimal timing and therapeutic effects of cataract surgery in patients with moderate to severe thyroid-associated ophthalmopathy(TAO).METHODS:Data from TAO patients who underwent cataract surger...AIM:To investigate the optimal timing and therapeutic effects of cataract surgery in patients with moderate to severe thyroid-associated ophthalmopathy(TAO).METHODS:Data from TAO patients who underwent cataract surgery between 2014 and 2024 were analyzed.patients were categorized into two groups based on the hospital where their cataract surgery was performed:an external hospital surgery group and an in-house hospital surgery group.Patients in external hospital presenting with complications within six months postoperatively were assessed for clinical features,imaging,thyroid function,and outcomes.Patients who underwent surgery at West China Hospital were evaluated for clinical status,imaging,laboratory findings,and manifestations.RESULTS:In the external hospital group(n=31),common symptoms included eyelid swelling(64.52%)and diplopia(51.61%),with restricted eye movement in all patients.Most patients were in the active stage(87.10%)and exhibited various complications,such as dysthyroid optic neuropathy(DON)in 4 patients,misdiagnosis of glaucoma in 1 patient,and enucleation due to fungal infection in 1 patient.In the West China Hospital group(n=30),2 patients were in the active stage,and 28 were in the inactive stage.Postoperative visual acuity improved in 36 eyes,except for in 2 eyes with DON.Active TAO patients with mature cataracts had effective inflammation control and no complications at the 6-month follow-up.CONCLUSION:In patients with moderate to severe active TAO complicated by cataracts,delaying cataract surgery until 6mo of TAO control should be considered if cataracts are stable.Simultaneous anti-inflammatory treatment and cataract surgery should be performed for mature/hypermature cataracts,and TAO management should be continued after surgery.展开更多
AIM:To investigate the relationship between preoperative corneal biomechanical properties and corneal tomographic properties in cataract patients.METHODS:The study consisted of 59 eyes of 30 participants who were diag...AIM:To investigate the relationship between preoperative corneal biomechanical properties and corneal tomographic properties in cataract patients.METHODS:The study consisted of 59 eyes of 30 participants who were diagnosed as cataract in Peking University Third Hospital between September 2019 and November 2019.Stepwise multivariable linear regression analysis was calculated to determine the relationship between corneal biomechanical parameters and tomographic parameters.The patients were classified into three groups of with the rule(WTR)astigmatism,against the rule astigmatism and oblique astigmatism.And the differences in corneal parameters among different groups were compared.RESULTS:There were significant differences in the first applanation time(A1T),the first applanation length(A1L),corneal velocity during the first applanation(Vin),the second applanation time(A2T),highest concavity(HC)radius,displacement amount(DA),DA ratio,stiffness parameter A1(SPA1)and integrated radius(IR)between oblique astigmatism patients and the other two groups.Total corneal steep meridian(K2)was negatively associated with A1L,A1T and corneal velocity during the second applanation(Vout).Patients with higher anterior corneal curvature had lower HC radius and central corneal thickness(CCT;P=0.001 and 0.006,respectively),while the Ambrosio relational thickness to the horizontal profile(ARTh)was higher than those with lower anterior corneal curvature(P=0.009).CONCLUSION:The study reveals that the elasticity of corneal collagen fibers is greater,but the viscoelasticity of cornea is smaller in patients with oblique astigmatism.There is no significant difference in ARTh between patients with different types of astigmatism,that is,the corneal biomechanical specificity of oblique astigmatism group is probably not caused by corneal thickness.Moreover,we find patients with higher anterior corneal curvature has lower HC radius and CCT but higher ARTh than those with lower anterior corneal curvature.展开更多
