AIM:To evaluate and compare alterations in the effective lens position(ELP)and refractive outcomes among three distinct intraocular lens(IOL)types.METHODS:Patients with cataracts were enrolled and allocated to 3 group...AIM:To evaluate and compare alterations in the effective lens position(ELP)and refractive outcomes among three distinct intraocular lens(IOL)types.METHODS:Patients with cataracts were enrolled and allocated to 3 groups:Group A(implanted with the SN6CWS),Group B(implanted with the MI60),and Group C(implanted with the Aspira-aA).ELP measurements were obtained with swept-source optical coherence tomography(SS-OCT)at 1d,1wk,1mo,and 3mo postoperatively.Subjective refraction assessments were conducted at 1wk,1mo,and 3mo following surgery.RESULTS:The study included 189 eyes of 150 cataract patients(66 males).There were 77 eyes in Group A,55 eyes in Group B,and 57 eyes in Group C.The root mean square of the ELP(ELPRMS)within the initial 3mo was significantly lower for Group A than for Groups B and C.Refractive changes within Group A were not significant across the time points of 1wk,1mo,and 3mo.Conversely,both Group B and Group C demonstrated statistically significant shifts toward hyperopia from 1wk to 3mo postsurgery.CONCLUSION:Among the three IOLs examined,the SN6CWS IOL showes the greatest stability during the first 3mo postoperatively.Between 1wk and 3mo after surgery,notable hyperopic shifts are evident in eyes implanted with the MI60 and Aspira-aA IOLs,whereas refractive outcomes remain relatively constant in eyes implanted with SN6CWS IOLs.展开更多
AIM:To investigate age-related differences in the irislens angle(ILA)among patients with age-related cortical cataracts and elucidate the impact of age on lens stability.METHODS:A prospective observational study was c...AIM:To investigate age-related differences in the irislens angle(ILA)among patients with age-related cortical cataracts and elucidate the impact of age on lens stability.METHODS:A prospective observational study was conducted on patients with age-related cortical cataracts scheduled for phacoemulsification surgery.Preoperative ultrasound biomicroscopy(UBM)images were collected and analyzed.Initially,patients were stratified into two age groups:<60y and≥60y,with no significant intergroup differences in sex or eye laterality.For further analysis,participants were subdivided into three age strata:<60y,60-75y,and>75y.The ILA was measured in four quadrants(superior,inferior,nasal,and temporal).Intergroup differences in ILA were compared,and correlations between age and ILA parameters were analyzed using statistical methods.RESULTS:The sample data were categorized into three groups according to age,<60y(113 patients;55.8%female),60–75y(245 patients;61.0%female),and>75y(70 patients;50.2%female).The superior quadrant ILA increased progressively with age stratification(P=0.02),and the maximum ILA difference(ΔILA)was significantly higher in patients over 75y(P<0.01).Simple linear regression analysis demonstrated a positive correlation between age and ILA in the superior(Y=7.487+0.096X,R=0.191,P<0.001)and temporal(Y=10.254+0.052X,R=0.104,P=0.032)quadrants.Additionally,the mean ILA across all quadrants(ILAmean)andΔILA were positively correlated with age(ILAmean:Y=9.721+0.055X,R=0.138,P=0.004;ΔILA:Y=3.267+0.044X,R=0.006,P<0.05).CONCLUSION:In patients with age-related cortical cataracts,ILA increases with age,particularly in the superior and temporal quadrants,suggesting that advanced age is associated with greater lens deviation and decreased lens stability.UBM imaging can effectively evaluate the status of the zonule and lens stability,providing crucial evidence for personalized surgical planning based on patients’age.展开更多
AIM:To investigate the long-term outcomes in acute primary angle closure(APAC)patients treated with lens extraction(LE)surgery and to identify risk factors for glaucomatous optic neuropathy(GON).METHODS:In this longit...AIM:To investigate the long-term outcomes in acute primary angle closure(APAC)patients treated with lens extraction(LE)surgery and to identify risk factors for glaucomatous optic neuropathy(GON).METHODS:In this longitudinal observational study,detailed medical histories of APAC patients and comprehensive ophthalmic examinations at final followup were collected.Logistic regression analysis was performed to identify predictors of blindness.Univariate and multivariate linear regression analyses were conducted to determine risk factors associated with visual outcomes.RESULTS:This study included 39 affected eyes of 31 subjects(26 females)with an average age of 74.1±8.0y.At 6.7±4.2y after APAC attack,2(5.7%)eyes had bestcorrected visual acuity(VA)worse than 3/60.Advanced glaucomatous visual field loss was observed in 15(39.5%)affected eyes and 5(25.0%)fellow eyes.Nine affected eyes(23.7%)had GON,and 11(28.9%)were blind.Six(15.4%)affected eyes and 2(9.1%)fellow eyes had suspicious progression.A significantly higher blindness rate in factory workers compared to office workers.Logistic regression identified that worse VA at attack(OR 10.568,95%CI 1.288-86.695;P=0.028)and worse early postoperative VA(OR 13.214,95%CI 1.157-150.881;P=0.038)were risk factors for blindness.Multivariate regression showed that longer duration of elevated intraocular pressure(P=0.004)and worse early postoperative VA(P=0.009)were associated with worse visual outcomes.CONCLUSION:Despite LE surgery,some APAC patients experience continued visual function deterioration.Lifelong monitoring is necessary.Target pressure and progression rates should be re-evaluated during follow-up.展开更多
