AIM:To compare the clinical outcomes of extended depth-of-focus intraocular lenses(EDOF IOLs)using either micromonovision implantation or mixed implantation of EDOF and diffractive bifocal IOLs.METHODS:This retrospect...AIM:To compare the clinical outcomes of extended depth-of-focus intraocular lenses(EDOF IOLs)using either micromonovision implantation or mixed implantation of EDOF and diffractive bifocal IOLs.METHODS:This retrospective clinical trial included 130 patients(260 eyes),who were divided into two groups.Group RR comprised 70 patients(140 eyes)bilaterally implanted with ZXR00 IOLs(Tecnis ZXR00,where one target was-0.5 D to-0.75 D and the other was 0 to-0.25 D).Group RM comprised 60 patients(120 eyes)unilaterally implanted with both ZXR00 and ZMB00 IOLs(Tecnis ZMB00,0 to-0.25 D).Postoperative outcomes were compared after 3 mo,including visual acuity,defocus curves,stereoacuity,modulation transfer functions(MTFs),higher-order aberrations,and Visual Function-14(VF-14)questionnaire responses.RESULTS:Group RR had superior bilateral intermediate vision,while the group RM had superior bilateral near vision(both P<0.05).Group RM also exhibited superior MTFs and reduced higher-order aberrations(both P<0.05).Stereoacuity and VF-14 questionnaire results showed no statistically significant difference between groups(P>0.05).CONCLUSION:The implantation of micromonovision has significantly improved near vision.IOLs and their collocation can be customized according to individual patient needs to achieve precise treatment and provide cataract patients with high-quality vision.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
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
Ocular hypertension(OHT),defined as increased intraocular pressure(IOP,>21 mmHg)in eyes without optic disc changes or visual field changes,is a condition that puts an eye at higher risk of developing glaucomatous o...Ocular hypertension(OHT),defined as increased intraocular pressure(IOP,>21 mmHg)in eyes without optic disc changes or visual field changes,is a condition that puts an eye at higher risk of developing glaucomatous optic neuropathy and may be related to the translaminar pressure gradient,individual differences in IOP-related glaucoma susceptibility,effects of arterial blood pressure on the optic nerve head,and vasospastic factors.IOP remains the most common modifiable risk factor to protect eyes against the development of glaucoma.The association between OHT and diabetes mellitus(DM)is poorly understood,although ocular effects of both conditions are related to vascular compromise of retinal and optic nerve circulation.Increased IOP in diabetic patients is attributable to increased aqueous osmotic gradient and accumulation of extracellular matrix constituents in the trabecular meshwork.Autonomic dysfunction and genetic factors may also play a role.Apart from eyes without diabetic retinopathy(DR)changes,OHT can also be observed in eyes with DR,where it can develop with or without antecedent vitreoretinal intervention.For example,photocoagulation of the retina in earlier stages of proliferative DR protects against the development of OHT,whereas intraocular silicone oil injection promotes it.While IOP has been directly implicated as an independent risk factor for DR,the retinopathy in DM is also related to comorbidities,like hypertension and heart disease,that are also correlated with OHT.All these factors are discussed in a comprehensive review exploring the association of OHT and DM in detail.展开更多
Objective:Accurate intraocular pressure(IOP)measurement is a cornerstone of glaucoma diagnosis and management.While Goldmann applanation tonometry(GAT)remains the accepted gold standard,technological advancements have...Objective:Accurate intraocular pressure(IOP)measurement is a cornerstone of glaucoma diagnosis and management.While Goldmann applanation tonometry(GAT)remains the accepted gold standard,technological advancements have introduced alternative methods such as noncontact tonometry(NCT)and the dynamic Scheimpflug-based Corvis ST(CST).This study aims to conduct a rigorous comparative analysis of IOP measurements obtained by NCT,GAT,and CST across a wide spectrum of intraocular pressures.The primary objectives were to evaluate the performance of these devices in both healthy and glaucomatous eyes,assess their intra-and interobserver variability,and determine their level of agreement with the established reference.Methods:In this prospective,comparative study,a total of 212 eyes from 212 subjects were enrolled,comprising 137 eyes of patients with glaucoma and 75 eyes of healthy individuals.All participants underwent IOP measurement using the three devices in a randomized order to minimize bias.Based on the initial GAT readings,eyes were systematically classified into one of four predefined IOP levels:Level A(low,<10 mmHg),Level B(normal range,10-21 mmHg),Level C(moderately elevated,>21 to 40 mmHg),and Level D(severely elevated,>40 mmHg).A mixed-model analysis of variance(ANOVA)was employed to statistically analyze the differences in IOP measurements among the three tonometers at each distinct pressure level.The agreement between each pair of devices(CST vs.GAT,CST vs.NCT,and NCT vs.GAT)was meticulously assessed using Bland-Altman plots,which provide metrics for bias(mean difference)and the 95%limits of agreement(LoA).Results:CST and GAT exhibited better intra-and interobserver variability compared to NCT.Significant differences in IOP measurements were observed among CST,NCT,and GAT at levels A and D(P<0.001,P=0.030).Bland-Altman analysis revealed biases between CST and GAT,CST and NCT,and NCT and GAT at different levels(level A:-0.61,0.94,and-1.55 mmHg;level B:0.16,-0.7,and 0.8;level C:0.5,0.5,and-0.1;level D:0.83,-3.4,and 4.2).Notably,NCT tended to overestimate IOP more at higher levels(level D)and underestimate at lower levels(level A)compared to CST.CST demonstrated better agreement with GAT than NCT did.Conclusions:This study confirms that the Corvis ST(CST)shows superior agreement with the Goldmann applanation tonometer than noncontact tonometry,particularly at low and high IOP ranges.It also exhibits greater measurement consistency.While NCT remains a useful screening tool,its significant over-and underestimation at pressure extremes is a critical limitation.The findings strongly suggest that CST may serve as a more suitable and reliable alternative to NCT for measuring IOP across a broad clinical range.However,the results underscore that these three methods are not directly interchangeable.Clinicians must therefore exercise careful interpretation of IOP values,taking into account the specific tonometer used and the patient's probable pressure level for accurate diagnosis and management of glaucoma.展开更多