AIM:To analyze the environmental impact of patient travel for cataract surgery at a German ophthalmology center.METHODS:All cataract surgeries performed between October 23 and October 27,2023,were analyzed,and all pat...AIM:To analyze the environmental impact of patient travel for cataract surgery at a German ophthalmology center.METHODS:All cataract surgeries performed between October 23 and October 27,2023,were analyzed,and all patient records were reviewed for follow-up visits.All travel distances were calculated,and the associated emissions were quantified.Additionally,patients’utilization of geographically closer branch practices for follow-up care was evaluated,along with the corresponding effects on travel-related emissions.RESULTS:A total of 69 patients underwent unilateral cataract surgery.The average one-way travel distance was 40.1 km(24.9 mi;SD=23.6 km).Corresponding emissions were 1284.8 kg of greenhouse gas(GHG),2.477 kg of nitrogen oxides,and 0.101 kg of particulates.All patients attended at least two follow-up visits.Conducting followup visits at branch practices reduced travel distance by 49.1%.The associated GHG emissions from all travel were 1984.3 kg.Emissions from follow-up visits were 54.4%higher than those from the surgery itself.Total GHG emissions amounted to 3269.1 kg,with an average of 47.4 kg of GHG per patient for all travel associated with cataract surgery.CONCLUSION:A dense network of branch practices contributes to reducing the carbon footprint of cataract surgery-related patient travel;however,the development of digital health approaches for follow-up care is necessary to further optimize the environmental sustainability of cataract surgery.展开更多
基金Supported by National Natural Science Foundation of China(No.61634006)the National Key R&D Program of China(No.2020YFC2008200)the Beijing Science and Technology Plan Project(No.Z191100007619045)。
文摘Dear Editor,Two cases of primary angle-closure glaucoma(PACG)with persistent shallow anterior chamber after phacoemulsification,intraocular lens(IOL)implantation and goniosynechialysis(GSL)were presented.PACG,which mainly presents with mechanical obstruction of the trabecular meshwork,is clinically characterized by elevated intraocular pressure(IOP)secondary to the apposition of peripheral iris or a synechial closure of the angle[1].A previous study reported that angle-closure glaucoma eyes experienced widening and deepening of anterior chamber angles following cataract extraction and IOL implantation,which could probably normalize the IOP[2].A randomized controlled trial demonstrated that in comparison with laser peripheral iridotomy(LPI),clear-lens extraction showed greater advantages in efficacy and cost-effectiveness and could be proposed as the first-line initial treatment for PACG[3].
文摘Extracapsular cataract extraction was performed combined with posterior chamber intraocular lens implantation on 120 inpatients (122 eyes) with traumatic cataract from 1992 to 1997. The results revealed that this combined operation can make most of them get useful visual acuity, although they were often accompanied with several comlicated eye injuries. We think the most important thing is to choose suitable opertion time, the reasonable operation method and take close followup after operation.
文摘AIM: To evaluate the safety, quality and prospects of day-case cataract surgery performed in a Jiangsu public tertiary hospital METHODS: The general and clinical data for patients who underwent day-case cataract surgery between August 1, 2014 and December 31, 2016 at this hospital were collected. The incidences of intraoperative and postoperative complications, preoperative and postoperative bestcorrected visual acuities(BCVAs), delayed discharge rate, rate of unplanned re-admission to hospital, and patient satisfaction were analyzed. RESULTS: A total of 4151 patients received cataract phacoemulsification surgery to correct age-related, congenital, traumatic, or complicated cataracts. Of these, age-related cataracts were the most frequently occurring. Patient age ranged from 18 to 101 y and the vast majority of patients were between 60 and 80 years old. Of the 4151 patients, 64.73%(2687/4151) had a systemic disease. The number of patients increased over the years, with the average number of patients per month being 90.4, 124.83, and 183.42 in 2014, 2015 and 2016, respectively. The average preoperative BCVA was 0.102±0.057 and average postoperative BCVAs at 1 d, 1 wk, and 1 mo post surgery were 0.453±0.264, 0.657±0.285, and 0.734±0.244, respectively. For intraoperative complications, 4.12%(171/4151) had posterior capsule rupture, 0.79%(33/4151) had iris or ciliary body injury, and 0.048%(2/4151) had suprachoroidal hemorrhage. For postoperative complications, 4.38%(182/4151) had cornea edema, 7.78%(323/4151) had intraocular hypertension, 0.096%(4/4151) had IOL toxicity syndrome, 0.28%(12/4151) had retained lens cortex, and 0.048%(2/4151) had hyphema. The delayed discharge rate was 0.82%(44/4151) and the unplanned re-admission to the hospital was 0(0/4151). The patient satisfaction rate was 91.42%(3795/4151). CONCLUSION: Day-case cataract surgery is safe and effective with good prospects for development.
