AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing techn...AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing technique during a 1-year follow-up period.METHODS:This study included 74 eyes from 37 patients,comprising 17 males and 20 females,with a mean age of 51.74±7.80 years.Using a coin toss method,one eye per patient was randomly selected for improved anterior capsular polishing,while the other eye received standard irrigation/aspiration(I/A)polishing.The polishing group consisted of 37 eyes,including 21 right and 16 left eyes,while the control group comprised the contralateral fellow eyes of the same individuals in the polishing group.Visual acuity and quality of the patients were evaluated before surgery and at 1 wk,1,6,and 12 mo after surgery.The OPD-Scan III was utilized to assess high-order aberrations,while the optical quality analysis system(OQAS)was employed to evaluate modulation transfer function(MTF cutoff),Strehl ratio(SR),and objective scatter index(OSI)for the purpose of visual quality assessment.Paired t-tests and repeated measures analysis of variance(ANOVA)were utilized to compare the results,and the SNK-q post hoc test was applied to identify significant differences.RESULTS:The polishing group’s uncorrected distant visual acuity(UDVA)and uncorrected near visual acuity(UNVA)significantly improved 1-week post-surgery(all P<0.05).At 12-months,UDVA,UNVA,and corrected distant visual acuity(CDVA)were better than the control group(P<0.05).The MTF cutoff,SR,OSI,and high-order aberrations in the polishing group also showed significant improvements compared to the control group at 12 mo(P<0.05).CONCLUSION:The improved capsular polishing method has been demonstrated to effectively maintain visual acuity and visual quality in patients with MIOL after FLACS within 1 a.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
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
AIM:To compare analysis of the impact of high altitude on corneal endothelial cells,and the prognosis in patients with cataract surgeries.METHODS:Totally 265 plateau patients with cataract surgeries performed between ...AIM:To compare analysis of the impact of high altitude on corneal endothelial cells,and the prognosis in patients with cataract surgeries.METHODS:Totally 265 plateau patients with cataract surgeries performed between January 2019 and July 2022(average altitude=3000 m),and 524 plain patients with cataract surgeries performed between January 2020 and July 2022 were included.The propensity score matching(PSM)method was applied to match the basic information of patients in both regions on a 1:1 basis.Corneal endothelial cell density(ECD),coefficient of variation(CV),hexagonal cell ratio(HEX),duration of surgery,and pre-and postoperative visual acuity(VA)were compared retrospectively,and correlation tests were done.RESULTS:Totally 223 pairs have been matched successfully.The HEX in the plateau group was higher than that in the plain group(61.95%±6.191%vs 44.91%±6.829%,P<0.001).For ECD and CV,no significant differences were observed between both groups(P>0.1).The pre-and postoperative VA of patients with cataract surgeries in the plateau group were lower(1.40±0.610 vs 0.71±0.514,P<0.001&0.68±0.479 vs 0.18±0.259,P<0.001),and the duration of surgery was longer than those in the plain group(27.06±14.900 min vs 16.03±8.033 min,P<0.001).No significant associations were found between the post-operative VA and the corneal endothelial parameters(P>0.05),while the post-operative VA was significantly related to the pre-operative VA and the duration of surgery(P<0.05).CONCLUSION:The relative hypoxic environment of the plateau does not promote the apoptosis of corneal endothelial cells,but may lead to the compensatory increase of their functions.In plateau patients,no significant associations are found between the poor VA and the corneal endothelial functions early after cataract surgeries.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 assess and rank the efficacy of various nonsteroidal anti-inflammatory drugs(NSAIDs)in preventing postoperative macular edema(PME)after cataract surgery.METHODS:A comprehensive search was conducted across PubMe...AIM:To assess and rank the efficacy of various nonsteroidal anti-inflammatory drugs(NSAIDs)in preventing postoperative macular edema(PME)after cataract surgery.METHODS:A comprehensive search was conducted across PubMed,Embase,Cochrane Library,and Web of Science databases.Randomized controlled trials(RCTs)comparing different NSAIDs and control treatments for the prevention of PME were included.Data from the studies were synthesized using the“gemtc”package in R.Risk of bias was assessed with the Cochrane RoB 2 tool,and heterogeneity was evaluated using the global I2 statistic.Surface under the cumulative ranking curve(SUCRA)values were calculated for each treatment.RESULTS:Of 132 identified records,9 RCTs met the inclusion criteria.The Network Meta-analysis indicated that nepafenac had the highest efficacy in preventing PME,followed by artificial tear substitute,ketorolac,diclofenac,and bromfenac.The league table comparisons and rankograms corroborated these findings,with nepafenac consistently ranking highest.Heterogeneity analysis yielded high I2 values,indicating substantial variability across studies.CONCLUSION:This Network Meta-analysis suggests that nepafenac is the most effective NSAID for preventing PME following cataract surgery.Given the substantial heterogeneity observed,further high-quality RCTs are required to confirm these findings and explore the sources of variability.Clinicians should consider these results when selecting NSAIDs for PME prophylaxis in cataract surgery patients.展开更多