AIM:To assess visual outcomes and satisfaction of a non-diffractive extended depth of focus(EDOF)intraocular lens(IOL)in individuals with ocular hypertension(OHT)and well-controlled mild glaucoma undergoing cataract s...AIM:To assess visual outcomes and satisfaction of a non-diffractive extended depth of focus(EDOF)intraocular lens(IOL)in individuals with ocular hypertension(OHT)and well-controlled mild glaucoma undergoing cataract surgery.METHODS:An investigator-initiated,single-center,prospective,interventional,noncomparative study conducted in Montreal,Canada.The study enrolled 31 patients(55 eyes)with OHT or mild glaucoma who received a non-diffractive EDOF IOL(Acrysof IQ Vivity).Participants underwent sequential cataract surgery with the Vivity IOL.Follow-up evaluations occurred at 1d,1,and 3mo postoperatively,assessing uncorrected distance,intermediate,and near visual acuity.Questionnaires(QUVID:Questionnaire for visual disturbances and IOLSAT:Intraocular lens satisfaction)were administered pre and post-operatively to measure visual disturbances and spectacle independence in various lighting.Safety parameters included intraocular pressure(IOP),glaucoma medications,spherical equivalence,mean deviation and pattern standard deviation or square root of lost variance on Octopus visual field.RESULTS:At 1 and 3mo postoperatively,significant improvements were observed in uncorrected distance and intermediate visual acuity.Spectacle independence was enhanced for distance and intermediate vision,especially in bright light settings.Spectacle-free intermediate vision was improved even in dim lighting.Visual disturbances,particularly glare symptoms,were reduced,and there was a notable decrease in IOP and glaucoma medication burden at 3mo.There was more hazy vision postoperatively with no impact on visual acuity and visual satisfaction.CONCLUSION:The non-diffractive EDOF lens improves distance and intermediate spectacle-free visual function in patients with OHT and well-controlled glaucoma.The findings highlight significant improvements in visual acuity,reduced glare,enhanced spectacle independence,and improved visual performance in different lighting conditions.展开更多
AIM:To investigate the effect of pharmacological pupil alterations on intraocular lens(IOL)power calculations.METHODS:A systematic review and Meta-analysis of studies published before December 2023 in the PubMed,Embas...AIM:To investigate the effect of pharmacological pupil alterations on intraocular lens(IOL)power calculations.METHODS:A systematic review and Meta-analysis of studies published before December 2023 in the PubMed,Embase,and Cochrane library databases on the accuracy of pharmacological pupil changes on IOL power calculation was performed.The primary outcome was the results of IOL power calculations before and after the use of medications.Subgroup analyses were performed based on participants’basic characteristics,such as age,axial length(AL),and whether miosis or mydriasis were used as classification criteria for further analyses.Each eligible study was evaluated for potential risk of bias by the AHRQ assessment scale.The study was registered on PROSPERO(CRD 42024497535).RESULTS:A total of 3062 eyes from 21 studies were eligible.There was no significant difference in the IOL power calculation before and after pharmacological pupil changes using any of the Hoffer Q(WMD=0.055,95%CI=-0.046–0.156;P=0.29),SRK/T(WMD=0.003,95%CI=-0.073–0.080;P=0.93),Haigis(WMD=-0.030,95%CI=-0.176–0.116;P=0.69),Holladay 2(WMD=-0.042,95%CI=-0.366–0.282;P=0.80),and Barrett Universal Ⅱ(WMD=0.033,95%CI=-0.061–0.127;P=0.49)formulas.On the measurement of parameters related to IOL power calculation,for either miosis or mydriasis AL(P=0.98 and 0.29,respectively),lens thickness(P=0.96 and 0.13,respectively),and mean keratometry(P=0.90 and 0.86,respectively)did not present significant differences,while anterior chamber depth(P=0.07 and<0.01,respectively)and white-to-white distance(P=0.01 and 0.04,respectively)changed significantly between the two measurements prior and posterior.At the same time,despite there being some participants with the difference between the before and after calculations greater than 0.5 diopter,there was no significant difference in the incidence rate between these formulas.CONCLUSION:There is no significant effect of pharmacological pupil changes on the IOL power calculation.It will considerably reduce the visit time burden for patients who require cataract surgery.展开更多
Dear Editor,We reported the case of idiopathic uveal effusion syndrome(IUES)with increased intraocular pressure.IUES is a disease caused by an abnormal increase in serous exudation of the choriocapillaris in the eye f...Dear Editor,We reported the case of idiopathic uveal effusion syndrome(IUES)with increased intraocular pressure.IUES is a disease caused by an abnormal increase in serous exudation of the choriocapillaris in the eye for unknown reasons;it accumulates in the choroid and subretinal space,leading to choroidal and ciliary body detachment and nonrhegmatogenous retinal detachment[1].The diagnosis of IUES requires the exclusion of other causes of uveal effusion,such as choroidal tumors,uveitis,and surgical causes[2-3].展开更多
BACKGROUND Occult intraocular foreign bodies(IOFBs)can present with atypical symptoms and clinical signs,making diagnosis challenging.We describe a case of an undetected IOFB that was missed on both computed tomograph...BACKGROUND Occult intraocular foreign bodies(IOFBs)can present with atypical symptoms and clinical signs,making diagnosis challenging.We describe a case of an undetected IOFB that was missed on both computed tomography and B-ultrasound,ulti-mately leading to ocular siderosis and secondary glaucoma.CASE SUMMARY A 55-year-old male patient presented to our clinic reporting a one-month history of right ocular discomfort and progressive visual deterioration.The patient had previously received a glaucoma diagnosis at a local healthcare facility.His ocular history included blunt trauma to the affected eye five years prior to presentation.Slit-lamp examination revealed corneal and iris lesions in the right eye.Pupillary dilation facilitated the identification of traumatic lens opacities.Diagnostic imaging modalities,including B-scan ultrasonography and computed tomo-graphy,showed no evidence of retained intraocular foreign material.The patient subsequently underwent uncomplicated pars plana vitrectomy,during which the occult foreign body was successfully extracted.The procedure was completed without intraoperative or immediate postoperative complications.CONCLUSION Awareness of IOFBs in individuals who work in high-risk occupations and prompt referral to a retinal surgeon are very important.展开更多
AIM:To examine how three distinct central positioning techniques for anterior capsulotomy-pupil center,limbus center,and lens apex-affect intraocular lens(IOL)placement and visual quality following femtosecond laser-a...AIM:To examine how three distinct central positioning techniques for anterior capsulotomy-pupil center,limbus center,and lens apex-affect intraocular lens(IOL)placement and visual quality following femtosecond laser-assisted cataract surgery(FLACS).METHODS:A total of 36 patients(72 eyes)with age-related cataracts who underwent FLACS and ZCB00 aspherical IOL implantation at Aier Eye Hospital Medical Center,Anhui Medical University between January and December 2023 were included in this prospective study.Patients were divided into three groups based on the central positioning mode for anterior capsulotomy:pupil center,limbus center,and lens apex center groups.IOL alignment and displacement were evaluated using the Casia2 device,and the postoperative visual quality was assessed.RESULTS:At 1 d postoperatively,the IOL tilt for the pupil,limbus,and apex groups were 3.96°±1.51°,4.63°±1.87°,and 3.90°±2.24°,respectively(F=1.07,P=0.35);IOL decentration values were 0.21±0.10 mm,0.23±0.16 mm,and 0.21±0.12 mm,respectively(F=0.14,P=0.87);total higher-order aberrations were 0.32±0.40μm,0.56±0.61μm,and 0.53±0.60μm,respectively(F=1.38,P=0.26);and coma aberrations values were 0.13±0.10μm,0.16±0.15μm,and 0.14±0.15μm,respectively(F=0.3,P=0.74).All results obtained postoperative day 1 did not differ significantly.At 3 mo postoperatively,IOL tilt values were 5.42°±2.00°,3.96°±1.44°,and 3.20°±1.19°,respectively(F=12.40,P<0.001);IOL decentration values were 0.33±0.07 mm,0.23±0.11 mm,and 0.21±0.11 mm,respectively(F=4.99,P=0.008);total higher-order aberrations were 0.67±0.29μm,0.44±0.37μm,and 0.42±0.19μm,respectively(F=5.50,P=0.006);and coma aberrations values were 0.21±0.12μm,0.19±0.12μm,and 0.12±0.11μm,respectively(F=3.87,P=0.03).All results obtained 3 mo postoperatively were statistically significant.CONCLUSION:Using the lens apex as the central positioning mode for anterior capsulotomy in FLACS improves postoperative IOL stability and reduces postoperative IOL tilt and decentration.If the lens apex cannot be determined intraoperatively,the limbus center-positioning mode is recommended.