文摘AIM:To evaluate the efficacy and safety of the excimer laser correction of the residual refractive errors after cataract extraction with intraocular lens(IOL)implantation in uncommon cases.METHODS:Totally 24 patients with high residual refractive error after cataract surgery with IOL implantation were examined.Twenty-two patients had a history of phacoemulsification and IOL implantation,and two had extra-capsular cataract extraction with IOL implantation.Detailed examination of preoperative medical records was done to explain the origin of the post-cataract refractive errors.All patients underwent photorefractire keratectomy(PRK)enhancement.The mean outcome measures were refraction,uncorretted visual acuity(UCVA),best corrected visual acuity(BCVA)and corneal transparency and follow up ranged from 1 to 8 y.RESULTS:The principal causes of residual ametropia was inexact IOL calculation in abnormal eyes with high myopia and congenital lens abnormalities,followed by corneal astigmatism both suture induced and preexisting.After cataract surgery and before the laser enhancement the mean spherical equivalent(SE)was-0.56±3 D ranging from-4.62 to+2.25 D in high myopic patients,instead it was-1±1.73 D ranging from-3.25 to+3.75 D in the astigmatic eyes,with a mean cylinder of-3.75±0 ranging from-3 to+5.50 D.After laser refractive surgery the mean SE was 0.1±0.73,ranging from-0.50 to+1.50 in the myopic group,and it was-0.50±0.57 ranging from-1.25 to+0.50 in astigmatic patients,with a mean cylinder of-0.25±0.75.In myopic patients the mean UCVA and BCVA were 0.038±0.072 logMAR and 0.018±0.04 respectively,both ranging from 0.10 to 0.0.In astigmatic patients,the mean UCVA and BCVA were 0.213±0.132 and 0.00±0.0 respectively,UCVA ranging from 0.50 to 0.22 and BCVA was 0.00.All patients presented normal corneal transparency.No ocular hypertension was detected and no corneal haze was observed.All registered values remained stable also at the end line evaluation.CONCLUSION:The excimer laser treatment of residual refractive errors after cataract surgery with IOL implantation in abnormal eyes resulted in satisfactory and stable visual outcome with good safety and efficacy.
文摘Purpose: To point out the indications for the use of the Anterior Chamber Maintainer (ACM) in order to facilitate cataract surgery in selective cases. Materials and Methods: In a time interval of 4 years the ACM was used in 28 special cataract cases 17 patients had high myopia (12 - 25 dpt, axial length 28 - 34 mm), 3 patients had vitreo-retinal pathology known pre-operatively and 8 cases were previously vitrectomized with silicon oil. In these cases the ACM was introduced either from the beginning or during the surgical procedure when excessive fluctuations of the Anterior Chamber (AC) were observed. Results: Though the new generation phaco machines tend to maintain the stability of the AC, the use of the ACM contributed to even greater stability during the insertion and the removal of probes and during the whole procedure, eliminating the risk of complications. All these risky cases were accomplished without intraoperative complications. The surgeons experienced a sense of increased safety during the procedure. Conclusions: The use of the ACM in cataract cases with high risk for complications offers a much greater stability of the AC, by eliminating the fluctuations of the posterior capsule and consequently prevents intraoperative and potentially postoperative complications.