The manipulation of intense shock waves to either attenuate or enhance damage has long been a key goal in the domain of impact dynamics.Effective methods for such manipulation,however,remain elusive owing to the wide ...The manipulation of intense shock waves to either attenuate or enhance damage has long been a key goal in the domain of impact dynamics.Effective methods for such manipulation,however,remain elusive owing to the wide spectrum and irreversible destructive nature of intense shock waves.This work proposes a novel approach for actively controlling intense shock waves in solids,inspired by the principles of optical and explosive lenses.Specifically,by designing a shock wave convex lens composed of a low-shock-impedance material embedded in a high-shock-impedance matrix,we prove the feasibility of transforming a planar shock into a spherically converging shock.This is based on oblique shock theory,according to which shock waves pass through an oblique interface and then undergo deflection.Both experimental and simulation results demonstrate that,as expected,the obtained local spherical shock wave has a wavefront that is nearly perfectly spherical and uniform in pressure.Thus,this work proves the possibility of generating spherical shock waves using plate-impact experiments and highlights the potential of further exploration of the manipulation of shock waves in solids.It also contributes an innovative perspective for both armor penetration technologies and shock wave mitigation strategies.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
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
Objective:To evaluate the performance of orthokeratology(ortho-k)lens reordering using software-designed system,so as to determine the feasibility of ortho-k lens reordering without discontinuing lens wear.Methods:Thi...Objective:To evaluate the performance of orthokeratology(ortho-k)lens reordering using software-designed system,so as to determine the feasibility of ortho-k lens reordering without discontinuing lens wear.Methods:This study is a retrospective analysis of data of ortho-k lens wearers who had a history of short-term discontinuation of lens wear.A total of 94 individuals aged over 8 years with spherical equivalent refraction ranging from-0.50 to-6.50 diopters were included.The corneal topography data at baseline(before ortho-k)and after lens wear discontinuation(cessation of ortho-k treatment)were imported separately into the lens-design software,along with corresponding refraction data.Subsequently,corneal and lens parameters were generated and compared.Intraclass correlation coefficients(ICC)were calculated,and Bland and Altman analyses were conducted.Results:All 94 children were involved in the retrospective analysis.Compared with baseline data,there was a high level of consistency between Rwo(without discontinuation)and Rwith(with discontinuation),with an ICC of 0.96(P<0.001).Furthermore,the comparison of lens parameters generated by the Easyfit software between baseline and after short-term discontinuation showed a high degree of consistency,with all of the ICC values exceeding 0.90.Similar results were obtained using the WAVE software,as both ICC values and Bland-Altman plots demonstrated a high level of consistency in lens parameters between two conditions(nearly all data points fell within the 95%LoAs).Conclusions:It is feasible to directly reorder new ortho-k lenses using software fitting approaches.However,further investigations are necessary to validate their practicability in a clinical setting.展开更多
Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow ...Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow of the aqueous humor between the sides of the intraocular lens.The design of Aquaport can also eliminate the complications associated with iridotomy and iridectomy.Therefore,the V4c ICL has the potential to significantly reduce the risk of pupillary block compared to its predecessors.展开更多
At present,the naked-eye three-dimensional(3D)display technology still has some drawbacks,such as low brightness uniformity,high crosstalk,low light efficiency,short viewing distance,and the manufacturing is difficult...At present,the naked-eye three-dimensional(3D)display technology still has some drawbacks,such as low brightness uniformity,high crosstalk,low light efficiency,short viewing distance,and the manufacturing is difficulty.Based on the principle of naked-eye 3D display and the Fresnel optical theory,this paper designs a Fresnel lens array and the star-shaped liquid crystal display(LCD)switch of unit LCD screen to achieve low-crosstalk and high brightness uniformity for the autostereoscopic 3D display.The unit parameters of a 139.7 cm 4K model autostereoscopic 3D displayer are provided and they are optimized by the TracePro software.The results show that when the pitch of the Fresnel lens on the exit surface is 0.304 mm,the width of each serration of Fresnel lens is 0.0234 mm,the length of the Fresnel lens is 2.87 mm,and the center height of star-shaped LCD switch is 0.030 mm,the center length is 0.040 mm,the width of star-shaped LCD switch is 0.050 mm,and the image crosstalk is less than 2%when the viewing distance is 2.50 m.The problem on the brightness of the image in different positions is improved.展开更多