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 assess whether the implantation of a posterior chamber phakic intraocular lens produces changes in optical coherence tomography(OCT)measurements of macular thickness(MT)and two parameters that define the struct...AIM:To assess whether the implantation of a posterior chamber phakic intraocular lens produces changes in optical coherence tomography(OCT)measurements of macular thickness(MT)and two parameters that define the structure of the optic nerve,the peripapillary nerve fiber layer(RNFL)and the Bruch’s membrane opening-minimum rim width(BMO-MRW).METHODS:This nonrandomized prospective pre-post study included 86 eyes of 48 patients(age,20-47y;axial length:23.10-28.95 mm)scheduled for myopia or myopic astigmatism correction with implantation of the implantable collamer lens(ICL).Eyes with glaucoma or any other ocular disease that could alter OCT results were excluded.RNFL,BMO-MRW and MT were measured preoperatively,and at 1 and 6mo after surgery using spectral-domain OCT.Changes between preoperative and postoperative values were evaluated.RESULTS:There was a significant increase in BMOMRW at 1mo(mean change:3.48±15.07μm,P=0.041).No significant changes were found during the rest of followup(1-6mo postop.,P=0.623).There was also a significant increase in RNFL thickness at 1mo af ter surger y(1.45±2.18μm,P<0.001),but with a significant reduction from 1 to 6mo postoperatively(P=0.002).Regarding MT,it increased significantly at 1mo(2.46±3.76μm,P<0.001),with a significant decrease afterwards(P=0.048).Measurements of the three parameters at 6mo were slightly superior to preoperative values(P<0.01).CONCLUSION:Minimal changes are induced in BMOMRW,RNFL and MT after ICL implantation in healthy eyes,confirming the safety of the surgical procedure regarding the structure of the optic nerve head and the macula,and indicating that this phakic intraocular lens seems to have a slight impact on OCT measurements.展开更多
AIM:To investigate the influence of postoperative intraocular lens(IOL)positions on the accuracy of cataract surgery and examine the predictive factors of postoperative biometry prediction errors using the Barrett Uni...AIM:To investigate the influence of postoperative intraocular lens(IOL)positions on the accuracy of cataract surgery and examine the predictive factors of postoperative biometry prediction errors using the Barrett Universal II(BUII)IOL formula for calculation.METHODS:The prospective study included patients who had undergone cataract surgery performed by a single surgeon from June 2020 to April 2022.The collected data included the best-corrected visual acuity(BCVA),corneal curvature,preoperative and postoperative central anterior chamber depths(ACD),axial length(AXL),IOL power,and refractive error.BUII formula was used to calculate the IOL power.The mean absolute error(MAE)was calculated,and all the participants were divided into two groups accordingly.Independent t-tests were applied to compare the variables between groups.Logistic regression analysis was used to analyze the influence of age,AXL,corneal curvature,and preoperative and postoperative ACD on MAE.RESULTS:A total of 261 patients were enrolled.The 243(93.1%)and 18(6.9%)had postoperative MAE<1 and>1 D,respectively.The number of females was higher in patients with MAE>1 D(χ^(2)=3.833,P=0.039).The postoperative BCVA(logMAR)of patients with MAE>1 D was significantly worse(t=-2.448;P=0.025).After adjusting for gender in the logistic model,the risk of postoperative refractive errors was higher in patients with a shallow postoperative anterior chamber[odds ratio=0.346;95% confidence interval(CI):0.164,0.730,P=0.005].CONCLUSION:Risk factors for biometry prediction error after cataract surgery include the patient’s sex and postoperative ACD.Patients with a shallow postoperative anterior chamber are prone to have refractive errors.展开更多
AIM:To evaluate the influence of ocular biometric parameters on the performance of actual near-add power in the spectacle plane of multifocal intraocular lenses(MIOLs).METHODS:This retrospective study defined predicti...AIM:To evaluate the influence of ocular biometric parameters on the performance of actual near-add power in the spectacle plane of multifocal intraocular lenses(MIOLs).METHODS:This retrospective study defined prediction error(PE)as the difference between actual postoperative near-add power and manufacturer-predicted values.Linear regression assessed PE correlations with axial length(AL),mean keratometry(K),pupil size,anterior chamber depth(ACD),lens thickness(LT),ACD+0.5×LT,and back-calculated IOL power.Differences in PE across MIOLs types,AL,K,pupil size,ACD,LT,ACD+0.5×LT,and back-calculated IOL power groups were compared.RESULTS:Totally 250 eyes of 250 patients(116 males and 134 females,mean age 56.22±12.31y)who underwent phacoemulsification with MIOL implantation were reviewed.PE showed no significant correlation with most parameters but had a weak positive correlation with LT.The mean predicted error(MPE)in the AL≤22,26–27,and 27–28 mm groups were 0.83(0.51,1.01)D,0.78(0.51,1.07)D,and 0.72(0.57,0.94)D respectively(P<0.001).The MPE in the K between the 45–46 D groups was 0.78(0.37,1.07)D(P=0.0004).The MPE in the LT between the 4.5–5.0 mm groups and≥5 mm was 0.72(0.50,1.01)D and 0.72(0.51,1.01)D respectively(P<0.001).The MPE in the back-calculated IOL power≥25 D was 0.86(0.60,1.01)D(P<0.001).CONCLUSION:Although there is no significant linear relationship between near-add power and most ocular biometry parameters,and specific segments of AL,K,LT,and IOL power have a significant impact on the near-add power of MIOLs.These factors should be taken into account in preoperative evaluations.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