文摘Purpose: To investigate the epidemiology of strabismus in cases of pediatric cataracts. To assess visual outcome following orthoptic treatment for amblyopia in cases of cataracts in the pediatric age group. Methods: This was a retrospective cohort study. We investigated a consecutive series of pediatric patients with congenital, developing, or traumatic cataracts who underwent surgery between January 1999 and April 2012 at our center. Patient demographics, cataract type, presenting symptoms, surgical intervention, postoperative visual acuity, and follow-up refractive changes were recorded. Results: In total, 1331 eyes of 1043 children were included: unilateral cataracts were present in 785 (59%) eyes. There were 605 (45.5%) traumatic and 726 (54.5%) non-traumatic cases. Ages at surgery ranged from 1 to 215 months. All eyes were examined for ocular alignment;66 (5%) were found to manifest strabismus. Deviation was significantly associated with age at intervention (p p < 0.001), and etiology of cataracts (p 0.001). We found significant differences in visual outcome following amblyopia therapy (p 0.001). Conclusions: Surgical treatment with intraocular lens implantation in children with congenital, developmental, or traumatic cataracts is effective for visual rehabilitation. Orthoptic treatment made a significant difference in visual outcome (p < 0.001).
基金Supported by the Natural Science Foundation of Fujian Province(No.2024J011318No.2024J011321)Fuzhou Science and Technology Program(No.2023-S-005).
文摘Dear Editor,Descemet’s membrane detachment(DMD)is considered as a potential sight-threatening complication following various intraocular surgeries,particularly cataract surgery[1].The labile adhesion between the Descemet’s membrane(DM)and the posterior corneal stromal layer can be easily separated with minimal mechanical force.Several risk factors have been associated with the development of DMD including old age,improper intraoperative operation,corneal ectatic disorders,and endothelial disorders and so on[1-4].
文摘As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL power calculation methods have evolved and innovated throughout time, from early theoretical and regression formulas to nonlinear formulas for estimating effective lens position (ELP), multivariable formulas, and innovative formulas that use optical principles and AI-based online formulas. This paper thoroughly discusses the development and iteration of traditional IOL calculation formulas, the emergence of new IOL calculation formulas, and the selection of IOL calculation formulas for different patients in the era of refractive cataract surgery, serving as a reference for “personalized” IOL implantation in clinical practice.
文摘Cataract surgery is still the most common surgery performed worldwide.It has evolved tremendously in terms of incision,from 12 mm to 1.8 mm,in terms of capsulotomy from envelope type to automated capsulorhexis,and from rigid intraocular lens to foldable intraocular lenses.Manual small incision cataract surgery(MSICS)remains a valuable technique,particularly in rural and underserved areas,due to its cost-effectiveness and simplicity.Its low logistics and favorable outcomes are particularly useful for managing the cataract backlog in developing countries.This review highlights the history and evolution of MSICS,and the reasons for the advent and popularity of this technique,especially in developing countries.It reviews the various recent modifications of the technique,for example,from a superior incision approach to temporal incision to customized MSICS,2 mm MSICS,and astigmatism-correcting MSICS.It provides an overview of its applicability in complicated scenarios(viz.,small pupil,compromised cornea,pseudoexfoliation,subluxated cataract,etc.).It briefly reviews the clinical trials on MSICS and its comparison with phacoemulsification.Finally,the review emphasizes why every ophthalmic surgeon must know MSICS,its relevance in postgraduate teaching,and the role of MSICS simulators for the same.Overall,the review presents a comprehensive picture of the present status of this technique in the surgical armamentarium of ophthalmology.
基金Supported by the National Natural Science Foundation of China(No.82271063No.82471054)Central Guidance for Local Scientific and Technological Development Funding Projects(No.2024ZY01057).