AIM:To explore the effect of Alpha angle and Kappa angle before multifocal intraocular lenses(MIOLs)implantation on postoperative visual quality of patients.METHODS:Before and 3mo after cataract surgery,Alpha angle an...AIM:To explore the effect of Alpha angle and Kappa angle before multifocal intraocular lenses(MIOLs)implantation on postoperative visual quality of patients.METHODS:Before and 3mo after cataract surgery,Alpha angle and Kappa angle were collected using IOL Master 700,iTrace,and Pentacam for clinical observation.Postoperative visual quality indicators,including high-order aberrations(HOA),modulation transfer function(MTF)and point spread function(PSF),were collected using iTrace.multiple linear regression analysis was used to analyze the correlation of the Kappa angle and the Alpha angle with age,axial length(AL),anterior chamber depth(ACD),keratometry(K),lens thickness(LT)and corneal white to white distance(WTW).Pearson correlation coefficient was used to analyze the correlation between Alpha angle and Kappa angle;Bland Altman analysis was used to evaluate the consistency of pairwise detection results of three instruments.RESULTS:The Alpha angle was modeled as Alpha=2.230+0.003×age-0.036×AL-0.025×K-0.058×WTW and the Kappa angle was modeled as Kappa=0.685+0.003×age-0.013×K-0.061×WTW.The correlation between the total Alpha angle and Kappa angle of the three instruments was weakly positive(r=0.291,P=0.000).Comparing the measurement of Alpha angle and Kappa angle using three instruments,only IOL Master 700 and iTrace showed good consistency in measuring Kappa angle(P=0.4254).After 3mo of surgery,the Alpha angle and Kappa angle significantly decreased(P=0.011,0.018;P=0.008,0.036).△Kappa=1.136-0.021×AL-0.013×K.Kappa angle could positively predict HOA(β=0.18,P=0.000),MTF(β=0.171,P=0.000),PSF(β=0.088,P=0.000),Alpha angle cannot(P>0.05).CONCLUSION:The patients with older age,flatter K and shorter WTW should be alert to the possibility of larger Alpha angle and Kappa angle.Alpha angle should also consider the factor of AL.When selecting patients with MIOLs implantation,there is no need to consider the Alpha angle.Careful consideration should be given to the Kappa angle,and the preoperative standard of<0.5 mm can refer to△Kappa=1.136-0.021×AL-0.013×K and be appropriately relaxed.展开更多
Background:Health professions education(HPE)in underserved and resource-constrained regions faces persistent challenges,including limited faculty development opportunities and the absence of context-specific curricula...Background:Health professions education(HPE)in underserved and resource-constrained regions faces persistent challenges,including limited faculty development opportunities and the absence of context-specific curricula.The growing need to increase access to cataract surgery and reduce avoidable blindness underscores the urgency of training more competent cataract surgeons.Developing a standardized,nationally endorsed,outcome-based curriculum for simulation-based training in cataract surgery represents a strategic solution.This study explores integrating online active and constructivist social learning strategies within team projects to address these educational gaps,emphasizing equitable international partnerships between experienced global ophthalmological societies(GOS)in HPE,and national ophthalmological societies(NOS)especially in underserved regions.Methods:We conducted an non-experimental investigation involving the Mozambican College of Ophthalmology(NOS),comprising ten senior ophthalmologist educators,including the President(A.B.),each with over ten years of postgraduate teaching leadership experience.To promote inclusivity and foster future leadership,six early-career ophthalmologists with under five years of experience were invited to join.The GOS was represented by two ophthalmologist educators(K.G.and H.P.F.)affiliated with the Ophthalmology Foundation and experienced in international HPE.Together,both organizations formed an equitable and culturally adapted partnership,led by the NOS,to co-design an outcome-based curriculum for cataract surgery simulation training.The collaborative process used a group mentor-facilitated model integrating design thinking,and social constructivist strategies.A virtual community of practice(vCoP),sustained through WhatsApp,enabled continuous peer support and knowledge exchange.The project spanned eight monthly 90-minute videoconferences via Zoom,incorporating online group mentoring and a virtual jigsaw exercise.Results:The collaboration resulted in the development of a competency-based,simulation-enhanced small incision cataract surgery curriculum structured around the Ophthalmic Simulated Surgical Competency Assessment Rubric(Sim-OSSCAR).The curriculum followed Kern’s six-step framework and was organized into four modular components covering the full range of surgical steps.The vCoP emerged as a key platform for sustained faculty development,collaborative problem-solving,and shared expertise,enhancing institutional capacity within the NOS.Participants anecdotally reported increased confidence in curriculum design,strengthened mentoring relationships,and greater engagement through active learning methodologies.The model demonstrated scalability and adaptability,indicating potential for broader application across other medical specialties and contexts.Conclusions:This study highlights the transformative potential of combining design thinking,active and social learning strategies,and digital tools in HPE.By fostering equitable,structured international collaborations,this approach supports sustainable faculty development and contextually relevant educational innovation.The creation of a dynamic vCoP was instrumental in promoting shared ownership and collaboration,ultimately advancing competency-based,simulation-enhanced training in ophthalmology.These findings suggest similar team-based,technology-enabled strategies could strengthen training and patient care in other underserved settings and with other disciplines.展开更多