Background:The Akreos®AO60 intraocular lens(IOL)has been employed for scleral fixation in eyes without capsular support,although surgical complications,including IOL opacification,have been reported.This study ai...Background:The Akreos®AO60 intraocular lens(IOL)has been employed for scleral fixation in eyes without capsular support,although surgical complications,including IOL opacification,have been reported.This study aims to evaluate the outcomes and complications associated with scleral fixation of the Akreos®AO60 IOL in vitrectomized eyes,with a particular focus on IOL opacification.Methods:Electronic medical records of consecutive eyes that underwent scleral-fixation of the Akreos®AO60 lens using Gore-tex®sutures from 2017 to 2022 were reviewed.The following parameters were collected:age,sex,laterality,past ocular/medical history,surgical indication,pre-operative visual acuity(VA)and intraocular pressure(IOP),surgical procedure,and post-operative VA and IOP.The types of complications,onset,management,and outcomes were also documented.Descriptive statistics,Wilcoxon signed-rank test,and Fisher’s exact test were employed for statistical analysis.Results:Eighty-nine eyes of 86 patients aged 31-100 years were included.The most common surgical indication was non-traumatic IOL displacement.Retinal tears and localized choroidal hemorrhage were found intraoperatively in 7.9%and 1.1%,respectively.The most common post-operative complications were vitreous hemorrhage(13.5%),corneal edema(12.4%),ocular hypotony(11.2%),and IOL opacification(11.2%).IOL opacification was associated with intra-/post-operative exposure to air/gas[odds ratio(OR):12.24;95%confidence interval(CI),1.46-103.0;P=0.006].Mean logarithm of the minimum angle of resolution(logMAR)best-reported VA(BRVA)improved from 1.22±0.77 pre-operatively to 0.56±0.67 on latest follow-up(P<0.001).Conclusions:The majority of the complications from scleral-fixation of the Akreos®AO60 lens in vitrectomized eyes were mild and transient;however,a proportion required surgical intervention.A significant risk for opacification was found in IOLs exposed to air/gas,although VA was often maintained.展开更多
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
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
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
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
Multispectral imaging plays a crucial role in simultaneously capturing detailed spatial and spectral information,which is fundamental for understanding complex phenomena across various domains.Traditional systems face...Multispectral imaging plays a crucial role in simultaneously capturing detailed spatial and spectral information,which is fundamental for understanding complex phenomena across various domains.Traditional systems face significant challenges,such as large volume,static function,and limited wavelength selectivity.Here,we propose an innovative dynamic reflective multispectral imaging system via a thermally responsive cholesteric liquid crystal based planar lens.By employing advanced photoalignment technology,the phase distribution of a lens is imprinted to the liquid crystal director.The reflection band is reversibly tuned from 450 nm to 750 nm by thermally controlling the helical pitch of the cholesteric liquid crystal,allowing selectively capturing images in different colors.This capability increases imaging versatility,showing great potential in precision agriculture for assessing crop health,noninvasive diagnostics in healthcare,and advanced remote sensing for environmental monitoring.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
AIM:To predict the post-operative vault and the suitable size of the implantable collamer lens(ICL)by comparing the performance of multiple artificial intelligence(AI)algorithms.METHODS:A retrospective analysis of 83 ...AIM:To predict the post-operative vault and the suitable size of the implantable collamer lens(ICL)by comparing the performance of multiple artificial intelligence(AI)algorithms.METHODS:A retrospective analysis of 83 patients with 132 eyes was conducted from 2020 to 2023.All patients underwent implantation of EVO-V4C ICLs.ICLs were selected based on STAAR’s recommended formula.Postoperative vault values were measured using anterior segment optical coherence tomography(ASOCT).First,feature selection was performed on patients’preoperative examination parameters to identify those most closely related to postoperative vault and incorporate them into the machine learning model.Subsequently,four regression models,namely MLP,XGBoost,RFR,and KNN,were employed to predict the vault,and their predictive performances were compared.The ICL size was set as the