BACKGROUND Phakic intraocular lens(IOL)implantation is a common treatment for high myopia.However,pre-and postoperative psychological changes,particularly anxiety and depression,are noteworthy concerns.Multiple studie...BACKGROUND Phakic intraocular lens(IOL)implantation is a common treatment for high myopia.However,pre-and postoperative psychological changes,particularly anxiety and depression,are noteworthy concerns.Multiple studies have indicated a close relationship between ophthalmic diseases,including high myopia,glaucoma,anxiety,and depression.AIM To evaluate the impact of phakic IOL implantation on anxiety and depression in patients with high myopia.METHODS Data from 136 patients with high myopia,who underwent phakic IOL implantation at the authors’hospital between June 2024 and December 2024,were retrospectively analyzed.Clinical data were collected from the hospital’s electronic medical records system.Preoperative and one-month postoperative data were compared.Anxiety,depression,sleep quality,and quality of life were evaluated using the Hamilton anxiety scale,Hamilton depression scale,Pittsburgh Sleep Quality Index,and 36-item Short Form Health Survey,respectively.RESULTS Of 136 patients,67.65%(n=92)were female and 32.35%(n=44)were male,with a mean±SD age of 28.02±5.72 years.The mean uncorrected visual acuity before and 1 month after treatment was 1.83±0.24 log minimum angle of resolution(MAR)and 0.03±0.07 log MAR,respectively.The mean best corrected visual acuity before and 1 month after treatment was 0.04±0.07 log MAR and 0.01±0.02 log MAR,respectively.All differences were statistically significant(P<0.05).Compared with pretreatment,Hamilton anxiety scale and Hamilton depression scale scores significantly decreased 1 month post-treatment(P<0.05).Furthermore,the Pittsburgh Sleep Quality Index score was significantly lower after than that before treatment(P<0.05).The 36-item Short Form Health Survey quality of life score significantly improved after treatment(P<0.05).CONCLUSION Phakic IOL implantation significantly reduces anxiety and depression and improves sleep quality and quality of life in patients with high myopia.This study provides new concepts for treating high myopia.展开更多
AIM:To report incidence,indications,and visual outcomes of intraocular lens(IOL)exchange/explantation surgery.METHODS:Retrospective analysis of 60 eyes requiring IOL exchange/explantation surgery between 1^(st) Januar...AIM:To report incidence,indications,and visual outcomes of intraocular lens(IOL)exchange/explantation surgery.METHODS:Retrospective analysis of 60 eyes requiring IOL exchange/explantation surgery between 1^(st) January 2017 and 31^(st) December 2022.The overall outcomes as well as comparison between the trainee versus experienced surgeons were analyzed.RESULTS:Out of 39778 cataract surgeries(with no preexisting ocular co-morbidities)during a six-year period(2017-2022),60(0.15%)needed IOL exchange/explantation.Surgeons-under-training performed 36/60 cases(60%)while 24/60(40%)were by experienced surgeons.The commonest indication was subluxated IOL in 26(43.3%),followed by dislocated IOL in 20(33.3%),postoperative refractive surprise in 7(11.6%),IOL induced uveitis in five and broken haptic in two eyes.Twenty-four(40%)eyes had intraoperative complications during primary surgery.Posterior chamber IOL(PCIOL)was the commonest secondary IOL in 21(35%)eyes,scleral fixated in 20(31.6%),anterior chamber IOL(ACIOL)in 13(21.6%),iris fixated IOL in three(5%)and three eyes(5%)were left aphakic.The mean time between primary and secondary surgery was 168d(168±338.8).Best corrected visual acuity(BCVA)of>20/60 was obtained in 43 eyes(71.66%),20/80-20/200 in 14(23.33%),20/250 in two and hand movements in one.No statistically significant difference in visual outcome was noted at post-op one month between trainees versus experienced surgeons(UCVA 0.45±0.29 vs 0.53±0.32,P=0.20,BCVA 0.34±0.25 vs 0.37±0.26,P=0.69).CONCLUSION:IOL subluxation as the commonest indication and posterior capsular rupture is the commonest intraoperative risk factor.This complication can be effectively addressed with selection of the appropriate secondary IOL achieving good visual outcomes in over 70% of patients.展开更多
AIM:To evaluate the visual and refractive outcomes in cases after sutured scleral fixation of existing subluxated or dislocated acrylic one-piece intraocular lenses(IOLs).METHODS:This study retrospectively enrolled a ...AIM:To evaluate the visual and refractive outcomes in cases after sutured scleral fixation of existing subluxated or dislocated acrylic one-piece intraocular lenses(IOLs).METHODS:This study retrospectively enrolled a consecutive series of patients who underwent a surgery of sutured existing subluxated or dislocated IOLs from October 2018 to June 2020.All patients underwent comprehensive preoperative and postoperative ophthalmologic examination,and data were collected including age,sex,surgical indications,best-corrected visual acuity,refractive error,intraocular pressure.Presence of intraoperative and postoperative surgical complications was documented.RESULTS:A total of 20 consecutive cases were enrolled for analysis with mean final follow-up period 9.8±5.3mo.Visual acuity improved from a mean of 0.35(0.46±0.32 logMAR)preoperatively to 0.61(0.21±0.18 logMAR)at the 3-month follow-up(P=0.002).The mean amount of preoperative keratometric astigmatism and total postoperative refractive astigmatism was-1.24±0.80 diopters(D)and-1.42±0.97 D,respectively.There was no statistically significant difference between preoperative and postoperative astigmatism(P=0.156).The mean IOL-induced astigmatism was-0.23±0.53 D.The mean spherical equivalent at the 3-month follow-up was-0.1±0.94 D.No major complications were noted during the follow-up period.CONCLUSION:Surgical techniques using sutured scleral fixation of existing subluxated or dislocated acrylic one-piece IOLs result in favorable visual and refractive outcomes without major complications.展开更多
Intraocular pressure elevation can induce retinal ganglion cell death and is a clinically reversible risk factor for glaucoma,the leading cause of irreversible blindness.We previously demonstrated that casein kinase-2...Intraocular pressure elevation can induce retinal ganglion cell death and is a clinically reversible risk factor for glaucoma,the leading cause of irreversible blindness.We previously demonstrated that casein kinase-2 inhibition can promote retinal ganglion cell survival and axonal regeneration in rats after optic nerve injury.To investigate the underlying mechanism,in the current study we increased the intraocular pressure of adult rats to 75 mmHg for 2 hours and then administered a casein kinase-2 inhibitor(4,5,6,7-tetrabromo-2-azabenzimidazole or 2-dimethylamino-4,5,6,7-tetrabromo-1H-benzimidazole)by intravitreal injection.We found that intravitreal injection of 4,5,6,7-tetrabromo-2-azabenzimidazole or 2-dimethylamino-4,5,6,7-tetrabromo-1H-benzimidazole promoted retinal ganglion cell survival and reduced the number of infiltrating macrophages.Transcriptomic analysis showed that the mitogen activated protein kinase signaling pathway was involved in the response to intraocular pressure elevation but was not modulated by the casein kinase-2 inhibitors.Furthermore,casein kinase-2 inhibition downregulated the expression of genes(Cck,Htrsa,Nef1,Htrlb,Prph,Chat,Slc18a3,Slc5a7,Scn1b,Crybb2,Tsga10ip,and Vstm21)involved in intraocular pressure elevation.Our data indicate that inhibition of casein kinase-2 can enhance retinal ganglion cell survival in rats after acute intraocular pressure elevation via macrophage inactivation.展开更多