AIM:To assess the refractive and functional outcomes of a novel trifocal intraocular lens(IOL)with smooth micro phase technology.METHODS:This prospective,single-arm,single-center,observational study included patients ...AIM:To assess the refractive and functional outcomes of a novel trifocal intraocular lens(IOL)with smooth micro phase technology.METHODS:This prospective,single-arm,single-center,observational study included patients who underwent cataract surgery with the implantation of the AT ELANA 841P(Carl Zeiss Meditec,Berlin,Germany)IOL.Visual acuity(VA)at distance,intermediate,and near were evaluated 1-and 3-month postop as well as refractive outcomes.Monocular and binocular defocus curve,binocular contrast sensitivity(M&S^(■)Technologies)and patient satisfaction with the Catquest-9SF questionnaire were measured at 3-month postop.RESULTS:In total,46 eyes(23 patients)were bilaterally implanted with the IOL.Mean patient age was 59.86±5.55y.At 1-month postop,monocular corrected VA for distance,intermediate,and near were-0.15±0.09,0.11±0.10,and 0.15±0.12 logMAR,respectively.These outcomes remained stable at the 3-month follow-up(P>0.05).Spherical equivalent(SE)at 1-and 3-month postop remained stable(P>0.05).Following surgery,91%of the eyes at 1mo and 95%of the eyes at 3mo were within±0.5 D of SE.Monocular defocus curve showed that the lens can be categorized as a steep transition IOL.The contrast sensitivity function revealed high values at low spatial frequencies and decreased values at high spatial frequencies.The results of the Catquest-9SF questionnaire showed that all patients were fairly or very satisfied with their vision after surgery.CONCLUSION:The AT ELANA 841P IOL offers excellent visual outcomes across distance,intermediate,and near ranges,along with satisfactory contrast sensitivity.Additionally,the lens is associated with high patient satisfaction and minimal visual difficulties during daily activities.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
Intraocular ointment is conventionally placed on the eye to prevent infection after cataract surgery.The purpose of this study is to report a case and conduct a systematic review of a rare occurrence of the entry of i...Intraocular ointment is conventionally placed on the eye to prevent infection after cataract surgery.The purpose of this study is to report a case and conduct a systematic review of a rare occurrence of the entry of intraocular ointment after cataract surgery.PubMed,Scopus,Embase,CNKI,WANFANG data,China Science and Technology Journal Database and Chinese Medical Journal Full-text Database were systematically searched from their commencement to 30 th October 2023,and 19 literatures were screened out and 31 cases of intraocular ointment after surgery were collected.Among the 31 patients,the age of presentation ranged from 55 to 87 years with a median of 73,males accounted for 45.2%and females accounted for 32.3%.The length of the incision was generally 3.2 mm.Most of the patients detected ointment within 3 days post-operation and presented without complications(45.2%).The most common ocular manifestations were corneal edema,glaucoma and uveitis.Early postoperative follow-up is very important.Presence of anterior chamber ointment is a rare complication after cataract surgery,but it can lead to severe vision loss if not detected and treated on time.When patients complain of foreign body sensation in the in the eye after cataract surgery,ophthalmologists need to take a kin interest and examine the eye for early detection of ointment for appropriate intervention and prevent further complications.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
BACKGROUND Pediatric cataract is a public health concern,and it causes long-term functional impairment and impacts the quality of life of the child with cataract.Visual impairment in children due to cataract has devas...BACKGROUND Pediatric cataract is a public health concern,and it causes long-term functional impairment and impacts the quality of life of the child with cataract.Visual impairment in children due to cataract has devastating consequences on their health,social life,and academic performance and places a socio-economic burden on the child’s family and society as a whole.Globally,pediatric cataract is a significant contributor to ocular morbidity and blindness.Findings from this study will help quantify the visual benefits of pediatric cataract surgical interventions and identify opportunities for improving pediatric cataract services.AIM To evaluate the visual acuity outcomes of children after cataract surgery.METHODS The study employed a retrospective electronic review of pediatric cataract surgeries from January 2019 to July 2021 at the pediatric unit of the eye department at Komfo Anokye Teaching Hospital(KATH),Ghana.Patient clinical data including demographics,cataract presentation,pre-operative and post-operative visual acuity,surgical procedure,postoperative complications,interventions and refraction were collected and analyzed using the Statistical Package and Service Solution.Pearson'sχ2 test and regression statistics were used to summarize data at a significance of P<0.05.RESULTS 163 children(257 eyes)underwent cataract surgery at KATH.The overall mean age was 3.81±3.56 years.Congenital cataract was commonly observed(56.4 All children underwent keratometry and phacoemulsification procedures.A few children(9.8%)experienced postoperative complications while 90.8%did not require further intervention after the surgery.After the surgery 27.0%of the children had refraction and the majority were corrected for myopia and near addition(12.9%).An analysis of the association of postoperative visual acuity and the type of cataract was statistically significant(P value<0.05).There was a significant improvement in the visual outcomes following cataract surgery.CONCLUSION Timely pediatric cataract surgery improves postoperative visual outcomes.Creating awareness and implementing screening programs is important to ensure that the prevalence of childhood blindness is reduced to the barest minimum.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