prediction target,with the vault and other input features serving as new inputs for predicting the ICL size.RESULTS:Among all preoperative parameters,16 parameters were most closely related to postoperative vault and were included in the prediction model.In vault prediction,XGBoost performed the best in the regression model(R^(2)=0.9999),followed by MLP(R^(2)=0.9987)and RFR(R^(2)=0.8982),while the KNN model had the lowest predictive performance(R^(2)=0.3852).XGBoost achieved a prediction accuracy of 99.8%,MLP had a prediction accuracy of 98.9%,while RFR and KNN had accuracies of 87.1%and 57.4%,respectively.CONCLUSION:AI effectively predicts postoperative vault and determines ICL size.XGBoost outperforms other machine-learning algorithms tested.Its accurate predictions help ophthalmologists choose the right ICL size,ensuring proper vaulting.展开更多
Ultrabright femtosecond X-ray pulses generated by X-ray free-electron lasers(XFELs)enable the high-resolution determination of nanoparticle structures without crystallization or freezing.As each particle that interact...Ultrabright femtosecond X-ray pulses generated by X-ray free-electron lasers(XFELs)enable the high-resolution determination of nanoparticle structures without crystallization or freezing.As each particle that interacts with the pulse is destroyed,an aerodynamic lens(ADL)is used to update the particles by focusing them into a narrow beam in real time.Current single-particle imaging(SPI)experiments are limited by an insufficient number of diffraction patterns;therefore,optimized ADLs are required to improve the hit rate and signal-to-noise ratio,particularly for small particles.Herein,an efficient and simple method for designing ADLs and a new ADL specifically designed for SPI using this method are presented.A new method is proposed based on the functional relationship between a key parameter and its influencing parameters in the ADL,which is established through theoretical analysis and numerical simulations.A detailed design process for the new ADL is also introduced.Both simulations and experiments are performed to characterize the behavior of the particles in the ADL.The results show that particles with diameters ranging from 30 to 500 nm can be effectively focused into a narrow beam.In particular,particles smaller than 100 nm exhibit better performance at lower flow rates than the injector currently used in SPI.The new ADL increases the beam density and reduces the gas background noise.This new method facilitates the design of ADLs for SPI and has potential applications in other fields that utilize focused aerosol beams.展开更多
AIM:To compare the accuracy of manual marking versus an image-guided system for toric implantable collamer lens(TICL)implantation and evaluate the short-term postoperative rotational stability of TICL and corneal surg...AIM:To compare the accuracy of manual marking versus an image-guided system for toric implantable collamer lens(TICL)implantation and evaluate the short-term postoperative rotational stability of TICL and corneal surgically induced astigmatism vector(SIA).METHODS:Retrospective analysis was conducted on eyes with TICL alignment achieved through manual marking(n=75)or VERION image-guided system-assisted marking(n=83).Each group was further classified into horizontal and vertical subgroups based on implant orientation.Additionally,patients were categorized into superior and temporal incision subgroups according to the position of main corneal incision.The misalignment and rotational stability of TICL were analyzed using slit-lamp anterior segment photography.Surgical predictability,efficacy,safety,and corneal SIA were also evaluated.RESULTS:In general,the TICL implantation with manual and digital image-guided systems all achieved robust predictability,efficacy,and safety.The misalignment of TICL was comparable between the manual and VERION groups(0.16°±3.97°vs 0.52°±5.59°,P=0.633),while a significant difference was observed in the absolute misalignment of TICL between the two groups(3.02°±2.55°vs 4.28°±3.61°,P=0.043).There were no significant differences in the distribution of TICL misalignment between the manual and VERION groups or between horizontal and vertical implant orientation groups(P>0.05).Furthermore,different orientations of TICL placement did not show statistically significant differences in rotational stability(P=0.46).Statistically significant differences were found in anterior corneal SIA between the manual and VERION groups(0.46±0.27 vs 0.33±0.21 D,P=0.001),especially for superior incision position(0.60±0.27 vs 0.35±0.23 D,P<0.0001).The anterior SIA exhibited a significant difference between superior and temporal incisions in the manual group(0.60±0.27 vs 0.35±0.20 D,P<0.0001).CONCLUSION:Compared with the conventional manual marking method,this study indicates that the digital image-guided system with VERION is safe and effective in TICL implantation.The digital system offers the advantage of minimizing corneal SIA compared to the manual method.展开更多
基金Supported by the Zhejiang Medical Health Science and Technology Project(No.2021KY217)the Basic Public Welfare Research Project of Wenzhou Municipal Science and Technology Bureau(No.2024Y1221).