文摘The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presumed that lens has no source of immune cells as an avascular zone.Latest research has challenged the longstanding view of the lens as an immune-privileged tissue,revealing the presence of resident immune cells and active immune responses within the lens.Thus,we summarized the immune involvement in maintaining lens homeostasis,which may be a deleterious role in the induction of lens opacification if inappropriately activated.Furthermore,bioengineer-based immunomodulatory therapies to fine-tune the micro immune environment within lens may be future strategies for in situ lens regeneration,as a novel treatment for cataract.
文摘Objective: To analyze the clinical manifestations of intraocular lens (IOL) opacity after cataract surgery through case reports, and to explore its pathogenesis and diagnosis and treatment ideas, so as to provide a basis for the early diagnosis and correct treatment of IOL opacity. Methods: The clinical data of one patient diagnosed with IOL opacity and underwent intraocular lens replacement in the Department of Ophthalmology, Affiliated Hospital of Youjiang Medical College for Nationalities in December 2023 were reported. The characteristics of IOL opacity were observed, and the research progress and pathogenesis of IOL opacity were understood by consulting the literature. Results: This patient is the first case of IOL opacity in our hospital. The specific reason is unclear. It is considered to be related to the IOL material. Conclusion: Hydrophilic acrylic IOL is widely used in clinic because of its good histocompatibility. However, due to its hydrophilicity, there are more cases of IOL opacity than other types of IOL. At present, there is no unified conclusion on the etiology and mechanism of IOL opacity. IOL opacity can seriously affect vision and is easily misdiagnosed as a posterior cataract. We should fully disperse the large pupil and carefully observe under the slit lamp. The most effective treatment for this disease is IOL replacement.
基金supported by the General Program of Natural Science Foundation of Guangdong Province(2023A1515011102).
文摘Pediatric cataract,a leading cause of blindness in children globally,imposing a significant financial burden on both families and society.The extensive phenotypic heterogeneity of this condition means that the underlying mechanisms remain poorly understood,limiting the development of precise and effective treatments.The advent of omics technologies has provided potent tools for unraveling the pathogenesis of pediatric cataract.By mapping expression profiles across various molecular levels,these omics approaches enhance our understanding of the disease’s etiological mechanisms,aid in the identification of novel biomarkers and key pathways,and offer researchers new insights for the innovative strategies in disease diagnosis and targeted therapies.In this review,we summarize the application of omics approaches in clinical and basic research on pediatric cataract over the past decade,encompassing genomics,transcriptomics,proteomics,and metabolomics.Furthermore,we discuss the current challenges and future prospects of omics analyses in pediatric cataract studies.
基金Supported by the“Pioneer”and“Leading Goose”R&D Program of Zhejiang(No.2022C03070)Zhejiang Medical and Health Science and Technology Plan(No.2023KY913)+2 种基金the Zhejiang Provincial Program of China for the Cultivation of Health Leading TalentsWenzhou Basic Scientific Research Projects(No.Y20220145)The Science and Technology Program Project jointly built by the Science and Technology Department of the National Administration of Traditional Chinese Medicine and the Zhejiang Provincial Administration of Traditional Chinese Medicine(No.GZY-ZJKJ-24089).
文摘AIM:To find out intraoperative and postoperative outcomes of congenital cataract surgery in eyes with microcornea.METHODS:This retrospective consecutive case series study compared outcomes after congenital cataract surgery in eyes with/without microcornea.Infants(<1 year old)who underwent lensectomy surgery left aphakic were included.Microphthalmos was defined as an eye that has a horizontal corneal diameter less than or equal to 9.0 mm.RESULTS:There were 40 infants(54 eyes)in the microcornea group and 58(87 eyes)in the control group.The two groups were age-and sex-matched.The microcornea group showed significantly smaller corneal diameter(P<0.001),steeper corneal keratometry(P=0.001),thinner lens thickness(P<0.001),and shorter axial length(AL,P<0.001).And microcornea increased the incidence of poor pupil dilation(P<0.01).The two groups showed no significant differences in postoperative intraocular pressure(IOP),best-corrected visual acuity,central corneal thickness(CCT),AL,and the incidence of strabismus and nystagmus at the last follow-up.CONCLUSION:Although microcornea have different features from normal ones,the one-year follow-up after surgery has shown that early surgical intervention for congenital cataracts in eyes with microcornea can result in favourable outcomes with an acceptable rate of postoperative complications.Regular follow-up and timely management of postoperative complications are crucial for successful outcomes.