●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical tria...●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical trial was conducted.Totally 98 eyes(74 patients)who underwent femtosecond laser-assisted cataract surgery(FLACS)with trifocal IOLs were enrolled in the study and followed up for 2y after surgery:46 eyes(33 patients)with capsular tension ring implantation in the long axial lengths(AL)group(26<AL<29 mm)and 52 eyes(41 patients)in the normal AL group(22<AL<24.5 mm).Postoperative outcomes about effectivity and safety,including the subjective and objective visual quality,and postoperative complications were assessed.●RESULTS:Uncorrected distance visual acuity at 5 m and uncorrected intermediate visual acuity at 60 and 80 cm in the long AL group were significantly worse than those in the normal AL group at 3mo postoperatively(P<0.05).The differences in reading speed,spectacle independence and potential visual complaints between the two groups were not statistically significant(P>0.05).The dysfunctional lens index and total modulation transfer function(MTF)average height were similar between the two groups.The postoperative internal coma aberrations in the axial high myopia eyes were significantly higher than that in the normal AL group(P<0.05).The total satisfaction score in the long AL group(91.32±2.76)was slightly higher than that in the normal AL group(90.36±3.47),but there was no difference(P=0.136).A statistically negative correlation was found between corrected distance visual acuity(CDVA)and dysfunctional lens index(r=-0.382,P=0.009),and between CDVA and the total MTF average height(r=-0.374,P=0.01).But there was no significant correlation between CDVA and total satisfaction score(r=0.059,P=0.696).Postoperative complications mainly presented as posterior capsular opacity(PCO),retinal detachment and cystoid macular edema.There was no difference in the incidence of fundus disease(6.5%vs 3.8%,P=0.663)or PCO(17.4%vs 7.7%,P=0.217)between the two groups at two years.●CONCLUSION:The utilization of trifocal IOL and capsular tension ring implantation is beneficial for cataract patients with axial high myopia undergoing FLACS.This approach not only ensures excellent subjective feelings and objective visual quality,but also does not increase the incidence of postoperative complications.展开更多
文摘AIM:To compare the clinical outcomes of extended depth-of-focus intraocular lenses(EDOF IOLs)using either micromonovision implantation or mixed implantation of EDOF and diffractive bifocal IOLs.METHODS:This retrospective clinical trial included 130 patients(260 eyes),who were divided into two groups.Group RR comprised 70 patients(140 eyes)bilaterally implanted with ZXR00 IOLs(Tecnis ZXR00,where one target was-0.5 D to-0.75 D and the other was 0 to-0.25 D).Group RM comprised 60 patients(120 eyes)unilaterally implanted with both ZXR00 and ZMB00 IOLs(Tecnis ZMB00,0 to-0.25 D).Postoperative outcomes were compared after 3 mo,including visual acuity,defocus curves,stereoacuity,modulation transfer functions(MTFs),higher-order aberrations,and Visual Function-14(VF-14)questionnaire responses.RESULTS:Group RR had superior bilateral intermediate vision,while the group RM had superior bilateral near vision(both P<0.05).Group RM also exhibited superior MTFs and reduced higher-order aberrations(both P<0.05).Stereoacuity and VF-14 questionnaire results showed no statistically significant difference between groups(P>0.05).CONCLUSION:The implantation of micromonovision has significantly improved near vision.IOLs and their collocation can be customized according to individual patient needs to achieve precise treatment and provide cataract patients with high-quality vision.
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Ocular hypertension(OHT),defined as increased intraocular pressure(IOP,>21 mmHg)in eyes without optic disc changes or visual field changes,is a condition that puts an eye at higher risk of developing glaucomatous optic neuropathy and may be related to the translaminar pressure gradient,individual differences in IOP-related glaucoma susceptibility,effects of arterial blood pressure on the optic nerve head,and vasospastic factors.IOP remains the most common modifiable risk factor to protect eyes against the development of glaucoma.The association between OHT and diabetes mellitus(DM)is poorly understood,although ocular effects of both conditions are related to vascular compromise of retinal and optic nerve circulation.Increased IOP in diabetic patients is attributable to increased aqueous osmotic gradient and accumulation of extracellular matrix constituents in the trabecular meshwork.Autonomic dysfunction and genetic factors may also play a role.Apart from eyes without diabetic retinopathy(DR)changes,OHT can also be observed in eyes with DR,where it can develop with or without antecedent vitreoretinal intervention.For example,photocoagulation of the retina in earlier stages of proliferative DR protects against the development of OHT,whereas intraocular silicone oil injection promotes it.While IOP has been directly implicated as an independent risk factor for DR,the retinopathy in DM is also related to comorbidities,like hypertension and heart disease,that are also correlated with OHT.All these factors are discussed in a comprehensive review exploring the association of OHT and DM in detail.
文摘Objective:Accurate intraocular pressure(IOP)measurement is a cornerstone of glaucoma diagnosis and management.While Goldmann applanation tonometry(GAT)remains the accepted gold standard,technological advancements have introduced alternative methods such as noncontact tonometry(NCT)and the dynamic Scheimpflug-based Corvis ST(CST).This study aims to conduct a rigorous comparative analysis of IOP measurements obtained by NCT,GAT,and CST across a wide spectrum of intraocular pressures.The primary objectives were to evaluate the performance of these devices in both healthy and glaucomatous eyes,assess their intra-and interobserver variability,and determine their level of agreement with the established reference.Methods:In this prospective,comparative study,a total of 212 eyes from 212 subjects were enrolled,comprising 137 eyes of patients with glaucoma and 75 eyes of healthy individuals.All participants underwent IOP measurement using the three devices in a randomized order to minimize bias.Based on the initial GAT readings,eyes were systematically classified into one of four predefined IOP levels:Level A(low,<10 mmHg),Level B(normal range,10-21 mmHg),Level C(moderately elevated,>21 to 40 mmHg),and Level D(severely elevated,>40 mmHg).A mixed-model analysis of variance(ANOVA)was employed to statistically analyze the differences in IOP measurements among the three tonometers at each distinct pressure level.The agreement between each pair of devices(CST vs.GAT,CST vs.NCT,and NCT vs.GAT)was meticulously assessed using Bland-Altman plots,which provide metrics for bias(mean difference)and the 95%limits of agreement(LoA).Results:CST and GAT exhibited better intra-and interobserver variability compared to NCT.Significant differences in IOP measurements were observed among CST,NCT,and GAT at levels A and D(P<0.001,P=0.030).Bland-Altman analysis revealed biases between CST and GAT,CST and NCT,and NCT and GAT at different levels(level A:-0.61,0.94,and-1.55 mmHg;level B:0.16,-0.7,and 0.8;level C:0.5,0.5,and-0.1;level D:0.83,-3.4,and 4.2).Notably,NCT tended to overestimate IOP more at higher levels(level D)and underestimate at lower levels(level A)compared to CST.CST demonstrated better agreement with GAT than NCT did.Conclusions:This study confirms that the Corvis ST(CST)shows superior agreement with the Goldmann applanation tonometer than noncontact tonometry,particularly at low and high IOP ranges.It also exhibits greater measurement consistency.While NCT remains a useful screening tool,its significant over-and underestimation at pressure extremes is a critical limitation.The findings strongly suggest that CST may serve as a more suitable and reliable alternative to NCT for measuring IOP across a broad clinical range.However,the results underscore that these three methods are not directly interchangeable.Clinicians must therefore exercise careful interpretation of IOP values,taking into account the specific tonometer used and the patient's probable pressure level for accurate diagnosis and management of glaucoma.