文摘AIM:To evaluate and compare alterations in the effective lens position(ELP)and refractive outcomes among three distinct intraocular lens(IOL)types.METHODS:Patients with cataracts were enrolled and allocated to 3 groups:Group A(implanted with the SN6CWS),Group B(implanted with the MI60),and Group C(implanted with the Aspira-aA).ELP measurements were obtained with swept-source optical coherence tomography(SS-OCT)at 1d,1wk,1mo,and 3mo postoperatively.Subjective refraction assessments were conducted at 1wk,1mo,and 3mo following surgery.RESULTS:The study included 189 eyes of 150 cataract patients(66 males).There were 77 eyes in Group A,55 eyes in Group B,and 57 eyes in Group C.The root mean square of the ELP(ELPRMS)within the initial 3mo was significantly lower for Group A than for Groups B and C.Refractive changes within Group A were not significant across the time points of 1wk,1mo,and 3mo.Conversely,both Group B and Group C demonstrated statistically significant shifts toward hyperopia from 1wk to 3mo postsurgery.CONCLUSION:Among the three IOLs examined,the SN6CWS IOL showes the greatest stability during the first 3mo postoperatively.Between 1wk and 3mo after surgery,notable hyperopic shifts are evident in eyes implanted with the MI60 and Aspira-aA IOLs,whereas refractive outcomes remain relatively constant in eyes implanted with SN6CWS IOLs.
文摘AIM:To investigate age-related differences in the irislens angle(ILA)among patients with age-related cortical cataracts and elucidate the impact of age on lens stability.METHODS:A prospective observational study was conducted on patients with age-related cortical cataracts scheduled for phacoemulsification surgery.Preoperative ultrasound biomicroscopy(UBM)images were collected and analyzed.Initially,patients were stratified into two age groups:<60y and≥60y,with no significant intergroup differences in sex or eye laterality.For further analysis,participants were subdivided into three age strata:<60y,60-75y,and>75y.The ILA was measured in four quadrants(superior,inferior,nasal,and temporal).Intergroup differences in ILA were compared,and correlations between age and ILA parameters were analyzed using statistical methods.RESULTS:The sample data were categorized into three groups according to age,<60y(113 patients;55.8%female),60–75y(245 patients;61.0%female),and>75y(70 patients;50.2%female).The superior quadrant ILA increased progressively with age stratification(P=0.02),and the maximum ILA difference(ΔILA)was significantly higher in patients over 75y(P<0.01).Simple linear regression analysis demonstrated a positive correlation between age and ILA in the superior(Y=7.487+0.096X,R=0.191,P<0.001)and temporal(Y=10.254+0.052X,R=0.104,P=0.032)quadrants.Additionally,the mean ILA across all quadrants(ILAmean)andΔILA were positively correlated with age(ILAmean:Y=9.721+0.055X,R=0.138,P=0.004;ΔILA:Y=3.267+0.044X,R=0.006,P<0.05).CONCLUSION:In patients with age-related cortical cataracts,ILA increases with age,particularly in the superior and temporal quadrants,suggesting that advanced age is associated with greater lens deviation and decreased lens stability.UBM imaging can effectively evaluate the status of the zonule and lens stability,providing crucial evidence for personalized surgical planning based on patients’age.