AIM:To establish a risk prediction model for secondary cataract within 2y after pars plana vitrectomy(PPV)in patients with primary rhegmatogenous retinal detachment(RRD).METHODS:Clinical data of patients with primary ...AIM:To establish a risk prediction model for secondary cataract within 2y after pars plana vitrectomy(PPV)in patients with primary rhegmatogenous retinal detachment(RRD).METHODS:Clinical data of patients with primary RRD treated at the Shenzhen Eye Hospital were retrospectively collected.Twenty-four potential influencing factors,including patient characteristics and surgical factors,were selected for analysis.Independent risk factors for secondary cataract were identified through univariate comparisons and multivariate logistic regression analysis.A risk prediction model was constructed and evaluated using receiver operating characteristic(ROC)curves,area under the ROC curve(AUC),calibration plots,and decision curve analysis(DCA)curves.RESULTS:The 386 cases(389 eyes)of patients who underwent PPV and had complete surgical records were ultimately included.Within a 2-year longitudinal observation,41.39%of patients developed cataract secondary to PPV.Logistic regression results identified a history of hypertension[odds ratio(OR)=1.78,95%CI:1.002–3.163,P=0.049],silicone oil tamponade(OR=3.667,95%CI:2.373–5.667,P=0.000),and lens thickness(OR=1.978,95%CI:1.129–3.464,P=0.017)as independent risk factors for cataract secondary to PPV.The constructed nomogram achieved AUC=0.6974.Calibration plots indicated good agreement between predicted and observed outcomes,while DCA curves demonstrated the model’s clinical utility.CONCLUSION:By incorporating a history of hypertension,vitreous substitute type,and lens thickness,this study constructs a prediction model with moderate discriminative ability.This model offers a valuable tool for clinicians to identify high-risk patients early,potentially allowing for more timely interventions and improved patient outcomes.展开更多
Background:Cataract surgery can cause disrupted tear film homeostasis,corneal nerve damage,and ocular surface changes and lead to or exacerbate dry eye disease(DED),and ultimately result in discomfort and visual probl...Background:Cataract surgery can cause disrupted tear film homeostasis,corneal nerve damage,and ocular surface changes and lead to or exacerbate dry eye disease(DED),and ultimately result in discomfort and visual problems.DED severity peaks one day post-surgery and can persist for up to a year.Current DED management includes patient education,lubricants,and medication adjustments.Diquafosol,a P2Y2 purinergic receptor agonist,stimulates tear component secretion and has shown efficacy in treating DED.Studies demonstrate its ability to increase tear production,improve ocular surface conditions,and facilitate corneal wound healing.In human studies,diquafosol 3%has been effective in improving DED symptoms,increasing tear break-up time(TBUT),and reducing corneal and conjunctival staining scores.Diquafosol has also shown promise in reducing post-operative DED prevalence.This retrospective,observational case series study aims to evaluate the efficacy of diquafosol sodium 3%eyedrops for dry eye management in patients undergoing cataract surgery.Methods:Data was extracted from records of cataract patients at a single private ophthalmic centre(LEC Eye Centre)in Malaysia from January 2021 to January 2022.Patients were 18 years or older with pre-existing mild-to-moderate DED and visually significant cataracts,excluding those with severe DED or other significant ocular conditions.Convenience sampling was used for enrolment.One drop of diquafosol sodium 3%was administered six times daily,starting 4 weeks prior(baseline)to cataract surgery until 12 weeks post-operatively.TBUT,National Eye Institute corneal and conjunctival fluorescein staining(CFS)score,Standard Patient Evaluation of Eye Dryness(SPEED)score,uncorrected distance visual acuity(UDVA)and corrected distance visual acuity(CDVA)were measured at baseline,on the day of surgery and at 4 and 12 weeks post-operatively.Results:Twenty-one patients(32 eyes)completed the study.The majority of the patients were female(n=18,85.7%),and the mean age was 64.06±8.93 years(range,45-77 years).Compared to baseline,mean TBUT was significantly improved at 4 weeks(P=0.001)and 12 weeks(P=0.01)post-operatively,while mean CFS score and mean SPEED score were significantly improved on the day of surgery(P=0.009 and P<0.001,respectively),and 4 weeks(both P<0.001)and 12 weeks(both P<0.001)post-operatively.In addition,UDVA and CDVA were significantly better at 4 weeks(both P<0.001)and 12 weeks(both P<0.001)versus baseline.All adverse reactions were mild and resolved with treatment.Conclusions:In patients with pre-existing DED,diquafosol sodium 3%effectively reduces signs and symptoms of dry eye when started at least 4 weeks prior to cataract surgery and continued for at least 12 weeks post-operatively.展开更多
The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which...The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which ranks in the second quartile in the surgery category.This remarkable achievement,which reflects LERS’s steadily increasing influencein the area of surgery,would not be possible without the peer reviewer’s invaluable contributions.On behalf of the Editorial Board and Editorial Office,we would express our sincere appreciation to the following reviewers,who reviewed at least one paper with rigorous and insightful comments.We sincerely hope to engage further with them,either as esteemed reviewers or outstanding authors,in 2026 and beyond.展开更多