文摘AIM:To assess visual outcomes and satisfaction of a non-diffractive extended depth of focus(EDOF)intraocular lens(IOL)in individuals with ocular hypertension(OHT)and well-controlled mild glaucoma undergoing cataract surgery.METHODS:An investigator-initiated,single-center,prospective,interventional,noncomparative study conducted in Montreal,Canada.The study enrolled 31 patients(55 eyes)with OHT or mild glaucoma who received a non-diffractive EDOF IOL(Acrysof IQ Vivity).Participants underwent sequential cataract surgery with the Vivity IOL.Follow-up evaluations occurred at 1d,1,and 3mo postoperatively,assessing uncorrected distance,intermediate,and near visual acuity.Questionnaires(QUVID:Questionnaire for visual disturbances and IOLSAT:Intraocular lens satisfaction)were administered pre and post-operatively to measure visual disturbances and spectacle independence in various lighting.Safety parameters included intraocular pressure(IOP),glaucoma medications,spherical equivalence,mean deviation and pattern standard deviation or square root of lost variance on Octopus visual field.RESULTS:At 1 and 3mo postoperatively,significant improvements were observed in uncorrected distance and intermediate visual acuity.Spectacle independence was enhanced for distance and intermediate vision,especially in bright light settings.Spectacle-free intermediate vision was improved even in dim lighting.Visual disturbances,particularly glare symptoms,were reduced,and there was a notable decrease in IOP and glaucoma medication burden at 3mo.There was more hazy vision postoperatively with no impact on visual acuity and visual satisfaction.CONCLUSION:The non-diffractive EDOF lens improves distance and intermediate spectacle-free visual function in patients with OHT and well-controlled glaucoma.The findings highlight significant improvements in visual acuity,reduced glare,enhanced spectacle independence,and improved visual performance in different lighting conditions.
基金Supported by Beijing Natural Science Foundation from Beijing Municipal Government(No.7202030).
文摘AIM:To investigate the effect of pharmacological pupil alterations on intraocular lens(IOL)power calculations.METHODS:A systematic review and Meta-analysis of studies published before December 2023 in the PubMed,Embase,and Cochrane library databases on the accuracy of pharmacological pupil changes on IOL power calculation was performed.The primary outcome was the results of IOL power calculations before and after the use of medications.Subgroup analyses were performed based on participants’basic characteristics,such as age,axial length(AL),and whether miosis or mydriasis were used as classification criteria for further analyses.Each eligible study was evaluated for potential risk of bias by the AHRQ assessment scale.The study was registered on PROSPERO(CRD 42024497535).RESULTS:A total of 3062 eyes from 21 studies were eligible.There was no significant difference in the IOL power calculation before and after pharmacological pupil changes using any of the Hoffer Q(WMD=0.055,95%CI=-0.046–0.156;P=0.29),SRK/T(WMD=0.003,95%CI=-0.073–0.080;P=0.93),Haigis(WMD=-0.030,95%CI=-0.176–0.116;P=0.69),Holladay 2(WMD=-0.042,95%CI=-0.366–0.282;P=0.80),and Barrett Universal Ⅱ(WMD=0.033,95%CI=-0.061–0.127;P=0.49)formulas.On the measurement of parameters related to IOL power calculation,for either miosis or mydriasis AL(P=0.98 and 0.29,respectively),lens thickness(P=0.96 and 0.13,respectively),and mean keratometry(P=0.90 and 0.86,respectively)did not present significant differences,while anterior chamber depth(P=0.07 and<0.01,respectively)and white-to-white distance(P=0.01 and 0.04,respectively)changed significantly between the two measurements prior and posterior.At the same time,despite there being some participants with the difference between the before and after calculations greater than 0.5 diopter,there was no significant difference in the incidence rate between these formulas.CONCLUSION:There is no significant effect of pharmacological pupil changes on the IOL power calculation.It will considerably reduce the visit time burden for patients who require cataract surgery.
基金Supported by the National Natural Science Foundation of China(No.81600747)Foundation of Liaoning Province Education Administration(No.JYTMS20230089)Joint Project Planned by the Department of Science and Technology of Liaoning Province(No.2023JH2/101700129).
文摘Dear Editor,We reported the case of idiopathic uveal effusion syndrome(IUES)with increased intraocular pressure.IUES is a disease caused by an abnormal increase in serous exudation of the choriocapillaris in the eye for unknown reasons;it accumulates in the choroid and subretinal space,leading to choroidal and ciliary body detachment and nonrhegmatogenous retinal detachment[1].The diagnosis of IUES requires the exclusion of other causes of uveal effusion,such as choroidal tumors,uveitis,and surgical causes[2-3].
基金Supported by The Tianjin Health Research Project,No.ZC20069the Foundation of the Committee of Integrated Traditional Chinese and Western Medicine,No.2021011the Science and Technology Foundation of Tianjin Eye Hospital,No.YKYB1901.
文摘BACKGROUND Occult intraocular foreign bodies(IOFBs)can present with atypical symptoms and clinical signs,making diagnosis challenging.We describe a case of an undetected IOFB that was missed on both computed tomography and B-ultrasound,ulti-mately leading to ocular siderosis and secondary glaucoma.CASE SUMMARY A 55-year-old male patient presented to our clinic reporting a one-month history of right ocular discomfort and progressive visual deterioration.The patient had previously received a glaucoma diagnosis at a local healthcare facility.His ocular history included blunt trauma to the affected eye five years prior to presentation.Slit-lamp examination revealed corneal and iris lesions in the right eye.Pupillary dilation facilitated the identification of traumatic lens opacities.Diagnostic imaging modalities,including B-scan ultrasonography and computed tomo-graphy,showed no evidence of retained intraocular foreign material.The patient subsequently underwent uncomplicated pars plana vitrectomy,during which the occult foreign body was successfully extracted.The procedure was completed without intraoperative or immediate postoperative complications.CONCLUSION Awareness of IOFBs in individuals who work in high-risk occupations and prompt referral to a retinal surgeon are very important.
文摘AIM:To examine how three distinct central positioning techniques for anterior capsulotomy-pupil center,limbus center,and lens apex-affect intraocular lens(IOL)placement and visual quality following femtosecond laser-assisted cataract surgery(FLACS).METHODS:A total of 36 patients(72 eyes)with age-related cataracts who underwent FLACS and ZCB00 aspherical IOL implantation at Aier Eye Hospital Medical Center,Anhui Medical University between January and December 2023 were included in this prospective study.Patients were divided into three groups based on the central positioning mode for anterior capsulotomy:pupil center,limbus center,and lens apex center groups.IOL alignment and displacement were evaluated using the Casia2 device,and the postoperative visual quality was assessed.RESULTS:At 1 d postoperatively,the IOL tilt for the pupil,limbus,and apex groups were 3.96°±1.51°,4.63°±1.87°,and 3.90°±2.24°,respectively(F=1.07,P=0.35);IOL decentration values were 0.21±0.10 mm,0.23±0.16 mm,and 0.21±0.12 mm,respectively(F=0.14,P=0.87);total higher-order aberrations were 0.32±0.40μm,0.56±0.61μm,and 0.53±0.60μm,respectively(F=1.38,P=0.26);and coma aberrations values were 0.13±0.10μm,0.16±0.15μm,and 0.14±0.15μm,respectively(F=0.3,P=0.74).All results obtained postoperative day 1 did not differ significantly.At 3 mo postoperatively,IOL tilt values were 5.42°±2.00°,3.96°±1.44°,and 3.20°±1.19°,respectively(F=12.40,P<0.001);IOL decentration values were 0.33±0.07 mm,0.23±0.11 mm,and 0.21±0.11 mm,respectively(F=4.99,P=0.008);total higher-order aberrations were 0.67±0.29μm,0.44±0.37μm,and 0.42±0.19μm,respectively(F=5.50,P=0.006);and coma aberrations values were 0.21±0.12μm,0.19±0.12μm,and 0.12±0.11μm,respectively(F=3.87,P=0.03).All results obtained 3 mo postoperatively were statistically significant.CONCLUSION:Using the lens apex as the central positioning mode for anterior capsulotomy in FLACS improves postoperative IOL stability and reduces postoperative IOL tilt and decentration.If the lens apex cannot be determined intraoperatively,the limbus center-positioning mode is recommended.