文摘AIM:To investigate the long-term outcomes in acute primary angle closure(APAC)patients treated with lens extraction(LE)surgery and to identify risk factors for glaucomatous optic neuropathy(GON).METHODS:In this longitudinal observational study,detailed medical histories of APAC patients and comprehensive ophthalmic examinations at final followup were collected.Logistic regression analysis was performed to identify predictors of blindness.Univariate and multivariate linear regression analyses were conducted to determine risk factors associated with visual outcomes.RESULTS:This study included 39 affected eyes of 31 subjects(26 females)with an average age of 74.1±8.0y.At 6.7±4.2y after APAC attack,2(5.7%)eyes had bestcorrected visual acuity(VA)worse than 3/60.Advanced glaucomatous visual field loss was observed in 15(39.5%)affected eyes and 5(25.0%)fellow eyes.Nine affected eyes(23.7%)had GON,and 11(28.9%)were blind.Six(15.4%)affected eyes and 2(9.1%)fellow eyes had suspicious progression.A significantly higher blindness rate in factory workers compared to office workers.Logistic regression identified that worse VA at attack(OR 10.568,95%CI 1.288-86.695;P=0.028)and worse early postoperative VA(OR 13.214,95%CI 1.157-150.881;P=0.038)were risk factors for blindness.Multivariate regression showed that longer duration of elevated intraocular pressure(P=0.004)and worse early postoperative VA(P=0.009)were associated with worse visual outcomes.CONCLUSION:Despite LE surgery,some APAC patients experience continued visual function deterioration.Lifelong monitoring is necessary.Target pressure and progression rates should be re-evaluated during follow-up.
基金supported by the National Key R&D Program of China(Grant No.2021YFB3802303)the National Natural Science Foundation of China(Grant Nos.12302493 and 12525211).
文摘The manipulation of intense shock waves to either attenuate or enhance damage has long been a key goal in the domain of impact dynamics.Effective methods for such manipulation,however,remain elusive owing to the wide spectrum and irreversible destructive nature of intense shock waves.This work proposes a novel approach for actively controlling intense shock waves in solids,inspired by the principles of optical and explosive lenses.Specifically,by designing a shock wave convex lens composed of a low-shock-impedance material embedded in a high-shock-impedance matrix,we prove the feasibility of transforming a planar shock into a spherically converging shock.This is based on oblique shock theory,according to which shock waves pass through an oblique interface and then undergo deflection.Both experimental and simulation results demonstrate that,as expected,the obtained local spherical shock wave has a wavefront that is nearly perfectly spherical and uniform in pressure.Thus,this work proves the possibility of generating spherical shock waves using plate-impact experiments and highlights the potential of further exploration of the manipulation of shock waves in solids.It also contributes an innovative perspective for both armor penetration technologies and shock wave mitigation strategies.
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 National Natural Science Foundation of China(82371089).
文摘Objective:To evaluate the performance of orthokeratology(ortho-k)lens reordering using software-designed system,so as to determine the feasibility of ortho-k lens reordering without discontinuing lens wear.Methods:This study is a retrospective analysis of data of ortho-k lens wearers who had a history of short-term discontinuation of lens wear.A total of 94 individuals aged over 8 years with spherical equivalent refraction ranging from-0.50 to-6.50 diopters were included.The corneal topography data at baseline(before ortho-k)and after lens wear discontinuation(cessation of ortho-k treatment)were imported separately into the lens-design software,along with corresponding refraction data.Subsequently,corneal and lens parameters were generated and compared.Intraclass correlation coefficients(ICC)were calculated,and Bland and Altman analyses were conducted.Results:All 94 children were involved in the retrospective analysis.Compared with baseline data,there was a high level of consistency between Rwo(without discontinuation)and Rwith(with discontinuation),with an ICC of 0.96(P<0.001).Furthermore,the comparison of lens parameters generated by the Easyfit software between baseline and after short-term discontinuation showed a high degree of consistency,with all of the ICC values exceeding 0.90.Similar results were obtained using the WAVE software,as both ICC values and Bland-Altman plots demonstrated a high level of consistency in lens parameters between two conditions(nearly all data points fell within the 95%LoAs).Conclusions:It is feasible to directly reorder new ortho-k lenses using software fitting approaches.However,further investigations are necessary to validate their practicability in a clinical setting.
基金Supported by the National Key Research and Development Program(No.2019YFC1710200)the Shandong Province Pharmaceutical Technology Development Project(No.202107020970).
文摘Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow of the aqueous humor between the sides of the intraocular lens.The design of Aquaport can also eliminate the complications associated with iridotomy and iridectomy.Therefore,the V4c ICL has the potential to significantly reduce the risk of pupillary block compared to its predecessors.
基金supported by the 2022 Fujian Provincial Young and Middle-aged Teacher Education and Research Project(Science and Technology)(No.JAT220468)the Xiamen Natural Science Foundation(No.3502Z20227334).