Objective:To explore the relationship between anesthetic depth and surgical stress response in minimally invasive cardiothoracic surgery.Methods:A total of 89 patients who underwent thoracoscopic minimally invasive ca...Objective:To explore the relationship between anesthetic depth and surgical stress response in minimally invasive cardiothoracic surgery.Methods:A total of 89 patients who underwent thoracoscopic minimally invasive cardiothoracic surgery in our hospital from June 2024 to December 2024 were selected as the research objects.They were divided into the light anesthesia group(n=45)and the deep anesthesia group(n=44).The vital signs at different intraoperative nodes and perioperative stress status of the two groups were compared.Results:Before lesion resection and after surgery,the mean arterial pressure and heart rate of the deep anesthesia group were lower than those of the light anesthesia group,with statistically significant differences.Conclusion:In thoracoscopic minimally invasive cardiothoracic surgery,deep anesthesia can effectively control the patient’s surgical stress response,but the postoperative awakening time is longer;patients under light anesthesia have a shorter awakening time,but the intraoperative stress response is obvious.展开更多
文摘AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing technique during a 1-year follow-up period.METHODS:This study included 74 eyes from 37 patients,comprising 17 males and 20 females,with a mean age of 51.74±7.80 years.Using a coin toss method,one eye per patient was randomly selected for improved anterior capsular polishing,while the other eye received standard irrigation/aspiration(I/A)polishing.The polishing group consisted of 37 eyes,including 21 right and 16 left eyes,while the control group comprised the contralateral fellow eyes of the same individuals in the polishing group.Visual acuity and quality of the patients were evaluated before surgery and at 1 wk,1,6,and 12 mo after surgery.The OPD-Scan III was utilized to assess high-order aberrations,while the optical quality analysis system(OQAS)was employed to evaluate modulation transfer function(MTF cutoff),Strehl ratio(SR),and objective scatter index(OSI)for the purpose of visual quality assessment.Paired t-tests and repeated measures analysis of variance(ANOVA)were utilized to compare the results,and the SNK-q post hoc test was applied to identify significant differences.RESULTS:The polishing group’s uncorrected distant visual acuity(UDVA)and uncorrected near visual acuity(UNVA)significantly improved 1-week post-surgery(all P<0.05).At 12-months,UDVA,UNVA,and corrected distant visual acuity(CDVA)were better than the control group(P<0.05).The MTF cutoff,SR,OSI,and high-order aberrations in the polishing group also showed significant improvements compared to the control group at 12 mo(P<0.05).CONCLUSION:The improved capsular polishing method has been demonstrated to effectively maintain visual acuity and visual quality in patients with MIOL after FLACS within 1 a.
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 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AIM:To compare analysis of the impact of high altitude on corneal endothelial cells,and the prognosis in patients with cataract surgeries.METHODS:Totally 265 plateau patients with cataract surgeries performed between January 2019 and July 2022(average altitude=3000 m),and 524 plain patients with cataract surgeries performed between January 2020 and July 2022 were included.The propensity score matching(PSM)method was applied to match the basic information of patients in both regions on a 1:1 basis.Corneal endothelial cell density(ECD),coefficient of variation(CV),hexagonal cell ratio(HEX),duration of surgery,and pre-and postoperative visual acuity(VA)were compared retrospectively,and correlation tests were done.RESULTS:Totally 223 pairs have been matched successfully.The HEX in the plateau group was higher than that in the plain group(61.95%±6.191%vs 44.91%±6.829%,P<0.001).For ECD and CV,no significant differences were observed between both groups(P>0.1).The pre-and postoperative VA of patients with cataract surgeries in the plateau group were lower(1.40±0.610 vs 0.71±0.514,P<0.001&0.68±0.479 vs 0.18±0.259,P<0.001),and the duration of surgery was longer than those in the plain group(27.06±14.900 min vs 16.03±8.033 min,P<0.001).No significant associations were found between the post-operative VA and the corneal endothelial parameters(P>0.05),while the post-operative VA was significantly related to the pre-operative VA and the duration of surgery(P<0.05).CONCLUSION:The relative hypoxic environment of the plateau does not promote the apoptosis of corneal endothelial cells,but may lead to the compensatory increase of their functions.In plateau patients,no significant associations are found between the poor VA and the corneal endothelial functions early after cataract surgeries.
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 Natural Science Foundation of Chongqing(No.CSTB2024NSCQ-MSX0900No.CSTB2023NSCQ-MSX0593).
文摘AIM:To assess and rank the efficacy of various nonsteroidal anti-inflammatory drugs(NSAIDs)in preventing postoperative macular edema(PME)after cataract surgery.METHODS:A comprehensive search was conducted across PubMed,Embase,Cochrane Library,and Web of Science databases.Randomized controlled trials(RCTs)comparing different NSAIDs and control treatments for the prevention of PME were included.Data from the studies were synthesized using the“gemtc”package in R.Risk of bias was assessed with the Cochrane RoB 2 tool,and heterogeneity was evaluated using the global I2 statistic.Surface under the cumulative ranking curve(SUCRA)values were calculated for each treatment.RESULTS:Of 132 identified records,9 RCTs met the inclusion criteria.The Network Meta-analysis indicated that nepafenac had the highest efficacy in preventing PME,followed by artificial tear substitute,ketorolac,diclofenac,and bromfenac.The league table comparisons and rankograms corroborated these findings,with nepafenac consistently ranking highest.Heterogeneity analysis yielded high I2 values,indicating substantial variability across studies.CONCLUSION:This Network Meta-analysis suggests that nepafenac is the most effective NSAID for preventing PME following cataract surgery.Given the substantial heterogeneity observed,further high-quality RCTs are required to confirm these findings and explore the sources of variability.Clinicians should consider these results when selecting NSAIDs for PME prophylaxis in cataract surgery patients.