基金Supported by the Iran University of Medical Sciences.
文摘AIM:To compare health-related quality of life and vision-related quality of life between patients with cataracts and healthy controls.METHODS:This research was carried out as a cross-sectional study.Participants were selected from Rasoul Akram Hospital in Tehran,Iran,comprised of two groups:healthy individuals and those diagnosed with cataracts,using a simple random sampling technique.Following the interviews,participants completed the SF-36 health-related quality of life questionnaire and the VFQ-25 vision-related quality of life questionnaire.Comprehensive optometric and ophthalmic assessments,were conducted for all participants.RESULTS:This research involved a selection of 130 healthy individuals and 154 cataract patients who were candidates for cataract surgery.The average ages of the healthy individuals and cataract patients were 69.7±3.5 and 69.5±6.5y,respectively(P=0.837),with 42.3%of the healthy individuals and 44.8%of the cataract male patients(P=0.672).According to the SF-36 questionnaire,the quality of life regarding physical functioning,role limitations due to physical health,social functioning,pain,and general health were significantly worse among cataract patients.The composite physical index for cataract patients and healthy individuals was 70.7±9.08 and 78.53±8.17,respectively(P<0.001;effect size=0.90,95%CI:0.66-1.15),while the mental index showed no significant difference between the two groups(P=0.112;effect size=0.19,95%CI:-0.04-0.42).All aspects of the VFQ-25 questionnaire were notably lower in cataract patients,with the mean final VFQ-25 scores being 56.49±14.81 for cataract patients and 92.9±4.64 for healthy individuals(P<0.001;effect size=3.21,95%CI:2.85-3.56).The VFQ-25 questionnaire indicated that the most significant effect size was associated with role difficulties and distance activities.More components from both questionnaires exhibited a substantial correlation with best-corrected visual acuity in cataract patients.CONCLUSION:Patients suffering from cataracts exhibit a significantly reduced health-related quality of life,especially concerning physical health and vision-related quality of life,compared to those without cataracts.Timely surgical treatment for these individuals can improve their overall quality of life.
文摘Malaria remains a major public health challenge necessitating accurate predictive models to inform effective intervention strategies in Sierra Leone. This study compares the performance of Holt-Winters’ Exponential Smoothing, Harmonic, and Artificial Neural Network (ANN) models using data from January 2018 to December 2023, incorporating both historical case records from Sierra Leone’s Health Management Information System (HMIS) and meteorological variables including humidity, precipitation, and temperature. The ANN model demonstrated superior performance, achieving a Mean Absolute Percentage Error (MAPE) of 4.74% before including climatic variables. This was further reduced to 3.9% with the inclusion of climatic variables, outperforming traditional models like Holt-Winters and Harmonic, which yielded MAPEs of 22.53% and 17.90% respectively. The ANN’s success is attributed to its ability to capture complex, non-linear relationships in the data, particularly when enhanced with relevant climatic variables. Using the optimized ANN model, we forecasted malaria cases for the next 24 months, predicting a steady increase from January 2024 to December 2025, with seasonal peaks. This study underscores the potential of machine learning approaches, particularly ANNs, in epidemiological modelling and highlights the importance of integrating environmental factors into malaria prediction models, recommending the ANN model for informing more targeted and efficient malaria control strategies to improve public health outcomes in Sierra Leone and similar settings.
基金Supported by Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases,Shanghai,China(No.19DZ2250100)Shanghai First People’s Hospital Featured Research Projects(No.CCTR-2022C08).