文摘At present,the naked-eye three-dimensional(3D)display technology still has some drawbacks,such as low brightness uniformity,high crosstalk,low light efficiency,short viewing distance,and the manufacturing is difficulty.Based on the principle of naked-eye 3D display and the Fresnel optical theory,this paper designs a Fresnel lens array and the star-shaped liquid crystal display(LCD)switch of unit LCD screen to achieve low-crosstalk and high brightness uniformity for the autostereoscopic 3D display.The unit parameters of a 139.7 cm 4K model autostereoscopic 3D displayer are provided and they are optimized by the TracePro software.The results show that when the pitch of the Fresnel lens on the exit surface is 0.304 mm,the width of each serration of Fresnel lens is 0.0234 mm,the length of the Fresnel lens is 2.87 mm,and the center height of star-shaped LCD switch is 0.030 mm,the center length is 0.040 mm,the width of star-shaped LCD switch is 0.050 mm,and the image crosstalk is less than 2%when the viewing distance is 2.50 m.The problem on the brightness of the image in different positions is improved.
文摘Background:The Akreos®AO60 intraocular lens(IOL)has been employed for scleral fixation in eyes without capsular support,although surgical complications,including IOL opacification,have been reported.This study aims to evaluate the outcomes and complications associated with scleral fixation of the Akreos®AO60 IOL in vitrectomized eyes,with a particular focus on IOL opacification.Methods:Electronic medical records of consecutive eyes that underwent scleral-fixation of the Akreos®AO60 lens using Gore-tex®sutures from 2017 to 2022 were reviewed.The following parameters were collected:age,sex,laterality,past ocular/medical history,surgical indication,pre-operative visual acuity(VA)and intraocular pressure(IOP),surgical procedure,and post-operative VA and IOP.The types of complications,onset,management,and outcomes were also documented.Descriptive statistics,Wilcoxon signed-rank test,and Fisher’s exact test were employed for statistical analysis.Results:Eighty-nine eyes of 86 patients aged 31-100 years were included.The most common surgical indication was non-traumatic IOL displacement.Retinal tears and localized choroidal hemorrhage were found intraoperatively in 7.9%and 1.1%,respectively.The most common post-operative complications were vitreous hemorrhage(13.5%),corneal edema(12.4%),ocular hypotony(11.2%),and IOL opacification(11.2%).IOL opacification was associated with intra-/post-operative exposure to air/gas[odds ratio(OR):12.24;95%confidence interval(CI),1.46-103.0;P=0.006].Mean logarithm of the minimum angle of resolution(logMAR)best-reported VA(BRVA)improved from 1.22±0.77 pre-operatively to 0.56±0.67 on latest follow-up(P<0.001).Conclusions:The majority of the complications from scleral-fixation of the Akreos®AO60 lens in vitrectomized eyes were mild and transient;however,a proportion required surgical intervention.A significant risk for opacification was found in IOLs exposed to air/gas,although VA was often maintained.
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.
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 the National Key Research and Development Program of China(No.2022YFA1203700)the National Natural Science Foundation of China(NSFC)(Nos.62405129 and 62035008)+1 种基金the University Research Project of Guangzhou Education Bureau(No.202235053)the Natural Science Foundation of Jiangsu Province(No.BK20241197).
文摘Multispectral imaging plays a crucial role in simultaneously capturing detailed spatial and spectral information,which is fundamental for understanding complex phenomena across various domains.Traditional systems face significant challenges,such as large volume,static function,and limited wavelength selectivity.Here,we propose an innovative dynamic reflective multispectral imaging system via a thermally responsive cholesteric liquid crystal based planar lens.By employing advanced photoalignment technology,the phase distribution of a lens is imprinted to the liquid crystal director.The reflection band is reversibly tuned from 450 nm to 750 nm by thermally controlling the helical pitch of the cholesteric liquid crystal,allowing selectively capturing images in different colors.This capability increases imaging versatility,showing great potential in precision agriculture for assessing crop health,noninvasive diagnostics in healthcare,and advanced remote sensing for environmental monitoring.
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.82271100)the Jiangsu Science and Technology Support Program(No.BE2022805)the Clinical Skills Enhancement Program of Jiangsu Province Hospital(No.JSPH-MC-2022-24).