基金Supported by National Natural Science Foundation of China(No.81902751).
文摘AIM:To explore the effect of Alpha angle and Kappa angle before multifocal intraocular lenses(MIOLs)implantation on postoperative visual quality of patients.METHODS:Before and 3mo after cataract surgery,Alpha angle and Kappa angle were collected using IOL Master 700,iTrace,and Pentacam for clinical observation.Postoperative visual quality indicators,including high-order aberrations(HOA),modulation transfer function(MTF)and point spread function(PSF),were collected using iTrace.multiple linear regression analysis was used to analyze the correlation of the Kappa angle and the Alpha angle with age,axial length(AL),anterior chamber depth(ACD),keratometry(K),lens thickness(LT)and corneal white to white distance(WTW).Pearson correlation coefficient was used to analyze the correlation between Alpha angle and Kappa angle;Bland Altman analysis was used to evaluate the consistency of pairwise detection results of three instruments.RESULTS:The Alpha angle was modeled as Alpha=2.230+0.003×age-0.036×AL-0.025×K-0.058×WTW and the Kappa angle was modeled as Kappa=0.685+0.003×age-0.013×K-0.061×WTW.The correlation between the total Alpha angle and Kappa angle of the three instruments was weakly positive(r=0.291,P=0.000).Comparing the measurement of Alpha angle and Kappa angle using three instruments,only IOL Master 700 and iTrace showed good consistency in measuring Kappa angle(P=0.4254).After 3mo of surgery,the Alpha angle and Kappa angle significantly decreased(P=0.011,0.018;P=0.008,0.036).△Kappa=1.136-0.021×AL-0.013×K.Kappa angle could positively predict HOA(β=0.18,P=0.000),MTF(β=0.171,P=0.000),PSF(β=0.088,P=0.000),Alpha angle cannot(P>0.05).CONCLUSION:The patients with older age,flatter K and shorter WTW should be alert to the possibility of larger Alpha angle and Kappa angle.Alpha angle should also consider the factor of AL.When selecting patients with MIOLs implantation,there is no need to consider the Alpha angle.Careful consideration should be given to the Kappa angle,and the preoperative standard of<0.5 mm can refer to△Kappa=1.136-0.021×AL-0.013×K and be appropriately relaxed.
文摘Background:Health professions education(HPE)in underserved and resource-constrained regions faces persistent challenges,including limited faculty development opportunities and the absence of context-specific curricula.The growing need to increase access to cataract surgery and reduce avoidable blindness underscores the urgency of training more competent cataract surgeons.Developing a standardized,nationally endorsed,outcome-based curriculum for simulation-based training in cataract surgery represents a strategic solution.This study explores integrating online active and constructivist social learning strategies within team projects to address these educational gaps,emphasizing equitable international partnerships between experienced global ophthalmological societies(GOS)in HPE,and national ophthalmological societies(NOS)especially in underserved regions.Methods:We conducted an non-experimental investigation involving the Mozambican College of Ophthalmology(NOS),comprising ten senior ophthalmologist educators,including the President(A.B.),each with over ten years of postgraduate teaching leadership experience.To promote inclusivity and foster future leadership,six early-career ophthalmologists with under five years of experience were invited to join.The GOS was represented by two ophthalmologist educators(K.G.and H.P.F.)affiliated with the Ophthalmology Foundation and experienced in international HPE.Together,both organizations formed an equitable and culturally adapted partnership,led by the NOS,to co-design an outcome-based curriculum for cataract surgery simulation training.The collaborative process used a group mentor-facilitated model integrating design thinking,and social constructivist strategies.A virtual community of practice(vCoP),sustained through WhatsApp,enabled continuous peer support and knowledge exchange.The project spanned eight monthly 90-minute videoconferences via Zoom,incorporating online group mentoring and a virtual jigsaw exercise.Results:The collaboration resulted in the development of a competency-based,simulation-enhanced small incision cataract surgery curriculum structured around the Ophthalmic Simulated Surgical Competency Assessment Rubric(Sim-OSSCAR).The curriculum followed Kern’s six-step framework and was organized into four modular components covering the full range of surgical steps.The vCoP emerged as a key platform for sustained faculty development,collaborative problem-solving,and shared expertise,enhancing institutional capacity within the NOS.Participants anecdotally reported increased confidence in curriculum design,strengthened mentoring relationships,and greater engagement through active learning methodologies.The model demonstrated scalability and adaptability,indicating potential for broader application across other medical specialties and contexts.Conclusions:This study highlights the transformative potential of combining design thinking,active and social learning strategies,and digital tools in HPE.By fostering equitable,structured international collaborations,this approach supports sustainable faculty development and contextually relevant educational innovation.The creation of a dynamic vCoP was instrumental in promoting shared ownership and collaboration,ultimately advancing competency-based,simulation-enhanced training in ophthalmology.These findings suggest similar team-based,technology-enabled strategies could strengthen training and patient care in other underserved settings and with other disciplines.