文摘This review is to elucidate the retinal toxicity following intraocular injections of cefuroxime,including possible risk factors,clinical manifestations,visual prognosis and treatment.Refereed publications were retrieved from PubMed,the Cochrane Library,and EMBASE databases,using the search terms cefuroxime,retina,macular edema,serous retinal detachment,toxic,cataract surgery.The screening was not limited by publication date,country or study type.We screened out 51 articles out of which 32 met the inclusion criteria for this systematic review.Data regarding sample size calculation reporting and trial characteristics were extracted for each trial.Retinal toxicity can be caused by both high and standard doses of cefuroxime injections in different ethnic groups,with risk factors including overdose,blood-retinal barrier disruption,anterior and posterior chamber connection.The typical clinical manifestations of retinal toxicity are cystoid macular edema and extensive serous retinal detachment,mainly involving the outer nuclear and outer plexiform layers,with a good prognosis for visual acuity in most cases,but in a small number of cases,the prognosis is not satisfactory.In conclusion,though the current use of intracameral injection antibiotics in cataract surgery is gradually increasing,the potential risks should not be ignored.Unexplained poor vision on the first day after cataract surgery can be supplemented with macular optical coherence tomography to rule out cefuroxime-related retinal toxicity.
文摘Background To comprehensively evaluate the agreement of component corneal aberrations from the newly updated wavefront analysis software of a swept-source optical coherence tomographer(SS-OcT)and a referential Placido-topography combined OcT device in elderly cataract patients.Methods Retrospective study including 103 eyes from 103 elderly patients scheduled for cataract surgery that were measured on the same day with a SS-OcT(Heidelberg Engineering,Germany)device and a Placido-topography combined OCT device(CsO,Italy).Anterior,total,and posterior corneal wavefront aberrations were evaluated for their mean differences and limits of agreement(LoA)via Bland-Altman plots.Vector analysis was additionally employed to compare corneal astigmatism measurements in dioptric vector space.Results Mean differences of all corneal aberrometric parameters did not exceed O.05 um.Total corneal aberrations were not significantly different from 0 except for vertical coma(-0.04μm;P=0.003),spherical aberration(-0.01μm,P<0.001),and root mean square(RMS)higher-order aberration(HOA)(0.03μm,P=0.04).The 95%LoA for total corneal aberration parameters between both devices were-0.46 to 0.42μm for horizontal astigmatism,-0.37 to 0.41μm for oblique astigmatism,-0.19 to 0.17μm for oblique trefoil,-0.33 to 0.25μm for vertical coma,-0.20 to 0.22μm for horizontal coma,-0.22 to 0.20 um for horizontal trefoil,-0.11 to 0.08μm for spherical aberration,and-0.22 to 0.28 um for RMs HOA.Vector analysis revealed no statistically significant mean differences for anterior,total,and posterior corneal astigmatism in dioptric vector space.Conclusion In eyes undergoing cataract surgery with a regular elderly cornea,corneal wavefront analysis from the SS-OcT device showed functional equivalency to the reference device.Nevertheless,clinically relevant higher-order aberration parameters should be interpreted with caution for surgical decision-making.
基金Supported by Sichuan Science and Technology Program(No.2022JDKP0010).
文摘AIM:To investigate the optimal timing and therapeutic effects of cataract surgery in patients with moderate to severe thyroid-associated ophthalmopathy(TAO).METHODS:Data from TAO patients who underwent cataract surgery between 2014 and 2024 were analyzed.patients were categorized into two groups based on the hospital where their cataract surgery was performed:an external hospital surgery group and an in-house hospital surgery group.Patients in external hospital presenting with complications within six months postoperatively were assessed for clinical features,imaging,thyroid function,and outcomes.Patients who underwent surgery at West China Hospital were evaluated for clinical status,imaging,laboratory findings,and manifestations.RESULTS:In the external hospital group(n=31),common symptoms included eyelid swelling(64.52%)and diplopia(51.61%),with restricted eye movement in all patients.Most patients were in the active stage(87.10%)and exhibited various complications,such as dysthyroid optic neuropathy(DON)in 4 patients,misdiagnosis of glaucoma in 1 patient,and enucleation due to fungal infection in 1 patient.In the West China Hospital group(n=30),2 patients were in the active stage,and 28 were in the inactive stage.Postoperative visual acuity improved in 36 eyes,except for in 2 eyes with DON.Active TAO patients with mature cataracts had effective inflammation control and no complications at the 6-month follow-up.CONCLUSION:In patients with moderate to severe active TAO complicated by cataracts,delaying cataract surgery until 6mo of TAO control should be considered if cataracts are stable.Simultaneous anti-inflammatory treatment and cataract surgery should be performed for mature/hypermature cataracts,and TAO management should be continued after surgery.