文摘AIM:To predict the post-operative vault and the suitable size of the implantable collamer lens(ICL)by comparing the performance of multiple artificial intelligence(AI)algorithms.METHODS:A retrospective analysis of 83 patients with 132 eyes was conducted from 2020 to 2023.All patients underwent implantation of EVO-V4C ICLs.ICLs were selected based on STAAR’s recommended formula.Postoperative vault values were measured using anterior segment optical coherence tomography(ASOCT).First,feature selection was performed on patients’preoperative examination parameters to identify those most closely related to postoperative vault and incorporate them into the machine learning model.Subsequently,four regression models,namely MLP,XGBoost,RFR,and KNN,were employed to predict the vault,and their predictive performances were compared.The ICL size was set as the prediction target,with the vault and other input features serving as new inputs for predicting the ICL size.RESULTS:Among all preoperative parameters,16 parameters were most closely related to postoperative vault and were included in the prediction model.In vault prediction,XGBoost performed the best in the regression model(R^(2)=0.9999),followed by MLP(R^(2)=0.9987)and RFR(R^(2)=0.8982),while the KNN model had the lowest predictive performance(R^(2)=0.3852).XGBoost achieved a prediction accuracy of 99.8%,MLP had a prediction accuracy of 98.9%,while RFR and KNN had accuracies of 87.1%and 57.4%,respectively.CONCLUSION:AI effectively predicts postoperative vault and determines ICL size.XGBoost outperforms other machine-learning algorithms tested.Its accurate predictions help ophthalmologists choose the right ICL size,ensuring proper vaulting.
基金supported by the Major State Basic Research Development Program of China(No.2022YFA1603703)Strategic Priority Research Program of the Chinese Academy of Sciences(No.XDB 37040303)+1 种基金National Natural Science Foundation of China(No.12335020)Shanghai Soft X-ray Free Electron Laser Facility beamline project.
文摘Ultrabright femtosecond X-ray pulses generated by X-ray free-electron lasers(XFELs)enable the high-resolution determination of nanoparticle structures without crystallization or freezing.As each particle that interacts with the pulse is destroyed,an aerodynamic lens(ADL)is used to update the particles by focusing them into a narrow beam in real time.Current single-particle imaging(SPI)experiments are limited by an insufficient number of diffraction patterns;therefore,optimized ADLs are required to improve the hit rate and signal-to-noise ratio,particularly for small particles.Herein,an efficient and simple method for designing ADLs and a new ADL specifically designed for SPI using this method are presented.A new method is proposed based on the functional relationship between a key parameter and its influencing parameters in the ADL,which is established through theoretical analysis and numerical simulations.A detailed design process for the new ADL is also introduced.Both simulations and experiments are performed to characterize the behavior of the particles in the ADL.The results show that particles with diameters ranging from 30 to 500 nm can be effectively focused into a narrow beam.In particular,particles smaller than 100 nm exhibit better performance at lower flow rates than the injector currently used in SPI.The new ADL increases the beam density and reduces the gas background noise.This new method facilitates the design of ADLs for SPI and has potential applications in other fields that utilize focused aerosol beams.
文摘AIM:To compare the accuracy of manual marking versus an image-guided system for toric implantable collamer lens(TICL)implantation and evaluate the short-term postoperative rotational stability of TICL and corneal surgically induced astigmatism vector(SIA).METHODS:Retrospective analysis was conducted on eyes with TICL alignment achieved through manual marking(n=75)or VERION image-guided system-assisted marking(n=83).Each group was further classified into horizontal and vertical subgroups based on implant orientation.Additionally,patients were categorized into superior and temporal incision subgroups according to the position of main corneal incision.The misalignment and rotational stability of TICL were analyzed using slit-lamp anterior segment photography.Surgical predictability,efficacy,safety,and corneal SIA were also evaluated.RESULTS:In general,the TICL implantation with manual and digital image-guided systems all achieved robust predictability,efficacy,and safety.The misalignment of TICL was comparable between the manual and VERION groups(0.16°±3.97°vs 0.52°±5.59°,P=0.633),while a significant difference was observed in the absolute misalignment of TICL between the two groups(3.02°±2.55°vs 4.28°±3.61°,P=0.043).There were no significant differences in the distribution of TICL misalignment between the manual and VERION groups or between horizontal and vertical implant orientation groups(P>0.05).Furthermore,different orientations of TICL placement did not show statistically significant differences in rotational stability(P=0.46).Statistically significant differences were found in anterior corneal SIA between the manual and VERION groups(0.46±0.27 vs 0.33±0.21 D,P=0.001),especially for superior incision position(0.60±0.27 vs 0.35±0.23 D,P<0.0001).The anterior SIA exhibited a significant difference between superior and temporal incisions in the manual group(0.60±0.27 vs 0.35±0.20 D,P<0.0001).CONCLUSION:Compared with the conventional manual marking method,this study indicates that the digital image-guided system with VERION is safe and effective in TICL implantation.The digital system offers the advantage of minimizing corneal SIA compared to the manual method.