文摘AIM:To assess the refractive and functional outcomes of a novel trifocal intraocular lens(IOL)with smooth micro phase technology.METHODS:This prospective,single-arm,single-center,observational study included patients who underwent cataract surgery with the implantation of the AT ELANA 841P(Carl Zeiss Meditec,Berlin,Germany)IOL.Visual acuity(VA)at distance,intermediate,and near were evaluated 1-and 3-month postop as well as refractive outcomes.Monocular and binocular defocus curve,binocular contrast sensitivity(M&S^(■)Technologies)and patient satisfaction with the Catquest-9SF questionnaire were measured at 3-month postop.RESULTS:In total,46 eyes(23 patients)were bilaterally implanted with the IOL.Mean patient age was 59.86±5.55y.At 1-month postop,monocular corrected VA for distance,intermediate,and near were-0.15±0.09,0.11±0.10,and 0.15±0.12 logMAR,respectively.These outcomes remained stable at the 3-month follow-up(P>0.05).Spherical equivalent(SE)at 1-and 3-month postop remained stable(P>0.05).Following surgery,91%of the eyes at 1mo and 95%of the eyes at 3mo were within±0.5 D of SE.Monocular defocus curve showed that the lens can be categorized as a steep transition IOL.The contrast sensitivity function revealed high values at low spatial frequencies and decreased values at high spatial frequencies.The results of the Catquest-9SF questionnaire showed that all patients were fairly or very satisfied with their vision after surgery.CONCLUSION:The AT ELANA 841P IOL offers excellent visual outcomes across distance,intermediate,and near ranges,along with satisfactory contrast sensitivity.Additionally,the lens is associated with high patient satisfaction and minimal visual difficulties during daily activities.
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.
文摘Intraocular ointment is conventionally placed on the eye to prevent infection after cataract surgery.The purpose of this study is to report a case and conduct a systematic review of a rare occurrence of the entry of intraocular ointment after cataract surgery.PubMed,Scopus,Embase,CNKI,WANFANG data,China Science and Technology Journal Database and Chinese Medical Journal Full-text Database were systematically searched from their commencement to 30 th October 2023,and 19 literatures were screened out and 31 cases of intraocular ointment after surgery were collected.Among the 31 patients,the age of presentation ranged from 55 to 87 years with a median of 73,males accounted for 45.2%and females accounted for 32.3%.The length of the incision was generally 3.2 mm.Most of the patients detected ointment within 3 days post-operation and presented without complications(45.2%).The most common ocular manifestations were corneal edema,glaucoma and uveitis.Early postoperative follow-up is very important.Presence of anterior chamber ointment is a rare complication after cataract surgery,but it can lead to severe vision loss if not detected and treated on time.When patients complain of foreign body sensation in the in the eye after cataract surgery,ophthalmologists need to take a kin interest and examine the eye for early detection of ointment for appropriate intervention and prevent further complications.
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.
文摘BACKGROUND Pediatric cataract is a public health concern,and it causes long-term functional impairment and impacts the quality of life of the child with cataract.Visual impairment in children due to cataract has devastating consequences on their health,social life,and academic performance and places a socio-economic burden on the child’s family and society as a whole.Globally,pediatric cataract is a significant contributor to ocular morbidity and blindness.Findings from this study will help quantify the visual benefits of pediatric cataract surgical interventions and identify opportunities for improving pediatric cataract services.AIM To evaluate the visual acuity outcomes of children after cataract surgery.METHODS The study employed a retrospective electronic review of pediatric cataract surgeries from January 2019 to July 2021 at the pediatric unit of the eye department at Komfo Anokye Teaching Hospital(KATH),Ghana.Patient clinical data including demographics,cataract presentation,pre-operative and post-operative visual acuity,surgical procedure,postoperative complications,interventions and refraction were collected and analyzed using the Statistical Package and Service Solution.Pearson'sχ2 test and regression statistics were used to summarize data at a significance of P<0.05.RESULTS 163 children(257 eyes)underwent cataract surgery at KATH.The overall mean age was 3.81±3.56 years.Congenital cataract was commonly observed(56.4 All children underwent keratometry and phacoemulsification procedures.A few children(9.8%)experienced postoperative complications while 90.8%did not require further intervention after the surgery.After the surgery 27.0%of the children had refraction and the majority were corrected for myopia and near addition(12.9%).An analysis of the association of postoperative visual acuity and the type of cataract was statistically significant(P value<0.05).There was a significant improvement in the visual outcomes following cataract surgery.CONCLUSION Timely pediatric cataract surgery improves postoperative visual outcomes.Creating awareness and implementing screening programs is important to ensure that the prevalence of childhood blindness is reduced to the barest minimum.
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.
基金Supported by the Shenzhen Science and Technology Program(No.JCYJ20220818103207015)the SanMing Project of Medicine in Shenzhen(No.SZSM202311012).