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.
文摘AIM:To assess whether the implantation of a posterior chamber phakic intraocular lens produces changes in optical coherence tomography(OCT)measurements of macular thickness(MT)and two parameters that define the structure of the optic nerve,the peripapillary nerve fiber layer(RNFL)and the Bruch’s membrane opening-minimum rim width(BMO-MRW).METHODS:This nonrandomized prospective pre-post study included 86 eyes of 48 patients(age,20-47y;axial length:23.10-28.95 mm)scheduled for myopia or myopic astigmatism correction with implantation of the implantable collamer lens(ICL).Eyes with glaucoma or any other ocular disease that could alter OCT results were excluded.RNFL,BMO-MRW and MT were measured preoperatively,and at 1 and 6mo after surgery using spectral-domain OCT.Changes between preoperative and postoperative values were evaluated.RESULTS:There was a significant increase in BMOMRW at 1mo(mean change:3.48±15.07μm,P=0.041).No significant changes were found during the rest of followup(1-6mo postop.,P=0.623).There was also a significant increase in RNFL thickness at 1mo af ter surger y(1.45±2.18μm,P<0.001),but with a significant reduction from 1 to 6mo postoperatively(P=0.002).Regarding MT,it increased significantly at 1mo(2.46±3.76μm,P<0.001),with a significant decrease afterwards(P=0.048).Measurements of the three parameters at 6mo were slightly superior to preoperative values(P<0.01).CONCLUSION:Minimal changes are induced in BMOMRW,RNFL and MT after ICL implantation in healthy eyes,confirming the safety of the surgical procedure regarding the structure of the optic nerve head and the macula,and indicating that this phakic intraocular lens seems to have a slight impact on OCT measurements.
基金Supported by the Innovation&Transfer Fund of Peking University Third Hospital(No.BYSYZHKC2021108).
文摘AIM:To investigate the influence of postoperative intraocular lens(IOL)positions on the accuracy of cataract surgery and examine the predictive factors of postoperative biometry prediction errors using the Barrett Universal II(BUII)IOL formula for calculation.METHODS:The prospective study included patients who had undergone cataract surgery performed by a single surgeon from June 2020 to April 2022.The collected data included the best-corrected visual acuity(BCVA),corneal curvature,preoperative and postoperative central anterior chamber depths(ACD),axial length(AXL),IOL power,and refractive error.BUII formula was used to calculate the IOL power.The mean absolute error(MAE)was calculated,and all the participants were divided into two groups accordingly.Independent t-tests were applied to compare the variables between groups.Logistic regression analysis was used to analyze the influence of age,AXL,corneal curvature,and preoperative and postoperative ACD on MAE.RESULTS:A total of 261 patients were enrolled.The 243(93.1%)and 18(6.9%)had postoperative MAE<1 and>1 D,respectively.The number of females was higher in patients with MAE>1 D(χ^(2)=3.833,P=0.039).The postoperative BCVA(logMAR)of patients with MAE>1 D was significantly worse(t=-2.448;P=0.025).After adjusting for gender in the logistic model,the risk of postoperative refractive errors was higher in patients with a shallow postoperative anterior chamber[odds ratio=0.346;95% confidence interval(CI):0.164,0.730,P=0.005].CONCLUSION:Risk factors for biometry prediction error after cataract surgery include the patient’s sex and postoperative ACD.Patients with a shallow postoperative anterior chamber are prone to have refractive errors.
基金Supported by the Fuzhou Science and Technology Program(No.2023-S-005).
文摘AIM:To evaluate the influence of ocular biometric parameters on the performance of actual near-add power in the spectacle plane of multifocal intraocular lenses(MIOLs).METHODS:This retrospective study defined prediction error(PE)as the difference between actual postoperative near-add power and manufacturer-predicted values.Linear regression assessed PE correlations with axial length(AL),mean keratometry(K),pupil size,anterior chamber depth(ACD),lens thickness(LT),ACD+0.5×LT,and back-calculated IOL power.Differences in PE across MIOLs types,AL,K,pupil size,ACD,LT,ACD+0.5×LT,and back-calculated IOL power groups were compared.RESULTS:Totally 250 eyes of 250 patients(116 males and 134 females,mean age 56.22±12.31y)who underwent phacoemulsification with MIOL implantation were reviewed.PE showed no significant correlation with most parameters but had a weak positive correlation with LT.The mean predicted error(MPE)in the AL≤22,26–27,and 27–28 mm groups were 0.83(0.51,1.01)D,0.78(0.51,1.07)D,and 0.72(0.57,0.94)D respectively(P<0.001).The MPE in the K between the 45–46 D groups was 0.78(0.37,1.07)D(P=0.0004).The MPE in the LT between the 4.5–5.0 mm groups and≥5 mm was 0.72(0.50,1.01)D and 0.72(0.51,1.01)D respectively(P<0.001).The MPE in the back-calculated IOL power≥25 D was 0.86(0.60,1.01)D(P<0.001).CONCLUSION:Although there is no significant linear relationship between near-add power and most ocular biometry parameters,and specific segments of AL,K,LT,and IOL power have a significant impact on the near-add power of MIOLs.These factors should be taken into account in preoperative evaluations.
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BACKGROUND Phakic intraocular lens(IOL)implantation is a common treatment for high myopia.However,pre-and postoperative psychological changes,particularly anxiety and depression,are noteworthy concerns.Multiple studies have indicated a close relationship between ophthalmic diseases,including high myopia,glaucoma,anxiety,and depression.AIM To evaluate the impact of phakic IOL implantation on anxiety and depression in patients with high myopia.METHODS Data from 136 patients with high myopia,who underwent phakic IOL implantation at the authors’hospital between June 2024 and December 2024,were retrospectively analyzed.Clinical data were collected from the hospital’s electronic medical records system.Preoperative and one-month postoperative data were compared.Anxiety,depression,sleep quality,and quality of life were evaluated using the Hamilton anxiety scale,Hamilton depression scale,Pittsburgh Sleep Quality Index,and 36-item Short Form Health Survey,respectively.RESULTS Of 136 patients,67.65%(n=92)were female and 32.35%(n=44)were male,with a mean±SD age of 28.02±5.72 years.The mean uncorrected visual acuity before and 1 month after treatment was 1.83±0.24 log minimum angle of resolution(MAR)and 0.03±0.07 log MAR,respectively.The mean best corrected visual acuity before and 1 month after treatment was 0.04±0.07 log MAR and 0.01±0.02 log MAR,respectively.All differences were statistically significant(P<0.05).Compared with pretreatment,Hamilton anxiety scale and Hamilton depression scale scores significantly decreased 1 month post-treatment(P<0.05).Furthermore,the Pittsburgh Sleep Quality Index score was significantly lower after than that before treatment(P<0.05).The 36-item Short Form Health Survey quality of life score significantly improved after treatment(P<0.05).CONCLUSION Phakic IOL implantation significantly reduces anxiety and depression and improves sleep quality and quality of life in patients with high myopia.This study provides new concepts for treating high myopia.