基金Supported by China Primary Health Care Foundation(No.MTP2022C025)Beijing Natural Science Foundation of China(No.7242168).
文摘AIM:To investigate the relationship between preoperative corneal biomechanical properties and corneal tomographic properties in cataract patients.METHODS:The study consisted of 59 eyes of 30 participants who were diagnosed as cataract in Peking University Third Hospital between September 2019 and November 2019.Stepwise multivariable linear regression analysis was calculated to determine the relationship between corneal biomechanical parameters and tomographic parameters.The patients were classified into three groups of with the rule(WTR)astigmatism,against the rule astigmatism and oblique astigmatism.And the differences in corneal parameters among different groups were compared.RESULTS:There were significant differences in the first applanation time(A1T),the first applanation length(A1L),corneal velocity during the first applanation(Vin),the second applanation time(A2T),highest concavity(HC)radius,displacement amount(DA),DA ratio,stiffness parameter A1(SPA1)and integrated radius(IR)between oblique astigmatism patients and the other two groups.Total corneal steep meridian(K2)was negatively associated with A1L,A1T and corneal velocity during the second applanation(Vout).Patients with higher anterior corneal curvature had lower HC radius and central corneal thickness(CCT;P=0.001 and 0.006,respectively),while the Ambrosio relational thickness to the horizontal profile(ARTh)was higher than those with lower anterior corneal curvature(P=0.009).CONCLUSION:The study reveals that the elasticity of corneal collagen fibers is greater,but the viscoelasticity of cornea is smaller in patients with oblique astigmatism.There is no significant difference in ARTh between patients with different types of astigmatism,that is,the corneal biomechanical specificity of oblique astigmatism group is probably not caused by corneal thickness.Moreover,we find patients with higher anterior corneal curvature has lower HC radius and CCT but higher ARTh than those with lower anterior corneal curvature.
文摘AIM:To analyze the environmental impact of patient travel for cataract surgery at a German ophthalmology center.METHODS:All cataract surgeries performed between October 23 and October 27,2023,were analyzed,and all patient records were reviewed for follow-up visits.All travel distances were calculated,and the associated emissions were quantified.Additionally,patients’utilization of geographically closer branch practices for follow-up care was evaluated,along with the corresponding effects on travel-related emissions.RESULTS:A total of 69 patients underwent unilateral cataract surgery.The average one-way travel distance was 40.1 km(24.9 mi;SD=23.6 km).Corresponding emissions were 1284.8 kg of greenhouse gas(GHG),2.477 kg of nitrogen oxides,and 0.101 kg of particulates.All patients attended at least two follow-up visits.Conducting followup visits at branch practices reduced travel distance by 49.1%.The associated GHG emissions from all travel were 1984.3 kg.Emissions from follow-up visits were 54.4%higher than those from the surgery itself.Total GHG emissions amounted to 3269.1 kg,with an average of 47.4 kg of GHG per patient for all travel associated with cataract surgery.CONCLUSION:A dense network of branch practices contributes to reducing the carbon footprint of cataract surgery-related patient travel;however,the development of digital health approaches for follow-up care is necessary to further optimize the environmental sustainability of cataract surgery.