文摘AIM:To establish a risk prediction model for secondary cataract within 2y after pars plana vitrectomy(PPV)in patients with primary rhegmatogenous retinal detachment(RRD).METHODS:Clinical data of patients with primary RRD treated at the Shenzhen Eye Hospital were retrospectively collected.Twenty-four potential influencing factors,including patient characteristics and surgical factors,were selected for analysis.Independent risk factors for secondary cataract were identified through univariate comparisons and multivariate logistic regression analysis.A risk prediction model was constructed and evaluated using receiver operating characteristic(ROC)curves,area under the ROC curve(AUC),calibration plots,and decision curve analysis(DCA)curves.RESULTS:The 386 cases(389 eyes)of patients who underwent PPV and had complete surgical records were ultimately included.Within a 2-year longitudinal observation,41.39%of patients developed cataract secondary to PPV.Logistic regression results identified a history of hypertension[odds ratio(OR)=1.78,95%CI:1.002–3.163,P=0.049],silicone oil tamponade(OR=3.667,95%CI:2.373–5.667,P=0.000),and lens thickness(OR=1.978,95%CI:1.129–3.464,P=0.017)as independent risk factors for cataract secondary to PPV.The constructed nomogram achieved AUC=0.6974.Calibration plots indicated good agreement between predicted and observed outcomes,while DCA curves demonstrated the model’s clinical utility.CONCLUSION:By incorporating a history of hypertension,vitreous substitute type,and lens thickness,this study constructs a prediction model with moderate discriminative ability.This model offers a valuable tool for clinicians to identify high-risk patients early,potentially allowing for more timely interventions and improved patient outcomes.
文摘Background:Cataract surgery can cause disrupted tear film homeostasis,corneal nerve damage,and ocular surface changes and lead to or exacerbate dry eye disease(DED),and ultimately result in discomfort and visual problems.DED severity peaks one day post-surgery and can persist for up to a year.Current DED management includes patient education,lubricants,and medication adjustments.Diquafosol,a P2Y2 purinergic receptor agonist,stimulates tear component secretion and has shown efficacy in treating DED.Studies demonstrate its ability to increase tear production,improve ocular surface conditions,and facilitate corneal wound healing.In human studies,diquafosol 3%has been effective in improving DED symptoms,increasing tear break-up time(TBUT),and reducing corneal and conjunctival staining scores.Diquafosol has also shown promise in reducing post-operative DED prevalence.This retrospective,observational case series study aims to evaluate the efficacy of diquafosol sodium 3%eyedrops for dry eye management in patients undergoing cataract surgery.Methods:Data was extracted from records of cataract patients at a single private ophthalmic centre(LEC Eye Centre)in Malaysia from January 2021 to January 2022.Patients were 18 years or older with pre-existing mild-to-moderate DED and visually significant cataracts,excluding those with severe DED or other significant ocular conditions.Convenience sampling was used for enrolment.One drop of diquafosol sodium 3%was administered six times daily,starting 4 weeks prior(baseline)to cataract surgery until 12 weeks post-operatively.TBUT,National Eye Institute corneal and conjunctival fluorescein staining(CFS)score,Standard Patient Evaluation of Eye Dryness(SPEED)score,uncorrected distance visual acuity(UDVA)and corrected distance visual acuity(CDVA)were measured at baseline,on the day of surgery and at 4 and 12 weeks post-operatively.Results:Twenty-one patients(32 eyes)completed the study.The majority of the patients were female(n=18,85.7%),and the mean age was 64.06±8.93 years(range,45-77 years).Compared to baseline,mean TBUT was significantly improved at 4 weeks(P=0.001)and 12 weeks(P=0.01)post-operatively,while mean CFS score and mean SPEED score were significantly improved on the day of surgery(P=0.009 and P<0.001,respectively),and 4 weeks(both P<0.001)and 12 weeks(both P<0.001)post-operatively.In addition,UDVA and CDVA were significantly better at 4 weeks(both P<0.001)and 12 weeks(both P<0.001)versus baseline.All adverse reactions were mild and resolved with treatment.Conclusions:In patients with pre-existing DED,diquafosol sodium 3%effectively reduces signs and symptoms of dry eye when started at least 4 weeks prior to cataract surgery and continued for at least 12 weeks post-operatively.
文摘The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which ranks in the second quartile in the surgery category.This remarkable achievement,which reflects LERS’s steadily increasing influencein the area of surgery,would not be possible without the peer reviewer’s invaluable contributions.On behalf of the Editorial Board and Editorial Office,we would express our sincere appreciation to the following reviewers,who reviewed at least one paper with rigorous and insightful comments.We sincerely hope to engage further with them,either as esteemed reviewers or outstanding authors,in 2026 and beyond.
文摘Objective:To explore the relationship between anesthetic depth and surgical stress response in minimally invasive cardiothoracic surgery.Methods:A total of 89 patients who underwent thoracoscopic minimally invasive cardiothoracic surgery in our hospital from June 2024 to December 2024 were selected as the research objects.They were divided into the light anesthesia group(n=45)and the deep anesthesia group(n=44).The vital signs at different intraoperative nodes and perioperative stress status of the two groups were compared.Results:Before lesion resection and after surgery,the mean arterial pressure and heart rate of the deep anesthesia group were lower than those of the light anesthesia group,with statistically significant differences.Conclusion:In thoracoscopic minimally invasive cardiothoracic surgery,deep anesthesia can effectively control the patient’s surgical stress response,but the postoperative awakening time is longer;patients under light anesthesia have a shorter awakening time,but the intraoperative stress response is obvious.