文摘AIM:To report incidence,indications,and visual outcomes of intraocular lens(IOL)exchange/explantation surgery.METHODS:Retrospective analysis of 60 eyes requiring IOL exchange/explantation surgery between 1^(st) January 2017 and 31^(st) December 2022.The overall outcomes as well as comparison between the trainee versus experienced surgeons were analyzed.RESULTS:Out of 39778 cataract surgeries(with no preexisting ocular co-morbidities)during a six-year period(2017-2022),60(0.15%)needed IOL exchange/explantation.Surgeons-under-training performed 36/60 cases(60%)while 24/60(40%)were by experienced surgeons.The commonest indication was subluxated IOL in 26(43.3%),followed by dislocated IOL in 20(33.3%),postoperative refractive surprise in 7(11.6%),IOL induced uveitis in five and broken haptic in two eyes.Twenty-four(40%)eyes had intraoperative complications during primary surgery.Posterior chamber IOL(PCIOL)was the commonest secondary IOL in 21(35%)eyes,scleral fixated in 20(31.6%),anterior chamber IOL(ACIOL)in 13(21.6%),iris fixated IOL in three(5%)and three eyes(5%)were left aphakic.The mean time between primary and secondary surgery was 168d(168±338.8).Best corrected visual acuity(BCVA)of>20/60 was obtained in 43 eyes(71.66%),20/80-20/200 in 14(23.33%),20/250 in two and hand movements in one.No statistically significant difference in visual outcome was noted at post-op one month between trainees versus experienced surgeons(UCVA 0.45±0.29 vs 0.53±0.32,P=0.20,BCVA 0.34±0.25 vs 0.37±0.26,P=0.69).CONCLUSION:IOL subluxation as the commonest indication and posterior capsular rupture is the commonest intraoperative risk factor.This complication can be effectively addressed with selection of the appropriate secondary IOL achieving good visual outcomes in over 70% of patients.
文摘AIM:To evaluate the visual and refractive outcomes in cases after sutured scleral fixation of existing subluxated or dislocated acrylic one-piece intraocular lenses(IOLs).METHODS:This study retrospectively enrolled a consecutive series of patients who underwent a surgery of sutured existing subluxated or dislocated IOLs from October 2018 to June 2020.All patients underwent comprehensive preoperative and postoperative ophthalmologic examination,and data were collected including age,sex,surgical indications,best-corrected visual acuity,refractive error,intraocular pressure.Presence of intraoperative and postoperative surgical complications was documented.RESULTS:A total of 20 consecutive cases were enrolled for analysis with mean final follow-up period 9.8±5.3mo.Visual acuity improved from a mean of 0.35(0.46±0.32 logMAR)preoperatively to 0.61(0.21±0.18 logMAR)at the 3-month follow-up(P=0.002).The mean amount of preoperative keratometric astigmatism and total postoperative refractive astigmatism was-1.24±0.80 diopters(D)and-1.42±0.97 D,respectively.There was no statistically significant difference between preoperative and postoperative astigmatism(P=0.156).The mean IOL-induced astigmatism was-0.23±0.53 D.The mean spherical equivalent at the 3-month follow-up was-0.1±0.94 D.No major complications were noted during the follow-up period.CONCLUSION:Surgical techniques using sutured scleral fixation of existing subluxated or dislocated acrylic one-piece IOLs result in favorable visual and refractive outcomes without major complications.
基金supported by the National Natural Science Foundation of China,Nos.81570849,81100931the Natural Science Foundation of Guangdong Province of China,Nos.2015A030313446,2020A1515011413(all to LPC).
文摘Intraocular pressure elevation can induce retinal ganglion cell death and is a clinically reversible risk factor for glaucoma,the leading cause of irreversible blindness.We previously demonstrated that casein kinase-2 inhibition can promote retinal ganglion cell survival and axonal regeneration in rats after optic nerve injury.To investigate the underlying mechanism,in the current study we increased the intraocular pressure of adult rats to 75 mmHg for 2 hours and then administered a casein kinase-2 inhibitor(4,5,6,7-tetrabromo-2-azabenzimidazole or 2-dimethylamino-4,5,6,7-tetrabromo-1H-benzimidazole)by intravitreal injection.We found that intravitreal injection of 4,5,6,7-tetrabromo-2-azabenzimidazole or 2-dimethylamino-4,5,6,7-tetrabromo-1H-benzimidazole promoted retinal ganglion cell survival and reduced the number of infiltrating macrophages.Transcriptomic analysis showed that the mitogen activated protein kinase signaling pathway was involved in the response to intraocular pressure elevation but was not modulated by the casein kinase-2 inhibitors.Furthermore,casein kinase-2 inhibition downregulated the expression of genes(Cck,Htrsa,Nef1,Htrlb,Prph,Chat,Slc18a3,Slc5a7,Scn1b,Crybb2,Tsga10ip,and Vstm21)involved in intraocular pressure elevation.Our data indicate that inhibition of casein kinase-2 can enhance retinal ganglion cell survival in rats after acute intraocular pressure elevation via macrophage inactivation.
文摘●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical trial was conducted.Totally 98 eyes(74 patients)who underwent femtosecond laser-assisted cataract surgery(FLACS)with trifocal IOLs were enrolled in the study and followed up for 2y after surgery:46 eyes(33 patients)with capsular tension ring implantation in the long axial lengths(AL)group(26<AL<29 mm)and 52 eyes(41 patients)in the normal AL group(22<AL<24.5 mm).Postoperative outcomes about effectivity and safety,including the subjective and objective visual quality,and postoperative complications were assessed.●RESULTS:Uncorrected distance visual acuity at 5 m and uncorrected intermediate visual acuity at 60 and 80 cm in the long AL group were significantly worse than those in the normal AL group at 3mo postoperatively(P<0.05).The differences in reading speed,spectacle independence and potential visual complaints between the two groups were not statistically significant(P>0.05).The dysfunctional lens index and total modulation transfer function(MTF)average height were similar between the two groups.The postoperative internal coma aberrations in the axial high myopia eyes were significantly higher than that in the normal AL group(P<0.05).The total satisfaction score in the long AL group(91.32±2.76)was slightly higher than that in the normal AL group(90.36±3.47),but there was no difference(P=0.136).A statistically negative correlation was found between corrected distance visual acuity(CDVA)and dysfunctional lens index(r=-0.382,P=0.009),and between CDVA and the total MTF average height(r=-0.374,P=0.01).But there was no significant correlation between CDVA and total satisfaction score(r=0.059,P=0.696).Postoperative complications mainly presented as posterior capsular opacity(PCO),retinal detachment and cystoid macular edema.There was no difference in the incidence of fundus disease(6.5%vs 3.8%,P=0.663)or PCO(17.4%vs 7.7%,P=0.217)between the two groups at two years.●CONCLUSION:The utilization of trifocal IOL and capsular tension ring implantation is beneficial for cataract patients with axial high myopia undergoing FLACS.This approach not only ensures excellent subjective feelings and objective visual quality,but also does not increase the incidence of postoperative complications.
